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Tufts University recently released the updated Food Compass, a nutrient profiling system to help consumers and policymakers determine the healthfulness of certain foods. You can read the full study here, (a subscription to Nature is required) read the brief overview here, or see a detailed list of the food rankings here. 

Dr. Tony Hampton joins me in this episode to discuss some of the shocking and inaccurate results of the Food Compass. Spoiler alert: Cheerios scored a 94 out of 100 while beef only scored a 24.

Dr. Hampton is a board certified obesity specialist, Certified Physician Executive, researcher and author. His goal is to empower his patients with knowledge in order to improve their health conditions. 

Like me, Dr. Hampton is passionate about the necessity of meat in a healthy diet, and takes issue with how animal-based foods are often vilified in studies like the Food Compass.

Guides like this are troubling because they serve as reference points for school lunches, food policy, and government programs like SNAP.  They claim to be intended for healthy populations but the sad fact is that many Americans are not metabolically healthy. 

Along with the Food Compass report, Dr. Hampton and I discuss:

• How Dr. Hampton started his journey in metabolic health with his wife’s diagnosis of Type 1 Diabetes
• The importance of bio individuality
• The concept of TOFI – Thin on the Outside, Fat on the Inside
• The importance of self-experimentation
• Why learning how to breakdown research papers is important, especially for clinicians
• The importance of a culturally appropriate diet
• The origins of soul food
• How small changes can make a big difference

Resources:

• Tufts University Friedman School of Nutrition and Policy
•  Dr. Tony Hampton’s book: Fix Your Diet, Fix Your Diabetes
• Nina Teicholz
• Dr. Eric Westman
• Dr. Dariush Mozaffarian
• Levels Glucose Monitor
• Dr Vyvyane Loh & her video on TOFI
• Society of Metabolic Health Practitioners
• Chris Masterjohn’s podcast on how to read a research paper 
• Chicken George

Connect with Dr. Hampton:

Website: Doctor Tony Hampton

Instagram: @drtonyhampton

LinkedIn: Tony Hampton, MD, MBA, CPE

Facebook: Tony Hampton, MD, MBA, CPE

Twitter: @drtonyhampton

YouTube: Dr Tony Hampton

Podcast: Protecting Your N.E.S.T

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Episode Credits:

Thank you to all who’ve made this show possible. Our hosts are Diana Rodgers, Lauren Manning, and James Connelly. Our producer is Meg Chatham, and our editor is Emily Soape. And of course, we are grateful for our sponsors, Patreon supporters, and listeners.

This episode is sponsored by Paleovalley, my go-to, grab-and-go source for products that prioritize nutrient density in an industry that prioritizes everything else. Their epic lineup of products includes Organic Supergreens, 100% Grass-Fed Beef Sticks, Grass-Fed Organ Complex, 100% Grass-Fed Bone Broth Protein, and low-sugar snack bars. Visit their website here and enter the code SUSTAINABLEDISH for 15% off your first order.

Quotes:

“We’re guided by guidelines that don’t necessarily treat the people that we’re concerned about and that’s those metabolically ill people.” Dr. Tony Hampton

“What we’re looking at is 70% of Americans are overweight or obese. We’ve got a growing type two diabetes, even bigger numbers of people that are right on that verge that have no idea.” Diana Rodgers, RD

“If anything, we would make these guidelines, if it makes sense to have at all, we would make it for people who need it the most.” Dr. Tony Hampton

“So I think it’s just  we have to individualize our treatment, and an approach. And more importantly, let’s be okay, there may be more than one way to do things. What I struggle with is when we demonize other approaches, just because it’s not our approach, and that’s just a disaster.” Dr. Tony Hampton

“I would argue, if you add these so-called nutrients back, is your body going to really appreciate that because it’s not in its natural form.” Dr. Tony Hampton 

“That’s why when I do a lot of these studies on vitamins, they find that the actual benefit doesn’t exist, because most of the vitamins are synthetic, and your body doesn’t quite know what to do with that. So, I think, you know, obviously, eating whole foods is the first answer – eating real food.” Dr. Tony Hampton

“That’s why we have to remind people, instead of depending on the medicine to somehow support you when you eat the wrong foods, let’s do the flip of that. Let’s eat the right food and then you won’t need the medicine.” Dr. Tony Hampton

“The first thing I do with my patients is I try to meet them where they are.  So there’s a lot of pushback if a person perceives that what you’re recommending is not culturally appropriate for them, right?” Dr. Tony Hampton

Transcript:

Diana Rodgers, RD  0:00  

Welcome back to the podcast everyone. Today I have with me Dr. Tony Hampton. Welcome, Doctor, thank you so much for joining us here.

Dr. Tony Hampton  0:07  

Happy to be here. Thank you for inviting me.

Diana Rodgers, RD  0:09  

And you’re literally at work right now clearly.

Dr. Tony Hampton  0:12  

Literally at work. Hopefully I don’t have any inappropriate corporate signs. But yeah, it looks like a typical doctor’s exam.

Diana Rodgers, RD  0:20  

Yeah. And so you are the author of several books, you’re very schooled in metabolic health. And I’m so happy to have you here, especially because… we’ll try to get this podcast out relatively soon.  You and I were just chatting about this new Food Compass paper that came from Tufts University. And I’m gonna give folks just a little bit of background, and then I would love for you to go off on it. But basically, Tufts University, Friedman School of Nutrition, they’re very interested in epidemiology, observational studies. And they came out with a paper that we’ll link to in the show notes. And it is a ranking of foods. It’s intended for policymakers and consumers to easily be able to figure out which foods are healthier and less healthy for them. which foods we might want to consider taxing, pulling out of school lunches, SNAP programming, things like that. So very concerning to me. Because as we were just chatting, foods, like potato chips are ranked higher than nutrient dense foods, like eggs, and dairy products and meat. Maybe before we jump into that real quick, give folks a little bit of your background, how you got interested in this specific, you know, not a lot of doctors are this educated in metabolic health?

Dr. Tony Hampton  1:45  

Yeah, well, I think a lot of it, where it started with my wife, she, when she got diabetes, her being a pharmacist was not ironically interested in taking a lot of medicine. So, so part of once she got past her anger, because she was not overweight, her fear, you know, thinking about needles and becoming a pin cushion, I promised her I would, you know, do a little bit of a journey. So I started my journey, where I spent a lot of time trying to figure out, you know, what can we do to help people with diabetes, and particularly my wife, and unfortunately, she end up being a type one. But even with that, we learned that if we do some things, from a lifestyle perspective, rather stress or eat better, it’s gonna really reduce her need for insulin. And it really did. I mean, there’s days when it’s 10 units for the whole day, 14 units, and that’s not a lot for a type one diabetic, you know. So so when you eat foods that do not raise your blood sugar, you’re going to do much better. But then I after learning about her, I said, You know what, guess what, I can apply these principles to my patients. So when I started writing my book, Fix Your Diet, Fix Your Diabetes, it was really just a reflection of what I was learning. So I learned that, for example, high blood sugar is not the disease. It’s the actual symptom of diabetes. So and then once I learned what, what’s this, what’s the disease – it’s insulin resistance. Well, how do you fix that? You fix it with diet. So once I kind of understood how – and that’s the type two, of course, but once I understood how that works, I started applying it in my clinic. I’ve been practicing for 28 years, and in my 28 years, I don’t recall anybody getting off insulin, how? Well let me say it differently, not since I started low carb and carb restriction. So once I started that approach, with diet, and really the entire nutrition, less stress, fasting. People get off insulin, they get off medicines. And it was like a miracle because I was trained that it was a chronic progressive disease. So So for me, it’s just providing hope, giving people a chance to know that yes, you don’t have the same destiny of your relatives who didn’t do well with amputations and dialysis and blindness. No, you can you can overcome this, it’s just making some small changes in diet, which is why the article you quoted is so important, because the information they get is critical if they’re going to be successful. And I don’t want anybody to feel guilty, because they didn’t know how to do it, or that some of the things that are being recommended can be harmful. And some of it should be fairly obvious once you know what causes insulin resistance, which is you’re just having too much of the foods that you can’t process. So it shouldn’t be a You don’t have to be a doctor, a scientist, a journalist, like Nina Teicholz, for example, to figure this out. It should be fairly common. It’s just that we’re guided by guidelines that don’t necessarily treat the people that we’re concerned about and that’s those metabolically ill people.

Diana Rodgers, RD  4:47  

And what we’re looking at is 70% of Americans are overweight or obese. We’ve got a growing type two diabetes, even bigger numbers of people that are right on that verge that have no idea. I mean, right now I’m wearing a continuous glucose monitor. And I’ve been learning a ton. I’ve only had it on for three weeks. And the timing of carbohydrate intake, I always knew about the context, but I didn’t know, for example, with with my body, I can handle carbs better in the evening than I can morning. Um, and I go super hypoglycemic at night, often, which is really interesting. And actually, when I’m super hypo, I have crazy nightmares, which I was reading is a symptom of hypoglycemia. Everyone is different. And and I highly recommend, I’ll put a link to Levels because people can, can just do it that you don’t have to be sick, you can just learn this information. And if you don’t want to invest in Levels, you can certainly just go to a local pharmacy and get a glucose monitor. You don’t need a prescription for that. And you can just test it yourself. But we have so many people that I mean, clearly I go to the grocery store, and I see people that look perfectly healthy, and they’re buying all kinds of stuff that I definitely can’t eat. And everyone’s on a spectrum of what level of carbs they can and can’t handle. If I ate anything even close to the standard recommendations of what I’m supposed to be dishing out to people, I would be incredibly sick. And so when you know the defense of guidelines, like what we’re going to be talking about with Tufts is that they’ll say, well, this is for healthy people what this is for the general population, but what we’re dealing with is the general population is not healthy.

Dr. Tony Hampton  6:28  

Right. Yeah, well, it would be okay if we lived in a world… I remember going to visit France and I know they have tourists in France. But why was everybody thin? I have no clue. I don’t understand how that works. But so you do have places in the world maybe where more people are healthier. But ultimately in the United States as an example, I think that the majority of the people are probably not metabolically healthy. And that and we’ve heard those stats, you know, the study that showed that only 12% are metabolically healthy and and then when you think about how we self select for the people who come see us, right as clinicians, then you’re going to assume that you’re going to be self selecting for people who have concerns everyone to why you do a physical somebody is completely healthy. But in the communities of color, where I work in this clinic most people are not at their ideal body weight weight, and most people have borderline or are diabetic. Most people have blood, you know, blood pressure issues, most people have stress. So it would be if it’s true that this is for the healthy then where is the one for the unhealthy? I mean, it doesn’t really make sense. And if anything, we would make these guidelines, if they if it makes sense to have at all, we would make it for people who need it the most. So I think we have a lot of reflection to do. And if we have to have guidelines and guidance, and that’s okay, then we need to do a better job of saying okay, here are the guidelines for the metabolically unhealthy and then we can have a conversation around you know which approach is a better approach for the majority. I do like bio individuality. So let’s give us give people some choices that have been proven to be effective. We just know that the standard American diet is not one of them.

Diana Rodgers, RD  8:19  

Exactly. And I also read recently that there’s a huge prevalence of people of average BMI, especially in Asian communities that are metabolically unfit. So it’s not just people who are overweight or obese, that might be metabolically unfit. It’s you can’t really just tell the book by its color. And, and certainly there’s people that are skinny fat or just whatever they do, they just can’t handle carbs as well as, as the other person for a variety of reasons

Dr. Tony Hampton  8:51  

It’s the TOFI, right? Thin on the outside, fat on the inside. I actually did a video with Dr. Vivian Lowe, who is a clinician who also works with me with the Society of Metabolic Health Practitioners and she’s, we’re on the outreach committee. And as we’re doing today, we’re outreaching right? And she’s she has an Asian background, but in that video, she talked a little bit about what TOFI is, and and you’re right, I mean, we we have, we have to have a waist conference that maybe a little, maybe a couple of inches smaller for that community. And people would be surprised I know when I talk to people in my community and when we talk about South Asians and things like that, they’re shocked to hear that some of those communities have a higher prevalence of heart disease than they do. It’s like they’re like what so I just think that that education and awareness that we’re all in this together and and it’s okay to look at yourself differently. You could argue like I you know, when I was in school, I learned what you know, we joke about being big boned it right? Well, that’s a real thing. You know, you can actually measure your wrist, and if it’s greater than seven inches, you know, maybe you are big boned and maybe your BMI is okay to be slightly higher if you’re metabolically healthy. And and LeBron James is BMI, I think is 29 or 30. Right. But we clearly know he’s metabolically okay. So I think it’s just we have to, we have to individualize our treatment, and an approach. And more importantly, let’s be okay, there may be more than one way to do things. What I struggle with is when we demonize other approaches, just because it’s not our approach, and that’s just a disaster. I think we have to know that there are people who can do it this way. I was a vegetarian for eight years. And and I found out later that that wasn’t the best diet for me. But I but it was so much better than the Standard American Diet, right? So I think you have to kind of figure out what’s best for people. And I think what a metabolically unhealthy population it’s clear that reducing carbs is probably the fastest way other than intermittent fasting to get people to recover from that.

Diana Rodgers, RD  11:02  

Exactly. So you know, and what we see with hunter gatherer populations that live closer to the equator is that what their carb intake can be quite high, but it’s, it’s not processed carbs, right. So the intervention once someone does reach the point of being kind of broken, even those natural mangoes and you know, high carb fruits that maybe someone who is healthy could do fine with. They can’t, I can’t do that anymore,

Dr. Tony Hampton  11:27  

Right. And that’s why I love Dr. Eric Westman’s quote, fruit is nature’s candy. Every time I talk about fruit as being nature’s candy my patients again, they look at me with like deer in the headlights. But I said you know, as you have learned, you know my wife actually said once you’ve tried a continuous glucose monitor, I think this interview this, this is my moment, I should have just listened to my wife. But I’m gonna listen to you, Diana. I’m gonna hear her and I’m gonna hear you and I’m going to, I’m going to do that little experiment in a very near future and document it. Because once you start to understand when I eat a banana, what happens to your blood sugar. Now if nothing happens, have at it but for a lot of people, they’re going to eat pineapples and things like that. And it’s going to create some spikes and those spikes can cause harm so so I think we just want to just have that awareness, that knowledge and I think that these tools that we’re now having access to will make our jobs a little easier because people if they would just simply do that experiment they figured it out. So it’s pretty cool to have these tools.

Diana Rodgers, RD  12:32  

It’s definitely cool. Yeah, I’ve learned so much and you know, stress also spiking my blood sugar crazy. You know, I’m able to control diet. I’m trying really hard to control stress, it’s not always easy. But let’s go back to fruit because that is something that I get someone that maybe is unfamiliar with my work and they’re referred by a doctor and you know, they either want to lose weight or they have either on the verge of type two diabetes are have type two diabetes. Fruit is something that is a shocker to them less fruit and more protein. It are like the two things I have to fight with people the most about, and I’m sure it’s the same for you. Chicago is not that much different from Boston. Let’s then relate that back to this Tufts Food Compass Study, where raspberries got a ranking of 100. Bananas, they got a slightly lower ranking because they’re highly glycemic but way, way higher ranking than a eggs, chicken. I’m kind of stunned. Will you talk a little bit about that you started talking a little bit about sweet potato chips? You saw some of rankings. 

Dr. Tony Hampton  13:39  

Yeah. I mean, I and thank you for sharing that study. I hadn’t seen it until I had a chance to take a look at it. And I’ll be honest, it is a little shocking to think about the fact that you know, how is it that you the question is where that the interpretation of the information in front of them come from because it just feels biased. But But again, even with that, what you just mentioned the sweet potato question, right? So I looked at it and I saw that it had a number out of 100 and 100 being a good number it was 69 right? And then my brain started to ask well, most people are more cautious with white potato so the question is, is a white potato and a sweet potato that different. And there are some differences you know, the fiber content per serving may be one you know, gram higher for the sweet potato, and you may have less carbs with the sweet potatoes so but it’s probably just one carb difference, right? It’s almost like white rice and brown rice. You know, in theory if anybody listening don’t believe me just go to your phone and just put brown rice carbs and then put white white rice carbs and yeah, you can have more fiber in the brown rice but you’re gonna have it so if you’re a diabetic, does it really get you know, support you in a way it needs to. I’m sure the sweet potatoes in my nutrition training I saw that had more nutrients, maybe more vitamin A vitamin C. So that’s all good, but it’s a chip. So we’re going to give a sweet potato chip a favorable score in this, you know, 69 to 70% range. Oh, by the way, what are we going to cook that sweet potato in? Well, I doubt it is a really quality oil. It’s probably going to be highly processed vegetable/seed oil. So now I have inflammation from the seed oil and all of that inflammation is what kind of leads to metabolic disease so so I just think that when it comes to these types of recommendations, it really it really perplexes me. I’m looking at it now and it says chicken breast grilled, and it’s got a score of 61. No skin is emphasized. Right? And the question is, well, what’s wrong with the skin? Is the fat really harmful? And finally to the College of Cardiology in June of 20, you know, 2020 finally say, oh, saturated fat, we should embrace saturated fat. Who would’ve known, right? So now we have the College of Cardiology admitting that saturated fat is not a problem. So do we really need to say no skin on a chicken now? Right? So the question is, why did they put that there. So I think that I look at the pizza, and that’s got a low score, maybe that’s appropriate. And I’m more concerned about the processed flour in the crust, not the extra meat that’s on the pizza. So quite but they but they emphasize extra meat. So their emphasis is to suggest that animals are harmful, you should minimize those. And some of the other things that are being emphasized are things that you put pause like the fruit. And again, if anybody listening is a diabetic, you know, and you really want to do an experiment, I don’t recommend it. But if you’re not eating fruit, and you just tried it, and I tend to tell my patients, no fruit is essential to life. I doubt Eskimos eat a lot of fruits, some of those tribes in Africa, Mansi tribe, etc. They don’t really eat fruit. So it’s not essential to life. But if you decide to experiment, you know, let’s compare a blueberry to the pineapple, and it’ll probably be a substantial difference. So if you eat fruit, you need to at least be aware which one has the biggest effect which one has the most glycemic effect. In other words, that peak of sugar and and I think we just need to continue to educate ourselves. But But I think the key is to do your own experiment. But the big picture is, the steak probably won’t raise your blood glucose much. I mean, I literally ate baked chicken for lunch, and I was kind of bored during that experience. I didn’t do anything with it. Yesterday I had steak for lunch. Now my mom would have had a fit if she knew her baby boy was not eating his vegetables with his lunch. But what I’ve learned is that when I eat my steak or my chicken with the skin on, what I find is that I feel phenomenal. I’m recording with you after lunch, I’m not tired. If I had had something starchy or sugary, I would be asking for coffee, just to get through this interview. And who wants to live like that? Who wants to have lack of mental clarity when they’re in my position? Having a conversation or just talking to a patient who’s in this exam room with me and not able to hear them? There have been times when I lived in my previous life with all those types of foods when patients are like are you okay Doc? Come in. And I’m sitting there falling asleep during the interview and it’s not a great way to practice this profession. So so I do agree with you that what I see here just as a glance, it’s it concerns me because it seems like the emphasis is not on the things we should be concerned about.

Diana Rodgers, RD  18:55  

Yeah, and I was actually in Zurich at a meeting with Eric Westman and a bunch of folks and actually Dr. Mozaffarian was there and said, I think that butter is actually neutral but yet on my I’ve got just a few I’m going to rattle off some of the scores with some of the foods. Yeah, butter got an eight. So I’m going to start at the top. Tomato juice was 100. Cheerios was a 94. Bananas 83.

Dr. Tony Hampton  19:22  

You said Cheerios was a 94?

Diana Rodgers, RD  19:24  

Cheerios a 94. I’m going to keep going. Dates were 76. Instant oatmeal 79. Potato chips 59. Canned tomatoes in heavy syrup 51. Organ meats 44. Eggs 39. Cheese 34. Bacon 31. Beef 24. I don’t even know how that one happened. Like Like I don’t have a problem with bacon. But I don’t know how bacon got above beef and unsalted butter 8. And I actually did just a few minutes ago get a response from the lead author Dr. Mozaffarian. And he said that he didn’t he didn’t respond to the potato chip comment, but he did say that there’s no nutritional value in meat.

Dr. Tony Hampton  20:13  

Wow. Okay. 

Diana Rodgers, RD  20:15  

And so my response was, wow, because I thought B12 and iron were the most common nutrient deficiencies worldwide. He did try to pull on me in an interview one time that you shouldn’t need heme iron, because of, you know, familial hemochromatosis, which is a super rare condition that that’s like saying the whole world shouldn’t eat gluten just because of celiac disease. And speaking of gluten, all of the refined pastas and everything were super high rated, of course, compared to nutrient dense foods, like meat products, and all animal source foods.

Dr. Tony Hampton  20:52  

It’s amazing because even in my nutrition training, which at times can be biased towards plant based, right, they have to admit that hard to get B12 if you don’t get it from, you know, animal source. You know, the anti nutrients in plants make it difficult to sometime absorb some of the nutrients.  You need to get you need a little zinc, you need a little iron, you need a little selenium. All of these things that you’ll find in abundance in protein. Oh, by the way, my patients, they always say Doc, you know, I’m not having as many bowel movements, I say you don’t need any, because you’re absorbing nutrients out of your meat and all that a fiber that you’re not consuming doesn’t, you know, you don’t have to get rid of that now. So as long as your bowel movements are normal, you’re okay. And yeah, the nutrient value of protein, I would argue maybe organ meats are a little higher than just beef. But to imagine I think you said organ meats were like had a low number. Are you kidding? That’s probably the most nutrient dense food that I can think of off the top of my head. And you’re going to get so much more nutrition from steak as an example. And and that’s really bizarre what I think the most bizarre thing that you mentioned was Cheerios being in the 97-98 range. That’s pretty perplexing, because it’s a highly refined grain and it’s so poor and so nutrient poor, you know, they have to fortified have to add the vitamins back to it. So why would that make more sense than the the natural products that have these nutrients already in them? And I would argue, if you add to these so called nutrients back is your body going to really appreciate that because it’s not in its natural form. And what I’ve also learned in my nutrition training is that a lot of these things have to work together in concert. And when you start adding, it’s almost like, eat what you want. And just take this multivitamin. And by the way, that’s synthetic. So you have this synthetically made nutrients that they add back to the cereal as an example, and your body’s like, not not a big fan. And that’s why when I do a lot of these studies on vitamins, they find that the actual benefit doesn’t exist, because most of the vitamins are synthetic, and your body doesn’t quite know what to do with that. So So I think, you know, obviously, eating whole foods is the first answer, eating real food. And then you try to go beyond that and try to you know, if we can raise our food in a way that’s ethical and, and that’s good for the planet. That’s a better approach when when possible. And I just think that as I work with my patients, I’m always trying to give them okay, let’s start simple, let’s get rid of the seed oils. Let’s get rid of the processed food. Let’s start cooking. And let’s move towards a model where food we gather, we have fun with food, we, we enjoy it, and we cook enough for two or three days. We keep it so what I try to do with patients is keep it simple. And and use a little common sense. And for the most part, if it’s in a box, it’s going to be processed, and it’s probably not the best choice. No matter what stamp is on this the Cheerios box. That stamp may not really reflect what’s good for the individual. And again, go back to that experiment. Let’s look what our continuous glucose monitor says, when I eat my cereal, is that gonna make it go up? Make it you know, and the answer is most of the time, it’s not going to be favorable, because as soon as it gets in your body, it’s sugar to your body. It’s quick energy. And unfortunately, that one teaspoon of glucose is floating around that your body can tolerate is going to be superseded, and it’s going to cause inflammation. And that inflammation affects my nerves in my feet. So now I’m at risk for amputations. That inflammation affects my glycation or inflammation affects my kidneys. So now I’m at risk for kidney failure. It affects my eyes. I’m now at risk for diabetes and affects my arteries and I’m now at risk for heart attack or stroke. And that’s a lot of things that diabetics have to worry about. But at the end of the day, your body doesn’t want all that sugar. It just can’t tolerate it. And that’s why we have to remind people, instead of depending on the medicine to somehow support you, when you eat the wrong foods, let’s do the flip of that. Let’s eat the right foods. And then you won’t need the medicine. And it’s not a big sacrifice to eat steak and chicken and ribs with no barbecue sauce. It’s not a big sacrifice. It’s not a big sacrifice to eat some bacon, sausage and eggs in the morning. That’s not anybody on this episode watching who prefers grits, oatmeal. Have at it. But bacon, eggs and sausage, knowing that it’s not harmful, is actually a pretty tasty option. So it’s really not hard to make the transition once you understand these things are not harmful. And now we have plenty of evidence that was done the right way that things are safe. And I’ve never felt better. I’m 53. And I feel like I’m 33. The energy is there. The mental clarity is there. And there’s really, it’s kind of hard to imagine going backwards to that old life where you just didn’t feel good. Yeah.

Diana Rodgers, RD  26:12  

Grits are my kryptonite, I love them. They send me straight into diabetes, even a very, very small portion. And it could be you know, for me, maybe maybe for others, it doesn’t. And it could be maybe I just have this sensitivity to the corn. And that’s why these continuous glucose monitors are so useful, because people are different. And what might spike me might not spike you. There’s a couple things you mentioned. And I and I definitely want to also talk a little bit more about communities of color and your experience with recommendations towards them. But firstly, I also just want to address one thing they didn’t address about the protein. And that’s just the satiating quality of protein, right, which wasn’t considered in any of their metrics, right? So they have, you know, all these different metrics that they were looking at, but out in the wild outside of a controlled experiment, which there aren’t many in nutrition, and I want to talk about that next, how they do nutrition studies, and what they based these recommendations on, which is kind of BS, right? But protein is the most satiating of the macronutrients. And so meat not only has B12, but it’s the it’s one of the lowest calorie ways that you can fill yourself up. And so out in the wild, when people you know, have especially during COVID, they’ve constant 24 access to their fridge. People eat to satiety. And so if you put a bag or even a box of Cheerios in front of somebody versus a steak, what’s going to make you feel more full a couple of hours later, it’s the steak. And so saying that meat has no nutritional value when you’re not considering the fact that people are hungry. And they need to be satiated, in order to stop eating, I think is really irresponsible.

Dr. Tony Hampton  28:05  

Yeah, it doesn’t really make sense from a biochemical perspective as well. And you know, if you think about the, the Cheerios it’s pretty much going to have to depend on getting it’s energy via using glucose. And if you do the best you can with that glucose, you’re probably going to end up going through the mitochondria, citric acid cycle and electron transport. When you finish that process, you’ll get about you know, anywhere from you know, 32 to 36 ATP. But instead if you are stuck, unfortunately with a steak right, and you depend on that you’re gonna have a couple of ways to you can use gluconeogenesis to, you know, take protein and break it down into a form of glucose. But But the thing that people miss is when you have fat in that steak, and you use fat as a source of fuel, through the process of beta oxidation, you’re able to take those long chain fatty acids and if I use 16, as an example 16, you know, carbon chain that will break down instead of like 32 to 36 ATP, you’re looking at about 134 ATP or forms of energy so and that’s adenosine triphosphate. So my point is this, you’re going to get more energy out of it. And anybody who tries to eat two or three steaks, good luck, right? Your body has the ability to you know, hormones like leptin, help to let us know we’re full. And so when you eat processed food, it doesn’t really trigger those hormones as well. And even if it attempted to, some of it depends on how your stomach kind of swells a little bit right? And the volume that is created from a steak is a lot different than… because when you put Cheerios in your mouth, it’s just it’s just going to dissolve So it’s not going to really create a lot of volume in your stomach. So I think there’s multiple biochemical mechanisms to explain this. But yes, when I ate my meal for lunch today, I’m pretty much going to be good. And I do drink water. So I don’t get thirsty, you know, and a lot of times thirst and hunger get confused. But absolutely, it is better for people to naturally feel a sense of satiety, simply by eating foods that do that, which then lead to I don’t, I barely prescribe appetite suppressants, because most of my patients naturally have, they don’t get hungry. And some of that is because that fat that I just described via beta oxidation, there’s after they’re finished with the steak, their body will then say, well I need more fat because you’ve turned into a fat burner. And lo and behold, most of us have a little belly fat, so so I can go to the belly fat, and continue to feed on that, where your body doesn’t really store starch. It doesn’t have a little Cheerio section in your body, or, hey, so so you tend to have to get that outside of the body. So I think that how we educate people will then lead to them eating in ways that’s easier to adapt to. And then all that guilt and, and frustration that they normally would feel goes away. Because when you eat the wrong foods, it makes you hungry in a couple of hours, and then you’re you’re literally fighting starvation, as opposed to just going through your day. And and the last thing I’ll say fat is such a good source of fuel. So it’s less problems with mental fog. And so you’re not only feeling full, but you’re just alert and sharpened. And I think almost everybody, we’ve been our community, low carb community, that’s one thing, they all say. Their mood’s better, their mental clarity is better. And that’s something we really need to have if we’re going to help people.

Diana Rodgers, RD  31:57  

Definitely. And so let’s just talk briefly about these observational studies and what they can and can’t prove, because clearly, even the folks making these recommendations are convinced that meat causes diabetes, I actually, I don’t understand how that works. So what we what can we learn and what can’t be learned from these large population studies?

Dr. Tony Hampton  32:23  

Yeah, well, I would have no problem with observational/epidemiological studies, which essentially lead to food frequency questionnaires as an example being sent to people. And then they have to answer questions, they’re not really given an option, they basically have to answer the question. So you know, how many blueberries did you have in 2020? How many steaks did you eat? How many ounces? You know, if they even know what an ounce is? So they, they’re forced to answer these questions, then they send the surveys in. And these surveys, these types of epidemiological studies are cheaper than your traditional randomized control studies. Because you’re just sending a survey, and people fill it out and you send it back. And the, what they call confounding variables are things that may or may not be present. So is that person who someone who exercises who ate those blueberries. Is that person, someone who smokes who ate those blueberries. Is that person, someone who’s you know, under a lot of stress, whatever the confounding variable is. It doesn’t really factor in any of that. And so what happens is, if we don’t have any other types of studies, we’ll use those studies to see if there’s an association, or a correlation between what we just surveyed or observed and some type of medical condition or disease. And that’s okay, if you don’t have any other types of studies. Now, the good news is, particularly when it comes to comparing low carb to low fat, they’ve done a ton of studies, people like Dr. Eric Westman, who you actually were meeting with. He’s been doing this since 2002, if I recall. And so we have plenty of studies that are double blind, randomized control trials where we know exactly what people are eating to the extent we can. We know what those confounding variables are. And we’re really comparing things in a way that’s like a scientific study as opposed to surveys. And if we do have studies that meet that level of quality, it would make good sense to at that point, if you’re looking at epidemiological study, and then you’re looking at a randomized control trial. It’s an interesting fact about what the you know, studies shown in some of those studies are retrospective where they look at a group of people and you go backwards a certain amount of months or years. And then some are prospective where you go forward into the future but but the bottom line If you can, if you look at those two options, you always choose the randomized control trials, because it’s a little bit more scientific. I know the public health collaborative was able to put together some of the comparisons between low carb and low fat. And when it comes to significant weight loss, it was I think it was like 36 to zero where there was 36, low carb studies that beat the low fat studies, randomized control trials. And then I think when it comes to greater weight loss, it was 58 to seven. So we don’t really have to have a long discussion about is the data out there, it’s there. We don’t have to argue about which study types are better. So once you get that information in front of you, so if people are listening, if they just say, if they just type in, you know, low carb versus low fat, they will find studies that show that the mortality is higher on a low carb diet, but what they don’t with it, but what you have to do is, is it a randomized control trial. I can pretty much guarantee you it wasn’t if it said that. So there are some old studies that show that there was this correlation. But when they did the right kind of studies, it cleared up the confusion, and it showed that there was no harm with fat was no harm with meat, etc. And it’s so reassuring, because you know what, when I was a vegetarian for eight years, I missed my bacon, right? So it’s nice to be able to speak to that in a way that because I don’t want to make any recommendations that are harming my patients. The biggest thing I struggle with, and it’s last thing I’ll say, is my I still struggle with having this conversation with my colleagues. And I don’t think they’re there. They’re kind of once they hear the old studies, they can’t look at the new studies with a fresh eye. And that bothers me because I’m like, Well, why wouldn’t they do that? I can understand a person who’s really advocating for animals, and they don’t want to see animals harmed, and that’s absolutely understandable. But if you’re just focused on what’s best for humans, I struggle to understand why they can’t look at that science and say, Oh, that makes sense. But I will say this, I had a whole class that talked about how to read research studies, right. And I doubt that my clinical colleagues did so they may not even fully understand what we’re talking about right now. So they just look at the abstract. And yeah, that’s the problem. So you know, that’s why we have to continue to educate. And I’m being respectful as I talk about my colleagues, they just don’t have that basic knowledge that I’ve been able to garner.

Diana Rodgers, RD  37:35  

It was hard for me to become a dietitian because I went back to school, you know, it, I’m glad I did. I’m glad I didn’t become a dietitian straight out of undergrad when I didn’t know much about eating real food. And I it’s really hard to unlearn something that you learned. But one of the only benefits I had of my training as a dietitian, was a class that was required by the school I went to, in how to break down a scientific paper. We had to do our own systematic review. And that has allowed me to do so much better research and writing because of that. So there aren’t a lot of people that do. I think Chris Masterjohn offers a class for the average person on how to break down the paper. So I haven’t I haven’t looked at it, but I but I know what’s out there. And folks can just maybe Google that. So the last thing I want to talk about, and I think we talked about this briefly a couple weeks ago was communities of color, this idea of heritage diets, and also just what folks are facing that, you know, the majority of dietitians in America are white. They often come from a background with an eating disorder. So all foods are okay, everything in moderation is the general recommendation. And, you know, more salad more salad, more salad. That’s kind of what I’m hearing. So how, how are we failing? And and then also, if you had a chance to with these, these heritage diets, which for populations that have been historically restricted meat, how does that kind of play in?

Dr. Tony Hampton  39:16  

Yeah, well, I the first thing I do with my patients is I I tried to meet them where they are so I there’s a lot of pushback, if a person perceives that what you’re recommending is not culturally appropriate for them, right? So I have a little bit of an advantage if I’m talking to an African American community because I’m you know, from that community. And my wife’s from Mississippi, my mom’s from Arkansas, and those are the southern states that are known eat, we know what we call soul food. And although that may have that term may have come from music back in the day, and it kind of migrated towards food it’s something people take A lot of pride in and they’d take it very seriously. So you have to sort of first thing is to understand, you know that that means you have to be careful, you have to do culturally appropriate recommendations. When I think about going back to, you know, 1500s or so when slavery was a thing, it’s, it’s clear that a lot of the foods that are commonly eaten are things that are from rations, right? So if you’re not clear why a person of color favors ribs, well, because that’s all they were given. If you’re not clear why a person of color may eat chitlins, or pig intestines? Well, that’s all they were given. If you’re not clear why you may see some pig feet in those greens well, because that’s all they were given. So a lot of those things are culturally important. And even if you go to chicken, which is kind of funny, I think about Roots and Chicken George and well, that was the only food that we could actually… the only animal we could own, right. So So of course, in what you eat, you become fond of, right? So I think that some of it is understanding the historical perspective. And and all I do is I let them have their ribs. I just say can we work on the Sweet Baby Ray part? You know, can we work on the sauce and then I’ll literally put the label in front of them and say, let’s look at the ingredients. And you’ll see fructose corn syrup. You’ll see you may see tomato paste shockingly in there, which is good. But then you you’ll see sugar, molasses, pineapple juice, and you’ll see 18 carbs for every two tablespoons. So what I do is say is it possible we can smoke these ribs like they did back in the day and make them so good that they fall off the bone, right. And you can still have your ribs so so what I do is I give them an approach that aligns with their values. And this is the part that’s really crazy. Most soul food is actually low carb, I mean greens are low carb, right? Okra, which is something we really ate a lot of going backwards a little bit. That’s very low carb. So what I do, as I say, you can still eat these things, you can still put your turkey neck in those things, because that’s not going to harm you. It’s the cornbread, right? And so and then you have to distinguish between, okay, so these some of these foods are heritage, you know, related, like okra, you know, as an example. And some are cultural, and more like maybe African American, what’s been going on here, but it’s all kind of connected. So what you say is, for the most part, you can eat most of the things you enjoy, we’re just going to create some nuance so that you can eat things just slightly different. So if you like we use when I went to school in New Orleans, you always will see okra in the gumbo, right? And all I would do is say do you think it’ll really matter much? If we did, if we did cauliflower rice instead of regular rice, and they realize rice don’t have a taste? It’s that other stuff, right? So what I’ll say I said, Let’s want you next time you make gumbo, how about if you instead of using you can make your rice for your family but have a little side version of it. Or even better who said you have to add rice at all? When I eat gumbo, I’m not really looking for the rice, I’m looking for the other stuff, the Italian sausage and all that good stuff. So So my point of it is I try to help people, I try to understand the past just enough so that when I’m making advice to my patients, I’m able to give them align with what they believe in their belief system while tweaking a few things. And when you tell the average patient I see that it’s okay to continue to put meat in their greens, they’re actually surprised by that. They think that that’s the thing that’s hurting them. And I’m like, No, that’s what’s going to save you and make those that dish healthier for you and richer for you. So so I really believe that almost any culture can find a path to eating better it’s just you have to know just enough about it. And it just starts with just asking them so what are you eating? What did you eat yesterday? That’s all we have to ask and then we can and then you just find a couple of areas to change. Give them something, eat this a little bit less of that handout, and then most people come back. I’m shocked at the number of patients just this past Monday at least half of my patients had achieved some weight loss since the last visit and that’s like half in one day. And that’s not an unusual experience in my clinical practice. That would never happen in my past practice where I did not focus on lifestyle. So so I really appreciate the question because I think if we know our clients just enough, it’ll they’ll they’ll help us help them move towards a better diet.

Diana Rodgers, RD  44:54  

That’s great and it’s so much better than you know putting a plate and saying we’ll just have a little less right because some of these foods That are hyper palatable. It’s really hard to say no, you know, like, you start eating cornbread. And it’s kind of if there’s no off switch for that, then it’s hard to moderate where if you just kind of fill up on the nutrient dense stuff, and everyone has part of their diet is nutrient dense in some way, if you can just

Dr. Tony Hampton  45:19  

There’s something about cornbread. It’s like, it’s like cake. I mean, honestly, it’s no different between cornbread and cake, right? Especially if it’s Jiffy. Right? So why is it that we can eat dessert when we’re full at the end dinner? Well, because it’s Jiffy is sweet, and it’s gonna, it’s going to trigger the dopamine and the all that euphoria that comes with that type of food. So you will override your hunger to get to that euphoria that dopamine, that beautiful feeling. If you eat the cornbread, which is nothing but cake, then you will tell your body, I can eat more. And so putting a little corn bread on there, it’s gonna let you eat more food. And that’s what and that’s a problem. And so I think for most of us, it’s best to not go there. Unless you’re you know, you’re not processed food addicted. And you’re just going to break the rule because it’s the holidays and, and your favorite is going to have a fit. But if that’s not the case, it’s best to not put yourself in that position. Because trying to overcome those temptations are very difficult.

Diana Rodgers, RD  46:28  

Yeah, totally. People get really nervous when I talk about pushing away things like cornbread or pasta and they ask me well, is this going to be forever and they start panicking. And you know, I definitely talked to them about you know, there’s Thanksgiving, there’s, you know, you can have a little bit during these things and probably be okay, it’s just the daily impact that they have,

Dr. Tony Hampton  46:51  

Right. And they just need to know that if you’re if your goal is to be metabolically healthy, and we’re not treating seizures, we’re not treating like, you know, some neurological disease. So it’s okay, to every once in a while to get out of ketosis or not be at the level of carb restriction. Assuming you don’t have an addiction. Now, if you’re addicted, you’re going to be triggered and it’s trouble, right? So I think it’s all about individualizing, who you’re talking to. They have to be honest about how they react to these things, I can resist things. However, I don’t keep skinny popcorn on my counter, even seeds and nuts. Once I start, I’ll just I won’t stop. So you have to know what your triggers are. And be honest about it. And if you’re gonna cheat on ice cream, it’s probably better to go to Oberweis or some ice cream place and not bring it home. And that way you have it one time you broke the rules that day you enjoy it with your family, and then you go home to your safe space. And you won’t have to worry about it.

Diana Rodgers, RD  47:55  

Well, it’s funny because I when I was becoming a dietitian and I know we’re getting short on time, but I wanted to mention I did I sat in on an Overeaters Anonymous meeting just to see how they how they went and it was you know, they practice abstinence. You have to identify your triggers and what sets you off. But folks would literally drive to the store and you know, buy a sleeve of Pringles or Oreos, and they’d be gone by the time they got home. Or they’d come home and bake an entire cake for themselves and eat it. And so so it is pretty dangerous baking, you know, for folks, because then you got 24 of whatever it is, instead of just going to the store and dealing with it. And that’s been one of the cool things about wearing this monitor. So I’m like, Well, I want to find out what the ice cream is doing to me, you know, and a little bit of ice cream after a meal is like doesn’t do anything actually amazing. Nothing like I have no spike at all. But then I tried it I was out in Michigan and I went to a dairy middle of the afternoon empty stomach. And you know, I’m testing a few things just to see. It was the highest I’ve ever rated. Wow. Yeah. So anyway, I highly recommend you try one of these just, it’s really cool.

Dr. Tony Hampton  49:08  

I am. What are what when we have a pharmacist as a wife, I should have access to it. Yeah, so definitely, we’ll be doing that. And I appreciate you because I again, part of our journey to teach people is to kind of experience some of this stuff ourselves. That really adds a lot of nuance and value to your recommendation. So I definitely plan and then may and maybe there are some things like my… the last thing I’ll say about that is my experiment is going to focus on these so called keto desserts. And is it really true that when I use this monkfruit, stevia, and God only knows these sugar alcohols, will my body respond favorably to that in a way that’s advertised. So so it’s gonna be interesting to see what happens with those items as well.

Diana Rodgers, RD  49:57  

I’m very curious to and I almost wonder If it might drop you hypo right, because your body thinks it’s getting insulin or glucose, and then I don’t you know, I’ve heard of that. But I don’t know if that’s true with diet soda. So I’m curious to hear. Yeah, let me know.

Dr. Tony Hampton  50:13  

I’ll make sure you know.

Diana Rodgers, RD  50:15  

Awesome. How can people find you?

Dr. Tony Hampton  50:18  

Well. I think… I do have a website, Doctor Tony Hampton dot com. And it’s spelled doctor entirely. And my big focus is that, you know, is really the YouTube channel where I do share my podcast as well. I just find that my patients what’s interesting about my community of color, a lot of people don’t do podcasts on the podcast app. So for me, I have to make sure it’s on YouTube as well. And that way people so that’s, that’s where I would really focus for those who want to listen to me, I tend to have experts like yourself and others that I interview and talk to, but I also will be making videos just me talking about a particular topic. So I’m looking, I just made one while I’m gonna talk about the lottery because my ROPE acronym, relationships, avoiding organisms and pollutants that harm you, making sure you protect your emotions and your life experience. I’m gonna talk about how your life experiences can harm you. But I’m going to use the lottery as an example. And contrast $5 a day in a lottery 47 years later, what would what would that look like? And you would be rich already. And so is our life experiences affect our dietary decisions like cornbread. Our life experiences affect our ability not to have generational wealth. And so my goal is to make people think outside the box, and if they’re 75, and they can’t, you know, have 47 years left, maybe that 18 year old and family will, and that’s my goal. Instead, let’s teach that person how to make sure the next generation doesn’t have to worry about money so much.

Diana Rodgers, RD  51:50  

Oh, that’s great. I love it. Awesome. All right. Well, thank you so much for your time out of your day. And yeah, it was really great to chat with you. Good luck with everything. Let me know how the glucose monitor goes.

Dr. Tony Hampton  52:02  

Oh, yeah, you I’ll make sure you know, and thank you for having me today.