1. Epigenetics: The study of changes in organisms caused by modification of gene expression rather than alteration of the genetic code itself.

2. Exposome: The totality of environmental exposures of an individual from conception onward, including all external and internal factors.

3. Phenotype: The observable physical or biochemical characteristics of an organism as determined by both genetic makeup and environmental influences.

4. Metabolic Resilience: The ability of an individual’s metabolism to adapt and respond effectively to changes in diet, lifestyle, and environmental factors.

5. Nucleus Accumbens: A region in the brain associated with reward, pleasure, and addiction.

6. Thrifty Gene: A gene that predisposes individuals to efficiently store fat and calories, possibly as an adaptation to periods of food scarcity.

7. Ketogenic Diet: A low-carbohydrate, high-fat diet that has been shown to help individuals achieve ketosis, a metabolic state where the body burns fat for energy.

8. Insulin Resistance: A condition in which the body’s cells become less responsive to the effects of insulin, leading to elevated blood sugar levels.

9. Functional Brain Imaging (fMRI): A technique that measures and maps brain activity by detecting changes associated with blood flow.

10. M N One Study: An individualized study or experiment designed to understand how a specific person responds to a particular intervention or treatment.

11. Metabolically Healthy: Refers to an individual whose metabolism functions optimally, with balanced blood sugar levels, healthy weight management, and overall well-regulated metabolic processes.

12. High-Intensity Interval Training (HIIT): A form of exercise that alternates short, intense bursts of activity with periods of rest or lower-intensity exercise.

13. Genetic Expression: The process by which information from a gene is used in the synthesis of a functional gene product, such as a protein.

14. Artificial Light at Night (ALAN): Exposure to artificial light during nighttime hours, which can disrupt circadian rhythms and negatively impact sleep.

15. Inflammation: The body’s response to injury or infection, often characterized by redness, swelling, heat, and pain.

16. Cortisol and Adrenaline: Hormones produced by the adrenal glands that play a role in the body’s stress response.

17. Dopamine Receptors and Melanocortin Receptors: Neurotransmitter receptors associated with pleasure and reward, and receptors involved in the regulation of appetite and energy balance, respectively.

18. Exposome: The sum total of environmental exposures, including diet, physical activity, stress, and toxins, that an individual experiences throughout their life.

19. Functional Health: A holistic approach to health that considers the optimal functioning of the body’s systems and emphasizes individualized care.

20. Insulin Sensitivity: The degree to which cells respond to the effects of insulin in promoting the uptake of glucose, crucial for maintaining healthy blood sugar levels.

Your genes, like I said, do play a role, but they don’t determine your destiny regardless of what your genes are and other health. Everybody can start with these strategies. Welcome to the Doctor’s Pharmacy. I’m Dr. Mark Hyman, that’s pharmacy with Apple Place for conversations that matter. And then I bring you a health bite to improve your health because taking little steps every day can make big changes in your health over time. So today we’re going to talk about genetics. One of my favorite topics, and I think all of us maybe think we know about genes, but most of us don’t realize actually how our genes work. And today we’re going to talk about that and why so much of what we think might be genetic is actually environmental. Our genes do predispose us to things, but they don’t predestine us to things. We can actually change our destiny by changing our behavior and the influence on our genes from our environment. And how this works is through the influence of everything washing over your life, like everything that you do, every bite of food you take in, every exercise you do, every stress you experience, every thought you have, every environmental chemical, you’re exposed to, all of these, wash over your biology, wash over your genetics and affect your gene expression, your genes are fixed. You can’t change those. But with genes turn on or off, you can regulate. So the entire field of epigenetics, which we’ve talked about before, is so important. It helps us to understand the ways in which our genes are regulated. Think of epigenetics as the piano player controlling the piano keys. The piano keys are your genes. They’re fixed. You can’t change ’em. There’s 88 of them. Well, there’s actually 20,000 plus genes. But anyway, you get the idea. And the epigenome is like the piano player that can play all sorts of music from stuff that sounds like noise to the most beautiful song you’ve ever heard. So how does that work and how do epigenetics work? It works through the influence of our environment. When I mean that our lifestyle and toxins and our thoughts, everything washing over our genes, regulating how these are regulated. This is one of the most important breakthroughs in science in medicine. We actually use this to measure now our biological age, which I talked about in young forever. How we measure our epigenetic age is way we measure the rate of biological aging. I mean, chronologically, we get older every day, but biologically we can get younger. Now I think people think, oh, my dad had a heart disease, or I got diabetes in my family, or I got cancer in my family. I’m sort of doomed, but it’s really not true. I think people blame their genes. Oh, everybody in my family was diabetic. Well, yeah, but it doesn’t mean you have to be. And my grandfather was a great example. He was a laborer. He was deaf. Born hearing, had spinal meningitis when he was three and was fully deaf, couldn’t hear a word. And so he was a manual laborer his whole life, and he exercised every day. He actually threw, he worked for the New York Times. He would throw the newspapers onto the truck every day, so was really strong. And he walked every night after dinner. He liked to feed the neighborhood cats in New York City, and he was a great guy. He used to do handstands when he was like 80 years old. And he actually did develop heart disease later in his life. But when we look at his brothers and sisters, and he had nine brothers and sisters, all of ’em had severe heart disease in their fifties. They all were educated and a little more sedentary and maybe didn’t eat as well. And they ended up actually having bypasses and heart attacks and deaths in their fifties. So he lasted well into his eighties because he actually lived a very different lifestyle. So same genes, very different inputs. And I think what you eat, how you move, how you restore your system, how you sleep, your thoughts, your feelings, your social relationships all influence and regulate your gene expression. And those genes express who you are in this moment. It’s called your phenotype. And you can regulate that and you can turn on genes for health or genes for disease. You can turn on genes for weight gain or weight loss by what you do. Now, there are some genes that do predispose you to diseases for sure. For example, I have genetics that make me more likely to have heart disease, but I’m good because I’ve done all the right things to not get that some genes predispose you to diabetes. “ www.arminic.com “We talk about some populations that are at high risk for type two diabetes or heart disease, but that is just a predisposition. It doesn’t mean you’re destined to get it. Now, what’s interesting is that 90% of our current health is controlled by the environment that washes over our genes. We call this the exposome, what our genes are exposed to. It’s the food we eat, it’s how we exercise, it’s our resilience, it’s our mindset and our thoughts. It’s our exposure to environmental toxins. So you don’t have to just kind of be a passive recipient of that what you think is your destiny and that you’re doomed to be sick and be fat and whatever. You actually have control over this. So we’re going to talk about how diet and lifestyle influenced your genes and what are my top strategies for actually regulating your weight metabolism and creating optimal health. So they did a number of studies on genes and obesity. For example, then’s going to talk about genetics and obesity. And people say, oh, everybody in my family’s overweight. But you all know those people who are, everybody in their family’s overweight, but they’re thin and healthy, right? I’ve seen this over and over again because they’ve taken a different track in their life. But there was a comprehensive study that looked at 32 different genes that may predispose you to obesity. And they found that if you had all 32 genes, it would only account for about 22 pounds of weight gain. And that doesn’t account for the massive change in obesity from when I was born, about 5% of the population to 42%. And now we have 75% of the population overweight, 93% poor metabolic health. I mean, this is not because of our genetics. Some people though, do have a high risk, and maybe most of the world has some degree of carbohydrate intolerance, genetically meaning they’re more to get insulin resistant when they have a certain amount of sugar or carbohydrate. Their insulin level go higher than the average person than me, for example. And that will make them more predisposed to getting type two diabetes or becoming overweight. So some ethnic groups are really at high risk. For example, native Americans, Samoans, Pacific Islanders, people from the Middle East. I mean, if you’re from the Middle East, your rate risk of diabetes is one in four. In American, it’s one in 10. It’s actually the highest density of obesity other than I think some of the Native American populations and the Pacific Islanders. Also, if you’re Asian, if you’re East Indian from India, you’re higher risk even at lower weights of getting poor metabolic health and diabetes. So when they have sugar and starch, their body likes it really not very much, right? So they will produce more insulin, they’ll get more weight gain, they’ll get vicious cycle of weight gain and hunger and fatigue and high blood pressure, obesity, type two diabetes. And it’s actually unfortunate because they don’t realize they’re like Dorothy with the ruby real slippers, and she can change her destiny anytime she wants. Just click her heels three times so she can get back to Kansas. So we can all get back to our metaphorical Kansas, essentially our real biology’s ability to regulate our health. So what we need to do is understand how to eat and how to exercise and live. That’s going to be in balance with our genetics. We have to actually live in harmony with our genes. Now, we might like it, right? For example, I might really like sugar, but I might be a Native American, and that’s poison to me. So I really can’t do that. And so we have to understand the genetics load the gun, but the environment pulls the trigger. So the Pima Indians is a great example. They had a metabolism was really adapted to their environment. They lived in the desert in Arizona and Mexico. And by the way, currently there are two populations of Pimas. One in Mexico, one in Arizona. The ones in Arizona are the sickest population in America. They are 80% of them get diabetes by the time they’re 30, their life expectancy is 46. They have kids who are as young as two or three years old getting type two diabetes. They grew up in an environment that was perfectly set for their genes. They lived on foods that exist only in desert environments. Acorns, they had jack rabbits, they ate, grew food. They were really well adapted. They were thin and fit a hundred years ago with none of the diseases they have now, like obesity, diabetes, and heart disease in a single generation. They become the most obese population in the world. Second to the Samoans. Now what happened? Their cousins in Mexico are thin, are healthy, don’t have diabetes, same genetics. So what happened? Did the Pima Indian suddenly genetically mutate and get the obesity gene? No. They really ate a diet historically of squash and melons and beans and chilies and gathered foods like mesquite, acorns, cactus, chia seeds, herbs, fish. And their diet was really unprocessed, whole and unrefined, and they were fit and healthy people. But then we came along, meaning we white people gave ’em the white menace, which I call white flour, white sugar and white fat, which is Crisco or shortening, and essentially shorten their life, which is what shortening does and all the rest of it. And they come up with these traditional Indian foods, fried bread, for example. It’s not a traditional Indian fruit. It’s basically deep fried flour in trans fats and it’s just deadly. So I think we have to understand that the genetics play a role, but because you have a predisposition does not mean you’re going to get it. Now, how is genes connected to weight gain? Well, the PMA Indian studies show that environment plays a huge role and fat being overweight and weight gain. But they, for example, have a thrifty gene, which means they’re really great at storing food when things are bad, right? So they might have scarcity genes, which we all have. We are really well adapted to scarcity, not to abundance. So when you have these scarcity genes, you basically store fat. And it’s a good thing if you came across a bunch of stuff that would make you store fat like a honey comb or a bunch of fruit or something, and you would berries and you would eat that, you would gain weight, which would keep you healthy through the winter. But we don’t need that anymore. We just keep eating all winter. So the other thing that happens is there’s genetics around pleasure and foods, for example, dopamine receptors and melanocortin receptors. And when you have certain of these genetic variations, you need more dopamine to make you feel pleasure. So one person can have one cookie to feel pleasure, another person might need 10 cookies. So I think that’s how we get into trouble with our genetics. But once you understand your genetics, you can personalize your diet and your lifestyle to actually match your genes. Now, sugar is really bad because sugar works on those dopamine receptors for all of us, even me, and it triggers the same response as cocaine or heroin. And when you stimulate those dopamine receptors, you need more and more over time to feel pleasure. And they set the stage for being addicted. And that’s why heroin, cocaine, nicotine, alcohol, all these things work on the dopamine receptors and they make you actually want more of the stuff and need more of the stuff to feel the same amount of pleasure. Now, when you look at the science on this, it’s pretty frightening around food addiction. I wrote a book about it called The Blood Sugar Solution 10 Day Detox Diet about how we deal with food addiction and sugar addiction. And it really provides a very clear roadmap on in 10 days how to completely reset your biology and get rid of the addiction to food and not crave the carbohydrates. If I said, you use willpower, it’s not going to work. You have to use science, not willpower. Now, when you look at these foods, what they do is they stimulate the brain. They did, for example, a study where they took guys who were overweight and they fed ’em a milkshake one day and it was a high sugar milkshake. Now, there were same study participants had different milkshakes on different days when they fed them. And by the way, they were same calories, same amount of carbohydrate, same amount of protein, same amount of fat, same amount of fiber. Identical tasted the same. The only difference was in one of the milkshakes, the sugar, the carbohydrate was a fast acting sugar, which raised their blood sugar quickly, and then there was a slow acting carbohydrate that raised their blood sugar slowly. When they had the fast acting carbohydrate, they spiked their insulin more, their cholesterol went up higher, their blood sugar went up higher, their triglycerides went up higher, their insulin went up higher, their cortisol went up higher, their adrenaline up higher. “ www.arminic.com “ Remember, these are the same calories, it tastes the same. They don’t know they’re eating something different. But what was really disturbing was when they did a functional brain imaging, an M R I of the brain, they found the nucleus accumbens, which is the addiction center of the brain, lit up like a crispus tree. So this area of the brain is what is the area that is the addiction control center, the pleasure center, the nucleus accumbens. And so the data on this is very compelling. I mean, they’ve done studies with the mice, which is not very ethical, but they basically put them in an electric shock cage where they would have an electrified floor and they let them eat sugar, and they would keep shocking them while they’re eating sugar, and they would keep eating sugar while they were getting electric shocks. And think about that’s what’s happening in America. People are getting fatter and fatter and fatter and fatter. I mean, how do you get to three, 400 pounds? It’s not overnight. You can see it in the mirror, but people keep doing it not because they want to be overweight, not because it’s their fault, but because the food has hijacked their brain chemistry. So it’s really important to understand how we need to regulate ourselves based on our biology. Now the other thing is we’re all different. So there’s no one diet that works for everybody, and we shouldn’t be trying to come up with the perfect diet. Now people say, oh, we should all be vegan. Oh, we should all be paleo. Oh, we should be all high fat, or we should be high carb or low carb. It really is individual. You have to figure out what works for your biology, and it’s by experimentation with yourself. We call this an n M one study. You really want to find out what works for you and how you feel. What happens to your metabolism, what happens to your energy, what happens to your digestion, what happens to your other health issues? But most people do better with a diet that’s higher in good fats and lower in starchy carbohydrates and sugar. I mean, there’s a one year multicenter trial controlled trial, a randomized study, which is hard to do in nutrition, but they did. It was published in the New England Journal of Medicine, looked at 63 obese men and women. They were randomly assigned either a low carb, high protein, high fat diet or a low cal, high carb, low fat conventional diet. So one was not restricted in calories, right? One was the one that was restricted in calories. They didn’t do as well. The low carbohydrate group actually lost more weight, had lower levels of triglycerides, cholesterol, blood pressure, and blood sugar. Even though they weren’t totally telling them to restrict their calories, they just ate more fat and less starchy carbs. Now, not everybody responds the same way, so we’re all a bit different. For example, I know I need more carbohydrates, so I have eat sweet potatoes, for example, or things like that, that actually are healthy carbohydrates, but have a little more starch because otherwise I will lose too much weight. I probably shouldn’t say that, but I’ll, so we want to actually make sure we are eating fewer starchy and refined carbohydrates, but based on whole foods, we can adjust our diet to be higher in fat or lower in fat or higher in carbs or lower in carbs. And I think we just need to see how we feel. Pay attention to how you’re doing your scale and your lab tests will help. What’s best, and there’s ways to track this. I’m now co-founder of a company called Function Health. You can go to function health.com and sign up for the wait list and become a member and be able to track your labs and your data on a regular basis at a very cheap price point to actually find out what’s going on with you and have real time feedback. So it’s important that you track what’s going on, and it is important to know what’s right for you. For example, if you’re a type two diabetic, you want to reverse that, and you’re not going to reverse it by eating more starch and sugar. You probably need more of a higher fat, lower carb diet, maybe even a ketogenic diet. And that may be extreme in your mind. But actually, if you have an extreme disease like diabetes, you might need extreme interventions, right? Benjamin Franklin said, A pound of prevention announcement prevention is worth a pound of cure. Some people need a pound of cure, which might be a ketogenic diet. Now, once you actually fix this problem and you become more metabolically resilient, then you can actually have a wider diet and more foods that may have been a problem in the past if you get yourself metabolically healthy and resilient. So what works for somebody else might not work for you. You have to figure out what works for you and how to personalize your approach to what you’re eating. So let’s talk about the seven simple ways that you can help your body get into more well-regulated metabolic state and lose weight. Now, your genes, I guess, do play a role, but they don’t determine your destiny regardless of what your genes are and other health. Everybody can start with these strategies. First, eat real food. Get rid of processed food. Get rid of junk. If it ain’t something that came from the ground or a farm, don’t eat it. I mean, if it’s mildly processed, for example, I had a can of mackerel today for lunch. I open it up, it’s got mackerel in there, a little olive oil and some capers salt. I mean, it’s food that I recognize, right? It’s a canned food, but still it’s real food. Eat lots of non-starchy veggies, lots of good quality protein and lots of good fats, and you want have fruit. (17:38): Fruit’s fine, but if you’re really metabolic and healthy, you might want to minimize the fruit. So lots of good fats are really important. That’s another key principle like avocados, nuts and seeds, extra virgin olive oil. So it able tolerate more saturated fat like grass-fed butter. But fats actually, when you cut down the carbs and you eat fat, it actually helps your metabolism with one caveat. If you’re eating starch and sugar and you eat fat, it’s deadly. So you can’t both eat, for example, a cookie is a lot of butter and flour. That’s bad news as opposed to, for example, butter on your broccoli, which is good news, really important. Also, avoid all the processed sugars, refined carbohydrates, ultra processed food. You can have some grains fine, but limit your intake from bread. Cereal, highly processed starches, avoid baked good sweets. And alcohol, by the way, is not a health food. So that also is a form of carbohydrate and sugar and is not good for you. Make sure you get the right nutrients because a lot of us are starving for good nutrients because we have a very nutrient poor diet, and we tend to eat more when it comes to our diet when we are nutritionally deficient. So good multivitamin and mineral really helps. Vitamin D, fish, oil, magnesium, probiotic, maybe fiber. All these can help balance blood sugar levels, and you can get them on our online store or any good quality outlet. It sell good quality nutrients. Also, stress. Stress is a big factor. Stress could hugely impact your weight. Your cells are listening to your thoughts, and actually your metabolism slows down when you are stressed, it wreaks havoc on your health, your hormones, your weight. So do something that’s going to help calm you down, whether it’s yoga, meditation, deep breathing, try those things. And there’s lots more guided imagery. The list goes on. There’s all kinds of apps and devices and sensate and Apollo. There’s lots of ways to do this. So I encourage you to just practice stress reduction. Next. Sleep is super important. Sleep deprivation actually makes you gain weight. It makes you hungry, it makes you depressed, it decreases inflammation. Increase your risk of heart disease, diabetes. So make sure you get at least seven or eight hours of sleep. Good sleep. Avoid the artificial light at night from your phones and tablets, from television, electronics. Keep your room really dark, keep it cool, keep it quiet. And there’s lots of other sleep hacks I’ve written and talked about. We have a whole sleep course, which we’ll connect to in the show notes. Also exercise. It’s a great way to activate all the pathways for longevity and health. You basically can’t exercise your weight up a bad diet, but exercise is a critical step to build muscle, to build cardiovascular fitness, to regulate insulin. I mean, even just taking a 30 minute walk after dinner has a huge impact on regulating your blood sugar and reducing your risk of disease, and that helps your body become more insulin sensitive, and that means less body fat, less inflammation, less belly fat. So just start with something. If you’re doing nothing or do more, if you’re already doing something, you can do high intensity interval training. You can do strength training, but you need to do all of it basically, if you want to stay healthy and live a long life, and I’ve written a lot about this, I’ve talked about it in my book, young Forever. “ www.arminic.com “ But make sure that you do the right kind of exercise and that’ll help speed your metabolism up. So bottom line, stop worrying about your genes. You can actually fix the gene expression by changing the way you live and what you eat and everything from your diet to exercise your sleep, your thoughts, and that’s what’s going to determine your health. It’s not your genes. So I hope you enjoyed this podcast. If you’ve learned how to overcome your genetic risk, we’d love to hear from you. Leave a comment, a subscriber, ever get your podcast, share this on social media with all your friends and family, and we’ll see you next week on The Doctor’s Pharmacy. Speaker 3 Hi everyone. I hope you enjoyed this week’s episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you’re looking for help in your journey, seek out a qualified medical practitioner. If you’re looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It’s important that you have someone in your corner who’s trained, who’s a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.