Air Date: 2/3/2020

The Upgrade by Lifehacker

How to Cut Down on Sugar, With Dr. Yoni Freedhoff

Melissa ​Hello and welcome to the upgrade, the podcast from the team at Lifehacker,
where we help you improve your life one week at a time. I'm Melissa Kirsch, editor in chief
of Lifehacker.

Alice ​And I'm Alice Bradley, Lifehacker's deputy editor.

Melissa ​And today we're talking about sugar. You know, sugar, the white devil?

Alice ​The ivory shadow?

Melissa ​The Devil's Candy?

Alice ​The play mate of Satan?

Melissa ​Yes, the devil itself? Everywhere you look, there is news about how sugar is
making you fat. It's making you tired. It's making you stupid.

Alice ​Then why must it be so delicious?

Melissa ​I cannot answer that question, but I think we're going to talk to some people who
can.

Alice ​We are. Some studies have shown that high sugar diets are linked to impaired
memory as well as reduced brain volume. It's also been associated with an increased risk
of depression.

Melissa ​And of course, studies show that it's been linked to obesity and diabetes and
cardiovascular disease.

Alice ​And yet it's so delicious.

Melissa ​I--you know Alice, it'ss killing you.

Alice ​Cruel. I'm eating a Snickers bar right now as we record this.

Melissa ​Well.

Alice ​Can't help myself.

Melissa ​Well, at least you're not eating white flour because that's going to...One bite and
you'll be dead. Yep. Our producer, Micaela Heck spoke with addiction specialist Kathleen
DesMaisons who talked about her approach to gradually cutting down on sugar.

Kathleen DesMaisons ​The really ironic thing is because we've done this background
ahead of time and basically rewire the brain going off in sugar is a non event.

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Alice ​Kathleen holds a P H D, an addictive nutrition and is the author of "Potatoes, Not
Prozac: Simple Solutions for Sugar Addiction."

Melissa ​We should note here that the concept of sugar addiction or food addiction is
contested in the field of science and in medicine, and we're not trying to claim any
particular stance on the issue. We're just interested in what these people have to say.

Alice ​Which is why we also have Dr. Yoni Freedhoff on the show today. Dr. Freedhoff is
director of the Bariatric Medical Institute in Ottawa and the author of "The Diet Fix: Why
Diets Fail and How to Make Yours Work.".

Melissa ​Our senior health editor, Beth Skwarecki, spoke with Dr. Freedhoff about the
controversy around, quote unquote, sugar addiction and got his tips for how to reduce your
sugar intake.

Dr. Freedhoff ​The other thing that's really crucial, I think, in trying to decrease sugar is
eating in a pattern that for the individual leaves them more happily satisfed.

Melissa ​Hey, Alice.

Alice ​Yes, Melissa?

Melissa ​Talk to me about your relationship with sugar.

Alice ​I think we've established already that I am something of a fan.

Melissa ​Really?

Alice ​I yeah, I have got a sugar, a sweet tooth? I've got a sweet tooth. I almost said I've
got a sugar tooth. Which sounded...

Melissa ​Like you have a—.

Alice ​Like just a melting tooth made of sugar.

Melissa ​One. Oh, that would be delicious or just a—

Alice ​Yeah.

Melissa ​Tooth that's just like riddled with cavities. But all you're to have these are in one
tooth.

Alice ​Call it the old sugar tooth.

Melissa ​Yeah. You know Alice, old sugar tooth?

Alice ​I got the sugar tooth real bad.

Melissa ​Yeah. Or sugar tooth is like a sweet talker.

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Alice ​Yeah. Yeah. I've, I'm, I'm, I'm a--I guess if there is such a thing as a sugar addict I'm
think I'm it.

Melissa ​What does that look like?

Alice ​I feel that I need to have dessert after every meal including breakfast.

Melissa ​Wow.

Alice ​Yeah.

Melissa ​And what does a breakfast dessert look like?

Alice ​I mean it's not like a bowl of ice cream.

Melissa ​Like a Sunday.

Alice ​But sometimes I just like I just have to have something a little bit sweet, just a little
like. Just maybe it does a couple of nibbles of granola or like little you know, something
like oh or I just have a sweet breakfast, which is, you know, yoghurt and granola, which is
my, as you know, one of my favorites.

Melissa ​But you're not like drinking two liter bottles of Coke.

Alice ​No, I--I try to avoid. I feel like if I'm going to be ingesting sugar, it's going to be in the
salad form. Yeah. Yeah, yeah.

Melissa ​So it's like a sweet treat.

Alice ​Like a sweet treat. I like a sweet treat.

Melissa ​Yeah, but.

Alice ​And I think that's fine. I personally think it's fine in balance. Like I don't overdo it. And
you know, I don't know even if I did overdo it occasionally, don't judge me.

Melissa ​Well, it's killing you.

Alice ​Geeze. Should we talked about your relationship with sugar?

Melissa ​I mean, we can talk about my relationship with sugar.

Alice ​What's what's yours?

Melissa ​Right now, I have no relationship with sugar because I'm not eating any sugar.

Alice ​Yeah? And how's that been?

Melissa ​It's been tough. It's been I can tell you probably precisely how many minutes. It's
not the sugar that's tough. I gave up all sweeteners in October and I thought that would be
very easy because I don't have a sugar tooth like you do. But it turns out that I have a fake

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sugar tooth. And there are various studies that say that, you know, fake sugar is just as
bad for you and it increases your glucose levels in the same way that actual sugar does. I
don't know what's true around that, but I know that trying to give it up has been a real
challenge for me.

Alice ​And have you felt any differences? Has it? Has it improved things for you with your
mood or...?

Melissa ​You know, it hasn't. It's actually.

Alice ​It's worse.

Melissa ​Well, my mood is pretty bad because I can't have sweetener in my coffee. And I
have talked to you about this a lot, but I don't see why I can't and maybe I can. But for right
now, I'm just trying. You know, if you're addicted to something, you know, it's worth you
know, or if you'd want to see if you're addicted to something, why not try giving it up and
see what happens? Right?

Alice ​Yeah.

Melissa ​And it turns out that whether or not you apply the term addiction to my relationship
with sweet things. I had a much more complex relationship with my morning coffee than I
knew. And, you know, I could say I don't have a sweet tooth, but I was drinking two cups of
what was essentially for taste purposes, melted coffee ice cream.

Alice ​Yeah.

Melissa ​Every morning in the form of an iced coffee. So delicious. You know, and so I
think I felt like a tiny bit superior or lucky that I didn't need to have dessert all the time. I
needed basically, you know, two cups of ice cream every morning and maybe one in the
afternoon. You know, it's really had a weird effect on my mood. I'm a little bit sad and I'm
still grieving. It's been several months and I know sort of grieving the loss of it.

Alice ​And every morning you drink a sip of your coffee, you do a spit take and then you
throw it at me, which I've got to get—rid you of that habit.

Melissa ​Well, you know, I'm just trying to wake you up. All right. Let's, let's talk to the
experts.

Melissa ​And now it's time for the interview. Our first guest today is Kathleen Desmaisons
author of "The Sugar Addicts Total Recovery Program," and "Potatoes Not Prozac: Simple
Solutions for Sugar Addiction."

Alice ​Kathleen is also the founder of Radiant Recovery, an online international community
focused on healing what she calls sugar sensitivity. Kathleen chatted with our producer,
Micaela Heck.

Micaela ​Thanks so much for coming on The Upgrade today, Kathleen.

Kathleen DesMaisons ​Oh, I'm really happy to be with you.

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Micaela ​So to start, I'd love to hear a little bit about how you got your start in nutrition.

Kathleen DesMaisons ​Well, I started out as the director of a rehab center and I was
looking for solutions to enhance what we were doing. Typically, alcohol and drug rehab
isn't very successful. And so I was I wanted to find something that would help people get
better, longer. So I started talking to everybody. And I realize that almost all of the people
that we were working with stopped using alcohol and drugs and then they started using
lots and lots and lots of sugar and that their whole behavior related to that was very similar
to drug behavior. And this was really intriguing to me. So I had an intern at the time and I
sent her to the library and said, "see if you can find anything on sugar." This was quite a
while ago. There wasn't very much, but there was one article in one very obscure journal
that made a reference between the connection between alcohol and sugar. And I thought,
well, that was really interesting because I was myself very attached to sugar. So I started
playing with the idea of using food as part of a treatment protocol and was astounded how
much better I felt. And so I began working with people in the clinic and saying, you know
what, you would you be willing to try some experiments and they said "whatever (laughs),
whatever you tell us to do, we'll do it." And so we began looking at ways of basically
enhancing what they were eating and also taking out the sugar. So we didn't just say, "OK,
we're going off with sugar." Intuitively, I knew at that point that that was not a smart idea or
a good approach to deal with it. And what happened was people who had never been able
to get sober started getting sober and staying sober. And I thought, well, this is fascinating.
So I basically decided to go back to school and find out what was going on because there
really wasn't anyone looking at that at that point in time. And I developed a whole theory
about sugar sensitivity and that some people are born with a genetic vulnerability to
addiction that's somehow connected to sugar. And that sugar is sort of the first drug that
leads into that whole delta of many different kinds of problems.

Micaela ​So tell us a little bit more about what sugar sensitivity is.

Kathleen DesMaisons ​Well, basically, it's a term that I coined to describe what I believe is
a package. Today we'd probably call it a matrix because that's how people refer to things
like this. But it involves having a blood sugar that is more volatile than normal. So when a
sugar sensitive person has a carbohydrate or has sugar, they get a larger biochemical
reaction to it. Their their blood sugar spikes up higher and then drops quicker. And it's not
that it necessarily goes lower. It's not the same as hypoglycemia. But you get this very
quick slope. So you you feel really good and then you feel terrible and that that's related to
an overproduction of insulin. And the second part is being born with lower levels of
serotonin and serotonin affects your mood and also your ability to say no. So if you have
low serotonin. You'll say, "I'm not going to eat that cookie, I'm not going to eat that cookie."
And then the cookie jumps into your mouth. That quality of feeling like you want to signal,
but not being able to. And the third piece is being born with a lower level of a brain
chemical called beta endorphin. And beta endorphin affects, affects your mood, how you
feel about yourself. So if you have low beta endorphins, you might be very successful,
have lots of money, have a partner that you adore, but you feel inadequate and hopeless
anyway. So that package of volatile blood sugar, low serotonin and low beta endorphins,
my hypothesis and still my working concept of it is that that package of those three things
as a profound effect on how people deal with the world and whether whether they like
sugar or whether they like other addictive substances or behaviors.

Micaela ​And I know you have a sugar sensitivity test. Can you tell us what that is? And
then you know how somebody can determine whether or not they're share sensitive.

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Kathleen DesMaisons ​So what you do is you imagine that you're walking into a kitchen.
And you're the only one there. This is an important thing that there's no one else there to
judge what you're doing and that there is a plate of chocolate chip cookies on the table.
And the question would be what do you do? And when I asked this, I can ask this question
to a roomful of five hundred people and the people who would self-identified as being
sugar sensitive, we'll all start laughing before I even ask the question. And I'll start
laughing at the idea of a plate of warm chocolate chip cookies coming out of the oven. The
people who are not sugar sensitive will sort of sit there and look at me and say, "well, what
do you mean? Am I hungry?" By which time the people are sugar sensitive, I've already
eaten the whole plate. So it's kind of basically what kind of emotional response do you
have to even the idea of chocolate chip cookies?

Micaela ​So you've touched on this a little bit briefly. You're talking about low serotonin
levels or low beta endorphins. But can you talk a little bit about what happens with our
brain chemistry when we have something really sugary?

Kathleen DesMaisons ​Well, at the basic level, if we have hit a sugar, you feel really good
because sugar evokes a biochemical response that's very similar to having alcohol or
taking opioids or using heroin or having OxyContin. You feel really good. Your self-esteem
goes up, you feel happy, you can feel euphoric depending upon how much you have and
how sensitive you are to it. So a person who is sugar sensitive would have even one
chocolate chip cookie and just feel really, really good and good about themselves,
whereas the person who is not sugar sensitive could have a bite and say, "well, OK, I'm
not really hungry, so I'll leave this for for later." A sugar sensitive person who would never
leave it for later.

Micaela ​So walk us through the seven steps of radiant recovery, the seven steps that you
cover and Potatoes Not Prozac.

Kathleen DesMaisons ​Well, I think the important thing is to not think you should just take
the sugar out. That's what people typically do. And sugar sensitive people are typically
impulsive. So the first idea is, OK, I'm just getting rid of it or my doctor says, "oh, you need
to take the sugar out" and people just drop it and then feel absolutely terrible because if
you do that, you go into withdrawal. So the the idea of the seven steps and these are steps
that are outlined in my book, Potatoes Not Prozac. So the first step is to have breakfast.
Most people skip breakfast or don't have breakfast until they get to the office. And then it's
ten, thirty or eleven and then falling off the cliff and they're crazy. So the idea is to have
breakfast within an hour of getting up to have enough protein for your body weight and to
have some kind of complex carb, which means having some oatmeal or having some
wholegrain bread or having a wholegrain bagel. It doesn't have to be sexy or anything like
that is having breakfast. And surprisingly, that takes a while for people to master. And then
step two is keeping a journal. And the point of that is knowing what you eat and when.
Putting in amounts, putting in times so that you learn to recognize what you're actually
having, because if you're using a lot of sugar. Sugar is actually an amnesiac and an
anesthetic. So we forget and we don't remember what we've had and we don't really feel
what we've had if we're using a lot of sugar. So the journal starts that process. Then step
three, is having three meals a day and having, not grazing, but actually starting and
stopping. So it's practice in learning how to say no. It's very hard for people to learn to just
have three meals because people can either skip meals as a way of not what they believe
is a way of not getting fat or they will just sort of graze their way through the day. So

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training yourself just to have breakfast, lunch and dinner and moving whatever sugar. This
is a trick that we sneak in there. Do we move the sugar to the meals? And it's very non
prescriptive and very kind. So that we teach people to eat real food, good food. Then the
first step after you've mastered that is, you add a potato in the evening. Three hours after
dinner, and that actually has a significant effect on your brain chemistry, which most
people find really bizarre to think of in our culture these days. You know, potatoes have
been badly maligned, but they're really wonderful and they're very healthy. And also a
baked potato with skin and some butter actually creates what seems to be the perfect
amount of insulin to alter brain chemistry. And there's a very complex cascade of how your
brain sends large, neutral amino acids across the blood brain barrier. And the one of the
amino acids is tryptophan. And tryptophan is little and it doesn't compete well with all the
other amino acids. Tryptophan is the amino acid that your brain uses to make serotonin.
And so the potato evokes an insulin response. And the insulin takes the other big amino
acids off to the muscles and leaves little trip to farm without any competition. And so
tryptophan hops across the blood brain barrier and gives itself to the serotonin factory,
sacrifices itself and says, take me, take me. So what the potato does is actually increase
the level of serotonin. So the potato helps you be able to have impulse control. So we
sneak it in three hours after dinner, which just happens to be the time that it's most
effective. It's not a magic thing. So that's part of step four. And the other part is to take
vitamin B complex C and zinc. And I just chose those because they enhance carbohydrate
metabolism. So now we've got we've been building this and we still haven't taken the
sugar out, which is very significant. People have a very hard time with that. They want to
get it out. Like, why can't I just dump it? And I will keep saying what we do. We're we're
rebuilding your brain first. We're getting you ready to do this. So then we go to step five,
changing from what I call white things, which is refined carbohydrates to whole grains to
brown things. Now, culturally, that's an in thing now people know what that is. When we
first started, nobody really thought about that a whole lot. And then we get to step 6. And
this is the point at which we say, OK. Now you get to take the sugar out. And the really
ironic thing is because we've done this background ahead of time and basically rewire the
brain going off of sugar is a non event. There's very little stress. It's not a big deal. It's like,
oh, OK, I can just take out the desserts. It's not you know, we're not having ice cream
every night at five o'clock anymore. So it's easy. It's not painful. And sometimes people are
off of sugar already and they don't even realize it.

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Micaela ​What are some of the effects you've seen as you've worked with people
throughout the years towards eliminating sugar from their diets? What have you observed?

Kathleen DesMaisons ​The most important thing is the change in self-esteem, which is
really was the most remarkable to me. Initially, I just thought it was that you're not feeling
crazy or you're not feeling—your moods even out. Your depression goes away, your
anxiety goes away, your reactivity goes away. And you just you feel calm and relaxed. But
the thing that actually caught me off guard and seems to be the most profound change is

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that the underlying feeling of self worth goes up dramatically. So instead of feeling like an
impostor, there's self worth matches who they are. If that makes sense.

Micaela ​It does. Do you think that's because they have felt helpless against their desire for
sugar for so long and now they have this newfound willpower against it? Or do you think it
has more to do with the change in brain chemistry that comes from drastically reducing the
sugar in your diet?

Kathleen DesMaisons ​Well, I think there's a whole series of things. One of them is, yes,
the psychology of not feeling out of control anymore. I think it's because the beta
endorphins function is restored and it increasing beta endorphin increases self-esteem.
And that we know that that's a scientific thing, that beta endorphin levels are correlated
with self esteem. And when you're beta endorphin level is low and you're using sugar to
take care of it and you stop doing that. First of all, you you do feel kind of disoriented and
at a loss. But part of what's step seven is learning how to do life, things that enhance beta
endorphin like hiking or exercising or having really good food or having good sex or having
nice environments or being around beautiful things. All of those ways be the endorphin
without spiking it. It really is a change in brain function. It's not psychological.

Micaela ​So how long does it take for people to feel like they've dropped the bad habit of
sugar?

Kathleen DesMaisons ​I'm going to give you an answer that's a little different from the
question. Sugar sensitive people are impulsive. They generally want to do it all in about a
week. Do all seven steps in a week, which is horrifying. So I'll tell you how long is what I
would consider if you have a motivated person who's ready to do it. What would be the
ideal time to work through the steps? I'd say maybe six or nine months. That would be
what I would consider a good time. Some people, it takes them, you know, two years on
step three. Some people do it. I've had people do it in a week and it doesn't make it better.
If you go faster and the whole model and I don't know if this was clear to you on the
website, but we try to be kind of funny and not real intense about it because addiction is
kind of a grim thing. And so we try to help people to kind of have fun and enjoy
themselves. And that seems to calm everybody down.

Micaela ​I think that's really important for people to hear, because I can imagine people
listening, maybe trying this out and thinking, you know, if they've maybe spent, let's say,
four weeks at step three, that they're not making enough progress or they're not doing a
good enough job, or maybe they'll never get there. So I think that's that's good to hear.

Kathleen DesMaisons ​Exactly. It's a very different approach than a magic cure-all that's
overnight.

Micaela ​Kathleen, thank you so much for talking with me today.

Kathleen DesMaisons ​I'm really I really enjoyed it.

Alice ​Next, our interview with Yoni Freed Hoff, associate professor of family medicine at
the University of Ottawa and medical director of the Bariatric Medical Institute, an ethical
evidence based entire professional weight management center.

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Melissa ​Dr. Freedhoff is the author of "The Diet Fix: Why Diets Fail and How to Make
Yours Work," as well as the blog Weighty Matters: Musings of an Obesity Medicine Doc
and Certifiably Cynical Realist.

Alice ​Our senior health editor Beth Skwarecki spoke with Dr. Freedhoff about why doctors
and dieticians find the concept of sugar addiction controversial. He also gave us his own
recommendations for reducing sugar consumption.

Beth ​Hi, Yoni. Welcome to the upgrade.

Dr. Freedhoff ​Thank you.

Beth ​So we recently spoke with Dr. Kathleen DesMaisons, who pioneered the terms,
sugar sensitivity and sugar addiction. So can you tell us, like, what's your take on whether
sugar or any kind of food is actually addictive? And is that a helpful way to talk about it?

Dr. Freedhoff ​So I'm definitely not a specialist in addiction medicine. However, I will say
that it's just it's it's a way to talk about it that might work well for some and not for others.
And I think it matters. And so I'm glad that you've spoken with some experts about it. In our
experiences here, and I've been practicing obesity medicine for 16 years. I'm not sure I
have ever met anybody who I would be describing as addicted to sugar. But I've met many
self-described sugar addicts. The I suppose that there's just a difference and I'm not sure
how to delineate it properly and medically between something that you would describe as
an addiction which has ramifications using that word or someone who is struggles to
control the consumption of something like sugar in larger quantities. I have zero doubt that
there are people who struggle more than other people, perhaps as a consequence of
differences in the way their brains are wired for rewards. I have no doubt that sugar is one
of the main things people struggle with. Although I've never met anybody who struggles to
control pure sugar. Generally speaking, people struggle to control combinations of sugar
and fat or sugar. Salt and fat people aren't struggling with big bags of white stuff. But yes,
there's definitely people out there who find it's very difficult for themselves to control their
intake of sugar.

Beth ​So is there a good way to think about sugar and our cravings for it? If it's not an
addiction like, you know, we do crave some of these sugary foods sometimes. Is there a
good way to think about that, to help us understand why are our brains are so into this?

Dr. Freedhoff ​Well, so cravings are interesting. And for me, I lump everything together in
a way that perhaps is nonscientific and describe hunger as whenever we eat foods in
quantities or with choices that we can't justifiably explain, there's no good reason for us to
choose that. And those choices may be contrary to our desires for health, for weight or
whatever that I describe as hunger. So cravings wise, for instance, we'll see many people
whose cravings are dependent on things that are modifiable. So people might crave
sugary foods if they have missed meals and snacks in their morning times and it's the
afternoon, evening or night and suddenly they're there. Cookies are calling to them from
their cupboards. But when we get them eating very differently throughout the day time with
an emphasis on satiety and fullness, sufficient quantities of calories, sufficient amounts of
protein, in many cases those cravings disappear. So it's it's hard to describe them
necessarily as cravings rather than describing them as physiologic drive for lack of a better
way to put it. But if a person's cravings are modifiable by patterns of eating, that does for
me challenge the notion that there is an addiction. Rather, I think of addiction or struggle

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as the natural consequence of having hormones in a physiology that tells us it's time to
eat. And where you know there's sugar provide readily accessible calories, as does fat,
which is why again, people often will crave both and not just one.

Beth ​So people talk a lot about sugar when they talk about, you know, cleaning up their
diet or eating healthier. So can you talk a little bit about whether sugar is uniquely bad for
us, or is it just that it tends to be part of a package of unhealthy eating?

Dr. Freedhoff ​So I think it would appear as if liquid sugars, so juice, soda, that sort of
thing may have some unique concerns and problems. Generally speaking, sugar is
something that's easy to consume in excess and as a consequence provides quite a lot of
calories. There's also, you know, common medical problems like diabetes, both type 1 and
type 2, where sugar may be a challenge to the treatment and management of that
condition. And so in regard to sugar, the goal for any food really is or any indulgence is the
smallest amount of it a person needs to be happily satisfied. And that question is what is
the smallest amount? That question is dependent in part on physiology and part on
patterns of eating, in part on our social lives. And so it's a very individualized thing what is
too much and what is too little. And I don't think that any person, doctor or otherwise can
identify a specific amount for an individual. But as I'm sure you are aware and probably are
discussing in this episode, there are limits that people like the World Health Organization
and dietary guidelines, folks put on the amount of added sugars we'd want in our diets. But
generally speaking, other than liquid sugars, I'm not sure we can vilify sugar very directly in
creating a unique problem, whereas the overconsumption of calories as a whole and ultra
processed foods as a whole, that might be an easier case to sell.

Beth ​So do you have recommendations for somebody who wants to cut down on their
sugar specifically if they notice that it's, you know, a major calorie source in their own diet?

Dr. Freedhoff ​Well, so, I mean, the easiest way that doesn't involve counting at all is to try
to reduce the reliance on on both liquid calories because they generally come from sugar.
It's usually either sugar or alcohol. So reducing liquid calories that are sugar based and
just reducing ultra processed foods. So that's for people who aren't necessarily looking to
want to count anything. You know, the sugar you might add to your own cooking from
whole ingredients at home is likely going to be less than the sugars that you'd find in ultra
processed foods. And certainly from a beverage perspective, it's an easy target. Again, the
goal being the smallest amount that a person needs to be happily satisfied. I'm not
suggesting everybody needs to suddenly start cooking every single meal from scratch, but
slowly improving that aspect of our lives may help to reduce sugar overall. The other thing
that's really crucial, I think, in trying to decrease sugar again is going back to what I was
saying about cravings and hunger is eating in a pattern that for the individual leaves them
more happily satisfied. Now, there is no right meal frequency, but one thing that appears to
be quite uniform is that protein matters quite a lot to satiety. And so ensuring that every
single meal and snack is inclusive of protein source is something that people can do to
help with satiety. I would argue that anybody who struggles at night could look to changing
their daytime patterns of eating to see if in turn that helps. And there are also medications
now that are useful in the management of cravings and hunger that in fact appear to be
safe and effective that people could discuss with their physicians.

Beth ​You've spoken before about how being overly restrictive about some part of your diet
can be counterproductive. Can you tell us a little bit about why that is?

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Dr. Freedhoff ​When it comes to overly restrictive diets we know, for instance, that they
are the number one trigger for the development or the recurrence of binge eating disorder.
And so when people are overly strict about their diets, it may backfire over time. I'm
definitely aware of people who feel that abstinence is the way to go when it comes to
something like a food they can't control. I've not had great success in seeing people stay
abstinent long term. There may be clinicians out there who are better than me at helping
people with abstinence. But our approach really here is to focus on satiety, on fullness, on
thoughtful indulgence. It may mean not having foods in our homes that we struggle with,
but likely in our offices doesn't mean you should never have this, that or the other. I really
do feel it's about the smallest amount of these foods we need to enjoy our lives and trying
to eliminate them altogether for many people leads them ultimately to quit their efforts
overall. I mean, food is not just fuel. It provides comfort, changing stress hormone levels.
It's the root of many celebrations, if not all of our celebrations. It's the world's oldest social
network. And when people, I guess, stop allowing themselves to take pleasure from food
or to celebrate with food or to socialize with food, I worry that those efforts, however
well-intentioned, may fail over time. And I'd rather a person lost less weight and a more
imperfectly, but actually sustain their efforts long term than to be overly strict for a
temporary period of time, only to quit all efforts. They just can't stand it any longer.

Beth ​So what do you think about like short term? You know, like detox or reset kind of
things like, you know, cutting out sugar for 10 days or something? Does the fact that, you
know, it's temporary make it better or worse?

Dr. Freedhoff ​Maybe, so maybe for some people it's useful. You know, people talk about
stuff like Whole 30 all the time. I definitely don't think it's a long term strategy, nor do I
necessarily think it's meant to be a long term strategy. Some people might find it useful just
as a means to almost reboot their relationship with food and start from scratch. We don't
approach things that way here, but I'm sure there are there are people who succeed with
it. I think that's the other thing that people ought to keep in mind is that there are success
stories with every approach. So if anybody tries to suggest theirs is the best. They're either
conflicted or ignorant or both. And so for me to suggest that, no, you should never do that,
I wouldn't. But I'm certainly not. It's not a practice we use here regularly, although I'm
definitely aware plenty of people will like to try these sorts of temporary removals of
various foods. And if that in turn leads them to come out the other end and cook more
frequently and be more thoughtful, well, that sounds terrific. If it leads them just to have,
you know, a temporary restrictive diet and then they're back to normal. I'm not sure how
helpful that is.

Beth ​So I've got a slightly different question. So, you know, we know you're an expert in
weight loss, and that's probably the topic a lot of people are thinking about, you know, at
least in part when they think about cutting sugar. But what about people who just want to
be healthy no matter what their weight is? Should they approach eating differently or, you
know, sort of in the same way?

Dr. Freedhoff ​No. I mean, so I think it is the same. Right? So I think that healthy living
really doesn't depend on a person's weight, meaning that all the same things that we
recommend to our patients here. I live with myself. You know, I try to exercise as much as
I can enjoy. I eat regularly with protein, inclusive meals and snacks. I try to minimize
hunger. I try to reduce my indulgences to the smallest amount I need to be happily
satisfied. I've reduced my restaurants, but I still go. I reduce my processed foods, but I still
have them. I sadly reduced my alcohol. But, you know, you've got to do what you gotta do.

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I guess where weight may have a role to play is in the two questions. Is it worth a
question? And what's the smallest amount I need to be happily satisfied, just as would any
diet responsive chronic medical condition. So if I had struggles with my weight, my
answers to those questions might be different because I might be able to be satisfied with
less because I don't have that condition as part of my sort of matrix of thinking about
what's worth it, what's not worth it. Certainly I know that if I were to develop type 2
diabetes, my eating pattern would change dramatically from where it is right now, because
suddenly when I'm evaluating the is it worth it? Question And what's the smallest amount I
need to be happily satisfied? Question I've got a medical condition superimposed on how I
consider those answers, but the same principles apply to everybody for sure.

Beth ​So one thing you're great at is calling out popular myths and misconceptions about
dieting or nutrition. Any particular ones you'd like to spotlight at the moment?

Dr. Freedhoff ​I guess the main one we've already touched on it is that there is a right way
for everybody. You know, first of all, there isn't. So there is there's no data that suggests
there's one best diet. You know, there's data out there on all sorts of diets, from fasting
diets to keto diets to low fat diets to vegan diets. At the end of the day, they all seem to be
just as good or just as bad as each other as far as weight loss goes. There may be some
slight differences in regard to their impact on specific chronic diseases like type 2 diabetes.
But at the end of the day, all that matters is a person likes their diet enough to sustain it
long term. You know, adherence that that is king. But there are plenty of gurus out there
who want you to believe that there is a right way or a best way to go. And that is the
biggest and most problematic myth out there right now. I think the other big one is that
there's, you know, that there's patterns of eating that are so remarkably good for you that
they are more important than just going through with the basics of healthy living as a
whole. And I think you can get a really long way just focusing on cooking from whole
ingredients, exercising as much as you can enjoy, not smoking, being vaccinated, sleeping
well, cultivating your relationships, not drinking too many calories and moderating your
alcohol. Those are the things that matter the most. And we get so caught up in the minutia
of healthy living that I think we forget those big ticket items are really probably enough to
get us an extremely long way as far as preserving our health and protecting ourselves as
best we can.

Beth ​Thank you so much for talking with us today, Yoni.

Dr. Freedhoff ​My pleasure.

Alice ​And now it's time for upgrade of the week, where we talk about that one tiny thing
that's making a big difference in our lives. Melissa, what's your upgrade?

Melissa ​So my upgrade this week is worm castings.

Alice ​Tell—tell me more.

Melissa ​Why? What's not clear?

Alice ​I am, um, many things.

Melissa ​So worm castings are an organic form of fertilizer that is produced from
earthworms. Sometimes worm castings are called vermicast.

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Alice ​Is it like their skin? Do they Shimmy off their skin and you get you get it? That's what
I like to think it is.

Melissa ​So worm castings are, worm shit.

Alice ​All right.

Melissa ​And they're used as a natural fertilizer. And I have been adding worm castings to
my house plants, which as we know, I am quite capable of murdering with out the slightest
provocation. And it actually works. I'm fertilizing my plants and I have replanted some of
my plants in half potting soil, half worm castings. And it does not smell like poop.

Alice ​Sure.

Melissa ​It looks like soil. It's actually a bit like an inky black soil and it's just filled with a lot
of good nutrients. It's a natural fertilizer.

Alice ​And so it's you really do like half and half. It's not like a little sprinkling.

Melissa ​No, you can do a little sprinkling on. I mean, a healthy sprinkling on the top of
your plants, on the top of the soil. Or you can actually mix it with the soil and you can buy it
at your garden center.

Alice ​Your garden center.

Melissa ​Yeah. Is that what you call it?

Alice ​I think so.

Melissa ​Your nursery, your garden center, your Amazon.com, Lowe's.

Alice ​Amazing.

Melissa ​Probably Target.

Alice ​All right.

Melissa ​Any other big box stores you want to name check?

Alice ​Costco.

Melissa ​You know what. At Costco's...

Alice ​BJ's.

Melissa ​At Costo's and Sam's Club I'm sure you can get like a nine hundred pound bag.
So if you have a farm...

Alice ​Modell's?

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Melissa ​Modell's does not carry a worm castings.

Alice ​Okay.

Melissa ​Okay.

Alice ​If you say so. Sorry, I'm just feelin' silly.

Melissa ​Yeah.

Alice ​I had a lot of sugar.

Melissa ​Did you?

Alice ​No.

Melissa ​Okay.

Alice ​Okay.

Melissa ​What's your upgrade?

Alice ​All right. Melissa, my upgrade is something that you recommended to me. So you're
gonna be mad at me for taking it. Or maybe you'll be pleased with me. It is a podcast.

Melissa ​Oh gosh!

Alice ​I think you know what it is.

Melissa ​Oh, no. I mean, come on. I support you.

Alice ​The podcast is My Brother, My Brother and Me, which is a delightful podcast with the
McElroy brothers where they supposedly give advice. But mostly they are just incredibly
silly and hilarious. And it's it's been around for 10 years. Many of you listening are saying,
"well, duh, of course, My Brother My Brother and Me, it's a great podcast," but I had never
listened to it. I don't know why. I just hadn't!

Melissa ​Or some people—some people are saying they're pretty, fratty. That sounds like.

Alice ​Yeah.

Melissa ​Not your cup of tea, Alice.

Alice ​If it is my cup of tea, it turns out it's very much like tea because they're very silly and
they're very, very funny. They'll answer questions from readers and also they'll do Yahoo!
Questions, which include things like "is dirt a spice?"

Melissa ​It's not. But, you know, what is?

Alice ​Might be my favorite. What is?

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Melissa ​Worm castings.

Alice ​Anyway. They're just they're really funny and I love them so much. And it makes me
so happy to listen to and it's been it's been some tough, some tough times in the Bradley
household. I think we can say.

Melissa ​Let's unpack.

Alice ​Yeah. Here's what's happening. No. Yeah. You know, when things are when things
are down plus it's January, which sucks.

Melissa ​Oh, yeah.

Alice ​And I needed. I needed a laugh. Sometimes you need a laugh.

Melissa ​A pick me up. Yep.

Alice ​And it has done it for me. So thank you. McElroy brothers, I love you.

Melissa ​Oh my god.

Alice ​Wow this took a turn.

Melissa ​OK.

Alice ​OK.

Melissa ​Thank you. Good one.

Alice ​You're welcome. Thank you.

Melissa ​And that's our show. The Upgrade is produced by Micaela Heck and Brad Fisher,
mixed the episode.

Alice ​Please rate us on Apple podcasts and leave us a review. It really helps other people
find the show, but more importantly, it helps us feel better about our lives.

Melissa ​Yes. Also, subscribe.

Alice ​And subscribe. You can also reach us by calling us at 3 4 7 6 8 7 8 1 0 9, leaving a

voicemail or write to us at upgrade at Lifehacker dot com.

Melissa ​You can also find us on Twitter, at Lifehacker, on Instagram, at Lifehacker dot
com. All one word and on Facebook at Facebook dot com slash lifehacker. You can sign
up for Lifehacker's daily newsletter full of tips and tricks and hacks at Lifehacker dot com
slash newsletter. And you can find show notes for this. And every episode of The Upgrade,
every single episode at Lifehacker dot com slash.

Alice ​The show.

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