Mark Hyman, MD, is leading a health revolution—one revolved around using food as medicine to support longevity, energy, mental clarity, happiness, and so much more. Dr. Hyman is a practicing family physician and an internationally recognized leader, speaker, educator, and advocate in the field of Functional Medicine. He is the founder and director of The Ultra Wellness Center, the Head of Strategy and Innovation of the Cleveland Clinic Center for Functional Medicine, a thirteen-time New York Times bestselling author, and Board President for Clinical Affairs for The Institute for Functional Medicine. He is the host of one of the leading health podcasts, The Doctor’s Farmacy. Dr. Hyman is a regular medical contributor on several television shows and networks, including CBS This Morning, Today, Good Morning America, The View, and CNN. He is also an advisor and guest co-host on The Dr. Oz Show.
Integrative Medicine: A Clinician’s Journal (IMCJ): Thank you very much for taking the time today to talk to us. IMCJ, this is a very important topic for us. Food is a big part of Integrative Medicine. I was very interested when I saw your book, it really discusses how food impacts our health.
Dr. Hyman: This book called “Food Fix: How to Save Our Health, Our Economy, Our Communities, and Our Planet One Bite at a Time.” After thirty years of seeing patients with chronic disease, mostly caused by food, I realized that I couldn’t cure diabetes or heart disease or autoimmune diseases, or a whole host of chronic illnesses that affect six out of 10 Americans in my office. Diabetes and chronic disease are cured on the farm, in our food production system, in the grocery store, in the kitchen. I began to ask myself, “If the food my patients were eating made them sick, why were they eating that food?” It is the food system. Then I asked myself as a good functional medicine doctor, “why is the food system producing food that destroys human and planetary health?”
It is our food policies that support the growing, production, distribution, marketing and consumption of toxic food. Going further upstream to the root causes I asked, “why do we have these food policies?” Digging into the research the it became clear that the food industry to drives our food policies, manipulates science, coopts public health groups, spreads misinformation through front groups and usurps and corrupts social action groups. This drives a system that produces commodity based food products that damage human health through an extractive, environmentally devastating agricultural system. The consequences of this food system is climate change, environmental degradation and loss of biodiversity. It drives massive health care costs, which today are a staggering one in five dollars of our GDP. The food industry, supported by complicit food polices privatizes profits, socializes costs, leads to social and racial injustice, health inequities, impairs children’s cognitive development and their ability to learn and succeed in life. This decreases our global economic competitiveness and even threatens national security because 70% of our applicants are rejected for military service.
When I followed the thread of all these national and global crises, the road led back the food system and the policies that perpetuate it. In order to solve these problems we must take a step back and see their web-like interconnections, name the problem, and then identify the key solutions that address the root causes. That is why I wrote Food Fix. It’s not called Food Apocalypse; it’s called Food Fix. The goal is to name the problem and map out the how, by addressing the root causes–the how we grow the food, what food we grow, produce, market and consume we could solve many of these problems.
IMCJ: And how did big food get to this point?
Dr. Hyman: We have had an unfortunate collision of historical events that led to our current food system. After World War II, the global population was increasing, and with it hunger and deprivation. The was a need to feed a growing population. The advent of industrial agricultural methods after World War II allowed us to produce more starchy calories for a hungry world. Bomb making factories producing nitrogen were converted into fertilizer companies, and biological weapon factories making nerve gas were converted to produce pesticides and herbicides. Farms consolidated, industrial monocrop commodity megafarms replaced family farms. In the 1970’s Nixon Secretary of Agriculture, Earl Butz told farmers “go big or go home.”
We’ve had the consolidation, centralization of the food industry. We’ve gone from, for example, hundreds of seed companies to just a handful. They’re controlled by a few multinational conglomerates. There are only a few dozen CEOs that control the entire food industry—big food, fast food, big ag, chemical and seed companies drive the enormous $15 trillion a year industry, the biggest on the planet. Everyone eats. The consequence is a food system destructive – to humans, the environment and the climate.
IMCJ: Do you see that the demise of the family farm, has that contributed to a lot of this?
Dr. Hyman: That’s one part of it. The real drives has been the overarching effort to ‘modernize our food system” from food production to food processing methods. In the sixties, Americans were introduced to TV dinners, Tang and astronaut food. It was aspirational to eat processed, packaged food, like the futurist cartoon characters the Jetsons. We had a love affair with industrialization of our food supply and processed food. The industrialization of agriculture focused on a few commodity crops (wheat, corn and soy) drove the production of enormous amounts of starchy industrial food ingredients used in processed food. And we now produce over 700 more calories a day than we did in 1960 per person in America. And globally, we produce more than enough food for 10 and a half billion people. Yet 40% is lost through food waste at the farm, grocery store, food service companies and in the kitchen ending up in landfills driving climate change from the methane produced by rotting food.
We are stuck in an antiquated food system that has not reconciled itself with its harmful consequences. The consequences of our food production methods include massive soil erosion and loss (1/3 of our topsoil), our loss about biodiversity including 75% of pollinators species essential for agriculture. Our water resources are threatened from irrigation of crops, mostly used to produce food for animals. Waterways flooded with runoff of nitrogen fertilizer produce algal blooms sucking the oxygen from rivers, lakes and oceans killing millions of tons of fish globally. One third to one half of all greenhouse gas emissions are from the food sector – from deforestation, soil erosion, factory farming, food waste and more. The health consequences of producing that poor quality, commodity food system are staggering, accounting for 11 million deaths a year around the world, making food the number one killer globally. Ultra-processed food comprises 60% of our calories, The corn, wheat, and soy turned in all manner of color, sizes, and shapes of extruded food-like substances that really resemble food, but are not food. For every 10 percent of our calories from ultra-processed food, our risk of death increases by 14%.
IMCJ: Do you think a lot of consumers may think they’re eating a healthier diet?
Dr. Hyman: Many don’t understand the full impact of eating processed foods on human and planetary health. There’s a general lack of awareness of the real health consequences of these and how bad could it be. It’s just a few Doritos, how bad can a can of Coke be, or a feedlot steak. These food produce profound harm to humans and the planet.
The food industry has done a great job, not only of influencing policy, but influencing public opinion and science. They funded 12 times as much “science” as the government, at $12 billion a year. They produce science that subverts real integrity in science, by publishing studies that show that soda has nothing to do with weight gain, or that dairy is nature’s perfect food. The have also co-opted public health organizations like the American Heart Association and Diabetes Association. The American Heart Association receives over $192 million a year from industry, including pharma and the food industry, which makes their recommendations suspect. The Academy of Nutrition and Dietetics receives 40% of its funding from the food industry.
Front groups are another pernicious source of disinformation. The American Council on Science and Health, as just one example, has repeatedly undermined real science declaring no health risks from tobacco pesticides or high fructose corn syrup, trans-fats. They claim that GMO foods are harmless and have spent $30 million just fighting one GMO labeling law in California, an effort funded by Monsanto and others.
The food industry funds and coopts social groups like the NAACP or Hispanic Federation which kind of makes those groups beholden into the food industry. They oppose soda taxes and other measures that might help to improve the health of their population, siding with the food industry. There is a coordinated strategic effort to influence food policy, corrupt science, coopt public health organizations, create front groups, and manipulate social action groups to subvert public opinion, sow confusion and undermine health. All these efforts allow the food industry privatize profits and socialize the costs.
IMCJ: And how do we change these policies?
Dr. Hyman: We need a multi-tiered approach that includes multiple stakeholders. I have launched the Food Fix Campaign, a non-profit designed to help bring together the stakeholders to drive change grassroots change and shifts in policy at a federal, state, and local level. It will require a multi-pronged effort over multiple years, which is not going to be easy, but will steadily make progress because there’s a growing understanding that our food is driving big global challenges and solving our food system challenges is the answer to chronic disease, the economic burden that it causes for society, as well as climate change.
It is not common knowledge that 50% of climate change is driven by the food system—our agricultural production methods, food waste, soil destruction, deforestation, factory farms, and the centralization of food system production and supply requiring massive distribution, refrigeration, transport. Combined these make food system the number one cause of climate change.
IMCJ: And how can policy impact both food systems and climate change?
Dr. Hyman: Regulations and legislation is that will require large fossil fuel consuming industries to buy to buy carbon offsets for their emissions. Regenerative agriculture, where the soil is a carbon sink, can be part of that solution.
For example, the airline industry needs to buy carbon offsets to mitigate their greenhouse gas emission. They are exploring buying carbon offset from regenerative farmers who put carbon back in the soil. The biggest carbon sink on the planet, far more than the rainforest, is our soil. Today a third of all the greenhouse gas emissions in the atmosphere are from the release of stored carbon in the soil–the result over tillage and chemical intensive agriculture that’s destroyed the microbial life that holds the carbon.
If we can re-carbonize the soil, we can go a long way to producing healthier food, regenerate soil and draw down enough carbon to mitigate all of climate change according to some estimates.
IMCJ: How do you explain to the consumer that these products that they’re going to be buying, the real food products, whether they’re organic, or locally grown, or whatever, which may have a slightly higher cost to it, really in the long run, isn’t more expensive?
Dr. Hyman: There’s a couple of issues. One is the hierarchy of needs. If people are eating processed American junk food, switching to a whole food diet, whether it’s organic or regenerative or not is affordable. The evidence is clear on this. Despite food industry propaganda, it’s not more expensive, more difficult, or more time consuming to make real food from scratch. Roast chicken, a salad and a big sweet potato is an inexpensive meal. For most families it can feed a family of four for less than you can serve them at McDonald’s. We must dismantle the myth that eating real food is expensive.
In addition, incentivizing regenerative agriculture and de-incentive extractive, destructive industrial commodity based agriculture will bring the costs of real food down. Government supports for agriculture privatizes profits and socializes the true costs. We’re not paying the true cost of a can of Coke or a factory farmed steak. What is the true cost of a can of soda? It should include the cost of growing corn in a way that destroys the soil, that depletes our freshwater resources, that kills biodiversity and pollinators, that pollutes our waterways with nitrogen fertilizer runoff that kills 212 000 metric tons of seafood in the Gulf of Mexico alone. The price of that soda does not include the cost of the health care burden of consuming these foods, the chronic disease burden, the disability, the healthcare costs, the medication costs, none of these are embedded in the price of the food.
We pay now or pay later. The costs are there in the system, they’re just not properly allocate or reflected in the price of food at the checkout counter. If we properly allocated costs and looked at a true cost accounting system for what we were doing, it would be far cheaper to eat regeneratively raised food than it would be to eat industrial food.
IMCJ: How do you get that message through healthcare practitioners so they can share that with their patients?
Dr. Hyman: The simple idea that food is medicine must be central to health care. The Cleveland Clinic, where I work, has a food is medicine initiative. There’s a food as medicine working group in Congress. There’s increasing awareness that food can play a big role in both preventing, mitigating, and even reversing chronic illness..
Today we don’t have evidence-based medicine, we have reimbursement based medicine. What we know works is not reimbursed including lifestyle change, behavior change and dietary change. Proven strategies exist for health care systems these approaches, but it requires both a paradigm shift that food is medicine and a shift in healthcare delivery models that address the social determinants of health and the obstacles to lifestyle and behavior change.
IMCJ: Do you think most healthcare practitioners are open to learning about that?
Dr. Hyman: I think they are. There is remarkable openness at Cleveland Clinic and other institutions. But often they don’t know how to implement these approaches. We are getting requests from multiple healthcare organizations and other groups to help them implement functional medicine approaches to chronic disease.
IMCJ: One of the big issues is on the federal government side is all the subsidies they provide for farmers.
Dr. Hyman: Farmers are not the enemy. Farmers are the middleman who gets squeezed by the government on one side, the banks on the other, and agrochemical and seed companies on the other. Here’s their trap. They take on big debt for industrial farm equipment, land and every year they require bank loans buy seed, agrochemicals and equipment to plant. To qualify for the loans, they need crop insurance from the government. All the money from the loans banks is passed through to the seed and agrochemical companies to buy the supplies.
At the end of the year, they end up with very little profit. The average farmer in America today makes minus $1600 a year. Farmers are not the problem. It’s our policies that force them into a dysfunctional system. But there’s a group called the Soil Health Academy, led by regenerative farmers and a USDA former employee who travel around the country teaching farmers how to transition to regenerative agriculture. Farmers who shift to regenerative agriculture are profitable within the first year. And the side effects were all good ones. They build soil, conserve water, increase biodiversity, increase food production, and increase profitability by up to 20 fold by using these methods.
IMCJ: What about the end product food manufacturers? How do they feel about the issue?
Dr. Hyman: Big food companies are starting to shift. Kellogg’s announced they would eliminate glyphosate from of all their cereal by 2025. General Mills and Danone are funding regenerative agriculture initiatives. In fact, they have hired the Soil Health Academy to help train farmers to convert millions of acres to regenerative agriculture. The reason they’re doing this is not out of goodwill or for social good. I believe they understand that if current agricultural methods continue, their supply of raw materials for their products are in danger because of how we’re growing our food. The very way we grow our food endangers our future ability to grow food. They have come to understand this, and now are funding these initiatives, which the government should also be supporting.
IMCJ: The foods that we’re eating now, what chronic health issues do you think it impacts the most?
Dr. Hyman: Nearly all chronic disease that now affects 6 in 10 Americans is caused by or influenced by food. By 2030, 83 million Americans will have three or more of these chronic illnesses. Heart disease, diabetes, cancer, dementia, kidney failure and depression. These are all diseases related to food. They’re all driven by our industrial processed food supply. According to the global burden of disease study, the number of people killed by food every year is 11 million people, which is more than any other cause of disease. I believe that’s an underestimate. Fifty six million people die every year from chronic disease and to some degree, most of those are caused by food. It is both the absence of protective whole foods too much bad food.
IMCJ: And so do you think there’s any relationship to the current pandemic that’s going on right now, as far as food and who’s getting the coronavirus and who’s able to fight it off or avoid getting it?
Dr. Hyman: The crisis in America the worse because of the staggering burden of obesity and chronic disease. There are fewer cases of COVID-19 in New Zealand, Taiwan, and Vietnam combined than there were in the White House.
Why is that? Vietnam has 1% obesity. We have 42% obesity. There are 500 deaths per million population in the US, and only 3 per million in China. The USA has an obesity rate of 42%. China’s obesity rate is 2.6. If you’re overweight, obese or metabolic unhealthy, which is 88% of Americans, your risk of getting COVID-19 is increased. Your risk of getting sick and dying is much higher, up to three to 12 times higher. The state of poor metabolic health is a state of inflammation. And when the COVID lands in a pre-inflamed metabolically unhealthy person, it’s like throwing gasoline on the fire that results in a cytokine storm.
IMCJ: Regarding obesity, is that based on the amount of food or the type of food that people are eating?
Dr. Hyman:The amount of food is not the issue. We’ve been mistakenly focused on calories for so long, but it’s the quality of the food that determines the effect on metabolic health. Food is information, it’s not just calories. And the need to improve the quality of our diet is ever more evident in this crisis of COVID-19 that afflicts those with poor metabolic health caused by poor quality food.
IMCJ: You mentioned a little bit about soda early on, do you think that’s one of the worst foods that we’re eating or that people tend to rely on?
Dr. Hyman:In some populations, soda comprises 10% of calories or more. Sugar and refined carbohydrates cause obesity, heart disease, diabetes, cancer and insulin resistance. There’s no doubt that soda is one of the worst actors. Of all the factors linked to obesity, it’s the worst.
Diet sodas also has been linked to obesity and diabetes. Artificial sweeteners drive poor metabolic health through a number of mechanisms, including changes in neurotransmitters, hormones, increasing insulin, increasing hunger, and affecting the microbiome increasing risks of diabetes and obesity.
IMCJ: To wrap up, what are you hoping people will get out of your book?
Dr. Hyman: My hope is that people will read it and will understand that these problems are all interconnected and will take steps to act in their own life and act within their communities and their families, as well as politically to make a difference. And I think we underestimate our political impact.
If 10 or 20 people call their Senator or Congressman, they listen. If you are voting, it matters. I think people think their vote doesn’t matter, but we are blessed. We all have a representative democracy and unfortunately only 50% of people vote in the presidential elections. But in others, and in most other countries that are democracy, it is over 70%.
There are great resources like foodpolicyaction.org that allows you to identify the voting behavior on food policy of your representatives and speak to them about it, or vote them out of office. I have created a Food Fix Action Guide that can be downloaded free at www.foodfixbook.com that outlines individual actions, and how businesses and policy makers can drive real change in our food system to regenerate human health, revitalize communities and heal the planet.