Dr. Mark Hyman: To Live Longer You Need...

0:00Loneliness is as big a killer as anything else. Some have said it's equivalent to smoking two packs of cigarettes a day. There's a huge biology to it. Why aren't doctors prescribing to spend more time with friends? I do.

0:16We are what we eat, or so the adage goes. But it turns out that statement is actually medically true. Dr. Mark Hyman is one of the leading voices in the field of functional medicine, which basically means that if we feed our bodies the nutrients it needs, not only does it help us prevent illness, but we can actually supercharge our immune systems to heal us when we get sick. So I wanted to talk to him about something we need in our lives as much as we need food. Friendship. World leaders ask Mark for health advice. He's the author of 15 books, many of them New York Times bestsellers, and the host of the podcast The Doctor's Pharmacy.

0:53So I really wanted to get his take. And it turns out, if we give our friendships the same attention as we give our diets, it benefits our minds, our spirits, and our bodies. This is a bit of optimism. Mark, thanks so much for coming today. It was such a treat to sit down with you. There's so much I want to talk to you about. My big thing right now is I'm writing about friendship. Yeah. Sort of mildly obsessed with it. It's a good thing to be obsessed with. It's a good thing to be obsessed with it. So I want to go down the path of the connection between between health and community and health and friendship.

1:27You made a comment that you can't be a good friend if you're not healthy. If you feel like shit, you know, you can't show up and be present and be there. Be there for someone. And be there and yeah, just even be present to have a conversation if you're foggy and fatigued and you feel like crap and you're dealing with all kinds of issues. It's hard to really be present. And that's what you need to do to be a friend. It's a paradox because you need mental health to be a good friend. Right. But if you don't have friends, it's hard to have good mental health. Right. We have such a crisis of mental illness in this country.

1:59And part of it's because of loneliness, isolation, disconnection, social media, all the things that you're thinking about and actually writing about, hopefully with your new book on friendship. Yeah, yeah. But from my lens, when I look at people's mental health, I look at it through the lens of biology. Because we now understand that the brain is obviously connected to the body, which has not actually been part of medicine. Isn't that a weird thing that that's a discovery that the brain is actually a part of the body? I mean, the old joke in medicine is psychiatrists pay no attention to the brain and neurologists pay no attention to the mind, right?

2:35But now psychiatrists are paying attention to the brain and they're finding that brain dysfunction, brain inflammation is actually driving much of mental illness, everything from depression to anxiety to OCD to bipolar to schizophrenia to autism. All these things are connected to brain dysfunction. And yes, it can be caused by an external stressor, like a spouse dying or trauma or things that are external, but it also can be caused by nutritional deficiencies and your microbiome and environmental toxins and things that actually are treatable and measurable. There's a very famous trial in Australia called the SMILES trial.

3:09They come with all these great names for studies. But it's Dr. SMILES? No, I forget the acronym, but it was essentially they swapped out, did a randomized controlled trial of giving people healthy whole foods and then versus processed food. And there was a huge improvement in mental health by eating whole foods on a depressed population. They've done studies, for example, in juvenile detention centers where there's a lot of mental illness. And these kids, by swapping out the crap for healthy food, had a 97 % reduction in violence. Wow. And 75 % reduction in use of restraints. 100 % reduction in suicide rates, which is the third leading cause of death in teenage boys.

3:49Wow. Profound. And presents is the same thing. you get prisoners healthy food compared to the crap 56 and it's not like you're putting them on like you they eat the food you give them it's not like they're going to the fridge and choosing no so it's a great it's a great space for a controlled study it is it is right because there's no there's no choice involved right it is yeah and so it's not like they have a mindset of health no they're just eating whatever they're given and then they you know they violent crime goes down 56 percent prisons if you add a multivitamin it goes down to 80 percent and with function health we're finding huge amounts of nutritional deficiencies.

4:18I just had a friend who's a vegan and he was severely omega-3 deficient, very depressed. And he's piling on omega-3s and his mood is completely different. And we know that omega-3s play a huge role in mood. We know that folate and B vitamins play a huge role. And we know that many people are deficient in these nutrients. And we can measure those biomarkers with testing that wasn't available before for people. Now it's accessible to anybody. Do you know what I think is really significant about this little insight, especially as we're relating it to friendship and having the mental capacity to be there for someone to having the strength of mind to be present for someone else as they're dealing with happiness or sadness or whatever they're dealing with just being there to be a friend so often when we talk about nutrition we talk about eating right we talk about you we talk about so that you can be healthy so that you can live longer so that you don't suffer from chronic disease and most of us let's be honest it's the same reason we don't save money you know if it doesn't have an immediate impact yeah it's a slow boiling frog yeah You know, nobody plans to get diabetes.

5:16It kind of just shows up after years of being like, I'll deal with this tomorrow. In other words, we're crap at doing things for ourselves, even though the data is overwhelming, that if you just exercise, sleep, and eat right, you'll be fine and healthier. But to think about eating well as an act of service. Yeah, to others, yeah. That I choose to eat well, not for me, though I may get benefits from it, you know, as an unintended byproduct. Yeah. I choose to eat well so that I can be a better friend to you. I choose to eat well so that I can be a better parent to my kids. So I'm less grumpy and less agitated.

5:50That's right. And to think of that, I think, as an act of service. Yeah. Yeah, that's right. Right? Well, illness starts with I. Wellness starts with we. Oh, yeah. Isn't that true? And so I think the correlation, and this is the thing that drives me nuts when we think about things like innovation or health, is we make it a very I thing. You have to get healthy. You have to take a multivitamin. You have to exercise. You have to sleep. But we don't make it about a we. And you know the data better than I do that when there's a group of people who are overweight and one of them decides to go on a diet, the disproportionately high number of them will decide to go on a diet.

6:28If there's a group of smokers and one of them says, I'm going to stop smoking, the disproportionately high number of them - Yeah, getting healthy is a team sport. Getting healthy is a team sport. And we are absolutely influenced by our friends. Yeah, you're only as healthy as your five closest friends. So it raises - Right. So it raises the question, because clearly we're failing as a people, as a nation, at doing all the things you recommend, because most of the things you recommend, at the high level, what you recommend is a lot of work, right? It can be or not. It's just what you set up for yourself.

6:58But at a functional level, a lot of the stuff that you recommend is not difficult, not expensive, and pretty basic. Yeah. It's kind of silly, but it is. And yet, for not any more money, I mean, you can buy broccoli cheaper than you can buy McDonald's. For not more money, a little bit of effort, but not complicated things, we can all live much healthier lives, and yet we're not. And so it raises the question, you know, are we banging our heads against the wall? Are we repeating the same behavior, expecting a different result? That maybe the drumbeat from the health establishment of change the way you eat, get more sleep, work out.

7:43Like we're all exhausted. We all know that. It's not like you're... I think a lot of us know it, but there's a whole subset of our population that doesn't know what it means to eat well. Different problem. Yeah. Different problem. I completely agree. It's shocking to me, but it's true. And it's because the food industry has been so good at manipulating the public to think that certain foods are healthy that are not. And they put health claims on labels of stuff that's the worst possible food. All natural, which means nothing. My basic rule is if it has a health claim on the label, it's bad for you.

8:15Don't eat it. If it has a health claim on the label, don't eat it. If it's trying to hide something, it's trying to hide something. Right. It's like low fat, low sugar, sugar-free. what else is going on in there? It's like my favorite ones are new and improved formula. Like what was in the old one? Yeah, yeah. Like, uh-oh. So you were kind of going into the rabbit hole of we know what to do, why don't we do it? Why don't we do it? And I'm asking the question, maybe if we refocused our attention in a different place, let's call it friendship, with the rising rates of anxiety and depression and mental fitness challenges and inability to cope with stress and then the worst case suicide, even the obsession with longevity, I'll throw that one as well.

8:56Friendship is the ultimate biohack. It is. Friendship literally fixes all of those things. We know the data that people who have close relationships live longer. People have close relationships are happier. And you look at Dan Buechner's work and the Blue Zones. And so much attention is put to them walking to the house and so much attention is put into what they're eating and how they're eating. But not enough attention is put into the fact that they're eating with their friends every single day. You're so right, Simon. I actually, I spent a lot of time in Sardinia and in Icaria or Acaria, however you pronounce it.

9:30It was just stunning to see the level of community and connection. Even if someone, for example, like this woman, Julia, was 100 and she was, I'm 103 months. Like, you know, like I'm five and three quarters. I'm 103 months. I think when you're very young and you're very old. Every month. The half, the quarter count. And now she didn't have kids, but she lived with her niece and nephew and there were no nursing homes. People just took care of each other. And it was really remarkable. And it was this guy, Carmine, who basically had this huge farm that he had his whole life and his family had. And he was 86 years old and he was raising animals and had fruit trees and gardens.

10:02And he was feeding his whole community and family had meaning and purpose. And he would live with his kids and his wife had died. But it was all this incredible sense of connection and community. And it's so essential. And I learned this lesson when I went to Haiti after the earthquake. And I was the first medical team on the ground at the main hospital, the general hospital in Port-au-Prince. And it was a disaster. I mean, you can't imagine the scope. It was 300 ,000 people injured and 300 ,000 people dead. It was an unbelievable massacre that was a natural occurrence, but it was horrible. And so we got there and there were people helping.

10:40Everybody was helping. There was a sense of community and service and connection. And I got to meet Paul Farmer, who was a hero of mine. He was a doctor who went to Haiti and decided that even though the whole world had neglected this community of people who were suffering from TB and AIDS because they were poor, they didn't have sanitation, they didn't have clean water, they didn't have watches, they couldn't take the drugs, it's complicated at that point to take the drug regimens for multi-resistant, drug-resistant TB or for AIDS. And he realized it wasn't a medical problem, it was a social problem.

11:12He called it structural violence, what are the social, economic, and political conditions that drive disease? and it wasn't that we needed better drugs or surgery we knew how to solve it but the entire public health community given up on them so he started to help by building a network of community health workers neighbors helping neighbors friends helping friends and he called it accompaniment and it was french but i'm not good at pronouncing french so i'm going to skip that accompaniment accompaniment yeah something like that and he built this whole model and he scaled around the world it was adapted by the clinton foundation the gates foundation to help he did He did this in Peru.

11:45He did this in prisons in Russia. He did this everywhere where people were struggling in Rwanda, built hospitals. And it was an incredible model. And I realized that most of the diseases we have now in the West are not infectious diseases. They're chronic illnesses, which are called non-communicative. What's the difference? Well, infectious diseases like malaria or measles or TB, right? These are the things that all were killing us a century ago. Now they're pretty much not, except in certain parts of the world. But the disease we now have are what we call non-communicable diseases. But that's a fallacy because they are very communicable.

12:19They're not infectious, but they're contagious. And chronic diseases like heart disease, diabetes, cancer, dementia, autoimmune diseases, these are diseases that are driven through our diet, toxins, but also through our social networks. And I realized that our social networks were more important than our genes. The social threads that connect us are more important than the genetic threads. And the data is really clear on this. Chris Stockis' work out of Harvard outlined this very clearly. He wrote a book called Connected about this. But he's published the research that showed, for example, if your friends are overweight, you're 170 % more likely to be overweight.

12:50And if your family's overweight, you're 40 % more likely to be overweight. Your social networks are driving your behavior for good or bad. So I realized that, yes, we have a society where the default is to do the wrong thing. And that we as a society aren't supporting each other to do the right thing. and I realized that community was medicine, just like food is medicine and that love is medicine. And that's, I mean, look, that's our anthropology, right? We're tribal animals that grew up historically in tribes, about 150 people, and that's how we lived. We lived in these relatively small, we help each other communities, communes.

13:26I mean, that's the history of humankind. We've only started farming 10 or 12 ,000 years ago, but for most of human history, we lived in these small groups where we couldn't have populations larger than about 150. Yeah. What's very interesting about the little statistic that you threw out and the thought that I had, which is when our family is overweight, we're 40 % more likely to be overweight. But when our friends are overweight, we're 170 % more likely to be overweight. And that's, you know, the immediate thing that popped into my head was when you think about children, right? Children, all they want is their parents' approval.

14:00Hey, mom, hey, dad, watch me, watch me, watch me, watch me, right? And they have no inhibitions in the outside world. They don't care what the world thinks about them at all. I'm going to dress like a princess. I'm going to dress like Spider-Man. But I want mom and dad to watch me jump off the step. And I desperately want mom and dad's approval. And that's where all of the learning about what's appropriate and what's inappropriate comes from. Strictly from our parents, nothing else. Until they reach about adolescence. And adolescence, we convert to only needing our parents' approval to only needing our friends' approval.

14:33Frustrating for the parents, but very, very important for social animals because what we're doing is acculturating outside of our families, beyond our families, into the broader tribe. And that lasts for the rest of our lives. We don't actually go back to the family. It's all friends. Which is why I have to believe, and I'm just sort of thinking about this out loud now, I have to believe that's the reason so many of us go on Instagram and wish our parents happy birthday when our parents aren't on Instagram. Right? Right. It's for the social approval that I'm a good kid and showing all the pictures of my dad holding me when I was a baby, like scroll through all those pictures and everybody likes that I'm a good son.

15:12Right. And yet my dad's not on Instagram. Right. And so I have to wonder if that same drive, that same weird need to want social approval for being a good son is the same. It comes from the same root. I mean, a hundred percent. If your friends are all drinking green juices and doing yoga. going to drink green juice then you're going to do the same thing if all your friends the amount of shit that i take simply because a friend's like you should do you know what you know what because you because you're in the industry i'm going to say something that's potentially insulting to you please that's what i like to do i like to have i like to i like to talk to guests and then insult them so this is potentially okay we're friends everybody so i so this is potentially insulting so i need you to work this through me okay okay it feels like i can't say that it is But it feels like that the complete explosion in the supplement industry where nothing is evaluated by the FDA and every influencer now has a vitamin or a supplement or powder or a drink with all kinds of nonsense claims.

16:16Maybe they're good. Maybe they're bad. It feels like we're living in the dot-com boom of supplements. That, you know, in the dot-com boom, you were like, I'm investing in this tech company because my neighbor told me I had to. And now that's been replaced with, I'm now taking these 87 pills per day because one friend told me to take these four. And just like the dot-com boom, you can't live in a bubble like that. It's going to have repercussions and it's going to be unexpected and it's going to be pretty violent. So riddle me this, like, is it time for the FDA to get involved? Like, I can no longer tell the difference between a claim on a product you're selling or a claim on something that some, like, literally their only qualification is they have a following on Instagram.

17:08Yeah. Isn't that a job of being an influencer? where was my course in college influencer 101 we're living we're living i think we're living in a supplement boom yeah it could be and it's gonna and it's gonna i don't know how it suddenly you know kicks back yeah but this can't this can't last forever yeah i think there and it's counted to everything you're trying to do yeah i what i want people to do is do the right thing it's what i've i've been my whole life trying to do is help people understand how to create health and part of the new company I co-founded Function Health is really empowering people with their own health data to make choices that are personalized that aren't just random because somebody said do this or do that and so that's what I love about the testing I had a for example a friend the other day who showed me her results from Function and she was low in zinc she was low in iron she was low in vitamin d she was low in omega-3 fats I'm like oh that's why you feel like crap you know you need to take these things and here's what to choose but most people don't have a way of navigating this sort of morass of products that have, again, no regulations in terms of quality or efficacy.

18:11Now, because people aren't protected in the sense that they don't know if the product they're taking has the exact ingredient it says, if the dose is what it says on the label, if there's any contaminants in it, if there's any fillers or products that kind of may be harmful to you. So it's kind of a shit show. And so as a physician, I've spent a lot of time investigating which companies are using pharmaceutical manufacturing practices, which do testing before and after their product. So they know that the purity and potency is exactly right. And they throw the product out if it isn't. So there are good companies that are doing that.

18:46But it's like - How do I even know? You can't unless you know what to ask. I did a thing a while ago where - There's a way to learn about it, Simon. Where they took my blood and they evaluated all of everything in my blood from, I mean, you name it. all the minerals and everything I'm supposed to get and have. Yeah. And then they made... A personalized cocktail. A personalized smoothie. Yeah. That replaced all my things and I'm supposed to come back every six months. Yeah. And it was really interesting. And then I talked to a doctor who walks me through my results. Yeah. And then they give me my smoothie and the only choice I get is what flavor.

19:23And it sounded good until I was like, I don't even know if this is bullshit. Yeah. If they're just like, I don't actually... Well, that's a problem. If someone's selling you something off of something else, that can be a problem. It's not always a problem. But if you're saying, do these tests and take these pills. I've done all of the things for a little bit. Like I took AG1 for a few months. And I mean, I do all these things. I feel the same. Like I've done AG1. I've done clostrum. I've done, I mean, you know, and again, all because somebody's like, you should try it. And there are people who I trust.

19:53That's why I did it. Yeah. And, you know, like you take these things, like it boosts your immune system. How do you measure that? Exactly. I got a cold. So does it work or does it not work? Well, it would have been worse if you, I mean, like, I don't know. And I, you know, I start, I get very cynical. Sometimes I'm all in and sometimes I'm very cynical. I'm in a very cynical mode right now. No, I hear that. I hear that. And I think it's fair and you're right to be cynical. And I think there's a lot of garbage out there and a lot of people pushing stuff. And there's a lot of companies, for example, doing tests and then selling you products on the back end.

20:22I think there's a problem with that. Okay. For example, function health, we don't do that at all. We just say, okay, for example, you have these things that you found that you need to fix that are affecting your health and well-being. And here's how to make a decision. Like, for example, we have a 30-page guide on how to choose the right supplements. And you don't take... We don't sell anything. And you don't take kickbacks from the products that you recommend. No, no, God, no. No kickbacks. No, no, no. We're completely agnostic. We don't have any... Do whatever you want. You just need this. No, but not only do whatever you want, but if you're going to...

20:48If you need something, here's how to choose the right product. Got it. And here's how to investigate the company. And here's the questions to ask. And here's what to look for. and here's how to make a good decision so we're teaching how to fish not giving you a fish i i like that you're doing this but i i'm remember i'm in a cynical mode what else is new

21:09which is when there's when there's a good business model even if it's for the for the greater good because money is fuel and that's totally fine that means you will have competition and other people will start doing similar things and then we're back at square one which is all of these companies are going to be funded by VC. And you and I know too well, unfortunately, the way VC and PE works, which is they all are wonderful. They're all fantastic in the beginning. And they're so behind you in your vision at the beginning. And just wait three to five to seven years. And all of a sudden, the pressures start to show up.

21:42And the growth, we want growth because that's our business model, not your business model. And then all of a sudden, especially if you've given up controlling interests, you will have built up this beautiful brand. You get fired from your own company i mean the number of companies that have like the brand avada burt's bees kashi amy's these were well they got bought by craft you know they were all great brands yeah that built their brands based on natural ingredients and we believed it because the founders were true and then they sold yeah to craft and l 'oreal and whoever buys these companies they strip the beautiful things out put the shit in because they can increase margin but we're none the wiser we don't know which ceos got fired from beautiful companies we don't know that these companies are owned by large conglomerates that are driven by shareholder value and then we end up suffering for these products that we were told were good and they were good until they weren't good and we're back at square one yeah so i think we should just have friends and well let's get back to the conversation about friendship because i think i think that that you know the the the fundamental thing is we should we should garden and farm with our friends that's and eat our own food oh we can't live you know i mean when you look when you look at the subsistence farming that's that's what i i think it's right i mean i think you know community gardens are amazing i think they're a great service for people and i i think that what we're finding is that loneliness is as big a killer as anything else.

23:14Some have said it's equivalent to smoking two packs of cigarettes a day. And how many, especially men, don't have someone who's a good friend? How many people don't have somebody to call when shit goes down? I go back to the work that I did some years ago when I was writing Leaders Eat Last with Alcoholics Anonymous. If you want to overcome alcoholism as a 12-step program, most of us are familiar with the first step, you know, admit you have a problem. Yeah. Okay, let's say I'm depressed or I'm lonely. Let's admit that's the problem, right? But it's the 12th step that people don't talk about. Right.

23:50And Alcoholics Anonymous knows, exactly. Alcoholics Anonymous knows that you can master 11 steps and not the 12th and you will succumb to the disease. And it's the, exactly, to help another alcoholic. It's service. Yeah. And so I think the people who are the most lonely are the ones who have to go first. because the way to solve your problem is to help your friend who's suffering from the same problem. If you're an alcoholic, you help another alcoholic. If you're lonely, help a friend who's lonely. That's right. And I think that the therapeutic benefits of helping someone who's struggling with the same thing that you're struggling with rather than worrying about yourself goes right back to the gym.

24:27There's a huge biology to it, too. I don't know if you know, but there's a whole field of sociogenomics, which is how our social interactions affect our gene expression. Say more. So if you're in a conflictual relationship with someone, your inflammatory genes are turned on. Literally, not just your emotions are inflamed, but your biology turns on the inflammation system. Like fight or flight kind of stuff? Not fight or flight. Just if you're like in a shitty relationship or if you're fighting with someone or you have a conflict, you turn on inflammatory genes that then increase expression of cytokines that cause inflammation and that cause disease.