jinping. george washington university professor has written close to 30 books devoted to the subject of asia. we talked with the professor about his newest book titled china's leaders from mao to now. >> listen to booknotes+@c-span.org/podcast or whatever you get your podcasts. my pleasure to introduce sam apple. sam is on the faculty of the inmate and science writing an inmate in writing programs at johns hopkins. prior to his arrival at johns hopkins, sam taught creative writing and journalism at the university of pennsylvania for ten years. he holds an ma in english and creative writing from the university university of michigan, and then msa in creative nonfiction from

columbia university. he has published short stories, personal essays, satires, journalistic features on a wide range of topics. in recent years he has primarily written about science and health, and his work has appeared in the "new york times" magazine, the new yorker, the atlantic, wired, the los angeles times, the financial times magazine, and mit technology review, among other publications. and, of course, he is the author of the book "ravenous" which you see the title on your screen and are able toee order, and that's what we're talking about today. so welcome, sam. >> thank you. thanks so much for inviting me on. >> of course. it's wonderful to have you. i loved your book. it reads as i've said on social media, it reads like a novel.

i was glued to it but it's all true. i don't know, i'm sure you will taught as go t through about yor came up withyou the idea about writing this book and connecting all these adopts, but anyway, so it is about the nobel laureate, the biochemist otto warburg who was a jewish homosexual living openly with his male partner in nazi germany, yet have protected him. so when hope he could cure cancer. this again reads like fiction but it's true. there are many parts to discussed but i would like to start with autos youth. his family dynamic, his early life. let's start there. tell us about his family. >> sure. so t otto warburg bother was vey prominent physicist. he was jewish, he was a part of the famous warburg family that

is best known as a financial family, the warburg bank. otto warburg and his father are cousins of these other warbirds and at the time it was unusual for summit of jewish descent to rise to high academic position. his father really rises with all the way to the top of the physics world and auto grows up in this house that is full of the world's greatest physicist come some of the great scientist in history, max, einstein very close, neil fisher, the great chemist. many of these world-famous personalities to go on at the happen to winin nobel prizes and otto warburg and tends to be a world changing scientist just like the people he grows up

with, his natural surroundings, when what he feels is expected of him. the question in his mind is really not easy going to make a world changing discovery, but in what field b it is going to be. and he does feel a sense of competitiveness with his father and wants to out to him which is not easy to do. his father, einstein loved his father and he helped actually show some of einstein series were correct. he provided experimental evidence. otto warburg decides if he's going out to his father and make his name is a great scientist he's going to do it not in the realm of physics but in the realm of biology in the living world, but throughout his life he continues to approach biology from the lens of the physicist. he's always interested in energy and how cells use energy. so that's really the background.

it's almost like a prophet with a religious devotion, that's how he felt about science. he said he pitied anybody who didn't become a scientist vickie couldn't imagine it. that's the world he growsy up n andal that's what we'll talk abt more, sure enough he does make his world changing discovery. >> a little pressure from the family, , or not. i've been feeling he just was who he was since he was a little kid. it was just in great in them to be a scientist, like said. before we move on to his work and his lab in all these other things, i want to talk a little bit about hitler because it's a main part of the book, how these two very different people are tied together. so in order to understand the relationship you need to understand hitler's childhood. i learned a lot about hitler

that i didn't know, the kind of childil he was, but mostly about his mother. let's now talk about hitler's youth and type in. >> sure. when i start to write this book i really didn't plan to write a lot about hitler's life but more research i did the more clear it became that almost from the time they were little warburg and have pursued on a collision course that sure enough they do collide in the 1940s as we'll talk about. both stories are very much wrapped around cancer. the reason in large part is tt cancer had been a relatively rare disease in the early 19th century and then warburg and hitler are both born in the 1880s and by then cancer is becoming more and more common over the next decade becomes really preoccupation of the german people.

this is in private they both grew up in. hitler is, you know, sort of a disgruntled teenager and his father dies when he is 13, if i recall correctly. he wants to be an artist that is kindnd of hapless figure, nobody really likes him and the only connection he has really in the world is his mother, then historians say it's really the only human being he was capable of loving, and right at the time when hitler is trying and failing to become an artist his mother is diagnosed with breast cancer. he's absolutely shaken. his once with a friend at the time said he had never seen somebody look so depressed. one of the extraordinary things, it's actually an austrian jewish doctor who is kerry, it's in

germany but i'm including austria that, an austrian and jewish doctor who is caring for hitler's mother, and hitler is very grateful and seems have a good relationship with this doctor. they try everything. hiser mother is dying of breast cancer nothing really can be done and hitler is just devastated. thee doctor also said he'd ever seen like a human being look so depressed. so his mother dies of breast cancer and cancer remains a threat to the very end of his life, central focus. he is an extreme hypochondriac, afraid that many diseases but none more so than cancer. the stories are just one after another. hitler stops everything he's doing and just write out the will because he's sure he's going to die of cancer and he has these horrible stomach cramps and all sorts of conditions which he always assumed were cancer, and part of the chilling aspect of it is he

said multiple different times one of the reasons he was such in a hurry to do all these horrible things he wants to do is because he's going to die soon of cancer and is got to take care of this before he dies. the stories are really bizarre. he even had an obsession with shellfish, which some historian historians, somewhat speculative but some historians, though word in german was crab and catching some people thought that was part of it. >> evidently his mother died a long, painful, horrific death that he witnessed. and that will you talked about, wasn't that written, did he stop everything, meaning he was about to launch some big battle and he stopped to do this? was in it during wartime?

>> i think the will itself was at a different time but yes, i can talk about that as well. i know what you referring to. there was this remarkable time in the 1940s which i can talk about that now. becomes a little, little later in the progression of the book. >> what did you think? is it more family where you're going to go with the? >> that comes up the little bit later. >> will talk about later then. so now we understand a little bit more where the early lives, what is driving these people, what is their focus, what is their passion, if you will, overused word but in this particular case i think it is appropriate.or let's talk about his lab. tell us about his lab and not

only this amazing lab that he designed it, that was quite frankly really interesting, tooy but then howng he behaved in tht lab. walk us through the lab. >> sure. by the 1920s warburg has a reputation as a brilliant cell physiologists, biochemists. in 1931 the rockefeller foundation actually says were going to build you sort of the lab of your dreams warburg pursley designs the institute. he wants it to look like a country manner. kind of an extra day thing, you have to remember this after not too long after world war i. you have an american nation building and institute for a german, and he assembles a small, he doesn'tad really want

academics working for him. he prefers these technicians who are brilliantly skilled but don't have their own academic interests. he has visiting scientist, a team of expert technicians who do whatever he says. he runs that. he has been in world war i and he went to basically like a military operation. they have these meetings where he just commands them what to do nobody says anything and they go back to the lab. it's incredible because relatively small operation but they are changing the world of biochemistry one phenomenal discovery after another, and this continues even into the 1930s after the nazis come to power and ease under incredible pressure. >> and surrounded in this lab, he was a mentor like the finer things in life, the arts and furniture and horses. but let's digress just a minute because you just brought up world war i. to me that part of his life

almost didn't fit. i was surprised at his service in world war i. tell us about that a little bit. >> sure. he was a german patriot and like many german patriots he believed in 1914 that it was a just cause for germany, and he also is of jewish descent, not really out, was a homosexual which he was about as out as you could be at the time. he lived openly with his partner, but i think particularly easily get german jews they were in 1914, they were patriotic and very anxious to prove that they were full-fledged germans and committed to the fatherland and they signed up for the war by the tens off thousands.

warburg also love horses and signs up for a cavalry unit which really was sort of an aristocratic unit. he was really drawn to it in a lot of ways. he wasn't, i don't think he was a particularly great soldier there, some stories about him but i think he served admirably and he got an iron cross. >> he was on the front lines, right? >> yes. certainly through part of the war on the eastern front. one of the remarkable part of the story is by 1917, 1918, but he was really paying attention, certainly by 1918 sees a disaster for germany, the deaths are mounting and hisn parents ae desperate to getting out of the german army and are sending letters, talking to like the ministry of the interior saying we need him to come home and do

research or german food production, so on. but warburg stays in the army and tell albert einstein about people write him a letter and says you are too important for science, we need you to come home. his parents asked einstein to this comeletters like home after einstein asked him to. it's interesting, einstein says you are too important for science and that really, warburg was very arrogant and, you know, i think einstein understood how to convince warburg, that playing to his arrogance. sure enough he comes home. it's possible if he doesn't come home he dies in the war. his incredible cantor discovery never happens, so to think that einstein really in three could've played a a very impot role in this story. >> okay. back to the lab now that we did our world war i which again was veryas interesting.

so talk about, was it sea urchins? what was it? it was a seaat creature he workd with. >> sea urchin. >> okay. and then explain his work. so otto warburg is in his lab. what was his goal? what was he searching for rex almost single-mindedly. sam: it even starts before when he was in training as a medical student and physiologist but he is going about the same european scientist to special train station in enables and a lot of the scientists at the time are using these eggs to as an

experimental tool and trying to understand chromosomes in the very foundation of of modern genetics with sea urchin. he was there with all of these famous scientists at same time but as i mentioned before he was the son of a physicist noise focus on energy and he wants to under stand how it appears in the growing these energies. he's coming up with these really innovative devices to sort of measure, talk to jen was being used and how much carbon dioxide is given often someone in fines with these sea urchins eggs was taking up a lot of oxygen and realizes that to the extent, if you're going in this energy and so that is a reason in his 90s try to understand it how it manages to grow. from the very beginning was to understand the answers and want

to understand cancer you have to understand self growth. so really interesting thing of this is when he starts to really harness full attention to cancer 1923, he had these sea urchins experiments the back of his mind rated this sea urchins eggs is growing in cancer cells can do the same thing. and it's really surprising of the discovery 1923, is why they're not taking up more oxygen, it's very strange and surprising as fermenting and taking it out of life glucose is. and you would expect this turning into this interactive acid and coming out of the cells. is the same fermentation process that microorganisms deal in and wine and cheese and yogurt. very strange that the cancer cells were doing this and really a big part of cancer science and

really trying to understand why was it off. and continues to this day. patty: yes, that we could take from science to talk about that as far as what he discovered. there was a couple of aha moment and that was one of them. and in his scientific community when he started talking about this, what was the reaction from a stellar scientist when he started to talk about what he was working on this discovery. sam: in early years for the very early years of such a new surprising discovery that cancer behaves like used to growing on the brain. it took a while to set in but in time, people started to take this is true from the experiments themselves, then every cancer they tested, seem to be true.

originally they were looking at cancers in the laboratory or in rats. the same effects in human cancers and so people accepted that this was valid from the cancer cells in a very unusual way take up and perform fermentation just like microorganisms but remains controversial part is otto warburg is sure that the cells not eating oxygen, it must be something must be broken. but we not eat oxygen. he had an extremely autocratic view pretty brought this to our oxygen to is the proper way it's what it a cell as opposed to. and a lower organism and the sale does this, then it must be somehow broken. and to this day as well.

it is there a problem with respiration rent breathing with oxygen for cancer cells doing this for another reason. for that continuous but in time, just affected the cancer cells are doing this, is widely accepted and considered very important discovery. in the cancer cells taking up all of this glue close and sugar and possibly start the cancer cells. so it's really all extremely important. and being discussed and after the war, sort of disappeared which is another strange part of the story. patty: is making a name for himself with his lab. he gets attention by the rockefeller institute pretty and he gets hitler's attention again a jewish man and were in a war

now and jewish people are a lot of his scientists leave, the walk-through walk us through the beginning of the war and otto warburg absolute, you gotta hand it to the man, he was sure that nobody was going to test him. he was just too important. in his basic persona as - tells about that. sam: most extraordinary part of the stories 1933 comes around and otto warburg won the nobel prize in 1931. and released at the top of the scientific world, and scientific nation and he was at the top of the german science. he is everything that he could want to do. he was with his partner in a beautiful home, a block away.

nila comes power and then suddenly everything is in jeopardy. in many of his colleagues leave right away. in otto warburg think about it coming at the opportunity to leave in 1933 in 1934 printed but, he decides to stay. he believes that the nazi party phenomenon will be short-lived. and just saying in this will be over in six months a lot of people believed this and otto warburg, he said i was here before hitler nobody is going to chase me out of here. an amazing thing is that he was harassed again and again in the early 30s. they come to his institute and they're saying why don't you why aren't you sending them to our marches and stuff and why aren't

you using hitler's solution you refuse to do it. what if you have a flag upgraded is limited and he chases them out of the screams at them. and he gets away with it. i almost doesn't. they tolerated him because he was such an important scientists in the early years he had all of this rockefeller backing. in the early 30s, germany to some extent took care of the national reputation. so he had some advantages over other scientists, he was only half joyce, only his mother was left 1935, there's essential rule. there was a lot going on but really nobody was more vulnerable, not only he had jewish father but he was living with his now partner. the nazi party could've gotten rid of him at any time.

they put up with him. they harassed him but they don't chase him out of his institute. in the meanwhile, all of colleagues by the late 30s are gone. it's too late for him to leave. he started to close this down. and it really come to a head extraordinary way 1941 were finally is literally the only jewish descendents in the society that is left now. in his running, like a dictatorship. too much for many of the people they dislike them. a lot of people dislike him even be for nazi party because of his personality. a lot of enemies in a 1941, it was the beginning of the end for him. so he had an international reputation in he calls the nazi

party headquarters. to my chance to see if hitler's imposing building and think they claim and it looks like, what is going to happen. i sit down with victor - joyous one of the worst, he designs a euthanasia program. and also worked in later with the nasi killings. he sits down with otto warburg and he tells him were going to let you live as long as you create this first cancer prayed was more extraordinary is one that we find out that you discovered the sort of daily planner that he met on the same day to talk about otto warburg

and victor and that would be interesting in any event on junf the most important dates and all of nazi party projects. only hours later, of dawn the next morning, march operations for the time, the biggest military operation the history of the germans, hours later he's willing into soviet territory and cap risk the entire nazi party project and meanwhile in june 31st, just before it happens, they're dealing with otto warburg in talking about his cancer science. and sure enough, in the diary late that night, he and hitler are staying up talking about how they will announce to the german people that have just invaded the soviet union in the middle of this, they stop and talk about cancer. just gives you a sense of how

strange the nazi party rule deal at this critical moment, there focused on otto warburg and cancer science. any explain it in this book. it is truly bizarre. patty: yes, i thought so too great was absolutely fascinating. almost hard to put somewhere in your head up in any way that is what happened. and now, let's continue on. might be getting my timelines well, he left the lab and he moved the u.s. for a while and drove this foresight is absolutely crazy was a very kind soul that was just didn't know what to deal with otto warburg. tell us what happened and why it happened.

and that would happen after. sam: swept the cement i just told you about, otto warburg is totally focuses on cancer he will be protected. say makes it to the end of the work and amazingly, not only to be survived, but in 1942, bombs start to fall, i'm sorry 1943, near his institute that essentially moved to new institute which is sort of refurbish mentioned. famous place in the german countryside and by the late 40s when nobody is allowed with the work efforts of using building materials. because what they're doing to build a new institute for otto warburg. and he carries out biggest trouble and again, almost

arrested again but in the end he survives. and he is as extraordinary treatment. in the soviets come to power in sort of takeover and part of germany and american part of it and otto warburg is hardcoded between these two worlds. and he doesn't have the institute and the americas take over his institute after war and they turn it into a military headquarters so is nowhere to go and no lab. ... ... >> robert anderson, famous researcher, and it was hard for him to find a place in part because, you know, when he

stayed in when he stayed in nazi germany people thought he must be a nazi, he must m have worked with them. in fact, he despised the nazis and hated them, but it did look at good he stayed the whole time. f illinois and, you know, he brings his partner, jacob. one of my favorite details from the book is thathe's the most pathetic human being -- [laughter] >> right. >> the look on his face walking into the frat house. but, you know, he gets involved in this huge debate about photosynthesis, you know? his life was always competing with other scientists about photosynthesis in particular,

and then he proceeds to drive everybody in the laboratory crazy not just with his disputes, but he says it's too warm, you know, he's used to working in these cold german buildings, so everybody is walking around in their winter coats, and he's never happy with the equipment or with who his given, you know, assistant is. at one point he literally is driverring emerson -- driving emerson crazy. he doesn't know what to do with himself. emerson was, like, a saint who, you know, one of the nicest human beings who ever livedded from everything i've read about him, and he nearly pushes him to the brink so it's a book about nazis, there are not many funny parts in the book -- >> that was a nice story, yeah. >> that, the comic relief, it, you know, if you can put up with

the antics. meanwhile, he's alienating more and more people, and he's making more and more extreme statements about cancer not saying not only is this -- saying not only is the thing he discovered important, but in the 1950s, there's a group of nobel laureates, and he says everything else is unimportant. he literally uses the word garbage for everything else. and he insists that, you know, if only the cancer lab would just pay attention to him, we could so this disease. and, you know, it is the incredibly important, what he's saying. but the times are already sort of changing, and, you know, in the 1950s we had the discovery of the structure of dna, there's all these interesting discoveries about viruses that are taking place in the '60s,

and in the 1970s we had this real breakthrough where, you know, modern molecular biology is born. they start to think that particular mutated genes can cause cancer. and by this point, it start to fade away. he dies in 1970, and, you know, the stuff that he studied, that was considered old world science. that was considered basic biochemistry, you know? sure, you know, metabolic enzymes are part of, you know, what a cell does, but they don't really matter in cancer. cancer is a sophisticated disease of genes and, you know, it's not basic biochemistry. so it just gets lost. it's just amazing how quickly it happens. partially because people don't like warburg, but more so just because new science is so much more sophisticated. and, you know, by, you know, the

1980s, you know, people had heard of warburg, and you have these famous papers and textbooks coming out that don't mention hum. even as lawsuit -- mention him. even as late as 2006 you have the seminal textbook that's put out that doesn't mention warburg at all. you know, the emperor of all maladies doesn't even mention warburg, the famous paper the hallmarks of cancer which talks about the six basic functions of cancer that comes out in 2000. and it doesn't even mention, you know, the shift offer fermentatn which really is fundamental to cancer. so it's amazing how it got lost, and, you know, a lot of what i write about in the last part of my book is how it was discovered and why it's to important. >> can that's what i would -- and that's what i would like to talk about now. just for our members and those who are listening to this, i always like to give people sort of something to take home, the

story in your book is what makes it so interesting. but you tied together a lot of science and great information that people can learn from. so talk about how it shifted and whew we're talking about it again. -- and whew we're talking about it again. so i'm sure you'll have to talk about, you know, fructose and glucose and metabolism and insulin resistance. so all those things from warburg, and then it got lost, and then now, why again now. >> sure. sure. so the story really picks up again, you know, warburg is lost, and then in the late 1990s these molecular biologists are focused on cancer in the modern sense looking at mutated genes and how these signals go out from one protein to the next which cause a cell

to replicate. you know, that's part of fundamentals, it's what cancer is, replication. and so they're tracing these genetic pathways, and they find that they lead them back to, you know, they seem to be causing these met boll you can enzymes to -- metabolic enzymes to change and rev up their activity. it seems like why is, what are these old world enzymes. it's peculiar to them because they literally called them housekeeping enzymes. sure, a cell needs energies but that's an afterthought. the energy just comes in when it needs it. but sure enough, the cancer networks seem to be bringing them back to these fundamental metabolic enzymes. so a few scientists, you know, rather than ignoring it and thinking, you know, this is just irrelevant, a strange mistake in findings, why is metabolism being connected to all this. and they start to look for the

connections between these cancer genes and how cells take up nutrients. and, you know, it really is remarkable over the next, you know, at first everybody's skeptical of it. but over the next decade, 15 years, they start to see that cancer, these signaling networks are actually fundamentally linked to metabolism. and it seem the most fundamental role of many of these networks is actually controlling metabolism, getting the nutrients into the cell. and it's when the nutrients come into the cell that the proliferation process occurs. you know, sort of the causal error, the direction that people thought the cancer cells -- i'll step back and say they thought that metabolism was an afterthought where, in fact, it seem like metabolism is driving the process. and it's kind of remarkable because when you think as a

creme starts to divides and -- a cell starts to divide and divide and doesn't have a way to take up nutrients, it's going to collapse. one cancer scientist referred to it as a catastrophe with the cell whereas with if you think about it from the perspective of a single-celled organism, i said before that the cancer cell acts a lot like a single-cell organism that just comes into nutrients and grows. the nutrients are a fundamentalled road signal as well. that's what you put yeast onto, your bread or grain, you know, it grows because it has the nutrients that makes as many copies of itself as it can. if it doesn't have a nutrient, it doesn't go into >> and he doesn't have nutrients a dozen going m to that mode so the scientists show there's a fundamental leg during the nutrient uptake and growth. and it started to rediscover that what they found is that it

goes into this growth mode and he thought that it would also oxygen but another hypothesis is that it's not because it can't use oxygen but because these metabolic enzymes are getting turned on causing it to override the glucose in overeating is shifting and into this growth most was really fundamentally different way to think about kthis. and it really hit home for me when i saw the famous scientist greg thompson who is now the president and ceo of memorial, he did it talk or took this piece of bread and he showed his mold growing over a piece of bread and he said okay, this is a cancer experiment and everybody has done this. this is what cancer does. so that is sort of the rediscovery in the question that i'm interested in is okay, so cancer cells there getting more glucose than they should in the proliferating. we always want to go how does

that happen and what is a have to do with our diet. it will for some cancer scientist, were not interested in a diet, the just interested in this is h what is happening with the drug that can somehow process and that's extremely important and amazing new drug that is comes out of this. and returning to warburg, and i i was interested in this wealth cancer cells overeating, and in many ways it's affecting our ways it affects that. and what is really interesting to me is that it really all comes together in the late 1990s because at the same time the cancer site is a rediscovery the cancer cells in the glucose in a fundamental to cancer so fundamental that if you do a test scan, just really shows you where the body it shows overeating glucose meant that is where the cancer is but at the same time, other scientists and

epidemiologist have studied cancer in population, they are finding that obesity has propounding linked to cancer. thirty different cancers and nailing to obesity, and others less strongly is probably just the tip of the iceberg. so this is the fundamental question of my mind, can we connect to these two stories. is there something about this obesity cancer connection which obesity is now overtaking smoking is a find a middle sort of most prominent cause of cancer. andn in also with otto warburg and the glucose and most of playing in our these two stories connected and that in a way, was my big project to see if there is a connection there. because you know i'mnn a journalist and trying i can't do with the scientist who but i can try to connect the dots with a different fields because scientist from different fields are often talking to eachsc othr and focus onen the same thing.

the not talking to each other so i think that this were a really discuss a lot of the last chapters of my book. i think these really are part of the same story and that is the fundamental thing thatha connecs them is this hormone insulin. and you know if i should pause here. it. patty: this is where i wanted to be at this point greatest of our focus on this for the rest of our time together. sam: so the real question is, if you think about a cancer and you think about a micro organism, and you put the brains were ever, just need to make copies of itself and when you get into multi- organisms, is more complicated because our sales don't just eat one of the encounter food. if they did it would be anarchy. so again, the scientists said that you can think about the multi- organism as between all of the sales and whatever,

trillion cells in the body to eat only when there full or it's kind of a remarkable thing because all of us don't have the ability and they don't we have this food distribution systemm which is regulated by hormones. in first and foremost insulin which is telling us which cells to take a new trade and how to store them and how do feel this cells in our body. so want to understand cancer as this fermentation of over eating glucose, you have a question of what makes ourselves take up glucose. and first and foremost, is this hormone insulin so the sales is over eating glucose and have to ask yourself, is there too much insulin and could that be part of this story and could that be driving this what they t call te otto warburg effect in metabolism and sure enough there's a remarkable body ofn

evidence which suggest insulin is quite a huge role in human cancers. insulin is a growth hormone and factor that tells the cells to eat and divide and grow. and for decades, people with elevated insulin as higher levels of cancer. it's been over a long time but also it's only became clear the 1990s and a number of fascinating discoveries were made. one personal maker the insulin and obesity and obesity is like the cancer rate in insulin also activates all of these networks that i talked about before that are changing the eats. these were some pious say downstream of insulin and ulinsulin entered insulin activates them in the same way that mutation works and sort of causes them to rub up and keep going and keep keep taking in nutrients printed out insulin is a natural hormone and we all need it.

we've insulin this condition where the insulin is elevated all the time and then you're going to have 24 hours a day far more insulin than you ever would and to be activating these cancer pathways and once a mutation arrives, it's a pathway that you can just think of as a growth pathway in response to insulin and once a mutation arises, that is even more sensitive than to the insulin these little microscopic cancers might appear all of c the time. so instead of being start for the body, insulin comes alive and many different types of cancers and many more insulin receptors and other cells. it striking to to the extent of which elevated insulin seems to play a causal role in all these obesity linked to cancers.

and also one of the more popular things in thehe book is to suggt that cancer used to make a fairly rare disease in the early 19 century and maybe that is because insulin resistance was you know fairly nonexistent in the early 19 century. in cancer and diabetes and obesity growing throughout the late 19th and 20th centuries so it is very clear to me that cancer is tied up into these metabolically diseases of obesity. and don't think that's controversial. i think it insulin is really a piece of the puzzle that sorta makes all of these things out of it. and that is always like one layer back. the obviousou question is will w does our insulin really had a weekend up at insulin in the blood and that's me that is the real question.

all of it is a little bit controversial but i think sugar first and foremost is sort of the most worrisome part of the story because sugar has been shown and i don't mean glucosamine like generally the stuff that we added to everything. it's one half fructose and no molecule we know that seems to sort of cause is internal metabolic destruction that storage around our internal organs which seems to cause the insulin resistance in the elevated insulin. so to me, if there's one super take away, it should be that insulin seems to be elevated it and if you want to keep your insulin low, person needs to avoid sugar. patty: and refined carbohydrates

and basically ultra processed foods. hamburgers are processed, is. reporter: ground up but, i mean, ultra processed foods. in the ingredients in the ultra processed foods other than the food colorings and all that because it's back to the sugar in our mutual friend doctor robert, has done a little bit of that omission about sugar and removing it from our. diets. our food system hase to have it completely reworked. wouldn't it be interesting i guess you mentioned the word fundamentals ever that many times over the years. otto warburg was working on the fundamentals of metabolism and then he got away from that and god to sexier things or things that the dial down from the genetics and all of these things

that are just amazing. but now we are going to back to the fundamentals. and otto warburg could not guest what is in our food system right now otherwise my guess is he might've dialed down a little bit but insulin, so what is it and we know sugar, and ultra processed foods. so what about and i know that you touch on this a little bit, nutritionist but i am not an dogmatic with people's eating styles other than i hope the people eat most of the meals at home and they eat real food. so no matter what their diet is. but, you talk in the book and another mutual friend gary talks about quito and then also low-carb us. so basically, out of all of these different eating styles and there is no well we don't have to make a decision as to what works forn us.

what works for you might not work for me to talk about eating styles and will be eating at we can work through somehow other than to remove sugar and processed or ultra processed foods for our diet. what about theee proteins in the carbs and fats and how they tie together. i'm sure you going to do focus on carbohydrates and theoc types thereof. in one of the thing on that note, the whole, don't mean to be pitching this with the new book, you know that metabolic old protect deliver and feed to god and the ties into this as well ferguson start with carbohydrates and proteins and healthy. if need be. sam: yes sure, the more famous line is sugar it deserves enormous credit.

in the harms of too much sugar in our diets. so for my perspective i want to specify the number one talk about prevention, and not talking about cancer treatment when i talkab about all of this. but for my perspective, i think the science that i have looked at in society is working on with his and i really point strongly in the direction of insulin resistance and elevated being a causal factor cancer so to me, we have to think about this elevated incident in the carcinogen something that causes cacancer. and if it were some sort of man-made chemical, that was in our food or in our hands or whatever it would be terrified it would be warning signs up in part of our biology. it's our biology o exaggerated. growth hormone that iss exaggerated. it reaches up to levels that it

should never beat so think about that is carcinogen. i carcinogen is metabolic regulation in any dietary strategy of a prevention therefore should be lowering and avoiding that carcinogen so how do you avoid that carcinogen and what you do is you do diet which causes insulin resistance to improve because almost all of us have had it or edit one study found that 80 percent of american adults have some signs of it. so if you want to avoid that, just think the strategy is to diet which would lower insulin levels and be healthy for many different conditions. and most likely to get cancer there are no guarantees that you would get but there are links that they could be genetically inherent but what causes insulin to rise pretty dietary seems to

have effects on and almost no effect on insulin and protein, there are some insulin spikes but not like carbohydrates because carbohydrates causes the most. if you are mad about it printed metabolically healthy, maybe it would be a fairly normal diet. and i think that the best evidence suggest that once sugar is introduced it into the diet, that a lot of the metabolic problems have, they start to have and what you have those metabolic problems, if you have the resistance, then the sugar eliminating sugar might not be enough you might have to cut more onea carbs and focus on healthy fats and proteins. so in terms of prevention and lowering insulin resistance the best evidence suggests that the diet is high in fats and proteins and carver hated kiev this is some scientists and

doctors point towards protein and centaurs fats but think the agreement of these answers and it circles is that the one thing you want to watch out is for two high carver hated sugar first and foremost buried and probably other carbohydrates asce well. michael pollick and cancer doctor in canada said to me, not the people can never eat sugar, think of it like. [inaudible]. don't eat a lot of it and certainly don't trinket because drinking sugar seems t to cause the worst metabolic effects quickly. he gets into the liver and causes fat storage which is part of the insulin resistance phenomenon. patty: people need to be very careful ideally don't you whole lotta foods with labels like there's no labels on chicken or

broccoli but you have to be careful of added sugar. and thatt is sugar. but just launched the word carbohydrate, there are carbohydrates in pasta, and carbohydrates andar bread, then there are different types of carbohydrates. there are in meaning they have never been fashioned and professionalized and then put back together like whole-grain bread is usually dissolved and taken apart and put back together. a week dairy whole, they are intact. so i think that sugars are carbohydrates but i think people here that carbohydrates and i have not gone on a there's no potatoes are certain things that have nutrients in them. so there are different carbohydrates out there and everybody has a different story

but so what is your take on that. you have an interest in research done from your perspective on types of carbohydrates and then to avoid sugar. sam: sure, there's more on the carbohydrates causes more profound influence like in think about fruits. fruits are sugar and fructose and most scientists are comfortable with the fruits in the diet because as you talk about the cell structure and the fiber in the fruit causes the fructose to not rise less dramatically don't get the same metabolic impacted greatest so that i don't think it all carbohydrates need to be thought of as bad, you have to figure

out what they called the glycemic effect. and how much of a glucose insulin it causes. some people, metabolic healthy ande there are many adults in te case in a situation but if you are then, you have to worry that much about the sugars. but some can tolerate a lot of carver carbohydrates. a lotha of societies in society that have been metabolically healthy eating those in high numbers pretty but first and foremost, we start a few lousy, so once you have these problems then you want to avoid most and certainly these high carbohydrates but i think each individual, get pretty good sense of what is working for you by several blood test and lookit your body, you need to lose weight. so don't think that has to be one size fits all but the common sense thing is to focus on more

protein and less carbohydrates to keep insolent lower and when you keep the insulin lower part of what it does is it traps fat and so the insulin is lower is the analogy of a log that the diet comes into the fat cells and then you burn it. but if you elevated of the time, as he walked in. and it's a natural sort of response to keep insulin lower to storagee of the whole body. it is even more evidence or influence on this. patty: four years ago, i did some volunteer work and center and local hospital. women would come in in treatment and we would all recommend a

very low sugar diet because simplistically, what sugar was a cancer feeder not everybody agreed with that at the time anything pretty much everybody agrees that now. so if you have and again i know you are working primarily on prevention so eat a healthy diet if you want to avoid any kind of metabolically disease of course and cancer. so healthy fats, fatty acids and relationship, healthy fats and then whatever hundred protein you eat but the big thing is that you recommend limiting the obviously sugar drinks particularly. and saying lower the carbohydrates. if you have cancer that is probably even more so important.

so that is probably a little bit of the summary through this and for those of you who have not read this book, we just touched on some of these details. we didn't really talk about the partner all that much of what he did no man, holy cow, anyway so it's really interesting read and more dialed down but the take-home is watch your sugar and nobody is everywhere. and your sugary drinks in your sundays and the fatty liver disease. and showing up in kids, that is all sugar. and metabolically, it's awi nightmare, cancer speaking it is as well.l. and somebody said and we talked about fiber and mitigate the glucose rising pretty we did talk about that and insulin, is that the culprit the elevated sugar causing insulin to rise

the culprit. about igs one. sam: yes that story is from by the growth factor one and that certainly is another hormone as part of the story. and there's a lot of nuance to that but the elevated insulin seems to also increase this signaling so a lot of them together for the sake of simplicity. i think it does sort of if you follow the incentive elevated insulin so i just focus on the insulin when i talk about it. but one of the interesting things about when i started to write this book, and that whole damaging effect of sucrose was sugar was just by its effect on elevated insulin but the emerging evidence that some cancers, colon cancer in particular can fructose directly

it is uniquely driving this affect. so the sugar continues to build even in a time that i was working on the book. patty: this is a fascinating book and we could talk for a couple more hours on this but hopefully everybody has been listeningg has to go purchase your book, this incredible story and how his work of this very difficult brilliant man is front and center again and with the means to us so basically sam, i want to thank you so much for your comments here today, they are wonderful read and i also want to thank all of you who are listening today. so this program will be on the commonwealth club website soon and again that is commonwealth club . org. and now this meeting at the commonwealth in california, commemorating 118 year of

enlightened discussions. >> weekend is on "c-span2" are an intellectual feast, every saturday documenting american stories, and on sunday, book tv brings you the latest nonfiction books and authors read running for "c-span2" comes from these television companies and more including charter communications. broadband is an empowerment, that's why charter is invested billions to build infrastructure and upgrading technology, empowering opportunity and communities big and small, charter is connecting us pretty charter communications along with these television companies support "c-span2" is a public service. harvard university history professor looked at three generations of black women

through the inheritance of a cotton bag, originally given by a mother to a daughter separated by slavery read here's a portion of that discussion. >> this is where i started when i was in spidered to work on the book and became the bag she carried. this bagger tote this bag has had a surprisingly eventful and impactful place. it looks on the surface to be quite plain. it's known as a sack and it was given the name by a person who was the first amino of and to describe it in a way. in the very first description of it. in south carolina, 1850, and

1921. it's needlework and it came about the fabrication, cotton and embroidery. it's 11 by 16 and a small entrance. in this cotton in this example was manufactured for lower and better beginning in the 1840s at the beginning of the industrial time. and it was made by hand and then by machines and so strong enough to hold heavy cotton. and rectangles across an end zone. and it was the work. [inaudible]. as well as her partner bag and save resumed to attach the name

to it. so in terms of this sacrifices were taken along the way from the african-american history and culture. and currently, the plantation it and you can actually see the landmark and from charleston's wealthiest family. and the plantation operated by the foundation and the owner of the southland the fact of the smithsonian. [inaudible]. and is properly exhibited in international african-american culture. this sack, as so many twists and so many turns along his journey

to these various sites in our country. was a pivotal moment of the south history in a place where like you just like keep me was looking through bands in tennessee, and was coming through rags and came across the sack. it looked like a rag. and it was with other rags, it cost around $20. and then discovered was on a doll when it seemed. because in fact, even while compelling of the twists and turns that it took, it could open up things about enslaved women's lives in about black

families, and about heirlooms and other things. and about rugs, and and thanks. as a passed down heirloom. his treasured through the generations. this is a common family practice and it's one that i have been fortunate enough to engage in as well. in a number of items that were given to me, from my mother and grandmother and my great aunt. and i think that the quilts and folks, clothing, and things that we received were passed down. in the sack was in keeping in the tradition but also stands apart from it and is and

difference to something and we feel very familiar with, that brings our attention and drives our focus. and enables us to see the wealth of this simple common sack. >> to watch the rest of this program visit booktv.org and search for the title of her book, all that she carried, using the box in the top of the page. >> your opinion matters, with cspan's video competition, be part of the national conversation by producing documentary is the federal government impact your life, and affect you in your community, "c-span2" competition as $100,000 in total cash prizes and if you have a shot of the grand prize, a $5000 pretty interest from the competition

will begin to be received wednesday, september 8th for competition rules, and more information on how to get started, visitor website, a student cam .org. >> the population of china in 1949, the communist took control was 540 million people. and during the 72 years, the prc has had five principled leaders and. [inaudible]. and since 2012, and the current head of state, and george washington university professor david has risen close to 30 books devoted to the subject of asia rated we talk with professor about his newest book