February 24, 2020

Nutritional Biochemistry

#94 – Mark Hyman, M.D.: The impact of the food system on our health and the environment

If we were eating what the government actually funded in agricultural supports, we'd be having a giant corn fritter, deep fried in soybean oil. And it's like, that's not exactly what we should be eating.” —Mark Hyman

Read Time 44 minutes

In this episode, Mark Hyman, M.D., director of the Cleveland Clinic Center for Functional Medicine and the author of Food Fix, discusses that if we can fix the food system, we can solve many big problems—namely the chronic disease/obesity epidemic, the rising costs of healthcare, as well as the big problems facing the environment. Mark first briefly lays out the health consequences of processed food with a focus on the gut microbiome. From there, Mark discusses the environmental consequences of industrial farming and lays out how we can affect change on the individual level, through policy and regulations, and perhaps most importantly through regenerative agriculture. Additionally, Mark talks about the potential health risks of consuming GMO foods, herbicides, and other chemicals used in industrial farming as well as the environmental consequences, such as the loss of soil, caused by those same fertilizers and methods of farming.


We discuss:

  • The negative consequences of the existing food environment [3:25];
  • What makes processed food so unhealthy? [9:00];
  • The gut microbiome: Inflammation from gut permeability, and how to measure gut health [18:30];
  • Steps to fixing a bad gut—The Five R’s [24:30];
  • Some staggering health statistics, and which races might be more genetically susceptible [27:15];
  • An argument for government regulations and policies to fight back against a massive food industry with unlimited resources (and what we can learn from the tobacco story) [29:00];
  • Industrial farming and climate change: The degradation of soil and use of fertilizer [41:45];
  • Regenerative agriculture: Could it be the answer to food waste, our health problems, and the environment? [51:45];
  • Comparing the “Impossible Burger” to regeneratively raised beef [1:06:00];
  • GMO and Roundup—The potential health risks of consuming GMO foods sprayed with Roundup (glyphosate) and other herbicides and pesticides [1:08:15];
  • How the livelihood of farmers are being affected by big ag companies and the current industrial farming system [1:16:30];
  • The loss of biodiversity in our food, and what “organic” really means [1:19:00];
  • What can people do on the individual level to protect themselves as well as affect change to the toxic food system? [1:25:00];
  • What role does the USDA play in this “toxic” food environment? And how do we fix it? [1:30:15];
  • The top 3 changes Mark would make if he was “food czar” [1:35:15];
  • Mark’s rebuttal against the argument that it’s best for the environment if stop farming animals and move to a fully plant-based diet (and his argument for “agriculture 2.0) [1:36:30];
  • What is Mark’s overall mission with the work that he’s doing? [1:40:30];
  • Bread in the US vs. Europe: Why does bread (and wheat products) taste different and potentially cause less health problems in Europe versus the US? [1:42:00]; and
  • More.


The negative consequences of the existing food environment [3:25]

Why did Mark decide to go into food research?

  • As a doctor seeing patients day after day for 30 years, as a functional medicine doctor, my focus is on why are my patients so sick? 
    • The majority of them, it has some relationship to food. 
    • I had to figure out why are they eating the food they’re eating?
    • The food system we have is the problem
  • Why do we have this food system?
    • It’s because of the food policies.
  • Why do we have our food policies
    • It’s the food industry that influences our government policies through lobbying and other influences that they do across the spectrum of society to drive their products to the market and sell them.

“There’s 11 million people that die every year from eating ultra processed food and not enough of the good food. And I think it’s an underestimate.”

The answer as to why Mark decided to focus on this issue: “I realized I couldn’t fix my patients in my office or in the hospital, or the clinic I had to go to where the source of the problem was.

Was the evolution of farming all bad?

  • No, in fact, Mark says that, “agriculture is a solution, if we do it right.

The main pillars making the current food environment “toxic”

  • Chronic disease: Food is the biggest driver of chronic disease affecting six out of 10 people
  • Economic crisis: It’s clearly the biggest driver of economic stress in this country, in our $22 trillion debt. 
    • One third of all Medicare expenses are for diabetes alone
    • One third of all of our federal budget is Medicare
    • And if it was a company, it would be the biggest company in the world at $1 trillion annually. 
  • Climate change: It’s also driving climate change. 
    • A food system, end-to-end, is the number one cause of climate change more than fossil fuels, says Mark
    • It’s causing massive environmental degradation including loss of bio-diversity (plant species, animal species, livestock species) 
    • And of course that leads to massive political instability because of our food system of climate refugees, because the food system is driving climate. 
      • The UN estimates that within a decade or few decades we’re going to have 200 to a billion climate refugees
  • Social injustice: It’s driving social injustice in many ways through how it affects our kids’ cognitive development and ability to learn (And there’s huge academic achievement gaps)
    • It leads to massive health disparities because poor communities are more affected by these foods and are more targeted by them. 
  • Cognitive behavioral issues: Violence, conflict, depression, suicide
    • And I think our diet has changed so radically, not just in the last 10,000 years, but in the last 40 years with the advent of massive amounts of ultra processed food and that’s driving cognitive behavioral issues, violence, suicide, conflict, etc.
  • National security: It even threatens our national security because 70% of military recruits are unfit to fight and they are rejected

The good news?

  • All these issues are connected by food, they can all be solved by going to the root and fixing our food system. 

{end of show notes preview}

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Mark Hyman, M.D.

Dr. Hyman is the Head of Strategy and Innovation for the Cleveland Clinic Center for Functional Medicine, and founder and director of The UltraWellness Center. He is the bestselling author of numerous books, including Food: What the Heck Should I Cook?Food: What the Heck Should I Eat?Eat Fat, Get Thin, and The Blood Sugar Solution 10-Day Detox Diet.

Dr. Hyman believes that food has the power to change our most important global issues – transforming individual, environmental, economic, societal, and global health, and everything in between. [foodfixbook.com]

Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user's own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.


  1. I’d echo what some have said in that Mark maybe headed in the right direction his conflation and very loose of statistics is troubling. I’d go even further and suggest that it hurts his cause and that of good science. I’m a paying member because I look to you to vet, and challenge, people who are not rigorous and this episode left me wanting. I listened all the way through and looked for items to take away but it was brutal frankly.

    • I had the same thought. Peter’s podcast is probably my favorite podcast at the moment, and I was following his old blog maybe as far back as 10 years ago (not sure on the exact timing). But if the podcast turns into a platform to spread mis-information, I’ll definitely stop being a paying member. Given Peter’s typical rigor though, I’m hopeful and optimistic that this episode will look like a fluke in retrospect, rather than an indication of what we should expect to see more of.

    • I’m shocked that you are talking to someone who is espouses “functional medicine”, which any scientific thinker knows is quackery. I have counted on your rigorous thinking for guidance and now I feel really let down and unsure of trusting you.

      • I hope you remain healthy enough that you won’t need to visit his clinic . Many patients visit after failing conventional treatment. You don’t have to believe in functional medicine, but it’s an important option to have. Perhaps this interview will incite some curiosity

      • They didn’t talk about functional medicine as Peter noted in the beginning. And
        to base your trust doubts on one, admittedly lower quality podcast is frankly pretty
        thin skinned. Peter is great. May be he can talk to Dr Mercola 🙂

      • Dr. Attia was brilliant to interview Dr. Hyman. A few years ago Cleveland Clinic CEO Toby Cosgrove specifically invited Dr. Hyman to come to Cleveland to head a new Center for Functional Medicine. The Center has had positive results, their services are in very high demand with long wait lists, and the heads of many other departments consult with Dr. Hyman because they sense that their patients need more than they could offer. Hyman has been practicing since the 80’s and has seen tens of thousands of patients from very diverse backgrounds, so indeed he knows what he is talking about, at least with regard to human health. I truly respect and appreciate that he offers an abundance of educational content through his website, newsletters and YouTube videos, with no paywall whatsoever. (Nope, I have no relationship with him, but admittedly I became a fan years ago when viewing his older PBS programs.)

      • Renee,
        I think you are being extremely rude and ignorant. If anything, true Functional Medicine (IFM.org) goes further and fills gaps and has much better outcomes than our fragmented ultra specialized allopathic medicine which does very little in supporting patients overall and gets to root causes. Take a trip to Cleveland Clinic and talk with the CEO. They see the vision of precision and personalized medicine.

    • Great episode, I really believe that soil degradation due to our messed up food chain is humanity’s biggest problem right now.

  2. I just wanted to add my thoughts. I think this topic is very important and deserves much attention. I’ve always wondered exactly how much our food system contributed to chronic disease and how fixing this system could lead to better health. There are hints of this in Good Calories, Bad Calories and Omnivore’s Dilemma but of course not definite proof. I was hoping Dr. Hyman would explain the link in detail. I was very disappointed to hear him quote statistics figures but had no idea how they were calculated. It made his argument much less credible. This is the only episode of The Drive that I haven’t finished because he spent more time dodging questions than answering them. I would love to hear more about this topic but from another person in the field. I hope you and your team continue to produce the podcast as all other guests have been incredibly knowledgeable. I’ve recommended it to several patients and family members.

  3. Yikes, that was a gish-gallop of statements, thank you Dr. Attia for your great follow-ups for which there were insufficient responses. I fact-checked just one claim, that being that one-third of Medicare goes to diabetes. The source from the show notes was about Medicare spending on insulin, which is indeed a huge number at $18B/year, but is a single-digit contributor to total Medicare. The source does mention that one-third of all Medicare recipients have diabetes, but that does noy

  4. Peter,

    This episode was severely disappointing.

    Please warn the listener when your guests will be pitching panaceas. Furthermore, a disclaimer in your prologue regarding Functional Medicine would have been extremely helpful and appropriately framed the conversation (https://en.wikipedia.org/wiki/Functional_medicine).

    Grandiose claims, implied conspiracy theories, and strawman arguments from a naturopath are an insult to those doing the scientific research required to address these monumentally complex issues (e.g., climate change, metabolic disorders).

    You can do better

    • James, the quackery claim is made by one individual who appears to have been given considerable editing privileges on Wikipedia . . . I don’t know much about the individual, but perhaps it’s more apropos to seek the opinion of physicians, staff, and especially the CEO of Cleveland Clinic (who extended a personal invitation to Dr. Hyman to join CC). There he sees thousands of chronic disease patients for whom standard treatments had failed, and he improves their health trajectories by seeking root cause resolution.

  5. One of the most informative POD casts I’ve heard. Please explore the topics discussed in this POD cast on future episodes. The current U.S. food system is the root cause of so many critical problems.

  6. Superb podcast full of stimulating and encouraging information that I hope will encourage all who listen to do their part to address this crisis. As a physician (Ob/gyn) keenly aware of the degradation of our society’s health status, I love to hear there are providers that are going beyond our normal training ( treatment of disease ) and focusing on the multiple levels of disease prevention and health promotion. And even more importantly, “going upstream” to address the government policies and industrial practices that have and are contributing to these issues. Thank you Peter for developing this forum and getting these most excellent and informative guests on The Drive. You all inspire me and I am more knowledgeable on how I can help my patients and what I can do to be a part of the changes that need to be made to make us all healthier.

  7. Elements of Dr Hyman’s conversation are correct, some worth debating and important. However he was absolutely wrong in a number of his “facts” and glib in many of his generalizations. The organic industry absolutely uses pesticides, for example. Farmers are not dumb; if it were as easy as he makes out they would have made changes decades ago. The solutions are not as black and white nor as easy as he seems to wish.

  8. Functional medicine is not quackery. Most rational people realize that our health system is broken and it only by opening our minds to other more holistic treatment protocols that will be begin to solve some of today’s biggest issues. It’s actually returning medicine to its roots, using modern tools.

    • Julian: I agree that our health system is broken. It is quite excellent at handling emergencies (myocardial infarction, trauma etc.) but when it comes to chronic disease, we simply blunt symptoms with medications and “oversee the progression” of disease, rather than truly resolving root causes. Physicians are trapped in this system by no fault of their own. How to “manage the decline” of chronic disease patients is what they are taught, first by their med school professors and then by the drug reps who incessantly hound them. Most physicians know that modern medicine has been polluted by “perverse incentives”, but quite understandably, they feel powerless to change the system. Swift persecution and punishment come to many physicians who attempt to”go outside the box”. I am encouraged, however, when I consider that important medical knowledge has been gained by the brave souls willing to challenge the prevailing dictum. They were soundly mocked, and sometimes called quacks, before their contribution was respected up to many years later. They include
      (1) Dr. Semmelweis, who insisted that physicians wash their hands when going from the morgue to the delivery room
      (2) Dr. Barry Marshall, who had to infect himself w/H. Pylori before anyone would believe that a simple antibiotic, without surgery, could cure ulcers
      (3) Dr. Judah Folkman, who discovered tumor angiogenesis, was derided before his theory was proven. Before his death he wrote the insightful essay “Cancer without Disease”.
      (4) Dr. Lucien Israel’s idea of cancer combination therapy, DESPITE its effectiveness, was scoffed at by other oncologists who insisted that this life-extending therapy wasn’t scientific enough (“we won’t know which agent worked”). Indeed, saving lives is very much an art as well as a science.
      It is encouraging to know that change is always possible.

  9. I’m a practicing internal medicine physician in Canada. This podcast concerns me. First, I hope this isn’t a harbinger of the future, as it looks like Dr. Attia is lending what is currently a credible platform to those that are completely non-credible. It’s clear from listening to this and researching Dr. Hyman that he defines what any serious scientist would consider illegitimate. Thus, Dr. Attia’s choice to interview him begs the question: what did he have to gain?

    Second, it’s a shame he chose this “doctor” of all people, which has stained the discussion. This is a very interesting and important topic. A brief Pubmed search reveals some limited data that although fraught with serious confounders, does have positive signals for human health: PMID: 25970146, PMID: 29190113. However, anyone that spends time studying preventative medicine and diet related data knows that it’s almost impossible to separate the socioeconomic factors that confound the results.
    I have no idea how Hyman went from some limited datasets that are mostly hypothesis generating to spewing that organic agriculture is the panacea for all of the world’s issues. That’s actually what was said in this podcast. Complete nonsense.

    Dr. Attia. Do better. This is embarrassing.

  10. Interesting group of comments here. I can’t speak to the statistics or the medical issues although I think it’s pretty clear that eating a well-balanced whole food diet can prevent several diseases that most medical professionals just throw medications at, but anyway. I also won’t speak to the cat-fight going on between some of you MD’s and a guy who is a functional medicine practitioner talking about food. What I can speak to is that I grew up on a farm in NC that sprayed, where Mark is correct about the issues these farmers face, but in Denver I’ve also visited several farms that are carbon neutral or carbon positive and it’s really not that hard. They provide an immense amount of food to the community as well. I think if our culture continues to shift towards these smaller farms our broken medical and food systems will be far better off.

  11. Thought I would join into this convo as well, as this is indeed a difficult area to make sense of. Functional medicine is obviously fraught with landmines of quackery, and yet conversations like these, I find my objections are minimal. Who in their right mind could disagree with this sort of approach? The various claims are obviously where things get suspect, and of course they are not investigated, but the logic of approaching things, dare I say, holistically? There’s got to be something there that can improve chronic medicine.

    As someone who’s been swindled in the health space before, but as a result has developed a very skeptical eye, its horrifically frustrating trying to sort out reality in these situations. Back to the main point, we know functional medicine is a mine field, but we also know that the medical establishment has its perverse incentives as well, even if they do have more “evidence” behind them. That’s what I value so much about Peter’s show, his commitment to not just “evidence”, which for many people is just the existence of studies, but *quality* evidence. For me, someone coming on Peter’s show is validation of that person, and not vis-versa, but what disturbs me here is that the aforementioned land mines are not addressed. If Peter really is in on the game, just another salesmen I suppose(?), then I’d say he’s a pretty damn convincing one, honestly, we have more information than ever, and idk what to believe anymore…

  12. It is a sad day where well educated adults spend so much time bashing an elite podcaster just to try and shame him into not having diverse opinions that they disagree with. I applaud Peter for expanding the input to many diverse voices. Dr. Hyman is neither stupid nor a charlatan as many are suggesting. You can disagree with the premise of his argument without the vitriol. That being said, the variables around food and chemical exposure in general are so difficult to tease out to answer these questions irrefutably. Yet, that does not prove them false so much as unanswered. It is so obvious, to me, that the Tsimane Indians and other developing cultures are without our chronic diseases of aging and that modern societal choices regarding food, chemical exposure and stress are likely the main causes driving root dysfunctions of the immune metabolic nature.
    It is useful to disagree and have quality discourse however, please stop trying to cancel opinions and change discourse. Not useful in the long run.
    Thank you for all you do Peter,

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