nations for vaccine development i made some progress but the point is this is a time when we needed more than ever and we can talk about what were seen unraveling what russia is doing in china is doing to some extent. and now as if life is an complicated enough a very aggressive antiscience campaign which is homegrown in the united states and being launched by russia, how do we walk all of this back and restore vaccine diplomacy to the rightful place because of its incredible track record of success. >> you can find the rest of the program on our website booktv.org search for peter or the title of the book preventing the next pandemic using the search box at the top of the page. >> it is now my pleasure to introduce sam apple. sam is on the faculty of the ma

in science driving and riding program at john hopkins prior to his arrival at john hopkins cm taught creative writing and journalism at the university of pennsylvania for ten years he has an ma in english and creative writing from the university of michigan and nsa in creative nonfiction from the university previous published short stories, personal phase, 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, the los angeles times, the financial times magazine and technology review among other publications. of course he's the author of the book ravenous which you have

seen the title onn your screen and are able to order that's what were talking about today, welcome sam. >> thank you, thank you so much for inviting me on. >> it's wonderful to have you, i loved your book as a set on social media it reads like a novel, i was glued to it but it's all true i'm sure you will talk how we came up with the idea of writing this book and connecting all these dots. anyway it is about the loyalist the biochemist a homosexual living openly with his male partner and not see germany and hope that he could cure cancer. this reflects fiction but it is

true. there are many parts to discuss but i would like to start with auto warbirds use, his family dynamic, his early life, let's start there. >> his father is a very prominent citizen and he was jewish and part of the famous mofamily that is best known as a financial family, him and his father are cousins of these other workers and at the time it was unusual for the jewish descent to rise to the expedition. his father really rises all the way to the top. auto grows up in the house that is full of the world's greatest scientists in history and einstein was a regular and very

close with him warburg, fisher, one of the great chemist many of these world-famous personalities that would go on to t win nobel prizes in auto warburg is a world changing scientist and he grows up with his natural surrounding and what is expected of him and the question in his mind is is it going to make a change in discovery of what is inclined to be and he does feelh a sense of competitiveness of his father and einstein loved his father and warburg and he helped show this with einstein in the experimental evidence.

auto warburg decides he's good and out to his father is in the great scientist he's going to do it not in the realm of physic but biology in the living world but throughout his life he continues to approach biology and he's always interested in energy and how cells use energy. that is the background he has and this is what he tells about science, he says he did it become a scientist and he could not imagine it, that's a world he grows up and and his world changed and discovered. >> what pressure from the family or not, i have a feeling it was just ingrained in him to be a scientist like you said. before we move on to his work and his lab and all these other

things, i want to talk a little bit about hitler because it's the main part of the book on how the two. if her people are tied together in order to understand that relationship you need to t understand hitler's childhood and i learned a lot about hitler i did not know the kind of child he was in mostly about his mother. let's talk about hitler's youth tying into his mom. >> when i started to write this book i did not plan to write a lot about hitler's life but the more research i did the more clear it became that almost from the time that they were little warburg and hitler were on a collision course and they do collide in the 1940s and will talk about that. both stories are being wrapped

around cancer and the reason the relatively rare disease in the early 19th century and warburg and hitler are born in 1880s and by then cancer is becoming more and more common and over the next decade and becomes of the german people and panic emerges. this is the environment that they grew upp in, hitler is a disgruntled teenager, his father died when he was 13 and it's kind of nobody really likes him, the only connection that he has in the world is his mother and she was only human being he was capable of loving. right att t the time when hitles

trying and failing to become an artist his mother diagnosed wito breast cancer and he's absolutely shaken. his one friend at the time says he never seen nobody look so depressed in one of the extraordinary things a jewish doctor in austria who is caring and a jewish doctor who is caring forot hitler's mother and hitler is very grateful and had a good relationship with this doctor and they try everything his mother is dying of breast cancer and nothing can be done and hitler is devastated and the doctor left the testimony saying he never seen another human being looks so depressed. so his mother dies of breast cancer and the cancer remains to the very end of his life, the central focus he is extreme

hypochondriac afraid of many diseases but none more so than cancer, the story is one after another and at one point hitler stopped everything he's doing and write out a will is a sure he's good to dieie of cancer and he had the horrible stomach cramps and all sorts of conditions t and part of the chilling aspect he said it multiple different times one of the reasons he's in suchas a huy to do all the horrible things he wants to do because he's going to die of cancer and he has to take care of business before he dies so the stories are really bizarre and even had an obsession with shellfish and it somewhat speculative and cancer some people thought even that was hard. >> evidently his mother died a

long painful horrific death that he witnessed. in the will that you talked about wasn't that written, did he stop everything meaning he was about to launch some big battles and he stopped to do this, wasn't it during wartime? >> the will itself was at a different. but i can talk about that as well and i know what you're referring to there was a remarkable. inhe the 1940s which i can talk about that now or it comes a little later. stuart: what do you think is a more family where you're going with this. >> that comes up a little bit later. t >> okay now we understand a

little bit more where the early lives and what is driving these two people, what is their focus, what is their passion if you will and in this particular case i think is appropriate. let's talk about his lab tell us about his lab and not only thisa amazing lab he designed that was really interesting to but how he behaved in that lab, walk us uthrough the lab. >> by the 1920s wahlberg has a reputation in a cell physiologist and biochemist and in 1931 the rockefeller foundation actually says were going to build you the lab of

your dreams or personally designed the institute he wants a country manor and it's kind of an extraordinary thing this is after not long after world war i and the american foundation building and institute for german and he assembles, he does not really want academics working for him he prefers the technician who are brilliantly skilled but don't have their own eacademic interest. he has a team of expert technicians who do whatever he says and he's been in world war i and he runs it like a military operation they have these meetings where he commanded what to do and no one says anything and they go back to the lab and its incredible with the relatively small operation but the change of the world of biochemistry and one discovery

after another, this continues even into the 1930s after the not these come to power and is under incredible pressure. >> surrounded in this lab he was the man that like the finer thingsgs in life, the art in the furniture and the horses but let's digress just a minute you just brought up world war i into me that part of otto warburg's life almost did not 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 manyy german patriots e believed 1914 was a just cause for germany and the jewish dissent not really out with a homosexual which he was about as

out as he could be he lived openly with his partner the particular if you look at german in 1914 they were very patriotic and anxious to prove they were full-fledged germans and committed to the fatherland and they signed up by the tens of thousands and warburg also loved horses and signed up for calvary unit which was an aristocratic unit and he wass really drawn to it in a lot of ways and i don't thank you particular great soldier there are some storiesm about him but he served admirably and he got an iron cross. >> he was on the front lines. >> certainly on the eastern front but one of the remarkable parts of the story by 1970

covid-19 18 anybody who is paying attention certainly by 1918 sees it's a disaster for germany and the deaths are mounting and his parents are desperate to get amount of the german army and their sending letters and their talking to the administrative saying we need him to come home and do research for german food production and someone but warburg stays in the army until albert einstein of all people right to a letter and said you're too important for science we need you to come home and it was warburg's parents that asked einstein to write a letter but warburgin comes home after einstein asks him to it's dinteresting einstein says you too important for science and warburg was very arrogant and einstein understood how to convince warburg to his

arrogance and if he comes home as possible if he does nott come home he dies in the war in his incredible answer has never happened so i like to think the einstein in theory could've played a very important role in theer story. >> back to the lab now that we did world war i which is very interestingti, talk about was it see creatures that he worked with. >> explain his work, otto warburg is in his lab, what was his goal, what was he searching for an almost single-mindedly. >> sure, the research actually starts even before he has his own lab weenies and training as a medical student and

physiologist but all the european scientists to a special marine station in naples and he's putting fear to them in nevada being a scientist at the time it's an experimental and trying to understand chromosomes in the very foundation of modern genetics, warburg was there with all the famous scientist at the same time i mentioned before he was the son and he focused on energy and he wants to understand how it grows and you need energy so he buys and comes up with these innovative devicef to measure how much oxygen was being used and how much carbon dioxide is given up and he finds

the taking up a lot of oxygen and it makes to assent if t youe going you need energy and that's always been his mind to try to understand how it manages to grow because from the very beginning he wants to understand cancer and if you want to understand cancer you have to understand cell growth and the interesting thing when he has attention to cancer 1993 he has these experiments in the back of his mind and is using more oxygen and growing cancer cells will do the same thing and it's really surprising in the discovery o in 1923 a cancer cel is not in fact taking out more oxygen and it's doing strange and surprising fermenting it is taking a lot of glucose but instead of burning it with oxygen as you would expect it is

breaking it down and turning it to for lactic acid and sitting at the cell, the same fermentation process and get beer and wine and cheese and yogurt, it is strange that cancer cells were doing this and really a big part of cancer science for many years trying to understand why and what setsnd t off and it continues to this day. >> yes and we can take some time talking about that. and what he discovered there was a couple of all hot moments. in his scientific community when he started talking about this, what was the reaction from his fellow scientist when you started talking about what he boswas working on and his discovery. >> in the early years, the very

early years it was a new surprising discovery that cancers behave, it took a while to sudden but in time people did start to accept that this is true in the experiments themselves every cancer they tested seem to be true and originally they were looking at cancers in the laboratory in the same affecting human cancers so people except this is experimentally valid of cancer cells in a very unusual way and take up a lot of glucose and perform fermentation just like microorganisms but what is not accepted and remains controversial, why are they doing this warburg is sure if they are not using oxygen it must be something broke why would they not use oxygen he had an aristocrat craddock role any

brought this to the cancer cell to oxygen and what cell is supposed to do that is the improper way and fermentation of a lower organism and if his cell does this, must behe broken in some way and that continues to this day as well, is there a problem with respiration breathing with oxygen or a cancer cell doing this for another reason, that to be continuous but in time the fact that cancer cells were doing this is widely accepted in the important discovery and at least all these questions of taking up the glucose and blood sugar with some therapy and impossible to start a cancer cell this is extremely important science being discussed and maybe we'll

talk about it later after the war it's another strange part of the story as we discovered. >> is making a name for himself with his lab and he gets attention funded by the rockefeller institute and then he gets hitler's attention, a jewish man in a war, jewish people a lot of his scientist leave, walk us through the beginning of the war and warburg's, you gotta hand it to the man he was sure nobody was going to touch him he was too important in his basic persona as part of this, he was harassed, tell us about that. >> to me in a way that the most extraordinary part in 1933 comes

around in wartburg won the nobel prize in 1931 he's at the top of the scientific world in germany is a leading scientific nation and he's at the top of german science and he has everything he could want his beatable institute that we talked about and he lives with his partner in a beautiful home a block away and hitler comes to power and suddenly everything is in jeopardy and many of his colleagues leave right away and warburg thinks about it, he has opportunity to leave in the early 1933, 34 but he decides to stay in many different reasons, part of it he believes the knotty phenomenon is going to be short-lived, his cousin max wartburg said it will be over in

six months, a lot of people believe this and warburg said i was here before hitler no one is going to take me out of here in the amazing thing, he is harassed again and again, in the early 30s and why aren't you sending your researchers to the knots he marches, why aren't you using the hitler salute, he refused to do it why don't you have the knotty flag up and he's livid he chases them out and screams and it's amazing he gets away with it. and he almost doesn't but they tolerated him because he was an important scientist and in the early years he had the rockefeller backing and in the early 30s germany to some extent still cared about his international reputation so we had some advantages over other scientist and he was only half

jewish, after 1935 the special rules according to whether or not of his parents, there was a lot going on but nobody should've been more vulnerable, only jewish father living with his male partner in the knotty's could've gotten rid of him at any time and they put up with him and they harassed him but they don't chase him out of his institute. in the meanwhile all the colleagues by the late 30s are gone and it's too late for him to leave things are closing in on him and it really comes to an extraordinary way in 1941 where finally he's like the only person of jewish descent in the society who has left and he's running working for him and he was running it like a

dictatorship and that is too ormuch for many of the people to dislike him and a lot of people dislike them because of his personality. a lot of enemies and they finally succeed in evicting him in 1941 and it looks like the beginning of the end in germany nobody cares about international reputation and he's called to not see hitler's chancellor that hitler has built that iss imposing a building and they call him and it looks like who knows what's going to happen and he's with victor one of the worst knots he's the guy who designed the euthanasia program and also worked later to map out the knotty killings and machinery, one of the worst knots he's he sits down with

warburg and he tells them were gonna let you live as long as you agree on cancer, it's an extraordinary moment and what makes it more extraordinary is you find out i discovered in hitler's daily planner that he met on that same day to talk about warburg with victor, that would be interesting in any event but the day turns out to be june 21, 1921, this is one of the most important days in all of the knotty projects, only hours later it donned the next morning with operation which is the biggest military operation in history and german tanks will be rolling in to soviet territory and risking the entire knotty project and meanwhile on that date just before happen there all busy dealing with

warburg and talking about his cancer science and sure enough in the diary late that night he and hitler are staying up and they're talking about how they will announce to theey german people that they just invaded the soviet union and in the hemiddle of this they stop and talk about cancer science i just give you a sense of how strange the knotty worldview is even at this critical moment on warburg and cancer science and it makes no sense i tried to explain in the book but it is truly bizarre. >> yes, i thought so y too. that was actually fascinating and almost hard to put somewhere in your head but anyway that is awhat happened. now let's continue on when did he, i might be getting my

timelines wrong he left the lab and he moved to the u.s. for a while and drove this poor scientist absolutely crazy who was a kind soul but didn't know what to do with warburg, tell us when that move happened and why it happened and then what happened "after words". >> sure after this event that i just told you about, warburg says if he focuses on cancer have been protected, he makes it through the end of the war amazingly not only survive but in 1942 bomb start to fall covid-19 43, bombs fall near his institute and is actually moved to a new institute to refurbish

mansion on a famous estate and the germann countryside and this is at a time by the late 40s when nobody is allowed to use gasoline but anything for the war effort in building materials and they pause what they're doing to build a new institute for warburg and he carries out and gets in trouble and again, almost arrested but in the end he survives and has an extraordinary treatment, the soviets come to power and take over part of germany and the americans take over the other part and warburg is caught between the two worlds and doesn't have its institute the americans take over the institute and turn it into a military headquarter he has nowhere to go and no lab and it's not like having a baseball

bat in his entire existence. so he is trying to find something to do a place to go and he ends up in the late 40s to get six-month appointments and the university of illinois with robert emerson in the sympathies researcher and it was hard for him to find a place in part because when he stayed and knotty germany he thought he must be a knotty and work with them and he despised the nasis and hated them but it did not look good that he stayed the whole time he gets his appointment for six months and he comes to the university of illinois and he brings his partner, my favorite detail frof the book heights is put into a frat house to stay in warburg sees the frat house and he's

like the most aristocratic human being that is government in 19 century german to look at it and he gets involved in the huge debate about photosynthesis and he's talking with other scientist about photosynthesis in particular and he proceeds to drive everybody in the laboratory crazy not just with his disputes but he says he's used to working in the german buildings and put on the heat in the winter and everybody's walking around in the winter and he's never happy with the equipment and at one point he literally is driving emerson crazy any circles aroundvi the town because he doesn't know what to doit with himself and emerson was like a saint one of

the nicest human beings that ever lived i read about him in warburg and it pushes him to the brink so it's a book about cancer and knotty and there's not many parts of the book. >> that is a nice story. >> if you can put up with warburg but in the meanwhile he's an alienating more people in more extreme statements about cancer say not only this thing that he discovered the fermentation but it's only thing that matters, he appears in 1950 and he said everything else is garbage, all you need to know is cancer cells eat other cells they can't use oxygen so they ferment and he uses the word garbage forga everything else ad he insist if only the cancer

would just pay attention to him we could solve the disease and it is incredibly important what he's saying but the science is already changing in the 1950s we have the discovery in the structure of dna and there's these interesting discoveries about cancer viruses that are taking place in the 60s into the 1970s we have a deal breakthrough for cancer molecular biology performs and we start to see mutated genes can cause cancer and by this point warburg starts to fade away and he dies in 1970. in the stuff that he studied on energy that was considered old world science and basic biochemistry. in his metabolic enzymes are

what sl does but it doesn't matter to cancer cancer is sophisticated disease and gene and it's not basic biochemistry, gets lost is just amazing how quickly it happens. partially because people don't like warburg but more so because the new science seem so much marcus is under emphasis for sticking itand some people f warburg in the famous paper and textbooks coming out but don't mention him. even as late as 2006 you have a seminal textbookem that robert puts out the doesn't mention warburg out all and a wonderful book it doesn't even mention warburg and the cancer talks about the six basic functions oa cancer that come down to 2000 and it doesn't even mention the shift of fermentation which

really is fundamental to cancer, it is amazing how it gets lost and how we discovered in life that is so important. >> that's what i would like to talk about now and members who listen tot this and something to take home and the story in your book is what makes it so interesting but you tie together a lot of science and great information that people can learn from talk about how it shifted and why were talking about it again i'm sure you have toto talk about fructose and glucose in your metabolism and insulin resistance. all of those things from warburg and then it got lost and then now, why now?

>> sure the story really picks up again and warburg gets lost in in the late 1990s these molecular biologist that are focused on cancer in the modern sense of looking at mutated genes and how these signals go out from one protein to the next which causes the cell to replicate in the fundamental to cancer which is replication into their creating genetic pathways and they lead them back and they seem to be causingan metabolic enzymes to change interrupt the activity and it seems like one of these old world enzymes itec seems peculiar to them because they literally called them housekeeping enzymes, sure they don't need the energy but that's

afterthought the energy comes in when they need it the cancer networkthn seems to be bringing them back to these fundamental model bought a and dimes and a few scientists rather than ignoring this and thinking this is irrelevant, strange they got to curious, why is metabolism being connected to all of this and they start to look for the connection of the cancer gene and how cells take up nutrients in it really is remarkable over the next, a first everybody's skeptical but the next decades in 15 years they start to see that the cancers singling networks were actually fundamentally linked to lead into metabolism and it seems the most fundamental of many of the networks is actually controlling the tablets them and getting nutrients into the cell and its when the nutrients come into the

cell phone that the proliferation process occurs, the direction that people thought they cancer cells step back and say they thought that metabolism was an afterthought where in fact metabolism is driving the process and it's kind of remarkable because if you think of a cell that divides it doesn't have a way to pick up nutrients and integrated into this process that will collapse once cancer science referred to as a catastrophe for the cell and if you think about it from the perspective of a single cell organism i said before the cancer cell acts a lot like a single cell organism that comes into nutrients and gross and nutrients are fundamental in themselves and that's what you putnt yeast, bread, it grows because it has a nutrient and

makes copies of itself again and if it doesn't havet a nutrient and doesn't go into the puller for ration mode scientists really start to feel there's a fundamental link between metabolism and nutrient outtake and growth and proliferation and they started to rediscover that warburg had found the cell would shift to the growth mode and he thought it was because the cell could not use oxygen but another hypothesis the cell not because it has to but it can't use oxygen but metabolic enzymes are getting turned dine and causing it in overeating and shifting into the growth mode, it is fundamentally in different ways to think about cancer, it really hit home when i saw the famous cancer scientist craig thompson who is the president and ceo memorial and a piece of bread and he shows mold growing over a

piece of bread and hean said ths is everybody's cancer experiment everybody has done this, this is what cancer does. so that is the rediscovery and the question i waste intereste in, cancer cells are getting more glucose than they should in the proliferating, you always want to go one step, how does that happen and what does have to do with her diet, for some c cancer scientist they are not interested in diets there interested in this is what set happening and we can create a drug and that is extremely important and amazing new drugs that have come out of this and return to warburg. i was interested in the cancer cells overeating in many ways and it affects that. what is really interesting to me

as it comes together in the late 1990s because at the same time these cancer scientists are rediscovering that a cancer cell overeat glucose and that's fundamental to cancer and so fundamental but if you do a cat scan to show where and the body cells are over eating glucose, that is where the cancer is, at the same time other scientists, epidemiologists have studied cancer populations they are finding that obesity is linked to cancer 13 different cancers have linked to obesity and strongly linked, others less strongly and is probably just the tip of the iceberg so this is the fundamental question, can we connect these two stories is there something about the obesity cancer connection which we didno not overtake in the fundamental most prominent cause of cancer and then you have a story cancer over eating glucose

and multiplying how these two stories connected and that and away was my big productivity if there is a connection there because i'm a journalist and i'm not a scientist but what i can do andca try to do is try to connect the dots between the different fields because scientists from different fields are not talking to each other and focus on the o same thing in this i discussed a lot in my last chapter of the book i think these are part of the same story and the fundamental thing that connects them in the hormonepa insulin and i don't know if i should pause. >> this is just where i wanted to be at this point. and i'll focus on this with the rest of our timein together. and if you think about cancer microorganism you put the yeast

or grains to make copies of itself, when you get into a multicellular organism it is more complicated because our cells don't just eat whenever they encounter food, it would be anarchy, this cancer scientist craig said he could think about a multicellular organism that's an agreement between all the cells in the trillion cells in your body being told only went to eat at. the remarkable thing because of all of our cells have the ability to take up nutrients and they don't and we have this distribution system regulated by hormones and first in four foret which cells to take nutrients and how to store them and petition the fuels in our body. to understand cancer as a fermentation over eating glucose you have the question of what makes ourselves to go glucose

and first and foremost it's hormone insulin so a cell is over eating glucose and you have to ask yourself is there too much insulin could that be a part of the story could that be driving what they call warburg effect and metabolism. and sure enough there's a remarkable body of evidence would suggest insulin as played a huge role in human cancers and it's a growth factor in a growth hormone that tells cells to eat and dividing grow and they don't really for decades people with elevated incident has higher levels of cancer, this is been known for a long time and it became clear in the 1990s and a number of discoveries were made, first of all it became increasingly clear that insulin drives the obesity of the cancer but insulin also activates all

of the singling networks that i talked about before that are changing the way sl eats these are what scientist use the word downstream it activates them in the same way a mutation would and it causes them to rev up and keep going and taking out nutrient, insulin is a natural homerun, we all need it but we have insulin resistance in the condition where insulin is elevated all the time then you will have 24 hours a day far more insulin than you ever would and it's activating the cancer pathways and once a mutation arrives it's called the pathway you can think of it as a growth pathway that response to insulin and once the occasion rises and it's more sensitive to insulin and little microscopic cancers alike that might appear all the time instead of dying and being

start by the body or wiped up by the immune system, insulin keeps them alive and you see many different types of cancer and many more insulin and other cells and it is really striking to the extent at which elevated insulin seems to play a role in all of the obesity linked cancers and also possibly one of the more positive things in my book to suggest cancer used to be a fairly rare disease inn the early 19th century and maybe that is because insulin resistance was fairly nonexistent in the early 19th century and you see sure enough cancer and diabetes and obesity growing throughout the late 19 and 20th century, it's very clear cancer is tied up into the metabolic diseases of obesity and in diabetes i don't think that's controversial and i think

insulin is a piece of the puzzle that makes all the data fit. that of course is the obvious question, how does the insulin -- how do we end up with 50 times more insulin in the blood into me that's a real question and all of this gets a little controversial but i think sugar first and foremost because sugar i don't mean glucose. this is like one half glucose one half fructose in one molecule we know it's a metabolic destruction and around our internal organ which causes

the insulin resistance and elevated incidents to me there is a lot of nuance to all of this but to me if there is one civil take away it should be insulin seems to be carcinogenic, elevated insulin and if you want to keep her insulin lot the first thing you would do is d avoid sugar. >> in refined carbohydrates and basically ultra processed foods. hamburger is a processed food because it's beef ground-up ultra processed food and a chunk of which the ingredients and alter processed foods other than the food coloring and all of that, it's back to sugar in our mutual friend is on a mission about sugar and removing it from our diet, that is our food system that has to have a complete rework, would it be interesting, i guess you

mentioned the word fundamental and i've heard that many times over the years but warburg was working on fundamentals, the fundamentals of metabolism and then we got away from that and we got to sexier things or the dial down, the genetics and all these things which is amazing but now were going back to the fundamentals and warburg could've not guessed what is in our food system right now, otherwise my guesses he might've dialed down into this a little bit but what is it we know sugar and alter processed foods. what about and i know you touch on this a little bit i'm a nutritionist but i'm not dogmatic with people's eating styles other than i hope people eat most of their meals at home and use real food, no matter

what their diet is. but you talk in the book and i know another mutual friend gary is into quito and you talked about low carbs, basically with all of these different easy styles, there is no -- we don't have to make a decision as to what works for us what works for you may not work for me but talk about eating styles what are we eating that we can work through somehow other than to remove sugar and processed, alter processed foods from our diet, what about the proteins in the carbs and the facts, how they tie together i'm sure you'll do a little focus on carbohydrates. one other thing on that mode i don't mean to be pitching rob's new book but the metabolicd

old is protect the liver and feed the gut, that ties into this to start with carbohydrates in approaching healthy fats if need be. >> called to say rob is most famous for his famous talk on sugar and it deserves an enormous amount of credit for waking everybody up to the harms of too much sugar in our diet. from my perspective i want to specify and i'm talking about prevention i'm not talking about cancer treatment but from mye perspective i think the science that i looked at, it's been five years working on this book and it points strongly in the direction of insulin resistance being a causal factor in cancer so to me we have to think of elevated insulin of carcinogen is something that causes cancer

and if it were a man-made chemical that was in our food or pans would be terrified, and be banned and there would be warnings but is part of our biology as part of our biology, it's a growth hormone that is exaggerating and ramped up to t levels that should never be. think about that as a carcinogen, our carcinogen is metabolic, dysregulation and any dietary strategy prevention therefore should be lowering and avoiding that carcinogen how do you avoid the carcinogen and what you do you diet which causes insulin resistance to approve because all most all of us have had it in one study found 88% of american adults has some sign of it. if you want to avoid that i think a sensible strategy is to follow with diet which would

lower insulin levels and would be healthy for many different conditions but that is probably to make you less likely to get cancer there is no guarantees with cancer some are bad enough but some are genetically inherited. so what causes insulin to rise, dietary fats have a low affect on insulin as possible, almost no effect. protein causes some insulin spike but carbohydrate causeste the most but if you're metabolically healthy you may be able to eat a normal diet and i think the best that everyone suggests is sugar introduced into the diet a lot of the metabolic problems have and start to happen once you have those metabolic problems in some

insulinin resistance then gettig rid of sugar may not be enough and you have to cuten more carbs and focus on healthy fats and proteins. i think in terms of prevention and lowering insulin resistance the bestt evidence suggest thata diet that is high in fats and proteins and low in covid hydrates some scientists and doctors.towards protein and some towards fat but i think the agreement in certain circles is one thing you want to watch out for too many carbohydrates, sugar first and foremost but if you had insulin resistance probably other carbohydrates as well as i like the notion that michael pollick with a cancer doctor in canada and think of it like a condiment or salt-and-pepper but don't eat a lot of it and certainly don't drink it because drinking sugar

seems to cause the worst metabolic effect in terms of quickly hitting your liver and causing those liver which is part of the insulin resistance phenomenon. >> people need to be very careful who are ideally seen mislabeled, there's no labels on broccoli or roasted chicken but you have to be careful with the added sugar but that is sugar, launch the word carbohydrate there are carbohydrates and pasta, there are carbohydrates and bread, but then there are different types of carbohydrates there are fat carbohydrates meaning they never been fashioned by simple back together like whole-grain bread is usually dissolved and putin back together but wheat berries are whole there intact so i think people sugar is a

carbohydrate but i think people here carbohydrates and i'm not on a quito diet personally but there is no root vegetable or potatoes or the have the nutrients in them. there is different carbohydrates to speak out there and everybody has a different story, what is your take on that or do you have an interest or research done from your perspective on types of carbohydrates other than avoiding sugar. >> it's very clear that mortifying carbohydrates causes more profound insulin spike and think about fruit, i said this all things about sugar but fruit and most scientists are comfortable with fruit in the

diet because as you talk about the cell structure and the fiber in the fruit causes the glucose less dramatically and you don't get the same metabolic impact. identical carbohydrates need to be thought is bad you have to figure out what they called the glycemic effect and how much of glucose and insulin and causes and some people with metabolic healthy and you don't have the i insulin resistance and many adults in that situation if you are i don't think you have to worry thatt much about sugar but you can tolerate a lot of carbohydrates there are many societies in human history that have eaten a lot of carbohydrates and metabolically healthy it's only after the introduction of sugar first and foremost that you see a lot of these problems so once you have

these metabolic problems i think you want to avoid most process carbohydrates but i think each individual you can get a sense of what's working for you by simply looking at your body are you losing weight, i don't think has to be one-size-fits-all but a common sense thing to focus on protein and less carbohydrates because that keeps insulin lower and when your insulin is lower and part of what it does it traps the fat cells into your insulin is lower in gary thomas the analogy that the fat cells and a slows back down and you burn it and elevated insulin all the time without us getting locked in and it's a natural plausible response to keep insulin lower to restore the

metabolism of your whole body and i'm only talking about cancer but even more evidence in another. >> you know years ago i did some volunteer work at a breast health center with my local hospital and a woman would come in that were in treatment and we would recommend a very low sugar diet, simplistically was said sugar is a cancer feeder, not everybody agreed without the time but pretty much everybody agrees with that now. if you have, again i know you are working primarily on prevention but a healthy diet if you want to avoid any metabolic disease and cancer. healthy fats into fatty acids and relationships in the healthy

fatsat and whatever kind of protein that you eat but the big thing you recommend limiting obviously sugar sugary drinks, particularly and staying low on the carbohydrates, if you have cancer that's probably more so important so that is probably a little bit of a summary and for those of you who haven't read sam's book we just touched on some of these details we did not really talk about otto's partner all that much and what he did, anyway really interesting and were dialed down near the take-home is watch your sugar and know that it's everywhere in your sugary drinks and your sodas in the fatty liver disease

that is not how gallic fatty liver disease showing up in kids, that is all sugar the sugar metabolically speaking is a nightmare, cancer speaking it is as well. we already talked about fiber mitigates the glucose and fruit we talked about that, is insulin the culprit or the elevated sugar causing insulin to rise the culprit, what about igf-i? >> the igf-i story is insulin like growth factor one and that is another hormone that is part of the story and there's a lot of nuance to the science and the elevated insulin seems to also increase the igf-i signaling so i sort ofo lump them together r theor simplicity but the igf-i s you follow the insulin i just focus on the insulin when i talk

thabout it but one of theal interesting things when i started writing this book i thought the whole t damagingma effect of sucrose the sugar was the effect on insulin resistance and elevated insulin but there is emerging evidence that: cancel or in particular can consume fructose directly and that is uniquely good at driving the effect. sugar continues to build in the time i was working on a book. >> a fascinating book and we could talk for a couple more hours on this but hopefully everybody is listening and has a reason to go purchase your book and read this incredible story and how his work from the very difficult brilliant man is front and center again and what that means to us, basically i want to thank you so much for your

comments here today they have been wonderful. you want to think all of you listening today, this program will be on the commonwealth club website soon that is incommonwealth club.org and now this meeting of the common wealth because the california commemorating its 118th year of light in discussions is adjourned. >> now on the tv more television for serious readers. christian baker, jack phillips recently discussed the supreme court case over his refusal to bake a same-sex wedding cake. here's a portion of that conversation. >> the government gives us the option to go to court to defend these things as well in our government we have a constitution that her government

is supposed to protect our rights and among them are the rights to free exercise religion. this is what that was it was a right because they did not want to create that message of the wedding cake and also a right to freely express my pain so the government is supposed to protect her right and when they weren't there is also our constitution where we are able to rule the court system like this and fight for these reasons. >> i think in the book you said your legal defense was the quote unquote rights of conscience of sense can you explain what that means? >> rights of conscience are asking me too create a message that is part of the speech but they're asking to make me create a message and to make the wedding cake is an iconic symbol is a message in itself, if you

were to get a hotel and lock into a conference room you were there for a business meeting and you walk in and see a cake or something like that on the corner you know it's not a business meeting you know without having to ask anybody it is a wedding so that wedding cake is a message. and to create that wedding cake the bible defines a marriage is between a man and a woman in this cake would be a message and go against my biblical belief, it's asking me too violate my conscience to create this cake and a message that i cannot do. >> to watch arrested this program does the booktv.org use the search box to look for jack phillips or the title of his book the cost of my faith. >> good evening in the president of the council of the library foundation of los angeles. this is my great pleasure to