#121: Simon Hill - The Proof, the Whole Proof, and Nothing But the Proof (Plant Proof, That Is)
Rip welcomes nutritionist, author, and podcaster, Simon Hill, to the podcast for an in-depth discussion of his new book, The Proof is in the Plants.
It's hard to imagine the life-long impact of seeing your own father have a heart-attack, but Hill has taken that harrowing experience as a teenager and turned it into his mission-driven work to help save the lives of countless others.
Today, Simon is passionate about making nutritional information simple and accessible so that people can make informed decisions about the food they feed themselves and their family.
Inspired by the work of his father, he is also a walking encyclopedia on the research and science that proves beyond the kale that a plant-based diet can save your life –and the planet.
They discuss:
The Diet of Confusion - Why the food industry is set up against us
Progress we are making in governments around the world and the work that still needs to be done
Is chronic lifestyle disease simply "in our genes?" How much control do we really have with the cards we were dealt?
Simon's largest recommendation for better health - FIBER
Why is fiber so important to our health and gut microbiome?
Simon's top foods we should avoid
Recommendations for helping people make the shift in their own lives
The vast plant-proof research around - cancer, heart disease, and brain health
Research and studies on minerals and supplements like iodine and zinc
This conversation is jam-packed with all the proof you need because, as you’ll hear loud and clear, the proof is in the plants.
About Simon Hill
Simon Hill is the founder of the hugely popular Plant Proof podcast and blog of the same name, and a nutritionist and qualified physiotherapist. On top of his formal education, Simon spends hours and hours deciphering scientific studies so he can break down how to fuel your body to promote longevity and reduce the chance of developing disease while simultaneously achieving whatever health and fitness goals you may have. He is the plant-based food contributor to Chris Hemsworth’s fitness app, Centr, and in 2019 Simon opened a plant-based restaurant, Eden, in his Sydney neighbourhood of Bondi.
Episode and PLANTSTRONG Resources:
PLANTSTRONG just announced our 2022 retreats and you’re invited to relax, refresh and recharge with us. Join us March 1st to the 6th in majestic Black Mountain or October 10th to the 15th in stunning Sedona. For details on both, go to plantstrong.com and select the locations from the menu.
Also - great news! Our PLANTSTRONG unsalted organic broths and ready-to-eat chilis and stews are now available nationwide thru plantstrongfoods.com. We’ve just unveiled our sampler packs so you can try one of each flavor - and you can enjoy free shipping when you spend $60 or more!
Simon Hill Website and Resources
Join the free PLANTSTRONG Community
Full YouTube Transcript
Simon Hill:
For most of these diseases, they're running in our families, not because of genetics, but because within families, we're making the same lifestyle decisions. Right. And so you mentioned there, a lot of people will say, "Well, high cholesterol runs in my family or high blood pressure runs in my family." And look, to a certain extent, that could be true, but keep in mind that it may be running in your family because your family is adopting the same lifestyle. And what that means is that there is a strong chance that if you make changes to your lifestyle, particularly your diet, which we know is the biggest lever that you can start shifting the blood pressure, the cholesterol into a favorable direction, which then is lowering your risk of these diseases, particularly your risk of having a heart attack or a stroke, which leading cause of death in this country.
Rip Esselstyn:
I'm Rip Esselstyn, and welcome to the PLANTSTRONG podcast. The mission at PLANTSTRONG is to further the advancement of all things within the plant-based movement. We advocate for the scientifically proven benefits of plant-based living and envision a world that universally understands, promotes and prescribes plants as a solution to empowering your health, enhancing your performance, restoring the environment and becoming better guardians to the animals we share this planet with. We welcome you wherever you are on your PLANTSTRONG journey. And I hope that you enjoy the show.
Rip Esselstyn:
Hello, my PLANTSTRONG cousins. I want to welcome you to another episode of the PLANTSTRONG podcast. I am your host, Rip Esselstyn, and I hope that you've all had a spectacular Thanksgiving holiday and, as we head into the rest of the holiday season, your spirits are high. I think that you know by now that our team here at PLANTSTRONG is always seeking the truth about health, nutrition, and research because the proof truly is in the truth. The proof is also in the plants and no one epitomizes that more than today's guest, Simon Hill. If you don't know who Simon is, he is the host of the wildly popular Plant Proof podcast. And he's also the author of the new book that just landed in the United States, The Proof is in the Plants.
Rip Esselstyn:
He is a physiotherapist and nutritionist who is passionate about making nutritional information simple and accessible so that people can make informed decisions about the food they feed themselves and their family. He is also, as you're going to see, a walking encyclopedia on the research and the science that proves, beyond the kale, that a plant-based diet can save your life and the life of the planet.
Rip Esselstyn:
Today, we go deep on a number of different topics that I know you're going to love. It was a treat to have this stud of an Aussie right here in Austin, Texas. And I want you to know that I squeezed as much information as I could out of him, and I am so grateful to Simon for being so generous with his time and his knowledge. Now, before we hop into this kind conversation, I want to share a couple of updates with you.
Rip Esselstyn:
First, we just announced our 2022 retreats, and you're invited to relax, refresh, and recharge with us. You can join us March 1st to the 6th in majestic Black Mountain, North Carolina, right outside of Asheville or October 10th to the 15th in stunning Sedona. For details on either, go to PLANTSTRONG.com and select the location from the menu. Also, more great news, our PLANTSTRONG unsalted, organic broths and ready-to-eat chilis and stews are now available nationwide through PLANTSTRONGfoods.com. We've just unveiled our sampler packs. So you can try one of each flavor and you can enjoy free shipping when you spend $60 or more. Now, my cruciferous cousins, let's get into this conversation because it is jam packed with proof from Mr. Plant Proof himself, Simon Hill.
Rip Esselstyn:
Simon Hill, great to see you again.
Simon Hill:
Rip, it's a pleasure to be here back in Austin. I'm glad we're doing this in person.
Rip Esselstyn:
Me, too. It's been a long time. I haven't done many of these in person in about two years. So I might be a little rusty I'm so used to seeing people on a screen.
Simon Hill:
I know the feeling I know. Yeah. Human-to-human contact. Who we are. It is different, but it's nice.
Rip Esselstyn:
It is. Although, you know who was just in town in Austin as well, I think you saw him, was Rich.
Simon Hill:
Yeah.
Rip Esselstyn:
Rich [Role 00:05:21].
Simon Hill:
Yeah.
Rip Esselstyn:
And so I was with Rich. He was sitting right where you are.
Simon Hill:
Okay.
Rip Esselstyn:
Exactly a week ago Friday.
Simon Hill:
Yeah, he told me about that. I bet that was a good conversation.
Rip Esselstyn:
Oh, yeah. It was.
Simon Hill:
Yeah. He's a great guy.
Rip Esselstyn:
Absolutely. Can't say enough good things about Rich. So I think the last time I saw you, you were in Austin and then you had me on your podcast.
Simon Hill:
Yes, which is still to this day one of the most popular episodes.
Rip Esselstyn:
Well, that's nice to know, but it is called the Plant Proof podcast. And you launched that, what, three years ago?
Simon Hill:
Yeah. I started that in, I think, the start of 2018, the very beginning. So nearly, it'll be four years pretty soon. Really didn't know what I was getting into.
Rip Esselstyn:
Do we ever?
Simon Hill:
And I think that was actually what enabled me to get started because I had no sort expectations or fear. I just kind of turned up and started recording, and I would hate to probably go back and listen to those first ever episodes, but it's been fun. You learn something every time, right? And you just get better and better and you feel more comfortable, and it's such a great way to learn and share information with other people.
Rip Esselstyn:
Yeah. But a long time ago, it seems like... I mean, the name of your podcast, the Plant Proof Podcast, the name of your new book, The Proof is in the Plants, so at some point, when did you decide to become a man of science? You got to prove it, right? Show me the proof. The proof is in the science. Tell me about that journey.
Simon Hill:
I think that was drilled into me by my father. He's a 40 year professor now. He's been publishing studies for the last four decades, pretty much, since he did his PhD actually here in Texas. So it all started here in Texas. He did his PhD in physiology at Texas A&M and has gone on to have a very successful career in science. His area of science is sort of deep mechanisms under a microscope looking at how our arteries function and looking at risk factors for cardiovascular disease, type two diabetes, etc. Now, all of that really meant nothing to me as a kid, but I could see how important science was to him.
Simon Hill:
And he would teach me little things along the way, and there was stacks and stacks of papers always printed out or all around the house and in his car and highlighted. So I really appreciated the role of science I guess in helping us look at what does our intuition say? What are our hypotheses and how can we use this method of science to test that and then make more informed decisions? So yeah, it really goes back to my childhood, I guess. It's kind of all I know and all I can remember.
Rip Esselstyn:
Yeah. Well, that's pretty darn cool. I mean, because both you and me, it sounds like, are greatly influenced by our fathers and the path that they chose and how that had a way of seeping into us or informing our journeys.
Simon Hill:
And it's hard not to when it's so important to them and such a big part of their life as their child, and you're surrounded by that all the time. It's impossible not to be affected by that, and I think my love of science was born out of his love for science. So it's nice to get to a stage where I'm old enough now to appreciate that.
Rip Esselstyn:
So let the PLANTSTRONG audience know a little bit about your background as far as... You didn't grow up in the States. You grew up Down Under, right?
Simon Hill:
Well, when dad was doing his PhD here, I was living in Texas. So believe it or not, I had a southern accent. I had learned to speak here in Texas, and so when we moved here, I was one and a half years old and pretty much learned to speak here. So I had a very southern American accent, and we lived in Texas for three years. Then we went to Virginia for about five years in Virginia Beach.
Rip Esselstyn:
Yeah, nice.
Simon Hill:
And then I was about eight years old by that stage, seven, eight I think, something like that, maybe nine. My brother is three years older, and my mom in particular wanted us to go back and do the rest of our schooling in Australia and be close to her. She has three sisters, and be close to all of our cousins, etc. So we moved back home, and I always knew that I would, when I finished school, science would be something that I would explore further. I didn't really know what area of science. At one stage, I'm sure I thought I would just follow my dad's footsteps and be in the lab coat. I can remember always spending a lot of time on weekends with him in his laboratory and watching him on the microscope. I did, at one stage, did think that could be for me as well, but I was playing a lot of football. And in the football club environments, I was surrounded by physiotherapists.
Simon Hill:
And I think in this country, they call it physical therapy. So I thought that was a pretty cool area of health and science and a nice blend of understanding physiology and anatomy and would enable me to work in an environment and culture that I really enjoyed with football players. And so I [inaudible 00:11:31] that. So that was my undergraduate degree. That was a four year course, and I finished that and started working with professional footballers in Australia and really, really enjoyed it. I had a great time [inaudible 00:11:50] that part of my career. And then a few various events unfolded, and my curiosity led me down the path of nutrition and was back to University to do a Master's in nutrition science.
Simon Hill:
And ultimately exploring that and digging into that was where the passion was born for Plant Proof and the book and trying to share some information that can help people make sense of all of this confusion that's out there.
Rip Esselstyn:
Yeah. So I got this probably three days ago. I was late the party, and this came out in Australia, what, six months ago?
Simon Hill:
Yeah. So May 1st in Australia, and I'm not sure when this episode is going up, but we're sitting here at the start of November. It's meant to be on the shelf now, but there has been delays with COVID. So I think it's going to be on shelf throughout the states in a couple of weeks, and there's an Audible version that I read, as well.
Rip Esselstyn:
Oh, wow.
Simon Hill:
But yeah, it's not far away.
Rip Esselstyn:
Well, and I got to say that I absolutely devoured this thing in about three days. It is a tour de force unlike anything that I've read in the plant-based world, and I think even a guy like Michael Gregor would go, "Holy shit. Simon knocked this thing out of the park." It's really spectacular.
Simon Hill:
That means a lot coming from you.
Rip Esselstyn:
I can't imagine the labor of love that you've poured into this. I mean, how many years did you spend kind of putting this together?
Simon Hill:
I think the actual writing process was about three, which is pretty significant chunk of time to write a book, and you know what that's like. It's a fun, but it can be a frustrating process at times. There were a lot more years before that in terms of just learning and reading science, and well before I decided I would try and put something onto paper, but that's a big compliment coming from you, mate. Thank you.
Rip Esselstyn:
Oh, yeah. Let me start by just kind of setting the stage the way you set the stage in this book, and you throw out some numbers like right now 71% of all deaths globally are coming from chronic disease. I think you also talk about how many of these chronic diseases start super early, like maybe even in some cases in-vitro.
Simon Hill:
And that's really important because we often feel, particularly in the early parts of our years, that chronic disease is not going to be something we're going to deal with for a long time. But understanding that there is a long latency period. You don't just wake up one day and you have clogged arteries. It's bubbling away under the surface for a long time, and you know this, and your dad talks about this all the time. So the earlier you can make the changes, the better you're going stop that bubbling away under the surface. And then when you get to your 40s, 50s and 60s which is the time where a lot of these chronic diseases start to pop up, hopefully your health is in a much better position, and you won't be relying on the healthcare system, and you won't be dealing with health issues and the quality of life will be better.
Rip Esselstyn:
Yeah. Yeah. I was just at a function speaking to 400 police chiefs just a couple days ago, and I can't tell you how many people came up to me afterwards just to let me know that they had high cholesterol or they had hypertension or whatever, but it ran in the family, and it was very much genetic. And in this book, you refer to the Danish twin study, which is super eye-opening as far as I think anyone that thinks that it's all in my genes, there's nothing I can do about it. Can you let us know about that study?
Simon Hill:
Yeah. And this kind of goes back to my personal... The first time I saw what loss of health looks like. I saw my dad have a heart attack in front of me.
Rip Esselstyn:
That's right.
Simon Hill:
And at that point in time, he was very lucky to survive. It was a helicopter to the nearest hospital, and he was only 41. And Rip, looking at my dad then, and I have lots of photos, so I know from my memories, but now I also have these photos to look at him when he was 41. He didn't look unhealthy. He was living a typical Australian lifestyle and eating the typical Australian diet, and he was still going to the gym and trying to do all the sort of right things. And this came out of nowhere, but where this ties into your question is, following that incident, when the cardiologist set our family down, he essentially made it very clear to my brother, who was 18 and I was 15, "Your dad's had a heart attack. Your grandfather," so my dad's dad, he'd had a heart attack as well. "This is running in your family, and we know that cardiovascular disease runs in families. So as you get older, you'll need to be screened."
Simon Hill:
Now, there's some truth to that, and there's some good advice there, but it's where the conversation ended. So for a long period of time, my brother and I certainly felt that we were dealt bad genes. That was our card. Cardiovascular disease was in our family, and more than likely, we would just follow down that path, and that's bad luck. But studies like the Danish twin study have been able to tease out how much do our genes have to say when it comes to these diseases that we've sort of accepted in our society as normal that other societies around the world have not versus how much does nature, the environment, the way we navigate through life, those decisions that we make on a daily basis, how much do they have to say?
Simon Hill:
And identical twins are the best sort of way to tease this out because their genes are exactly the same, but if they go off on different paths, what happens to their outcomes? And you can see from these studies that genes perhaps control about 20% of your health fate. But your environment and the lifestyle decisions you're making are having about 80% of the say. So four times more powerful. And when you think of it like that, it then becomes clear that, hang on. For most of these diseases, they're running in our families, not because of genetics, but because within families, we're making the same lifestyle decisions. Right. And so you mentioned there, a lot of people will say, "Well, high cholesterol runs in my family or high blood pressure runs in my family." And look, to a certain extent, that could be true, but keep in mind that it may be running in your family because your family is adopting the same lifestyle. And what that means is that there is a strong chance that if you make changes to your lifestyle, particularly your diet, which we know is the biggest lever that you can start shifting the blood pressure, the cholesterol into a favorable direction, which then is lowering your risk of these diseases, particularly your risk of having a heart attack or a stroke, which leading cause of death in this country.
Rip Esselstyn:
You have a line in there, and I've heard it by lots of different people, but it's, "lifestyle..." No. It's, "Genetics loads the gun. Lifestyle is what pulls the trigger."
Simon Hill:
Mm-hmm (affirmative).
Rip Esselstyn:
It is so true, and I think what people need to realize is that they can totally out-trump any genes they've been dealt with what we're talking about right here today. So I'd love to kind of, at a high-level, dive into different sections of your book.
Simon Hill:
Sure.
Rip Esselstyn:
I mean, this is a 400 page tour de triumph, like I said. Part one, you say it's a diet of confusion, and you're not referring to the plant-based. I think you're referring to just kind of everything that's floating around out there. And then you talk about how we basically... You lead with we have our food environment. Let me rephrase that, our food environment should focus on foods that promote health and reduce the environmental degradation of our planet. Yet that's not the case, and it's far from it. And you site basically three overarching reasons, and that is we got this rigged food environment. We got a hijacked healthcare system, and then thirdly, we have a for-profit nutrition culture. And so it seems like we are up against almost an impossibility here. So what are your thoughts on that, and then is there anything we can do to come out on top here?
Simon Hill:
This is a very important question. I think the sort of individual advice and certainly what listeners can do today is super important because I think giving people information that can help them make changes in spite of the food environment and ahead of changing our food environment is really important. Think about if you got that information in the 1940s about quitting smoking and you acted. Well, you were 20, 30 years ahead of when the regulations came in to start putting taxes and have advertising restrictions, etc. And there would have been many people that didn't act, and they unfortunately, many would've died. They would've developed lung cancer and lived a shorter life and a life with lower quality of life.
Simon Hill:
So the individual education's important, but I think to really solve this to make a big dent in the chronic disease burden, the food environment has to show up differently. And the convenient, easy, affordable choice needs to be a healthier choice than it is today, and we've got that backwards. And why? Well, there are many influences, and they're powerful influences that large trans-national food companies that really want to operate in an under regulated market. So what that ends up looking like is a whole heap of hyper-palatable ultra-processed foods that are a very poor at satiating us. They're very easily over-consumed. They create what's called hedonic hunger.
Rip Esselstyn:
Yeah. I never heard that term before.
Simon Hill:
Yeah. So hedonic hunger is you're craving more food, but you do not have a physiological requirement for that.
Rip Esselstyn:
Does it come from the base, like, hedonistic?
Simon Hill:
I think so. So these food manufacturers are very good at formulating the food in a way that hits that bliss point, and you will continue to eat beyond your physiological requirement. And so essentially, one of the most important things that I feel we need to do is to change that food environment, and there are a number of public health strategies that are starting to be implemented in certain countries to varying degrees, which are preliminary reports are showing them to be successful. But this is going to require very multi-pronged approach. Things like restricting the marketing of unhealthy foods to children, really important. We should be setting up future generations from the start with a healthy diet. So we know that those marketing restrictions, they do work. Not just restricting what's on TV but also what's at the sporting stadiums where kids are going, now, what's showing up on their mobile phone.
Simon Hill:
And they're being advertised, I think it's 50 to 100 times an hour by ultra-processed foods on their mobile phone, if they're a social media user. So there's things like that. There is taxes on sugar, which countries are playing around with. And sometimes there is sort of a reaction to that where some people feel that could be seen as unfair, and it could penalize more so people of lower socioeconomic status. And it's a fair point, but I also think we need to remember that chronic disease is disproportionally effecting people of lower socioeconomic class. So they actually need more help, and I would agree that if you're going to tax certain foods making them more expensive, you need to subsidize on the other side healthier foods to make them even more affordable for these households.
Rip Esselstyn:
Wasn't one of the countries that you cited in your book was I think the Philippines.
Simon Hill:
Yeah.
Rip Esselstyn:
Was doing something with the sugar beverage, right?
Simon Hill:
Yeah, the Philippines and Brazil, UK, have actually got a sugar tax that's being implemented and seems to be successful so far. The UK have also, which I think is a great initiative, they've banned ultra-processed foods at checkout. So those impulse purchases. These are the kind of strategies that we need our governments to get behind and to create policy to enforce those so grocery stores have to do that. There's a very interesting thing, area of science called choice architecture. I didn't write about this in my book so much, but Harvard University has done a lot of different studies, and they did a study with Boston, a hospital in Boston.
Simon Hill:
And they were really interested in looking at a couple of things. If you have very clear sort of labeling that helps a consumer decide is that health or not, and in this case, they used a green light, an amber light and a red light. And they graded foods based on how processed they were, how much saturated fat and sodium did they have. Of course, those foods rich in those were red. And then as foods got a little bit healthier, they were amber, and then foods were green that had fruits and vegetables in their whole form and whole grains and plant protein for example. And this was a two-phase study they did. The first phase was just to go into the kiosk at the hospital and label all of the food with the traffic light labeling system.
Simon Hill:
And just in doing that without anything else, they saw a significant increase in the consumption of healthy food. So very simple sort of intervention and great, great success of the other side. And it wasn't even removing any of the unhealthy food out of the kiosk. They were still giving people choice, but just helping them make a better choice. So that's another sort of nice intervention that people can look into, and I think that various countries around the world now are starting to look at those, particularly at school settings and hospital settings. And then they did the second part of that study, which saw an even greater increase in the consumption of health foods was actually how the foods were positioned on shelf.
Simon Hill:
And this is super important. So there are a lot of studies showing that whatever's at eye-level, people are going to buy more of. So they shifted the healthy...
PART 1 OF 5 ENDS [00:29:04]
Simon Hill:
So they shifted the healthier products to eye level, the sugar sweetened drinks to the bottom. You know, again, simple, not removing the choice from people, but just changing the architecture, and it's quite a neat way to do it. And then also what they did within that choice architecture experiment was instead of having water in one or two places, they put water in six or seven, so strategically placed around the kiosk in more locations. Again, they saw through that part, phase two of the intervention, a huge increase in the consumption of healthy foods and a much bigger increase in the consumption of water. So these are the kind of interesting things that I think we need to be looking at leaning into to better set up the grocery stores, better set up the food in our hospitals, better set up the food in our schools and people will, on their own accord, make a healthier decision.
Simon Hill:
There are a whole lot of other things that need to be explored. One of the things I write in the book is about the revolving door and I was super interested to learn about the revolving door and it's this phenomenon where people from within our government, and it happens here in America, it happens in Australia, they go between a position in the government that is a position where they can create policy to a very high position in the food industry. And they go back and forth. And these close relationships between food industry and government, really we need to be questioning should they exist because as long as there's those close relationships, the skeptic in me has me wondering is the main motivation here about protecting the industry and protecting their profits, or is it about serving the public, which is what government should be doing and prioritizing health? So there are countries now around the world who are stepping in and saying, "Hey, if you're in the government and you leave, cooling off period." You can't work in the food industry for three, five years, for example.
Simon Hill:
And so that's another sort of strategy that I think I would like to see more countries leaning into and just cut those ties between government and industry.
Rip Esselstyn:
Yeah, curtail the revolving door.
Simon Hill:
Yeah, let's get rid of it. I think that's absolutely prevalent just about everywhere.
Rip Esselstyn:
Yeah. I mean, think about it, I mean the food industry, it's such a... Well, it's so huge, it's so powerful, it's so profitable, and there's lots of money.
Simon Hill:
And in Australia, there is some regulations around if you donate to a political party, because the food industry will make donations, particularly come election time, there is some regulation around if you donate and it's over a certain amount of money, it has to be made public. However, that amount in Australia is $13,800 and I found this super interesting when I was researching for the book, so what do you think happens? They just make many, many donations just below $13,800 to keep it discreet, which is again, I think we need to be questioning whether we want the food industry to be donating money into the government to run these campaigns and to be establishing these ties, which then go on to affect the policy that is or isn't made, ultimately affecting the food that everyone in our country is consuming on a daily basis and then ultimately affecting the chronic disease burden.
Rip Esselstyn:
It is rampant. So let's go to kind of our hijacked health care system. And for example, in Australia, you mentioned how I think it's 1.7% of your national health funds go to prevention.
Simon Hill:
That's right.
Rip Esselstyn:
To me, in light of where we are now in 2021 and the amount of science that we have showing that these major chronic diseases can be halted and even reversed. That 1.7 goes to that, I mean, that's crazy.
Simon Hill:
It's a very sort of reactive approach and we need to flip that on its head. And a lot of that feeds in back to the food system, but also beyond food to education and programs that focus on physical activity. And so it's disappointing to see that 1.7% is going into prevention. And there are some other countries like New Zealand who are actually investing a little more, that are up at around 7-8% of their healthcare budget, but I do feel like it is going to reach a tipping point. It's probably already there where it becomes too large to ignore. And when it's costing the country too much in terms of loss of productivity, in terms of the actual healthcare cost to help manage these diseases, then perhaps we'll see that approach to healthcare switch and flip on its head.
Simon Hill:
And I think, I'm sort of careful when I talk about this not to sort of blame doctors because doctors are great people and they all go into this profession to help people. The problem is they're in this system where they can only really help people once they have established disease, which is great, we still want them to be there for that. But in an ideal healthcare system, we would be able to prevent a lot of this disease from occurring in the first place. And so, a lot of work needs to be done to change that, but tackling that, tackling the food environment, two very big things that a lot of countries need to be focusing on in the next couple of decades.
Rip Esselstyn:
Yeah. Well, you know who Kim Williams is?
Simon Hill:
Yeah.
Rip Esselstyn:
Yeah. So I had Kim on the podcast not too long ago and one of his goals when he was the President of the American College of Cardiologists he said was to basically put ourselves out of business, put cardiologists out of business, and you can imagine the uproar that came from these cardiologists. Like, "No, no, don't be taken away my $600 to $800K annual salary here, man. I want to put that stent in and I want to do that bypass. It's exciting stuff for me. And prescribing sweet potatoes and brown rice and leafy greens, come on, man, that's not where it's at."
Simon Hill:
Yeah. Well, I mean, it doesn't come without its challenge, but these doctors, we need to find a way for them to work within the healthcare system where they are remunerated.
Rip Esselstyn:
Sure.
Simon Hill:
But for preventing the disease and for creating a healthier population, which at the end is a happier population, which is a more productive population.
Rip Esselstyn:
So you mentioned cigarette smoking just a little while ago, we now have over 7000 studies or plus showing that cigarette smoking is bad for our health. You mentioned the book in 1964, we had the US Surgeon General report that basically let everybody know that cigarettes are bad for us. How many scientific studies are there showing that a plant-based diet and what it can do for a chronic Western disease and how long will it take before what we're looking at with food is similar to what happened with cigarettes? Is there a lag time of like 30-40 years?
Simon Hill:
I'd say that the guidelines are already pretty much there in terms of, if you look at the American Heart Association guidelines, now a new one came out yesterday or the day before, the 2021 guidelines, and if you read through that, they speak about plant-based dietary patterns and they talk about the dash diet and a sort of very plant-based Mediterranean diet and they talk about vegetarian and whole food plant-based diets in there, and they're pointing people in that direction. And then, in their sort of summary of dietary sort of guidelines in this brand new paper, they're of course advocating fruits and vegetables and whole grains when it comes to protein, and this is a big change for them, the very first thing that they say is to choose plant-protein over animal.
Rip Esselstyn:
And these are the guidelines for-
Simon Hill:
This is in the American Heart Association 2021 guidelines.
Rip Esselstyn:
Okay.
Simon Hill:
Okay. So, they're not saying adopt a completely plant-exclusive diet, but they are now being very clear to choose plant-protein over animal protein. And I think that's the beginning of a change from a big organization like that. It's great to see that now in those guidelines, which a lot of people respect and look to, and certainly a lot of the doctors around the country are looking to those. So to answer your question, I think there are big changes actually occurring and every single guideline that I read now, be it out of Europe or out of this country, including like the endocrinology guidelines or the American Cancer Society, they're definitely very plant-forward guidelines.
Simon Hill:
Now, when will we see the kind of changes that we've seen with smoking with regards to advertising and taxation and perhaps we could think about the meat industry. I think there are some problems with how meat is subsidized and also what they're getting away with in terms of the environmental impact. And really those externalities should be factored into the price of that product. I think we are perhaps a little ways away from that. It's a very powerful industry that's stopping a lot of that regulation from happening at the government level. But I think at a healthcare level and a health professional level, across the board now, definitely, unless you're looking at very sort of fringe carnivore, low-carb crowds, which are loud but definitely not the consensus across the board, everyone is on board that the scientific evidence is very clear, if you want to prevent chronic disease, then you want to be adopting a diet that is very, very plant rich.
Rip Esselstyn:
You mentioned in the book, you cite an example as a country that's kind like getting it right with its nutritional guidelines is Canada and what their kind of food plate looks like. Can you describe that?
Simon Hill:
Yeah. So, that came out in 2019. And again, similar to what the AHA have sort of just put out, this is a largely plant-based plate. It's the first time that Health Canada has removed dairy as an essential food. And there was some commentary around that and I think it might have been David Jenkins maybe, I may have that wrong. I can't remember who made this comment, but they said that on the formulation of these guidelines, dietary recommendations out of Canada, this was the very, very first time that they did not allow industry influence. That's a big statement. And the result is this very plant-forward plate. As I said, dairy has been removed as an essential food, which came as a shock to a lot of people because I know when I was growing up in this country, it was all about having three glasses of milk a day. I was chugging that down. I thought I needed that for strong bones and that was the only way to get there.
Simon Hill:
And also in their guidelines, very similarly, they say choose plant-protein over animal protein where possible. So you're starting to see this very consistent messaging and that's because, as you sort of alluded to at the start, there is so much science actually looking at populations and clinical studies all around the world showing that when you're doing that, when you're choosing legumes over beef, when you're choosing legumes over poultry, and the more consistently that you are doing that, the lower your risk is for these diseases.
Rip Esselstyn:
Do you know if the Canadian guidelines also include the environmental footprint that each-
Simon Hill:
Yeah, but the Canadian guidelines and the AHA guidelines out from this week both mention the environment and sustainability and the importance of, again, understanding that plant foods have a much lower environmental footprint. To produce, for example, 100 grams of protein from beef compared to producing 100 grams of protein from tofu, there's 30 to 50 times as much greenhouse gas emissions. And to produce that amount of beef compared to tofu requires 74 times more land. And the problem with using a lot of land is we have to, in many cases, create that room, which means clearing and we're either clearing to put animals on pasture or we're clearing to grow crops that are then fed into that industry. And so it's a very inefficient, it's a very hard process on our environment, deleterious, and so it is nice to see that these dietary guidelines are now saying, "Hey, if we are going to talk about human health here, we have to understand human health is tied to planetary health," and they're assuming some responsibility for that.
Simon Hill:
So again, I think, coming back to the original question, I think we're making big progress to see these big organizations saying, "Look, this is the science. This is how we need to shift the dietary pattern across our population for people and planet." I think it's amazing.
Rip Esselstyn:
Well, you mentioned the inefficiency of it and I know in the book you talk about, for example, how a cow, 97% of the calories that a cow takes in basically yield 3%.
Simon Hill:
Isn't that incredible?
Rip Esselstyn:
It's crazy. It's absolutely insane. And then I think with the chicken, you say it takes in what, I'm just going to say 3500 calories, and then basically then when you eat it, you're getting like 300 or something. The inefficiencies are just mind boggling.
Simon Hill:
The least efficiency is the biggest animal, the cow, because the way I like to describe this is just think about that animal. It requires energy just to be alive. It has a basal metabolic rate like us. It's burning fuel just to be alive, so a lot of the energy that you're feeding in to it is not turning into muscle. It's just being burnt up to keep that animal alive and then also goes into a lot of parts of the animal that we don't eat. And so it is a very inefficient process. And the point that I really wanted to make in the book there was that we talk about food waste and food waste is very important, but often what we are talking about is food waste at the restaurant or at our home, but what about the food we're wasting inside that system?
Simon Hill:
If you were to take the amount of food that was required to produce three kilograms of beef and you were to stack that side to side, the plant food versus the beef, I think most people would go, "Holy shit! Wow! Every time I pick up that steak at the grocery store, that's how much went into creating that and that's how much we lost." And when you sort of reconcile that, and you think about the environmental impact of that and you think about the fact that so many people in this world do not have food security and enough calories, it makes you start to question how everything is currently set up and the changes that we need to see to move to a world where we have a sort of planet first approach with our food system and we're creating greater equity and a fairer, more just system.
Rip Esselstyn:
We need to get there and we need to get there as fast as humanly possible. And to me, everything you just described here, I mean, look at your subtitle, How Science Shows a Plant-Based Diet Could Save Your Life, and then, and the planet. They're so absolutely interconnected.
Simon Hill:
Yeah. And we do need to get there as fast as possible and don't get me wrong, I get extremely frustrated with this pace of the changes and I know the COP26 climate summit is on at the moment. And it was disappointing to see that there was a lot of meat on the menu and from what I've read, there is some improvement from previous summits, but to see a lot of red meat still on the menu, it was interesting.
Rip Esselstyn:
Well, so you bring that up and I did a little research into COP26 and their goals are to be a net zero by the middle of the century, by 2050. They want to obviously keep the planet from raising another 1.5 degree Celsius and keep that within reach. But what they did is they asked all the countries that were coming to the meeting to come with timelines as far as, A) when can they accelerate the phase out of coal; B) when can they curtail deforestation; C) when can they speed up the switch to electric vehicles; and then lastly, when can they continue to encourage the investment in renewables. But to me they're completely missing the forest through the trees, big pun intended there, because where is we got to transition to a plant-predominant diet?
Simon Hill:
Yeah. And I think there's a few reasons for a lack of political will to talk about diet. It's seen as unfavorable. A lot of governments historically have not wanted to go there because as soon as you start telling the population what they can and cannot eat, it's much harder to get the support of the population.
Rip Esselstyn:
But don't you think, you don't tell them what to eat and what not to eat, there has to be some salesmanship there.
Simon Hill:
100%. And you need to sell the benefits. Let's be clear, the benefits here are huge. We wouldn't be having this conversation if they weren't. So it is about improving the quality of life and the happiness of the population. It's not about changing the way people consume to make their life worse off. I think we should be clear on that. But sometimes it can be perceived by someone as an infringement on their right, for example, to eat meat. And you hear all the time when people talk about this idea of meat tax, a lot of people get upset. In that list you just reeled off, one of those points was curtailing deforestation. So maybe they didn't address diet directly, but leading cause of deforestation in Australia right now is the beef industry.
Simon Hill:
And pretty much around the world, the leading cause of deforestation is livestock. So, it is kind of in there. I would like to see it a little more prominent than that, but there are a lot of organizations at COP26 who are there to change the food system. So my hope is that if out of COP26 we get another kind of Paris agreement, they may sign an agreement off the back of this, that there are some pledges in to help shift the population to more plant-forward, plant-rich, plant-based dietary patterns and the strategies they're going to use to get there. I'm not sure if that's asking too much. I don't think it is. I think, as you alluded to earlier, we have to get moving.
Simon Hill:
And right now the attention on coal, it's warranted sure, but we have to realize that if we just address the way we're producing energy and we don't look at diet, we don't solve this problem. And so if you factor in the direct emissions right now from the food systems and agriculture, plus you look at land use and the deforestation, because that comes with a huge sort of carbon cost to it because you are clearing all these areas of land that are natural carbon sinks, that are our ally, that are helping cool the planet and draw carbon down. So you have this twofold effect, you're getting rid of these natural carbon sinks and then you are using that land and it's producing emissions. So if you consider all of that and look at the emissions from that in totality, that is around 30-35% of total greenhouse gas emissions.
Simon Hill:
So our food system for a long time, we have over understated how impactful the food system is on planetary health and we need to get moving.
Rip Esselstyn:
Well, I've heard a bunch of different numbers. I mean, I've heard as much as... The typical number that we hear in a lot of the documentaries is 14%, the same as all forms of transportation combined. I also heard that in, I think it was 2009, there was a paper written by the World [inaudible 00:52:26] Institute, part of the World Health Organization and... No, the World Bank rather, and they came out with the paper called Livestock's Long Shadow, showing it was actually 51%.
Simon Hill:
Yeah.
Rip Esselstyn:
And then most recently, have you ever heard of a guy named Sailesh Rao?
Simon Hill:
No.
Rip Esselstyn:
He's from Stanford. He's the director of a nonprofit called Climate Healers. He actually has done some research and studies and he actually has it as high as 87% between the supply chain and the life cycle of these 80 billion animals, the deforestation.
Simon Hill:
It's a good point. Definitely today, I think, there's that range that you sort of speak of, and that's why I don't use 14% anymore because it's very clear that 14% was not considering so many other aspects of the food system and agriculture. And Draw Down Project, they recently the report and they speak exactly to what you just mentioned that there is this range. There's some evidence to suggest it might be 51%, maybe even higher, and then they kind of land at, "Well, it seems that it's definitely at least 30-35%." So that's the kind of figure, I guess, which is a little bit in the middle of some of those where I'm using at the moment, which I think when people hear they go, "Wow, it's actually a large, large chunk. We're not just talking about a small percentage and therefore we can just move from coal to renewable energy and we'll be fine. We need to be tackling both of these things at the same time."
Rip Esselstyn:
Well, I think if we want to get to those goals that COP26 has set about, net zero by 2050, keep the planet from going up to 1.5 degrees Celsius, we got to address the food. Without it, I don't know if we can even come close to getting there. So, I mean, green energy, green food, speaking of green food, let's now transition to our health because part two is all about out our personal health and you start out by tackling kind of, I think, the number one pandemic in the states, and it's probably starting to tackle us globally here, and that's just how we're all becoming overweight and obese. I mean, it's nothing short of a pandemic. How does a plant-based diet work to help curb being overweight and obese? Where do people start?
Simon Hill:
Well, if I was to kind of summarize why a plant-based diet can be very favorable from a weight point of view, a lot of that comes down to the lower calorie density of the diet and the fact that it's rich in fiber, those two factors. And maybe if we start with calorie density, I think that's an interesting one. And that is why ultra processed foods are so problematic when it comes to managing our weight because they're very, very calorie dense. And there's a researcher, Kevin Hall, you've probably heard of him, right? He's like a famous sort of American researcher who does very tightly controlled metabolic ward studies so that you can bring folks into an inpatient setting and really get a good idea as to what's going on because you know every bit of food that they're eating. And he compared an unprocessed whole food diet to an ultra processed diet.
Simon Hill:
And in this study, what he was able to show was that he... I should take a little step back because it was a neat study design. He actually matched the two diets for protein, for carbohydrates, for fat, for sodium, for fiber, between the ultra processed and the unprocessed.
Rip Esselstyn:
So they're the exact same?
Simon Hill:
Exactly the same, right. Very interesting. And you just have one set of meals are unprocessed and the other are ultra processed. And this is interesting because you may sort of assume ultra processed foods are lower in fiber, they're higher in sugar, that's probably why people over consume them. Now, what he did was, in this study, it was a crossover trial, you would consume one of the diets for two weeks and then you would consume the other diet for two weeks, and subjects did that in a randomized order. And what he was able to show... And these subjects were given meals and they weren't given a calorie limit. They were just told eat until you are full. So we are looking at satiation here. And what he was able to show was that when subjects were eating the ultra processed foods, they ate on average 500 calories more per day. And over the course of the two weeks, they gained about a kilogram of weight.
Rip Esselstyn:
2.2 pounds.
Simon Hill:
2.2 pounds, around about that. And then on the other side of the trial, on the unprocessed-
PART 2 OF 5 ENDS [00:58:04]
Simon Hill:
Two pounds, a around about that, and then on the other side of the trial, on the unprocessed diet, they lost that kilogram or 2.2 pounds. And this is just a short term trial, but it does sort of speak to something very important here that even when these macronutrients and sugar and sodium and fiber were matched, people were still eating more ultra processed foods. And Kevin Hall stated a couple of his sort of hypothesis as to why he thinks that's happening.
Rip Esselstyn:
Yeah. Why?
Simon Hill:
The first one is that calorie density. You were getting more calories per bite in the ultra processed foods. So they were, the volume of the food was lower so you could potentially eat them much quicker. Okay. And if you're eating food that's very calorie dense and you can get more in quicker, perhaps instead of getting those hunger signals, having time to feel full and your brain saying, hey, you've had enough, you're sort of, you're missing out on that benefit, that feedback loop that you would normally get with a more whole food diet.
Simon Hill:
And then the second one, which I think is really interesting is that we know that fiber prebiotic fiber in particular, when it is metabolized by our microbiome, the microbiome feed on it, they produce compounds. And a lot of these compounds reward us. And in particular, some of the downstream effects of this fermentation of fiber in our large intestine is the production of appetite suppressing hormones. And-
Rip Esselstyn:
Is that the leptin and the ghrelin?
Simon Hill:
Exactly. And also another hormone called PYY and GLP-1. And so the idea here is that, sure they matched fiber, but just putting in one type of fiber into an ultra processed food does not match the fiber found in a diverse range of plants. And from a mechanism point of view, that does make sense because we know that, we call it fiber, but that's an umbrella term.
Simon Hill:
There's so many different types of prebiotic fiber. And that's one of the reasons why eating the rainbow is so important. You are providing this sort of substrate, all of these different types of prebiotic fiber to different species of bacteria, which then are producing varying metabolites that have these health effects on us. So super interesting, but that's one reason why a plant based diet based on whole foods is particularly beneficial from a weight point of view, because you are lowering the calorie density of the diet.
Simon Hill:
The second is certainly the fact that a plant-based diet is much higher in fiber is very important. And we sort of just spoke to some of the benefits there. But we know that fiber is particularly important for regulating the appetite. And so when you combine these two factors together, you end up feeling full on fewer calories.
Rip Esselstyn:
And why do you guys spell fiber F-I-B-R-E?
Simon Hill:
Yeah.
Rip Esselstyn:
Is that just the way it is? Because here it's E-R.
Simon Hill:
That's right. And Dr. B gives me a lot of stick for that. I said to him, you'll have to change the title of your book for Australia. He didn't. I don't know why, but we also spell center center, C-E-N-T-R-E.
Rip Esselstyn:
Right, right, right. Yeah. Yeah. I mean, and in the book you have a chart and basically let me say that the graphics and the charts that you have in here are insane. They are spectacular. So I don't know who you got to help you.
Simon Hill:
Chloe, she's great.
Rip Esselstyn:
Wow. Chloe.
Simon Hill:
She would love to hear that.
Rip Esselstyn:
Way to go, Chloe.
Simon Hill:
Yeah, she's amazing.
Rip Esselstyn:
But you talk about the average American is consuming 58% of their calories from these ultra processed calories. And I think in Australia, it's a little bit lower. It's like 52%. But I mean, the odds are stacked against you when the typical American is consuming almost 60% of the calories from these high calorie dense foods that aren't filling them up, aren't [inaudible 01:02:40] them. That don't have fiber. These guys are stripped to fiber completely.
Simon Hill:
Exactly. And that's, often I'm asked, just tell me one thing to focus on. Just give me one thing. And my response to that is the average fiber intake in this country is about 12, 15 grams, depending on the kind of study you look at, maybe a little higher in Australia. But you want that up north of 30 grams a day as a minimum. And it might take you a little bit of time to sort of get there and allow your microbiome to adjust, but that will automatically straighten up people's diets because the only way to get there, and I'm not talking about getting grandma's Metamucil and just having 30 grams of that. I'm talking about accessing this diverse range of fiber through a diverse range of plants. And if you were to focus on that, you would automatically start crowding out these ultra processed foods that we're talking about.
Rip Esselstyn:
So what would be that one thing you'd tell people to do? Up their fiber? Would you give them a specific goal, like eat how many different kind of fruits, vegetables-
Simon Hill:
Yeah. I mean, there is a great study out called the Gut Microbiome Project by Dr. Rob Knight. And he was really looking at the composition of our microbiome. And he had 10,000 plus stool samples, people all around the world, really big study. And he was able to show that compared to people eating 10 or fewer plants per week, those who are eating 30 or more, had significantly more diverse microbiomes. And we know that a diverse microbiome is associated with better health, healthier people have a more diverse microbiome. So I do often talk about that and this idea of trying to eat 30 unique plants. And it can become a bit of a game, it's fun for people. And again, everyone has their own starting point. You don't have to jump from six plants a week to 30 overnight. You can step that out slowly.
Simon Hill:
And I think that in some ways that is better for allowing your microbiome to adjust. And there was an interesting study out of Stanford that I'll summarize just quickly, that kind of speaks to this. They compared fermented foods versus a high fiber diet. And fascinating study. Dr. Christopher Gardner, have you come across his work?
Rip Esselstyn:
No. No.
Simon Hill:
Okay. We're going to get him on your show. Okay. He's from Stanford University, really, really fascinating guy and does great studies. And he and his colleagues wanted to look at, is there a difference between adding fermented foods to the diet and adding fiber in terms of microbiome composition?
Rip Esselstyn:
Yeah.
Simon Hill:
And in terms of inflammation and how our immune system is functioning. Really interesting study, 10 week study, two groups. One group took their fiber from 20 to 40 grams. One group added fermented foods. And it was about six serves of fermented food. So it's a lot, but in future they're going to run further studies with less to see if you can still get the same benefits, because that's what they saw. In the fermented food group across the board, people had increased in diversity. So this is a great case for adding kraut and kimchi to your diet.
Simon Hill:
And so they saw across the board increase in this diversity and a decrease in 19 of these inflammatory protein markers. So signs that the immune system was more robust. And as I said, that was across the board, pretty much every single subject that added fermented foods got that benefit. On the other side, the increasing the fiber is what I found really interesting. Certain people had the same thing, increased diversity, decrease in inflammation. Now others didn't see that. And some people actually saw an increase in inflammation by adding the fiber.
Simon Hill:
And that's not to scare people off fiber. It's just a really interesting finding. And I think it does line up with some of the feedback that I get from people who say, hey, I've added all of these plants. And it's uncomfortable. I'm feeling bloated. Maybe plants are not for me. And I don't think-
Rip Esselstyn:
What's going on there?
Simon Hill:
I don't think at all, that it's, that plants are not for you. I think in this case, and this study speaks to this, they went back and looked at, okay, so some subjects on the fiber arm did well, and some did poorly. At baseline at the start of the study when they, was there a difference in their microbiome? And there was. So those who had a nice, diverse microbiome at the baseline, they did very well when you added fiber from 20 to 40 grams.
Simon Hill:
Those who had low diversity. So perhaps these are people who have been eating a lot of ultra processed foods, perhaps a lot of antibiotics in their history, for example. And had, what we would describe as sort of a weak gut, when they increased their fiber from 20 to 40, they didn't go so well. And I think the takeaway points here are that depending on where you are sort of starting from, you may need to take a bit of a different approach. If you're finding that you are increasing your fiber and you're not feeling great, you're feeling a bit uncomfortable, then you might need just to back it off and allow your microbiome more time to adjust. And it will. As you're slowly increasing the plants in your diet, the good gut bacteria that we want more of, they will proliferate.
Rip Esselstyn:
Yeah.
Simon Hill:
And the pathogenic ones will begin to be suppressed and over time you'll be able to handle more. The other interesting thing from this study is that maybe if you are struggling to increase your fiber, the addition of fermented foods first might be a good way to increase the diversity and then start to add more plants to your diet. So that's an interesting study and those researchers are going to go and test some of those hypotheses in future studies.
Rip Esselstyn:
That's interesting. It's so funny. I've never loved fermented foods. I mean, I do like tempe, tempe counts as a fermented food, right?
Simon Hill:
Well-
Rip Esselstyn:
Or no?
Simon Hill:
It's interesting because I would say that tempe, and it's a amazing food. I eat a lot of it. It's super healthful. But from a kind of traditional definition of a fermented food, what they were using in this study were foods that had live cultures. And so with tempe, usually it's heated and the probiotics are killed off.
Simon Hill:
So does it have the same effect? I'm not sure that we know that, but in saying that there is a lot of interesting science coming out showing that even dead bacteria seems to have a beneficial effect on the microbiome. So I'm not sure we fully understand that, but I think my advice based on that study was they used a lot of kimchi and kraut. So if you can, try and work that in. There are a lot of plant-based yogurts now that have live cultures in them as well. So that's another one that people can consider. And yeah.
Rip Esselstyn:
Yeah.
Simon Hill:
Fermented foods.
Rip Esselstyn:
Yeah.
Simon Hill:
Try and get them in.
Rip Esselstyn:
Yeah, no, that's interesting about certain people having a hard time when they start upping their fiber intake. I know when I got the guys at Fire Station Two to do this, there was one guy in particular that after every meal he'd be like double overed, double overed because he just was bloated. He got gassy. He was just in pain. But probably two or three months later, he was absolutely fine. It just took him a while to kind of work up to that kind of a load.
Simon Hill:
Yeah. And that's a very kind of typical response for some people. Everyone that I've worked with who has struggled at the beginning, they do get through it. And I think it's an important takeaway point is that even if you've taken, had a lot of antibiotics and the worst diet for a number of years, from the age of about two or three, our microbiome is set in terms of the actual species we have. Right. And that's really interesting. So even if you take a lot of antibiotics, you might lower the diversity, but you still have the same species there. You just need to feed them the right food for them to proliferate and create that diversity that you want again. So you have everything in you that you need, you just need to build the strength. And it's like going to the gym.
Rip Esselstyn:
Yeah.
Simon Hill:
If you haven't been to the gym ever, and you walk in and you pick up, let's call it 30, 40 pounds and try and bicep curl that, then you're going to be very, very sore. And you perhaps will cause an injury.
Rip Esselstyn:
Yeah. Yeah.
Simon Hill:
But if you go in there and you pick up a weight that is comfortable but still a little bit challenging and you over time progressively increase that overload, your body will adapt. You will grow stronger and you'll achieve the goal that you're setting out to.
Rip Esselstyn:
All right, let's move on to heart disease. The number one killer of Americans, cardiovascular disease. You in the book you cite a, what I thought was a fascinating study. I think it's the 108 West African green monkey, green monkey study I think. Something like that. Where they fed certain half kind of a high fatty diet and the other one more of a whole food plant based diet. Can you talk about that?
Simon Hill:
Yeah. So this is animal based research, but they're looking at these green African monkeys.
Rip Esselstyn:
Yeah. Do you know what year this was?
Simon Hill:
That's a good question. There's been a few different studies looking at this, but I'm going to say it was in the nineties maybe.
Rip Esselstyn:
Okay. The reason I ask is because I know that my father was very much excited by some studies that were done with green monkeys that influenced him and his research.
Simon Hill:
Yeah.
Rip Esselstyn:
With heart disease.
Simon Hill:
I think some of this research was done through the seventies, but then maybe the paper I cited in there was 98 or something. But very clearly they show that when these monkeys are fed the high saturated fat diet, their arteries clog. And that relationship between dietary fat, cholesterol and heart disease is one of the most established relationships that exist. And it goes back all the way to the early 1900s. And then the work in the 1950s in the metabolic ward, like Ancel Keys was doing where again, bring people in, feed them different fats, animal fats versus plant fats. What happens to their cholesterol? And it's very clear that if you want to jack up your cholesterol levels, particularly your LDL cholesterol, then eating a diet rich and saturated fats is a good way to do that.
Simon Hill:
So, I mean, I put that into that part of the book there, just to emphasize that this is not just something that we see in humans, we're also seeing it in non-human primates as well, consistently, not just those monkeys, but a whole lot of other species as well.
Rip Esselstyn:
Yeah, yeah. Yeah. So in your opinion, if you wanted to avoid heart disease, what's the number one food you think people should stay away from?
Simon Hill:
That's a great question. I mean, based on current diets, I would say, I'm going to say two, red meat and dairy. Yeah.
Rip Esselstyn:
Is that because of the saturated fat or is that because of the trans fats or a combination of both?
Simon Hill:
I mean there are trans fats in those animal foods. Trans fat consumption has gone down a little bit with reformulation of ultra processed foods. But there are some trans fats in there which certainly do affect your cholesterol levels, but they're also the greatest contributor of saturated fat in the Western diet. So I think currently in America, the amount of saturated fat in the average diet is about 13% of total calories. And we know that when you actually get that down south of 10%, there's a significant reduction in the risk of cardiovascular disease. And then if you have existing cardiovascular disease, there's a very strong case to be getting it down much further, five, 6%.
Rip Esselstyn:
I think the age [inaudible 01:16:04] you mentioned earlier, the American Heart Association recommends both 7% of calories coming from saturated fat.
Simon Hill:
And really the only way that you can get there is by eating a diet which is either predominantly or completely plant based. It's very difficult to get your saturated fat to that level when you're eating a lot of animal products.
Rip Esselstyn:
Yeah. Is it fair to say that saturated fats for the most part only exist in animal products and animal byproducts, except for maybe nuts and seeds? There's some saturated fat.
Simon Hill:
There's some saturated fat in nuts and seeds, but I would say one of the advantages of nuts and seeds is that they're rich in polyunsaturated fats.
Rip Esselstyn:
Yeah.
Simon Hill:
And so, Ancel Keys, his initial work which was then built on by Hegsted in the nineties actually showed that saturated fat raises LDL cholesterol twice as much as polyunsaturated fat lowers it. And there's an equation that he has called the Hegsted equation now. So nuts and seeds, you may get some slight offset of the saturated fat content through the unsaturated fats that are in there as well. But yeah, of course, you're still going to get saturated fat in a plant based diet. But I think the recommendations, the ones that you just mentioned there from the AHA to try and get it below 7% percent are good ones.
Rip Esselstyn:
What about, what are your thoughts on cholesterol?
Simon Hill:
Dietary cholesterol?
Rip Esselstyn:
Yeah.
Simon Hill:
Yeah. I think that again, and the science on this is really fascinating because if you look at a whole lot of the research, you could be led to believe that it doesn't affect your LDL cholesterol at all. And there's a reason for this. And it's because as you increase dietary cholesterol in your diet, it doesn't just keep increasing the serum cholesterol, it plateaus off. And so if you just take a population of people who already have a high background intake of dietary cholesterol, let's say they're already eating a lot of meat. Chicken contains cholesterol as does red meat. And so does dairy. And if you take someone like that, who already has sort of four or 500 milligrams of dietary cholesterol, and you add in a couple of eggs to their diet, sure, you won't see a big impact on their cholesterol.
Simon Hill:
But if you were to take all dietary cholesterol out of that person's diet then you would see a reduction in their serum cholesterol. Is it as impactful as saturated fat? No. But it still is impactful. And given that the average LDL cholesterol in this country is about 130 milligrams per deciliter. And there's a lot of work now showing that even though doctors are recommending to get to about a hundred, really, it's not until you're down at 70 or lower that you see people who do not have atherosclerosis. So I'm sort of of the opinion that in a society where the average population is way, the average cholesterol is way above where it should be, then we should be really trying to limit our exposure to saturated fat and dietary cholesterol as much as possible and moving that risk factor into a more favorable direction.
Rip Esselstyn:
I had Colin Campbell on the podcast who I think everybody knows of the China study and whole, and one of the most amazing biochemists on the planet. He mentioned to me that another thing that raises cholesterol that most people are completely unaware of is animal protein. That it jacks it up. I don't know if you've seen that in your research because you're Mr. Research.
Simon Hill:
Yeah. I haven't seen any of that science, but it's interesting. I've seen him talk about it. I mean, yeah, it would be something that I would need to go away and look at. I wouldn't want to comment on it.
Rip Esselstyn:
Maybe in the proof is in the plants part too.
Simon Hill:
Yeah. But I guess that question speaks to also the importance of not being too reductionist. I think saturated fat is very important, but there are other aspects of these foods that affect cardiovascular disease. Even haem iron is clearly associated with cardiovascular disease. And so I guess we need to be careful that it's not just one nutrient, it's a collective of things. And it's also the fact that when you are eating the red meat continually, what are you missing out on? Well, instead you're not having those legumes, which are rich in fiber, for example, and phytochemicals, which offer enormous benefit and protection against cardiovascular disease. So it's kind of a twofold effect here.
Rip Esselstyn:
Yeah. So let's move from heart disease to cancer. What is it about meat and dairy that in incite cancer?
Simon Hill:
There's a range of different, I guess, properties in meat in particular and I guess ultra processed meats and red meat. And we mentioned haem iron.
Rip Esselstyn:
Yeah.
Simon Hill:
That's one significant sort of component of these foods which is believed to be carcinogenic. And so there is mechanistic research showing that when you consume a lot of red meat in particular, which is very rich in haem iron, a lot of that goes through undigested in the small intestine, gets into the large intestine and can damage endothelial cells. And is believed to be one of the contributing factors to colorectal cancer. Then of course, you've got nitrates which are put into, which are not to be confused with nitrates in plant foods and green leafies because they go down a different pathway and are extremely beneficial. I'm sure you've spoken about nitric oxide on this show with your dad before.
Rip Esselstyn:
I have.
Simon Hill:
And so I'm telling you something that everyone's already heard, but on the flip side, the nitrates that are in these ultra processed foods and to a lesser extent ultra processed meat and to a lesser extent in unprocessed red meat, they're packaged next to different molecules. They're not next to the antioxidants, the vitamin C that's in these plant foods. Instead, they're next to a means. And as a result, they go down a completely different pathway. They end up being converted into these end nitroso compounds, which again at a mechanistic level have been shown to be carcinogenic. And so that's another kind of component.
Simon Hill:
There's new 5GC. There's polycyclic aromatic hydrocarbons. There's heterocyclic, a means. The list kind of goes on. And what you see quite clearly is that if you consume about 50 grams of ultra processed meat a day, which let's be honest, that's not a lot, right. Your risk of colorectal cancer goes up by about 18%. And whereas with red meat that's not ultra processed, it's about a hundred grams of red meat a day will do the same thing to your risk of colorectal cancer. So these are very clear associations and we see these around the world. There are some studies that haven't found those associations and often people point those out to me. And I think one of the critical learnings here is exposure level is really important. So there are studies out there that have shown no clear association but it's looking at a population in Europe where they're really consuming much lower than a hundred grams of red meat per day. In some of these studies, 40 grams, for example. And so you start to see-
Rip Esselstyn:
How much is 40 grams?
Simon Hill:
40 grams is-
Rip Esselstyn:
Give me a size.
Simon Hill:
Probably two thumbs worth, something like that, maybe a touch bigger. But not a lot. Right. And when you get to that level, you start to see the association get weaker, sure. But there is a clear association once you get to about hundred grams a day, you will significantly increase your risk. And then dairy is a, dairy is an interesting one for me because when it comes to colorectal cancer, there's actually evidence that it can be protective and-
Rip Esselstyn:
Come on.
Simon Hill:
Yeah, I know. Right. And I dug into that because I found that very interesting and you'll see the World Cancer Research Fund in their recommendations. They talk about this. And I don't think it's that dairy itself is protective.
Rip Esselstyn:
Yeah.
Simon Hill:
The mechanism seems to be calcium and that when you have sufficient calcium in the diet it does seem to be protective against colorectal cancer. So I don't think that that finding suggests you need dairy in your diet, but if you're removing it, you want to make sure you're getting enough calcium.
Rip Esselstyn:
And we are on a plant based diet.
Simon Hill:
That's right. So there are a lot of different ways. And again, dark leafy greens come up there, Tahini, there are a lot of ways to get calcium. And I think it's good that a lot of the plant-based milks now are fortified with calcium. And a lot of the plant-based yogurts are starting to do that too. And then prostate cancer. There's some evidence to suggest that dairy increases the risk of prostate cancer. So, I think overall there is, from a cancer point of view, it is very clear when you zoom back out and you just look at total risk of cancer, these plant predominant, or plant exclusive diets, people eating this way do better. And so if you look at the vegetarian or vegan cohorts, they do have significantly less risk of dying from any form of cancer. So I think it's good to zoom in on the individual food, but then it's really important to zoom back out and look at total dietary pattern from a cancer...
PART 3 OF 5 ENDS [01:27:04]
Simon Hill:
Dietary pattern, and from a cancer point of view, that's where the whole plants definitely seem to win.
Rip Esselstyn:
So do you love diving into the research and reading theses studies?
Simon Hill:
I do, yeah.
Rip Esselstyn:
Was it something you had to learn to love? Because it seems like a real skill to be able to do that.
Simon Hill:
I do like, and I like being challenged. Looking at the data, for example, on dairy and colorectal cancer, I found that very interesting because that was news to me that the association there was that dairy was protective. And getting into these studies and looking at compared to what? What exposure level are we talking about? What cohort are we talking about? All of these little bits of nuance. Yeah, I find it very interesting and I think it's something that's often left out of the mainstream media kind of headline.
Rip Esselstyn:
Oh, yeah. Well, I mean, most people wouldn't know where to begin as far as [inaudible 01:28:05]. I mean, I'll read some research, and I'll be like, "Whoa. This is kind over my head. I've got to kind of get my education up, my nutritional literacy up to a certain point in order to even grasp all this." So you got your Master's in nutritional science, and you were interested in this before you got that, am I correct?
Simon Hill:
Yeah. And it doesn't really just stop with the University. Now, it's a daily practice like anything else. And I lean on so many people who are way more experienced than me to workshop a lot of these, and when a new study comes out, I'm in a bunch of different groups where people are sharing new studies and talking about them, what are the strengths, what are the limitations, what does this study actually show us? When we zoom back out and look at the totality of the evidence, where does it kind of fit in and how would this effect recommendations? So it's an ongoing process. I certainly haven't mastered it, a long way from mastering it, but certainly something that I enjoy.
Rip Esselstyn:
So tell me this, this program, this Master's in nutrition science, how long was it?
Simon Hill:
Four. Four years. Yeah, you can complete it and be quicker if you wanted.
Rip Esselstyn:
So four years. And you probably went into it with a certain knowledge or even bias, and then did you find that what you were learning, did some of it feel antiquated or were they pushing a certain agenda, so to speak? Or was it completely wide open?
Simon Hill:
I get asked this so much. I think it depends on the unit and the teacher of that unit. So I had sort of different experiences. In some of the units, it was very, very evidence-based. The unit was more focused on teaching you how to look at evidence, but then letting you go and look at the evidence and make sense of it and writing about it. So I was certainly able to express myself objectively based on how I was looking at the research, and I wasn't getting any pushback. And I would say overall, given that the course is so evidence-based, that the recommendations are up to date, and they're very, very plant-forward, and all of this stuff we're talking about was covered within the course. They're certainly recommending that people eat much more whole plants and less animal foods and less ultra-processed foods.
Simon Hill:
So across the board, I was pretty happy. There were certainly some moments in there where I'd read something and think that's a little outdated, but on the whole, it was a good experience.
Rip Esselstyn:
Did you find yourself challenging the instructors?
Simon Hill:
There is a bulletin and a discussion board. Yeah, in a kind of gentle way, I would ask questions and cite some research. And there was always really healthy conversations about that stuff, and I think a lot of the teachers and the ones that were very engaged in the discussions, they also want to stay on top of the research. So having someone send some science that maybe speaks to looking at something through a different lens, it was generally received very well by these guys.
Rip Esselstyn:
Were you one of the older or younger people as far as students?
Simon Hill:
Probably sort of towards the older, I'd say. Yeah.
Rip Esselstyn:
Uh-huh. That's awesome that you went back and you devoted however much time in four years to that. I mean, way to go. Awesome. What about organic versus conventional when it comes to cancer? I know you talk about that a little bit.
Simon Hill:
Yeah. No much data, to be hones. There's a couple of studies, observational studies, one out of UK and one out of France. And so they look at people over a period of time. These are large cohorts and look at see, is there a difference in the incidents of cancer depending on whether someone was consuming conventional or organic food. And across the board, they tended to find that there wasn't much difference albeit for non-Hodgkin's Lymphoma, a certain type of cancer. There seemed to be slightly increased risk in those consuming conventional. But then there was also in one of those studies an interesting finding where women consuming more organic food had higher risk of breast cancer, for example. And there could be many reasons to kind of explain that other than organic food. It might be that women buying organic food are more likely to go and get screening.
Simon Hill:
And so what was, I guess, interesting from these two studies was that there was no real alarming jump-out finding across the board. If you're eating conventional, you're going to have increased risk of all these cancers. That certainly was not observed in these studies. So I'm often asked what do I recommend. I would like to see a lot more research done on that, but my position today is that we are not in the health predicament we're in because people are failing to eat organic. It's because people are just not eating fruits and vegetables and whole grains, nuts, seeds, and legumes of any type. So I think we need to be clear that in these studies showing huge benefits of plant-based diets, it's not just in studies where subjects are consuming organic food.
Rip Esselstyn:
Yeah.
Simon Hill:
So there are benefits up for grabs by adding more whole plants on your plate no matter how they're grown. And then is there any reason to kind of choose organic? I think maybe there is a slight signal there for non-Hodgkin's Lymphoma. So perhaps you could sort of buy organic where possible. There is some studies showing organic food is a little bit richer in antioxidants, which is interesting. But again, if someone can't afford organic, you could make up for that just by eating a little bit more fruits and vegetables.
Rip Esselstyn:
Which, to me, is very comforting.
Simon Hill:
Yeah.
Rip Esselstyn:
I mean, there's some people that it's got to be organic. If it's not organic, I'm not touching it. I think most people, I would have to say most people in America are probably buying conventional stuff not organic. And I think it's comforting to know that you can be eating fruits, vegetables, whole grains and beans, they don't have to be organic. And you're still going to be fine.
Simon Hill:
I'm with you there. There really shouldn't be the fear that does exist on that because the data that I'm speaking to, it's two studies, and they're very weak, and across the board, we see consistently benefits from eating these plant foods in populations that, as you say, are eating conventional. So I think unless there's other evidence that decides to surface, I think that's a very sensible position.
Rip Esselstyn:
Yeah, I had a guy on the podcast, I don't know if you ever heard of him, Dr. Nathan Bryant, and he's probably one of the foremost authorities on nitrous oxide in the world. And they've done extensive studies. And he actually has shown that there's actually more nitrates in conventional green leafies than in organic.
Simon Hill:
From the fertilizer?
Rip Esselstyn:
You know what? I don't know. I don't know, but it's a hodgepodge of stuff that's out there related to it all. Let's dive into keeping our brains young.
Simon Hill:
Yes.
Rip Esselstyn:
And I think what, to me, one of the things you write about that's so comforting is you basically talk about 3% of all Alzheimer's are categorically determined by our genes. Only 3%. So that to me gives so many people a lot of hope out there. And then we've had the [inaudible 01:36:53] on the podcast, who were amazing, but you cite in the book for example that you have some friends that say, "Hey, Simon. There are studies out there. People say that 20% of cholesterol, our brains are 20% cholesterol and 60% fat. So don't tell me I don't need all this cholesterol and all this fat."
Simon Hill:
Yeah.
Rip Esselstyn:
I don't think they realize the damage they're doing.
Simon Hill:
No. And we know very clearly, if you have high cholesterol in your midlife, and we just spoke to how you jack up your cholesterol, you're significantly more likely to develop Alzheimer's/Dementia. And it is... Something else that's quite interesting is the cholesterol that you eat does not cross the blood brain barrier. So the cholesterol in your brain is actually manufactured in your brain, and if the cholesterol in your egg is crossing into your brain, there's a problem. Seriously. There is a problem, it's called a leaky... Instead of a leaky gut, it's a leaky brain.
Rip Esselstyn:
That's a real thing.
Simon Hill:
That is a real thing. And so I do find it a little bit amusing. I get tagged in certain posts on social talking about the need to eat cholesterol to then fuel your brain, but that's kind of, I guess, overlooking some of that biochemistry there.
Rip Esselstyn:
Is it the same thing with the fat? Can the fat cross the barrier?
Simon Hill:
Fat can cross, but you certainly don't want a whole lot of saturated fat in your brain, that's for sure. There are certain fats that are very healthy for brain function and cognition, and those are the poly-unsaturated fats, Omega 3's which people will be quite familiar with. They're going to come in your foods like chia seeds and flax seeds and walnuts. So that chapter for me was about what information can help people in their day to day protect them against long term neuro-degenerative disease? And also, how can they fire up their brain in their day to day? Because a lot of these foods that are protecting long term through dialing down the inflammation in the brain, for example, through lowering cholesterol, they're also having some acute effects which effect how your brain is operating in your day to day. So a good example of that is the polyphenols that are in our colorful fruits and vegetables.
Simon Hill:
One major example of that being anthocyanins that are in berries. And that's why I routinely recommend people try and have a serve or two of berries every day. And we've known that polyphenols have been associated with good health for quite a time, and I think when people hear of polyphenols, often, people go to red wine because resveratrol got marketed, but in fact, you can get much more polyphenols through whole plants and in much higher volumes. In the last, say, five to 10 years, there's been a lot of emerging science that has really teased out how polyphenols effect our cells. And a lot of this has come through advancements in our ability to study and look at the microbiome. So only 5% of these polyphenols, these polyphenols or phytochemicals, only 5% of these, and these are what gives the blueberry the kind of dark blue pigment and the strawberry the red pigment, for example, and citrus fruit the orange pigment.
Simon Hill:
Only 5% of these are actually absorbed in the small intestine, and 95% go through to the large intestine and act as prebiotics. And this is really, really interesting and important because through this advancement in research, we've been able to see that those 95% that land in your large intestine, the microbiome metabolizes them and they produce about 500 to 1,000 different metabolites. So rewind 10 years ago, we actually couldn't even see those metabolites. The technology wasn't there. Now, we're able to see that polyphenols absorbed in the small intestine, they do, the 5% of them go through into the blood. They only hang around for about an hour. Whereas, these metabolites that are produced hang around your blood for up to two days.
Simon Hill:
And so this is helping piece together some of the benefits that we see when people consume polyphenol-rich foods. And there is a whole plethora now of studies looking at in children, in adult, in elderly, even elderly with some mild cognitive impairment, if you feed them blueberries, for example, or blueberry extract so they get sort of a large amount of anthocyanins, these polyphenols, equivalent to about a cup. And then you measure their cognitive function in the sort of three to six hour period after. Compared to placebo, they performed significantly better. And that difference really seems to be when the cognitive task they're given is a challenging one. If you give someone just a basic task, the addition of polyphenols doesn't really help, but if you're putting their brain under some stress and demand, then you start to see those who consumed the berries rich in these polyphenols performing significantly better.
Simon Hill:
And there are some sort of various explanations for that that they've been able to see in human studies and animal studies following the consumption of these anthocyanins by about three hour mark. You get peak increase in blood flow to the brain, and you get increase in protein called brain-derived neurotrophic factor, which is like a fertilizer to help promote neuroplasticity, reorganization of the brain. So there's all this magical stuff happening, and I probably went into the weeds there, but that's one example in that chapter of a food that you can lean into and try and make regular and really get some benefits out of, not just in the longterm but from today.
Rip Esselstyn:
Yeah. The next section, you talk about how you can add years to your life and life to your years, which is awesome and that kind of health span that we have. I do want to be sensitive to the time and the fact that I want you to be able to catch your flight, but part three of the book, it's basically making the shift. And you basically have the plant proof pyramid, and you talk about eight different things that you think people should do. The first one, I absolutely love, and it's basically focus on food groups, not macro-nutrients, and everywhere I go, it seems like people, they've got their different apps and they're plugging in their grams of protein, carbohydrates and fat and all that. It just seems like since when has eating food become such a scientific experiment?
Simon Hill:
Yeah. And it's a distraction from what matters most, which is the diet quality. Where are those nutrients coming from? You can have the perfect protein, carb, fat numbers, but if you're accessing those nutrients from foods that we know are associated with poor health, then what does that data really mean?
Rip Esselstyn:
And then according to your plate, what would you like that plate to look like?
Simon Hill:
At least half of it is fruits and vegetables or one of, particularly those dark, leafy greens and cruciferous vegetables. You want to be having multiple serves of those throughout the day.
Rip Esselstyn:
Do you have a favorite?
Simon Hill:
Dark leafy green?
Rip Esselstyn:
Yeah.
Simon Hill:
I love arugula, which I know it's not everyone's favorite.
Rip Esselstyn:
It's the pirate's favorite.
Simon Hill:
Yeah. I really love it. It's a little bit spicy almost. But to be honest, I try to practice what I preach, so diversity is important. And I try and aim for one big, big dark leafy green salad every single day, no matter how the rest of my diet's looking. It's like a main stay for me, particularly if I'm at home. So half the plate is going to be either fruits or vegetables. We've got legumes are going to be in there, and I lean a little bit more personally into legumes than whole grains, not because whole grains are unhealthy at all but because I am trying to consume a bit more protein with my training, and legumes are going to be the food group where you get most of your protein in a plant-based diet.
Simon Hill:
And then on top of that, usually there'll be some nuts and seeds or some sort of nut-based dressing over that, lemon, sprouts, been big on sprouts particularly lately. My friend Doug isn't. I think he's changing the way that everyone is seeing sprouts.
Rip Esselstyn:
Oh my gosh. He is such a hoot.
Simon Hill:
So sprouts and then don't forget some fermented food, scoop or two of sauerkraut. Yeah, something like that. That's kind of how I would base my meal.
Rip Esselstyn:
Well, and in this section of the book, I like the way you talk about nuts, as well, as maybe not something you necessarily snack on, but they're great for topping whether it's over cereal or salad or something like that.
Simon Hill:
Yeah. Well, if you're like me, I know if someone hands me a bag of nuts, I'm going to polish those off. And they are very calorie-dense. There are some extremely health-promoting properties in nuts, but I think if you're like me and you do have that problem where one handful becomes seven, eight, then it's much easier portion control to either put them on top of something, on top of your salad or a handful into a smoothie. That way you can sort of manage the calorie consumption a bit better.
Rip Esselstyn:
Six, seven handfuls, I mean, 180 calories per handful. We're talking close to 1400 calories.
Simon Hill:
Yeah. I've been known to do that.
Rip Esselstyn:
You can do some severe damage with that. Listen, I love nuts. I really like walnuts.
Simon Hill:
Same.
Rip Esselstyn:
I think it's probably because of the science that I've read that they're the most, and I don't know if you'd agree, the most anti-inflammatory and they have the friendliest Omega 3 to Omega 6 ratio. So with the people that we have that are coming to our events and our emergent programs, we recommend about a handful of walnuts a day.
Simon Hill:
Yeah. That's my nut of choice, too. I think I had...
Rip Esselstyn:
I also like the Brazil nut because of selenium.
Simon Hill:
Yeah, I like one or two Brazil nuts in the diet.
Rip Esselstyn:
They're tasty, too.
Simon Hill:
To get, but again with Brazil nuts, and I think that's a bit of a good takeaway point here is that just because a food is healthy doesn't mean it's healthy at any level. And Brazil nuts, I actually like to think of it as a bit of a supplement because they're loaded with selenium, but the problem with Brazil nuts is if you were to eat a whole bag, you would actually be consuming toxic levels of selenium. That's how rich in selenium they are. And the upper level intake for selenium is not that high. So look at Brazil nuts as a supplement. One or two a day. You're still going to get some selenium through a lot of other plant foods, but that one or two will just make sure you do tip into that adequate intake level. Yeah. To your point, walnuts are certainly... If I'm having a salad or something and I'm going to put some nuts on top of that on those dark leafy greens, that's the nut that I'm going with for those reasons that you made about the nutrition for sure.
Rip Esselstyn:
Point number two, and we've really kind of hammered this home is to be fiber-obsessed. But you also actually say it's almost like it should be considered the fourth macro-nutrient.
Simon Hill:
I think so. I mean, and perhaps should be the first one if someone is going to be plugging into a calculator because it automatically means your diet will have to straighten up in order to get there, again, unless you sort of hack your way there with a fiber supplement. But if we're talking about getting it from whole foods, it's something that we should be focusing more on than protein, for example.
Rip Esselstyn:
And in parentheses on that one, you do have protein-aware. Is that for certain people that kind of maybe need a little higher protein requirement?
Simon Hill:
Yeah. I certainly don't think we need to be protein-obsessed. I think it's gone a bit far, but usually what happens is, when something goes too far like that, then the other side is like, "Okay, let's just not talk about it at all." And I think it still is worthy of being spoken about, and for a few reasons. One, certainly for athletes that are looking to optimize and get every bit out of their performance. It's important for them to understand that they can do that with a plant-based diet. There's ways to definitely consume enough protein. So I go through that in the book. And then I also do make a recommendation in there for folks that are over the age of 60 to be conscious if they're eating a completely plant-based diet to make sure they are regularly consuming legumes, for example.
Simon Hill:
And the reason for this is that... And I should add on top of that, it's not just diet but it's also continuing to train and say stay strong and move, but the rationale for that is that we know having lean muscle and being strong and having strong bones is particularly important for longevity. So if we're talking about muscle for a moment here, protein is important for maintaining lean muscle mass along with doing some form of exercise that places the body under some demand. And the actual protein recommendations do go up a bit as someone reaches 60 and beyond. So my recommendation in the book is to lean a little more into those legumes if you can when you get to that age, and from a bone health perspective, we've reduced bone health to calcium, and yes, calcium is important, but it's one...
Simon Hill:
Building strong bones is a team game. Again, the exercise, the movement needs to be there because structure reflects function. And yes, calcium is important, but you can consume all the calcium you want in the world, and if you don't have the rest happening, you can develop weak bones. So calcium, regularly consuming enough protein. It's not about being obsessed and having to go and have heaps of protein shakes or anything like that, but just the chickpeas and the lentils and the kidney beans and the tofu and the tempeh, just keeping these consistently in your diet, and I know I have to work with my mom a bit on these. She's about 65, and she's noticed her appetite is a bit lower these days. So it gets a little tricky to try and just remind her to regularly consume that food group in particular. And in my family, we have my mom's mom had osteoporosis.
Simon Hill:
So protein just to sort of tie that together, yes, I think that we should be aware of it, and we should be making sure that we have these very health-promoting plant protein rich foods in our diet, but we don't need to obsess over it.
Rip Esselstyn:
Yeah. Yeah. Point number three, and I'm just going to quickly go through these. I think that they're so great. Diversity is key for the gut health. We've talked about that. Your recommendation is try and get 40, 40 different unique plants a week. It's a great way to go, and then you're crowding out all the other stuff.
Simon Hill:
And herbs and spices count in that.
Rip Esselstyn:
Good, good. Thank you. Yeah. You also talk in this particular point about resistant starch. Can you explain to people what that is?
Simon Hill:
So we spoke about polyphenols and sort of prebiotic fiber. But resistant starch is another type of prebiotic. And it's a type of indigestible carbohydrate, starch, that passes through to the large intestine. We don't absorb it in the small intestine. And in a similar manner to prebiotic fiber or polyphenols, it feeds the microbes. And when you feed these microbes, they're producing metabolites that help reduce inflammation, maintain the lining of the gut.
Rip Esselstyn:
Where's that resistant starch found? What foods?
Simon Hill:
So one of my favorites is potatoes, and there's a trick to increase the resistant starch in them. And that is cook the potatoes, and then allow them to cool. And that can be in your fridge. So this is great to do with leftovers. If you are doing some baked spuds and cooking up some extras for tomorrow, let them cool in the fridge, and then the next day, you can throw them into a salad, or you can recook them again if you want. And the resistant starch content of those potatoes will be significantly higher. So it's a little bit of a potato hack.
Rip Esselstyn:
Yeah, that's a good one. Have you ever taken...
PART 4 OF 5 ENDS [01:56:04]
Rip Esselstyn:
What...? Have you ever taken, this isn't, but have you ever taken tofu, put it in the freezer and then watched everything? Just that tofu completely transforms itself, and then when you use it, it just so absorbs anything you put in.
Simon Hill:
So I have done this, and I've done it once and it was amazing. The reason I've done it once is because it was the week before I came to the States, not too long ago. And it was a guest, John Rush. Do you know him? Have you heard him?
Rip Esselstyn:
No.
Simon Hill:
He's a professional Canadian footballer. He's been plant-based for a number of years now. Super big guy, very strong and loves his tofu. He brought that to my attention. But yeah, that's a great trick.
Rip Esselstyn:
So you mentioned him, you work with a lot of these athletes in Australia. Now, are you friends with Chris Hemsworth?
Simon Hill:
Yeah. Chris is a friend of mine and I'm the plant-based nutrition advisor within... He has an app called Centr which is a combination of workouts and food. And I do all the plant-based recipes and blogs and all that stuff in there.
Rip Esselstyn:
Did you say plant-based?
Simon Hill:
He's not fully plant-based, but he's very plant forward. And I would say certainly very receptive to new information, and is making a lot of tweaks and changes. So very supportive of it and has given me a huge opportunity within the app to help educate and write blogs about a lot of things that are in the book to that community. So it's been nice to see that within that community, there's very big interest in plant-based foods and yeah, it's been fun.
Rip Esselstyn:
And he's got some brothers too, right?
Simon Hill:
He's got two brothers, Luke and Liam. Yeah.
Rip Esselstyn:
Yeah. But Chris is the... What? The Hercules guy? Or what is it?
Simon Hill:
Thor.
Rip Esselstyn:
Thor. That's right.
Simon Hill:
Yeah.
Rip Esselstyn:
Thor. Yeah. That's pretty cool. So let's say Thor goes all plant-based, right?
Simon Hill:
Mm-hmm (affirmative).
Rip Esselstyn:
And you talk about considering nutrients to focus on omega-3s, B12, D?
Simon Hill:
Mm-hmm (affirmative).
Rip Esselstyn:
We've talked about calcium. We've talked about selenium. Can you talk about... I want to be respectful here because I could milk you for forever. What about zinc and iodine? I feel like those are two that we don't [crosstalk 01:58:44].
Simon Hill:
I'm glad you, you brought up iodine. Yeah. Iodine is the least spoken about, but one of the most important particularly for plant-based eaters. And that stems from anyone from pescatarian to vegetarian to a completely wholefood plant-based person. And iodine itself is very important for thyroid health, for a production of thyroid hormones, which help regulate our metabolism. And in a typical omnivores diet, a lot of people getting their iodine through iodized salt. And that's why fortification actually came in because across the general population, there was problems with iodine deficiency. So this is not just a plant-based thing, but can become an issue in a plant-based diet when there is no iodized salt in particular. And also in an omnivores diet, you'll get a little bit of iodine through seafood and some through dairy.
Simon Hill:
Now, it's very easy to cover in a plant-based diet. I just think that not everyone is fully aware of how to get it. You only need a tiny, tiny amount. 150 micrograms a day. It's tiny, minuscule. And so there are really three ways that you can go about getting it. The first is through nori or wakame or dulse flakes. These are seaweed. And you only need a small amount. Two teaspoons of dulse flakes will provide that 150 micrograms of iodine, and you can check.
Rip Esselstyn:
And is that what you want a day?
Simon Hill:
Yeah. And you can check-
Rip Esselstyn:
Oh, I haven't been doing anywhere close to that.
Simon Hill:
Yeah. So you can actually check your iodine levels through a urinary test with your doctor. That's probably the best most specific way to do it. And so that's one option is through this regular inclusion of seaweed, but I'm also quite aware that not everyone loves seaweed. And I've worked with people when they've been able to take those. That two teaspoons and put it into a smoothie and you can barely taste it. But some people don't want to go down that route. And even with that route, you need to be very specific when you buy dulse, wakame, nori turn around and read on the package, how much iodine is in there because it can vary. Iodized salt, so this is an interesting one. You probably need around half a teaspoon of this, is not really going to be an issue for someone who is healthy and has healthy blood for pressure. But not the best option if you are at risk of cardiovascular disease, have high blood pressure have cardiovascular disease.
Simon Hill:
So that's context dependent who you are. And then on top of that, you've got supplement. And so you in most multivitamins that you can buy, you can turn it around, check iodine, is it 150 micrograms? If it is, that's great. Otherwise, you can buy an isolated iodine supplement, iodine just by itself. And there are loads of brands that sell 150 micrograms and it's a very cheap supplement as well. So quite accessible.
Simon Hill:
The other one was zinc. Yeah. So zinc levels actually vegetarians and non-vegetarians, there is usually not a significant difference in zinc status. I just put it in the book more for something people to be aware of. It's not like vitamin B12 where you need to supplement. It's more being conscious of in regularly including foods that are rich in zinc, like cashews, for example. But again, you don't need to go to town on them. You're going to get zinc through a lot of the different plant foods that you're eating.
Simon Hill:
But I guess one of the big tips in there that I have for people that I think is really interesting is, most people are going to have enough zinc in their diet. But you can increase the zinc absorption, which is really helpful. So a little bit like if you put lemon over your salad, you'll increase your iron absorption. With zinc, if you cook your meals with some onion and garlic, the onion and garlic will increase the zinc absorption. So pretty much air every time I'm making a meal, I'm putting onion and garlic in there.
Rip Esselstyn:
Because they're aromatics.
Simon Hill:
Yeah. And so zinc is not I think as important as I say iodine and B12 to zoom in on. Most people will get that.
Rip Esselstyn:
You say when we eat matters, do you try and eat let's say the bulk of your calories between let's say 8:00 in the morning and 3:00 in the afternoon?
Simon Hill:
Mm-hmm (affirmative). In a perfect world, yeah, my more food when I'm active in the middle part of the day and still have dinner, but it's usually a lighter meal. That of course is not a strict rule. And when I'm traveling around, I don't follow that perfectly. But there is some science that speaks to your body better metabolizing food nutrients when you're more active and being a little worse later or night, particularly if it's very close to going to bed when melatonin is increasing and cortisols dropping. Your body's really preparing to go to sleep, not to make use of the nutrients in your food.
Simon Hill:
So that section of the book was to summarize. I think there's a lot of crazy ideas out there about fasting and what people need to do and don't do. And I think there are some really good research out Satchin Panda's lab in California. It doesn't need to be too complex for people. You can still have your breakfast, your lunch and your dinner. Should we be eating from the moment we wake up to the moment we go to bed? Probably not. Probably allow a little bit of time when you wake up, have some water, hydrate and then have a meal a little bit after that. And before you go to bed, allow some time between your dinner and going to bed instead of eating all the way up to going to dinner.
Rip Esselstyn:
It seems like, and I don't know how popular it is right now. But I mean, a year ago, everywhere I turned, it was intermittent fasting and, "Yeah, I'm doing 16:8 I'm eating for eight hours and then I'm not doing anything for 16 hours."
Simon Hill:
Yeah. And for some people that can be helpful for helping control calories and reducing their caloric intake. But for many people, particularly if you say start that eating window very early, it means not having dinner with your family. So it's not going to work for everyone. And I guess when I was looking at the research, what became quite clear to me is that, there is no really good science to suggest eating in say a very restricted six or eight hour window is significantly better than say a 10 or 12. And a 10 or 12 hour window allows you to have breakfast with your kids, allows you to have lunch at work, allows you to have dinner with your family when you get home. And I think that's going to be much easier for people to adhere to, which of course is very important. You can have all the studies you want in the world, but if you can't actually implement that in the real life, how valuable is that?
Rip Esselstyn:
Yeah. Totally. What's your beverage of choice during the day?
Simon Hill:
Water and tea.
Rip Esselstyn:
And tea.
Simon Hill:
Water, tea. Yeah. And coffee. I do drink coffee.
Rip Esselstyn:
Yeah. And I think you cite some research that shows a little bit of coffee and tea actually can be beneficial. Don't you?
Simon Hill:
Yeah. We just had a great big mug. There is some research for both of those. And again, it probably comes back to polyphenols, catechins in green tea and chlorogenic acids in coffee. Surprisingly coffee is the number one source of antioxidants in the American diet. Now, I'm not sure if that says much about coffee or about the American diet. And I actually just did a podcast with a guy called Danny Lennon on coffee. And there is some interesting findings because acutely coffee can negatively effect lipids and increase cholesterol a little bit. But across the larger studies looking at health outcomes, seems to be around 2, 3, 4 cups of coffee a day is associated with a reduction in risk of cardiovascular disease. But as you go above that, you get an increased risk.
Simon Hill:
So it may be that the polyphenols in the coffee are offering protection, but I think coffee is one of those that I say to people, "If you don't drink coffee, you don't need to start." You can get polyphenols from so many other foods. And if you do drink it, then I think what you put in it, think strongly about that. Because adding the full fat dairy and the cream and-
Rip Esselstyn:
The sugar.
Simon Hill:
I'm not talking about that. When I'm talking about these studies, I'm just talking about black coffee. And so there's some important considerations there.
Rip Esselstyn:
Yeah. It's interesting. My father with his patients that have had all kinds of heart disease and they're per much a hot mess. He keeps their coffee to one cup a day. And he cite some research that actually shows that the caffeine actually can disrupt and harm the endothelial cells. But I don't know how old that study was, but I [inaudible 02:09:13].
Simon Hill:
Yeah. I think again, it's, I don't think that that coffee needs to be added. I think that the studies that I'm citing as well, the observational studies, these are showing associations. It's not a clinical trial, cause and effect. So we don't have a study, for example, that says, "Let's randomize people. No coffee, coffee. These people with heart disease and let's track them for 10 years and see the outcomes." So have to make the most of the data that you've got, but I'd like to look at that.
Rip Esselstyn:
Yeah. I'll afford it too. Don't let perfection be the enemy of the good. I think that that's a really beneficial one that maybe a lot of people could take to heart. Sometimes we get a little too hard on ourselves.
Simon Hill:
Yeah. And I find myself falling into that trap as well where you constantly think about every each meal, making sure it's the healthiest option. And then tomorrow needs to be healthier than today. And you get stuck in that cycle. You can lose your passion for food. So I think the point of that, that there was mainly to remind people that consistency over time is much more important than any single meal or food that you eat in one sitting. And by that I'm not throwing out this line of everything in moderation, no. I'm just suggesting that the dietary pattern that you stick to overall for as many years as possible, that's what's most important here.
Simon Hill:
And I know through the work that you do and certainly what I do and how I speak to this, I don't want someone to change the way they eat just for two weeks and then rebound back because it wasn't sustain. You have to find that dietary pattern that is sustainable for you and leaves you feeling good physically, mentally, you still have your love for food. Take some of that pressure off. Don't focus on being perfect in every single moment. And I think that's the key to building these changes in a way that makes them sustainable.
Rip Esselstyn:
One of the things in that section of the book that I read, and I don't think I'd ever read this before, is that you mentioned how you can eat certain parts of foods and you mention in the banana peel.
Simon Hill:
Mm-hmm (affirmative). Put those into a curry. Yeah.
Rip Esselstyn:
I've never ever. So into a curry?
Simon Hill:
You have to boil them first, okay?
Rip Esselstyn:
Okay.
Simon Hill:
So take the banana peels, and I really discover this because I ate a lot of bananas. Yeah, a lot. Both fresh on oatmeal in the morning, but also a lot of frozen bananas that I'll put into smoothies and make nice cream, for example. Delicious. And I was always thinking about these peels. It was a lot of peels. And you can put them into compost and stuff, which is great. But I came across a few recipes where you are using the banana peel. Essentially it creates, in a Curry, a very stringy, almost like pulled pork texture. So you boil them first and then of then you cook them through in a curry,. Let them soak up the flavor. Yeah. They're amazing.
Rip Esselstyn:
Yeah. So this book, The Proof is in the Plants. You if I'm not mistaken here, every penny from this book is going to support a rainforest in Northern Queensland. What's the name of it?
Simon Hill:
You really did read the whole book.
Rip Esselstyn:
I did.
Simon Hill:
I'm impressed. I'm so impressed.
Rip Esselstyn:
I did.
Simon Hill:
Gosh. Yeah, that's inspirational. So the organization is called the HalfCut organization. And it's actually led by a guy who I had on my show. And he's an interesting fellow. His name is James Stanton-Cooke. But he goes by Jimmy HalfCut, and I met him at an event. There was this environmental climate thing in Bondi where I live. And I saw room from the other side of the room and he has half a beard, right? So like a big, big beard, fully clean shaven on the other side. And I was thinking, "This guy is interesting. I want to talk to him." And so we got talking and sure enough, and it's a great conversation starter having half a bit, right?
Rip Esselstyn:
Yeah.
Simon Hill:
And he's at it for four years. And it represents the fact that we've lost half of the world's forest. And so what he's doing through his organization is raising awareness, raising funds to help protect existing forest because yes, we need to regenerate, but we need to hit the breaks on the clearing as well. So there's this huge tropical rainforest called the Daintree in Northern Queensland.
Rip Esselstyn:
It says it's the oldest-
Simon Hill:
It's the world's oldest rainforest.
Rip Esselstyn:
It's insane.
Simon Hill:
And it's the most biodiverse place almost on earth. It's incredible. And so yeah, the all process from this book are going to that organization. And he's actively up there working with the indigenous Australians to buy back the parts of the land that the government sold off in the '80s, and to stop proposed developments through those areas, give the land back to the indigenous Australians that are from that area. And then ensure that it's not cleared. So yeah, the idea is that if you buy the book, hopefully there's some information in there that helps improve your health and at the same time the planet.
Rip Esselstyn:
Yeah. And so that rainforest did not get hit by the forest fires?
Simon Hill:
No, thankfully. But yeah, Queensland is a very, very big state. So a lot of those fires were a bit more south. They were devastating. Rich was actually, he was in Australia when that happened because I remember we had dinner and the entire sky above us was red. Yeah. They were horrific those bushfires.
Rip Esselstyn:
Yeah. And another thing that you got going on is you've got a restaurant, right?
Simon Hill:
Yeah.
Rip Esselstyn:
I mean, give me a break. How do you find time for all this stuff?
Simon Hill:
I've got a wonderful partner, Tanya. She looks after the restaurant. It's really her baby. So we set it up together, and of course I'm very involved in terms of what's on the menu and the dishes and stuff that we're bringing out. But she manages it and does a great job. As in Bondi, we opened up in an interesting time. The start of the bushfires and then into COVID.
Rip Esselstyn:
Wow.
Simon Hill:
But it's still, when it is open, it's been very, very busy. It's been incredible to see the community you get around plant-based food. So a lot of the people coming dining with us haven't seen food like this before. So it's been fun.
Rip Esselstyn:
How far is that from where you live?
Simon Hill:
I walk there. It's a four minute walk.
Rip Esselstyn:
So I mean, whenever you want a good plant strong meal, you just walk to your restaurant?
Simon Hill:
Yeah.
Rip Esselstyn:
It's just not fair.
Simon Hill:
I'm definitely made a habit of that.
Rip Esselstyn:
Oh my gosh. So one of the things I was just looking at is, you've got a great, I love reading acknowledgements. Like who you thank for helping make this fruition. There's no dedication?
Simon Hill:
There is. It's at the back.
Rip Esselstyn:
The dedications at the back.
Simon Hill:
All the acknowledgements are at the back. Yeah. Gratitude.
Rip Esselstyn:
The acknowledgement at the back. Yeah, yeah.
Simon Hill:
Yeah. Should that be at the front?
Rip Esselstyn:
Well, no, no. Usually the acknowledgements are in the back. But then also you dedicate the book usually to [crosstalk 02:18:00], and there's no one. So it sounds to me like it's, I mean, I could be wrong, but your dad was a huge inspiration for you.
Simon Hill:
Oh, for sure. Yeah. And this brings us full circle. I've really through this process and reflecting back on my childhood and thinking about the work that he's done. I've certainly grown to really appreciate his role in science. And me going back and learning nutrition science has taken our relationship to a whole nother level because we have now this huge topic to be discussing all the time. And I love that. And his health journey planted the seed for the book. And I think that that experience as frightening as it was, it was necessary.
Rip Esselstyn:
So are your dad and your mom and your brother, James, are they all plant-based? Are they all [crosstalk 02:19:08]?
Simon Hill:
James is, mom is, and my dad is about 90%.
Rip Esselstyn:
Oh, really?
Simon Hill:
So it's interesting. He has a few foods that he struggles with.
Rip Esselstyn:
What?
Simon Hill:
Mainly cheese. And I'm working to get some streamer sent over to him.
Rip Esselstyn:
Oh, good, good.
Simon Hill:
I'm chipping away on that. He's made such huge changes to his diet that I've been super proud of. I haven't wanted to drill in on what he's not getting right yet. And I think we're getting there.
Rip Esselstyn:
Well, he needs to read your book.
Simon Hill:
Yeah. He tells again.
Rip Esselstyn:
Again and again. That's the cool thing. I mean, I powered through this thing, but I can't wait to read it at a slower pace and really absorb all this information. Kudos to you.
Simon Hill:
Thank you so much.
Rip Esselstyn:
It is such a total triumph. And thank you for everything you're doing to inspire people and to help us move the needle as far as getting people more plant predominant. Because as we said here, it's not only about our health, it's about the health of the planet. Man, make it happen. People-
Simon Hill:
We need to make it happen. And thank you to you too. You and your dad, and many of the people that we've mentioned in this podcast. The Shares Eyes, for example, are all huge influences on me and really paved the way for so many decades to even create this movement, this area of wellbeing. So I'm super appreciative for that.
Rip Esselstyn:
Well, collectively it's like our bones, right? You said it's a team effort. And this is the ultimate team effort right here. And the more people we can get behind and create an amazing all star team and well, I'm optimistic we're going to get there one way or the other. I don't know if it'll be in five years or 50 years, but we're going to get there.
Simon Hill:
I think so. I mean, there's just so much momentum going in that direction. And I feel some of the change at the government level can seem slow, but by and large, most of these people that are in government are good people. And there's a lot of moms and dads in there now who have kids, and they're in government positions and they're thinking about the future for their children. And so it's only a matter of time until more and more policy is put into place that is favoring the health of the planet and future generations. So I'm incredibly optimistic. I know not everyone is, but I just see too many positive things happening not to be.
Rip Esselstyn:
Have you been to Casa De Luz since you've been here?
Simon Hill:
Yeah, I have. And I went last time too.
Rip Esselstyn:
Good, good.
Simon Hill:
I love it. Little macrobiotic place.
Rip Esselstyn:
Awesome, awesome, awesome.
Simon Hill:
It's great.
Rip Esselstyn:
Well, man, I hope you have a great flight.
Simon Hill:
Yes. Thank you.
Rip Esselstyn:
And the next time you're in Austin, let me know again, and let's grab a bite.
Simon Hill:
Let's do it.
Rip Esselstyn:
And will you do the sign off with me?
Simon Hill:
Yeah.
Rip Esselstyn:
Ready? Repeat after me.
Simon Hill:
Okay.
Rip Esselstyn:
Peace.
Simon Hill:
Peace.
Rip Esselstyn:
Turn it around. Engine 2.
Simon Hill:
Engine 2.
Rip Esselstyn:
Keep it PLANTSTRONG.
Simon Hill:
Keep it PLANTSTRONG.
Rip Esselstyn:
Yeah. Again, I want to thank Simon for the eye opening conversation and the really captivating information that could save the lives of so many. To order his book, The Proof is in the Plants, visit plantproof.com or the episode page at plantstrongpodcast.com. Thanks so much for listening. See you next week. The PLANTSTRONG Podcast team includes Carrie Barrett, Laurie Kortowich, Ami Mackey, Patrick Gavin, and Wade Clark. This season is dedicated to all of those courageous true seekers who weren't afraid to look through the lens with clear vision and hold firm to a higher truth. Most notably, my parents, Dr. Caldwell Esselstyn Jr and Ann Crile Esselstyn. Thanks for listening.
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