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Cellular clean up by immune cells and how early-life fructose exposure leads to neurodevelopmental problems.

Episode Summary: Dr. Justin Perry talks about the body's constant cellular turnover—about 3 million cells die per second in adults (double in children and women)—handled by phagocytes like macrophages that engulf and digest debris to prevent diseases like lupus. They explore phagocytosis steps, macrophage adaptations in tissues like the brain (microglia), and how high fructose intake impairs microglial function in developing mice, leading to uncleared brain cells and anxiety-like behaviors, with implications for human neurodevelopmental disorders amid rising fructose consumption.

About the guest: Justin Perry, PhD is an immunologist and clinical psychologist who leads a lab at Memorial Sloan Kettering Cancer Center focusing on how the body clears dead cells and debris to maintain homeostasis.

Discussion Points:

• The body turns over 1-2% of its 30 trillion cells daily, mostly blood cells, but neurons in kids and endometrium in women turnover at ~2x this rate
• Phagocytosis involves "find me," "eat me," and digestion signals; failures can cause autoimmunity.
• Microglia are brain macrophages that uptake fructose via GLUT5 transporter.
• Early high fructose exposure (comparable to one soda daily) impairs the pruning of synapses and dead neurons.
• In mice, prenatal or postnatal fructose causes phagocytosis deficits in the prefrontal cortex, leading to heightened fear responses and poor fear extinction, mimicking anxiety disorders.
• Fructose correlates with rising neurodevelopmental issues like autism and anxiety; it's passed via breast milk, and liquid forms (e.g., sodas) overwhelm metabolic shields more than solid fruits.
• Macrophages may hold keys to diseases from atherosclerosis to cancer; deleting GLUT5 in microglia reverses fructose's effects, hinting at evolutionary roles in aging or low-oxygen states.

Related content:

• M&M 215: Cancer Metabolism: Sugar, Fructose, Lipids & Fasting | Gary Patti
• Article | Dietary Fructose & Metabolic Health: An Evolutionary Perspective

Reference Paper:

• Study | Early life high fructose impairs microglial phagocytosis and neurodevelopment

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The potential link between acetaminophen (Tylenol) and autism, with a surprise phone call from RFK partway through.

Episode Summary: Dr. William Parker talks about autism spectrum disorder (ASD), its rising prevalence since the 1980s, and the controversial hypothesis that acetaminophen exposure in susceptible infants and children triggers most cases via oxidative stress. They discuss ASD's clinical definition; historical misconceptions like the "refrigerator mother" theory; genetic susceptibilities; acetaminophen's metabolism, which produces toxic byproducts in underdeveloped livers, leading to brain effects.

About the guest: William Parker, PhD spent nearly 30 years as a professor at Duke University researching underlying causes of chronic conditions, including discovering the immune function of the human appendix and pioneering studies on immune systems in wild animals.

Discussion Points:

• Autism is a spectrum disorder with core symptoms like social deficits, repetitive behaviors, and aversion to new stimuli.
• Parker argues overwhelming evidence points to acetaminophen as the primary trigger in susceptible individuals, causing oxidative stress via toxic metabolite NAPQI.
• Acetaminophen, marketed as Tylenol or paracetamol, was not tested for neurodevelopmental effects in neonatal animals until 2014, despite widespread use since 1886; it's metabolized differently in babies, whose livers lack mature detox pathways.
• Susceptibility factors include low glutathione (an antioxidant), poor sulfation/glucuronidation metabolism, folate receptor autoantibodies, and events like immune reactions that prompt acetaminophen use during oxidative stress.
• Regressive autism, where children lose milestones after seeming normal, often follows acetaminophen given for fevers or illnesses, explaining parental vaccine suspicions (as shots coincide with drug use).
• Adult acetaminophen is generally safe but causes liver toxicity in overdoses or with alcohol; antidote is NAC to boost glutathione.
• Parker has suggested to policymakers that we should avoid acetaminophen during pregnancy, birth, and early childhood (under age 3-5); parents should plan ahead for fevers/pain without it, but seek medical help for unusual symptoms.

*Not medical advice.

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Wide release date: August 25, 2025

Episode Summary: Dr. Uffe Ravnskov talks about his decades-long career challenging the idea that high cholesterol causes heart disease, discussing LDL's protective role in the immune system by binding to bacteria, the harms and biases in statin research influenced by pharmaceutical companies, evidence that high cholesterol benefits the elderly and reduces infection/cancer risks, and how mental stress or infections elevate cholesterol as a response rather than a cause.

About the guest: Uffe Ravnskov, MD, PhD is a physician and independent researcher who earned his MD from the University of Copenhagen in 1961 and a PhD in nephrology. He has worked in various clinics in Sweden since the 1960s, focusing his research on challenging the cholesterol hypothesis in heart disease. Now 91, he has published over 200 papers, authored books like "The Cholesterol Myths.”

Discussion Points:

• LDL cholesterol helps the immune system by sticking to bacteria, clumping them for removal; low LDL increases infection risk.
• Animal studies show injecting LDL protects against lethal infections, while historical data links severe infections to worse atherosclerosis.
• Elderly people with high cholesterol live longer; low cholesterol raises mortality risk more than high levels.
• Familial hypercholesterolemia (FH) doesn't cause early death via cholesterol alone—co-inherited coagulation factors are the issue, and FH patients often have lower infection rates.
• Statins lower LDL but increase infection risk, cause muscle weakness/brain issues (often blamed on aging), and show no clear benefit in unbiased meta-analyses.
• Research biases include cherry-picking studies, exaggerating benefits via relative (not absolute) risk, and pharma funding suppressing critical views.
• Mental stress can raise cholesterol by 10-50% in 30 minutes, often misread as a heart disease cause rather than an effect.
• Saturated fat and high cholesterol aren't proven harmful; Ancel Keys' claims ignored contradictory evidence.
• Stopping statins often reverses side effects quickly, improving quality of life.

Related episode:

• M&M 244: Seed Oils & Heart Disease: Oxidized LDL, Cholesterol, Fat & Cardiology | Tucker Goodrich

Reference Paper:

• LDL-C does not cause cardiovascular diseas

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The appendix's hidden role and how "good" parasites like helminths shape immune health.

Episode Summary: Dr. William Parker discusses gut anatomy, the appendix's role in harboring beneficial bacterial biofilms and immune tissue, and how modern hygiene depletes helminths (intestinal worms), causing immune overreactions like allergies, autoimmunity, and psychiatric conditions. He explores helminth self-therapy for treating relapsing MS, depression, and allergies; challenges in clinical trials due to patent issues; and why COVID-19 was milder in low-income, helminth-rich regions.

About the guest: William Parker, PhD conducted research at Duke University for over 27 years on immunology, appendicitis, and the hygiene hypothesis. After retiring from Duke, he serves as a visiting scholar at the University of North Carolina at Chapel Hill, leading efforts on biome reconstitution via helminths.

Discussion Points:

• Appendix is not vestigial; it concentrates immune tissue and biofilms to cultivate good gut bacteria, preventing pathogens via mucus and IgA antibodies.
• Hygiene hypothesis: Soap, toilets, and clean water reduce helminths/protozoa, leading to untrained, hyperactive immunity and rising allergies/autoimmunity since the 1800s.
• Helminths (worms) stimulate immune "exercise," training immunity; biohackers use hookworms (cheap, skin-entry), porcine whipworms, or rat tapeworms orally for relief from allergies, MS flares, depression/anxiety.
• Effects are temporary; need ongoing exposure (e.g., replenish every 6 months); immigrants from helminth-rich areas develop Western diseases within a few years.
• COVID-19: Hyper-immunity caused severe reactions in hygienic West, but helminth presence in low-income Africa/Asia prevented cytokine storms, leading to empty clinics.
• Therapy barriers: Non-patentable organisms require $100M+ trials; push for open-source, government-funded biome restoration over crude immunosuppressants.

Related episode:

• M&M 144: Inflammation, Innate Immunity, Allergies & Allergens, Immune System Evolution, Fasting & Metabolism | Clare Bryant

*Not medical advice.

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What is the core evolved function of the endocannabinoid system?

Episode Summary: Dr. Giovanni Marsicano is a neuroscientist based in Bordeaux, France, where he leads a research group at INSERM focusing on the endocannabinoid system.

About the guest: Giovanni Marsicano, PhD discusses the endocannabinoid system, starting with its core components like CB1 receptors and lipid-based molecules derived from omega-6 fatty acids; its cellular signaling, evolutionary role in energy storage for uncertain futures (exostasis vs. homeostasis); effects across tissues; motivation, appetite, pain relief, and anxiety regulation; biphasic effects of cannabinoids.

Discussion Points:

• The endocannabinoid system acts as an "exostatic" regulator, promoting energy accumulation for future needs by enhancing food palatability, nutrient absorption, and fat storage, unlike "endostatic" systems that address immediate hunger.
• CB1 receptors appear in vertebrates with adipose tissue, suggesting an evolutionary link to storing fat for survival in unstable environments.
• Endocannabinoids are lipids from omega-6 fats; high intake boosts their levels, potentially fueling obesity by creating a self-perpetuating cycle of overeating.
• Activation of CB1 can have biphasic effects due to receptors on different cell types like excitatory vs. inhibitory neurons.
• Pregnenolone, a steroid precursor, acts as a natural CB1 inhibitor to prevent excessive activation, blocking harmful effects like psychosis from high THC doses.
• The system influences motivation beyond food, including sex and even human activities like sports or storytelling, by rewarding actions for potential future benefits.
• In the brain, CB1 on mitochondria and astrocytes modulates energy use, olfaction, and social stress transmission, with implications for disorders like Alzheimer's.

Reference Paper:

• CB1 Receptor as the Cornerstone of Exostasis

Related episode:

• M&M 123: Endocannabinoids, Stress, Anxiety, Cannabis | Matthew Hill

*Not medical advice.

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Overview and alternative interpretation to the mainstream view on how dietary fat and cholesterol relate to cardiovascular disease.

Episode Summary: Tucker Goodrich is an engineer by training who has become a prominent independent researcher and blogger on nutrition and metabolic health, focusing on the harms of seed oils and polyunsaturated fats.

About the guest: Nick Jikomes and Tucker Goodrich explore atherosclerosis and heart disease, critiquing the standard model that blames high LDL cholesterol while highlighting how oxidized LDL—driven by dietary linoleic acid from seed oils—plays a key role in plaque formation and inflammation; they discuss historical shifts in heart disease rates, genetic factors like familial hypercholesterolemia, the limitations of animal studies, and why reducing seed oil intake could prevent issues more effectively than just lowering cholesterol.

Discussion Points:

• Atherosclerosis involves plaque buildup in arteries, often leading to heart attacks, but plaques contain oxidized fats and cholesterol, not just native cholesterol.
• Dietary cholesterol has little impact on blood levels or heart disease in humans, unlike in rabbits used in many studies.
• High LDL may not be inherently bad; oxidized LDL from polyunsaturated fatty acids (PUFAs) like linoleic acid causes macrophages to overeat and form harmful foam cells.
• Familial hypercholesterolemia patients only show higher heart disease rates in modern, industrial diets high in seed oils, not historically.
• Populations like the Kitavans and Tsimané have high apoB but no heart disease on traditional diets low in industrial foods.
• Fried foods are oxidized seed oils, explaining why they're unhealthy despite omega-6 fats being labeled "heart-healthy."
• Omega-3 fats can displace omega-6 in cells, reducing oxidation risk.

Reference Papers:

• Witztum & Steinberg (1991)
• Boren et al. (2022)

Related episode:

• M&M 136: Seed Oils, Omega-6 PUFAs, Inflammation, Obesity, Diabetes, Chronic Disease & Metabolic Dysfunction | Chris Knobbe

*Not medical advice.

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Human metabolism, primate evolution, and modern health challenges with evolutionary anthropologist Herman Pontzer.

Episode Summary: Anthropologist Dr. Herman Pontzer discusses human evolution and metabolism, comparing humans to primates like chimps and gorillas to explain our higher energy use, bigger brains, and longer lives despite trade-offs in reproduction and activity; they discuss dietary shifts from plant-based to hunting-gathering, metabolic adaptations, and modern issues like obesity, where exercise aids health but diet drives weight loss, emphasizing ultra-processed foods' role in overeating and the promise of new drugs like GLP-1 agonists.

About the guest: Herman Pontzer, PhD is a professor of evolutionary anthropology and global health at Duke University. He is the author of books like "Burn" and "Adaptable," which explore how bodies adapt to diets, activity, and environments.

Discussion Points:

• Humans burn 20% more daily energy than other primates (controlling for body size), enabling big brains, more babies, and longer lives, but requiring efficient food strategies like hunting and gathering.
• Unlike apes, humans evolved smaller guts, higher body fat (15-30% vs. apes' <10%), and mixed diets of animal and plant foods.
• Hunter-gatherers like the Hadza are far more active than sedentary Westerners but burn similar calories, as bodies adapt by reducing basal metabolism, inflammation, and hormones.
• Obesity stems more from increased calorie intake via ultra-processed foods than it does from reduced activity; exercise boosts health but rarely causes major weight loss on its own.
• Early humans likely scavenged rancid meat, evidenced by low stomach pH similar to vultures, aiding digestion of risky foods.
• Ketosis isn't unique to high-meat diets; even Inuit on low-carb diets resist it, and other carnivores don't stay in ketosis constantly.
• Across global populations, richer countries have higher BMI and slightly higher total energy expenditure due to larger bodies, but basal rates drop with lower pathogen loads.
• For weight loss, Dr. Pontzer points to diets high in fiber/protein for satiety; intermittent fasting works by cutting calories, not magic; GLP-1 drugs mimic hormones to curb hunger, although we stay mindful of potential long-term effects.

Related episode:

• M&M 160: Diet, Hunting, Culture and Evolution of Paleolithic Humans & Hun

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The deep connection between sunlight and life, from the scale of the cosmos to the quantum.

Episode Summary: Astrophysicist Dr. Robert Fosbury discusses the sun's characteristics as a star, its analogies to living systems via entropy and complexity, and Erwin Schrödinger's insights on life as order-maintaining entities; he explores how near-infrared (NIR) light from the sun penetrates bodies to enhance mitochondrial function and metabolism, critiques modern artificial lighting's health impacts like mitochondrial dysfunction leading to diseases, and advocates returning to natural light environments for better wellness, drawing connections from cosmology to everyday architecture and lifestyle.

About the guest: Robert Fosbury, PhD is a is a retired astrophysicist. He spent his career at the European Space Agency, working on Hubble and JWST projects, and now pursues interdisciplinary research linking stellar phenomena to biological processes like light's impact on vision and metabolism.

Discussion Points:

• Stars like the sun maintain low-entropy states by exporting entropy as light, mirroring how life ingests low-entropy food to sustain order and homeostasis.
• The universe's complexity peaks midway in entropy increase, with stars producing elements that enable biological complexity, evolving toward cognition.
• Near-infrared light, peaking in solar output at ~1.6 microns due to atmospheric physics, catalyzes mitochondrial ATP production by facilitating electron transport, not via photosynthesis but photo-metabolism.
• Modern LEDs and windows block near-infrared, contributing to mitochondrial dysfunction, obesity, diabetes, and aging; historical thermal lights like incandescents provided beneficial infrared.
• Outdoor environments, especially under trees, flood bodies with reflected near-infrared for health, while blue skies act as cold sinks boosting thermodynamic efficiency.
• Eyes are mitochondria-rich, vulnerable to poor light; therapies using near-infrared slow macular degeneration by improving energy production.
• Ultra-processed foods are "high-entropy" with no structural order, akin to waste, reducing nutritional value for maintaining bodily order.
• Practical fixes: Use low-voltage incandescents indoors, prioritize outdoor time, design buildings with infrared-transmitting glass, and light people, not spaces, for energy savings and health.

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How brain synapses work and fuel themselves with fat.

Episode Summary: Dr. Timothy Ryan talks about the high energy costs of synapses, the role of mitochondria and glycolysis, and challenge the long-held view that the brain relies solely on glucose by discussing new evidence that neurons burn fats from lipid droplets for fuel, especially during activity. The talk touches on metabolic flexibility, links to epilepsy treatments like ketogenic diets, neurodegenerative diseases, and future research on brain energy sources.

About the guest: Timothy Ryan, PhD is a professor of biochemistry at Cornell University. His research focuses on the molecular mechanisms of synaptic transmission, particularly vesicle recycling and the bioenergetics that power neural communication. 

Discussion Points:

• Synapses are tiny structures with ~100 vesicles per site (on average), converting electrical signals to chemical ones.
• Brain tissue is energy-hungry due to trillions of synapses (in humans), relying on local mitochondria (present in only ~half of synapses) and glycolysis.
• Vesicles use proton pumps and transporters to concentrate neurotransmitters, requiring ATP to maintain gradients.
• Neurons are metabolically fragile; cutting fuel supply quickly impairs synapses.
• Dogma held brains don't burn fats, but new work shows neurons form lipid droplets (fat stores) that are invisible because constantly used for energy via beta-oxidation.
• Silencing neurons builds lipid droplets like resting muscle; activity speeds their breakdown, indicating demand-driven fat use.
• Inhibiting neuron-specific fat-processing enzymes accumulates droplets and induces torpor (hibernation-like state) in animals, signaling metabolic stress.
• Ketogenic diets aid epilepsy by shifting to ketones; fats may explain this, with potential ties to aging and neurodegeneration like Alzheimer's.
• Brain may be a "hybrid" fuel user (glucose + fats), with open questions on fat sources and roles in cognition or disease protection.

Related episode:

• M&M 158: Ketosis & Ketogenic Diet: Brain & Mental Health, Metabolism, Diet & Exercise, Cancer, Diabetes | Dominic D'Agostino

*Not medical advice.

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Episode Summary: Dr. Eugene Chang talks about the microbiome’s role as a vital organ, the impacts of antibiotics and Western diets on microbial health, and strategies for restoring a damaged microbiome through diet and fecal microbial transplants. They delve into microbiome dysbiosis, its links to modern diseases, and Chang’s research on personalized microbiome interventions.

About the guest: Eugene Chang, MD is a physician-scientist and Professor of Medicine at the University of Chicago, specializing in gastroenterology. His research focuses on the gut microbiome as a vital organ influencing metabolic and immune health.

Discussion Points:

• The gut microbiome is a vital organ, acquired early in life, that supports metabolic and immune functions, but can be disrupted by antibiotics, leading to diseases like C. difficile colitis.
• Western diets, high in saturated fats and low in fiber, contribute to microbiome dysbiosis, linked to modern conditions like inflammatory bowel diseases, obesity, and allergies.
• Microbiome health is better assessed by functional markers (e.g., short-chain fatty acid production) than taxonomic diversity, as diversity varies widely among healthy individuals.
• A patient with severe food intolerance due to antibiotic-induced microbiome damage was treated over 50 weeks with a tailored diet, restoring healthy microbiome function.
• Different dietary fibers (e.g., beans vs. seaweed) are metabolized at varying rates, affecting gut health; fermented foods like kefir can bypass digestion issues.
• Diet can rapidly reshape the microbiome within 24-48 hours, but severe dysbiosis may require microbial transplants if key microbes are extinct.
• Chang’s research shows a high-fiber, low-fat diet outperforms fecal microbial transplants in restoring microbiome resilience in mice post-antibiotics.
• Future microbiome medicine may involve personalized “omni microbial transplants” targeting both small and large intestines for comprehensive restoration.

Related episode:

• M&M 203: Metagenomics, Microbiome Transmission, Gut Microbiome in Health & Disease | Nicola Segata

*Not medical advice.

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