Welcome everybody, this is our first always hungry public class.
We are at George Brown College Chef School.
We're really excited to be teaching here.
Our collaborations with George Brown have been fantastic and we look forward to doing
more.
We're going to be doing some culinary classes tomorrow.
We're working with their chef program.
And today we're doing a lecture where Dr. Ludwig is going to start the class and we decided
to open it to the public so that you could share in this with us.
So I am going to turn it over.
I will also be online so if you have questions you can type them in and as you type them
in I can answer them and we'll see if Dr. Ludwig can answer some of those questions that
don't get answered automatically.
Thank you very much and I'm going to turn it over.
Hello everyone and welcome to the George Brown College.
Before I introduce Dr. Ludwig I'll quickly give you the format for today.
Dr. Ludwig will give a 45 minute presentation followed by Q&A so thank you and write down
all your questions.
And then roughly at one o'clock everyone will be signing and the customers all should agree
so that you have a problem with you and we also have a few questions for you so I'll
start with Dr. Ludwig.
It gives me great pleasure to introduce Dr. Ludwig, one of my nutrition heroes.
You may all have culinary heroes and sports heroes but I have nutrition heroes and I
think you've been lovely because you've been one of mine.
Dr. Ludwig is a practicing endocrinologist, researcher and professor at Harvard Medical
School and Harvard School of Public Health.
Dr. Ludwig also directs the New Malmonds Foundation Obesity Prevention Center at Boston Children's
Hospital.
His research focuses on how food affects hormones, metabolism, body weight and well-being.
Described as an obesity warrior by Time Magazine, Dr. Ludwig has fought for fundamental policy
changes to restrict junk food advertising directed at young children, improve the quality
of national nutrition programs, and increase insurance reimbursement for obesity prevention
and treatment.
He has received numerous grants from the National Institutes of Health and published
over 150 scientific articles and is a contributing writer to JAMA.
He has written two books for the public including the number one New York Times bestseller
always on a great, conquer your cravings, retrain your fat cells and lose weight permanently.
So with all these amazing accomplishments, you can imagine how nervous I was when we
wanted to invite him to our first efficient nutrition symposium in Maine and I had to
make the call.
And then he answered the phone and I was expecting voicemail and I said to myself, now what?
This was the beginning of a great collaborative relationship with Dr. Ludwig and Chef Don
Ludwig.
We have incorporated the Always Hungry program into the curriculum and the second year culinary
management nutrition students here today are working on designing and developing recipes
according to the principles described in this amazing book.
They are also here visiting a college again, the first public Always Hungry culinary class
which starts tomorrow in the continued education department.
So please join me in giving Dr. Ludwig a big round of applause.
Thank you Moira, you're my culinary education hero and it's a great pleasure to be back
to beautiful Canada and the world renowned Georgetown College.
So the question today is, which comes first, over-eating or obesity?
In other words, does over-eating make us fat or does the process of getting fat make us
over-eating?
This isn't just an academic question.
It has profound implications to how to prevent and treat excessive weight which is a huge
public health issue as you know because of its relation to diabetes, heart disease, cancer
and even as we're now discovering Alzheimer's and neurodegenerative disease.
So the basic principle of visits called the first law of thermodynamics says that energy
can either be created or destroyed and that means for living systems like humans calorie
intake minus calorie expenditure equals calories stored in the body and since for humans most
calories are stored in fat tissue, we can also say change calorie storage and change
in out-of-possibility is the amount of fat in the body.
Now according to the conventional interpretation of this principle of visits, over-eating is
simply the failure of an individual to control his work or energy.
In other words, the environment with ubiquitous, tasty foods is really easy to over-eat and
we also in our environment don't get enough physical activity, those calories don't get
burned off.
So this excess builds up in the bloodstream as calorie-rich molecules, substances, glucose,
fatty acids and other such problems and then this excess gets forced to fasten.
Maybe those fat cells, anabolic, they grow, they gain weight and if this continues, obesity
grows.
So from this perspective, the solution is simple, right?
You turn it a thousand times, eat less and move more.
Let's shift, voluntarily shift that balance to reduce the amount of the build-up of fuel
so they don't get forced into fat cells.
This conventional approach puts the primary emphasis on the individual to control their
calories.
So the USDA Mind Plate website says the pinching a healthy weight is a balancing act.
The secret is learning how to balance energy and energy out.
Now the ultimate expression of this calendar perspective was the low fat diet of the last
40 years, exemplified by the first USDA food guide here.
Here we put all fats at the top because fat has twice the calories, more than twice the
calories of carbohydrate.
So we were told to eat all fats fairly and instead load up on these carbohydrates, bread,
crackers, pasta, cereal, remember, 6 to 11 servings a day and if you include the potatoes
that you get in this level, that could be up to 13 servings of these carbohydrates.
And the emphasis, so reducing fat, became the single most important goal of public health
nutrition for four years.
Now the consumption general's report in the United States, which came out in the 80s,
said that reducing fat consumption is the primary diet of today, but more important than
everything else.
Children was of secondary interest.
It was listed, for example, under issues for some people.
For example, people who are at risk of getting habits, especially children, yes, they might
want to reduce sugar intake, but they didn't seem to have at that time any particular problem,
metabolic.
Experts from the United States, Europe, around the world, experts in some of the world's
leading journals consistently made this report, arguing that all fats were, at that
date, all, I'm sorry, all carbohydrates were at that date just all fats.
One quote that the Journal of the Dietetics Association said, when people are allowed
to eat from a range of high-fat, high-sugar foods, overconsumption occurs only with fat.
It follows that fat causes us to overeat, whereas sugar probably prevents it.
The evidence intriguingly suggests in another book that it is specifically the intake of
sugars, rather than complex carbohydrates, that helps us eat less fat.
And another quote, by decreasing the ratio of fat to carbohydrate, we can get a balance
of calories in the body with less emphasis on carbohydrate source.
And so, the government called on the food industry to produce thousands of new fat-induced
processed foods, which were understood would replace those fat calories with carbohydrate
starch and sugar.
Unfortunately, things didn't work out so well.
The proportion of fat in our diet came down systematically over the last 40 years,
from over 40% to near the government revenue of 30%, as the obesity epidemic exploded.
And there's evidence that these aren't just coincidental relationships.
This slide shows meta-analysis. Meta-analysis are systematic reviews that take into account
all of the published data in fair ways.
And there have been five major systematic reviews of this question.
And every single one of them has found that low-fat diets are inferior to all other higher-fat
comparison diets, be they either a training diet, a low-carbohydrate diet, a very low-carbohydrate
diet, or the ultimate of low-carbohydrate and high-fat diets, a keto diet.
So, low-fat diets are inferior, suggesting that that focus on reducing dietary fat has
directly contributed to the old disability.
Of course, we know very few people can successfully manage to evaluate over the long term with
conventional approaches. This nationally-represented survey in the United States found that only
one in six people who had high body weight could successfully maintain a weight loss
of just 10% for just one eater.
Now, that's not the entire excess weight that most people with obesity have.
One year is, of course, not a whole lot.
And these numbers are probably overestimated because this is by self-report.
And we all, when we report our high body weight, we all think we're a little taller
and a little thinner than we really are.
And the situation in pediatrics is just as bleak.
These reviews found that most of the pediatric obesity interventions are marked by small
changes in relative weight, or out of muscle, and substantial weight loss.
So, we have to ask, raise the simple paradigm.
It's based on a law of physics.
All we have to do is just eat a little less, move a little bit.
Very simply.
But we have to ask, raise this been an adjunct failure for 40 years.
We have to increase the epidemic, explore it during the session.
And then, at rates of diabetes, and then uptake, we tend to incarnate vascular disease,
despite our drugs, our surgeries, and the intensive classes.
And so, all based on genetics and other factors.
But if we do have a body weight second one, we have to answer two questions.
First, why is this level that we're defending crept up systematic year after year
over the last 40 years?
Why is the average person defending a body weight that's 35 pounds higher than it was in the 1960s?
And most importantly, what do we do?
We say, law of physics, energy balance, but that can't be done.
But perhaps, our assumptions about the cause and effect are a fact.
We typically focus on the left-hand side.
We think that's the problem.
But what if the problem is in the other direction?
The problem begins with the fat cells.
According to this carbohydrate insulin model, the new way of looking at this,
something just triggered our fat cells to become cannabinoid,
to go on calorie storage over them, to suck it and hold on to too many calories.
We think too few for the rest of the body.
But instead of too many calories in the bloodstream, there are too few.
The brain realizes that and makes us hungry.
And therefore, we eat more as a consequence.
And our metabolism slows down in the bodies that we have to save energy
because the body thinks it's actually starving.
Plenty of calories in the fat cells, but not enough available for the rest of the body.
From this perspective, the conventional suggestion to eat less and move more
is symptomatic, destined.
In fact, it actually makes the situation worse.
The main problem is that there aren't enough calories available in the bloodstream,
eating less and moving more puts the body further into starvation.
So what's triggering our fat cells into this feeding frenzy?
Well, the most likely culprit is too much of them around insulin.
You could think of insulin as the sort of miracle drug for your fats,
just not the sort of miracle you want happening in your body.
We know that people with diabetes give in too much insulin, predictably gave in.
Whereas a child first coming to the attention of a tight blend,
who can't make enough of insulin, will have been very, very lost.
That child could be consuming 5,000, 7,000, 10,000 calories a day.
Without insulin, you lose weight.
And so what could be causing too much insulin?
Well, this is endocrinology 101, and that's the types and amounts of carbohydrate we consider.
Both the amount, total amount, but also the type,
which is characterized by the glycemic index,
which glycemic index basically is a system for understanding how carbohydrate
digests into glucose and raises blood sugar.
White bread, white rice, potato products,
all these processed starches digest into sugar
and raise blood sugar very quickly,
within literally within minutes after eating a bagel, blood sugar, and insulin are shooting up.
Whereas calories for calorie unprocessed carbohydrates,
whole fruits, non-starchy vegetables, beans,
and to a considerable degree, minimally processed grains,
grains like our grand parents used to consume,
those have a more gentle effect on the patient.
They don't surge much higher in insulin, you know,
than the steel cutouts from the vegetable body.
So what's that going to do to these key metabolic fuels?
Glucose and fatty acids.
So glucose surges in the bloodstream as those calories rush in,
but what goes up must come down under the influence of the insulin.
Blood sugar comes down to be precious a few hours later
after this high glycemic index is no real.
At the same time, free fatty acids.
That's a key metabolic fuel, they're suppressed.
So we're kind of running gas tank, we're running low.
And how does the body react to this?
With stress.
This is epinephrine, an emergency stress hormone.
So the levels of that hemoglobin
remain perfectly stable for five hours
after the low and medium glycemic load meals
can surge to really high levels after the insulin, the high glycemic.
So the body, the brain is thinking,
Houston, we have a problem, we're running out of food.
And what are you going to feel like?
Hope.
And if you can find food, you're going to probably go for it.
When we gave subjects free access to food,
they consumed six or seven hundred calories more by five hours
after the high glycemic index is no real.
They're not going to be able to eat it.
If a fraction of this difference
would maintain the electric field they have today,
it would explain much or maybe all of the obesity epidemic
as we've been cutting back with fat
and loading the products towards this carbohydrates.
Now what's happening in the brain
as blood sugar is crashing and we're getting hungry?
To examine it, we gave 12 men with high body mass index
one of two milkshakes.
And these were done in our randomized double-wide fashion.
So neither the subjects nor the researchers knew
which was much to prevent subconscious bias.
One had fast digesting carbohydrate,
the other had slow digesting carbohydrate.
And as expected, the milkshake was fast acting,
there was blood sugar more.
And then we saw this rapid supply of blood sugar
and we can assume also that many acids were dropping.
And at four hours, they were also getting hungrier
by self-report.
This slide shows self-reporting hunger
after the fast-acting carbohydrate.
So same calories again with different states of hunger.
And then at four hours, we did brainage.
Functional and we're off.
One area lit up like a laser
and that area was called the nucleus accumbens.
It happened after every single subject in this study.
So we have astronomical power to see this effect,
even taking into account statistically controlling
for all other brain areas.
Nucleus accumbens is considered ground zero
for the classic editions, cocaine, heroin, alcoholism, tobacco.
Raising a provocative question,
that these highly processed carbohydrates
may be hijacking basic pleasure and reward systems,
driving the obesity at the end.
It's one thing to be hungry after,
hungry too soon after eating the wrong kinds of foods.
But the nucleus accumbens relates to your cravings
and your willpower.
So if the nucleus accumbens kicks in,
it's really capable.
You're going to walk by that pasty shop
and say yes to the 500 calorie cinnamon caramel.
Can we demonstrate this effect over a longer term?
In humans, these studies are difficult and ongoing,
but we can begin to get a sense of what happens in animals.
In this case, we looked at rodents, rats,
at risk for diabetes, and made them identical diets again.
But just one had fast digesting carbohydrates
and the other had slow digesting carbohydrates.
Then we found something interesting happened.
The animals that got fast digesting carbohydrates
began to gain weight excessively.
And so to prevent that from becoming a factor,
we had to cut back their calories.
So the total number of calories we gave them
was less in this fast active group
than the slow active number.
So they could consume fewer calories
and get weight the same.
So what does that mean?
Their metabolism was slowing down, right?
But nevertheless, based on the study designed,
we kept their weight the same.
And at the same weight, the animals
eating the fast active carbohydrate
had 70% more fat and thus less lean tissue.
Now, I'm glad this is a deluxe lecture.
This is by one graphic slide.
These two animals weighed identically,
weighed the same.
One, that the slow digesting carbohydrate
was metabolic healthy
and had very little belly fat.
And in the other case, at the same weight,
the belly was filled with fat
and it had sky-high heart disease and diabetes.
Now, think of what we did.
This group was developing excess weight.
And so we did what we're supposed to do
according to the conventional teaching.
We cut back calories.
We prevented weight gain,
actually more successfully than most humans.
And despite that, it was still metabolic healthy.
There's no way to explain this finding
based on the calorie and calorie level.
In fact, this finding completely defies
a professional understanding of e-blessable blood.
All right, is there any evidence
that this factor occurs in people?
In this study, we looked at 21 drug adults
with high body weight,
lower weight down by 10 to 15%,
or during control feeding part,
when we gave them all their foods,
but they're weight down.
Stabilizing them.
And then thinking for a month at a time,
in one of three diets,
either a very low carbohydrate diet
with just 20% carbohydrate,
sorry, very low carbohydrate diet with just 10% carbohydrate.
Or a very low fat diet with 60% carbohydrate.
Or something in the myth,
we called it a low glycemic index,
sort of a Mediterranean diet with 40% carbohydrate.
And here's what we think.
Following weight loss,
this was a crossover study,
so everybody got each of these three diets
in radical order.
Following weight loss,
when they were eating a low fat diet,
their metabolism plumped
by more than 400 calories.
But when they were consuming the low carbohydrate diet,
their metabolism didn't fall statistically at all.
It was like the body didn't even know
that it had lost 10 to 15% weight.
It's no pushback for the body.
So, poor calories.
There was no evidence of this starvation.
This difference, 325 calories per day,
again, it couldn't be the whole obesity effect.
So, the type of calories going into the body
may affect the number of calories per calorie body.
And if that's real,
it has very basic significance to how we treat it.
Now, what about the long term studies in humans?
Well, they usually,
they have these studies,
and there's this notion that it doesn't matter
what you eat,
that you can lose weight on any diet
as long as you can fly.
We treat this, right?
You can lose weight on anything.
And it comes from studies like this,
the Pound's Lawson studies,
which took 800 adults,
studied them for two years,
on diets that had a broad knee-ranging macronutrients.
So, the carbohydrate was 35 to 65%.
That was 20 to 40%.
13 was 15 to 15.
These are as big of a difference as you can get.
We looked at bigger differences in our study
that I just showed you,
but this is significant.
So, if you can't see something bigger,
you know, we might ask,
really, what is the meaning of these different diets?
And so, the people who were putting these groups
assigned these different nutrient compositions,
and then, given counseling,
they weren't fed,
so they were just told,
go out, here's what you should eat,
here's how you should do it,
go buy your food,
prepare it,
and stick to this diet.
And they found that there was no difference
in body weight in any way.
Yeah, giving this notion of all diets in the sky.
There's a big problem with these studies,
and hundreds of other studies,
that they consistently failed
to achieve their dietary tolerance.
Humans, people in the real world,
have difficulty changing their lifestyle,
especially when we're surrounded by junk foods,
and we're constantly advertising the wrong foods,
and amidst our busy life,
when we have stresses and other changes,
it's hard to keep these changes up for the world.
Now, that tells us something about our environment,
that we do need to change our environment,
but it doesn't tell us anything about the diets themselves.
Because when we look at what people were actually eating,
the reported differences were very small,
much less than what was intended,
and these were by self-reporting.
So they asked the people in the diet,
what do they need?
Now, think about it.
You know, if I assigned you to a low-fat diet,
if you volunteered for a study,
I assigned you to a low-fat diet,
and they paid you regular stipends
for participating in the study,
and then I asked you,
what are you eating?
What are you going to say?
You'll say a low-fat diet.
And so that's called social desirability bias.
When they looked, the experimenters looked at biomarkers,
things about biology,
which would tell us what people were really eating.
There was no difference.
Triglycerides are a sensitive market of carbohydrate intake,
and they didn't differ between the groups.
Nitrogen excretion in the urine
is a sensitive market point,
and there was no significant difference.
So the problem of the study
is that they were not able to actually
help people sustain actual differences
in their food.
But a few studies did a better job.
One of them was called the Direct Study,
in which 322 adults
that were studying for 2 years on low-fat,
medium-fat and trinium diets,
or high-fat and low-carbohydrate diets.
This was done in Israel
at a nuclear power facility.
So this was done among the employees
who would check into the nuclear power facility.
They would be served lunch and come to the cafeteria.
They wanted to control access
of people that believed during the day.
They got their main meal in Israel,
and many people in their main meal could live there.
So the investigators could work with the cafeteria
to actually get people in the different groups
eating differently, with only for that one meal.
And what did they find?
Well, in this case,
there was a substantial
and sustained difference in volume.
As predicted,
low-carbohydrate foods show this rapid reduction
in volume.
A little bit of weight regained,
but they wound up significantly lighter than they started.
The Mediterranean diet was a little slower,
maybe like the tortoise,
to the low-carb hair,
but the Mediterranean diet
could just as well.
Low-fat diet could significantly reduce cholesterol.
Now, the differences in weight were massive,
but they're highly significant.
And this was just changing one meal a day.
If we change all of the meals,
potentially the effects would be much larger.
So I've presented a model
in which the processed carbohydrates
in the flutterberry diet from the low-fat foods
has stimulated too much insulin,
this ultimate fat cell food,
and these fat cells to go on calorie-storage over time.
Those fat cells are sucking into many foods.
There aren't enough calories for the rest of the body.
And the brain perceives that
as a threat,
as a question of starvation.
It makes us hungry.
It slows down our metabolic rate.
And simply eating less and eating more
isn't going to solve the problem with low-carbohydrate.
But in addition to carbohydrate,
insulin do many other factors.
This is not just about carbohydrates.
Many other factors can affect
our fat cell storage capacity.
Types of fats that are neat,
saturated or unsaturated, or trans,
the amount and type of protein.
We've got microbiome,
which we're hearing a lot about today.
We've talked directly about those fat cells.
The micronutrients of the chemicals.
Antioxidants.
Also, as we discussed, we're always hungry,
which is not just about diet,
but sleep, stress, and physical activity.
Feedback to the fat cells
by influencing insulin resistance,
and chronic inflammation.
And we also have to remember that we live in a,
in some cases,
seriously contaminated environment.
Our air, our water, our food
is not always pure and clean.
There are substances, for example,
those that come from plastics,
like BPA, that can disrupt
endocrine systems.
Again, having threatened
affects our fat cells.
So we want to be very mindful
about what we're using,
using the water purifier.
Making sure that our foods
are as natural as possible.
And being mindful about plastics
that touch our foods.
So, before concluding,
I want to just take a step back.
Remember that we're not
talking about obesity as a cosmetic issue,
but because of its serious
implications to health.
Most importantly, cardiovascular diseases.
There have been many studies
of low fat versus high fat violence and heart disease.
For many years, we were told
that we have to cut back on fat
not just to lose weight,
which we now know is non-true.
But also to avoid clogging our arteries.
That was the complaint about
applicants diet.
Okay, maybe you can lose weight
on your applicants diet,
but there'll be a good looking corpse.
Probably for that, right?
What are the datas?
These are the two largest,
$100 million plus multi-section studies.
The Women's Health Initiative clinical trial
put 50,000 women
for eight years on either a low fat diet,
which got lots of support that year.
Individual and group sessions.
A lot of encouragement.
Versus a control diet
that got just pretty much control materials.
So in effect, the study was biased
to favor of the low fat diet.
And despite a substantial
sustained reduction in fat intake,
there was no effect on stroke
and coronary heart disease.
Well, for that matter,
on any other health health
that they looked at.
The look-ahead study,
which was recently published
in the New England Journal of Medicine,
studied people with type 2 diabetes
who we know are great to us for heart disease.
Again, a low fat diet
compared to an investor-intensive control group
that biased the study design.
And they had to close the study early
for futility.
So I just hate that.
What does that mean?
Initial analysis by statisticians
found no evidence
of the beneficial effect of the low fat diet.
Or any comments,
no matter how long they would continue to study,
that there would never be an effect of the low fat diet.
Now, to compare that to
predetermined study,
which coincidentally was published
in the Stegers Journal,
the very same year as local,
predetermined was done in Spain
among 7,000 people after this for heart disease.
And this was not a low fat,
but a high fat diet.
It tended to be more than 40% fat.
One group got healthy, not today,
a lot of fat in that.
And the other group, one of the other high fat groups,
got a liter of olive oil a week.
And then from a calorie balance model,
that's a nighter,
a liter of olive oil per person per week.
And they were compared to a low fat diet.
So in this case, they made attempt
to do the study fairly,
comparing control and treatment intensive.
They tried to get all groups equal attention.
So that's a better study.
They had to close the study early as well.
But for the opposite reason,
unexpected straight efficacy.
Cardiovascular disease rates
dropped so fast,
in the high effect groups,
they could all the study quits,
go home and enjoy a glass of wine
years before the intended completion.
So these studies should really put the final nails
in the coffin of the low fat diet
of heart disease.
And finally, this recent observational study,
done with 125,000 adults,
free of chronic disease,
studied for up to 32 years,
found that total dietary fat
was inversely related to mortality.
The higher the fat consumption,
the lower the mortality.
And now you'd say,
well, this is an observational study.
This was founded, yes,
but they intended to control it,
but the founding was likely in the opposite direction.
Remember, this was during the low fat,
this was done over the low fat diet of friends.
So people eating low fat diets
would tend to be healthy,
because they weren't following government recommendations.
The people who ate low fat diets
typically also exercised vitamin pills,
didn't smoke alone.
So if there was confounding,
it would be in the other direction.
So people doing what they were told to do,
eating a low fat diet,
had 19% greater mortality
than those eating the high fat diets.
Amazing.
Of course, the types of fat
was also important influencers.
All fats, just like all public records.
So, despite these data,
the low fat diet
continues to operate
in our public policy and in our society.
The majority of the U.S. public
is still actively avoiding fat,
thinking that it is some kind of community fat.
The school lunch program lets kids have
sugary fat from milk,
pain from chocolate milk,
but prohibits them from having a plain form.
That's national policy.
The nutrition facts later
continues a minor lack of total fat.
There's no evidence that there's an upper limit
for healthy fat.
In fact, these data suggest
in a certain sense, more primarily.
And lastly, government education
and policy continue to
explicitly advocate fat production.
I'll just show this one slide.
This is the weekend go slow and low foods
for the National Institutes of Health
presently online.
So this is a little hard to see,
but I'll just read it.
Breads, tortillas,
rice, breakfast soups.
You can have these almost any time.
As long as they're over,
it doesn't matter how costly.
Have this as much as you want.
But go slowly on vegetables
if you saw it, sort of take it all.
Go slowly on peanut butter or nuts.
Disregarding that pregnant study
that the nuts, not only didn't cause great gain,
but caused heart disease-raised decline.
And according to this again,
this calorie balance model,
even white rice, waffles, and pancakes
are desirable over eggs
if you saute them in olive oil
with the peanut butter.
And frozen yogurt.
And ice cream, which we know is going to be full of sugar,
is preferable to plain whole milk.
Whereas plain whole milk is equated
to sugar-stewful salt.
This is the confusion that arises
from the calorie and calorie levels.
So in summary of the conclusion,
improving diet quality may be easier
and more successful
with the calorie restriction for long-term wages.
A simple dietary strategy
is to lower insulin
and promote weight loss
is to replace highly processed carbohydrates
with healthy high fats.
Nuts, nut butters, full-factory, olive oil,
rich sauces and sprints,
and real dark chocolate.
The culinary experts here will love this because
cooks know that fat is delicious.
And yet we've been depriving ourselves
of unnecessary and harmful
from this delicious future.
And we need much better research
to definitively test these theories,
these hypotheses.
So closing thought,
that the ideas that I presented to you today
may be provocative,
but they're not entirely new.
The editors of a leading medical journal
will follow.
When we read that the fat woman has the remedy
in her own hands,
or rather between her own teeth,
the obesity is merely the result
of unsatisfactory diets
in the book
of the logic suggested body fat
increased by altering the balance sheet
through provincial intake,
increased output, and both.
The problem is not really so simple
and uncomplicated
as is in this picture.
These words were written by the editors of JAMA
in 1924.
Thank you
for your attention.
Please follow me on social media.
Thank you
for your patience
with our technical difficulties.
And
if we have time for a question.
We're going to open it to questions.
We have a catch box here
that we can put up your hand.
I can throw it to you
and you can ask your questions.
And maybe don't
you have questions from our
you can start while your folks are
thinking here in the audience
are doing questions.
We can take a question or two
from our online
social media.
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