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Today, I'd like to talk about[br]turning around an epidemic.

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One hundred million Americans right now[br]do have either diabetes or pre-diabetes,

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and that puts them[br]at risk for amputations,

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for heart disease, for blindness.

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and we're exporting[br]this epidemic overseas.

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The word "epidemic" comes from Old Greek:

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'epi' means 'on', 'demos' means 'people',

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so an epidemic is something we study with[br]sterile statistics, and maps, and graphs,

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but the truth is, it's something

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that impinges directly on people,[br]on living, breathing human-beings.

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But my story actually starts[br]in the basement of a Minneapolis hospital.

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The year before I went to medical school,[br]I was the morgue attendant,

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or as I'd like to say,[br]"the autopsy assistant".

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What that meant was,

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whenever anybody died,[br]I would bring the body out of the cooler,

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and put the body on[br]an examination table,

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and the pathologist[br]would come into the room.

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And one day, a person died[br]in a hospital of a massive heart attack.

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Probably from eating hospital food,[br]but that's another story.

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(Laughter)

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To examine the heart,[br]you have to remove a section of ribs,

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and this is not done with great delicacy:

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you take what looks like a garden clipper,

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and you go crunch, crunch, crunch,[br]through the ribs on this side,

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and crunch, crunch, crunch,[br]through the ribs on this side.

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And the pathologist pulled[br]this big high wedge of ribs off the chest,

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set it on the table.

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And he knew I was going to be[br]going to medical school,

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so he wanted to make sure[br]that I saw everything.

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And he would say, "Neal, look at this.[br]These are the coronary arteries,"

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- we call them coronary[br]because they crown the heart -

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and he sliced one open,[br]and he said, "Look inside."

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With my gloved finger, I poked around,[br]and it wasn't a wide open artery,

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it had what was sort[br]of like chewing gum inside,

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except that it was hard[br]like a rock, and he said,

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"That's your bacon and eggs,[br]Neal, that's atherosclerosis."

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And we looked at the carotid arteries[br]going to the brain,

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the arteries going to the legs,[br]the arteries going to the kidneys.

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They all had this hardening[br]of the arteries, that's atherosclerosis.

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He said, "We see the beginnings of this[br]in two thirds of people by age 23,

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which happened to be the exact age[br]that I was at the time.

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(Laughter)

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So, anyway, he writes up his findings,

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"massive atherosclerosis,[br]acute myocardial infarction,"

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and he leaves the room.

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So, I picked up the ribs[br]and put them back in the chest,

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tried to make them fit[br]right with the other ribs,

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and I sewed up the skin, and cleaned up,

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and then I went out[br]and went up to the cafeteria,

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where turned out[br]they were serving ribs for lunch.

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(Laughter)

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Now, let me tell you something,[br]I knew about ribs.

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I grew up in Fargo, North Dakota,[br]I come from a long line of cattle ranchers

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and I remember the smell[br]of the cows out in the field,

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I remember the smell of the cows[br]in my grandpa's barn

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and driving a load of cattle[br]with my uncle to East Saint Louis,

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to the National Stockyards,

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and I remember the National[br]Stockyards hotel, two dollars a night,

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and the smell of that room.

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(Laughter)

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And I have to say, everyday in my life,

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it was roast beef,[br]baked potatoes, and corn.

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Except for special occasions, when it was[br]roast beef, baked potatoes, and peas.

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(Laughter)

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And that's the sort of the way we ate,

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but my father did not like[br]the cattle business, so he left,

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left the family farm,[br]and he went to medical school.

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And he spent his life at the Fargo clinic[br]treating diabetes,

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he became a diabetes expert[br]for the whole region.

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And I have to say[br]my father really was frustrated

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because patients were given diets[br]that they did not like.

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What we would say is,[br]or what they would say,

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is diabetes is a condition[br]where it's too much sugar in your blood,

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so don't eat anything that turns to sugar,[br]so don't eat bread, don't eat fruit,

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don't eat pasta, rice, sweet potatoes,

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don't eat regular potatoes,[br]beans, don't eat carrots;

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all these things had to be limited[br]and while you are at it, cut calories,

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and that's what people had to adhere to,[br]that's gets old by Wednesday.

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Patients were also given medicines,[br]and they were given needles,

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and instructions on how to stick[br]their fingers and how to inject insulin.

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And despite all of this,[br]diabetes never got better,

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it always progressed,

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and it then became something[br]that we're exporting overseas.

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And when I got out of medical school,[br]we had more medicines,

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and I think we had sharper needles,[br]but to tell you the truth,

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it was the same sort of result,[br]we had unhappy patients,

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and we've never ever cured[br]this disease, it never turned around,

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it was always considered[br]a progressive disease.

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But there are two scientific discoveries[br]that really turned all this around.

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And the first one was taking[br]the widest possible lens.

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If you look around the world,

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at those countries that have the least[br]diabetes, like Japan, for example,

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they weren't following anything

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like the diet we were given[br]to diabetic patients.

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They weren't saying, "I'm not going[br]to eat rice, I won't eat noodles,"

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they eat this kind of food all the time,[br]it's front and center on their plate.

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And the second discovery[br]came from looking inside the cell,

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especially the muscle cell.

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And the reason we look[br]at muscle cells in particular

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is that's where glucose is going,[br]that's where blood sugar is going,

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that's the fuel that powers your movement.

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Do you know about a person[br]who's running a marathon?

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What are they doing in the weeks leading[br]up for it? They're carbo-loading.

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So they're eating pasta,[br]they're eating bread

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to try to get that glucose[br]into the cell for energy.

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And that is the problem in diabetes,

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because glucose, glucose is there,[br]outside the cell, trying get inside.

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In order to get in, it needs a key.[br]And that key is insulin.

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Now, what if I get home,[br]and I'm getting up to my front door

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and take my key out of the pocket,[br]I put it in the front door--

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Wait a minute, it's not working.

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And there's nothing wrong[br]with my key, but I look in the lock,

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and while I was gone,[br]somebody put chewing gum in my lock.

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So what am I going to do?[br]Crawling in and out the window? No.

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I'm going to clean out the lock.

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Well, when a person has diabetes,[br]their insulin key is not working.

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Why would that be?[br]Why could insulin not signal?

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What supposed to happen is the glucose[br]is supposed to enter into the cell.

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And [insulin] is the key[br]that makes that happen.

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But the reason it doesn't happen

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it's not that there's[br]chewing gum inside the cell.

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What there is, is fat.[br]Fat, little globules of fat.

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I have to say, doctors hate[br]words like "fat",it has one syllable.

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(Laughter)

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So we want to call it[br]intramyocellular lipid.

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(Laughter)

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'Intra' means' inside', 'myo' means[br]'muscle', 'cellular' means 'cellular'

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(Laughter)

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'lipid' means 'fat'.

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Intramyocellular lipid is fat[br]inside your muscle cells,

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and that is what interferes

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with insulin's ability to work[br]like a key to signal glucose coming in.

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In 2003,

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The National Institute of Health[br]gave my research team a grant and said,

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"Let's test something[br]completely different.

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Instead of limiting breads[br]and all these kinds of things,

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if fat is the issue, what if we have[br]a diet that has effectively no fat in it?"

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Well, where does fat come from?

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It comes from two sources:

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animal products, animal fat,[br]and vegetable oils.

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So we brought in 99 people,[br]and we asked them to do two things:

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to really eat a bounty of food[br]and not worrying about quantity,

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we're not counting calories here,

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we're not counting carb grams[br]or anything like that.

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What we're doing instead,

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is we're setting the animal products aside[br]keeping the vegetable oils low.

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Very simple.

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One of our participants[br]was a man named Vance,

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and Vance's father was dead by age 30.

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Vance was 31 when he was[br]diagnosed with diabetes,

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he was in his late 30s[br]when he came to see us.

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And he said, "This is not hard!"

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Unlike every other diet he'd been on,[br]we didn't care how many carbs he ate,

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or how many calories,[br]or how many portions.

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If he was having chilli,[br]not a meat chilli,

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would be a bean chilli,[br]chunky vegetable chilli.

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If he was having spaghetti,[br]instead of a meat topping,

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it would be topped[br]with artichoke hearts

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and wild mushrooms,[br]and chunky tomato sauce.

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So that kind of thing; very, very easy.

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Over the course[br]of about a year, he lost 60 pounds,

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his blood sugar came down[br]and down, and down,

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and one day his doctor[br]sat him down and said,

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"Vance, I know you've had[br]family members die of this disease."

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But he said, "I look at your blood tests;[br]you don't have it anymore."

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And can you imagine what that feels like[br]to have family members who felt

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there's this absolutely one way street[br]and have this disease just turn around?

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And when I asked Vance's permission[br]to tell you about his story, he said,

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"Make sure you tell everybody that[br]my erectile dysfunction went away too."

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(Laughter)

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Write that down.

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(Laughter)

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So, we published our findings[br]in peer-reviewed journals,

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the American Diabetes Association cites it[br]and accepts this as an effective approach.

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And people around the world[br]started using this

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and I heard from a man in England,

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who wanted to let me know[br]about his experience.

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He had had diabetes,

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tried all kinds of diets[br]without a lot of success.

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And then he heard about our approach,[br]tried it for several weeks,

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went to the doctor,[br]the doctor drew a number of blood tests.

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And he got home.

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The phone rang,[br]"This is the doctor's office.

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Could you come back right now?

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So he [goes], "Good heavens![br]What's in my blood test?

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He races into his car,[br]he's driving to doctor's office

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thinking what disease did they discover[br]on my blood test, what did they find ..."

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And he runs into.

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They say,"We need you to sit down.[br]Explain exactly what you've been doing."

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All traces of his diabetes were gone.

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The doctor said,[br]"Your blood tests are better than mine,

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and I don't have diabetes,[br]how is this possible?"

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The doctor explained to him, "We can never[br]say a person has been cured of diabetes

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because we all know that's not possible,[br]but technically, it's not there.

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And the doctor was skeptical,

0:10:08.137,0:10:11.060
he said, "Come back in two months,[br]I want to test you again."

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Never came back.

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Now, wait a minute.

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Diabetes is genetic, right?

0:10:16.299,0:10:17.734
It runs in families.

0:10:17.735,0:10:20.300
And there, in fact,[br]are genes for diabetes,

0:10:20.301,0:10:22.640
but this is an important thing[br]to remember,

0:10:22.641,0:10:25.368
genes are in two categories.

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Certain genes are dictators,

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I'm talking about the genes that say,[br]'blue eyes' or 'brown hair'.

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They are dictators,[br]they give orders, you can't argue.

0:10:35.874,0:10:40.128
But the genes for diabetes are committees.

0:10:40.129,0:10:42.639
They're making suggestions.

0:10:42.654,0:10:44.872
And you can say, "Wait a minute,

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I don't really think[br]I want to have diabetes."

0:10:47.738,0:10:51.161
And, in fact, most disease genes,[br]whether it's for heart disease,

0:10:51.162,0:10:54.571
or diabetes, or hypertension,[br]certain forms of cancer,

0:10:54.572,0:10:57.024
even Alzheimer's disease,

0:10:57.025,0:10:59.577
they're not dictators, they're committees.

0:10:59.578,0:11:05.200
And their activity depends on[br]what we put into our bodies.

0:11:05.201,0:11:08.275
So, what I'm saying is

0:11:08.276,0:11:14.117
that we're putting into our bodies[br]foods that we're really not designed for.

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Which raises the question:[br]what foods are we really designed for?

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There are different ways[br]of looking at this.

0:11:20.501,0:11:24.583
And one is called the dental test.[br]Do you know the dental test?

0:11:24.584,0:11:28.679
What you do is you wait[br]for your cat to yawn,

0:11:28.680,0:11:31.264
and you look in your cat's mouth[br]and what you notice is

0:11:31.264,0:11:35.280
in its mouth are these very, very long[br]protruding canine teeth,

0:11:35.281,0:11:38.235
and on each side of its mouth,[br]it's just like a pitchfork

0:11:38.236,0:11:42.703
that's really good for capturing pray,[br]killing small animals,

0:11:42.704,0:11:46.050
and ripping the hide off the flesh[br]and eating meat.

0:11:46.051,0:11:48.091
So now look at your own mouth.

0:11:48.092,0:11:49.733
What you discover

0:11:49.734,0:11:53.645
is that your canine teeth[br]are no longer than your incisors.

0:11:53.646,0:11:56.764
And that change occurred[br]at least 3,5 million years ago.

0:11:56.765,0:11:59.467
So our molars are really good[br]for crunching on an apple,

0:11:59.468,0:12:01.955
they're not so hot for handling roadkill.

0:12:01.956,0:12:05.005
There's the bunny test.[br]Do you know the bunny test?

0:12:05.006,0:12:06.193
(Laughter)

0:12:06.194,0:12:07.935
You take a bunny,

0:12:07.936,0:12:11.228
and you put the bunny[br]in front of your cat

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(Laughter)

0:12:14.504,0:12:16.103
what you discover,

0:12:16.104,0:12:20.064
no matter how young your cat is,[br]the cat has this irrepressible desire

0:12:20.065,0:12:24.513
to capture, attack, kill,[br]and swallow that bunny.

0:12:24.514,0:12:28.007
Now, you put the very same bunny[br]in front of a toddler or baby. (Laughter)

0:12:28.007,0:12:30.732
And what you discover is[br]the toddler say, "Bunny, bunny!"

0:12:30.733,0:12:33.562
They want to play and the baby[br]is just absolutely delighted,

0:12:33.563,0:12:36.389
the idea of killing and eating him[br]would never occur to him

0:12:36.390,0:12:37.597
in a million years.

0:12:37.598,0:12:39.204
We're learning something here.

0:12:39.205,0:12:41.329
Do you know the box test?[br](Laughter)

0:12:41.330,0:12:44.930
You take a box that it was used[br]to carry electronic equipment,

0:12:44.931,0:12:49.773
and you look around at the bottom[br]and what you find is silica gel.

0:12:49.774,0:12:54.503
And silica gel is there[br]to take moisture out of the box.

0:12:54.504,0:12:58.738
And apparently, the manufacturers[br]of silica gel have realized

0:12:58.739,0:13:02.389
that human-beings are so indiscriminate[br]in their eating habits,

0:13:02.390,0:13:07.789
that they have to put[br]these words on it, "Do not eat".

0:13:07.790,0:13:10.129
(Laughter)

0:13:10.130,0:13:13.217
So, here's how I put this together:

0:13:13.218,0:13:18.421
human-beings are naturally herbivores,[br]but we're really easily thrown off track.

0:13:18.422,0:13:20.311
(Laughter)

0:13:20.312,0:13:24.254
The fact of the matter is,[br]before the Stone Age,

0:13:24.255,0:13:27.724
people would have been[br]just terrible hunters, really.

0:13:27.725,0:13:30.118
You know this is true[br]because we're not very quick.

0:13:30.118,0:13:32.064
A lion, a lion is quick,

0:13:34.355,0:13:37.354
in the forest,[br]a lion can easily catch a gazelle.

0:13:37.355,0:13:40.453
A hawk or a falcon[br]can easily catch a mouse.

0:13:40.454,0:13:43.389
Humans, we sort of catch cold.[br]That's like it. (Laughter)

0:13:43.390,0:13:47.276
We don't really detect pray very well,[br]we don't have sensitive noses.

0:13:47.277,0:13:48.575
If you look at the dog,

0:13:48.576,0:13:51.785
a dog has a very highly[br]developed sense of smell,

0:13:51.786,0:13:54.048
they can detect pray at long distances,

0:13:54.049,0:13:56.785
which is why they are used in airports

0:13:56.786,0:14:00.347
to detect bombs, and drugs,[br]and that kind of things.

0:14:00.348,0:14:02.513
And their sense of hearing[br]far outstrips ours,

0:14:02.514,0:14:04.713
they are outfitted[br]to be able to detect pray.

0:14:04.714,0:14:08.923
Now, human-beings, we have[br]cute noses and we have cute ears,

0:14:08.924,0:14:12.411
but we really are pathetic as hunters.

0:14:12.412,0:14:15.553
And if you're going to succeed[br]as a carnivore,

0:14:15.554,0:14:18.525
you need good sharp claws,[br]good sharp teeth,

0:14:18.526,0:14:20.468
you need to be very, very quick,

0:14:20.469,0:14:24.908
and you need to have sensitive hearing,[br]sensitive smell, sensitive vision.

0:14:24.909,0:14:27.322
Which actually raises the question:

0:14:27.323,0:14:30.463
what is the most sensitive part[br]of the human body?

0:14:31.769,0:14:33.336
What do you think?

0:14:34.286,0:14:36.040
Well, I actually learned the answer.

0:14:36.041,0:14:38.051
As I was coming here,[br]I was at the airport.

0:14:38.051,0:14:41.763
And the TSA agent pulled me aside[br]and said, "I got to do a pat down,

0:14:41.764,0:14:44.093
and when I get to a sensitive part[br]of your body,

0:14:44.094,0:14:45.681
I'll use the back of my hand."

0:14:45.682,0:14:47.295
And I realized that apparently,

0:14:47.296,0:14:51.957
the most sensitive part of the human body[br]must be our back side, I guess.

0:14:51.958,0:14:56.976
So, anyway, what I take from this[br]is that meat eating began somehow.

0:14:56.977,0:14:58.239
How did it begin?

0:14:58.240,0:15:00.902
I put that question to Richard Leakey.

0:15:00.903,0:15:04.023
- Richard Leakey,[br]the famous paleoanthropologist -

0:15:04.033,0:15:05.168
and what he said was,

0:15:05.169,0:15:08.948
"You know, human-beings as herbivores,[br]you don't have to be quick,

0:15:08.953,0:15:11.442
you don't have to be[br]particularly sharp or sensitive

0:15:11.443,0:15:14.322
because you don't really have[br]to sneak up on a strawberry,

0:15:14.323,0:15:16.394
it's just sitting, not doing anything.

0:15:16.403,0:15:20.124
But to become carnivores[br]really took some work.

0:15:20.125,0:15:23.188
And it probably started as scavenging."

0:15:23.189,0:15:25.550
In other words,[br]a lion doesn't eat everything.

0:15:25.551,0:15:28.520
When they walk away[br]from the little pile of bones they've left

0:15:28.521,0:15:29.861
there's a little meat there,

0:15:29.861,0:15:32.269
and humans could[br]relatively easily sneak in

0:15:32.270,0:15:34.933
and cut some of that off and take it back.

0:15:34.934,0:15:37.843
Now, that requires having[br]some tools to do that with.

0:15:37.844,0:15:40.946
So once the Stone Age arrived,

0:15:40.947,0:15:44.110
then we had the possibility[br]of actually doing that.

0:15:44.111,0:15:47.050
And once we had arrowheads,[br]and axes, and that sort of thing,

0:15:47.051,0:15:48.784
then we were really on to something.

0:15:48.785,0:15:53.439
Meat eating really became a big thing.[br]But, we have pre-stone age bodies.

0:15:53.440,0:15:57.759
To this day, when a person puts[br]into their body plant foods,

0:15:57.760,0:16:00.871
their arteries open up again,[br]their diabetes starts to get better,

0:16:00.871,0:16:04.801
their weight starts to come off,[br]their bodies start to recover.

0:16:10.716,0:16:15.913
Americans, unfortunately, are[br]really not on a diabetes reversal diet.

0:16:15.914,0:16:19.374
Americans today eat more[br]than a million animals per hour.

0:16:19.375,0:16:21.958
And the Centers for Disease Control[br]and Prevention say

0:16:21.959,0:16:25.117
that one of three kids born[br]in the year 2000 and in the years since

0:16:25.117,0:16:28.099
is going to get diabetes[br]at some point in their life.

0:16:28.100,0:16:30.888
And you see the truth of it,[br]turn on the television:

0:16:30.889,0:16:35.328
half the commercials are for burgers,[br]chicken wings, snack foods,

0:16:35.329,0:16:38.338
the other half of the commercials[br]are for medicines

0:16:38.339,0:16:41.756
to undue the effects[br]of all the foods that we're eating.

0:16:41.757,0:16:43.214
So, that's where we are.

0:16:43.214,0:16:44.349
And what if it happened

0:16:44.349,0:16:46.558
that instead[br]of a hundred million Americans

0:16:46.559,0:16:48.896
having diabetes or pre-diabetes,

0:16:48.897,0:16:51.498
what if all hundred million[br]had diabetes itself?

0:16:51.499,0:16:53.193
Or more people than that?

0:16:53.194,0:16:57.129
All of them need medicines, and testing,[br]and hospital care, and so forth.

0:16:57.130,0:16:59.732
Financially, it's a disaster.

0:16:59.733,0:17:03.821
But, personally,[br]the personal cost is just incalculable.

0:17:03.822,0:17:06.503
I think we're starting[br]to turn the corner:

0:17:06.505,0:17:10.199
my family has promoted me for generation[br]after generation, after generation.

0:17:10.200,0:17:11.181
However,

0:17:11.182,0:17:16.479
in 2004, we reached the peak[br]at 201,5 pounds of meat.

0:17:16.480,0:17:18.970
That's what the average person[br]consumed in that year.

0:17:18.971,0:17:21.507
And in the subsequent years,[br]it's dropped and dropped,

0:17:21.507,0:17:23.050
and we're now under 190,

0:17:23.051,0:17:26.348
and hopefully,[br]that downward trend will continue.

0:17:26.349,0:17:30.386
But to this day, doctors,[br]dieticians, nurses will say,

0:17:30.387,0:17:33.563
"Diabetes is a one way street,[br]it never goes away."

0:17:33.564,0:17:35.791
But that was before[br]we looked around the world

0:17:35.792,0:17:39.068
and saw, you know, there are[br]dietary patterns that are more helpful.

0:17:39.069,0:17:42.727
And that was before we realized[br]that looking inside the cell,

0:17:42.728,0:17:44.774
we can understand how this occurs,

0:17:44.775,0:17:47.397
and we can understand[br]how to reverse this process.

0:17:47.398,0:17:49.068
And it was before we realized

0:17:49.069,0:17:54.064
that patients will make bigger changes[br]than we gave them credit for.

0:17:54.065,0:17:55.647
So, families like mine,

0:17:55.648,0:17:57.778
that have been selling meat[br]for generations,

0:17:57.779,0:18:02.102
instead, maybe could sell carrots,[br]asparagus, sweet potatoes, and beans,

0:18:02.103,0:18:05.420
and hopefully, the autopsy room[br]will more neglected than ever,

0:18:05.421,0:18:08.152
because people are going to live longer,[br]and look better,

0:18:08.153,0:18:10.897
and maybe the hospital cafeteria,[br]instead of serving ribs,

0:18:10.898,0:18:13.259
could serve a bounty of helpful foods,

0:18:13.260,0:18:16.098
and instead of studying epidemics,

0:18:16.099,0:18:18.522
maybe we could celebrate[br]a resurgence of health.

0:18:18.523,0:18:19.551
Thank you very much.

0:18:19.552,0:18:20.603
(Applause)