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Omega-6-9 Fats, Vegetable & Seed Oils, Sugar, Processed Food, Metabolic Health & Dietary Origins of Chronic Inflammatory Disease | Artemis Simopoulos | #134

Updated: Jan 10

Full AI-generated transcript below. Beware of typos & mistranslations!

Nick Jikomes 5:44

Can you start off by just telling everyone a little bit about who you are and what your scientific background is? Yes,

Artemis Simopoulos 5:52

I am the president of the Center for genetics, nutrition and health, which is a nonprofit educational organization in Washington DC. By training, I am a physician who specialized in endocrinology genetics. And with the emphasis on nutrition. I did my research at the National Institutes of Health. And I actually was the chair of the nutrition Coordinating Committee at the NIH, which subsequently coordinated the activities of all the other agencies within the Department of Health and Human Services. Then all the departments of the federal government that had nutrition programs, and eventually became the joint subcommittee for human nutrition research that operated out of the White House. Before that, I had been in academic medicine and having my boards in pediatrics and neonatology. I was the director of the newborn nursery at the George Washington University Hospital. And I was a professor in both pediatrics and obstetrics. Subsequent to my NIH training and chairmanship, I have also worked at the National Academy of Sciences.

Nick Jikomes 7:34

Okay, so you've, you've done quite a bit, and we're going to talk a lot about nutrition and diet and metabolism stuff today. All right, can you just start off by just describing for everyone in very sort of general terms? What are some of the key characteristics that distinguish a metabolically healthy person from a metabolically unhealthy person?

Artemis Simopoulos 7:54

Well, to begin with, all you have to do, you look at the person, make sure they are not overweight, or obese. A person who is overweight or obese cannot be considered healthy, because it carries risk factors that relate to chronic diseases. So if there are some obese persons who do not have metabolic changes, but these are very rare, the majority of the persons who have been studied extensively, and they are obese, they have risk factors that increase the cardiovascular disease, diabetes, arthritis, high blood pressure, and some forms of cancer. And all these diseases are related and are characterized by a degree of inflammation that is present throughout the body. So you can think them of chronic diseases and having a common denominator, which is inflammation, or you can think of inflammation as being at the base of all chronic diseases.

Nick Jikomes 9:14

And in general terms, we'll get into probably some more details later. Is inflammation a consequence of these diseases? Or is it part of the cause of these diseases?

Artemis Simopoulos 9:25

I think it's at the base, whether it is entirely the cause associated with other factors. I think the way to think of it is that inflammation is at the base of all chronic diseases that occur throughout the world. More so in countries where there is more obesity and diabetes and cardiovascular disease.

Nick Jikomes 9:49

And what for those that don't know I think we all have an intuition for what inflammation is, but physiologically at the cellular level, what exactly is inflammation? Yes,

Artemis Simopoulos 10:02

it inflammation is a condition of the cell. And eventually, the organ that the cells make up that particular order are characterized by higher levels are higher amounts in the cell, or the liver or the heart muscle of what we call substances that are called cytokines. And they are very much related to the production of cytokines, to the amount of the vegetable oils that we have in our diet, particularly the Omega six essential fatty acids, and the ratio of the Omega six essential fatty acids to the Omega threes, and quote Western diets are characterized by our high amounts of sunflower oil, safflower, corn oil, cottonseed oil, and soybean oil. These fatty acids are called the amount of omega six fatty acids in those oils, is extremely hard. For example, in the case of sunflower, which is very commonly used oil is 77%, or omega six, corn oil is a little bit less 63. But the high amounts of omega six fatty acids that are in our diet in the body in the cell are metabolized to substances that are pro inflammatory. By that we mean they increase the production of inflammatory substances that those, as I mentioned earlier, are called cytokines. And a lot of them are also prothrombotic. In other words, they make the blood thicker, and may lead to strokes. So it's prothrombotic and proinflammatory, during evolution will have equal amounts of essential fatty acids of omega six and Omega three from our diet, that after the Second World War, there has been an enormous production of the oils that are high in Omega six. And so the Western diets are characterized by high amounts of pro inflammatory metabolites or pro inflammatory substances that are the result of the metabolism of the Omega six in the cell. Whereas omega threes at the acids that are found, for example, in flaxseed, or in fish and fish oils, they are anti inflammatory and anti thrombotic. That's why you need to have them in equal amounts, the way we had them during evolution. Today, this ratio, it varies enormously, and you has from 10 to 15 to 20, to one that isn't consistent with health.

Nick Jikomes 13:29

So yeah, one of the things I wanted to talk about here is, you know, ancestral diets and human evolution. So, you know, for, you know, we're descended from our ancestors, and most of human evolutionary history was during the periods where we were hunter gatherers, before civilization before farming started, for, you know, hundreds and hundreds of 1000s of years we lived as hunter gatherers. The question I have for you is one thing that's very interesting to me here is, there are many different types of hunter gatherers all over the world. And they have very different diets, some of them and high fat, high protein diet, some of them had high carbohydrate diet. But despite all of those differences in that diversity in their diets, none of them really had the level of metabolic and inflammatory and chronic diseases that we do today. And so why is that is that they all have something in common to do with this omega six Omega three ratio, or, or why is it that you could have such vastly different diets, some high protein, high fat, some high carb, but you didn't have the chronic diseases in those traditional societies that we have so much today?

Artemis Simopoulos 14:34

Well, they did have but not to the extent that they exist today. Or for the last, I would say 50 to 70 years, particularly in Western cultures. Set certainly diet is one of the most important components in terms of health, but don't forget they were also much more physically active so you should not ignore Are the importance of physical activity, because it influences metabolism. And it influences brain development. And it's your brain that actually makes you think and makes you select what you eat or what you do. So let's go back about 10,000 years ago is usually the time where we think that people began to develop agriculture. And this agricultural development was not really industrial the way it is today, that hunter gatherers no matter where they were, they ate meat that they hunted. But that meat came from animals that were eating grass, they were not eating grains. And this is a really important aspect, because grass fed animal has a balanced Omega six to Omega three ratio, because grass contains alpha linoleic acid, which is the parent fatty acid of the Omega three family. So they they got a balanced ratio from eating meat, then the, the women would gather a master of their vegetables, vegetables are balanced in Omega six and Omega three slice fruit, they would collect the fruit of the tree. And as agriculture expanded, it really did not become an agriculture where the Omega six fatty acids predominated until after the first, particularly after the Second World War, where the was the agricultural development focused on producing animals, or increasing the weight of the animal over a short period of time. And in doing so they used grains rather than grass. So it was an economic as well as I would say, a food need, following the Second World War, to increase the production of protein, in this case, from animals. And definitely, in terms of the production of oils, it became very common to take all these previously used industrial oils, from sunflower and safflower, and change their taste, and use them for food production. It was also a way to increase the caloric content of the population, particularly in Europe after the Second World War, because there was a need for more calories. So there were a number of factors as well as the technology being there, to use it in a way where they felt it was needed in terms of caloric development, but in reality, they never focused on the ingredients and the composition of the diet. And that was a mistake, because they should have actually evaluated what happens when you have a tremendous production of, of products, food products for people that are very high in Omega six, and they're practically deficient in omega threes. And you ended up with a Western diet that is high in saturated fat, high in sugar, high in fructose corn syrup, high in sodium, and much higher amounts of saturated fat. All of these do not exist in this form, the way it has been the last 50 to 70 years. Going back to your question about hunter gatherers, yes, they had different amounts of protein and different amounts of carbohydrates that they did not have the problem of the pro inflammatory aspects of the diet that relate specifically to the amount of omega six fatty acids and a deficiency of omega threes. For example, when I describe the Greek egg you know, I was born in Greece, and we have a summer home and I was having coffee with my parents in the afternoon, and I saw chickens eating purslane and purslane is a wild plant that when I was at the NIH I had studied, and it has the highest amount of omega three fatty acids. But I never knew, or no one had described that purslane is a source of food for the chickens. And my father said to me, of course, they need to the chickens need to eat parsley, because if they don't eat parsley, they don't really make eggs that are actors in the parsley. In any event, when I came back to the NIH, I brought this eggs from Greece that they were boiled. So they can go through customs without any problem. And, to my surprise, when I compare the composition of the Greek egg to that of the egg from the Department of Agriculture, the ratio of omega six to Omega three in the Greek egg, it was one balanced, whereas that of the agriculture was about 12 to one. And then later on, as we did more and more, it averaged up to about 20 to one. So that it's not only you know, the protein and carbohydrate, the amounts is to look at the ingredients that make up the food supply, and understand their metabolism. And I think, whenever a new product is developed, you have to be certain as to what kind of changes take place, for example, in the ultra processed foods, they have very little in common from what you find in real food. And the milk that is made out of almonds, almond milk, it produces a lot more co2 during the process as you go from the almond, to the almond milk, which really does not make it a good product for the environment because it produces more co2. So if you want to think of the diets, you have to think in terms of the evolution for the worse, the changes that have taken place, the importance of the inflammatory components of these diets, the importance of the ratio. And as you continue to understand that you have to find out, you want to know, are they sustainable, these diets? What are the effects on the environment? What's the point of producing a food if you're going to increase the production of co2, which is about environmentally sustainable. So we really need to broaden our thinking, and our knowledge and the data are there. That's why I did the book. Because all this information is described in detail in the book. So it's not just the carbohydrate, and it's just not just the product.

Nick Jikomes 23:09

So we've got these two different polyunsaturated fatty acids, you've got omega six, and omega threes, the Omega sixes tend to be pro inflammatory, in general, in the Omega threes tend to be anti inflammatory in general. Can you unpack that a little bit more for us? What makes the Omega sixes pro inflammatory? And what are the Omega threes doing that causes them to be anti inflammatory? And why is our metabolism set up with these two different pathways that are sort of competing or imbalanced with each other,

Artemis Simopoulos 23:41

right. So, first of all, you have the you to know that the Omega six and Omega three are essential fatty acids, the body cannot make them we must take them from our diet. So that is a very important principle. And they have opposing properties. Once you have learned in your body, the Omega six develop into substances that are you know, the name is prostaglandins and leukotrienes. From the Omega six and the leukotrienes from the Omega six, they are pro inflammatory, and the prostaglandins from the Omega six or prothrombotic. But whereas those from the Omega threes, there, prostaglandins are less thrombotic. And the the local trains from the Omega threes are much, much less inflammatory. Therefore, since they have opposing properties inside the cell, there must be in equal amounts in the Diet, in order in the cell, there's a balance is maintained, so that the diet is a healthy diet, it's not a pro inflammatory diet. Now, because golf essential fatty acids, the Omega six and the Omega three are using the same enzymes in their metabolism. What happens if you have tremendous amounts of omega six fatty acids, they take over the metabolism, and the Omega threes cannot metabolize. So you become much more proinflammatory. Now, all these pathways are we call them they, they're, I would say, orchestrated by enzymes. And they are the same enzymes for the Omega six and the Omega threes going down to, I would say, prostaglandins and leukotrienes. But the most important aspect is that when you change the diet, and you end up with 20, times as much Omega six, as omega three is, it is a total imbalance throughout human metabolism. And since they use the same enzymes, if you have too much Omega six, they don't let the Omega three, the enzyme is not there to do its job for the Omega threes. Furthermore, there are genetic differences. And this is another very important concept. The enzymes that lead to the metabolism into prostaglandins and Luca trials are, they can vary there is genetic variation. So there are populations in various parts of the world where they have enzymes, that as you go down the metabolism, you end up with a much more rapid production of the prostaglandins and leukotrienes. So you not only have the issue of that, how much Omega six you have, how much of the metabolites you produce, but you have individuals with genetic variants, that they have a much more rapid metabolism. So a pro inflammatory diet, a Western diet, in an individual that carries this genetic variants is much more, I would say harmful than the one that does not have the very rapid type of enzyme enzymatic metabolism. Okay,

Nick Jikomes 27:54

so so to make sure I'm following so far, Omega six is omega threes, the Omega six fatty acids, which come from vegetable oils and things that we've developed

Artemis Simopoulos 28:03

relatively recently. Because the meat is grain fed, yes.

Nick Jikomes 28:07

And meats that are fed some of these things that have high omega six content, right? They tend to produce things that have a pro inflammatory effects. That includes you said, molecules are known as prostaglandins and leukotrienes. Yeah, and the Omega threes are slightly different polyunsaturated fatty acids, and they don't have this effect, or they lessen that inflammatory effect. Correct.

Artemis Simopoulos 28:30

And on top of that, you have individuals with genetic variants that exactly, exactly exaggerate this type of, I would say inequality. Yeah.

Nick Jikomes 28:42

So those people, those people would, yeah, yeah. So So those populations, if they're eating a modern Western diet that's high, it's got a high omega six to Omega three ratio. Not only are they going to have a pro inflammatory effects, it's going to be even greater than other people. Correct? Correct. What populations tend to have those variants more often? Well,

Artemis Simopoulos 29:03

they're, they're found throughout their populations, but then higher frequency is in African Americans, American Indians, indigenous populations, and Italy. And in, in Europe, within Europe, there is quite a variation, where as much as 50% of the population in certain countries can have their pro inflammatory, where in other countries, it is down to 30%. I see. So there's, so it varies, it varies with the ethnic groups, and it varies with racial groups. And yes,

Nick Jikomes 29:53

I see. And so you know, this could be one reason I suspect why. You know, if you just look at all the people Linear life around you. You know, there could be people in your own family, or that are your neighbors, and they're eating a comparable diet to you, but some of them, you know, might have more chronic disease and it could be related, like this metabolic effect.

Artemis Simopoulos 30:15

Yes. So the family history, the genetic variation, the Western diet, they all combine in to really leading to obesity, cardiovascular disease, diabetes, some forms of cancer, all of which can be modified through diet. That's why in all epidemiologic studies, can they evaluate the environmental factors and affect health, nutrition and diet? Number one, no matter where you do the studies, so we have to start thinking very seriously. And we've got to educate the population in the selection of foods, number one, and I think we need to work with industry and modify the production of the processed food. Because today, ultra processed foods provide 50 to 250 4% of calories for the average person. So the altar process foods that really do not have ingredients that come from foods account for a significant amount, over 50%. And when you look at in terms of calories, if you want to count calories, how many calories come from ultra processed foods, it's 72% in western diets, and that's why there are now many, many studies, epidemiologic studies that show the higher the intake of ultra processed foods. The higher the obesity, the higher the diabetes, the cardiovascular disease, hypertension, arthritis, arthritis is an inflammatory disease.

Nick Jikomes 32:09

Yeah, and I've even seen data that, you know, not only do we accumulate fat in our bodies, but the specific composition of that fat, the the individual fatty acids in our fat cells can be different. And, you know, one thing we haven't talked about yet are specific examples of, say omega sixes. So something like linoleic acid, I've seen data showing that, you know, when they look at studies over the decades, that biopsy the fat tissue from people, the linoleic acid, it's going up. So people's fat is not people are not only getting more fat tissue over time, or obesity, but the fat tissue itself is composed of higher and higher proportions of omega six fatty acids.

Artemis Simopoulos 32:49

Absolutely. And since you mentioned that, let me add that the Omega six fatty acids increase the production of the white adipose tissue, which the body stores does not metabolize, whereas the omega three fatty acids produce browning of their adipose tissue, which is energy expenditure. That's why a high omega six diet is associated with obesity. Clad hours, when you balance the ratio, you begin to lose weight. Because the composition of the adipose tissue values,

Nick Jikomes 33:31

and are there so there's this association that I think we've seen in humans, are there? Like animal studies? Is there preclinical work that's done cause and effect here? Like if you give animals more omega sixes and you take down their omega threes, does that cause them to become more obese?

Artemis Simopoulos 33:47

Yes, yes, the the model actually was the animal model. It was developed at Mass General by Dr. Alec leaf, who was at one time the director of Mass General, and a person who worked with him. Dr. Cohn, who is the Omega six Omega three model, which is a rodent, and what they have been able to do, they haven't been able to genetically modify their model saw that no matter what they feed, because it's very hard, you know, to do feeding status. The moment they balance the Omega six and omega three fatty acids, you can actually get a different picture of development of sepsis in the animal the development of infection Sometimes, Claire hours, when you have the animal that genetically is developing more of the metabolites of the Omega six fatty acids, they are very pro inflammatory. Whereas by using the model, or genetically, you have a balanced or a higher amount of omega threes, you can actually show that in the animal model, it has been shown over and over again, in many diseases. And now there are people who are looking specifically a genetic variance in depression, where the omega three fatty acids appear to be helpful, it's very difficult to treat depression, and there are not that many good drugs, so that people are doing some studies in Taiwan, in fact, Dr. Sue on the role of omega three fatty acids, in decreasing the rate of depression, and also the severity of the Depression. And there's some very good studies, since you're a neuroscientist on migraine headaches. And as you balance the Omega six Omega three ratio in the diet, which is not easy to do, in Western diet takes a lot of effort. You get the migraine, the frequency, and the severity of migraine, decreases. Animal studies and human studies. Interesting.

Nick Jikomes 36:33

What are these fatty acids, the Omega sixes, the omega threes, what are they doing in the brain in particular? Oh,

Artemis Simopoulos 36:41

that a number of things, for example, are the the omega three fatty acids metabolize down to EPA and DHA. And EPA is a lot more important in terms of the inflammatory state of the brain, where the DHA has to do a lot more with the actual metabolism of the brain in terms of maintaining neurons and the type of glial cells, which are the cells in the brain so that they metabolically control some of the functions of the brain, particularly in the hypothalamus. And most recently, in terms of the appetite, for example, if you feed adults, in fact, the study was done at Yale, you give them high amounts of sugar, and then you look into the brain through X rays to see what is the metabolism like, and when you use sugar, regular cane sugar, you don't really see that much activity at the appetite center. But when you use fructose corn syrup, you really see a lot of activity. So a combination that of having drinks, or foods high in fructose, and low in omega three fatty acids, which is what currently the diet consists of, it really increases the appetite. And it becomes very difficult to stay on a diet or eat less. And this is something that people are now focusing more and more, because many of the drugs that are being used. You know, the GLP is the new drugs. Yeah, they work through the appetite center. And so I could see that you could potentiate some of these effects through proper diet. In other words, avoid fructose and balance the Omega six Omega three or give them extra DHA.

Nick Jikomes 39:13

So having an unbalanced Omega six Omega three ratio with too much Omega six, and consuming fructose in particular, as opposed to other sugars. Those are those are both problematic and they probably exacerbate,

Artemis Simopoulos 39:29

they cooperate.

Nick Jikomes 39:32

Yes. And so one of the other things that I think is interesting here that you've written about, you know, when we think about hunger and appetite, and all of this stuff, you know, the brain is ultimately what's controlling how much you eat and what you decide to eat and stuff. One of the interesting things that you have written about and researched is the relationship between omega sixes and omega threes to the endogenous cannabinoid system, and how that ties into Oh

Artemis Simopoulos 40:00

yes, this is sort of a new area of research. And you know, the more omega six you have, the more the Endocannabinoid you produce. And the those endocannabinoids are also pro inflammatory. And, and so the idea is to begin to control the production of endocannabinoids. By having less Omega six, otherwise, you'll end up with much higher amounts. And so that people who are obese, they have high omega six, they have higher endocannabinoids, they have lower omega threes, because the Omega six and the Omega three produce different types of endocannabinoids. Okay, and so are the metabolism from the linoleic acid, which is the parent fatty acid down to like a Donek acid, and then through the enzymes to prostaglandins, and leukotrienes and cannabinoids, and then you have to think of the other side of the Omega three is alpha linolenic acid being the parent of fatty acid that produces EPA and DHA. And then the most recent studies, which I think are very important is that from EPA and DHA, you have further metabolites that go by the names of actually, medicines, which are neurotropic factors. And they now also, as you go from alpha linoleic acid omega threes to EPA and DHA to morass and sort of influence the neurotropic factors. And you get that right down on the one hand, in terms of their brain metabolism, in terms of the other in terms of the inflammatory aspects, so that you can cut down on inflammation by giving them some of the already formed substances. And this is a new area of research that I think is expanding a lot more in. And I think, once you understand, and you isolate the metabolites, and Dr. Serhan, at Harvard has done a lot of work in this area, you can actually then know how much you need to give off the metabolites from DHA, in order to either cut down the inflammation, or, for that matter, improved brain metabolism. So this is a very exciting area of research. So we take together the genetics, genetic variation, the evolutionary aspects of diet, and all these metabolic factors. And you can see that we cannot continue the food supply have high amounts of fat, high amounts of omega six, not enough fruits and vegetables, particularly green leafy vegetables, and, and then the enormous production of ultra processed thoughts. They're all against helps you no way you can actually have a healthy population, as long as we continue with the Western diet, and they increase production of ultra processed foods.

Nick Jikomes 43:55

So if you want a balanced ratio of omega six and omega threes, in our current modern food environment, it sounds like you have to do two things. One, you have to cut down the Omega sixes because they're so prevalent in our food supply. And, and you have to ensure that you get enough omega threes because those are so much less common. So taking those one at a time. You know, if I go to the grocery store today in the United States, what's the best way for me to cut back on my omega six intake?

Artemis Simopoulos 44:27

Very easy. To begin with, you don't use any of the oils that are high specifically, you should not buy sunflower or safflower or corn oil, or cottonseed oil or soybean oil. A lot of some people might tolerate soybean oil because only 39% Omega six and instead, you buy oils that are high in mono AMSAT naturopaths or that are high, or they have a balanced ratio of omega six and Omega three. So a high monounsaturated oil is olive oil. And olive oil, for example is 80% monounsaturated, and not only is a healthy oil in terms of the type of fatty acids, but it's also because it comes from the fruit of the olive, the fruit of the olive tree, which is the olive, you really have high amounts of antioxidants, which makes it a very inflammatory and a healthy oil. Another one is avocado oil is very high in monounsaturated fats. And then there are a number of oils that are made from, for example, on filberts hazelnuts in countries around the Black Sea that don't have olive trees, but they have a lot of hazelnuts. So the most commonly used oil there is oil made out of hazelnuts. And then there are oils that are high in omega threes. For example, flaxseed oil, is has a ratio of one to one omega six to Omega three. And many of the oils used in the Far East. They also are balanced in Omega six omega threes. chia oil used in South America is balanced in the Omega six and omega threes. So you have a combination of oils that you can use, I usually when I want to use a good oil on my salad, I would use extra virgin olive oil. But if I'm going to cook I can use regular oil is not as expensive and it does not really need to be extra virgin. And this is much cheaper where extra virgin is expensive. The can also combine any of the mono unsaturated oils, whether it is from avocado or whether it's from hazelnuts with canola oil, which is Canada oil, which is flaxseed. And you can combine that half olive oil or half monounsaturated oil and half of the balanced Omega six Omega three. So there are combinations that you can use, and people have been using them for a long time. That's one thing that follows the Omega six and then eat more fish. And you don't have to buy you know, the very expensive fish. You can buy sardines in a camp or herring, and they are very high in EPA and DHA. Salmon is very expensive. You know, and I always remind people that cost does not have any amounts of omega threes because all the Omega threes are in the liver. That's why people that's why liver oil for the vitamin D that's why they took it same time. They had they were lucky they had the Omega threes. So

Nick Jikomes 48:37

certain fish are high on omega threes. Salmon pairing sardines.

Artemis Simopoulos 48:43

Any other real Fish Blue Fish? Yes.

Nick Jikomes 48:47

And is there a difference between like wild caught fish versus farm raised fish? Yes,

Artemis Simopoulos 48:52

there's definitely a difference. Farm raised fish has more saturated fat and less omega threes than the same fish like salmon in the wild versus someone that is cultivated in aquaculture. But still, aquaculture keeps the amount of Omega three in good amount. So I would say bite. You should never use either one just because it's aquaculture and has a little bit less than usual and a little bit more of saturated fat. It is still a good source of Omega threes.

Nick Jikomes 49:40

I see. Um, is there any risk to cooking with any of the oils that you mentioned? Even like olive oil or avocado oil? Can those fatty acids become oxidized by high temperatures? Should people be concerned about how how high they're heating their food with?

Artemis Simopoulos 49:59

Well, it's not some match how, you know, Hi, what's the temperature they used to cooking as it is, if you fry, for example, you shouldn't use the same oil more than twice or three times. Most of the food in the US is fried rather than baked. And unfortunately, they use the same oil over and over again. So you not only have oxidized oil if you don't want to, but you also form trans fatty acids of high heat. But the more non saturated are the best in terms of maintaining their structure, and not oxidized as easily. And plenty not to eat too much fried food.

Nick Jikomes 50:56

How do you feel about coconut oil?

Artemis Simopoulos 51:00

How do I feel about coconut oil, coconut oil? Well, coconut oil is a vegetable oil, but the saturated fat, there is not much work, I would say if you happen to live in a country where they produce coconut oil like they do in Southeast Asia. And you have a diet that is consistent with that is not as bad as using coconut oil in western diets makes a difference what else you eat with that. And palm oil, really, I think it should be avoided except the one that comes directly from the fruit, not the one that comes from the curb. You know, there is a big concern about that.

Nick Jikomes 51:48

So it is it is a fundamental difference here. Whether the oil is extracted from the fruit of a plant versus the seed of a plant.

Artemis Simopoulos 51:57

Apparently, it makes a difference in the olive oil, the extra value and it just you press the fruit and there is no temperature or severe pressure. And it makes a difference in the pommel for you get it from the fruit, or from the kernel. I would not get anything from the carbonyl. The fruit I think is different because in addition to the fatty acid, you always have antioxidants and vitamins and minerals. It's a better source of food. I

Nick Jikomes 52:36

see. And so how should we think about saturated fat in general? Do you think people are eating too much saturated saturated fat? Does this tend to the saturated fat tend to have a pro inflammatory or anti inflammatory effect? Is it more saturated

Artemis Simopoulos 52:53

fat? Yeah, saturated fat is Dr. Amadori. And most traditional diets are not high in saturated fat Western diet is very high in saturated fat. I think the diet of correct when I calculate it was about eight to 10% rather than 20% as it is here. So you keep your saturated fats as low as you can, that I for example, for people who like to drink milk, I don't think you need to worry about skim milk, you know, you can have whole milk to drink or to cope with it's not. It's not that bad that using high amount of butter, which is actually a modified milk. In essence, you know, butter comes from dairy, but it's all saturated for milk because not all saturate has other aspects to it as well. So I personally recommend that if you like data on your toast, you certainly can use that. You can use half bath or half olive oil. If you're going to cook up mushrooms or artichokes, it gives you a better flavor. It isn't that much saturated fat. The traditional Greek diet is about 10% of saturated fat.

Nick Jikomes 54:22

And how do you so certain fish are a good source of Omega threes? A lot of people don't like fish or it's too expensive or they just don't like the taste or whatever. How do you feel about fish oil supplements? Because those are very popular and is there any risk to supplementing with fish oil supplements?

Artemis Simopoulos 54:40

Alright, let me back up a bit. When we did the studies on evolutionary aspects of diet and then on the diet have we discover that the Omega threes are present in every meal? So eating fish two three times a week is not the same as being on a traditional diet. have credit. And the only way to get close to the traditional diet of credit is actually dude to use fish oils, and take the capsules every day. And the amount that you take, I think just to maintain an adequate amount for metabolism is about a gram a day of EPA and DHA for the average person for those who have like history of heart disease, and they're over 50 years of age, but even the American Heart Association came around and now they recommend two grams per day. I don't think there are any side effects that would prevent me from recommending Who should I take some of the day? You know, in the field. Thanks. That was well? Well,

Nick Jikomes 55:59

I mean, my question here is related to you know, I've heard that a lot of the fish oil supplements are no good because they're made with rancid oils. So is that a factor here? And how do you select which fish oils to take?

Artemis Simopoulos 56:12

Well, that's it, the FDA does not take any responsibility, you know, of evaluating supplements and their exact amounts. So there is no way you can be absolutely certain that you are taking the right fish out. So how do you decide? I think you either talk to people who will know and to have analyzed it, or you can there are certain companies that are much more reliable than others in terms of the quality. Sooner or later, I think the FDA has to change its approach, but God knows when where you can do you can examine the composition of the sacrament and be stamped and know exactly what it is. But this does not exist today. So I would say it depends either on your physician or your dietitian, who they happen to know what are some of the better ones on the market?

Nick Jikomes 57:14

Which one do you take?

Artemis Simopoulos 57:17

puts you on it? I usually I don't make our soils. And I I take the ones that I think are very good. And while standardize that, um, I don't make any recommendations.

Nick Jikomes 57:36

Oh, I see. Okay. Yeah. Well, for those listening, the one that I take for what it's worth is Carlson's, and it's wild caught Norwegian Coldwater, salmon derived fish oil that is verified to contain fresh EPA. Okay, so what about Okay, so now now I want to talk about some other aspects of diet trends that are that are popular today. Some people are all about, you know, animal based foods, some people are all about plant based foods, vegan diets, things like that. So not everyone eats fish. So fish is a great source of Omega threes. What are the best? And I know that you've mentioned this already, but it's worth just saying it again, what are some of the plant based foods that have higher levels of omega threes and how do those compare to the fish oil in terms of the total amount of omega threes,

Artemis Simopoulos 58:27

right? So, alpha linolenic acid is the parent fatty acid that is found in you know, in Earth products rather than Aqua? The the amount that is present it in it varies. For example, green leafy vegetables all contain alpha linolenic acid, wild plants, like firstline contain higher amounts of alpha linolenic acid than spinach or lettuce. Now in for example, at Union Square market in New York City, they sell per slide and there are not a lot of people who grow it so it's not that you don't find it. Some purslane is a good source of alpha linolenic acid lessons spinach have less but they also have some amount of the alphabet and cash. Then when you think in terms of the actual all ales, perilla oil, which is the oil that they use in the Far East, is about almost 70% on regulatory so the Japanese who use thriller they They get enough alpha linolenic acid, which is in the body can be metabolized, but they also eat a lot of fish at the same time. And so a diet like the Japanese, they get the Omega threes from their oils, as well as their fish. Now how it compares. And it's fairly difficult to compare that the amount that is considered them, you know, the one could recommend of alpha linoleic acid could be about, you know, one, or 1% of the fatty acids, or up to 2%, you don't really need a very high amount the fish oils for in terms of the of the fish and where it comes from. Certainly tuna, and salmon, and blue fish. And sardines, and herring are the highest amounts that you would use that if you were to eat a diet, like the the traditional diets, you would get your alpha linolenic acid from your green leafy vegetables, you would get it from all the legumes, you know, rice and beans is a very good combination beans contain alpha linolenic acid, all traditional diets, when you go down to them, you'll see that they had alpha linolenic acid, they had EPA, they had DHA, they had adequate amounts of omega six in terms of anecdotic acid. And so and then the animals that the word grass fed, they had the balanced amounts in their, in their meat, the grass fed. And so you have to think of green leafy vegetables, you have to think of legumes as alpha linolenic acid, you have to think of fish in the various types. And then you have to think of the oils that you're going to use to cook. So you really need to think about all of this in order to have a healthy diet.

Nick Jikomes 1:02:26

So our foods with high omega six content and a very high omega six Omega three ratio, are they just absent in nature. And that's why no traditional culture has had a skewed Omega six ratio.

Artemis Simopoulos 1:02:43

Obviously, they are never part of the evolutionary aspects of diet in those Imams never. These are add ons, that the high amounts that we have today of omega six is the result of the food industry and food technology that became very prominent after the Second World War. Also they're able to produce and they're very cheap. And it's the economic aspects. When you don't, can you remove all the industrialization out of the food supply? Everything else is balanced. This is a human production. And Ultra processed foods is the worst example of it right now. We didn't have that problem 20 years ago, not to the degree that exists today. As far as all the other new products that come from plant sources are you know, for example, you have chicken nuggets that are not meat, you have fish, that is not fish. You have hamburgers, that is not meat. I personally do not recommend any of them for tourism's. I know in their production, they increase the co2, so they're not good for the environment, and they are not sustainable diets. And number two, nobody seems to know the ingredients that are there in detail. And of course, they do on their evaluate in terms of molecular biology methods. We find out that if you take a grass fed hamburger, and then you take one that is made out of plant, the composition is at a molecular level is very different. There's one of them, I don't know what is the function of all this new peptides that are now I'll found in the I call them fake foods,

Nick Jikomes 1:05:05

assuming you mean things we've never even seen before. We don't know what they are at all.

Artemis Simopoulos 1:05:09

Yeah, so I've never, I'm telling you on 72% of calories comes from ultra process is an enormous amount of calories, and 150 4% of the foods are ultra processed, is a real problem. People are concerned. And I think there's a reason to be concerned. And I think the lower you are on the scale of food production, the better you're off in terms of the composition. Because remember, we, as human beings are, more or less, I would say, ordered by our genes. And our genes were programmed through evolution, to respond to another environmental factors, and to a number of ingredients in the food supply. So when you give them 54%, the majority of the foods are foreign to the genes, the genes do not know how to adapt. And then you have the genetic variant. That's why I think it's very important to understand what makes a food appropriate for a human being, and what scale of evolution you're going to consider. And don't forget, that environment is very important. And it's influenced by the production of all this ultra processed foods. So I diet has to be healthy, balanced and sustainable. For the environment.

Nick Jikomes 1:06:53

Do we know what the Omega six Omega three content is of the new plant based meat products like Beyond Meat and things like that? I

Artemis Simopoulos 1:07:04

have never seen any data on any of that.

Nick Jikomes 1:07:10

So so it's an it's a no, no.

Artemis Simopoulos 1:07:13

I know that through fermentation, there are all kinds of companies in the US and outside of the US are they're trying to remove the Omega six fatty acids from the oils. So all right, the industry knows that this is a problem and they're moving in a direction. I don't know how long it will take before it reaches the market and that you don't need to go through fermentation, you can just avoid and need the type that's available around.

Nick Jikomes 1:07:44

So how important so obviously, you think the Omega six Omega three ratio is critically important. Do you think that's the most important factor in our diet today in terms of macronutrients? Do you think it's equally important or comparable important to things like sugar and fructose intake? What are the other key sort of levers people can pull besides the Omega six omega? Okay,

Artemis Simopoulos 1:08:05

I think the most important is the Omega six Omega three because they are essential fatty acids, the body cannot make them they are taught that the body is entirely dependent on the food supply to have a balanced Omega six Omega three. Also we have a lot of information, what the imbalance does to the body. Okay, now, certainly sugar a webisode was never part of the evolution, or aspects of diet. People had handy, but Handy was in small amounts. They never had this enormous amount of sugar in in the food you eat for breakfast, lunch and dinner. It was never part of that. So you should limit your sugar. You should definitely avoid any fructose or fructose syrup that don't belong into the healthy diet.

Nick Jikomes 1:09:04

What about found in fruits? And what about whole fruits? Don't they contain fructose?

Artemis Simopoulos 1:09:14

Yes, but they also contain a lot of other factors and they contain very small amounts of fructose. It's the concentration of pure fructose of fructose corn syrup and seem to have this adverse effect on brain an appetite.

Nick Jikomes 1:09:31

Yeah, so it's just it's just a highly concentrated form of fructose. Yes, yeah. Yeah, I had I'll share a story with the audience real quick and probably comment on this. I, I'm not diabetic, but I got a heart monitor a couple years ago, just to check my blood sugar and see how it reacted to the foods I was eating. And at that time of my life, I would often at breakfast time I would eat what I thought was a nice, healthy cereal. You know, it's whole grains but high vitamins, no added sugar. Um, you know, as it said on the box, but what I didn't pay attention to is it had its ingredients, high fructose corn syrup, and my that cereal that supposedly heart healthy cereal spiked my blood sugar more than anything else I was eating. It was it was not even close. And so I think it was the high fructose corn syrup. And that's what you're saying. It's just that that ingredient in particular is just so concentrated? Yes.

Artemis Simopoulos 1:10:24

Yes. Because it also interferes with liver metabolism, you know, fructose or directly to the liver and becomes fat triglycerides. So it really affects the whole liver metabolism. And if you happen to have a gene that is sensitive, let's say, or is not completely normal in terms of your fat metabolism, you end up with very high triglycerides. High triglyceride is the risk factor for heart disease.

Nick Jikomes 1:10:59

So the heart rate, high triglyceride levels in your blood coming from the liver doesn't come from fat, it comes from dietary

Artemis Simopoulos 1:11:08

sugar. A lot of it is from fructose. I see. It's heavy requires you Yes.

Nick Jikomes 1:11:16

What, um, can you talk to people a little bit about, you know, the book you've written and where they can find it and things like that? What, what's the title of your book? And oh, God, can people find it. So

Artemis Simopoulos 1:11:29

I personally feel that we need to educate the public as much as we can, so they can make the right selection, because you cannot depend on that Teddy guidelines that come from various organizations, because science is also political. And then you're better off for you to agitate yourself. And you can, there are a lot of very good papers and reviews and medical literature. But I felt that I had to write a book that emphasizes the political, the scientific, the agricultural, and the health aspects of our food, both nationally and internationally. Because we're now talking terms about, you know, global health, nothing is limited in, you know, an area. So the book is called the healthiest diet for you, scientific aspects and consists of 13 chapters. And then I discussed the evolutionary aspects of diet, the exercise, composition of the food, the importance of aging, what affects aging, and whether you can delay aging through through diet, and also discussing when I was at the NIH, and there were committees on the Hill, particularly the committee, the McGovern committee that developed the first dietary guidelines, actually what they did, they wanted to tell, everybody wants to eat. And they call them dietary goals. And at that time, I was the chair of the nutrition Coordinating Committee of the NIH. So they sent the report to us to review it, and I had to write the review of their dietary goals. And I pointed out that you cannot have the same quantitative recommendations for everybody. Because a dietary goal that depends on the exact amount for everybody is scientifically incorrect. What you can have is you can have guidelines and modify them accordingly, based on their family history, their genetics, and the food supply that is available where they live. And it's interesting that that goes back in 1977. And three years ago, NIH developed a program called all of us, which is they're standing genetic variation in the population. And just two years ago, they started the personalized nutrition program. It took that long, but at least who stopped it. The NIH is a very important scientific agency and probably the jewel in the crown of all the agencies of the federal government. And we did not hesitate to tell them exactly, because they didn't like it. But they also knew that there was enough scientific evidence of what we said because we never Say anything that didn't, was not referenced properly. And so that I think it was a very important part of the job I had and what I did. It also sensitized me to how industry functions, how Congress functions. What happens in terms of the pharmaceutical industry? Why would you have a food supply? When you know, it's not consistent with evolution? That I guess you need to have more science out to the public. And I wrote the book, because I wanted all of this information to be available to anyone who's interested and educated. But also the books would be read, you know, by high school teachers and taught in high school, I think, medical schools, schools of public health, because it's the only book that brings everything together in terms of the science, politics, evolution, global issues. And, unfortunately, what is going on today with the fake foods and ultra process.

Nick Jikomes 1:16:18

Based on all of your experience at the NIH and elsewhere, how much influence does the food industry have over the construction of things like the dietary guidelines that we get from federal agencies,

Artemis Simopoulos 1:16:34

more so than any other group? So you really have to work with food industry. Or you have to develop a mechanism where it's regulated a bit more than it is, including, you know, they're standardizing the various supplements, because there's no question that there are deficiencies in the diet, and there are people because of the way they select food, they would efficient, and they are going to need supplements. But I think all supplements need to be standardized, or at least know exactly what's in it. That is an important aspect.

Nick Jikomes 1:17:20

You know, you briefly mentioned earlier, this new class of drugs that's being heavily marketed right now, as a weight loss drug, as Empik is the name of one of them. How do you feel about these drugs? How do they work? And do you think they're going to work? Well, do you think they're going to cause any unforeseen problems based on how they work? Yeah, thoughts?

Artemis Simopoulos 1:17:41

You're talking the ones that are based on the GLP? One? Yes, yes, yes. Like semaglutide. And elimite tell you Science Magazine selected as being the most important, I would say event in science, the result of the clinical studies, and they are very impressive. Because what they do, they work on the appetite center. And they decrease the appetite. So people do not eat as much, and they lose weight. This is a fundamental aspect. They also the way that they lose is very significant, as much as you know, 15% over a period of a year or a year and a half. When you stop them, part of that weight is regain. So there are two questions. One is, what does it mean? Are you going to have a population that gets an injection once a week to lose weight? Starting, let's say in adolescence, because we have now evidence that children are heavier, adolescents are heavier and in larger numbers, is this something that is going to the question is, is this something that is going to have to give it for the rest of the life of the particular individual, or along the way we might be able to modify so that you're not going to worry about how long you're going to give it to a person who is obese. But I think it's the best thing that ever happened. I think it's a very good reason to see why it works. It has to do how much you eat, it controls how much great now there are some people who can do that without the drug. That's how they keep their weight. And then don't forget that the omega three fatty acids decrease appetite. So I would probably like To see a study where the drug is combined with modification of the diet or other components, so that you may not have to worry about side effects, because so far, the side effects are mostly nausea, and the GI tract, that's where they are. But like any new drug you need to follow very carefully. But it is the major discovery and the clinical studies that have been published so far. They show that the side effect is minimal, but for how long you're going to give it and what does that mean, both in terms of economics, because it takes about what is it $1,000 A month?

Nick Jikomes 1:20:47

1000 bucks a month? Yeah, well, so

Artemis Simopoulos 1:20:51

the price is an issue. You have to figure out, if we're going to keep somebody sane, and they're not going to get heart disease or diabetes, then you save on the health care delivery system, which means then the government has to cut down the price. I mean, these are things to consider.

Nick Jikomes 1:21:13

Do you think there's any risk that people taking that drug will simply eat less of the diet they're already eating? In other words, if someone has an imbalanced Omega six Omega three ratio that's pro inflammatory? Perhaps they're eating less of it, but they're still eating that imbalanced diet? And do you think that could be a problem, but I

Artemis Simopoulos 1:21:34

think it's very important to make sure you have a healthy diet and balanced diet, with adequate vitamins and minerals and fiber plus the drug to to help the brain or the appetite center is less.

Nick Jikomes 1:21:57

So they're losing about 50% body weight?

Artemis Simopoulos 1:22:01

One, five, yes. 15. One 5% on 5%? You know,

Nick Jikomes 1:22:05

I've heard, I've heard that they're losing a mixture of both fat and muscle. Is that true? Is that concerning? Anytime

Artemis Simopoulos 1:22:13

you lose weight, you lose both. Every time you lose weight.

Nick Jikomes 1:22:25

So we've we've discussed a lot today, we talked a lot about the Omega six Omega three ratio. We talked about fructose, we talked about a lot of detail related to those aspects of diet. Is there anything else that you want to add that we didn't discuss, or anything you want to reiterate for people that you think is really important for them to just go home with?

Artemis Simopoulos 1:22:45

Well, I think your questions were very good. And it covered a lot of the things that I think the public ought to know. Because one of the reasons for having the podcast or for writing the book, is to make sure to stimulate people to begin to have expand their knowledge about the food supply, and how to select food, and how to use food and physical activity to maintain health. So I was going to say that in the back of the book, there is a chapter where it tells you what to shop, what to avoid, which foods to buy. And the difference. For example, you know, people like to snack and Americans more so than any other group of people. And I was pointing out in the book, and I think it's important to consider in the winter, for example, I like to have as a snack, figs, this dry figs, and you stop them with either almonds, and then you increase the protein intake of the snack. Or I put walnuts and I increase the Omega three part of the snack, which is very different from having a chocolate chip cookie made with fructose. And that's what I really want to finish with pointing out that you really once you have the knowledge, it becomes easier to make changes and at the same time to select the most appropriate food for you. Because diet is the most important environmental factor in maintaining health. No question about that.

Nick Jikomes 1:24:34

So it sounds like two big things that you would recommend to people are, do your best to figure out how to get a balanced Omega six Omega three ratio as close to that as you can, and basically to avoid fructose and high fructose corn syrup and similar things as much as possible.

Artemis Simopoulos 1:24:49

And Ultra processed foods tried to eat fluid, as close to its origin as possible. Yes.

Nick Jikomes 1:25:01

Okay, one more time. Tell everyone, what's the name of your book and who you are.

Artemis Simopoulos 1:25:04

Yeah, I have a copy of the book. He wanted to show the book. Yeah, go for it. Okay. So this is the cover of the book. And it. This, of course, is a great column, the Greek food guide or a column,

Nick Jikomes 1:25:20

can you hold it up? A little bit more, but

Artemis Simopoulos 1:25:23

you should be. Yeah, there you go. You see, at the top, it all tells you, you know, what, sort of, it's a Monday, Tuesday, Wednesday over a week, and then the type of foods that you should eat plenty of. And then various activities, exercise be an important aspect. And knowing your family history and genetics, just eating one or two foods is not going to make a difference, you need to bring everything together. And I think, and then in the back, it just describes some of the things I have done. I should also tell you that the book is available online. And it is available to download freight. And so far, there have been 1000s of books that have been downloaded. Also, what I showed you is the hardcover of the book that people can buy that because I wanted people to expand their knowledge in terms of a healthy diet, healthy lifestyle, physical activity, and avoid chronic diseases. I felt that the only way to reach more people is to make it freely available to download. And so far, it's just done exceptionally while I'm very, very pleased with the interest of people in the book. Yeah, well, thank you for doing that. It's been translated into Greek. And now we're considering a Chinese translation.

Nick Jikomes 1:27:03

Excellent. Well, I'll put a link to that in the episode description so people can find it very easily. Once again, thank you for your time. This was fascinating. I enjoyed reading your stuff, and I really appreciate it.

Artemis Simopoulos 1:27:14

Well, thank you very much for the opportunity to do the podcast with you. Thank you very much.


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