Latest / Wellness, Actually with Emily Oster & Perry Wilson, MD / What's the deal with red meat?

Transcript

What's the deal with red meat? · Wellness, Actually with Emily Oster & Perry Wilson, MD

• 0:01
  Speaker 1: Before we get started, a brief correction from last week's
• 0:03
  Speaker 1: methylene blue episode. My wife, the brilliant breast surgeon, informed
• 0:08
  Speaker 1: me that I neglected to mention a very important use
• 0:10
  Speaker 1: of methylene blue, which is that it is used for
• 0:13
  Speaker 1: sentinel lymph node biopsy in all types of surgeries where
• 0:16
  Speaker 1: surgeons need to figure out where cancer may be spreading
• 0:20
  Speaker 1: and along what path. So one more good use of
• 0:23
  Speaker 1: methylene blue amidst the many bad uses that we talked
• 0:27
  Speaker 1: about last week. Let's get on with today's episode.
• 0:31
  Speaker 2: Okay, So, Perry, I'm going to tell you a story
• 0:33
  Speaker 2: about a colleague of mine at my old job who
• 0:36
  Speaker 2: ate only.
• 0:38
  Speaker 1: Meat, only meat pretty much.
• 0:41
  Speaker 2: Okay, So here's what happened. He was on a carnivore
• 0:44
  Speaker 2: paleo meat granted diet and his main snack food was
• 0:51
  Speaker 2: I want you to imagine, you know, those like ice
• 0:54
  Speaker 2: pop things that your kids have that are like long
• 0:57
  Speaker 2: plastic things at blue ice in the middle and it's.
• 0:59
  Speaker 3: Like a pushpop.
• 1:00
  Speaker 1: Yeah.
• 1:00
  Speaker 2: Yeah, it was like that, but instead of the blue ice,
• 1:05
  Speaker 2: it was a meat slurry. So it's sort of like
• 1:08
  Speaker 2: a like a like a beef tartar, but more of
• 1:11
  Speaker 2: a of a slurry he would just sort of like
• 1:14
  Speaker 2: push it up and eat it, okay, So that already
• 1:16
  Speaker 2: was like m he had the office next to mine.
• 1:20
  Speaker 2: Then it's the summer and he goes out of town
• 1:23
  Speaker 2: and he gets right before it's like quite hot, and
• 1:27
  Speaker 2: he gets a box of this stuff delivered right before
• 1:31
  Speaker 2: he leaves, and they put it in his office. The
• 1:35
  Speaker 2: course of the next few weeks, the smell just gets
• 1:39
  Speaker 2: worse and worse and worse, and finally it's like our
• 1:42
  Speaker 2: offices are around this open space where like the graduate
• 1:45
  Speaker 2: students work, and she's getting worse and worse and worse,
• 1:48
  Speaker 2: and finally we call in security and they go in
• 1:50
  Speaker 2: and there's just this box of like rotting meat slurry.
• 1:55
  Speaker 2: Did you think that someone had died, Well, we thought
• 1:59
  Speaker 2: it was animal like we didn't think it was in
• 2:01
  Speaker 2: dead person, but we thought there was an animal that
• 2:03
  Speaker 2: had died.
• 2:04
  Speaker 3: And then we opened it and the security guys are like,
• 2:07
  Speaker 3: there's a box of meat.
• 2:09
  Speaker 4: And.
• 2:11
  Speaker 3: I was mad. I was really mad.
• 2:15
  Speaker 1: I mean I would be livid. We're going to talk
• 2:19
  Speaker 1: about the benefits and risks of a red meat diet today,
• 2:22
  Speaker 1: but boy, this is what I didn't think of.
• 2:25
  Speaker 5: Keep your meat refrigerated people, geez, give your meat slurries.
• 2:28
  Speaker 2: Guys, your meat push up slurry pops. They need to
• 2:31
  Speaker 2: be refrigerated. If you learn nothing else from this episode,
• 2:33
  Speaker 2: it should be that I'm Emily Oster, I'm an economist
• 2:39
  Speaker 2: and a data expert.
• 2:40
  Speaker 1: And I'm Harry Wilson, I'm a medical doctor.
• 2:43
  Speaker 2: It's Thursday May twenty eight, twenty twenty six, and this
• 2:46
  Speaker 2: is wellness.
• 2:46
  Speaker 1: Actually, because you're getting a staggering amount of health and
• 2:50
  Speaker 1: wellness information nowadays from every source imaginable, and some of
• 2:54
  Speaker 1: it is awesome and some.
• 2:56
  Speaker 3: Of it is well actually both.
• 3:00
  Speaker 2: Fortunately we are both people who know how to read studies,
• 3:03
  Speaker 2: how to parse the data, and can tell you what's
• 3:05
  Speaker 2: worth thinking about and what you can safely ignore.
• 3:09
  Speaker 1: But before we dig in, a note that this podcast
• 3:11
  Speaker 1: is for educational purposes and should not be construed as
• 3:14
  Speaker 1: medical advice. We don't know your unique situation, so talk
• 3:17
  Speaker 1: to your doctor for personal health decisions.
• 3:20
  Speaker 2: This week, we're asking what's the deal with red meat?
• 3:23
  Speaker 2: Harry and I will give the official smasher pass, and
• 3:26
  Speaker 2: then we'll get to your question of the week. But
• 3:28
  Speaker 2: first let's do the health news roundup.
• 3:30
  Speaker 3: After the break.
• 3:43
  Speaker 1: And we're back with your Health News of the Week, Emily.
• 3:47
  Speaker 1: Running influencers are having a moment with peptides. What's going
• 3:53
  Speaker 1: on here? This is your world?
• 3:55
  Speaker 2: Okay, So there's a fight going on between two running
• 3:58
  Speaker 2: influencers about use of peptides. So there is one running
• 4:03
  Speaker 2: influencer who ran the Eugene Marathon and he's not even
• 4:08
  Speaker 2: really a running influencer. He's like a wellness guy influencer,
• 4:12
  Speaker 2: and he ran the Eugene Marathon actually quite fast, in
• 4:15
  Speaker 2: like two thirty nine. He's fifty, so it's actually a
• 4:18
  Speaker 2: very fast time, and he won his like old person
• 4:20
  Speaker 2: age group or whatever.
• 4:22
  Speaker 3: But he's not a professional athlete.
• 4:23
  Speaker 2: But then ex post he really he revealed that he's
• 4:26
  Speaker 2: been using BPC one fifty seven, which you may recall
• 4:30
  Speaker 2: as being part of the Wolverine.
• 4:32
  Speaker 3: Stack that is recommended by Joe Rogan.
• 4:35
  Speaker 1: And then the peptide episode please.
• 4:39
  Speaker 3: Listen to our theptid episode.
• 4:41
  Speaker 2: And then another running influencer is an ultra runner influencer,
• 4:46
  Speaker 2: is very upset about this because BPC one fifty seven
• 4:49
  Speaker 2: is not sanctioned by WATA, which is the antidoping agency.
• 4:54
  Speaker 3: But this guy's view is.
• 4:55
  Speaker 2: Like he's not a professional athlete, he's not in a
• 4:57
  Speaker 2: doping pool, and the other other guys view is you're cheating,
• 5:01
  Speaker 2: and my view is there's no evidence that this peptide
• 5:04
  Speaker 2: improves your performance. But I love the overlap of like
• 5:07
  Speaker 2: endurance sports and peptides and influencers.
• 5:12
  Speaker 3: It's just it's a dream.
• 5:14
  Speaker 1: Yeah. I mean, as more of this stuff gets out there,
• 5:17
  Speaker 1: with less and less data, these issues just you can
• 5:21
  Speaker 1: you can impose whatever you want on the effects of
• 5:23
  Speaker 1: these things because there's no one who can prove you
• 5:26
  Speaker 1: wrong since there's no strong data. So you can say like, oh,
• 5:28
  Speaker 1: this is the same as taking steroids, or you can
• 5:31
  Speaker 1: be like it's a fancy placebo and it made me
• 5:33
  Speaker 1: believe in myself. And you've got equal evidentiary support for
• 5:36
  Speaker 1: both of those statements totally.
• 5:39
  Speaker 2: So anyway, that was my that was my thing. I
• 5:41
  Speaker 2: am going to refrain from making us do an entire
• 5:43
  Speaker 2: episode on a thing called the enhanced Games, but we
• 5:45
  Speaker 2: can discuss that at another time.
• 5:47
  Speaker 1: Oh I saw that fascinating.
• 5:49
  Speaker 3: Yes, absolutely, all right.
• 5:51
  Speaker 2: In less fun news, please tell us what's going on
• 5:54
  Speaker 2: with Ebola.
• 5:56
  Speaker 1: Yeah. I'd like to not have this be a news
• 5:58
  Speaker 1: item every week, but it is important. The Abola outbreak
• 6:03
  Speaker 1: continues in the Democratic Republic of Congo right now as
• 6:07
  Speaker 1: of the recording, today's Tuesday, the twenty six, when we're recording,
• 6:10
  Speaker 1: you'll hear this a couple days later. They're about a
• 6:13
  Speaker 1: thousand suspected and confirmed cases and two hundred and twenty
• 6:17
  Speaker 1: three suspected deaths. The outbreak has spread into Uganda now
• 6:22
  Speaker 1: with seven confirmed cases and one confirmed death. One American
• 6:26
  Speaker 1: has been infected. They were administering care to people in
• 6:31
  Speaker 1: the Democratic Republic of Congo, tested positive and has been
• 6:34
  Speaker 1: evacuated to Germany to a hospital there. Obviously, we wish
• 6:39
  Speaker 1: them the best. I think. One of the concerning things
• 6:42
  Speaker 1: that has emergency weeks, there have been several attacks against
• 6:45
  Speaker 1: health centers in the Democratic Republic of Congo that are
• 6:49
  Speaker 1: you know, ministering to this population. You know. One of
• 6:52
  Speaker 1: the issues is apparently that the cultural funereal practices are
• 6:59
  Speaker 1: very important in this part of the world, and healthcare
• 7:03
  Speaker 1: workers have been limiting access to dead bodies to their
• 7:10
  Speaker 1: families and loved ones, in part because inebola deceased bodies
• 7:14
  Speaker 1: are highly highly infectious. This is transmitted by bodily fluids
• 7:17
  Speaker 1: and in fact, in prior outbreaks, sixty to eighty percent
• 7:21
  Speaker 1: of the infections were attributed to funereal practices because there,
• 7:25
  Speaker 1: you know, families will like bathe the bodies, even sleep
• 7:29
  Speaker 1: near the bodies for several days at a time. There's
• 7:33
  Speaker 1: really interesting public health work being done there to like
• 7:36
  Speaker 1: work within the communities, work with religious leaders to try
• 7:39
  Speaker 1: to you know, educate the populace on safe funereal practices here.
• 7:44
  Speaker 1: But obviously there's a lot of anger and mistrust in
• 7:46
  Speaker 1: the populace as well, which is why you see these attacks,
• 7:48
  Speaker 1: which you know, it goes without saying, are a terrible
• 7:51
  Speaker 1: thing to you know, you're not going to reduce the
• 7:54
  Speaker 1: spread of this if you attack the clinics that are
• 7:57
  Speaker 1: isolating and treating people as best they can.
• 8:01
  Speaker 2: This is very I hope we will not keep talking
• 8:03
  Speaker 2: about this, but it is scary but also very very
• 8:07
  Speaker 2: sad it is.
• 8:10
  Speaker 1: Let's move on to let's add more crazy. I think
• 8:13
  Speaker 1: I read the wildest quote I've seen in a long
• 8:17
  Speaker 1: time from a legitimate researcher. So this comes from doctor
• 8:22
  Speaker 1: Glenn Jeffrey. He's at University of College London. He's a
• 8:26
  Speaker 1: mitochondrial researcher. So there we go, all of you playing
• 8:29
  Speaker 1: the drinking game at home. We've now mentioned mitochondria. You
• 8:32
  Speaker 1: have to take a shot. He's a mitochondrial researcher and,
• 8:36
  Speaker 1: appearing on Huberman's podcast, referred to LED lighting as an
• 8:42
  Speaker 1: asbestos level crisis. Bonker's statement to make Emily, why does
• 8:49
  Speaker 1: he think that LED lights are as bad as asbestos?
• 8:53
  Speaker 2: Asbestos a substance which, just to be clear, is well
• 8:57
  Speaker 2: known to have caused many, many cases of cancer in
• 9:01
  Speaker 2: people over time.
• 9:03
  Speaker 1: Yes, very difficult to treat cancer, MUSICIELI almost.
• 9:06
  Speaker 2: Difficult to treat cancer, all right. So this researcher was
• 9:10
  Speaker 2: working on LED lights and he ran an experiment in
• 9:14
  Speaker 2: which he exposed some people to LED lights with sunlight
• 9:18
  Speaker 2: and some people with INCANDESCI lights like different kinds of lighting,
• 9:21
  Speaker 2: some of which was more LED focused than others. And
• 9:25
  Speaker 2: he showed some changes in the retina after two weeks
• 9:30
  Speaker 2: of this exposure and concluded that this might be related
• 9:37
  Speaker 2: to the mitochondria, and as a result, it's as bad
• 9:41
  Speaker 2: as asbestos. I will be Frank. I can read the paper.
• 9:44
  Speaker 2: The paper says we did this thing with the light
• 9:46
  Speaker 2: and there was some small changes in retinal function, and
• 9:48
  Speaker 2: that's an interesting thing to explore. But I'm failing to
• 9:53
  Speaker 2: see the link the jump between small changes to the
• 9:58
  Speaker 2: retina and then cancer.
• 10:01
  Speaker 3: Did you did you see it?
• 10:03
  Speaker 6: No?
• 10:03
  Speaker 1: I the link as far as I can see. And
• 10:06
  Speaker 1: this is like a theme that I keep seeing now
• 10:09
  Speaker 1: that I'm exposed to, like the wellness and influencer space
• 10:13
  Speaker 1: is like apparently you can just say like that that
• 10:16
  Speaker 1: that's where we are right now, And it's much more
• 10:18
  Speaker 1: interesting to say this is an asbestos level health crisis
• 10:22
  Speaker 1: than as expected when exposing people to different kinds of
• 10:26
  Speaker 1: bright lights, there are subtle changes in the eye right
• 10:29
  Speaker 1: like this.
• 10:32
  Speaker 3: I did not click on that.
• 10:33
  Speaker 1: I didn't So, you know, anyway, for listeners, just like
• 10:37
  Speaker 1: claims like this, you know, trustworthy science communication unfortunately is
• 10:44
  Speaker 1: not that exciting because most evidence is somewhere in the
• 10:48
  Speaker 1: middle and and requires nuance.
• 10:51
  Speaker 3: And and most effects are small. I mean I think
• 10:53
  Speaker 3: that's the thing.
• 10:54
  Speaker 2: Like most things, if they have a positive effect or
• 10:57
  Speaker 2: a negative fact, most of these effects are very small.
• 11:00
  Speaker 3: Yeah.
• 11:00
  Speaker 1: And also, I you know, one of the things that
• 11:02
  Speaker 1: he said was like, oh, you know, you should consider
• 11:04
  Speaker 1: moving back to incandescent lights, And it's like we've made
• 11:08
  Speaker 1: so much like this is one area where technology I
• 11:11
  Speaker 1: think just completely fixed a problem like led lights are
• 11:16
  Speaker 1: so much better than incandescent totally.
• 11:18
  Speaker 2: They are better for the environment, cheaper, last, longer, last way.
• 11:23
  Speaker 1: Is there that a superior product in every possible way?
• 11:26
  Speaker 1: Don't move us back to the dark ages, no pun intended.
• 11:32
  Speaker 2: That is the health news of the week. After the break,
• 11:34
  Speaker 2: what is the deal with red meat? Okay, Perry, let's
• 11:43
  Speaker 2: talk about red meat.
• 11:44
  Speaker 1: I'm here for it. I am like a hack of
• 11:47
  Speaker 1: a politician. I want to throw out some red meat
• 11:50
  Speaker 1: to my listeners.
• 11:53
  Speaker 2: So I want to start with a short disclaimer, which
• 11:55
  Speaker 2: is that we are going to talk here about red
• 11:57
  Speaker 2: meat and its impacts on health and varying sources of
• 12:01
  Speaker 2: protein and how nutrition relates to human health.
• 12:05
  Speaker 3: We are not going to talk about climate. I know
• 12:07
  Speaker 3: that a.
• 12:07
  Speaker 2: Lot of people avoid red meat because of the impact
• 12:10
  Speaker 2: of cows on climate, and we are not going to
• 12:14
  Speaker 2: be talking about that today, not because it's not important,
• 12:16
  Speaker 2: but because that's not the topic of today's podcast.
• 12:19
  Speaker 1: Excellent disclaimer. There you go.
• 12:20
  Speaker 3: Yep.
• 12:21
  Speaker 2: Okay, let's start with some basic science. What makes red
• 12:26
  Speaker 2: meat red? Trivia question for the doctor?
• 12:30
  Speaker 1: My aglobin In a word, my globin is a protein
• 12:36
  Speaker 1: that lives in muscle, cells and has a heme group
• 12:41
  Speaker 1: in the middle, which is an iron containing group in
• 12:43
  Speaker 1: the middle, and it provides oxygen to muscle cells which
• 12:47
  Speaker 1: need that oxygen so that they can run their mitochondria
• 12:50
  Speaker 1: and contract and things like that. Differing amounts of myoglobin
• 12:54
  Speaker 1: colors muscles differing shades of red, and so you know,
• 12:58
  Speaker 1: when we think about red meat like cows and pork
• 13:01
  Speaker 1: and stuff like that, that's basically what you're seeing. It's
• 13:04
  Speaker 1: the same heme group that comes in hemoglobin, which delivers
• 13:06
  Speaker 1: oxygen to the rest of the body, but myoglobin is
• 13:08
  Speaker 1: quite concentrated in muscle cells. It does lead to the question,
• 13:12
  Speaker 1: of course, like why don't birds and chickens have myoglobin
• 13:18
  Speaker 1: in their muscle fibers. And it turns out that birds
• 13:22
  Speaker 1: don't use aerobic respiration to fuel their muscle movements. They
• 13:27
  Speaker 1: use anaerobic respirations, so they aren't using their mitochondria, they
• 13:30
  Speaker 1: don't need an oxygen carrier in their muscle fibers, and
• 13:34
  Speaker 1: hence they have white muscle, and fundamentally that's what explains
• 13:40
  Speaker 1: the color. But of course what's interesting to us is
• 13:43
  Speaker 1: less like a why is it red? And more what
• 13:45
  Speaker 1: are the nutritional differences? Writen large between you know, a
• 13:49
  Speaker 1: given amount of red meat and a given amount of
• 13:51
  Speaker 1: non red or white meat. So we should probably dig
• 13:54
  Speaker 1: in there.
• 13:54
  Speaker 2: Yeah, I think we should start there because in general,
• 13:57
  Speaker 2: when people are eating meat, this is an important source
• 14:01
  Speaker 2: of protein.
• 14:03
  Speaker 3: And that is what people are mostly getting.
• 14:07
  Speaker 2: That is the most important macronutrient people are getting out
• 14:10
  Speaker 2: of meat.
• 14:11
  Speaker 3: And there are.
• 14:11
  Speaker 2: Sources of protein that come from animals and sources of
• 14:14
  Speaker 2: protein that come from plants, and I think gets useful
• 14:18
  Speaker 2: to do a little bit of a comparison for people about,
• 14:21
  Speaker 2: you know, what are some common sources of protein and
• 14:24
  Speaker 2: what do they deliver, So we can maybe think about beef, chicken, fish,
• 14:29
  Speaker 2: and tofu as being kind of representative of the kinds
• 14:32
  Speaker 2: of meat.
• 14:34
  Speaker 1: I would say the four proteins of the Apocalypse.
• 14:37
  Speaker 2: Lean, ground, beef, skinless chicken, breast, salmon, and tofu.
• 14:42
  Speaker 3: Distinguishing features among these are.
• 14:46
  Speaker 2: Beef has more calories than the other items because it
• 14:53
  Speaker 2: has more fat. Like that's like the for me, that's
• 14:57
  Speaker 2: like the most crucial element of this is that that
• 14:59
  Speaker 2: for a guin amount of protein, beef is going to
• 15:01
  Speaker 2: have more calories because it has more fat, and particularly
• 15:04
  Speaker 2: more saturated fat.
• 15:07
  Speaker 3: Tofu is going to have sort of slightly.
• 15:11
  Speaker 2: Less much less fat, much less saturated fat. The lowest
• 15:15
  Speaker 2: thing in saturated fat or Jeff fat in general is
• 15:18
  Speaker 2: like skinless chicken breast. That's why that's everyone's favorite nineteen
• 15:21
  Speaker 2: eighties diet food. But when I think about how we
• 15:26
  Speaker 2: organize the questions about health here, it is really about
• 15:29
  Speaker 2: around the fact that this is a higher calorie food
• 15:32
  Speaker 2: because it has more fat.
• 15:34
  Speaker 3: Is there more that you would say about the nutrients?
• 15:37
  Speaker 1: I'd say a couple little other things, But yes, I
• 15:39
  Speaker 1: think when it comes to health, we're talking not just
• 15:43
  Speaker 1: about fat, but about saturated fat. And I think everyone's
• 15:46
  Speaker 1: heard the term saturated fat, so we should, but we
• 15:47
  Speaker 1: should actually define it like what it is and why
• 15:50
  Speaker 1: we care. And that is kind of the distinguishing feature
• 15:55
  Speaker 1: of beef. As you say, there are a couple little
• 15:57
  Speaker 1: other things that, like micronutrients, that are worth describing. People
• 16:01
  Speaker 1: won't be surprised to hear that beef has more iron
• 16:03
  Speaker 1: in it than chicken and salmon, although actually tofu has
• 16:08
  Speaker 1: quite a bit of iron as well. The other major
• 16:12
  Speaker 1: thing that comes up all the time we talk about
• 16:14
  Speaker 1: carnivore based diets are heavily meat protein based diets. Is
• 16:18
  Speaker 1: that meat has no fiber, not red meat, not chicken,
• 16:23
  Speaker 1: not salmon. There's no dietary fiber in these and in
• 16:26
  Speaker 1: so far as dietary fiber is important for promoting colon
• 16:29
  Speaker 1: health and reducing the risk of colon cancer, that is
• 16:33
  Speaker 1: the absence of fiber. It's something that we need to
• 16:38
  Speaker 1: think about. So, but maybe let's just start with saturated fat. Emily,
• 16:41
  Speaker 1: do you like? What do you think me?
• 16:43
  Speaker 3: Pushback on?
• 16:44
  Speaker 2: Like, I think fiber is very important, but none of
• 16:46
  Speaker 2: these things have fiber in them. So like if you
• 16:49
  Speaker 2: said chicken doesn't have fiber.
• 16:50
  Speaker 1: Either, chicken doesn't have fiber either, right, I mean like,
• 16:53
  Speaker 1: but but plant based proteins do, right.
• 16:55
  Speaker 3: So plantbease proteins have fiber.
• 16:56
  Speaker 2: But is this is that people's most important source of
• 17:00
  Speaker 2: fiber mostly?
• 17:01
  Speaker 1: Well, it could be like if you're if you're sitting
• 17:03
  Speaker 1: here and asking the question of my concern is getting
• 17:07
  Speaker 1: adequate amounts of protein and how should I do it?
• 17:09
  Speaker 1: By the way, call back to the what's the deal
• 17:11
  Speaker 1: with protein? Episode? Like plant based proteins would offer you
• 17:15
  Speaker 1: fiber in addition to similar amounts of protein and less
• 17:18
  Speaker 1: saturated fat than red meat. Okay, if you think that matters,
• 17:24
  Speaker 1: I think, okay.
• 17:26
  Speaker 2: Fine, I'm gonna I think we're already getting a sense
• 17:29
  Speaker 2: that Perry and I are not going to agree about
• 17:30
  Speaker 2: everything here. I don't think this is that your protein
• 17:33
  Speaker 2: sources are an important source of your fiber.
• 17:35
  Speaker 3: But let's move on.
• 17:37
  Speaker 1: Okay, let's talk about saturated fat.
• 17:39
  Speaker 3: Let's talk about saturated fat.
• 17:41
  Speaker 1: Yeah, what makes saturated fat saturated? So should we do
• 17:46
  Speaker 1: a very quick chemistry?
• 17:48
  Speaker 3: Your fat carbon chains big.
• 17:50
  Speaker 1: Long carbon chains. So fat is just a big long
• 17:54
  Speaker 1: chain of carbons, you know, whereas sugars, like the kind
• 17:57
  Speaker 1: of sucrose that we eat, are two carbons stuck together,
• 17:59
  Speaker 1: so it's simple. And then like glucose is just one
• 18:01
  Speaker 1: carbon with some stuff attached to it, but you know,
• 18:03
  Speaker 1: you're getting their energy from there. And fats like carbon
• 18:05
  Speaker 1: carbon carbon carbon carbon, You can have different lengths of
• 18:08
  Speaker 1: these carbon chains, and then you break those things down
• 18:10
  Speaker 1: and you digest them, and that's how you get energy.
• 18:13
  Speaker 1: The end of that long chain of carbon has a
• 18:14
  Speaker 1: little acid on it, which is why people used to
• 18:17
  Speaker 1: talk about fatty acids. We now just say fats. That's
• 18:19
  Speaker 1: basically what we're talking about. It's all fatty acid now
• 18:22
  Speaker 1: saturated fats. The reason they're saturated is that their carbons
• 18:27
  Speaker 1: are connected are fully bound to hydrogen, so they only
• 18:30
  Speaker 1: have single bonds to each other. And the practical upshot
• 18:34
  Speaker 1: of that is that those long, squiggly chains can pack
• 18:38
  Speaker 1: very tightly together. And the way you notice that is
• 18:42
  Speaker 1: that when something has more saturated fat, it will be
• 18:46
  Speaker 1: solid at room temperature because the fat can all kind
• 18:50
  Speaker 1: of pack together. So if you're wondering like butter or beef,
• 18:55
  Speaker 1: tallol or like coconut oil, right, like, so there are more,
• 18:59
  Speaker 1: there are relatively more and less saturated fats. And a
• 19:02
  Speaker 1: hint as to what that is is you know whether
• 19:05
  Speaker 1: it's a liquid or not at room temperature. But like,
• 19:09
  Speaker 1: that's a fun trivia fact, I guess. But the reason
• 19:11
  Speaker 1: people care is because I'm curious if you'll agree with
• 19:15
  Speaker 1: me on this, Emily. There is a clear and causal
• 19:19
  Speaker 1: relationship between saturated fat intake and serum cholesterol levels.
• 19:25
  Speaker 3: Yeah, I think that's true.
• 19:27
  Speaker 5: Okay, all right, just want to make sure you weren't
• 19:29
  Speaker 5: like gonna come out with like, well, actually, okay, great,
• 19:34
  Speaker 5: So saturated fat raises cholesterol and higher.
• 19:37
  Speaker 1: Cholesterol levels are causally linked to cardiovascular disease and stroke.
• 19:43
  Speaker 2: Right, what I think is interesting and is a great
• 19:46
  Speaker 2: opportunity to get into some complaints.
• 19:48
  Speaker 3: I have, Okay, are how we draw links between those things.
• 19:55
  Speaker 2: So consumption are more saturated fat leading to higher cholesterol
• 19:59
  Speaker 2: on our ridge, people with higher cholesterol more likely to
• 20:02
  Speaker 2: have cardiovascular disease. I think the question is, then if
• 20:05
  Speaker 2: you change someone's diet from a low saturated fat to
• 20:08
  Speaker 2: a higher saturated fat or vice versa, would that alter
• 20:12
  Speaker 2: their cardiovascular risk? And that is the question that I
• 20:15
  Speaker 2: think we want to talk about because in the course
• 20:18
  Speaker 2: of this discussion on red meat, I think the core
• 20:20
  Speaker 2: question is whether a diet that has its meat source
• 20:24
  Speaker 2: be higher and saturated fat is going to put you
• 20:28
  Speaker 2: at higher risks for cardiovascular disease than a calorically equivalent
• 20:31
  Speaker 2: diet with less saturated fat. Right, Okay, I want to
• 20:38
  Speaker 2: take an opportunity to give some complaints about nutrition science.
• 20:42
  Speaker 1: At this idea. This is a perfect time.
• 20:46
  Speaker 3: Great.
• 20:47
  Speaker 2: A lot of what we know about nutrition is based
• 20:51
  Speaker 2: on studies which are very large, but in my personal view, terrible.
• 20:57
  Speaker 2: Many of these studies, many of the studies you hear
• 20:59
  Speaker 2: about the difference in health outcomes for people who drink
• 21:03
  Speaker 2: more coffee, or drink more milk, or dark chocolate, chocolate
• 21:09
  Speaker 2: or GC's or blueberries or whatever. Is the most of
• 21:13
  Speaker 2: that is based on getting data on people's diets and
• 21:18
  Speaker 2: comparing the health outcomes for people who have one kind
• 21:21
  Speaker 2: of diet versus another kind of diet. The problem is
• 21:24
  Speaker 2: that those two groups are typically very very different in
• 21:27
  Speaker 2: many other ways that are not about their diet, and
• 21:32
  Speaker 2: it is extremely challenging for researchers to fully adjust for
• 21:38
  Speaker 2: those factors. And I think people would be surprised at
• 21:43
  Speaker 2: how much you can mess around with things to make
• 21:47
  Speaker 2: stuff show up in whatever way you want. So, for example,
• 21:51
  Speaker 2: I once took the Marquee study data source on diet,
• 21:57
  Speaker 2: the en Hanes, which is where we survey many Americans thousands.
• 22:01
  Speaker 1: Of nationally representative survey sample.
• 22:04
  Speaker 2: National representative survey, and I showed that you can do
• 22:07
  Speaker 2: something that looks very close. It actually is kind of
• 22:09
  Speaker 2: the standard approach to analyzing diet, and you can show
• 22:13
  Speaker 2: that consuming iceberg lettuce raises your BMI, but consuming dandelion
• 22:17
  Speaker 2: greens lowers your BMI.
• 22:19
  Speaker 1: Yeah.
• 22:19
  Speaker 2: Now, both iceberg lettuce and dandelion greens contain no calories.
• 22:23
  Speaker 3: They are calorically free.
• 22:26
  Speaker 2: But the difference is that people who are poor tend
• 22:28
  Speaker 2: to eat iceberg lettuce, and people who are rich tend
• 22:30
  Speaker 2: dandelion greens.
• 22:31
  Speaker 3: And in fact, even though you see in these.
• 22:34
  Speaker 2: Data sets things like education and income, you don't see
• 22:37
  Speaker 2: enough about them.
• 22:37
  Speaker 1: You can never adjust enough, you.
• 22:39
  Speaker 2: Can never adjust enough, and so in like, my view
• 22:43
  Speaker 2: is that basically all studies that rely on this kind
• 22:47
  Speaker 2: of observational data to analyze nutrition are just trash.
• 22:52
  Speaker 3: Honestly, that's my view that they're all trash. Okay, I'm
• 22:55
  Speaker 3: going it's a hot take.
• 22:57
  Speaker 1: It's a hot take, and I'm not I'm not even
• 23:01
  Speaker 1: that offended by your hot take. And I'm going to
• 23:04
  Speaker 1: add one other problem to this body of literature, which
• 23:08
  Speaker 1: is the food frequency questionnaire, where the enhanes data and
• 23:11
  Speaker 1: a lot of other data comes from. A food frequency
• 23:13
  Speaker 1: questionnaire is something that says, over the past week, how
• 23:17
  Speaker 1: many times did you eat bananas over the past month,
• 23:19
  Speaker 1: how many times over the past year, how many times, okay,
• 23:22
  Speaker 1: over the past week, how many times did you eat
• 23:24
  Speaker 1: walnuts over the past month, over the past and so
• 23:27
  Speaker 1: on and so forth. And there's about one hundred and
• 23:29
  Speaker 1: ten different food items on the standard Food Frequency keshnaire,
• 23:32
  Speaker 1: there of course variants. Okay, what I can do with
• 23:36
  Speaker 1: that data if I have that on all the enhanes people,
• 23:39
  Speaker 1: and I have outcomes on these endhanes people I know
• 23:41
  Speaker 1: who had you know, heart attacks or whatever, at least
• 23:43
  Speaker 1: maybe cross sectionally, I know what their BMI is, for example,
• 23:46
  Speaker 1: But in other data sets, I might have longitudinal outcomes.
• 23:49
  Speaker 1: I can take all of those one hundred and ten
• 23:52
  Speaker 1: things on the food frequency questionnaire and test whether they
• 23:56
  Speaker 1: you know, statistically associate with hard tech stroke divorce rates,
• 24:00
  Speaker 1: whatever it is. And because there's one hundred and ten
• 24:02
  Speaker 1: of them, several of them just by chance alone will
• 24:04
  Speaker 1: be statistically significant.
• 24:06
  Speaker 3: Five.
• 24:06
  Speaker 1: Wait, there's more at the level. That's what Okay, go ahead,
• 24:10
  Speaker 1: weight there's more. People have taken those one hundred ten
• 24:12
  Speaker 1: items on the food frequency questionnaire and grouped them in
• 24:15
  Speaker 1: weird ways. Sure, by macronutrients, right, like, okay, based on
• 24:19
  Speaker 1: your answers, how much carbs do we think you get?
• 24:21
  Speaker 1: But they've done it for like pesticide exposure. Right, they'll say, okay,
• 24:25
  Speaker 1: based on your food frequency questionnaires, how much pesticide are
• 24:28
  Speaker 1: you probably taking in? Because we know that like whatever,
• 24:30
  Speaker 1: cucumbers have more pesticides than cherries or something like that.
• 24:35
  Speaker 1: And now you have a new exposure called like pesticide exposure,
• 24:37
  Speaker 1: which is based on no measurement whatsoever except how you
• 24:39
  Speaker 1: answer to survey, and you can link that to a
• 24:41
  Speaker 1: bunch of different outcomes. And so there's a huge opportunity
• 24:45
  Speaker 1: for kind of trolling through data and finding interesting things.
• 24:49
  Speaker 1: They often get published because people love to talk about
• 24:52
  Speaker 1: this stuff, right, like it's it's relevant to everyone. We
• 24:55
  Speaker 1: all have to eat. The one thing I do want
• 24:57
  Speaker 1: to say is that while I agree that randomized trials
• 25:02
  Speaker 1: are the gold standard of evidence, here, it is completely
• 25:07
  Speaker 1: infeasible to randomize someone's diet for a long enough period
• 25:11
  Speaker 1: of time to witness the effects of that diet on
• 25:15
  Speaker 1: hard clinical outcomes. And so we'll talk about.
• 25:20
  Speaker 3: Something rather trash than nothing.
• 25:23
  Speaker 1: I'd rather have trash than nothing. Yes, I think that
• 25:27
  Speaker 1: I can, you know, take sort of triangulate from the
• 25:33
  Speaker 1: these I'm not going to call them trash. I'm going
• 25:36
  Speaker 1: to call them, you know, less than ideal study designs
• 25:41
  Speaker 1: to make inference. And because if we don't, then we're
• 25:44
  Speaker 1: like we're totally what are we going to say? Like
• 25:46
  Speaker 1: we don't know? And we'll never know, so go crazy.
• 25:48
  Speaker 2: Yeah, that's I think that's fair. I guess for me,
• 25:52
  Speaker 2: that makes it very important to look at the size
• 25:55
  Speaker 2: of these impacts. So an example that people always give
• 25:58
  Speaker 2: in this space when they want to argue that we
• 26:00
  Speaker 2: should use observational data that it's good is smoking. They say,
• 26:04
  Speaker 2: you know, well, in you know, when the first evidence
• 26:07
  Speaker 2: that's smoking gave you lung cancer was from just comparing
• 26:10
  Speaker 2: smokers to non smokers, And you know.
• 26:12
  Speaker 3: That if we had really trusted.
• 26:14
  Speaker 2: That evidence, then you know, which later was confirmed my
• 26:16
  Speaker 2: randomized trials. But if we'd really trusted that evidence, we
• 26:19
  Speaker 2: would have you know, told people to stop smoking earlier.
• 26:22
  Speaker 3: And that's true.
• 26:23
  Speaker 2: But in the smoking data, the excess risk of lung
• 26:26
  Speaker 2: cancer was like sixty times. It was like a sixty
• 26:29
  Speaker 2: six thousand percent increase in lunchture and it was not subtle.
• 26:33
  Speaker 2: And so you could say, well, is it likely that
• 26:36
  Speaker 2: the other differences across these people could drive this effect
• 26:40
  Speaker 2: to be sixty times as big, especially given that it's
• 26:43
  Speaker 2: a cancer associated with something that you're inhaling through a smoke,
• 26:47
  Speaker 2: like there's some biological plausibility, and the effect size was
• 26:51
  Speaker 2: so big. I think where I get stuck in a
• 26:53
  Speaker 2: lot of these things. Is we're saying, Okay, we're comparing
• 26:56
  Speaker 2: this kind of diet to this kind of diet or
• 26:58
  Speaker 2: this food to this food, and the increase in cardiovascular
• 27:01
  Speaker 2: risk is like seven percent, And it feels to me
• 27:04
  Speaker 2: like I can I can imagine we get a seven
• 27:07
  Speaker 2: percent increase from the many other differences across these people,
• 27:11
  Speaker 2: and so like maybe we look at the observational data,
• 27:14
  Speaker 2: but the kind of observational data with tiny effect sizes
• 27:17
  Speaker 2: tells me like you should this is it feels like zero.
• 27:21
  Speaker 1: Yeah, I mean, we may conclude that the evidence and
• 27:26
  Speaker 1: is strong enough for you to seriously worry about, and
• 27:29
  Speaker 1: like in terms of the mental energy you want to
• 27:30
  Speaker 1: spend trying to get healthier, Like there are other areas
• 27:34
  Speaker 1: where there's stronger evidence, like not smoking. Right, if you
• 27:37
  Speaker 1: are a smoker and are debating whether you should be
• 27:39
  Speaker 1: eating red meat or chicken, don't worry about it. Quit
• 27:42
  Speaker 1: stop smoking.
• 27:44
  Speaker 2: Yeah all right, I feel like I literally, I mean,
• 27:47
  Speaker 2: this is a topic of my research.
• 27:48
  Speaker 3: So I could literally talk about.
• 27:49
  Speaker 2: This for like an entire semester course, but maybe we
• 27:53
  Speaker 2: should move on to.
• 27:55
  Speaker 1: As long as I can get a credit because.
• 27:58
  Speaker 2: Continuing medici metaical education credit for I need some of
• 28:01
  Speaker 2: those we meant about my feelings. Okay, all right, So
• 28:06
  Speaker 2: with that as the background, I think that tells us
• 28:08
  Speaker 2: the to step out of the weeds a bit. I
• 28:12
  Speaker 2: think what this says is that it is actually quite
• 28:13
  Speaker 2: difficult to answer this question. And part of the reason
• 28:16
  Speaker 2: we see so much debate and discussion and disagreement about
• 28:21
  Speaker 2: questions around nutrition, including red meat, is that the data
• 28:26
  Speaker 2: is not perfect or really very good for the most part.
• 28:33
  Speaker 1: Yeah, so let's let me draw mechanism for you and
• 28:37
  Speaker 1: saying what we do have with high quality data. Let's
• 28:40
  Speaker 1: start with cardiovascular disease because I think that's what people
• 28:43
  Speaker 1: often think about, but we will get to cancer because
• 28:46
  Speaker 1: that's sort of an emerging concern from certain dietary habits.
• 28:50
  Speaker 1: So in terms of cardiovascular disease, we do know from
• 28:55
  Speaker 1: fairly high quality evidence that in randomized trials over a
• 28:59
  Speaker 1: limited period of time, yes not over years and years
• 29:01
  Speaker 1: and years, but over you know, weeks to months, replacing
• 29:05
  Speaker 1: a diet high and saturated fat with a diet lower
• 29:09
  Speaker 1: and saturated fat reduces LDL cholesterol. So this comes from
• 29:15
  Speaker 1: the Cochrane collaboration, which is many people would say the
• 29:19
  Speaker 1: gold standard of evidence synthesis groups. They performed a meta
• 29:24
  Speaker 1: analysis of fifty something trials in this space and found
• 29:30
  Speaker 1: this relationship to LDL cholesterol. It was stronger in people
• 29:34
  Speaker 1: who had higher LDL cholesterols to begin with. So there's,
• 29:37
  Speaker 1: you know, potentially some floor effect here. You can only
• 29:40
  Speaker 1: you know, there's only so much bang for your buck
• 29:41
  Speaker 1: you can get by switching out saturated fats for unsaturated fats.
• 29:45
  Speaker 1: And of course you can get saturated fats from places
• 29:47
  Speaker 1: that aren't red meat. But I think if we're really
• 29:49
  Speaker 1: thinking about like a high red meat diet, that is
• 29:52
  Speaker 1: an area of major concern is the saturated fats. So
• 29:55
  Speaker 1: looks to me like it increases LDL. I think, rightly,
• 29:59
  Speaker 1: switching it out decrease LDL.
• 30:01
  Speaker 2: Yeah, that switching it out will decrease l D. I
• 30:03
  Speaker 2: think that seems that seems fair. I think the biological
• 30:06
  Speaker 2: mechanism works. I think the evidence is reasonable. But these
• 30:10
  Speaker 2: effects are not like spectacularly large, but they are.
• 30:14
  Speaker 3: Significant yep, in a statistical sense.
• 30:18
  Speaker 2: Okay, And then what we I think would most want
• 30:21
  Speaker 2: to know then is does that have any actual like
• 30:25
  Speaker 2: health implications?
• 30:26
  Speaker 1: Yeah? Like so okay, so we know, go with me. Here,
• 30:32
  Speaker 1: we know from randomized trial data that reducing LDL reduces
• 30:37
  Speaker 1: the risk of cardiovascular events. This is from Staton trials
• 30:41
  Speaker 1: for example. Okay, so I know what you're gonna say,
• 30:46
  Speaker 1: but you know, if reducing saturated fat intake reduces LDL
• 30:53
  Speaker 1: and reducing LDL, albeit by some other mechanism, reduces cardiovascular events,
• 31:00
  Speaker 1: I'm comfortable saying probably reducing saturated fat intake will reduce
• 31:04
  Speaker 1: the risk of cardiovascular events.
• 31:07
  Speaker 3: And I will say that.
• 31:10
  Speaker 2: If you look in the Cochrane review trials that do
• 31:15
  Speaker 2: try to look long term at saturated fat and cardiovascular events,
• 31:20
  Speaker 2: you do see a small, marginally significant reduction in cardiovascular
• 31:26
  Speaker 2: events with a diet. What you don't see is impacts
• 31:31
  Speaker 2: on mortality.
• 31:32
  Speaker 3: So although we see.
• 31:33
  Speaker 2: Reductions in cardiovascular events, we do not see reductions in
• 31:37
  Speaker 2: all cause mortality or cardiovascular mortality.
• 31:41
  Speaker 3: So this relationship seems is more complicated to me.
• 31:46
  Speaker 2: Then we might think, Yeah, I guess I think it
• 31:49
  Speaker 2: would be a stretch to say that reducing your red
• 31:52
  Speaker 2: meat intake, of reducing your saturated fat intake would cause
• 31:54
  Speaker 2: you to live longer.
• 31:56
  Speaker 3: Maybe it's not a stretch to say.
• 31:57
  Speaker 2: It would reduce your LDL and that it might reduce
• 32:00
  Speaker 2: your risk of cardiovascular events by a small amount.
• 32:04
  Speaker 1: Yeah. I mean death is messy. That you can unfortunately,
• 32:07
  Speaker 1: you can die. You can die from many things and uh,
• 32:11
  Speaker 1: and so it's always harder to prove an overall mortality benefit. Certainly,
• 32:15
  Speaker 1: I'm not seeing anything that suggests that like enhancing red
• 32:18
  Speaker 1: meat in your diet is doing anything particularly wonderful for
• 32:22
  Speaker 1: you systematically, and we should say or in terms of
• 32:25
  Speaker 1: cardiovascular disease at least. And we should say though that
• 32:29
  Speaker 1: the vast majority of real studies that look at red
• 32:33
  Speaker 1: meat and take are using unprocessed like lean red meat,
• 32:38
  Speaker 1: like not lean, you know, but like red meat that
• 32:40
  Speaker 1: you would buy in the refrigerator section of the grocery store,
• 32:45
  Speaker 1: not processed red meat. And I think we need to
• 32:48
  Speaker 1: touch on this when we get to cancer, because there's
• 32:50
  Speaker 1: a big difference between eating like a steak, you know,
• 32:55
  Speaker 1: with its high saturated fat and but high amount of
• 32:57
  Speaker 1: protein and relatively little other things and like a equivalent
• 33:02
  Speaker 1: amount of processed salami or something like that, And we
• 33:07
  Speaker 1: can talk about that.
• 33:08
  Speaker 3: Yeah, let's get into that.
• 33:09
  Speaker 2: But I think here here we are really talking about
• 33:12
  Speaker 2: the like again kind of switching out your red meat
• 33:19
  Speaker 2: for a calorically equivalent amount of chicken.
• 33:24
  Speaker 1: Yeah, it's a way to slightly party vascular resists. They're
• 33:27
  Speaker 1: probably they're probably better ways to reduce your cardiovascular risk.
• 33:30
  Speaker 3: Yeah, like exercising or not smoking.
• 33:32
  Speaker 1: Yes, yeah, those are better. But let's talk about cancer.
• 33:38
  Speaker 1: This is the concern I've heard most from people I've
• 33:40
  Speaker 1: talked to about this. But it's interesting. I feel like
• 33:42
  Speaker 1: for my parents' generation, like heart attacks and strokes were
• 33:45
  Speaker 1: the thing that killed everyone, and they were very concerned
• 33:47
  Speaker 1: about this. And I think to some extent, because we've
• 33:50
  Speaker 1: gotten a better handle on cholesterol management, like that's at
• 33:53
  Speaker 1: less scary to our generation who thinks more about cancer
• 33:56
  Speaker 1: and dementia. There has been a row eyes in colon
• 34:01
  Speaker 1: cancer diagnoses among younger and younger people in the United States.
• 34:07
  Speaker 1: There's an interesting discussion about what the causes of that are,
• 34:12
  Speaker 1: but it's certainly in the zeitgeist. People are thinking about this.
• 34:14
  Speaker 1: Even the guidelines for colon cancer screening have recently changed
• 34:17
  Speaker 1: to start at a younger age, to start at forty
• 34:20
  Speaker 1: five instead of fifty. Based on some of this data
• 34:23
  Speaker 1: and most of the again observational data would suggest that
• 34:28
  Speaker 1: higher red meat intake does increase the risk of correctal cancer.
• 34:33
  Speaker 3: Yes, most of the observational data would say.
• 34:35
  Speaker 1: That, yeah, does that worry you?
• 34:40
  Speaker 2: No? I mean, like, does it worry I am worried
• 34:45
  Speaker 2: about the rise in colon cancer among younger people?
• 34:47
  Speaker 3: Of course, do I.
• 34:52
  Speaker 2: Me think about how to say this?
• 34:54
  Speaker 4: So?
• 34:54
  Speaker 2: Do I think it is plausible that changes in dietary
• 34:58
  Speaker 2: patterns have driven some of this and colon cancer.
• 35:00
  Speaker 3: Absolutely?
• 35:01
  Speaker 2: I think people obesity rates have gone up. My guess
• 35:04
  Speaker 2: is that explains a fair amount of this surprise. Consumption
• 35:08
  Speaker 2: of whole foods fiber in particular, has gone down. My
• 35:11
  Speaker 2: guess is that also explained something with the rides, clearly
• 35:14
  Speaker 2: something we need to understand much better. Some of the
• 35:17
  Speaker 2: data that's come out of at GLP ones suggests that
• 35:19
  Speaker 2: they reduce the risk of colon cancer, which I think
• 35:22
  Speaker 2: points to at least the first of those mechanisms as
• 35:25
  Speaker 2: being important. If you asked me, do I think that
• 35:31
  Speaker 2: replacing tofu and chicken with a calorically equivalent amount of
• 35:38
  Speaker 2: beef in your diet would raise your risk of colon cancer?
• 35:43
  Speaker 2: I do not think that that is supported by the data.
• 35:47
  Speaker 2: The observational data on this is just it's really weak.
• 35:51
  Speaker 2: It's confounded by other aspects of people's diet. It's confounded
• 35:55
  Speaker 2: by the fact that a lot of the ways people
• 35:56
  Speaker 2: are eating red meat are altar processed.
• 35:59
  Speaker 3: A Yeah, with Dorito's.
• 36:03
  Speaker 2: I mean this feels to me like the data is
• 36:06
  Speaker 2: so poor that if that's the question people are asking,
• 36:10
  Speaker 2: I think absolutely absolutely not. And I will say, let
• 36:13
  Speaker 2: me just say one other thing, which is that we
• 36:15
  Speaker 2: have one pretty large scale, long term health study that
• 36:19
  Speaker 2: evaluated the risk of cancer with a with a low
• 36:22
  Speaker 2: fat diet. It wasn't red meat and specific specifically, but
• 36:25
  Speaker 2: by evaluated low fat diet called the Women's Health.
• 36:30
  Speaker 1: Is Sorry, Women's Health Initiative Dietary Modification Trial.
• 36:34
  Speaker 2: Yes, the Women's Health Initiative Dietary Modification Trial. And that
• 36:36
  Speaker 2: showed no impact of switching people to a low fat
• 36:39
  Speaker 2: diet on cancer risk or basically anything anything else. And
• 36:43
  Speaker 2: you know that's that feels informative to me.
• 36:47
  Speaker 1: Yeah. I suspect this is true for unprocessed red meat,
• 36:54
  Speaker 1: and I'm worried. From a biological perspective on process meats,
• 37:01
  Speaker 1: there has long been, for example, a dramatically higher rate
• 37:04
  Speaker 1: of gastric cancer in China than there is in the
• 37:07
  Speaker 1: United States and thought to be driven by heavily uh
• 37:14
  Speaker 1: preserved you know, meat intake and protein intake. There have
• 37:18
  Speaker 1: been a number of studies that show that these nitroso compounds,
• 37:23
  Speaker 1: like use nitrates to preserve to preserve meats in things
• 37:26
  Speaker 1: like slim gems and stuff like that. There are studies
• 37:30
  Speaker 1: in you know, in patry dishes and stuff that that
• 37:33
  Speaker 1: do show that these these compounds can damage cells and
• 37:36
  Speaker 1: can affect the lining of the GI tract. And you
• 37:38
  Speaker 1: can actually recover these compounds in stool in like the
• 37:43
  Speaker 1: poop of people based on how much they take in. So,
• 37:47
  Speaker 1: you know, I think, you know, having that nice steak
• 37:51
  Speaker 1: is one thing. Having a bunch of slim gems is
• 37:54
  Speaker 1: another thing. But you know, to your point, Emily, there's
• 37:57
  Speaker 1: a certain type of person who can afford to have
• 38:00
  Speaker 1: the nice steak, and they probably can afford a lot
• 38:02
  Speaker 1: of other healthful things. And then there's a type of
• 38:05
  Speaker 1: person whose major source of calories is going to come
• 38:08
  Speaker 1: from that type of foods because they can't afford to
• 38:11
  Speaker 1: eat the nice steak at the end, and that's going
• 38:13
  Speaker 1: to be a major source of confounding.
• 38:15
  Speaker 2: Yeah, it's a major source of confounding. And I will say,
• 38:17
  Speaker 2: you know, back to my point about sizing. If you
• 38:19
  Speaker 2: look at like these meta analyzes and you know, what's
• 38:22
  Speaker 2: the size of the increase in risk. We're talking about
• 38:24
  Speaker 2: like a twenty percent increase in risk, not a four
• 38:27
  Speaker 2: hundred percent increase or a four thousand percent increase, and.
• 38:30
  Speaker 3: That that's not that big an effect.
• 38:32
  Speaker 2: I mean, it feels big, it's like, wow, twenty percent increase,
• 38:35
  Speaker 2: but it's actually magnitude quite small, and it could easily
• 38:39
  Speaker 2: be explained by either other aspects of people's diet, other
• 38:43
  Speaker 2: aspects of their exercise smoking. I mean, we see like
• 38:46
  Speaker 2: everything is different between groups that eat more and less
• 38:51
  Speaker 2: red meat in these observational studies.
• 38:52
  Speaker 3: Everything, not just a few things, literally everything. Yeah, And
• 38:56
  Speaker 3: I think that's Destra's really hard to fix.
• 38:59
  Speaker 1: It's very hard to fix. And diet is so culturally relevant,
• 39:02
  Speaker 1: Like diet is just it's so much a part of you.
• 39:05
  Speaker 1: It is very hard to control anything here. I want
• 39:09
  Speaker 1: to move on to some other cancers, particularly breast cancer,
• 39:14
  Speaker 1: which is another obesity associated cancer as they are defined.
• 39:19
  Speaker 1: But there's an interesting trial here, the preadimed trial, which
• 39:23
  Speaker 1: I really like. This is about a seventy five hundred
• 39:25
  Speaker 1: participant trial who are randomized to sort of a Mediterranean diet,
• 39:31
  Speaker 1: which you know is again it's not really red meat.
• 39:33
  Speaker 1: It's actually a lot of like fish and legumes and
• 39:36
  Speaker 1: things like that. But it's a lower carb diet and
• 39:39
  Speaker 1: a higher amount of meat protein either with olive oil
• 39:43
  Speaker 1: or nuts versus a control diet. And the Mediterranean diet
• 39:48
  Speaker 1: arms which you know limit red and processed meat, significantly
• 39:51
  Speaker 1: had a sixty two percent reduction in breast cancer incidents.
• 39:56
  Speaker 1: Now this wasn't the primary endpoint of the trial, but
• 39:59
  Speaker 1: you know, this is a Hasard issue zero point three eight.
• 40:03
  Speaker 1: That's a relatively big effect size. You wanted some big
• 40:06
  Speaker 1: effects sizes. This is a randomized trial. It's not just
• 40:10
  Speaker 1: limiting red meat. It's also like olive oil and nuts
• 40:12
  Speaker 1: and beans and all the other wonderful things from the
• 40:16
  Speaker 1: Mediterranean diet that might be affecting things here. But it's
• 40:21
  Speaker 1: again some evidence that the dietary, a red meat dominant
• 40:24
  Speaker 1: dietary pattern may not be the best.
• 40:28
  Speaker 2: Yeah, I mean, I think we have the Mediterranean diet
• 40:30
  Speaker 2: is one of our best tested diets. Like you if
• 40:33
  Speaker 2: you said, you know, I'm totally neutral.
• 40:36
  Speaker 3: I don't care what.
• 40:37
  Speaker 2: I eat, just tell me what's the best kind of
• 40:40
  Speaker 2: diet for overall health that we have seen in the data.
• 40:43
  Speaker 3: I think it is it is the Mediterranean diet.
• 40:46
  Speaker 2: This has a lot of components, as you said, not
• 40:49
  Speaker 2: just an avoidance of red meat.
• 40:50
  Speaker 3: It's not that we have head to head tested that
• 40:53
  Speaker 3: versus a version of that that has.
• 40:55
  Speaker 2: A higher red meat, right component, And I think that's
• 40:58
  Speaker 2: there's a limit to what we can from that.
• 41:00
  Speaker 1: Yeah, yeah, fair. There's a couple of things that people
• 41:05
  Speaker 1: wanted us to dig in on here as they're thinking
• 41:08
  Speaker 1: about red meat. I think people get the idea that,
• 41:11
  Speaker 1: like there's a difference between beef, jerky and salami and
• 41:13
  Speaker 1: like processed meats and the steak and unprocessed stuff. You
• 41:17
  Speaker 1: get people like eating steak. It's quite pleasurable for a
• 41:21
  Speaker 1: lot of people. One question I got asked a lot
• 41:23
  Speaker 1: is the difference between like grass fed and non grass
• 41:27
  Speaker 1: fed beef, Like should we be paying a premium for this?
• 41:33
  Speaker 3: I think it just it tastes different.
• 41:35
  Speaker 2: And I think this to me feels like you absolutely
• 41:38
  Speaker 2: absolutely are not going to get any evidence that is
• 41:42
  Speaker 2: meaningful on this. What you're going to find is that
• 41:43
  Speaker 2: grass fed beef is eaten by rich people, average people
• 41:46
  Speaker 2: are doing better on their health for a lot of reasons.
• 41:49
  Speaker 2: It's probably not the grass fed beef. But if that's
• 41:53
  Speaker 2: a thing you want to spend your money on and
• 41:55
  Speaker 2: you like the way it tastes better and you feel
• 41:56
  Speaker 2: better about it, like that's great.
• 41:58
  Speaker 1: It is it is a bit leaner. So again, yeah,
• 42:01
  Speaker 1: I agree, you're not gonna it's not gonna make a
• 42:03
  Speaker 1: difference in your in your long term health. It does
• 42:05
  Speaker 1: have slightly less fat. Actually in the research though, I
• 42:08
  Speaker 1: found that in twenty sixteen, the US uh what is it?
• 42:12
  Speaker 1: USDA eliminated their definitions, like their inspection process for grass
• 42:19
  Speaker 1: fed beef. So now it's it's via self certification, so
• 42:24
  Speaker 1: the meat producers themselves get to tell you whether they
• 42:28
  Speaker 1: are grass fed or not they have seen the cow.
• 42:32
  Speaker 3: Unless you have seen the COWI you cannot be sure.
• 42:35
  Speaker 1: You cannot be sure. This is like a trust us
• 42:36
  Speaker 1: brouh type of situation. So let's touch on the carnivore
• 42:41
  Speaker 1: diet because like we've kind of talked about dietary patterns.
• 42:47
  Speaker 1: Certain dietary patterns have more red meat. But like this
• 42:50
  Speaker 1: is the apotheosis of being a meat eater, right, I
• 42:53
  Speaker 1: am only going to eat meat. This isn't even paleo
• 42:56
  Speaker 1: where it's like we can have greens. This is meat
• 42:58
  Speaker 1: exclusively and or meets exclusively.
• 43:01
  Speaker 3: It's like the I mean, it's so.
• 43:03
  Speaker 2: I think what's interesting about the carnivore diet is its
• 43:05
  Speaker 2: connection to the keto diet, which is something that we
• 43:07
  Speaker 2: should spend an episode on, which is a diet with
• 43:11
  Speaker 2: effectively no carbohydrates.
• 43:13
  Speaker 1: Like extraordinarily low carbs.
• 43:14
  Speaker 2: Yeah, I had some interesting results on treating some diseases.
• 43:18
  Speaker 2: It's like, that's an interesting Diet's very very heartistic too,
• 43:22
  Speaker 2: because it's really really restrictive.
• 43:25
  Speaker 3: The carnivore diet is kind.
• 43:26
  Speaker 2: Of a like a Broye version of more relaxed Broi
• 43:30
  Speaker 2: version of that. It has almost no fiber. So I
• 43:33
  Speaker 2: would be shocked. I'm not saying I would be interested
• 43:37
  Speaker 2: in this. I am kind of interested in how people's digestion.
• 43:41
  Speaker 3: Is on the carnivore diet.
• 43:43
  Speaker 2: I would imagine if fiber is nature's broom, I'm concerned.
• 43:47
  Speaker 1: Oh my god, that what happens bro Bruh, I haven't
• 43:52
  Speaker 1: I haven't pooped in two weeks, bra, exactly.
• 43:54
  Speaker 2: I haven't put in two weeks, BRA, and so I
• 43:56
  Speaker 2: think this is going to be a this is a
• 43:58
  Speaker 2: very extreme form of the diet. To know often when
• 44:01
  Speaker 2: we are eating something that is so extreme, like what
• 44:04
  Speaker 2: that's going to do to our yeah systems.
• 44:08
  Speaker 1: And just like evolutionarily right, like we're not carnivores. Humans
• 44:12
  Speaker 1: are clearly omnivores. And in fact, you don't have to
• 44:15
  Speaker 1: take my word for it, we don't contain the apparatus
• 44:19
  Speaker 1: to synthesize certain things that only come from plants, like
• 44:22
  Speaker 1: vitamin C. For vitamin C, for example, some animals carnivores
• 44:27
  Speaker 1: actually synthesize their own vitamin C. So like tigers and
• 44:30
  Speaker 1: lions don't get scurvy because they can make their own
• 44:32
  Speaker 1: vitamin C and they don't have to eat fruits and
• 44:34
  Speaker 1: vegetables and stuff. We can't, so we need to get
• 44:37
  Speaker 1: vitamin C from other sources. Actually look to see if
• 44:39
  Speaker 1: there's been case reports of people on the carnivore diet
• 44:42
  Speaker 1: developing scurvy. I did find one case of a guy
• 44:46
  Speaker 1: who was kind of he was living alone in a
• 44:49
  Speaker 1: hut in Appalachia. I don't think he would have described
• 44:52
  Speaker 1: himself as being on the carnivore diet, but he clearly
• 44:55
  Speaker 1: was only eating meat and he did develop scurvy.
• 44:59
  Speaker 2: There are some meat that have vitamin C at like
• 45:01
  Speaker 2: seal meat. That's what I learned from one of the many, many,
• 45:05
  Speaker 2: many books I've read about people who die in Antarctica,
• 45:07
  Speaker 2: which is my favorite book genre. But it turns out
• 45:10
  Speaker 2: eating like penguins and seals have have vitamin C.
• 45:14
  Speaker 1: Right. It was always kind of a mystery that, like,
• 45:17
  Speaker 1: how do you know Inuits who really have almost no plant
• 45:20
  Speaker 1: intake like not get scurvy? And and yeah, that's part
• 45:23
  Speaker 1: of it. Blubber has vitamin C. Vitamin c's broken down
• 45:25
  Speaker 1: by heat though, so a lot of that comes from
• 45:28
  Speaker 1: like eating stuff raw, the organ meats that people who
• 45:33
  Speaker 1: adhere to the carnivor diet, like liver does have some
• 45:36
  Speaker 1: vitamin C and it's still very low, like you've got
• 45:38
  Speaker 1: to be eating a fair amount.
• 45:39
  Speaker 2: But you know, let's just say it probably don't do this.
• 45:44
  Speaker 1: Don't do this. I'm not sure what it like. It's
• 45:48
  Speaker 1: of a theme of do you remember when we were
• 45:50
  Speaker 1: talking about declining sperm counts and we were sort of
• 45:54
  Speaker 1: like like, if you're not trying to get someone pregnant, like,
• 45:59
  Speaker 1: why do you care about that? I don't know there's
• 46:01
  Speaker 1: some like relationship here that I see. I think this
• 46:04
  Speaker 1: is a manosphere thing. I think this is a diet
• 46:08
  Speaker 1: that's like I'm a big tough guy and all I
• 46:10
  Speaker 1: have to do is eat me. And it's like I
• 46:11
  Speaker 1: don't care if I get you know, calling cancer from
• 46:15
  Speaker 1: you know, or just severe constipation from not having any
• 46:18
  Speaker 1: fib or scra or whatever terrible. Like you know, guys
• 46:23
  Speaker 1: eat a very diet.
• 46:25
  Speaker 2: Let's talk about beef tallow before we end, because people
• 46:30
  Speaker 2: love beef tallow and really loves it.
• 46:33
  Speaker 1: Yeah.
• 46:33
  Speaker 2: Yeah, Sometimes people as just like what do I do
• 46:35
  Speaker 2: with beef tallow? And it's just an it's another fat
• 46:38
  Speaker 2: and you could cook with it, and he can has
• 46:40
  Speaker 2: quite a high it has quite a high smoke point,
• 46:44
  Speaker 2: maybe making it good for cooking. I have one friend
• 46:47
  Speaker 2: who's like a very serious chef, and he said he
• 46:49
  Speaker 2: has beef tallow in his fridge because it's useful for
• 46:52
  Speaker 2: particular cooking cooking sources. People do like to put it
• 46:57
  Speaker 2: on their face as a moisturizer, but it can clog
• 47:01
  Speaker 2: your pores.
• 47:01
  Speaker 1: I think so, I would imagine it can.
• 47:05
  Speaker 2: But as some other moisturizers that you might purchase from,
• 47:08
  Speaker 2: say CBS so you know, we have I would say
• 47:12
  Speaker 2: this is a fat, you could use it to cook.
• 47:17
  Speaker 3: It's not a magic fat.
• 47:18
  Speaker 1: It's just no, it's not particularly healthy. There's a meta
• 47:23
  Speaker 1: analysis of fifty four randomized trials looking at LDL reduction
• 47:28
  Speaker 1: through supplements of various types of fats, and all of
• 47:33
  Speaker 1: the plant based oils reduced LDL more than beef tallow,
• 47:38
  Speaker 1: but beef tallow was better than butter. Like beef tallow
• 47:42
  Speaker 1: raise your LDL less than butter. So but like you've
• 47:45
  Speaker 1: got a million choices for fats, I don't particularly know.
• 47:48
  Speaker 1: I mean, it tastes good, actually, I mean, I think
• 47:50
  Speaker 1: the reason to use beef tallo is it's actually quite tasty.
• 47:53
  Speaker 1: If you've ever had French fries deep fried in beef tallow,
• 47:56
  Speaker 1: this isn't a good healthy snack by any stretch. But
• 47:59
  Speaker 1: they do they do taste good. Maybe that's okay. We're
• 48:01
  Speaker 1: supposed to get enjoyment out of life, right.
• 48:03
  Speaker 2: Totally, And I think that is I mean, that is
• 48:05
  Speaker 2: an important point for me here because sometimes we will
• 48:07
  Speaker 2: talk about sort of these these products that you'll say, well,
• 48:12
  Speaker 2: you know, what's the reason to have steak? If you know,
• 48:15
  Speaker 2: even if we only have a little bit of evidence
• 48:16
  Speaker 2: that plant based sources reduce our LDL and we can't
• 48:19
  Speaker 2: really connect it to health outcomes, you know, why not
• 48:22
  Speaker 2: do it? And the answer is like, well, I I
• 48:25
  Speaker 2: that's not the diet I would most prefer, and food
• 48:28
  Speaker 2: is something that we enjoy, and so that's actually a reason.
• 48:32
  Speaker 3: To do it.
• 48:34
  Speaker 1: Yeah, yeah, yeah yeah. Life is for the living.
• 48:36
  Speaker 3: Life is for the living.
• 48:38
  Speaker 1: I've got to go to one more thing before we
• 48:41
  Speaker 1: smasher past this one, Emily, because I had a feeling
• 48:43
  Speaker 1: how this was going to shake out. I felt like
• 48:45
  Speaker 1: Emily was going to look at all the observational data
• 48:47
  Speaker 1: and be like, this is all crap. It's fine, you know,
• 48:51
  Speaker 1: just be healthy. And and then I was like, but
• 48:54
  Speaker 1: I've got a trump card because I'm going to scour
• 48:57
  Speaker 1: the literature to find a study of endurance athletes and
• 49:02
  Speaker 1: see if I could show her that actually, if you're
• 49:06
  Speaker 1: an indurance athlete, eating red meat is better. So I
• 49:09
  Speaker 1: found a study, a huge study of twenty eight cross
• 49:14
  Speaker 1: country runners who were randomized to their usual diet versus
• 49:20
  Speaker 1: supplementing nine ounces of lean red meat a week times
• 49:24
  Speaker 1: eight weeks. It's not that much, but it's the best
• 49:26
  Speaker 1: I could find they looked at about eight hundred different
• 49:31
  Speaker 1: outcomes like metabolicalcy.
• 49:32
  Speaker 3: How you get some things to be significant.
• 49:34
  Speaker 1: It's an insane amount. And actually I was quite surprised
• 49:37
  Speaker 1: at how few of these were statistically significant, because just
• 49:41
  Speaker 1: my chance, they measured so many things. But I do
• 49:44
  Speaker 1: have one women in the control armed hamatocrit, which is
• 49:48
  Speaker 1: their red blood cell concentration, decreased by three point eight
• 49:52
  Speaker 1: percent over the eight weeks, and women who got randomized
• 49:56
  Speaker 1: to have the lean red meat had a fourteen point
• 49:58
  Speaker 1: eight percent in the harmatocrit, that's their red blood cell count.
• 50:03
  Speaker 1: This is biologically plausible because red meat contains iron, and women,
• 50:09
  Speaker 1: as a postman, certainly college age women, premenopausal women have
• 50:15
  Speaker 1: ongoing iron losses due to menstruation, and maybe this is
• 50:21
  Speaker 1: a decent source of iron to help mitigate the anemia
• 50:24
  Speaker 1: that can come from that.
• 50:26
  Speaker 2: Yes, Actually most of the serious endurance athletes that I
• 50:31
  Speaker 2: know do eat like do eat a reasonable amount of
• 50:35
  Speaker 2: red meat or eat red meat because it is very common.
• 50:38
  Speaker 3: To be anemic and iron.
• 50:41
  Speaker 2: The iron levels that are optimal for endurance performance are
• 50:45
  Speaker 2: typically much higher, particularly ferretin levels are much higher than
• 50:49
  Speaker 2: would be sort of necessary for just being a person.
• 50:53
  Speaker 2: And so people like to sell thement with iron, but
• 50:56
  Speaker 2: they also like to eat meat. But I will say
• 50:59
  Speaker 2: that the carnivore diet is not well suited for endurance
• 51:03
  Speaker 2: efforts who primarily should be consuming carbohydrate. Yeah.
• 51:07
  Speaker 1: Now, when you have ten pounds of stool that you're
• 51:09
  Speaker 1: carrying around on the run, very.
• 51:13
  Speaker 3: Very challenging to run. If you have eaten exclusively liver.
• 51:19
  Speaker 1: Iron is absorbed from my globin better then it's absorbed
• 51:24
  Speaker 1: from plant based sources. So like soy. I mentioned early
• 51:28
  Speaker 1: on that soy has a fair amount of iron in it,
• 51:30
  Speaker 1: but it isn't absorbed quite as well as from red meat.
• 51:33
  Speaker 1: That is mitigated somewhat by vitamin C intake. So if
• 51:35
  Speaker 1: you really do want to avoid red meat but get
• 51:37
  Speaker 1: your iron through a natural source, you can soy plus
• 51:40
  Speaker 1: something that contains vitamin C, so soy plus orange, or.
• 51:44
  Speaker 2: You can take a hymn adecriate iron pill which comes
• 51:47
  Speaker 2: to vitamin C. You can also that is that is
• 51:50
  Speaker 2: mostly what people are doing. Okay, very are you smashing
• 51:54
  Speaker 2: or passing red meat?
• 51:56
  Speaker 3: I'm so interested.
• 51:57
  Speaker 1: I am as on processed or red meat. I think
• 52:02
  Speaker 1: it should be avoided. I think go ahead and eat
• 52:06
  Speaker 1: unprocessed red meat if you enjoy it. But I wouldn't
• 52:09
  Speaker 1: like target. I'm not gonna smash it. I'm not going
• 52:11
  Speaker 1: to say, like, go out and have more of it.
• 52:13
  Speaker 1: I think there are plenty of other good sources of
• 52:14
  Speaker 1: protein that are probably better for you. So I guess
• 52:17
  Speaker 1: I'm a pass. Emily, smash your pass.
• 52:21
  Speaker 3: Yeah, I'm I'm a smash. I think that again.
• 52:24
  Speaker 2: I will say I don't think eating a lot of
• 52:25
  Speaker 2: processed food in general is very good, so let's put
• 52:28
  Speaker 2: that aside.
• 52:28
  Speaker 3: But on the red meat, I think that this can.
• 52:33
  Speaker 2: Be a part of a balanced diet, and if it
• 52:36
  Speaker 2: is something that people enjoy, they should consume it.
• 52:40
  Speaker 3: I'm a smash.
• 52:43
  Speaker 1: All right, that's it for red meat. Your mail back
• 52:45
  Speaker 1: Question of the week after the.
• 52:46
  Speaker 4: Break, Hi, Emily and Perry. I'm Genevieve calling from Hudson, Ohio,
• 52:55
  Speaker 4: and my question is do dath piercings really help with migraines?
• 53:00
  Speaker 4: Something to do with the pressure points. I would love
• 53:02
  Speaker 4: to get one for the looks, but I just think
• 53:04
  Speaker 4: it's interesting that people say they helpathetics. So thank you.
• 53:08
  Speaker 1: So this is an interesting question. I'm going to disclose
• 53:12
  Speaker 1: something here like I lack the part of your ear
• 53:16
  Speaker 1: that gets a daith piercing like it is. I don't
• 53:20
  Speaker 1: know if you can see on video here. It is
• 53:23
  Speaker 1: problematic because like, earbuds don't stay in my ears, like
• 53:27
  Speaker 1: they have nothing to tuck into, so they just kind
• 53:29
  Speaker 1: of fall fall out. I did look into this. It
• 53:33
  Speaker 1: is apparently a normal and atomical variant. So if you're
• 53:37
  Speaker 1: like me and your earbuds always fall out and there's
• 53:38
  Speaker 1: nothing to pierce in your like inner helix of your ear,
• 53:42
  Speaker 1: I guess we should say that, right, A dath piercing
• 53:44
  Speaker 1: is like that, like inside of your ear helix piercing.
• 53:48
  Speaker 1: Look it up. I think it looks kind of cool.
• 53:50
  Speaker 1: Actually you don't like it.
• 53:52
  Speaker 3: It seems still painful.
• 53:53
  Speaker 1: Oh, definitely painful. But you know, yeah, it's better to
• 53:56
  Speaker 1: look good than to feel good.
• 53:57
  Speaker 3: Not No, I don't think that is.
• 54:01
  Speaker 1: Anyway does help with migraines. I don't know. Uh no,
• 54:07
  Speaker 1: I don't think so.
• 54:08
  Speaker 4: No.
• 54:09
  Speaker 1: I mean this is out there, like people people say
• 54:11
  Speaker 1: and and they argue that, you know, maybe it's stimulating
• 54:15
  Speaker 1: the vagus nerve or something like that, but there haven't
• 54:17
  Speaker 1: been any rigorous studies. But even the sort of observational
• 54:20
  Speaker 1: ones don't support any long term benefit, but.
• 54:23
  Speaker 2: It could be the placebo effect, which is our favorite effect.
• 54:26
  Speaker 1: Short term. Absolutely, if you believe it. Yeah, if if
• 54:29
  Speaker 1: you believe you're not going to get migraines, you will
• 54:32
  Speaker 1: get less migraines. But those things do tend to wane
• 54:36
  Speaker 1: over time. You sort of forget that that it's there.
• 54:38
  Speaker 2: Yes, the all of the evidence for this is like
• 54:41
  Speaker 2: some people said, it might help.
• 54:44
  Speaker 1: Yeah, yep, that's fine. But I but it does look cool,
• 54:48
  Speaker 1: So go ahead and and uh and and get it
• 54:51
  Speaker 1: if you can tolerate the pain.
• 54:53
  Speaker 3: Do you have any weird body parts pierced?
• 54:56
  Speaker 1: I have entirely normal body parts pierced. No, I'm just
• 54:59
  Speaker 1: going I don't have I don't have any what's a
• 55:01
  Speaker 1: weird body part? No, I don't.
• 55:04
  Speaker 3: I have no piercing the unusual like piercings that you do.
• 55:08
  Speaker 3: You have any tattoos?
• 55:09
  Speaker 1: I don't know. I don't have tattoos. I don't have
• 55:11
  Speaker 1: no tattoos. No, what about you? You don't have tattoos,
• 55:14
  Speaker 1: I'm sure absolutely, I don't even have botox.
• 55:18
  Speaker 3: I'm afraid of needing to forget about tattoos.
• 55:20
  Speaker 2: Okay, all right, that's it for us today. Stick with
• 55:26
  Speaker 2: us next week when we'll ask what's the deal with
• 55:29
  Speaker 2: cupping and dry needling? Speaking of needles, Wellness Actually is
• 55:35
  Speaker 2: produced in association with iHeartMedia.
• 55:38
  Speaker 3: Our senior producer is Tamar Avishaik.
• 55:40
  Speaker 2: Our executive producer at iHeart is Jennifer Bassett. Our theme
• 55:44
  Speaker 2: music is by Eric Deutsch, and our content is for
• 55:47
  Speaker 2: educational purposes only.
• 55:49
  Speaker 1: If you like the show, help other people find us.
• 55:51
  Speaker 1: Leave a rating and review on Apple Podcasts or your
• 55:54
  Speaker 1: podcatcher of choice and help us spread the word about
• 55:57
  Speaker 1: the show. You can follow us on Instagram at all
• 56:00
  Speaker 1: miss actually pod and don't forget We want to hear
• 56:03
  Speaker 1: from you. Head over to Wellness Actually dot fm and
• 56:06
  Speaker 1: leave us a question for our mailbag or suggest a
• 56:08
  Speaker 1: topic for a future show.
• 56:10
  Speaker 2: We'll let the influencers have the last word.
• 56:12
  Speaker 6: I've eaten nothing but meat and butter for seven years.
• 56:15
  Speaker 6: My husband thinks I'm absolutely insane for this, but I'm
• 56:17
  Speaker 6: obsessed with eating cold meat. The flavor and texture it
• 56:20
  Speaker 6: gets better, and the cold fat turns into this buttery frosting.
• 56:23
  Speaker 6: I literally cook extra steak on purpose, just so I
• 56:25
  Speaker 6: can eat it straight out of the fridge. Am I
• 56:27
  Speaker 6: the only one