most nights we were the only people who knew where we were. there were many definitions of freedom but surely that is one of them and one that i particularly enjoy. >> it is now my pleasure to introduce sam. sam is on the faculty of the science writing and ma in writing program at johns hopkins. prior to his arrival, sam taught creative writing and journalism in pennsylvania for ten years. he holds an ma in english and creative writing and in creative nonfiction from columbia university. he's published short stories,

personal essays, satires, journalistic features on a wide range of topics. in recent years he's primarily nwritten about science and healh and his work has appeared in "the new york times" magazine, the newhe yorker, the atlantic, wired, the los angeles times, the financial times magazine and mit technology review among other publications and of course the author of the book ravenous which you see this title on the screen and you are able to order and that is what we are talking about today so welcome, sam. >> thank you so much for inviting me on. >> of course.nv it's wonderful to have you. as i've said on social media, it reads like a novel. i was glued to it, but it's all true. i'm sure you will talk as we go

through. but anyway, so it is about the nobel laureate chemist who was a jewish homosexual living openly with his male partner in nazi germany, yet hitler protected him in the hope that he could cure cancer. but there's many parts to discuss. itthe family dynamic, his early life. let's start there. a very prominent physicist. the family that's known as a

financial family at the time it was unusual for the jewish dissent to rise to a high academic position. he really rises all the way to the top of the field and grows up in this house that is full of the world's greatest physicists and scientists. he was a regular einstein. many of these world-famous personalities would go on and say he intends to be a world changing scientist. he grows up with his natural surroundings that what he feels

is expected of him he does file competitiveness with his father and einstein loved his father. he decides he's going to make his way is a great scientist not in the realm of physics but in the realm of biology and the living world. throughout his life, he continues to approach from the lens of a physicist and is interested in how they use energy so that's the background he has with religious devotion,

that's how he felt about science. he said he pitied anybody who didn't become a scientist. that's the world he grew up in. a little pressure from the family or not. i have a feeling he just was who he was. before we move on to his work in the lab and all these other things, i want to talk about is a main partit of the book how these two people are tied together. in order to understand the relationship you need to understand hitler's childhood. i learnedd a lot that i didn't know, the child he was but

mostly about his mother. so let's now talk about his tying into his mom. >> i didn't plan to write a lot about his life but the more clear it became they were sort of on a collision course that sure enough would collide in the 1940s as we c will talk about but the stories are very much wrapped around cancer and the reason in large part is it's a rare disease. cancer is becoming more and more common over the next decade it becomes a preoccupation of determined people and full-fledged cancer panic

emerges. hitler is sort of ar, disgruntld teenager and his father dies when he's 13. he wants to be an artist but is kind of a hapless figure. nobody really likes him and the only connection he has is with his mother. his mother was diagnosed with breast cancer and he's shaken. it's one of these extraordinary things. a jewish doctor that is caring

for hitler's mother and hitler is actually very grateful. his mother is dying of breast cancer and hitler is just devastatedd. it's to the very end of his life a central focus but not any more so than cancer. he had these horrible stomach cramps and all sorts of conditions he always assumed were cancer. part of the chilling aspect he says multiple different times

one of the reasons he's in such a hurry to do these horrible things he wants to do he's got to take care of business before he dies. the stories are really bizarre. he even had an obsession with shellfish, which some historians think isb a word for cancer. evidently his mother died a painful death that he witnessed and the will you talked about, didn't he stop everything manning he was about to launch a big battle and he stopped to doa this? wasn't this done during wartime?

>> and the will it self was at period but, yes, i can talk about that as well. i can talk about that more now as it comes a little more in the progression. >> what do you think is it more family? >> that comes up a little bit later. >> now we understand a little bit more where what is driving these two people and what is their passion if you will but in this particular case i think it's appropriate. let's talk about his lab. not only is it an amazing lab that he designed, that is quite

frankly interesting but also how he behaved in that lab. walk us through the lab. >> by the 1920s, he's got a reputation and a brilliant biochemist. in 1931, the rockefeller foundation actually says we are going to build the labct of your dreams. you have to remember this is not too long after world war i the nationbuilding and institute. he doesn't want academics working for him he prefers technicians who are brilliantly

skilled but don't have their own academicde interests. tihe had a team of expert technicians. no one says anything and they go back to the lab. it's a relatively small operation changing the world of biochemistry surrounded in this lab he was a man who liked the finer things in life. you brought up world war i and to me that as part of his auto workers life that didn't fit.

i was surprised at his service in world war i. tell us about that a little bit. >> he was a german patriot and believes 1914. he was of jewish dissent. it wasas about as out as you cod be at the time. particularly if you look at german jews 1914 they are very patriotic and anxious to prove they were both full-fledged germans committed to the fatherland and signed up by the tens of thousands. he loved horses and signed up

for the calvary but was sort of an aristocratic unit and he was really drawn to it. i think he served admirably and got hannah iron cross -- got an iron cross along the eastern front. 1 of the remarkable parts of the story is by 1917, 1918, anybody that is paying attention, certainly by 1918 sees they are sending him letters and talking to the ministry saying we need to go home and do research or german food production until

albert einstein and they say you're too important for science we need youe to come home. his parents asked him to write the letter after einstein asked themtt to. you are too important for science. einstein understood how that claim to the arrogance so he comeses home, if he doesn't come home he died in the war and the cancer discovery never happened so i like to think that in theory he could have played an important role in the story.

talk about was it see urchins, you talk about a sea creature. explain his work so auto workers in. his lab. what was his goal, what was he searching for almost single-mindedly? >> it starts even before he has the lab when he's still in training as a medical student and physiologist but he goes with all of these famous european scientists in a special marine station a lot of famous scientists at the time are using it as an experimental tool trying to understand chromosomes

and the very foundation f of modern genetics. there were all these famous scientists at the same time i mentioned before. he comes up with these innovative devices to measure how much oxygen is being used and how much carbon dioxide is given off. he finds that they are taking up a lot of oxygen as they grow and that makes sense if you're growing you need energy. in the very beginning he wants to understand cancer. if you want to understand cancer you have to understand cell growth. the interesting thing is when he

starts to really turn his full attention to cancer in 1923, he had these experiments in the back of his mind. this discovery in 1923 it's taking up more oxygen. it's taking up a lot of glucose but instead of burning it with oxygen as you would expect, it's breaking it down turning it into lactic acid and it's the same process microorganisms to to give beer and wine and cheese and yogurt. a big part for many years is trying to understand why and it

continues to this day. >> and that we could take some time talking about what he discovered. there were a couple of moments, that was one of them. in the scientific community, when he started talking about this, what was the reaction from his fellow scientists when he started talking about what he was working on in the discovery? in the early years there was a surprising discovery. it took a while to set in but in time people started to accept that this is true.

to the same effect of human cancers and people accept that it is experimentally valid. the cancer cells eat in a very unusual way and take up glucose and form fermentation like microorganisms but what remains controversial is why they are doing this. if a cell isn't using oxygen, something must be broken. yet extremely aristocratic. it's the proper way and fermentation and if the cell does this it must be broken in some way. is there a problem with

respiration or is it doing this foryg other reasons, so that continues but in time the fact they are doing this is widely accepted and considered an important discovery. it is impossible to block it with some kind of therapy. it was extremely important science and may be we will talk about that later after the war as we discovered. >> he's making a name for himself,tt funded by the rockefeller institute and then he gets hitler's attention. a jewish man in a war now jewish

people are a lot of his scientists leave. walk us through the beginning of the war. you've got to hand it to the man he was sure no one was going to touch him. he was important and the basic persona he was harassed so tell us about that. >> the most extraordinary part 1933 comes around and they won the nobel prize in 1931. germany is the leading scientific nation and he is at the top of german science. he has everything he could want. a beautiful institute as we talked about. he's worked with his partner in the home a a block away and then suddenly everything is in

jeopardy and many of his colleagues leavele right away. he had the opportunity certainly to leave in the early 1933, 34. he decides to stay and there's many different reasons. part of it is he believes the nazi phenomena is going to be short-lived. just give him enough rope to hang himself. a lot of people believe this, and he said i was here before hitler. no one is going to take me out of here. and he made them think he is harassed again and again. they come to the institute and why aren't you sending your researchers to the marches.

he is livid and chases them out and screams and it's amazing that he gets away with it. he almost doesn't. they tolerate him because he was such an important scientist in the early years. in the early 30s, germany didn't care about the international reputation so he had some advantages. nobody should have been moreut vulnerable than leaving with his male partner,as he had not ceasd could have gotten rid of him at any time and they put up with him and harassed him but they

don't chase him out of the institute. all of the colleagues by the late 30s are gone and it's too late for him to leave. it really comes to the head in an extraordinary way were finally he's the only person of jewish descent who ises left now and he's running like a dictatorship with too much for many of the people that dislike him and a lot of people disliked dislikehim even before because s personnel. he had a lot of enemies and they finally succeeded in evicting him and it looks like the beginning of the end for him. he no longer cares about the reputation and he's called the nazi headquarters.

he sits down with the guy that designed the euthanasia program that also worked on the nazi killings machineries, just one of the worst. he sits down and tells them. 1 that i discovered in hitler's sort of daily planner that he has met on that same day and that would be interesting in any

event. but it turns out to be 1,june 201st, 1941. 1 of the most important days in the entire nazi project, only hours later at dawn the next morning they launched the operation which at the time was the biggest operation in history and hours later it will be rolling into soviet territory. meanwhile on that day just before it happens they are all busy talking about the cancer signs and sure enough you look at the diaries and they are staying up talking about how they are going to announce to the german people that they just invaded the soviet union and in the middle they talk and talk about cancer science. to give you a sense of how strange the nazi worldview is even at this critical moment

they are focused on cancer science. it makes no sense. i try to explain it in the book and we can talk about how it would be but it's truly bizarre. >> i thought so. fascinating. almost hard to put in your head. but that's what happened. so, now let's continue on. when did he -- i might be getting my timelines wrong -- he left the lab and moved to the u.s. for a while and drove this scientist crazy who was a very kind soul but just didn't know what to do. tell us how that happened and why and then what happened after that.

>> after this event that i just told you about, he's told if he focuses on cancer he will be protected so he makes it to the end of the war amazingly not only does he survive in 1942 bombs start to fall near, sorry, 1943, near the institute that he's essentially moved to a new institute that is a sort of refurbished mansion on a famous estate in the countryside. this is at a time when by the late 40s nobody is allowed to use gasoline for anything but the efforts and building material. they promise to build a newe institute and he carries out, he gets in trouble again and is almost arrested again but in the end he survives and has an

extraordinary treatment. so they come to power and take over. he's sort of cotton between the two worlds. the americans take over his institute after and turn it into a military headquarters. so he ends up managing in the late 40s to get a six month appointment in the university of illinois with robert emerson. it was hard to find a place in part because when he stayed in nazi germany, people thought he must be a nazi, he must've

worked with them and it didn't look goodok that he had stayed e whole time. so he gets this appointment for six months and comes to the university with jacob who is one of my favorite details in the book that [inaudible]. always competing with other scientists on photosynthesis in particular and then he proceeded into the laboratory not just

with his disputes but he says he's used to working in these cold german buildings. he's never w happy with the equipment or who is given assistance. at one point, he literally is drivingiv emerson crazy and he starts just kicking up circles around the town and doesn't knoa what to do with himself. he really pushes him to the brink. so -- >> that was a nice story, yeah. if you can put up with it.

but, so he's alienating more and more people and this thing he discovers, the only thing that matters in 1950 before a group of nobel laureates and everything else is dark and all heneeds to know is cancer cells eat other cells and they can't use oxygen so they ferment and he literally uses the word garbage for everything else. .. >> he dies in 1970, and, you ,

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 that proliferation mode. so scientists really start to see that there's a fundamental link between me tab limb and nutrient uptake and growth and proliferation. and they started to rediscover that, you know, what warburg had found which was that the cell shifts to this grow mold. he thought it was because a cell

couldn't use oxygen. but another hypothesis not because it can't use oxygen, but with because the metabolic enzymes are caused to turn on, and it's shifting it into this growth mode. so it's really fundamentally a different way to think about cancer, you know? it really hit home for me when i saw the famous cancer scientist, craig thompson, who's now the president and coo of memorial sloan-kettering. he did a talk where he put up a piece of bread, and he shows mold, and he says, okay, this is the everybody's first cancer experiment. everybody's done this. this is what cancer does. so that's sort of the rediscovery. and the question i was interested in is, okay, cells, cancer cells are getting more glucose than they should, and they're proliferating. well, how does the that -- you know, you always want to go one step, how does that happen? what does it have to do with our diet? for some cancer scientists,

they're not interested in a diet. they're just interested in, okay, this is what's happening. let's create a drug that can somehow blast this, and that is extremely important, and there are some amazing new drugs that have come out of this return to warburg. but i was interested in, naturally, a, you know, the cancer cell's overeating. is that in any way, does our eating in the any way affect that. >> yep. yep. >> and what's really interesting to me is that it really all comes together in the late 1990s because at the same time that these cancer scientists are rediscovering that a cancer cell overeats glucose, and that's fundamental to cancer, it literally just shows you where in the body cells are overeating glucose, and that's where the cancer is. but at the same time, other scientists, epidemiologists have studied cancer in populations. they're finding that obesity is

profoundly linked to cancer. thirteen different cancers have now been linked to obesity, strongly linked. others less strongly. i think it's probably just the tip of the iceberg. and so this is the fundamental question in my mind, can we connect these two stories. is there something about this obesity-cancer connection which, you know, obesity is now overtaking smoking as the fundamental, sort of most prominent, preventable cause of cancer. and then you have the warburg story, the cancer cells overeating glucose and multiplying. how are these two stories connected. and that, in a way, is my big project to see if there's a connection there. i'm a journalist. i'm a science writer. i'm not a scientist, but what i can do, what i can tell you try to connect the dots between these different fields because scientists from different fields aren't often talking to each other focused on the same things. and i think, and, you know, this is really what i discuss a lot in the last chapters of i my

book. i think these really are part of the same story and that the fundamental thing that connects them is this hormone, insulin. and i don't know if i should pause here, or do you want me to go on? >> no. no, no, this is where i wanted to be on this point -- at this point. focus on this point the rest of our time together. >> okay. so the question is, you know, if you think about a cancer, if you think about a microorganism, you know, you put the wreath, you know -- the yeast, you know, the grains, whatever, it makes copies of itself. but when you get into multicellular organisms, it's more complicated because our cells don't just eat whenever they encounter food. if they did, it would be anarchy. [laughter] so, again, craig thompson said you can think about a multicellular or nhl, it's almost like an agreement to eat only when they're told to eat.

it's kind of a remarkable thing because all our cells have the ability to take up nutrients, but they don't. and we have this food distribution system which is regulated by hormones. and, you know, first and foremost, the hormone insulin which sort of tells which cells to take up nutrients and how to store them as fuel in our body. so to understand cancer as, you know, this permutation of overeating glucose, you have this question, well, what makes our cells take up glucose. and first and foremost, it's this hormone insulin. so if a cell is overeating glucose, you have that. the cell has too much insulin could that be a part of this story. could that be driving this, you know, what they call the warburg effect, the warburg metabolism. and sure enough, there is a remarkable body of evidence that insulin is plague a huge role in human -- playing a huge role in human cancers.

it's a growth hormone that tells cells to eat and to divide and grow. and they don't, you know, really since, for decades people with elevated insulin have higher levels of cancer. this has been known for a long time. it also sort of became clear in the 1990s. and a number of fascinating discoveries were made. one -- well, first of all, it became increasingly clear that insulin drives obesity and that to obesity is, like, the cancer. insulin also activates all of these same networks that i talked about before that are changing the way a cell eats. these are what scientists use with the word downstream, they're downstream of insulin. insulin activates that in the same way that a mutation would. it sort of clauses them to -- causes them to keep going, keep taking the nutrients. insulin's a natural hormone, we all need it. but if you have an insulin

resistance, a condition where insulin is elevated all the time, then you're going to have far more insulin signaling than you ever would x it's going to be activating a cancer pathway. and once this mutation arrives, you can just think of it as a path that responds -- once mutation rises -- [inaudible] sensitive to insulin and little microscopic cancers that might appear all the time, ine stetted of dying, instead of being starved by the body, insulin keeps this many awe live. and you see 90% of cancer has many, many more insulin reaccept to haves than other cells. it's really striking to the extent which elevated insulin seems to pay a causal role in all these cancers. and, you know, it also possibly one of the more provocative things in my book is to suggest that, you know, cancer used to be a fairly rare disease in the

early 19th century, and maybe that's because, you know, insulin resistance was, you know, fairly nonexistent in the early 19th century. you see, sure enough, in lock step that cancer and diabetes and obesity growing throughout the late 19th and 20th centuries. so it's very clear to me that cancer is tied up into these metabolic diseases of obesity and diabetes. i don't think that's controversial. and i think insulin is really a piece of the puzzle that sort of makes all the data fit. and that, of course, there's always, like, one layer back. if you accept all this, then the obvious question is, well, how does our insulin, you know, how do we end up with 50 times more in the blood. and, to me, that's the real question. all this gets a little bit controversial, but i think that, you know, sugar, first and

foremost, is, you know, sort of the most worrisome part of the story because sugar has been -- when i say sugar, i don't mean glucose, i mean sucrose. yeah. so it's the sweet white stuff that we add to everything. it's one-half glucose, one-half sucrose and no molecule that we know of seems to cause this internal met boll you can destruction d metabolic destruction in the fat storage which seems to cause the elevated insulin. so to me, you know, there's a lot of nuance to all this. but to me, you know, there's one simple takeaway that it should be that insulin seems to be carcinogenic, elevated insulin. and if you want to keep your insulin lower, the first thing you should do is avoid sugar. >> yeah. and refined carbohydrates and, basically, ultra processed foods.

hamburger's a processed food because it's beef ground up, but i mean ultra-processed food and a chunk of which are the ingredients in processed foods other than the food colorings and all that. it's back to sugar. and our mutual friend, you know, is on a little bit of a mission about sugar and removing it from our diets. well, that's -- our food system has to have a complete rework. wouldn't it be interesting, i guess you mentioned the word fundamentals, and i've hard that many times over the years, but warburg was working on fundamentals, the fundamentals of the metabolism. and then we got away from that and got to, you know, sexier things or more, you know, the dialdown of the genetics and all these things which is amazing. but now we're going back to sort of the fundamentals. and warburg, who does not guess

what's in our food system right now, but insulin, so what is it other than -- we know sugar and ultra-processed foods. so what about, and i know you touch on this a little bit, and, you know, 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 they use real food no matter what their diet is. but you talk in the book and i know another mutual friend, you know, gary, is very keto. and then you talk about low carbs. basically, there's all these different eating styles, and there's no -- we don't have to make a decision as to what works for us. but talk about eating styles. what are we eating that we can

work through somehow other than to remove sugars and processed, ultra-processed foods from our diet? what about the protein teens and the carbs -- proteins and the carbs and the fat, how they tie together. i'm sure you're going to do a little focus on the carbohydrates and the types thereof. and one other thing on that mold is, you know, the whole -- and i don't mean to be pitching rob, but his new book, you know, the metabolic, it's protect the liver and feed the gut. and that tie it is all into this. so start with carbohydrates and bring in pro if teens and healthy fats if need by. >> sure. i was going to say, rob ludwig deserves an enormous amount of credit for waking everybody up to the harms of too much sugar in our duet. but, you know, from my

perspective -- and i want to specify that i'm really talking about prevention. i'm not talking about cancer treatment when i talk about all this. but from my perspective, i think the science that i've looked at, you know, i spent five years working on this book, and it's really pointing strongly in the direction of insulin resistance and elevated insulin being a causal factor in cancer. to me, we have to think of the carcinogen as something that causes cancer. and if it were some or sort of,u know, manmade chemical that was in our food or in our -- we'd be terrifying, it'd be banned. but the strange thing is it's part of our biology. just our biology exaggerated, you know? it's a growth hormone that's just, you know, ramped up to levels that should never be. so think about that as a carcinogen. a carcinogen is metabolic

disregulation, and any dietary strategy of prevention, therefore should be avoiding, lowering that carcinogen. what you do is you eat a diet which, you know, causes insulin resays tan -- resistance to improve. one study found that 88 of american adults have some type of it. if you want to -- i could say a sensible strategy is to follow a diet which would lower insulin levels and would be healthy for many different conditions. and that is what will probably make you less likely to get cancer. some cancers are bad luck, but some are genetically inherited. but, you know, so what causes insulin to rise. dietary fats seem to have, you know, as little if effect as

possible, almost no effect. carbohydrates cause the most. but, you know, if you follow, you know, if you're metabolically healthy, you may be able to eat a fairly normal diet. and i think the best that suggests is once sugar is introduced into the diet, that a lot of the metabolic problems start to happen. and once you have those metabolic problems, if you have the insulin resistance, then getting rid of sugars may not be enough. then you may have to focus more on healthy fats and proe teens. i think in terms of prevention, in term of lowering insulin resistance, the best evidence suggests that a diet that's high in proteins and low in carbohydrates is key. some scientists and doctors point more towards protein, some towards fat. but i think that the agreement

at least, you know, in certain -- the one thing you want to watch out for is too many carbohydrates, sugar first and foremost. but if you already had insulin resistance, then probably other cash carbohydrates as well. i really like the notion that michael pollack, an important cancer doctor in canada, said think of it like a condiment. think of it like -- don't eat a lot and certainly don't drink it because drinking sugar, you know, seems to cause the worst metabolic effects of all in terms of quickly hitting your liver and causing this liver fat storage which is part. >> and people need to be very careful, well, ideally, you know, -- there's no labels on broccoli, but you have to be careful with thed ad sugar. that's sugars.

but just with carte blanche the word carbohydrate. there are carbohydrates in process, there are carbohydrates in bread, but then there are different types of carbohydrates. i mean, there are intact carbohydrates meaning they've never been fractionalized and back together like whole grain bread is usually taken apart put back together of but they're intact. i think for people sugar's a carbohydrate, but i think people hear carbohydrates and, you know, i'm not on the keto diet personally, but, you know, there's no root vegetables or potatoes or certain things that have some nutrients in them. so there's different carbohydrate speak out there, and everybody has a different story. so what is your take on that or do you have an interest or

research done from your perspective on carbohydrates other than avoid sugar? >> sure. yeah, and it's very clear that, you know, more carbohydrates cause a more profound influence. think about proof, i said all these awful things about sugar, but fruit is full of sugar, and host scientists are comfortable with fruit in the diet because, you know, as you talk about, the cell structure and the fiber in the fruit causes the i glucose to, you know, rise dramatically, and you don't get the same metabolic impact. i don't think i'll be, you know, you have to figure out what they call the glycemic effect, how much of the glucose insulin it

causes and some people if you're met boll you cannily healthy, there aren't many adults in that situation, but if you are, i don't think you have to worry that much about -- i think you can tolerate a lot of carbohydrates. you know, there are many societies in human history that have eaten a lot of carbohydrates and been metabolically healthy. it's rolle only, i think, after the introduction of sugar first and foremost that they could start to see a lot of these problems. i think you want to avoid most, certainly, processed carbohydrates. but, you know, i think each individual, you know, you can get a pretty good sense of what's working for you by looking at, you know, your waste. i don't think it has to be one size fits all, but i think a common sense thing is, you know, to focus more on fats and proteins and less carbohydrates.

when your insulin's lower, part of what it does is it trapped fat inside your fat cells so your insulin's lower. there are gary used the analogy of a wallet. you burn it. but if you have elevated insulin all the time, the fat is getting mopped in, and it's just a natural sort of logical response to keep insulin lower to sort of restore the metabolism of your body. i'm only talking about the cancer, but there's even more evidence in other conditions. >> right. well, you know, years ago, i mean, i did the some volunteer work at a breast health center with my if local hospitals, and the women would come in that were in treatment, and we would all recommend a very low sugar diet because simplistically,

sugar's a cancer feeder. not everybody agreed with that e time, but with i think everybody pretty much agrees with it now. again, i know you were working primarily on prevention, so eat a healthy diet if you want to avoid any kind of metabolic disease and cancer. healthy fat, you know, omega 3 fatty acids and the 60s and the healthy fats and whatever kind of protein you eat. ..

so that is a little bit of a summary. for those who haven't read sam's book we just touched on some of these details. we didn't talk about his partner and what he did. and the take-home is watch your sugar and know that it is everywhere and nonalcoholic liver disease showing up in kids, the sugar, metabolically speaking is a nightmare, cancer speaking it is as well. . we talked about cyber. we talk about that. is the elevated sugar causing it to rise?

>> the igf-i story, certainly that is another hormone that is part of the story, there's a lot of nuance but it seems to increase one thing so i lump them together for the sake of simplicity you think those, one issue follows the elevated insulin so i focus on the insulin when i talk about it. on one of the interesting thing about that, i thought the whole damaging effect of sucrose, the sugar was by its effect on insulin resistance, emerging evidence that colon cancer can consume the fructose directly,

uniquely good at driving the effects so it continues to build even in the time i was working on the book. >> a fascinating book and we could talk for a couple more hours about this but hopefully everybody listening has a reason to go purchase your book, read this incredible story and how his work, very difficult brilliant man is front and center, and what that means to us. basically sam, i said to thank you so much for your comments here today, wonderful and i want to thank all of you who are listening today. this program will be on the commonwealth club website soon, commonwealthclub.org and now this meeting of the commonwealth club of california, more rating its 100 eighteenth year of enlightened discussion is adjourned.