c-span2 with top nonfiction books and authors every weekend, booktv, television for serious readers. .. creative writing english, from university of michigan. and creative nonfiction from columbia university. has published short stories, personal essays journalistic features, and a wide range of topics. in recent years is primarily written about science and health is work has appeared in the new

york times magazine, new yorker, the atlantic, los angeles times, the financial times magazine, and mit technology review among other publications. and of course he is the author of the book which can see the title on your screen and you are able to order it. that is what we are talking about today. so welcome sam apple. sue and thank you for inviting me. a. patty: of course is wonderful to have you. i love your book edit raises i said, on social media, every dislike a novel. i was glued to it, it is all true. i am sure that you will talk as we go through about your work how you came up with the idea about writing this book. i connecting all of these thoughts. it is about the biochemist.

biochemist otto warburg he was gay and jewish of living openly with his male partner nazi party in germany and hitler protected him. in hopes of curing cancer. but this is true. but there are many parts to this book. but i would like to start with biochemist otto warburg as you. his family dynamics. his early life rated let's start there and tell us about his family. sam: so his father was very prominent physicist. he was jewish, and part of the famous warburg family that is best known as a financial family of the warburg bank. and trento is a product of these other warburg senate the time it was unusual for somebody of

jewish descent to rise to a high academic position and his father really rises all of the way to the top of the civics world and otto warburg present the sum of the greatest scientists in history. a regular einstein it was very close to camille warburg and fisher and was great chemistry to so many of these world-famous personalities and someone, they had many of these world-famous personalities who would go on to win nobel prizes, otto warburg intends to be a world changing scientist. he grows up with it. his natural surroundings, what he feels is expected of him. the question in his mind is not is he going to make a world changing discovery but in what field it is going to be and he does file competitiveness with

his father and wants to outdo him which is not easy to do. his father, einstein loved his father emile warburg, helped to show that some of einstein's theories were otto warburg decides to outdo his father and make his name as a great scientist, doing it not in the realm of physics but biology and the living world. he continues through the lens of a physicist, always interested in energy and how cells use energy. that is the background. someone described him as a prophet with religious devotion to science, anybody who didn't become a scientist, who couldn't imagine it. that is the world he grows up in, we will talk about that

more, he does make a world changing discovery. >> a little pressure from the family or not, i have a feeling he was who he was since he was a little kid and it was ingrained in him to be a scientist. before we move on to his work and his lab and all these other things i want to talk a little bit about hitler. it is part of the book, two very different people, in order to understand that relationship, you have to understand hitler's childhood and i learned a lot about hitler that i didn't know the, the kind of child he was but mostly about his mother. let's talk about hitler's youth. >> i really didn't 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 they were little, warburg and hitler were on collision course that sure enough they do collide in the 1940s as we will talk about. both stories are very much wrapped around cancer. the reason in large part, cancer had been a relatively rare disease in the early 19th century and then warburg and hitler were born in 1880 and by then cancer is becoming more common and over the next decade becomes a preoccupation, full-fledged cancer panic emerges, this is the environment that both grew up in. hitler is a sort of disgruntled teenager, his father dies when he's 13 as i recall correctly and he wants to be an artist,

but this hapless figure, nobody really likes him in the only connection he has with the world is his mother, 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 had breast cancer and he is absolutely shaken. is one sort of friend at the time, he's never seen somebody looked so depressed, and a jewish doctor, austrian jewish doctor is -- i'm including austria, and austrian jewish doctor is caring for hitler's mother and hitler is grateful and had a good relationship with this doctor, they try everything, his mother dies of breast cancer and nothing can

be done it hitler is devastated. the doctor, the testimony that he had never seen another human being looks so depressed and so his mother dies of breast cancer and slow cancer remains a threat to the very end of his life. he's an extreme hypochondriac afraid of many diseases but none more so then cancer. stories one after another, at one point he stops everything he's doing, he is sure he's going to die of cancer and has these horrible stomach cramps and all sorts of conditions he always assumed were cancer. part of the chilling aspect of it, he says multiple times one of the reasons he is in such a hurry to do the horrible things he wants to do is because he's going to die soon of cancer and has to take care of this before he dies. the stories are really bizarre.

he even had an obsession against cell -- shellfish which some speculate, the word in german is cribs for crap and the word for cancer some people thought even that was part of it. >> host: his mother died a long, painful, horrific death that he witnessed. and that -- you talked about wasn't that written? didn't he stop everything to launch some big battle and stopped to do this? wasn't it during war time? wartime? >> it was at a different period but i can talk about that as well. there was this remarkable period in the 1940s, i can talk

about that now. that comes later in the progression. >> host: is a more family? >> guest: that comes up later. >> host: now we understand a little bit more where their early lives, what are driving these two people, what is their focus, what is their passion but in this case it is appropriate. let's talk about his lab. tell us about his lab, not only this amazing lab that he designed, that was really interesting too, but how he behaved in that lab. walk us through the lab.

>> by the 1920s otto warburg has a reputation as a physiologist and biochemist. in 1931 the rockefeller foundation says we are going to build you the lab of your dreams so he designed the institute, to look like a country manor, this is not long after world war i where you had an american foundation, institute for a german and he assembles -- he doesn't like academics, he prefers to commissions that are brilliantly skilled but don't have their own academic interests and he had visiting scientists, a team of expert technicians to do whatever he says. he runs up like a military

operation. these meetings where he commands them what to do, and take it back to the lab. it is incredible because a relatively small operation but they are changing the world of biochemistry one phenomenal discovery after another and this continues into the 1930s after the nazis come to power and he's under incredible pressure. >> guest: he likes the finer things in life but let's digress for a minute because you just brought up world war i and 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.

>> guest: he was a german patriot and he believed, 1914, it was just for germany, and he was of jewish dissent, not really out as a homosexual which he was as out as you could be at the time, lived openly with his partner but i think particularly if you look at german jews, in 1914, very patriotic and very anxious to prove they were full-fledged germans and committed to the fatherland and they signed up for the war effort by tens of thousands and also otto warburg loves horses and signed up to the cavalry which was sort of an aristocratic unit and he was really drawn to it in a lot of ways. he wasn't -- don't think he was

a particularly great soldier, there are stories about him but he served admirably and got an iron cross. >> he was on the front lines, right? >> guest: yes. on the eastern front. one of the remarkable parts of this story is by 1917-18, anyone who's paying attention, by 1918, sees disaster for germany, the deaths are mounting and his parents are desperate to get him out of the german army and they are sending letters, talking to the ministry of the interior saying we need him to come home and do research for german food production and so on but he stays in the army until albert einstein writes him a letter and shows you are too important for science, we need you to come home. 's parents asked einstein to

write the letter but he does come home after einstein asked him to. einstein says you are too important for science and is very arrogant and i think einstein understood how to convince him by playing to his arrogance, sure enough he comes home and it is possible if he doesn't come home he dies in the war and his incredible cancer discoveries never happen. i like to think einstein played of an important role in this story. >> host: back to the lab, talk about was it see urchins? what is it? it was a sea creature. explain his work.

otto warburg is in his lab. almost single heart -- single-mindedly. >> it starts before that, medical student and physiologist, studying, goes with all the famous european scientists to a special marine station. a lot of scientists at the time are using this as an experimental tool in trying to understand chromosomes.

and his always focused, he grows energy and really comes up with innovative devices to measure how much oxygen is being used and how much carbon dioxide is given off and so on and finds the see urchin eggs are taking up a lot of oxygen as they grow. if you are growing you need energy. that is always in his mind, trying to understand how it manages to grow but in the very beginning he wants to understand cancer and if you want to understand cancer you have to understand cell growth. when he gives attention to cancer he has these see urchin experiments the back of his mind, the see urchin egg is

growing, cancer cells do the same thing and it is surprising, the cancer cell is not in fact taking up more oxygen. it's doing something strange and surprising, it is fermenting, taking up a lot of glucose but instead of burning it as you would expect, it's breaking it down, turning it into lactic acid and spitting it out of the cell. the same fermentation process that gives us beer and wine, cheese and yogurt so very strange that cancer cells were doing this and a big part of cancer science for many years is trying to understand why, it continues to this day. scott keeter yes. and we could take some time talking about that as far as what he discovered. there were a couple real aha

moments. his scientific community, when you started talking about this, what was the reaction from his fellow scientists when he started talking about what he was working on and his discovery? >> in the early years it was such a new, surprising discovery that cancers behave like this, took a while to start in but in time people really did start to accept that this is true, they did the experiments themselves and every cancer they tested, it seemed to be true. they tested -- originally looking at cancers and laboratory, eventually they see the same effect in human cancers. people accept that this is experimentally valid, cancer cells eat in a very unusual

way, a lot of glucose and fermentation like microorganisms. what is not accepted but remains controversial is why they are doing this and warburg is sure that officials not using oxygen something must be broken. extremely aristocratic, he brought this to the cancer cell or any cell, oxygen is what cells are supposed to do, that's the proper way, fermentation is a lower organism and the cell does this it must be somehow broken in some way. that continues to this day as well. is there a problem with respiration, breathing with oxygen where a cancer cell is doing this for another reason. that debate continues but in time just the fact that cancer cells are doing this was widely

accepted, very important discovery and cancer cells taking up almost glucose and blood sugar you can block it with some sort of therapy, possible to start a cancer cell. it is extremely important science being discussed and after the war, another strange part of the story he disappears. >> he gets attention funded by the rockefeller institute but again, a jewish man, we are in a war now, jewish people, a lot of his scientist, walk us through the beginning of the war and how -- warburg's absolute, got to hand it to the

man. he was sure nobody was going to touch him, he was just too important and his basic persona is part of this, he was harassed. tell us about that. >> to me in a way that's the most extraordinary part of his story that 1933 comes around, he has won the nobel prize in 1931, really at the top of the scientific world, germany is the leading scientific nation and he's at the top of german science, he has every thing he could want, a beautiful institute as we talked about, 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 he thinks about it, he has the opportunity to leave in the

early 1933-34, but he decides to stay. there's many different reasons. part of it is that he blues the nazi phenomena and is going to be short lived. just give hitler enough rope to hang himself and it will be over in 6 months. a lot of people believed this and warburg says i was here before hitler, no one is going to take me out of here. he is harassed again and again in the early 30s. why aren't you sending your researchers to nazi marches and stuff? why aren't you using hitler's salutes and have the nazi flag up, he's livid, chases them out, screams at the man's gets

away with it and they tolerated him because he was such an important scientist and in the early years had the rockefeller backing and in the early 30s germany cared about its international reputation so had advantages over other scientists. after 1935, whether you get one jewish parent or two jewish parents there was a lot going on but nobody should have been more vulnerable. not only jewish father, living with his male partner, the nazis could have 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. all his colleagues by the late 30s are gone. it's too late, things are

closing in on him. really comes to a head in an extraordinary way in 1941 where finally he is literally the only person of jewish dissent in society who is left now and aryans working for him and running it like a dictatorship and it's too much for so many of the people who dislike him. a lot of people dislike him even before the nazis because of his personality. he had a lot of enemies. they finally succeed in evicting him in 1941 and looks like the beginning of the end, germany no longer cares about its international reputation. he's called to nazi headquarters, the chancellery that hitler has built, really imposing building. they call him in and it looks like he knows what is going to

happen and one of the worst nazis, the guy who designed the euthanasia program, also worked later would help map out the nazi killings machinery, one of the worst nazis, sits down with warburg and tells him we are going to let you live as long as you agree to focus on cancer. it is an extraordinary moment. what makes it more extraordinary is i discovered in himmler's daily planner, he met on the same day to talk with him, that would be interesting in any event, but the day turned out to be june 21, 1941. one of the most important days in all of the entire sort of nazi project. only hours later at don the

next morning they lunch operation barbara roeser, the biggest military operation in history, the german tanks will hours later be rolling into soviet territory risking the entire nazi project and on june 21st just before 21 just before it happens they are busy dealing with warburg talking about his cancer science and sure enough in his diary late that night he and hitler are staying up talking about how they are going to announce to the german people they just invaded the soviet union in the middle of this they stop and talk about cancer science. gives you a sense how strange the nazi worldview is that even at this critical moment, focusing on warfare and cancer science. it makes no sense i try to explain in the book. it is truly bizarre.

>> host: i thought so too. it is somewhat hard to understand but that is what happens. and now let's continue on. when did he, might be getting my timelines wrong, he left the lab and moved to the us for a wildlands drove this poor scientist absolutely crazy who was a very kind soul who didn't know what to do. tell us when that move happened and why it happened and what happened after? >> guest: after the event i just told you about, warburg is told that if he focuses on cancer he will be protected so he makes it to the end of the

war, amazingly, in 1942 bomb start to fall, 1943, his institute, he is moved to a new institute which is a refurbished mansion on a famous estate in the german countryside and this is at a time by the late 40s nobody is allowed to do anything but the war effort, they are what they are doing to build a new institute for warburg and he gets in trouble again, almost arrested again but in the end he survives and has such extraordinary treatments. the soviets come to power, takeover part of germany, americans take over the other party and he's caught in

between these two worlds and doesn't have his institute, the americans take over his institute and turn it into a military headquarters so he has nowhere to go, no lab and for warburg not to have a lab, it is his entire existence so he's trying to find something to do, a place to go and he ends up managing in the late 40s to get a 6 month appointment in the university of illinois with robert emerson. it was hard for him to find a place in part because when he stayed in nazi germany people thought he must've worked with them. he despised the nazis and hated them but it didn't look good that he had stayed the whole time so he gets this

appointment for 6 months and comes to the university of illinois and brings his partner, one of my favorite details in the book, heise is put into a frat house to stay and warburg comes and sees the frat house and is horrified. the most aristocratic -- 19th-century, imagine the look on his face. but he gets involved in a huge debate about photosynthesis. throughout his life he is always feuding with other scientists and then he proceeds to drive everybody in the laboratory crazy not just with his views but he used to work in german buildings but in the heat of the winter, everyone is

walking around the winter coats, he's never happy with the equipment or who has given assistant is. at one point he drives emerson crazy, emerson circles around the town because he doesn't know what to do with himself. emerson was like a saint, one of the nicest human beings who ever lived and warburg pushed him to the brink. it is a book about cancer, there are not many funny parts in the book but -- that chapter is, relief. if you can put up with warburg's and text. so in the meanwhile he is alienating more and more people and making more extreme statements about cancer saying not only is the fermentation important but is the only thing that matters.

he appears in 1950 before group of nobel laureates and says everything else is garbage, all you need to know is cancer cells can't use oxygen so they ferment and he uses the word garbage for everything else and he insists, if only the cancer world would pay attention to him we could solve this and it is incredibly important what he is saying but the tides of science are changing in the 1950s with the discovery of the structure of dna and always interesting discoveries about cancer virus is taking place in the 60s and then we have a real breakthrough where cancer, modern molecular biology, they start to see particular mutated genes can cause cancer and by

this point, all the warburg stuff starts to fade away and he dies in 1970. the stuff he cited how cells use energy was considered all world science, basic biochemistry, these mobile enzymes are part of what a cell does but don't matter to cancer. it is a sophisticated disease of the gene, it's not biochemistry. it is amazing how quickly it happens. people don't like warburg but even more so, the new science is so much more sophisticated. by the 1980s some people haven't heard of warburg and you have these famous textbooks that don't mention him. even as late as 2006 you have the seminal textbook robert weinberg puts out the doesn't

mention warburg at all, a wonderful book, the emperor of all maladies doesn't mention warburg. a famous paper, the hallmarks of cancer which talks about the basic functions of cancer comes out in 2000 and it doesn't even mention, the shift to fermentation which really is fundamentally cancer. it's amazing how it got lost. a lot of what i write about is why it is so important. >> host: that is what i would like to talk about now. members are listening to this. giving something to take home, the story in your book is what makes it so interesting but you try to get through science and great information people can learn from so talk about how it

shifted and why we are talking about it again. i'm sure you will have to talk about fructose and glucose, insulin resistance, and all those things from warburg and it got lost and now, why now? >> the story really picks up again, in the late 1990s, and talking about mutated genes and how these signals go out from one protein to the next cause both cell to replicate, fundamental to what cancer is, replication. they are tracing genetic pathways. leads them back to metabolic

enzymes. it seems like, why are these enzymes, a housekeeping enzyme. cancer networks seem to be bringing them back to fundamental metabolic enzymes. rather than ignoring it, with mistaken findings. they have cancer genes, and really is remarkable, everybody is skeptical of it.

they start to see singling networks, fundamentally linked to metabolism, the most fundamental role of many of these, giving nutrients into the cell and when nutrients come into the cell proliferation process occurs, the direction people fought cancer cells, step back and say metabolism was an afterthought when it seems metabolism is driving the process, and a way to pick up nutrients and integrated into this process, and referred to as a catastrophe.

and cancer cell act a lot like a single celled organism that grows. that is what you put yeast onto. it grows because, and there's a fundamental link between metabolism and nutrients uptick and the growth and proliferation. and shifting to the growth mode. and used oxygen. another hypothesis is it is not because it has to because it can't use oxygen but metabolic enzymes are getting turned on

and causing it to overeat glucose and shoot again into this growth mode, a fundamentally different way to think about cancer. it hit home for me when i saw craig thompson now the president of memorial did a talk where he put a piece of bread that shows mold growing over people's bread, everybody's first cancer experiments, everybody had done this, this is what cancer does. so that is the rediscovery. cancer cells are getting more glucose than we should and they are proliferating. you always want to go how does that happen? what does that have to do with diet. for some cancer scientists they are not interested in diet. they are only interested in what is happening with the beta drugs that can block this mess.

it is important and there's an amazing new drugs that have come out of this but i was interested. the cancer cells, does that affect how that happens? what is really interesting to me is it all comes together in the late 1990s, if cancer scientists are discovering a cancer cell and that is fundamental, do a pet scan that shows you where they are over reading glucose that's where the cancer is but at the same time other scientists, epidemiologists are finding obesity is linked to cancer, 15 cancers have been linked to obesity, and i think just the tip of the iceberg.

this is the fundamental question on my mind. can you connect these stories? is there something about this obesity cancer connection, the most probable cause of cancer, and multiply yang, how these stories connect and that was my big project. if there's a connection. i am a science writer, and scientists from different fields, focused on the same things. and the fundamental thing that connects them was this hormone. i don't know if i should pause here.

>> host: this is where i wanted to be at this point. >> guest: the real question, if you think about a cancer, a microorganism and makes copies of itself. when you deal with multicellular organisms it is more complicated because our cells don't just eat when they encounter, if it did it would be anarchy. craig thompson says you can think about multicellular organism. almost an agreement between all these cells in your body to eat only when told to eat. all ourselves have the ability to take up nutrients but they don't. you have this food distribution

system regulated by hormones and insulin tells which cells to take up nutrients and how to store them. understand cancer as fermentation already and glucose, the question, what makes ourselves take up glucose, first and foremost this hormone insulin and you have to ask yourself is their too much insulin? could that be part of the story driving what they call the warburg effect? sure enough, there is a remarkable body of evidence to suggest insulin plays a huge role in human cancer. the growth hormone tells cells to eat and divide and grow.

for decades, they have higher levels of cancer. this has been done for a long time, in the 1990s. a number of fascinating discoveries, insulin drives obesity and it is like cancer. the singling networks that are changing the way a so eats, what scientists need to work downstream, insulin activates them the same way it causes them to rev up and keep taking nutrients. we all need it but we had insulin resistance where it is elevated all the time. 24 hours a day far more insulin and it will be activating cancer pathways.

once the mutation arrives, the pathway you can think of as a growth pathway. once mutation arises, more sensitive to insulin, microscopic cancers that might appear all the time instead of dying. and wiped out by the immune system. many more insulin receptors than other cells but it is striking to the extent that elevated insulin plays a causal role in obesity linked cancers and possibly one of the most positive things in my book is to suggest cancer used to be a fairly rare disease in the 19th century and maybe that is because insulin resistance was barely nonexistent in the early nineteenth century and sure

enough in lockstep, cancer and diabetes and obesity growing through the 19th and 20th century. it is clear to me that cancer is tied up in these metabolic diseases of obesity and insulin and diabetes. i don't think that is controversial, it is a piece of the puzzle put makes all the data fit. that of course is always one way back, the obvious question is how does insulin -- how did we end up with this? that is the real question. all this gets a little controversial but sugar first and foremost is the most worrisome part of the story because sugar, i don't mean glucose, i mean sucrose.

the sweet white stuff we had to everything. and no molecule we know of seems to cause internal metabolic disruption, the storage around internal organs seems to cause insulin resistance and elevated insulin. there is a lot of nuance on this but one simple take away that it should be that insulin seems to be carcinogenic and if you want to keep insulin low you want to avoid sugar. dirksen senate office building 0 -- >> host: refined carbohydrates, hamburgers are meet ground up but ultra processed foods and a chunk of ingredients, both food coloring and all that but back

to sugar, the mission about sugar and removing it, the food system has to have that. wouldn't that be interesting, you mention the word fundamentals and i've heard that many times over the years but warburg was working on fundamentals, metabolism and we got away from that and got to sexier things, the dial down, itches amazing, to the fundamentals, warburg could if not just what is in our food system, otherwise my guess, he might have gone into this a little bit.

what is it? we know sugar and ultra processed foods. i know you touch on this a little bit, i'm a nutritionist but not a -- dogmatic with people's eating styles, i hope people eat most of their meals at home and use real food so no matter what their diet is but you talk in the book and another mutual friend, talk about low-carb is so basically all these eating styles, we have to make a decision as to what works for us, what works for you might not work for me, talk about eating styles, what are we eating that we can work through other than to remove sugar and process, ultra processed food for the diet.

what about proteins and fat and how they tie together. i'm sure you will focus on carbohydrates. one other thing on that is the whole -- don't need to pick on rob, the metabolic, protect the liver and feed the got the gut and that ties into this too so start with carbohydrates and healthy fats. >> most famous for his famous talk on sugar, waking everybody up to the harms of too much sugar so from my perspective, talking about prevention, not cancer treatment. from my perspective i think the science that i looked at,

points strongly on insulin resistance being causal factor. it is a carcinogen, something that causes cancer. if it was a man-made chemical, it would be banned, there would be warning signs but the strange thing is it is part of our biology. a growth hormone that ramps up to levels that should never be. think of it as a carcinogen that is metabolic. i need dietary strategy should be lowering, avoiding that carcinogen, how do you avoid

that carcinogen? diet which causes it to improve because almost all of us have had it. one study found in american adult -- if you want to avoid that, would lower insulin levels would be healthy for these conditions. cancers are bad luck. what causes insulin to rise, almost no effect. protein causes some insulin spikes but not like carbohydrates. carbohydrates cause the most.

if you are metabolically healthy you eat a normal diet and the best evidence suggests once sugar is introduced a lot of metabolic problems have. and the insulin resistance, getting rid of sugar may not be enough, you have to cut more carbs to focus on healthy proteins. in terms of prevention, lowering resistance, the best evidence suggests a diet that is high in fat and protein and low in carbohydrate, more towards proteins and some toward fat. in certain circles, one thing is too many carbohydrates.

and other carbohydrates as well. i like the notion that michael pawlak in canada said to me not the people, think of it as a condiment. certainly don't drink it. drinking sugar causes the worst metabolic effects, hitting your liver and causing this liver fat storage which is part of the insulin resistance phenomenon. >> host: people need to be careful. ideally don't eat a lot of foods with labels. there's no labels on broccoli or chicken but you need to be careful with the added sugar. just carte blanche the word carbohydrates. there are carbohydrates in concepts. there are carbohydrates in fat.

there are different types of carbohydrates. there are in tact carbohydrates that have never been a fraction allies are put back together like whole-grain bread which is taken part and back together but wheat berries are whole. they are intact. sugar is a carbohydrate. i think people here, carbohydrates, i am not anna keto diet personally but there are no root vegetables or potatoes or certain things that have nutrients in them so there are different carbohydrates out there and everybody has a different story, but 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 is clear that more refined carbohydrates cause a more profound insulin spike. think about fruit. i set a couple things about sugar, most scientists are comfortable with what was proved in the diet. talk about both cell structure and fiber, causes the glucose to not rise, less dramatically, you don't get the same metabolic impact. i don't think all carbohydrates need to be thought of as bad. you need to figure out what they call the glycemic effect. how much glucose and insulin hit it causes. some people are metabolically healthy, many adults in that situation but if you are, you don't have to worry that much

about sugar, there are many societies in human history, a lot of carbohydrates are metabolically healthy. only after the introduction of sugar, you see a lot of these problems so once you have these, process carbohydrates. you get a good sense what is working for you. using weights, doesn't have to be 1-size-fits-all but to focus on less carbohydrates, keep insulin lower and when insulin is lower, what part, it traps fat in your fat cells, the

analogy, and elevated insulin all the time, a natural sort of thing to keep insulin lower, and >> and we would all recommend a very low sugar diet. simplistically. not everybody agreed at the time. everybody agreed to that now.

you were working primarily on prevention. if you want to avoid any metabolic disease, and cancer. healthy fats, and relationship to make fixes and healthy fats and whatever. the big thing is you recommend limiting obviously sugar, sugary drinks particularly and staying low on carbohydrates. if you have cancer it is more important. that is a little bit of a summary. for those of you who haven't read sam's book we just touched on these details, we didn't talk about otto warburg's

partner and what he did. anyway, more dialed down in the food, the take-home, watch your sugar and know that it is everywhere in your sugary drinks and sodas and liver disease, nonalcoholic liver disease showing up in kids. the sugar metabolically speaking, cancer speaking as well. we talked about fiber. insulin, is insulin the culprit? what about igf-i? >> guest: the igf story, and

another hormone, there's a lot of nuance to that science, but elevated insulin seems to increase the igf one signaling. for the sake of simplicity, it does sort of the igf-i issue follows elevated insulin so i focus on insulin when i talk about it but one of the interesting things when i started writing this book, i thought the damaging effect of sucrose, the sugar, was by its effect on insulin resistance, elevated insulin but some cancers can consume the fructose directly and it is uniquely good at driving the warburg effect so it continues to build in the time i was working on the book. >> host: a fastening a book, we could probably talk for a couple more hours on this but

hopefully everybody listening has a reason to purchase your book, and incredible story, and how his work from this difficult, brilliant man, basically i want to thank you so much for your comments today, wonderful, as well. i want to thank all of you who are listening today. this program will be on the commonwealth club website soon, commonwealthclub.org. this meeting of the commonwealth club of california, commemorating its one hundred eighteenth year of an lightened discussion, is adjourned. ..

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