Winning the Battle Against Metabolic Disorders: Iñigo San Millán at TEDxMileHigh (Transcript)

Iñigo San Millán – TRANSCRIPT

Never in the history of humankind are so many people dying from non-infectious diseases. Diseases that we call nowadays, non-communicable diseases as well.

About 2/3, or two out of three people, die in the world of these diseases which, in the developed society, start from these non-communicable diseases. The major bulk are what we call nowadays the cardiometabolic diseases which comprises diseases like cardiovascular disease, obesity, or type 2 diabetes. Now, is this somehow a price that we have to pay for our progress? For the luxury of working from home or from an office instead of a farm?

There are many components involved in these diseases. The one thing that we don’t know is what happens at the cellular level? What happens in the cells of humans that make us develop these diseases? We have no idea. In the meantime, we open any medical text book and we can see that these diseases are a medical condition or a metabolic disease, however, we are treating these diseases as a nutritional disorder.

And that’s where, in the meantime, we have a $600 billion dollar industry which is the weight-loss industry, that for about two decades they’ve been pushing these products, their pills, their weight-loss products, their diets, making us believe that they have the key to restore our health and to prevent diseases. We know very well that they’ve been failing miserably because they haven’t been able to cure the diseases at all. As a matter of fact, we’re getting worse and worse and worse.

Now, some people say, is this a nutritional disorder? Some people say that the lack of physical activity and some people say – and some people say that this is a problem with the environment. Some people say it’s a little bit of everything.

But again, we have no idea what’s going on. Imagine that there’s a virus out there that is killing millions of people and that we would not know what are the mechanisms of the replication and infection of that virus? We would not be able to develop a vaccine and therefore a treatment. This is the same scenario that we’re seeing with these diseases. And again, the weight loss industry is trying to push all these products for us to be able to hold onto something that we believe can cure the diseases. But they don’t know.

We, as researchers, we have no idea what causes this, and the society thinks that we know, so we’re in big trouble. Look at the whole thing that happens with nutrition and the whole carbohydrates and sugars, for example. We have embedded in our heads that carbohydrates and sugars are the number one causes for diseases, the one to blame. It’s like if they were sent, a few years ago, by aliens from outer space to exterminate humankind. Come on. Give me a break.

Humans have been around carbohydrates and sugars for thousands of years as a normal part of their diet. They never dieted or developed these diseases. Elite endurance athletes. They’re the healthiest and the leanest population on earth, and they have the highest consumption of carbohydrates and simple sugars.

Societies that historically have lived the longest, like the Japanese or the Mediterranean, they also have tons of carbohydrates in their diets in the form of white pasta, white rice, and white bread. When we were kids, our generation and the previous generations, we ate tons of sugary foods. Who didn’t have sugar when they were a kid? Everybody. We didn’t develop obesity. It was very rare.

The brain – the brain is the most perfect machine that has ever been built. And yet, the sole fuel the brain uses is sugar. The human body has a very tight and precise mechanism to regulate glucose. So if we still think that carbohydrates and sugars are the ones to blame, we’re probably dead wrong, and we’re just following the path that the multi-billion dollar weight-loss industry wants us to follow. Now, I really think that one of the problems that we have is that we don’t even have a reference that is straight.

And let me explain this. In every field in life, we work with references, we work with a gold standard. And that’s a reference, for example. And with that, thanks to that, we develop things, we create infrastructures. And in science, we explain and discover new things.

In the automobile industry we have three references: we have the regular cars that we drive, we have the broken cars, and then we have the ultimate machines. And those machines are the Formula One and high performance cars. Those are the perfection. And most of the safety features, fuel economy, design, technology, aerodynamics and performance, come from the development of those high performance cars. When it comes to humans, we don’t have that reference.

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Forever, we’ve been using, in every study out there, working with either a population with some diseases or some conditions, and we’ve been always comparing to the control group, and that control group has been always the “sedentary” healthy individual. It’s very possible that that sedentary healthy individual is already developing these diseases. So therefore, we can never get to understand what imperfection is. You wouldn’t know what perfection is first. We’re comparing imperfection with imperfection.

We don’t use the Formula One cars in humans, but we have them out there, and we watch them on TV almost every day. And this population are the elite endurance athletes. The elite endurance athletes are the only population in the world where 100% of them are free of any acquired cardiometabolic disease. It doesn’t exist in this population. And yet again, they have the highest carbohydrates and simple sugars of any humans.

Dentists love them, by the way. So it’s time to really start using – that’s perfection. And that’s where we can really start changing gears and start using that reference as anything else in life. Now why do elite endurance athletes have the highest performance and they’re so good? Well, for the past 20 years, I’ve been working with elite endurance athletes around the world, and I’ve been able to study their metabolism and physiology. And one thing that I see as a secret for their performance is that it resides in their cells.

And within the cells, it resides in the mighty mitochondria. The mitochondria are the areas in the body where we burn fuels to energy. That’s where we burn glucose, where we burn fat, where we burn protein for energy. Now, elite endurance athletes, they need to really perform at the highest level seen in humans, and for that, you need the best mitochondria there. They have the most developed mitochondria of any human.

Lactic acid, or lactate, a key element for endurance performance, is the byproduct of glucose utilization. So with exercise, we use glucose and therefore we produce lactate. Now, not lactate, per se, but the hydrogen ions associated with lactate, it builds up in the muscle, and eventually, it decreases performance. That’s key. And I have 20 years worth of data seeing that those ones with the highest lactate clearance capacity, they’re the best ones out there.

And where do you clear lactate? In the mitochondria as well. So they have an amazing mitochondria. And that’s perfection. On the opposite metabolic pole, we see recent, but overwhelming evidence from researchers around the world, working with these different cardiometabolic diseases like type 2 diabetes, obesity, cardiovascular disease, even Alzheimer’s, soon to be called the new type 3 diabetes, showing one thing in common in all these diseases: a mitochondrial dysfunction. Those mitochondria are not working properly.

And then, we have a big metabolic problem. When the mitochondria is not working properly, we cannot burn the glucose. At rest levels, that’s when we burn the glucose. It’s a complex process, but ultimately, glucose is burned in mitochondria. And when mitochondria’s not functioning properly, the pancreas is going to release insulin to try to get the mitochondria in, but it’s a faulty mechanism in the mitochondria, so the glucose is going to end up building up, giving rise to insulin resistance, and eventually type 2 diabetes.

The same thing happens with fat. The fat can only be burnt in the mitochondria. If the mitochondria’s dysfunctional, we cannot burn fat properly and it’s going to be building up, giving rise to a wide array of pro-inflammatory responses related to cardiovascular disease, weight gain, and also, probably cardiovascular disease. So that’s why we have a big problem here, and that’s where we have to see that’s imperfection. And we need to know what perfection is, because everything seems to be related at the mitochondria.

So why do elite endurance athletes have such an incredibly developed mitochondria? The main reason is exercise. They train like nobody else on the planet. And exercise is the stimulus mitochondria need to grow and to function properly. Without exercise, mitochondria atrophy. Going back to the example of nutrition.

If you go in this country, in the US, to a dietitian, and say, “Hey, I want to be healthy, I want to be away from these diseases, but, I want to eat twice a day, and every day of the week, white bread, white pasta, and white rice,” they’ll shoot you. They’ll say, “You’re crazy.” Right, there’s no way, that’s the worst thing you can have.

And well, this is exactly the diet all these societies that historically have lived longest and with the lowest incidence, have on a daily basis. And that’s historically because things are changing, and they’re just starting to develop these societies. But why are they protected and they don’t die eating bread and pasta and carbohydrates? Because they move and they walk. They walk to work. They walk to the grocery store. They walk to buy wine. They needed to have the wine. They walk to do errands. And by walking, that hour a day, that’s the stimulus, that’s physical activity. That’s the stimulus the mitochondria need to keep proper functioning, keep growing and not die.

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On the other hand, what do we walk in America? Here in the US, except for some urban areas like Manhattan or San Francisco, where by the way, they have one of the lowest incidences of these diseases in America, we can’t walk anywhere. We don’t walk to work, we can’t walk to the grocery store, we can’t walk to do errands. We need the car for everything.

And we end up for years, sitting on our butts, going to and from work, plus sitting on our butts at our desk for many years. And that causes mitochondrial dysfunction. We know very well with athletes that well-trained athletes, we know from research that if they stop and become sedentary for two months, their mitochondria decreases by 40%. Imagine if you haven’t exercised in 20 years. There’s no way you’re going to have mitochondria right? Very difficult.

And that’s very important to know. On top of that, of course, throw all the extra nutrition, we’re over-fed in our society, you then keep overloading those mitochondria. The problem that we have nowadays is that in this country about 33% of the people already have pre-diabetes or diabetes. The projections by 2020, that is tomorrow, is that 52% of the adult population in the US is going to be pre-diabetic or diabetic. And let’s not forget that being pre-diabetic is already having that metabolic disease.

So if walking is so important, so good for you, why don’t we walk? Right? It’s something that can do the trick. Well, the main thing is it’s been erased completely out of our brains. We watch these TV shows, the reality shows, with the extreme diets and extreme exercises where they sell deprivation when it comes to nutrition, and they sell “no pain, no gain” when it comes to exercise — if you put the two of them together, we’re creating legions of miserable and unhappy people.

But, we’re not sending the message, right? That’s the gold standard, that’s the only way we can be healthy and lose weight. We know that’s not true. We know that 90% of those people, they’re never successful. On the other hand, we have the multi-billion dollar fitness industry. They have to sell memberships, they have to sell products, and they’re not going to sell you walking. They’re not going to do that, right?

So, it’s what I think. I’m not against that industry, of course, but if you haven’t exercised in recent memory, that’s probably not going to be the best thing for you. Hippocrates, the first human researcher and the father of medicine, already had this figured out about 2,000 years ago when he said that walking is man’s best medicine. So to conclude, we need to really make sure that first, we have to focus, scientists, the scientific community, on really getting the references right. We have to use perfection to understand imperfection. And for that, elite endurance athletes is the way to go.

Second, we have to stop thinking that our problems with the diseases is what we eat. We have to really identify that we have a mitochondrial dysfunction because we don’t use them. And we start to use comfortably that term and then we have to take action. And then we need to also make sure that we wash out our brains that the only way is “no pain, no gain” to be healthy.

Walking just can do the trick, especially for those people who haven’t exercised in a long time. And that’s very important. Einstein said that we cannot solve a problem with the same intelligence we had when we created it. And this is what we’re doing right now. We’re not changing.

We’re not creating new thinking. So we need to think out of the box, to probably, and maybe as simple as that, to go back about 2,000 years ago to the words of wisdom of Hippocrates who had everything figured it out.

Thank you very much.

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