1
00:00:12,937 --> 00:00:15,958
I'm wearing a sport coat
so that you will trust me.

2
00:00:15,958 --> 00:00:18,349
(Laughter)

3
00:00:24,358 --> 00:00:28,299
If I had wanted you to think
I was creative, I would have worn jeans.

4
00:00:28,299 --> 00:00:30,009
(Laughter)

5
00:00:31,089 --> 00:00:34,979
But I have a story
to tell you about chronic disease,

6
00:00:34,979 --> 00:00:37,974
and you're the first generation
that can ever hear this story

7
00:00:37,974 --> 00:00:40,061
because we didn't know it before.

8
00:00:41,601 --> 00:00:44,520
I want you to join with me
in a "hard think."

9
00:00:44,520 --> 00:00:48,160
I'm going to tell you some nice stuff
to make you feel good at the beginning,

10
00:00:48,160 --> 00:00:50,160
but we have a lot
of serious issues to face

11
00:00:50,160 --> 00:00:51,969
and I'm going to tell you about those.

12
00:00:52,419 --> 00:00:56,848
I hope you'll enjoy it so you will feel
like we're all part of the same team

13
00:00:56,848 --> 00:00:59,202
that's going to make our world better.

14
00:00:59,662 --> 00:01:04,094
When I talk to you, I want you to answer
this question all the way through:

15
00:01:04,424 --> 00:01:11,055
I want you to ask, when will we decide
to eliminate chronic disease?

16
00:01:11,735 --> 00:01:16,425
The reason we can ask that question now
is because we know what causes it,

17
00:01:16,835 --> 00:01:18,855
and we know how to fix it.

18
00:01:18,855 --> 00:01:21,856
So I hope that by the time
I've finished my talk,

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00:01:21,856 --> 00:01:25,945
you will be convinced that you can make
a big difference to do something about it.

20
00:01:26,305 --> 00:01:28,105
So first the good feelings.

21
00:01:28,105 --> 00:01:31,144
Here's the good feelings:
if you look at the last century,

22
00:01:31,144 --> 00:01:35,706
you'll notice that in 1900,
we had a life expectancy of 50.

23
00:01:36,376 --> 00:01:38,447
And now, at the end of the century,


24
00:01:38,447 --> 00:01:42,044
actually in 2010,
when we calculated it again,

25
00:01:42,044 --> 00:01:44,906
our life expectancy was now 80.

26
00:01:44,906 --> 00:01:46,035
Can you believe it?

27
00:01:46,035 --> 00:01:50,898
Our life expectancy increased
by 30 years over one century of time.

28
00:01:51,878 --> 00:01:53,839
There's another interesting fact,

29
00:01:53,839 --> 00:01:59,661
and that's chronic diseases
like heart disease, stroke, and cancer,

30
00:01:59,661 --> 00:02:03,981
those diseases have been killing
fewer people every year.

31
00:02:04,281 --> 00:02:09,002
So we should start feeling good
that we're going to be healthier.

32
00:02:09,002 --> 00:02:12,612
And if you look at these two facts,
what you're going to think is,

33
00:02:12,612 --> 00:02:15,604
"I can sit back and relax
because isn't it nice

34
00:02:15,604 --> 00:02:19,710
we as a human race, and we as Americans,
are getting healthier?"

35
00:02:20,010 --> 00:02:23,362
Now if you think that,
you would be dead wrong.

36
00:02:24,952 --> 00:02:30,983
And the reason is that our health
has been declining over the last 25 years.

37
00:02:31,923 --> 00:02:33,645
Now, why is that true?

38
00:02:33,965 --> 00:02:37,325
We have some evidence for that
and some of it you've read in the paper.

39
00:02:37,585 --> 00:02:41,715
For example, more people
are becoming obese,

40
00:02:42,425 --> 00:02:45,819
more people are acquiring diabetes,

41
00:02:46,229 --> 00:02:49,648
more people have
uncontrolled blood pressure,

42
00:02:49,948 --> 00:02:54,577
and all of these three things
are the foundation for heart disease.

43
00:02:54,827 --> 00:02:59,179
Now the interesting part of it is,
we don't see it in our statistics yet

44
00:02:59,179 --> 00:03:02,789
because it is predominantly
affecting younger people

45
00:03:02,789 --> 00:03:06,900
and they haven't died yet to show us
that there has been a change.

46
00:03:07,710 --> 00:03:12,300
So what you have to realize
is that we are in a new predicament

47
00:03:12,300 --> 00:03:16,311
of being able to predict
what's going to happen in our future.

48
00:03:16,581 --> 00:03:20,591
And here's one other thing I need to say
that you might not have thought of before:

49
00:03:20,941 --> 00:03:25,431
That is that our children
are the first generation

50
00:03:26,851 --> 00:03:32,531
that represents three generations
of eating processed food.

51
00:03:33,601 --> 00:03:38,036
And because of that, we now have
a really big job on our hands

52
00:03:38,036 --> 00:03:41,752
to understand what that has done
to the human race

53
00:03:41,752 --> 00:03:43,883
over the last three generations.

54
00:03:44,993 --> 00:03:49,262
In this slide, you can see the first line
is the one I already showed you,

55
00:03:49,262 --> 00:03:51,282
that's 100 years of increase


56
00:03:51,282 --> 00:03:54,203
that's perfectly linear
over that period of time.

57
00:03:55,163 --> 00:03:57,103
And if we did everything right,

58
00:03:57,103 --> 00:04:01,013
we should be able to gain another 30 years
in the next century, right?

59
00:04:01,593 --> 00:04:03,054
That's what we'd like to do.

60
00:04:03,504 --> 00:04:05,533
But, in fact,

61
00:04:05,533 --> 00:04:11,013
medical scientists now tell us that
because of diabetes and because of obesity

62
00:04:11,013 --> 00:04:13,313
that are happening in our young people,

63
00:04:13,313 --> 00:04:15,594
that they are going to be
the first generation

64
00:04:15,594 --> 00:04:19,523
ever in the United States to live
shorter lives than their parents.

65
00:04:20,033 --> 00:04:24,885
So what that means is that we are now 
on the trajectory that's going down.

66
00:04:25,365 --> 00:04:27,112
And we don't even know it.

67
00:04:27,422 --> 00:04:31,923
We know it because we who study disease
can predict what's going to happen

68
00:04:31,923 --> 00:04:34,573
to the people who have these diseases.

69
00:04:34,573 --> 00:04:36,060
Are you feeling better?

70
00:04:36,060 --> 00:04:37,074
(Laughter)

71
00:04:37,074 --> 00:04:38,440
Just checking your pulse.

72
00:04:38,440 --> 00:04:42,134
Okay, so what we need to do is find a way


73
00:04:42,134 --> 00:04:45,075
to take that downward arrow,
and put it on the up.

74
00:04:45,465 --> 00:04:50,875
And if we can do that, we should be able
to face a century of increased health,

75
00:04:50,875 --> 00:04:52,897
and increased longevity.

76
00:04:54,167 --> 00:04:57,276
Now I have to talk
about my friend, David Barker.

77
00:04:57,276 --> 00:05:00,369
David Barker is a brilliant Englishman,

78
00:05:00,819 --> 00:05:04,656
who came to Portland
to work with us over a decade ago.

79
00:05:04,656 --> 00:05:06,940
He died a year ago, last August.

80
00:05:07,300 --> 00:05:10,260
And 25 years ago, he started
the whole movement

81
00:05:10,260 --> 00:05:13,179
for us to understand
how chronic disease works.

82
00:05:13,839 --> 00:05:15,790
So what he showed was this curve,

83
00:05:15,790 --> 00:05:18,749
and if you forget
everything else I say today,

84
00:05:18,749 --> 00:05:22,322
take this curve home in your mind
because it tells the whole story.

85
00:05:22,772 --> 00:05:28,253
What he showed was that if you're born
at the low end of the birth-weight scale -

86
00:05:28,523 --> 00:05:30,846
this has been done
in seven countries now -

87
00:05:31,166 --> 00:05:34,694
if you're at the five-pound end
of the birth-weight scale on the average,

88
00:05:34,914 --> 00:05:39,015
you have a three to five times higher risk
of dying of heart disease

89
00:05:39,015 --> 00:05:42,155
than if you were born
at the eight to nine-pound range.

90
00:05:45,395 --> 00:05:49,346
And furthermore,
if you are on the upscale,

91
00:05:49,746 --> 00:05:51,974
at the very high end of that scale,

92
00:05:52,424 --> 00:05:54,846
say, above nine or ten pounds,

93
00:05:55,196 --> 00:05:58,576
your risk goes up like the babies
that were born small.

94
00:05:59,606 --> 00:06:04,096
So, all of the sudden, we have
a really new profound thing to say

95
00:06:04,096 --> 00:06:07,506
about chronic disease
that we never knew before.

96
00:06:08,236 --> 00:06:13,847
And what that is, is that how you grow
before you're born matters.

97
00:06:14,687 --> 00:06:17,229
And it's not just how [you grow]
before you're born,

98
00:06:17,229 --> 00:06:20,032
it's also in the first
two years of your life.

99
00:06:20,422 --> 00:06:24,128
So the nutrition,
and the conditions you lived in,

100
00:06:24,128 --> 00:06:27,109
in your very earliest moments of life

101
00:06:27,109 --> 00:06:28,629
determine whether or not

102
00:06:28,629 --> 00:06:31,609
you're going to have
a high risk for disease later on.

103
00:06:32,409 --> 00:06:33,982
And how does this work?

104
00:06:34,442 --> 00:06:36,171
I need to tell you a little about it

105
00:06:36,171 --> 00:06:39,242
so that you can believe something
about how this works

106
00:06:39,492 --> 00:06:43,521
What it means is that the babies born
at the low end of the scale

107
00:06:43,521 --> 00:06:45,501
are small for two reasons.

108
00:06:45,501 --> 00:06:48,500
One: they didn't get enough nutrition
from their mothers.

109
00:06:48,500 --> 00:06:50,059
That can be for lots of reasons.

110
00:06:50,059 --> 00:06:51,671
Her diet, for example,

111
00:06:51,671 --> 00:06:57,092
or her placenta that she tried to make
to give nutrients to the baby didn't work.

112
00:06:57,092 --> 00:06:58,901
Those babies are very different,

113
00:06:58,901 --> 00:07:01,302
and they are vulnerable
for the rest of their life.

114
00:07:01,302 --> 00:07:02,591
Why are they vulnerable?

115
00:07:02,591 --> 00:07:04,712
Because they have fewer heart cells,

116
00:07:05,242 --> 00:07:08,802
they have fewer
filtering units in their kidney,

117
00:07:08,802 --> 00:07:12,662
and they also have one other problem
and that is that their pancreas,

118
00:07:12,662 --> 00:07:16,762
that makes insulin,
has fewer insulin-making cells.

119
00:07:16,762 --> 00:07:20,974
And because of that, they're vulnerable
for disease as they get older.

120
00:07:20,974 --> 00:07:23,164
Now what about the babies at the high end?

121
00:07:23,164 --> 00:07:27,856
The babies at the high end are vulnerable
because they got too much nutrition

122
00:07:27,856 --> 00:07:32,186
and that's almost always because
their mothers had poor glucose control,

123
00:07:32,566 --> 00:07:36,286
their blood sugars were high,
that sugar went across the placenta,

124
00:07:36,286 --> 00:07:39,975
and the baby saw it as energy,
and deposited it as fat.

125
00:07:40,225 --> 00:07:42,126
So those babies have a lot of fat,

126
00:07:42,126 --> 00:07:45,887
and I just want to tell you the most
interesting thing we've discovered:

127
00:07:45,887 --> 00:07:49,369
The babies at the small end
and the babies at the large end

128
00:07:49,369 --> 00:07:51,357
have almost the same risks.

129
00:07:51,687 --> 00:07:53,899
And the interesting part about those risks

130
00:07:53,899 --> 00:07:58,151
is they cause an inflammatory reaction
that's very low-grade,

131
00:07:58,151 --> 00:08:01,700
and they make those people vulnerable
for the rest of their lives.

132
00:08:02,060 --> 00:08:03,830
Now if you're feeling bad about that,

133
00:08:03,830 --> 00:08:06,660
I'm just going to try
to make you feel worse.

134
00:08:06,660 --> 00:08:08,170
(Laughter)

135
00:08:08,170 --> 00:08:10,409
And the reason I am going to
make you feel worse

136
00:08:10,409 --> 00:08:15,220
is because it turns out that those cases,

137
00:08:15,220 --> 00:08:17,720
the small babies and the large babies,

138
00:08:17,720 --> 00:08:22,204
can pass that effect on to their babies
in the next generation.

139
00:08:25,234 --> 00:08:27,887
First of all, I have to tell you
a story about me.

140
00:08:28,857 --> 00:08:32,278
I'm trying to get you convinced
of this, so here it is.

141
00:08:33,278 --> 00:08:37,382
I'm in my late 60s,
not many months left, actually.

142
00:08:38,052 --> 00:08:42,444
It turns out that the egg that made me


143
00:08:43,494 --> 00:08:47,525
was made in my mother -
she is 90-some years old,

144
00:08:47,525 --> 00:08:48,785
still alive -

145
00:08:50,035 --> 00:08:54,825
it was made in her ovary
when she was in my grandmother's womb.

146
00:08:55,785 --> 00:08:56,785
Do you get that?

147
00:08:56,785 --> 00:08:59,436
The egg that made me
was made in my mother's ovary,

148
00:08:59,436 --> 00:09:01,967
when she was a fetus in my grandmother.

149
00:09:01,967 --> 00:09:06,406
That means that the egg that made me
was nourished by my grandmother.

150
00:09:07,276 --> 00:09:13,852
That nourishment changed the way
my risks for life will be.

151
00:09:13,852 --> 00:09:15,511
I was also nourished by my mother,

152
00:09:15,511 --> 00:09:18,610
so there's a two-generation effect
on the nourishment.

153
00:09:20,210 --> 00:09:22,073
I want to tell you about this picture:

154
00:09:22,073 --> 00:09:25,919
This picture was taken in 1931,
and if you look at the woman on the right,

155
00:09:25,919 --> 00:09:29,803
she's a handsome woman,
she's 86 years old,

156
00:09:29,803 --> 00:09:33,993
and when she was a baby,
she was being held by her mother in 1931.

157
00:09:34,753 --> 00:09:41,572
It turns out that the egg that made her
was made in her mother's womb

158
00:09:41,572 --> 00:09:43,996
when her mother was in
her grandmother's womb,

159
00:09:43,996 --> 00:09:46,535
who was born in 1897.

160
00:09:47,195 --> 00:09:49,375
There's one other
interesting fact about this:

161
00:09:49,375 --> 00:09:51,994
If you look at the lady on the left,

162
00:09:53,234 --> 00:09:55,766
she was born to the woman
sitting down in front.

163
00:09:55,766 --> 00:09:57,876
Now that lady doesn't look too happy.

164
00:09:57,876 --> 00:09:59,847
(Laughter)

165
00:10:02,827 --> 00:10:04,838
I don't actually know what her issue is,

166
00:10:04,838 --> 00:10:06,928
(Laughter)

167
00:10:06,928 --> 00:10:12,550
but I think part of it is she was born
before the civil war, right?

168
00:10:12,850 --> 00:10:14,371
Times were tough.

169
00:10:14,841 --> 00:10:20,520
So it turns out that I,


170
00:10:21,710 --> 00:10:23,780
who am now in my late 60s,

171
00:10:24,600 --> 00:10:29,043
the egg made me was made
in my mother almost 100 years ago.

172
00:10:29,453 --> 00:10:32,115
So that means in egg years, I'm 100.

173
00:10:32,115 --> 00:10:34,154
(Laughter)

174
00:10:37,274 --> 00:10:43,555
And this lady, that I am showing you here
on the right, in egg years, she's 110.

175
00:10:44,665 --> 00:10:47,105
We call this "The 100-Year Effect."

176
00:10:47,105 --> 00:10:51,605
The 100-year effect means
that nutrition flows across generations

177
00:10:51,605 --> 00:10:54,487
from one person to the next,
through mothers,

178
00:10:55,037 --> 00:10:57,076
each successive generation.

179
00:10:57,076 --> 00:11:01,656
And this nutritional flow means
that you have to have good nutrition

180
00:11:01,656 --> 00:11:07,195
every single generation in order to keep
from having a risk for chronic disease.

181
00:11:08,355 --> 00:11:12,908
So it turns out that it's a more
complicated story than you might think.

182
00:11:13,458 --> 00:11:17,776
That's because the nutrition that a woman
gives her baby when she's pregnant,

183
00:11:17,776 --> 00:11:21,066
not only comes from the food
she eats, her diet,

184
00:11:21,066 --> 00:11:25,888
but it also comes from the body
which she was made as a child,

185
00:11:25,888 --> 00:11:27,656
and as she was growing up.

186
00:11:28,496 --> 00:11:30,618
And there's a man's story here too.

187
00:11:31,018 --> 00:11:35,808
And that's because men also influence
the health of their babies,

188
00:11:35,808 --> 00:11:40,967
and both men and women do this
through an effect we call "epigenetics."

189
00:11:41,457 --> 00:11:44,208
Now if you don't know
this word, learn it right now:

190
00:11:44,208 --> 00:11:46,255
Epigenetics.

191
00:11:46,675 --> 00:11:49,788
Learn it, say it,
and use it on your friends.

192
00:11:50,158 --> 00:11:51,739
(Laughter)

193
00:11:52,169 --> 00:11:55,298
It'll wear out in a few generations,
but right now it's hot.

194
00:11:55,728 --> 00:11:56,958
(Laughter)

195
00:11:57,408 --> 00:11:58,617
So here's the word.

196
00:11:58,617 --> 00:12:01,677
Epigenetics means this:

197
00:12:02,747 --> 00:12:05,718
The genetic code you got
from your mother and your father

198
00:12:05,718 --> 00:12:08,307
determines many things about you.

199
00:12:08,307 --> 00:12:10,827
Those genes you got
are expressed all the time,

200
00:12:10,827 --> 00:12:14,338
and they're made of a DNA code,
that you learned in biology.

201
00:12:14,608 --> 00:12:17,479
The truth is, you can't change that code.

202
00:12:17,479 --> 00:12:23,409
That code is found in every chromosome
in your body, in every cell.

203
00:12:23,409 --> 00:12:24,888
And that doesn't change.

204
00:12:24,888 --> 00:12:28,688
However, what you might not know,
is epigenetics, and what that means

205
00:12:28,688 --> 00:12:32,498
is that before you're born, those genes,
some of them, not all of them,

206
00:12:32,498 --> 00:12:37,808
some of them are very sensitive to stress
from the mother and diet from the mother,

207
00:12:37,808 --> 00:12:40,983
and you can alter those genes
that will change the way

208
00:12:40,983 --> 00:12:43,348
you're going to grow
for the rest of your life.

209
00:12:46,358 --> 00:12:48,321
So you can't blame women

210
00:12:48,971 --> 00:12:52,669
for the bad health of everybody.

211
00:12:53,999 --> 00:12:55,508
And you shouldn't try.

212
00:12:55,508 --> 00:12:56,560
Why?

213
00:12:56,560 --> 00:13:00,927
Because both men and women,
in this country now,

214
00:13:00,927 --> 00:13:04,959
eat the worst diets
of any Western country in the world.

215
00:13:05,519 --> 00:13:10,858
We eat fast foods and we've been trained
by industry to love the food they feed us.

216
00:13:12,408 --> 00:13:15,099
And many of us
have trouble getting off of it.

217
00:13:15,459 --> 00:13:18,515
So don't blame women for this;
blame our food culture,

218
00:13:18,515 --> 00:13:21,771
because our food culture is doing us in.

219
00:13:21,991 --> 00:13:23,932
So what will happen if we don't change?

220
00:13:23,932 --> 00:13:28,501
Well, in 1960, one person
out of every 100 was diabetic.

221
00:13:28,781 --> 00:13:32,771
In 1995, one person
out of 50 was diabetic.

222
00:13:33,091 --> 00:13:37,112
Today, in 2015, one person
out of eight is diabetic.

223
00:13:37,432 --> 00:13:42,593
And it's predicted that by 2050,
one person out of three will be diabetic.

224
00:13:42,883 --> 00:13:46,222
Why do we care about this epidemic?

225
00:13:46,672 --> 00:13:47,902
There's one reason:

226
00:13:47,902 --> 00:13:51,190
We not only care for those people
who are going to suffer the illness,

227
00:13:51,190 --> 00:13:53,492
but we are also going to
have to pay for it

228
00:13:53,492 --> 00:13:56,835
because 70 percent of people
who get diabetes

229
00:13:56,835 --> 00:13:59,162
will also acquire heart disease.

230
00:13:59,162 --> 00:14:04,581
And heart disease is terrible
and expensive, and by 2026,

231
00:14:04,581 --> 00:14:09,933
we estimate the financial burden
to be $650 billion a year,

232
00:14:09,933 --> 00:14:12,693
and by the way,
it's $1 billion a day right now,

233
00:14:12,693 --> 00:14:15,202
and then it'll be $2 billion a day.

234
00:14:15,702 --> 00:14:17,382
We can't afford this.

235
00:14:18,202 --> 00:14:20,003
And because we're becoming diabetic,


236
00:14:20,003 --> 00:14:22,111
and it's the younger people
who are doing it,

237
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we're going to pay this bill
in our future.

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So, what is a good diet?

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A good diet, you don't have to read
a fad-ish book to get it.

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All you have to know is to eat
fruits and vegetables, beans,

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nuts, and whole grains.

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And if you eat those most meals,
every day, you'll be eating a good diet.

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If you're a pregnant woman,

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I recommend you throw fish in
two or three times a week,

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because the development of a baby's brain
needs the oils that you get from fish.

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Otherwise, it's a simple prospect.

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So how are we going to get better?
And what are we going to do about this?

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Because we are in an epidemic.

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And of course, the answer is you,
and the answer is me.

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We have to work together,
and how can we do that?

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We can do that because we can influence
our family, our schools,

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and the policies that we make.

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So let me just suggest one thing for you:

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If you care about yourself
and your family,

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go home and find out how many
processed foods you are eating.

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You know, those ones
with the labels all on them.

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And gradually find foods
that are actually healthy,

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and replace all those, and stop buying
those foods with all those labels.

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(Applause) (Cheers)

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The next thing is make sure
that the kids that we love

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go to school and have healthy meals.

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(Applause)

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Influence the workplace where you work,

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and make sure that healthy foods
are always available,

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and lastly, don't forget
to talk to your legislators:

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We need policies to stop what's happening,
and poisoning our bodies.

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(Applause) (Cheers)

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When will we decide
to eliminate chronic disease?

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Today.

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When we realize that our society
today is providing

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the nourishment for children,
and our grandchildren of tomorrow,

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and if all of us work together,
we can better the future.

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Thank you.

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(Applause)