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Travel for GFJA is in full swing again, so I am headed to Australia this week. While I’m there, I will be meeting up with my favorite Aussie health influencer, Dr. Pran Yoganathan, so I wanted to feature our previous episode together.

Dr. Pran Yoganathan is a gastroenterologist based in Sidney, Australia. As the director of The Centre for Gastrointestinal Health, he is taking a unique approach to achieving health for his patients.

Dr. Yoganathan sees people fall victim to “modern lifestyle” diseases in his practice, which are those brought on by a low protein, and the hyper-palatable food landscape coupled with a sedentary environment. In treatment, his guiding principle is “let food be thy medicine,” and assesses the lifestyle of patients to determine a course of action with a team that includes accredited dietitians. 

I met Dr. Yoganathan through his Instagram feed which is filled with entertaining, educational, and sometimes controversial information about nutrition and health. Be sure to check it out and give him a follow. You’ll be glad you did.

Our conversation today is insightful and brings attention to the role your environment and circumstances play in your health.

Listen in as we chat about:

• Pran’s background and what led him to medicine
• America’s global exports: the dietary guidelines and hyper-palatable foods
• How the current approach to healthcare is disease management
• The problems with nutrition research
• The Corporatization of food
• The problems with plant-based diets
• How poverty affects health
• The effect of immediate gratification on health
• GI conditions as a warning sign for metabolic disease

 

Resources:

Centre for GastrointestinaI Health

Celiac Center for Research

Walter Willett

Global Food Justice Alliance

Vegan Fridays in NYC

Protein Leverage Hypothesis

Dietary Guidelines for the Brazilian Population

 

Connect with Dr. Yoganathan:

Website: The Centre for Gastrointestinal Health

Instagram: @dr_pran_yoganathan

Facebook: dr_pran_yoganathan

 

Episode Credits:

Thank you to all who’ve made this show possible. Our hosts are Diana Rodgers and James Connelly. Our producer is Emily Soape. And, of course, we are grateful for our sponsors, Global Food Justice Alliance members, and listeners.

If you believe in making sure that people all over the world should have access to nutritious food, please join my mission through my non-profit, the Global Food Justice Alliance. All sustaining members get early access to ad-free podcasts plus free downloads, and you’ll be helping get healthy protein like meat, fish, and eggs to food-insecure kids. That’s sustainabledish.com/join.

 

Transcript:

Diana Rodgers, RD 

Welcome to the Sustainable Dish Podcast. I’m Diana Rodgers, a real food registered dietitian, author, and sustainability advocate. I co-host this podcast with James Connolly, who was a producer on my film Sacred Cow. I also founded the Global Food Justice Alliance, an initiative advocating for the inclusion of animal-source foods like meat, dairy, and eggs for a more nutritious, sustainable, and equitable worldwide food system. You can check it out and join me at global food justice.org. Thanks again for listening. And now, on to our show. 

Diana Rodgers, RD   

Hi, everyone, Diana here, and because I’m doing so much travel for the Global Food Justice Alliance, I’ve dipped into the archive and selected some of my favorite shows for you in order to keep my content flowing on a weekly basis. If you’d like to keep up to date on the travel and advocacy work I’m doing, please join my growing Patreon community. You’ll get access to a discussion community, ad-free podcasts, exclusive interviews, and you’ll be helping to spread the word about the importance of livestock to our global food system. Visit sustainabledish.com/join, and thank you so much for your support.

Diana Rodgers, RD 

Welcome back to the podcast everybody. I’m so psyched today with me. I have Dr. Pranyoganathon. Is that close enough? I’m sorry. I think maybe I even said it more accurately before we got on the air.

Dr. Pran Yoganathan  

That’s fine. Very close. That’s all right.

Diana Rodgers, RD    

Well, so I met him on Instagram. And I’m a huge fan of his Instagram feed; it’s pretty cool to see another medical professional, especially a doctor –  a GI doctor, talking about crazy things like diet. So I’m so psyched to have you straight from Australia. And I love everyone’s origin story. I always love to kind of go into that first. So why did you become a doctor and specifically a GI doctor? And then how did you get into this whole sort of crazy alternative way of thinking that, you know, maybe we shouldn’t be eating so many processed foods?

Dr. Pran Yoganathan   

Sure. Thank you. Thank you for having me, on your podcast Diana. And it’s a pleasure to finally catch up with you. I’ll give you a little bit about myself. I am originally from Sri Lanka, which is a country in Southeast Asia. I left that country very early on in the peace and my father took us through Africa, and we lived in a couple of countries in Africa then ended up in New Zealand and I did all my medical training and high school years in New Zealand actually. I’m located now in Sydney, Australia, where I’ve worked for the last 20 years. But going through medical school, I was fairly early on in medical school, I think I was about 16 When I entered it, so I entered it very, probably very immature. You know, I’ve been sort of pushed into medicine rather than an actual passion. My true passion was mathematics. And I’m a very objective, pragmatic type of thinker. I think a mathematical mind kind of leads to that type of analysis generally, and a lot about medicine, when I was going through medical school didn’t kind of make sense to me, it was… I was always uneasy with it. I think really clicked for me in third year of med school when we started doing clinical work, which is that we were allowed to go into the hospital and meet with patients. It started making sense to me then, and I think I started enjoying it more because you saw the actual, practical side of healthcare rather than just the theory. But I can tell you as a doctor going through that six, six and a half years of training, very little attention was paid to that nutritional aspect of it. And we were told and then we were told very quickly on that almost all modern illnesses are created by the modern lifestyle, yet there was just very little focus on the lifestyle, they talked about the importance of non-sedentary behaviors that we weren’t taught how to action that and what constituted non-sedentary behaviors. We weren’t really taught diet. And to me the diet that was really pushed was obviously the food pyramid, I think which we’re all familiar with the USDA Food Pyramid, which is America’s sort of global export, and it’s been assumed everywhere and the food pyramid to me didn’t really sync up to what humans have kind of eaten for millions of years. Because I had a very, very big passion for kind of understanding our history. And I spent a lot of time studying papers on that even though it wasn’t really relevant to my medical degree at the time. So coming out as a junior doctor. I mean, you see a lot of illness, it’s it really is quite overwhelming. As a young doctor, you see a lot of chronic illnesses. And as you progress through the ranks, you see a lot of futility of care as well where all these enormous resources are thrown at people that some of them sadly don’t even know who they are because they’ve got dementing illnesses and I just saw a lot of honestly, I wouldn’t describe it as cruelty but I felt a lot of patients were going through things that they may not necessarily would have wanted to go through, driven a lot by hospital protocol, doctors preferences, and families guilt that they were, you know, sort of passing on. So, given that I, about five years ago, when I was about 35 years old, when I started sort of suffering probably early metabolic syndrome, Southeast Asians are sadly predisposed to diabetes and we tend to develop metabolic syndrome at a very low body fat percentage. My father, who’s a diabetic, type two diabetic, and all his brothers that died of coronary artery disease before the age of 60. Most of them will go on with metabolic syndrome. I decided I kind of didn’t want that for myself. So I fell into a bit of a rabbit hole, sort of like Alice falling into that hole and just discovered a different way and of doing things and not all of it is being led by traditional healthcare models, like having followed people like yourself, and many others in this space, who kind of opened my eyes. I think, initially, I went down that low carb, lifestyle, and then eventually more down that whole foods pathway, which is where I am now. And the lesson that I’ve kind of learned from what is really the food is almost everything in terms of generating health. And exercise follows that very, very closely, which seems to be a radical way of thinking in the healthcare industry, which blows my mind. I think you said it best when you put it up, I think it was a post that you’ve done, I think you quoted someone when you said you got the healthcare industry that doesn’t care about food, and I’m paraphrasing here, but and then the food industry that doesn’t care about health, I think that’s perfectly said.

Diana Rodgers, RD   

Yes, oh, my goodness, I took so many notes. And I relate so much to so many things you said and I mean, I got into this with undiagnosed celiac and metabolic syndrome. And so why, I mean, particularly for GI doctors, I find it fascinating that so many of them are still… I have a good friend who was at a major hospital here in Boston, we have some of the best hospitals in the world. She was in one of the best. She had ulcerative colitis. And the doctor said, Well, you can change your diet if you want, but it’s really just we’re gonna have to do a resection to a woman who at the time was about 30. And it’s very rare that I find a GI doctor… I mean, maybe ones who deal with celiac, I did a rotation at the Celiac Center for Research and you know, we were talking about gluten-free diets and things like that. But it’s very rare to find a GI doctor that actually believes that food. I’m almost laughing because it’s just so ridiculous that food… I mean, especially for GI, right. Why is it so radical?

Dr. Pran Yoganathan   

I think it’s important to kind of look at that. And I’ve spoken on this before a lot of my posts are extremely political and polarizing. But the reality is, I’m saying the truth from my perspective, I guess it polarizes people. But you know, I’ve got to be honest to myself, and the reality is, Diana, we’ve got… and you know, we’ve heard of Eisenhower’s military-industrial complex, right, which he warned, when he was the outgoing president, there are on that. We’ve got the food pharma medical complex, you know, it’s this triangle which, sadly, I think we’ve been, it’s been infiltrated. I think disease is so profitable. And really, we’re kind of indoctrinated as doctors, from a very early stage that it is, we’ve got to practice evidence-based medicine and evidence-based medicine largely is keeping on top of these new medications that they keep bringing out. It’s almost impossible to do it because there’s hundreds, if not 1000s of papers every year, that are being generated on newer therapies. And now we’re in this realm of biologics and so forth. And the way it’s made to look is that diseases inevitable at every stage of life for human beings, but this is not the case. You just have to look at the way these hunter-gatherers and you know, just a more ancient civilizations that lived away, they, they’ve all humans have always lived to see that these people don’t get that disease. And, you know, 50 years ago, even in the developing nations, you could look at the developing nations that said, well look at this, that they don’t develop the disease. That’s until, of course, as I said before America kind of exported its diet globally, and now we’ve got this global pandemic of illness. But it’s really interesting. I mean, you, you mentioned this at medical meetings and straight away the response from a lot of my colleagues as well, they die young, you know, these people die young, which, as we know, is partially correct. I mean, you know, infection is very prevalent in the sort of

Diana Rodgers, RD   

And infant mortality, right? 

Dr. Pran Yoganathan    

That’s right. Infant mortality. And even in the developing nations, that’s the way you know, like a lot of them die of just drinking contaminated water. But that’s, again, a function of kind of their civilization, and poisoning has nothing to do with chronic illness. When I’m talking about chronic illness, I’m largely talking about obesity, type two diabetes, hypertension, ischemic heart disease, or heart disease, strokes, gout, and the list goes on really… Alzheimer’s, dementia. So we become accustomed as in the medical industry to assuming that, well, disease is inevitable that is going to occur, regardless, and we need drugs to combat that. But really, very little attention is being paid to the preventative model of healthcare, which I think is where the true answer lies for a lot of people.

Diana Rodgers, RD  

Right. And so you were talking about how America is exporting our horrible way of eating to the rest of the world. And it really is true, and a lot of people have also sort of implied that it’s like colonialism through junk food, really. And you’ll even see people who will, you know, it might be cheaper for them to eat their traditional food, but you’ve made it if you can afford American junk food. And so that’s like a status symbol in some countries that I’ve been to. And if you can control a culture’s food, then you can control the people, right? So I mean, this gets political really fast.

Dr. Pran Yoganathan   

It does. And, you know, listen, I love Americans, I love a lot of country music, my family’s, my wife’s family, are American, we might be coming to America, later on in the year. It’s nothing to do with the country, per se. It’s everything to do with this horrible model of corporatism of food, really the corporatization of the food supply in America. Really kind of, I mean, it had its advantages. No one can doubt that right, like, you know, corporatization allows for that efficiency. But then when you’ve got these companies like Nestle and McDonald’s and so forth, the list goes on KFC and everything, it’s more that hyper palatability aspect of it that these guys have really mastered the marketing obviously to every age group and the hyper palatability aspect of it and out on the diet. And I think when you’ve got a global population, that’s kind of protein starved. Fundamentally, that’s this insatiable hunger that what have they got surrounding them America’s export, basically. And then that’s a sad fact.

Diana Rodgers, RD  

So I know exactly what you’re talking about. But some people may not. I talked about this in my book, Robb talks about this a lot in wired to eat. But can you just for the folks that aren’t familiar with this idea, because a lot of people have never maybe heard of it? Or there’s a lot of people out there denying it right, Walter Willett at Harvard, you know, “Mr. Dietary US Guidelines.” We don’t have a problem with protein in the US. So can you talk a little bit about our protein need and what happens when we’re feeding that with hyper-palatable junk? 

Dr. Pran Yoganathan   

Sure. I think there’s this concept out there work that we need to eat to fuel ourselves fundamentally. Okay, that’s step one. Now, fuel… I think most of us don’t realize we carry kilograms of fuel on us in terms of body fat, okay. So people think that they’re eating to fuel themselves and really, we should be eating to constitute turnover. That’s what it comes down to. I mean, you can eat to fuel if you’ve got the activity to support it, you know. We know of you know, guys like Michael Phelps. He was knocking back I think, something like ridiculous 15,000 to 20,000 calories when he was competing. They basically fuel that activity and still managed not to have a very athletic body and a low body fat percentage. It fundamentally comes down to activity. So if we can assume or we can pretty much say that most people in the world now have very low levels of activity, because we got cars and public transport and so forth. And humans by nature, I think are a very lazy species were built to conserve energy in a low energy environment, historically, but now we exist in this high-energy environment. We are drawn to sedentary behavior. We’re lazy, essentially, where you’ve got this situation where people’s protein intake is extremely low. And I disagree with Walter Willet. If you assume that 35% of your daily intake should come from protein, you know, you got America sitting, I think it’s something like 10 to 12% is where their dietary protein is. And I think a lot of that actually comes from plant protein, which is… we know is, I mean, it goes in, but is it absorbed and broken down and assimilated into our bodies as quickly? I don’t think so. I think plant protein is far less anabolic in its ability and its ability to incorporate into muscle protein in particular.

Diana Rodgers, RD    

I mean, we know that because of the amino acid, you know, there are very specific amino acids that are much higher in meat that are and when you say anabolic, that means being able to build new muscle.

Dr. Pran Yoganathan   

Correct. And we’ve got to acknowledge that as a species, our muscle quality has really declined in the last few decades. People don’t realize that there is an epidemic of muscle loss, there really is, and so did this is the issue we’ve come to come to believe that our protein into like, you look at America, they thought of as a big meat-eating country, they’re really not when you break down the figures that their proteins starved. And they’re surrounded by these foods that are rich in carbohydrates and fats, your milkshakes your fries, burger patties, and so forth. But what is interesting, to me is what may constitute a McDonald’s meal, or something similar with milkshake, fries, burgers, and the patty only makes up probably 10 to 12% of the actual calorie intake that yet that meal will be labeled a meat-based meal. And a lot of our nutritional research obviously focuses in on those aspects of it. So this is why a lot of the issues arise from that type of nutritional epidemiology that is used to then make these broad statements that meat’s causing all this disease. It’s flawed from the start. So the point that I’m trying to make fundamentally if you look at it is I’m trying to acknowledge something called a protein leverage hypothesis, which is that when an animal in particular mammals, keep their protein intake low, they are driven to find protein that they’ve got this hunger, but we are replacing that protein with fats and carbohydrates, which are both energy sources. And so we’re just storing this energy, we’re unable to build new muscle. Because of the low protein intake, we’re losing muscle and bone yet putting on energy. So you know, obesity is often thought of as overnutrition and fact that it’s a state of malnutrition. So really, we’ve got global malnutrition on a grand scale. So you can get malnutrition with low energy. Like we’ve seen a lot of these developing nations with these very thin, starved children. There’s are people that have malnourishment in the setting of energy scarcity. And then you’ve got what we see in the developed nations and some developing nations where you’ve got protein starvation and energy excess, basically, which is what obesity is.

Diana Rodgers, RD   

Yes. And so when I go around talking about why we’re not eating too much meat, you know, so in America, it’s about two ounces per person per day of red meat intake, that is not too much. And this whole idea that you know, we’re eating too much, we all need to eat less meat. It’s easy for me to make the case in, like the work I do through Global Food Justice Alliance, in low and middle-income countries, where people may not have the access to all the plant-based foods to make a vegan diet. And perhaps grazing animals might do best in their area. People get it right, of course, don’t take meat away from them. But we need to eat less meat right. And I try to point out that increasing animal-source protein will help not only with malnourishment from low calories, but also the obesity epidemic we have here. Because we still have iron deficiency. We have B12 deficiencies and we have this overconsumption of calories driven not only from seeking protein but also then these foods are hyper-palatable. So we’re just like, we can’t stop eating them. And, you know, one of the major issues I have with the Meatless Mondays campaign, and also now this new Vegan Fridays in New York City public schools, most of these kids are low income in New York City. And when you look at like the meal that you illustrated, the burger, the fries, all that kind of stuff. When you think of what a typical American child eats, it’s chicken nuggets, mac and cheese, pizza, and burgers. And so when we tell these kids that meat is bad, they’re not replacing it with kale salads and chickpeas, they’re replacing it with what? Just more fries. I’ll go and get a Subway sandwich and just don’t put the meat on it. Right. So we’re actually doing a massive, massive disservice. And people don’t understand how absolutely elitist it is to be telling these poor kids, that meat is the problem when anyway… I find it just so incredibly frustrating where this rabbit hole that we’ve gone down, and I’m sure you’re seeing it in Australia too.

Dr. Pran Yoganathan   

Absolutely. And listen, there are people that can thrive on a plant-based diet, I think it’s a low percentage of the population. Humans are amazing, like, you know, the genetic pool was amazing, we’re always kind of prepared for a disaster that requires us to be flexible, right? Like, you know that’s how evolution works, there’s no doubt there are some people that can pull it off on a plant-based diet. However, it is often with the requirement for supplementation. That’s number one. And number two, a hell of a lot of preparation required for that. Right, and what we know about the economics of health for healthcare based economics, the lower someone is on their socio-economic rung less that food is a priority to these people survival is a priority, avoiding domestic violence as a priority, you know, just putting a roof over their head as a priority. So absolutely, it is elitist to expect these people to know number one, what a good plant-based source of protein is, such as soy or chickpeas, and then number two have the preparation to do that. And with plant-based food, I’ll be the first to say that is it is very difficult to make it palatable. So you know, that’s a fact.

Diana Rodgers, RD  

Well, especially when you’re competing with these beautiful fat and salt combos that you get with pizza and mac and cheese.

Dr. Pran Yoganathan   

100%. That’s exactly right. So you can do it. If ideology drives your behavior, and you’re an animal activist or whatever it is of climate change, you can push yourself through it. But naturally, if you take a human in the natural state outside of the ideologies of civilization, a hunter-gatherer, for example, that there’s no doubt what they will, what they will choose if you’re given the option, but then give them the option of hyper palatability. And eventually, you’re hooked onto that, because that’s what hyper palatability is, it’s a drug. So you get these this situation, you know, when most of… you’d have to acknowledge and most of America probably lives right on that border of that poverty line, and you’re expecting these people to pull off a plant-based diet, that’s impossible because food is not a priority to them. And in a lot of these suburbs where these people exist, they are surrounded by the predatory food environment that I’ve described. You could walk into a petrol store and purchase a meal in there, but it’s all hyper-palatable energy. It’s very low-protein meals. And I think this is the situation that we’ve got, we do have the global elite that seem to be pushing this agenda and what their end purposes I’m not too sure, because I think it is going to destroy a lot of health. I think we’ll see the pharmaceutical industry flourish, of course, but you know, economically you just want to have either or this is

Diana Rodgers, RD  

I learned that lesson when I… what you were just talking about. I just want to drive that home a little bit because as a dietetic student, I was working in a low-income area of Boston, I was helping in a store that was selling health food in a pretty bad neighborhood, very bad neighborhood. And they were selling made meals with like steamed rice and collard greens and jerk chicken like culturally appropriate meals for this community at a very low price cheaper than the fast food and they didn’t know why people weren’t coming in, like, we did had no customers, right. And so I went around to these health clinics and asked, Why aren’t people coming in here? Everyone talks about food deserts and access, and here we are, with all this access? Why aren’t they coming in? What can we do better? And they quickly put me in my place and told me, okay, if you have a hard life, and you’re worried about not getting shot and your car starting tomorrow and not losing your job, at the end of a really stressful day, do you want steamed chicken and kale or do you want something that’s going to taste good? Like that might be the cheapest way to instant pleasure that some people have in their whole day, you know, they might be looking forward to and so getting a relatively inexpensive, fast food meal where the kids aren’t going to argue where you know, it’s going to tastes good, you know, on the Maslow’s hierarchy of needs, it’s a privilege to worry about long term health and not getting Type Two Diabetes and all these things. You can only worry about those things if everything else is taken care of, right? If you’re not worried about meeting your mortgage, and you know all these other things that just so many people are worried about because humans only have the capacity to worry about so many things, right? You can’t worry about every single issue there is.

Dr. Pran Yoganathan   

Absolutely, and I’ve made this point before, again, I get into the economics of it to really improve people’s health, you’ve got to kind of pull them out of poverty, but more people sink into poverty. And on top of that, if the messaging the subliminal, well, it’s not subliminal, it’s overt messaging that meat’s bad I mean, makes destroying both your health and the environment

Diana Rodgers, RD  

And by the way, you’re a bad person if you eat it because you’re killing beautiful animals.

Dr. Pran Yoganathan 

That’s right. That’s exactly right. So if you’ve got that sort of messaging, I think you’ve got a perfect storm there where people… it really fundamentally drops in only one way. And then that’s down the hyper-palatable pathway. So you’ll find that a lot of people that are plant-based be in higher socio-economic statuses or where they’ve got more disposable income, they tend to do a lot better than someone trying to build on a low income. It is impossible to pull off.

Diana Rodgers, RD   

And we’ve also seen skewed research there was that paper that came out, funded by the Bill and Melinda Gates Foundation that showed plant-based pregnant women in India do better, better pregnancy outcomes right? And nobody is even pointing out the fact that it’s socio-economic. This has nothing to do with the fact that it’s meat or not meat.

Dr. Pran Yoganathan   

Exactly right. Exactly right. I think India… just to touch on that example since you brought it up. I mean, if you look at a nation that is very low on animal-sourced protein, India is a great example. I’ve got a few billion people there. They’re ideologically you know, the majority religion there is Hinduism and I’m born, a Hindu, nonpracticing. The whole concept behind that is that they’re basically… the cow’s a sacred animal you can’t consume it. Historically was not the case that the origins of Hinduism the cow was sacred because they treasured its flesh, and its milk and, and so forth. But it’s been subverted over these few 100 if not 1000 years to mean that it cannot be eaten. India is a great example of a country starved of animal-source protein. Now, India’s metabolic health is an absolute mess. They may or may not have the obesity rates that the Americans do because as I pointed out before such subcontinental Asians tend to develop diabetes at a lower body fat percentage. So one of these people that huge numbers of diabetes in Cuttack, a city in India, where 35% of them will be diabetic at about the age of 18. Right? We’re talking big, big cities and another 35% on top of that are pre-diabetic, right pre-diabetic, not defined by fast fasting insulin level. Now, if you were to do fasting insulins, on most of these people over 18, you’d find that probably the majority of the population from 90% probably have elevated fasting insulin. So because as you know, for pre-diabetes criteria, fasting insulin is not necessarily criteria to diagnose it, but if it’s a great marker of evolving type two diabetes. So you’ve really got a situation that kind of proves on a very large scale that plant-based eating really hasn’t worked in India, and it was a perfect storm for them, because they think it’s fair to acknowledge that they had massive nutritional issues, and then the Western diet got introduced to them. And that’s when things really amplified in terms of their poor health outcomes. I think something like 60 to 75% of Indians are iron deficient. And that’s including children. I think it’s a huge proportion. So it is very elitist of the Bill and Melinda Gates Foundation to publish that sort of research because it really doesn’t take into account the actual practicality of the issue.

Diana Rodgers, RD  

Right. And it’s so funny, because when I talk about metabolic issues with a vegetarian diet, and the lack of protein, people here will cite well, but everyone’s healthy in India. Like, wow, there’s this romanticism that I think that you know, people who are Hindu, or Buddhist are healthy and more spiritual and better people. That started in England with Pathagarus actually coming back and went vegetarian and thought that that’s what would make him pure, right. Anyway, it’s fascinating to look at all of that. And also, what I tried to point out is you can only have a vegetarian society if you have Muslims to eat the meat from the dairy. You can’t have all this dairy, which is highly consumed in India if you don’t have another group of people who are willing to eat the male cows that are the byproduct of the dairy industry.

Dr. Pran Yoganathan   

Yeah, exactly. Great point.

Diana Rodgers, RD   

I think, I mean, one of the issues that we have, also in America, I think, is this immediate gratification culture, and this consumerism and materialism. I want what I want, and I want it right now. And Amazon Prime, you know, is only forcing that if you can’t get it, you know, waiting a week for something to be delivered is way too long, right? You want it within the next two days. So I think that that also kind of fuels this expectation that I deserve any flavor that I want right now because I deserve it.

Dr. Pran Yoganathan  

Absolutely, absolutely. I think the current culture kind of builds that egocentric model where the kind of the world revolves around the individual and instant gratification as part of that culture, but you can’t kind of blame them because, you know, they’re conditioned for this right… for everything from Instagram likes to Facebook, they’re conditioned for instant gratification. And food is just one part, one facet of that instant gratification aspect of a modern society. That comes at a price, I think, Diana.  One I think is physical health. And secondly, the mental health. And the resilience that goes with it, we were seeing an epidemic of that in our younger age group where they’ve got anxieties and depression and just to name a few psychiatric conditions. But we’re not built for this, this sort of environment… really wants us to almost acknowledge that modern civilization is fundamentally poisoning us not just the food environment, but just this corporatism that’s evolved. And, you know, I admire America. It was built on capitalism, it was free markets. And I think that’s what makes America such a superpower. And look at what they’ve done. I mean, they’ve been responsible for so many developments in human culture, but at the same time, that capitalism, unfortunately, evolves into this accumulation of power, which is corporatism… the corporates, then start running the show. And once the corporate start running the show, you’ve got a real issue because they’ve got unlimited money to throw at advertising and research on how to hook people and this is what’s happened. So to almost get your health back, it’s almost important to unplug from that environment and seek a different way of doing it.

Diana Rodgers, RD   

Yeah, I don’t know if you’ve ever read the Brazilian food policy where they tell people to be highly critical of marketing from corporations, to cook more at home, to teach other people how to cook. It’s pretty cool.

Dr. Pran Yoganathan   

Yeah, that sounds brilliant. I’m unaware of sort of Brazil statistics in terms of health

Diana Rodgers, RD   

Well, I don’t know that it’s made great strides in translation to the public, because the last time I checked, I think they were number one, or in the top three of sugar consumption in the world. So and, you know, as you know, they have a lot of poverty there as well. But the document is really great. 

Dr. Pran Yoganathan   

Oh, that’s brilliant. I agree. I think we’ve got to bring that back. I think we’ve got to reintroduce ourselves to the kitchen. People spend less time in the kitchen I think and really pass that culture on to our children, that joy that comes from cooking a meal, or even just making a simple omelet, you know, which a lot of kids have lost sight of all of that, you know, for them a meal is finish school and walk through McDonald’s and pick up a meal. That’s become normal and normalized. That’s a real pity.

Diana Rodgers, RD   

And actually, a new trend is snacking culture. And we know that like you take the same amount of calories and condense it into two meals a day, or maybe three meals a day, has a very different effect than grazing all day. But that’s what you’re seeing now, especially with my two teenagers. And they’re just, they whenever they want. That’s what we’re seeing now. And it’s setting people up for a much worse metabolic condition.

Dr. Pran Yoganathan   

Absolutely, I mean, as human beings just on a basic physiological level, like, I don’t think we’re meant to graze, I think you’ll look at grazing animals that we see in the wild, where the ruminant or nonruminant and really what they’re trying to do is they’re trying to extract meaningful nutrients, including amino acids, out of food, that’s not all that meaningful, or nutrient-rich, which is basically we’re talking about plant food. So you’ve got to eat for large proportions of the day, to be able to extract the nutrients, you’ve got to have the gastrointestinal tract that’s designed for such nutrient-poor food in terms of the ability to process. And that’s very marked in ruminants, where they have this, you know, four-chambered, stomach, but human beings we’ve got an extremely simple digestive tract. And that’s what I’ve come to appreciate. As a gastroenterologist that really, there’s nothing spectacular about our gastrointestinal tract, it’s extremely simple. Because a lot of the foods that we were consuming over our three and a half, 4 million year history, as a human was extremely nutrient-dense, it was so nutrient-dense, we probably spent 2% of our day eating, versus what we do now, which is spend the majority of it, you know, sort of grazing away because what we’re consuming is nutrient-poor, as opposed to eating nutrient-dense meals, where you’ll find automatically, put emotional eating aside, if you were to consume nutrient-dense foods, through the course of the day, the eating frequency really drops off. And a lot of people find that when they have a lot of our protein that they want to drop their meals down to twice a day with no snacks in between. Again, it’s the messaging around that animal protein’s bad. I think these people are driven to graze, but we’re not grazing animals.

Diana Rodgers, RD   

Yeah. And it’s so liberating when you’re not constantly thinking about food all the time, or feeling hungry all the time. I think a lot of the mood swings and anger and traffic rage that you see out there is really just people who don’t have stabilized blood sugar and are, you know, really fully satiated and happy because they’re getting, you know, full bellies full of nutrient dense food. And I feel so much better when I’ve eaten larger meals of pretty good servings of meat.

Dr. Pran Yoganathan   

Absolutely, absolutely. Without a doubt it. You know, we’re really built for that feast and famine type of makeup. And it’s very difficult to spend 4 million years evolving into this beast and then have that… pull that rug pulled out from under us in the last 30 to 40 years with these changing eating guidelines. I still don’t quite understand what an eating guideline is, Diana.  That why should we, as a species of animal need to be told what to eat, it should just be so intuitive to us. Yet they destroyed it with these eating guidelines and protein, demonization of animal-sourced protein, and then surrounded us with hyper-palatable foods. What a great way to kind of destroy human health. If you step back and take a big picture view of it. That’s fundamentally what happened. And this is why I’m so passionate about kind of educating people on Oh, you can’t stop it. You can’t stop the corporations. But if you can educate people enough, potentially they’ll be able to see that but you know, just in clinical practice having done this for years now with a team of dietitians, great team of dietitians that work with us, a very small minority will actually embrace what you’re telling and go on to adhere to it long term. So which leads me back to the original point that we made that we, as a species, we are sort of driven towards addictive behaviors and some people will take on ill-health in the pursuit of that. And that, to me has been very frustrating to watch as a doctor.

Diana Rodgers, RD   

So I deal with two, in my clinical practice, I’ve two main areas of interest. And two very different types of people that come to me. One are, you know, metabolically broken, overweight, want to lose weight, and the second are gi cases, I have a wonderful GI doctor that sends me his, you know, troubled cases, and I can magically cure them all with just, you know, basically putting them on a very similar diet of just largely meat and maybe cooked vegetables, you know, just depending on how severe it is. And it’s really rewarding for me to work with sick people, because they are much more motivated to change, like, there is, you know… as somebody with celiac, I am not gonna go off the rails and eat a bagel on vacation, you know, like, there’s just no way, right. But I think it’s a lot harder when, you know, high blood sugar kind of feels good. And so, you know, and you’re so tempted, it’s just so much easier for me to be allergic to the middle of the grocery store. And just to have that completely, you know, I find that it’s sort of like a blessing that I can’t eat the majority of the foods that are making so many people metabolically broken.

Dr. Pran Yoganathan   

Yeah, high blood sugar is a high. But if you’ve done a low carbohydrate diet, or stuck, stayed clear of refined sugar for two months, then you feel terrible. And you know, and I think this is what we’re trying to get people to see to understand what health looks like. And the earlier you could start them, the better they do. Whereas when you’re older, the patterns are set generally, like they’re stuck in routines and to embrace new concepts are found challenging with older people, whereas with the younger ones who genuinely want to improve their health, they can be a lot more dynamic.

Diana Rodgers, RD   

Well, I think there’s hope with older people, I guess, I don’t know what you’re thinking of older, I guess I’m thinking like 40 plus, and I would put myself in that category. But one is, you know, the access to these continuous glucose monitors, at least in the US, there’s a couple of companies now that you can actually I’ve got one on now. You can get them without having the diagnosis of being diabetic, you know, to show people a window into their bloodstream so that they can see when the glucose is too high, I think is a really empowering tool for people. And also for people to understand that metabolic conditions and GI conditions can be reversible, or can you know, go into remission, you know, when we’re talking about things like Crohn’s disease. Not all the time, but certainly it’s possible if you give it a good shot.

Dr. Pran Yoganathan   

Absolutely. I won’t sit here and lie and say inflammatory bowel disease will reverse itself with the right changes in diet. But we’ve seen huge amounts of people that do. Not everyone will, because immune system-based diseases are complex, complex things. And, you know, I don’t think any doctor or scientist quite fully grasps what they are as yet, but we’ve seen huge amounts of people go into remission with Crohn’s and Ulcerative Colitis, some, sometimes it’s a dual approach to require medications and diet to get these brilliant outcomes, which we certainly aim for. But I will say that things like irritable bowel syndrome, bloating, flatulence, reflux, these things very rapidly, largely speaking, we’ll settle down on food that basically eliminates a lot of the refined carbohydrates, it really does. And once you start emphasizing protein, the system really settles. So as a gastroenterologist, those kind of very satisfying seeing a lot of people when they come in and tell me that they’ve got gut symptoms, which they think is irritable bowel, I try and explain to them that is fundamentally your gut telling you that it’s not happy with what’s been put in. And I see often describe it as potentially could be early or evolving metabolic syndrome, which is a gut, your guts, basically telling you that’s what’s occurring. But, you know, people lack that intuition with their own body now.

Diana Rodgers, RD   

I think it’s because a lot of people are just living… they think it’s normal all the time. I’ve been…  when I finally got my diagnosis at 26 of celiac disease and two weeks on a gluten-free diet, I didn’t realize that you could not be in searing pain every day after every meal. I think that sometimes a lot of these things are so normalized. You know, even with aging, too, there’s this assumption that you must gain tons of weight and have stiff joints. And all these, just feel terrible, you know, starting at age 40, or whatever, and it’s just not true. And I think one thing that you, and then I’ll let you go, but one thing that you brought up in the beginning, and I’m thinking it towards end of life, but is these dementing illnesses, and I don’t think there’s enough attention paid on, you know, this idea of type three diabetes with diseases like Alzheimer’s, and how we can actually try. I mean, not always, but again, there’s a good chance that you can make the end of your life a better way to go than other people if you just take care of yourself. And it, again, is something that even if you’re 40, 50, 60, changing your diet can have a massive impact on what it’s going to look like at the end, basically.

Dr. Pran Yoganathan   

Absolutely, Diana. I think I don’t mean to be controversial here, but I think the way that humans were built or evolved to go out as elderly people was with infection, right? Now, that’s not to say that cancer didn’t exist in pre-agricultural, early agricultural society. We know it did, but not to the extent that it does now, right? It’s become normalized. Cancers kind of become normalized as part of an end-of-life event, but really isn’t. It used to be a rare event. Same applies to things like heart disease, and strokes, and so forth, the way human beings are supposed to go, the large majority of us is with infection, with a declining immune system that that sort of age. So this is the thing, we’ve become fearful of infection, and we’ve done everything to try and prevent it. And that’s fine. That’s reasonable. You know, there’s no question that antibiotics lead to this increase in human lifespan. That’s brilliant. One of the most important inventions along with some pertinent vaccinations in our history. But the modern era assumes that metabolic syndrome is the way to go. And I think Alzheimer’s and type two diabetes and even heart disease, you’d have to lump in with that. But I think our perspective has become skewed over time. And when something happens gradually, like it has for the last 50, 60 years, we’ve just come to assume it as normal. So you know, for your children and my children, this will become their normal. That’s what they’ve been used to infection, cancer, and autoimmunity. Sorry, autoimmunity, cancer, and metabolic syndrome, and its resulting complications, and that is sad.

Diana Rodgers, RD   

Yeah, and I think, you know, I’m sure it’s similar in Australia. But when I was working in the hospital, it was amazing for me to see how many people did not have end-of-life plans. And I looked into it a little bit more, only 30% of Americans have wills. I’m sure it’s similar in Australia. So people don’t want to think about that we’ve, you know, we just push people into nursing homes, so that we don’t have to look at it, we don’t have to think about death. And as you mentioned, then you’ve got guilty family that are prolonging someone’s suffering, instead of you know, maybe doing what the person would have wanted in the first place. And so anyway, not food-related. But I think all this stuff is related. And it’s, you know, it’s really cool to talk to somebody who has a very similar worldview to health because you end up finding out that you align on all kinds of things that are just, you know, within this worldview, like once you start looking through the lens of evolutionary biology, everything falls into place.

Dr. Pran Yoganathan  

Everything falls into place, and I think, evolutionary biology kind of lends an interest to history that you understand how things work on a political, social, economic scale from the lenses of history, and I think you sort of realize that we’re just… we fall into the same cycle over and over again, but we now exist in a cycle which has never existed before, which is a state of corporatism. And I think everyone should be warned about that to try and kind of extricate themselves from that for the betterment of their health. I often tell people like the best thing you can do, in terms of your health is to extricate yourself from the healthcare industry and make yourself healthy because there’s no doctor who’s going to really advocate for your health. They’ll advocate for the management of your disease, of course, they’ll do that very well. But health really lies…. It’s a personal journey, and you’ve really got to go through it yourself.

Diana Rodgers, RD   

Yeah. And be a wildly crazy advocate for yourself in the face of, you know, pretty much every doctor that you’re going to meet.

Dr. Pran Yoganathan   

Absolutely, absolutely. And you know, you look at the obesity rates and metabolic syndrome and in our own medical and nursing personnel, and they estimate something like 60 to 75% are either obese or overweight in the healthcare industry, and you realize like we… if you don’t know health, how can you teach it? You can’t, so we’ve, we’ve got a problem there.

Diana Rodgers, RD   

Yeah. Anything else? Before you go?

Dr. Pran Yoganathan  50:45  

No, listen, I love your work, Diana. And I think you know that the work you’ve done to date is so important. And I hope, you know, more people can view it, I think your book and documentary should be pertinent viewing for anyone going through the schooling system. However, with the current political rhetoric and narrative that’s been put out there by forces much more powerful than yourself. When I say powerful, that far more armed financially than yourself, you’ll find that that narrative won’t be widely followed. But I really appreciate all the work you’ve done, and I wish you all the best.

Diana Rodgers, RD  

Well, thank you. I mean, it definitely can feel very lonely doing all of this from, you know, my little desk over here. And certainly, if you… if your practice was local, I think it’d be so much fun to work with you and your team of dietitians, I’m sure that you have a much more satisfying practice than most GI practices and much happier patients. And I just think what you’re doing is great, too, and let’s let people know how to find you.

Dr. Pran Yoganathan  

Yeah, thanks, Diana. I’m probably most active on Instagram, I find it a good medium.

Diana Rodgers, RD  

It’s amazing. I absolutely love your feed so much. It’s fantastic.

Dr. Pran Yoganathan   

Thank you. Just it’s @dr_pran_yoganathan. It’s a very visual medium. And I tend to use that a lot and same handle on Facebook as well. I tend to just blog daily on various things that I’m interested in. And some people find it interesting, such as yourself, so I appreciate that.

Diana Rodgers, RD   

Yeah. All right. Well, have a beautiful morning. I’m heading into dinner here in the Boston area. And thank you so much for your time. It was really great to talk. 

Dr. Pran Yoganathan   

Pleasure. Thank you, Diana. Appreciate it. 

Diana Rodgers, RD 

Thanks so much for listening today and for following my work. If you believe in making sure that people all over the world should have access to nutritious food, please join my mission through my non-profit, the Global Food Justice Alliance. Visit sustainabledish.com/join and become a sustaining member today. All sustaining members get early access to ad-free podcasts plus free downloads, and you’ll be helping get healthy protein like meat, fish, and eggs to food-insecure kids. That’s sustainabledish.com/join. And thank you.