Chris: Doctor Johnson, thank you so much for joining us today.

Duke: Thank you, Chris. It is wonderful to be with you.

Chris: So, you have written a great book called the Optimal Health Revolution. You cover so many topics in it to talk about inflammation; you talk about how to create health. How did you create this book? What inspired you?

Duke: I was an emergency room physician and I switched to preventative medicine after diagnosing heart attacks in people in their late thirties and early forties. It is ridiculous. We shouldn’t be dying of these chronic diseases at such an early age. In the last several years, I have been involved in prevention for twenty years; in the last several years, I have noticed so many fad books that would actually point away from the most recent research as far as what we need to do to reduce chronic disease. I just couldn’t take it anymore. I thought people really need to know the best science and that is the origin of the book. The number one killer in essentially just about every industrialized nation, not just the US, is heart disease. It used to be around 45 percents of people, now it is a little bit closer to 35 percent. Heart disease has gone down a little bit. We are going to see an upswing of that in the not too distant future because of the worldwide epidemic of type-two diabetes, which is another chronic disease. The number one cause of death of diabetics is heart disease. The second biggest killer would be cancer. Among all of the in essence chronic disease are diseases that occur over a long time-period. That would include type- two diabetes, obesity, Parkinson’s, Alzheimer's, etc.

Chris: What are the numbers on worldwide obesity?

Duke: In general, it is interesting. As a country industrializes, obesity has a tendency to go up. I list a range of numbers in the book because not every country is the same. Roughly, there is a similarity in that 50 to 60 percent of people in most countries that are industrialized are now overweight. It is more than just ready access to food. In fact, the largest chapter in the book is about the worldwide obesity epidemic. I honestly believe that on a simplified form yes we are taking on more calories more often than we need and we all have very commonly a sedentary life style so we are not burning those calories up. But beyond that I also believe that our chronic inflammatory lifestyles are actually triggering mechanisms that accelerate the obesity epidemic and there is some research that points in that direction. That is really why I really focused on what is inflammation and where did it come from. It seemed to be the unifying factor in almost all scientific literature that has come out in the last ten years. It is interesting that we noted that the inflammation was involved but the big debate is if it is a cause or a result. I really think it is both. I think it actually causes chronic disease and it also a result. If I may first define what is inflammation and then it will help them understand how to avoid it. Inflammation is really a reaction of the immune system. To give you an idea our immune systems are not all bad in essence. Our immune system is beautifully to…when an offending organism like bacteria or virus, etcetera comes in then the immune system will release inflammatory molecules to kill it. The way I like to give the analogy if our body was a house and our immune system was a lion defending the house against a mouse, mainly a virus or bacteria. The way it is designed is the lion when it sees a mouse it gets up, it gets incredibly angry, it races over, it pounces on the mouse, it kills it then it lays back down again looking for another mouse. In our industrialized society we have entered in a lot of components into our bodies whether it be manufactured fats, false fats, processed foods, false sugars, herbicides, pesticides, all kinds of chemicals that the immune system sees as foreign but it wasn’t designed to kill it. In essence, what they are doing is they are kicking the lion and they are making the lion angry. It is walking around the house looking for something to kill but it doesn’t see any mice. So it is ticked off, it wants to kill something; it is knocking over tables and chairs. In other words, it is causing damage. That is how these chemicals are stimulating the immune system. When I say these chemicals are kicking the lion there are a lot of inflammatory molecules that rise. So it is a chronic condition when we eat processed foods and foods that are high in lots of different chemicals etcetera. We are over time, over months and over years, taking in chemicals that are actually destructive. When they were originally created, they were created to make more food which is good, but when people around the world stop dying of starvation then the negative side effects of these chemicals is that they tend to over stimulate the immune system which is not what it was designed for.

Chris: So, is that why we are seeing this increase in chronic disease?

Duke: Absolutely. In fact in the US, I have statistics in the book that show that heart disease and cancer were not a major cause of death at the turn of the 20th century. With industrialization when we started mass- producing cars, we also started mass-producing animals and food production etcetera. All of a sudden, you can see in the graph beginning in that time period the major causes of death, heart disease and cancer, start rising. I actually have patients from thirty different countries that come to our center in Southern California. Most doctors have a perspective of people who come from those countries that move to the United States for an example but I literally have people that come to our center, we assess them, and then they go back to their country with their cultures, their diet, their lifestyle, etc. Then we will see them on repeat visits again and again. So literally, they are living in thirty different countries, which is a very unique perspective. Where I started getting insight into this was when I looked at the Ministry of Health or the World Health Organization of these different countries because I wanted to design our program to be unique to each of those countries. What I noted was that each country industrializes that same graph I told you about with the US kicks in; the only difference is which year. For example in Japan heart disease and cancer start rising rapidly right after World War II. Cancer was very low in Japan prior to World War II. Right after World War II it has gone up and gone up steadily every year. Korea after the Korean War, Brazil and India in the 1970s, and in China of course it all started in the 1990s. In just 16, 17, 18 short years they have caught up to us as far as chronic disease ratios are concerned, very closely in a very short period.

Chris: So, what are some of the things? Obviously, we are living in this culture of processed foods and things that aren’t necessarily great for your health. What are some of the things that people can do to turn that trend around?

Duke: Well, the first thing is to reduce our risk factors for chronic disease. The real Ah-ha moment I had was in 2004 when I realized that all of the risk factors I had taught for 15 years at that time all increased inflammation in our bodies. If we know the risk factors for chronic diseases, and we list 15 risk factors for heart disease and 16 for cancer. If you have many risk factors I can tell you that you are in a chronically increased inflammatory state no matter what your blood-work shows because there are scores of inflammatory molecules. If we reduce those risk factors, the inflammation will go down. That is the most important thing we can do. Secondly would be to consume a natural anti-inflammatory. For example, like omega-3. Omega-6 and omega-3 are required fats, but omega-6 is inflammatory and we get way too much of it. Omega-3 is anti-inflammatory. Exercise reduces inflammation. Multivitamins have been shown to reduce inflammation. Vitamin D for example is a great anti-inflammatory and has been shown in lots of studies in the last year and a half in reduction in chronic disease. A reduce in the saturated fats in our diet, etcetera. Eat seven to nine servings of fruits and vegetables every day. Fruits and vegetables are loaded with plant chemicals which are anti- inflammatory. Avoid processed foods and fast foods as much as possible. Try to go in the direction of organic as much as we can. I give some nutrigenomic guidelines in the book. It is a whole new science that has developed in the last ten years or so as what we can do to reduce inflammation if we know how to eat. Adequate sleep has been shown to reduce inflammation and reducing salt. There are many steps we can take; you don’t have to have a weird lifestyle. I don’t work at all at my lifestyle. I know what to do and I live it. It is normal for me. I don’t feel like I have to have an MD or PhD to live the lifestyle I teach. .

Chris: Do you eat processed foods at all?

Duke: Very rarely. I just avoid it as much as I can. I was a vegan essentially for four years, and I have been primarily a vegetarian about 12 years. What I found is when I have circumstances where the food I need or desire are not readily available because I am on vacation with my family I don’t want to be obsessed with my diet because obsession just causes stress which is a risk factor for heart disease. With the information that has come out with the benefits of omega-3 I have gone from essentially a vegetarian to also including salmon and omega-3 fish oils. Occasionally I will have meat just depending upon the situation, but it is a very small percentage. This is Chris Costello reporting for Michael Senoff’s

Chris: I have heard you cannot get everything you need from it. What is your experience with that?

Duke: You really can get everything you need, especially if you take a multi vitamin, which will reduce any anxiety. It is so interesting, if you ask almost any nutritionist, dietitian, or physician “How much chromium or B6 have you had today?” They don’t know. They know roughly but people don’t add up those nutrients. That is where the role of a multivitamin will cover a lot things in our diet. Generally if you get in soy or a non-fat organic milk those contain the required proteins that we need. A vegan is very commonly going to have inadequate levels of B12 and occasionally calcium. That is where the dairy can be some benefit for example for the calcium. But again you can get the nutritional support elsewhere. Supplementation helps to alleviate that. If you are extremely knowledgeable and really understand your legumes very well you can get your required proteins from beans. The required proteins are the toughest ones to keep track of.

Chris: Are you familiar with the China study at all? I know Doctor Campbell recommended that we eating too much protein and that levels should be at about a ten percent level.

Duke: I am familiar with it and have read that. Certainly, we have some areas of agreement and we are going to have some areas of disagreement. That is true of every scientist on the planet. From what I saw, he was most concerned with certain proteins especially from cow’s milk. There is other research that seems to indicate that people from the Far East have a lot harder time digesting milk than people from other nationalities. When we look at some of those proteins, there is a lot of research that would point to the fact that it might not be as worrisome. I would agree on the trend of high protein diets that have been fads recently. I do not agree with them. I think that in order to get proteins in the higher percentages of 30 percent you almost have to eliminate fruits and vegetables and a lot of real solid carbohydrates that are going to be anti-inflammatory, and many protein sources are inflammatory.

Chris: What else can people do, Doctor Johnson?

Duke: That is why I wanted to make the book. I have almost 900 scientific references. People get so confused “Who do I believe? Do I believe the latest fad who is a doctor or do I believe this guy?” I figure what I will do is I will just put it out there and I’ll put almost 900 scientific references and if that is not enough then there is not much else that I can do. What I wanted to do was then break down all of that complex information and write it in a way that a non-science trained person can read it, and then break it all down in 25 easy steps. I wouldn’t want someone just reading the conclusion of a mystery novel and think they have the whole understanding, but in breaking it down I wanted simple. So, more fruits and vegetables would be the foundation of one of those steps. Most people get intimidated by that because they perceive a serving as an extra sized large fry and it’s not really a serving of a fruit or vegetable. Decrease or quit smoking is number two. I understand that it is tough to stop but if someone would go from a pack to three quarters of a pack, or three quarters of a pack to half a pack, any decrease. Whole grains are beneficial and a lot of fad diets have treated carbohydrates as a square word. That was one of my greatest motivations for writing the book was just how carbohydrates were just abused for decades. Number four; get help for depression or stress. Depression accelerates heart disease. It stimulates two hormonal pathways that accelerate heart disease. Get some idea of your weight and whether or not you are overweight or obese. Takes steps to reduce it in a non-inflammatory way, which I think is most beneficial. Also, in calculating your intake; most people have no idea how many calories they are taking in a day. They are not even within 500 calories. They have no idea at all. One hundred less calories a day would result in a ten pound loss a year. That is why I want people to get some sort of ballpark idea. Most of only need about 1500-2000 calories a day or even 1800-2200, but I have seen studies where the average American gets 3100-3700. A thousand extra calories a day, you are going to gain weight!

Chris: Yes, and in a lot of the longevity studies they talk about actually reducing your caloric intake, right?

Duke: They do but what is interesting is that those kinds of studies use almost a starvation model. That just didn’t make sense to me. I know that is freaking out some people right now, but let me finish this thought. Obesity did not become a problem globally or in the United States until about the last 30 or 50 year or so. People weren’t starving themselves prior to that, so the molecule that is reduced or most impacted by a starvation type diet that leads to longevity is one that has a long name to it. It is (chemical name 14:30). In other words, it is a chemical in our body that is affected so that when people starve they reduce that. Omega-3 has the same impact on that molecule. So all of the benefits of starvation may come from adequate amounts of omega- 3 and that is why people in the Mediterranean, a true Mediterranean diet live longer. The point being is that we all can’t say that we are going to eat 3700 calories and add an omega-3 tablet. Everyone in our society wants the quick fix “I want the drive-through radar beam that will make me thin” but in reality, we cannot live the normal industrialized high processed garbage diet life and then add one or two things and think it is going to make us perfectly healthy. That is why we are seeing type-2 diabetes in young kids. That is astounding to me from my perception. When I was trained and went to medical school in UCLA we were taught type-one and type-2 and there was adult onset and it’s not called adult onset anymore type-two because we are seeing it in children. That is ridiculous. Everyone ate organically prior to 1950 basically. It’s a total lifestyle. It is not just the food we eat. It is everything about the lifestyle we are doing and that is why I try to wrap it into the revolution as a revolution of thinking of how we are normally living. We have to revolt from how most people live. If we don’t revolt we are going to end up as innocent bystanders of these chronic disease that people didn’t have. For example, they were not of any significant percentage in China just 20 years ago and in Japan 50 years ago. The lifestyle that we are living is what is creating it, so if we make some simple changes then we can protect ourselves from the kidney damage, the accelerate heart disease, the blindness, the loss of limb. This is not a good disease. In our experience if someone is borderline diabetic if they follow the guidelines in the chapter I have, we are able to very commonly pull completely away from that impending monster of a disease. I have 22 steps that people can do and they are not that complicated to pull them away from it. We have proven that over and over again. Now if someone has type-two diabetes very rarely can we pull them out of it? Something changes physiologically which I am not understanding yet. But if someone is considered borderline then we can keep them away from a very serious disease. I give an example in the end of the book of a gentleman named Larry. He had metabolic syndrome and was going to have type-two diabetes within a year. In four months, he so dramatically changed his lifestyle that he didn’t have any insulin resistance at all in just four months.

Chris: What kind of things do you tell people with pre-diabetes to do?

Duke: There are many steps that have been shown to help reduce insulin resistance. I can just list some of those for you right now. For example, reducing saturated fats, trans fats, and omega-6 fats in the diet. Omega-6 are found in cheap oil like corn oil. The best oil is either canola or olive oil. Omega-6 is found in dark meat. We get massive amounts of omega-6 now. It is a required fat but we are getting probably ten times the amount we need. The true Mediterranean diet used to be a ration of omega-6 to omega-3 of one to one or no worse than four to one. We are eating a diet now that is 14 or 20 to one. We are getting way too much. If we cut that down we are going to reduce inflammation. Those high saturated fats and trans-fats are associated with increased insulin resistance. Also reducing high fructose corn syrup. Lots of “healthy” sports drinks are high in high fructose corn syrup. That is associated with increase insulin resistance. Exercise reduces insulin resistance as does reducing excess weight. Smoking increases insulin resistance so we need to stop that. Get more omega-3 in our diet. Chromium has been shown to reduce insulin resistance and stabilize glucose metabolism. Whole grains reduce insulin resistance, and reducing our total body inflammation certainly does that as well. It is interesting because there is a study that just came out recently. They think they found the inflammatory molecule that links obesity to type-two diabetes and it is called (chemical name 18:31). There are tons of inflammatory molecules. If we reduce that inflammation, we can block that progression. Increasing fiber, mono and saturated fats I talked about. Getting more fruits and vegetables in our diet. They take down insulin resistance. Maybe even consider being a vegetarian. Get enough calcium in our diets. Buy low fat organic dairy products. Those have been shown in studies, believe it or not, some dairy products have been shown to reduce insulin resistance. We don’t know if it is the calcium or the protein in the milk but there are several studies that show that. Magnesium. Coffee has been shown to reduce insulin resistance. Cinnamon, vitamin D, many different things. They are all listed in the chapter on steps that we can take that aren’t that complicated.

Chris: Thank so much, Doctor Johnson. And for our listeners if you would like to find out more about Doctor Johnson you can go to http://doctordukejohnson.com.