Dr. John Briffa – So Many Nutritional Myths, So Little Time
Dr. John Briffa
Jonathan: Hey everyone, Jonathan Bailor back with another bonus Smarter Science of Slim podcast. Today’s show is going to be a great one because we have back wonderful friend of the show, someone who – listeners just get used to because we are going to have this guy on again and again and again because I tell you we must have a common ancestor somewhere because while he is across upon over in lovely England when I discovered his book Escape the Diet Trap, I was just like “Oh thank God, I didn’t read this before I wrote my book or someone would accuse me of plagiarizing.”
He is a brilliant physician over in the UK who literally if you like anything about this show or the Smarter Science of Slim, you are going to have to check his work out because it is just absolutely fabulous. He has been doing this for many, many decades. He is seeing patients, he is writing books, he is changing the world. The book is called Escape the Diet Trap. He is called Dr. John Briffa.
John, welcome to the show.
John: It’s fantastic to be here and thank you for that introduction.
Jonathan: My pleasure, my pleasure. Dr. Briffa, last time you were on the show, we waxed a bit philosophical about policy and all that kind of fun stuffs. So, today I wanted to get a bit more scientific and then a bit more practical and jump right into. You are one of the few people in the world who comes right out and says, “You can eat a lot and not really exercise all that much and lose weight for good.” How is that possible?
John: I think part of it is essentially based on an understanding of some of the basic pieces of physiology and biochemistry to determine fat storage. Obviously, there is a genetic component here, but generally it’s quite a malleable thing and if we think about not so much about calories, as I am sure you are aware this idea that eating less and exercising more leads to weight loss. Only that works, I suppose on a logical level and it seems very persuasive. The vast majority of people as you know just can’t really make it work in the long-term, may be in the short-term, but not in the long-term and I think there are few reasons for why that is.
You basically put a dent in the metabolism when you eat less. You also get hungrier which can make the whole thing unsustainable and as I am sure you know, when you exercise more, theoretically you are burning more calories, but unless [indiscernible 02:56] exercise, it’s difficult to burn significant numbers of calories, right? You may get a bit hungrier or reward yourself may be with food after exercise and as a result when you look at all of this, it usually ends up in a bit of a mess for most people and people would then say we haven’t been strong enough and you still been eating too much, you are exercising [indiscernible 03:23].
If something is wrong with you, people conclude that they must be broken or inadequate or whatever, but because of these reasons this I think good reason to look at the calorie principle and say “Look, it doesn’t work and can we find something that works better?” So, my particular approach is really not to look at the calorie thing and [indiscernible 03:42] with people because as I say it does not really get them very far down the path I think most of the time, but to think about sort of fat storage, you know it is a concept, you know what is it that causes fat to be stored in the body and at least part of the answer comes from hormones and there are several hormones at play, a major one being, for example insulin.
So, insulin is a fat storage hormone and it basically facilitates the uptake of fat into fat cells and also inhibits its release. These are two fundamental things that insulin does. So, following that theory you could say, “Well, if we get insulin levels down, then we can promote fat loss, not weight loss.” Weight loss is well, but I am being specific about weight loss here because it is one thing to lose weight and it is another thing to lose fat because as you will know if you go on a relatively calorie restricted diet that tends to lead to malnourishment, you can lose muscle and may be other important tissues as well, but that’s not necessarily the aim of the game, the aim of the game is to lose fat.
So, let’s say you have lowered your insulin, now you are losing fat, then you are achieving your objective which is fat loss, right? One of the questions that might ask so is where is that fat going to end up? It doesn’t just evaporate, so one theory is of course that it goes out of the fat into the bloodstream from where it can be then delivered into, for example our muscles where we can burn it for fuel.
So, now you are using your stored fat as a form of fuel. That’s what it’s there for of course, isn’t it? That’s why it’s there, but some people have suggested that if you are burning fat in this way, [indiscernible 05:28] not eating if you like is being supplemented by your own fat, so you may not get so much of a reduction in your metabolism and also you may not be very hungry and there are some people who are quite well adapted to burning their own fat. You can go actually for very long periods of time without eating and people say, “Well that’s bad, they are not feeding themselves.” It is not that they are necessarily on the fuel. They may not be eating very much, but it doesn’t mean they are on the fuel because of course they may be burning their own fat which remember is why it is there.
So, I think when individuals basically understand this component and goes for this little approach, the usual results what I see commonly is that individuals are able to eat less, lose weight and specifically fat and not be hungry. This is the key because one thing that makes diets really quite unsustainable for most people is that they get hungry and not really do they just want to eat more food, if they drop their blood sugar for example, they can start intensely craving certain foods that make the whole thing very, very unsustainable. So, time and again, I have seen individuals [indiscernible 06:43] their diet in a way that on testing they will then basically be able to lose weight in the long term without hunger.
So, the whole thing is sustainable and of course eating foods that they generally like to eat, certain foods would not be very compatible with this way of eating, but there are plenty of other foods that people would be very happy to eat generally as long as they don’t have it stuck in their head that somehow [indiscernible 07:06] which it doesn’t appear to – that’s a whole other story, but as long as they are confident, happy with what they are eating, not hungry and achieving their health objectives with regard to weight and may be their biochemistry, then they [indiscernible 07:20] liberated, hence escaping the diet trap that some of us have had experience of.
Jonathan: Dr. Briffa, many, many gems of knowledge there. So, let me see if I can capture a few of them. Correct me if I misrepresent any of this. First and foremost, once we give our body the ability to burn fat, fuel us, hunger takes on a new definition because traditionally we would think that we are hungry unless we are eating, but we can get fuel from our hips just as readily as we can get fuel that passes through our lips if we are fat adapted and able to burn stored calories as energy just like we could burn calories we are eating as energy. Is that fair?
John: Yes, that’s totally fair. I think you have articulated that brilliantly. That’s exactly how it is. There is a bit of a vogue in the UK, I don’t know whether it is on your side of the pond, but there is a bit of a vogue for intermittent fasting here in the UK. There was a successful book. I think it’s called The 5:2 Diet, no it is called The Fast 2 Diet. There are a few incarnations of it and this elements [indiscernible 08:29] I don’t particularly agree with which is some of the books say “You can eat what you like for five days, just don’t eat very much for two days.” That’s essentially the message.
I don’t really agree with it to be frank, but the idea of restricting food on certain days, as long as people don’t get very, very hungry and then spin out and then eat rubbish food, I think it helps push the body towards the side that it should be able to grab hold of its fat stores and then use that for fuel. [indiscernible 09:00] used to be a bit of three meals a day for the person, that’s what I would generally advocate, but I realized I was advocating on the basis of allowing people not to be hungry which is the key component I think of eating healthfully.
When people get hungry – I sometimes say to patients if you got the option of eating a shrimp and avocado salad or a shrimp and avocado sandwich, imagine if you are not very hungry making that choice and that one being the salad basically and then imagine making it when you are much, much hungrier, does not work out for you and obviously it’s much more difficult to resist the sandwich in that situation, right? So, appetite control I see is being one of the key elements of weight control and it’s the exact reverse of what I think many of us are being led to believe, but most people believe that if they are hungry, they must be in calorie deficit and that’s a prerequisite of weight loss.
As you well know and we are suggesting here when people get very hungry, it is very difficult to eat healthfully and that’s [indiscernible 10:07]. So, while they are possibly starving, they might be losing by the way a tiny amount of weight, but then when they do eat, they may tend to overeat and eat foods that are going to leave high levels of insulin and more fat storage. So, that can’t really work any.
Jonathan: Dr. Briffa, I want to say something here which may or may not be controversial, may or may not be off base, I am curious to get your thoughts on it and that is around this whole intermittent fasting, eating less. What I hear or might be hearing you say is at the heart of sustained, life-long, until you die, healthy weight and a version of hunger is to make your body regulate your appetite appropriately and unconsciously and that unconscious part I think does not get talked about enough because I don’t know about you, but I am pretty busy, I can imagine you are pretty busy, I can imagine most of our friends listening are pretty busy, so the more structure like 5:2, 8:7 whatever count calories, it seems that if we give our body what it needs, it should be able to regulate our appetite and avoid hunger effortlessly in the sense that that’s what it’s designed to do, isn’t it?
John: Yes, I totally agree with that. Sometimes I say to people, when you look up, for example anthropological studies, people living quite naturally and eating essentially what is a hunter-gatherer diet, if we can call it that, there is essentially zero obesity in those people and none of them on 5:2 regime and none of them are counting calories and none of them are particularly concerned about their fat intake, none of them are taking necessarily formal exercise or any of these things and yet there is essentially zero obesity and I am very believer and probably having an inherent wisdom to it that we will enable it to find and maintain what is the correct way for it as long as we give it the right circumstances and one of those circumstances I think is not to apply too many sort of contrived rules about when we should be eating and precisely what.
There is a lot I think in what you say about listening to the body because the fact of the matter is if you tell people you need to eat three meals a day and breakfast is the most important meal of the day for example and that becomes someone’s truth and reality then that may lead to an element of overeating. They may not need that much food, they may not need to eat that frequently, their body may not demand that and people vary I think in terms of their ability to go for periods of time without eating, but there is absolutely no doubt in my mind there are people out there who quite frankly do not benefit by eating breakfast and in fact many of them actually say “When I eat breakfast, I am actually hungrier for the rest of the day than when I don’t eat it” and many people say that. I have heard that I don’t know literally hundreds of times I think over the years.
Some of that may be due to whether they say they are eating as well because of course what we are encouraged to eat is [indiscernible 03:24] cereal and toast for example, which is generally disruptive to blood sugar levels. You get this peak of sugar may be leading to surges of insulin which causes fat storage and then you get this low blood sugar may be two to three hours later typically, which causes people to be hungry again and want to eat more foods and not particularly healthy foods and these things can be quite sort of deeply engrained in people’s psyche. I need to eat in the morning and I need to eat cereal or toast preferably a whole grain thing because that’s what I have been told and it often gets the day off in my view to the worst possible start.
Even oatmeal I think is massively overrated. These are essentially a bowl of starch, which is starchy sugar, it is not [indiscernible 14:09] many better things you could do and one better thing for some people may be not to eat at all. I know loads of people that eat breakfast or rather I have met loads of people that eat breakfast even though they are not hungry. How does that work? They have been sort of indoctrinated to believing that they have to do it. A lot of people have been indoctrinated to believe they have to be hungry to lose weight as we mentioned earlier.
So, I am a great believer in people getting back in touch with what’s really going on to them and most people when you put that idea to them Jonathan, are utterly relieved because on a deep level they knew possibly what they have been led to believe was right wasn’t really right for them, like eating breakfast when they are not hungry, which is for me is madness really, but that’s something when people will understand that we are variable here and we have different requirements and it’s all right not to eat breakfast for example, that might be sacrilege in certainly different circles, but I think it’s true. Some people really don’t need to eat breakfast. They are very good at fueling themselves through the morning on basically their fat stores.
When people hear these things and integrate them, usually they are utterly relieved and they can go on to have lives that are much more suitable for them in terms of how they are eating, but also in terms of their health and they can also be more confident about what they are doing. They feel it is right for them intuitively and now in tune with what they felt they should be doing all along, but have been [indiscernible 15:42] by whatever conventional wisdom or their doctor or their dietician or the media or food companies or whatever.
Jonathan: John, I can definitely see how this would be liberating for individuals and there might be two levels of adaptation we are talking about here. Tell me what you think about this. We talk about being fat adapted meaning where your body can fuel itself from calories stored on your hips rather than calories necessarily always passing through your lips.
It also seems like there is a mental adaptation that takes place here because at the heart of what I hear you saying is we need to take a step back and trust the wisdom of our bodies and our internal world rather than looking always to the external world and these rules which again don’t account for our unique circumstances, but before we can do that there is another adaptation that has to take place because if we are eating starches and sugars and these addictive type foods, if we trust our body we know we are just going to keep eating Pringles until four cans are gone because that’s what our body is telling us to do.
So, for a lot of people I think this might leave them scratching their head because until you free yourself from these toxic edible products, like if you are eating toxic edible products and you trust your body, you will weigh 600 pounds. However, if you are eating real whole healthy nutrient dense foods and you trust your body, you will be slim and healthy effortlessly. What do you think about that?
John: I think that’s probably true and I don’t [indiscernible 17:05] I think some foods are being specifically designed to essentially cause people to overeat. So, they say as [indiscernible 17:15] line the Pringles, I think used to use, but don’t use anymore here in the UK which is “Once you pop, you can’t stop.” Do you have that in the States?
Jonathan: That is literally my – that and Jell-O. “There is always room for Jell-O.” My two go-to examples.
John: Okay, so we have got a few things going on and I am sure you are familiar with the concept of rewards that a food can be rewarding to people. So, can light up reward center in the brain a bit like recreational drugs do and I think some foods are designed to do that. They can also be disruptive to blood sugar as we told about earlier so you can drop your blood sugar now, be falsely hungry. You feel like there is food in your stomach, but you are craving something madly because your brain feels it’s unfulfilled and there are probably many other mechanisms, may be MSG has a role in overeating, may be artificial sweeteners have a role in overeating.
So, there are probably many, many different mechanisms that might cause the very food that you are eating to cause you to eat too much food overall, but as you alluded to when people eat basically what, for want of a better term, we are designed to eat, a natural and precious foods that we have been eating for very long time in terms of our evolution, one thing that are found consistently true.
Once these glitches have worked out of the system because it can take a week or two basically to stabilize blood sugar levels and become as you refer to as fat adapted so that you are now better able to burn your own fat. Once that’s done, the overeating basically goes away. It just goes away. Sometimes I will ask people in practice. I will say, “When was the last time you found yourself overeating?” When they do, obviously they have got too hungry and may be they are eating not very healthy food. So, they will say “I ate a cookie, a biscuit, and then – sorry we call them biscuit, a cookie, and I wasn’t even very hungry and the next thing I knew I had eaten eight.” That’s food reward I think again at play there basically, but when was the last time someone gorge themselves on I don’t know a piece of meat with some vegetables.
Most people will eat that, enjoy it, go perfectly satisfied [indiscernible 19:31] feel perfectly satisfied and [indiscernible 19:34] hungry to begin with, have no real desire to go back and eat anymore of it. It is only inside the body says “Thank you very much, you nourished me properly and I actually don’t need anymore of that now” as long as you are obviously listening to your body. So, it’s exactly as you say. When individuals eat foods that you can say we are designed for, the issue around overeating just seems to evaporate really automatically and this is one of the reasons why I don’t really recommend portion control because another thing that’s stuck in our head Jonathan if you know is 4 ounces of this and 100 g of that and this and that and whatever and sometimes my patients will say to me “So, how much can I eat of that?” I will say as long as it requires you to feel properly satisfied. That’s the right portion for you.
You can take it they are getting used to that. What is appropriate, what feels like an appropriate portion, but once people have got used to it, they become incredibly self-regulating and now they are not worried about calories or fat grams or portion control or any of that stuff. They are just eating food they like to eat, they have lost weight. Their doctors are delighted by the way that their biochemistry has now normalized and their triglyceride levels have come down and their blood sugar levels are under much better control. They have lost fat. They feel much better. That’s the other thing. [indiscernible 21:04] in practice.
When individuals eat the sort of diet that we are talking about here, almost always they feel much more energized like the body is finally being given the right fuel [inaudible 21:16] diesel into their diesel driven cars rather than petrol [indiscernible 21:19] they feel more vital. When you think about – I think at least [indiscernible 21:26] healthy diet is obvious and I will say to audiences sometimes or even the patient, but if you think about the food we have evolved on that we have become best adapted to, likes to be the best for us and we are looking at things like meat and fish and eggs and nuts and seeds and vegetables and may be a bit of fruit. When individuals eat diet basically laid up with these foods then so many good things tend to happen.
First of all, they tend to feel better as you will know. People generally will have more energy and why is that? For a variety of reasons. First of all, you are putting the right fuel into the car, long last, say you have got petrol going to the petrol engine, not diesel. You have also potentially made the body more nourished with some of these foods, some of the most nourishing foods, aren’t they? Another thing is that you possibly excluded foods that were dragging the energy down. So, I think a very common food here is wheat and may be other grains. A lot of people react to these foods. It can cause a variety of issues, but one of them is fatigue and lack of vitality.
You got all of that and then you got probably normalization of imbalanced biochemistry that doctors can sometimes be right about, raised blood sugar levels tend to improve considerably, triglyceride levels will come down and then of course we have got the weight thing. Because if someone has spent literally years yo-yo dieting, going on and off different regimes, they were frankly ineffective and unsustainable, finally find a way of eating that is enabling them to essentially enjoy their eating, not be hungry and maintain a healthy weight, is hugely liberating and it’s impact is enormous because it very often impacts on people for example self-esteem and general outlook in life and this is a major issue for lots of people as I am sure you know and many of your listeners with know.
So, I am enthusiastic [indiscernible 23:29] because of the change that I have seen in so many times over the years and also because like you have seen a quite a lot of suffering in people when they have essentially no fault of their own used approaches that simply can’t work. It’s not just most diets don’t work, they can’t work, they can’t work for good physiological reasons. They are flawed on that level. So, to make them work is asking too much and it’s asking too much of ourselves I think to be honest to expect them to work. Obviously, I am enthusiastic because I can see that the suffering it can avoid for people and also the treasure it can bring them by getting control of this area. For many people this area is something that their life tends to revolve around. So, this can finally crack it for them.
Jonathan: Dr. Briffa, it’s very encouraging and I think we see this in many areas of life where when we find the right fit, when we find for example may be the right partner, business partner or intimate partner, things just work, things just fall into place and you have mentioned biochemically this just works, just makes sense. Evolutionarily it works, it just makes sense and also for those individuals out there who may believe in a more intelligent design approach, it even makes sense there like why would an intelligent designer design us to thrive on anything other than the things that designer made available to us naturally, right? In some ways, in any way you look at it, it just makes sense, which I can see why you get excited. I get excited too.
John: Yes, I think it does make sense and I think the science is there and I also like you have some experience in the area. If you see enough people, talk to enough people, why would enough people try different approaches to see what works, you will notice that some of the possibly most vocal exponents of these sort of approach people work in clinical practice actually see patients through seeing patients and individuals and attempted to do their best to help them with their issues. So, on all of these three levels, I think there is considerable power in this message.
This may be sort of supported by each of these areas and there is no lack of congruence here for me and I find this repeatedly in individuals that there isn’t usually for anyone a major sticking point for them. It is even when you start looking at [indiscernible 26:15] heart disease and you find there is really no evidence for that. People can generally ultimately have confidence in this way of eating, not only do they get the results, but they feel confident in it. They feel it is right for them and that’s key for any approach in life. It has to be fit that you are talking about because if you don’t have that and even if something is working, if it doesn’t feel right, intuitively if doesn’t feel right to you, again it’s something that this holds back any sustainability, it can’t really work and you can’t really be doing something [indiscernible 26:48] in the long term, deep in your heart you are thinking is somehow harming you, you have to be confident.
That’s one of the reasons why in my book I go through all of the evidence around things like saturated fat and cholesterol and whether these things are actually truly problematic as well as looking at the supposedly healthy foods that quite clearly are not and probably like you I have taken a fairly scientific approach here because I think the science generally has been misrepresented and it’s an attempt partly to get people practical solutions as all books do I think, but also it’s an attempt for people to understand things at a level so that they can feel totally confident in what they are doing.
Jonathan: Listeners, hopefully you can now see why I am such a fan of Dr. Briffa. Lots of brilliance, lots of common sense and lots of just pearls of wisdom we can apply day in and day out. So, if you like today’s show, do not worry. There are going to be a lot more coming as you can tell. Dr. John and I could talk forever. Dr. Briffa what’s next for you?
John: I just [indiscernible 28:00] writing a new book which will be on some time next year. So, that’s been occupying some of my time and I don’t know if you know that I travel quite a lot with my work, so [indiscernible 28:13] relatively far-flung places. I have just come back from Canada. I am off to a place called Luxembourg which is in Central Europe tomorrow for example. Last weekend, I was in France. So, I do a fair amount of travel. So, it occupies my time as well as my clinical practice where I do actually go there and see patients from time to time. So, next thing for me actually is Luxembourg and then I am away in the West Country of England next week.
Jonathan: Brilliant. Keep up the good work, spreading it all around the world and I look forward to having you back on the show Dr. Briffa.
John: It’s been an absolute pleasure and thank you very much.
Jonathan: Listeners I hope you enjoyed this wonderful conversation as much as I did. Again, today’s guest is the always amazing, Dr. John Briffa. You can learn more about him at DrBriffa.com. Check out his first book Escape the Diet Trap. Literally, I don’t do this very often, but I am going to do it here. Go, you need to go buy this book right now because it will free your mind and once your mind is free, the body will take care of the rest. So, this week and every week after; eat smarter, exercise smarter, and live better. Chat with you soon.