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

About the Guest: Dr. Chris Knobbe is a physician (ophthalmologist), diet & nutrition researchers, and author of, "The Ancestral Diet Revolution."

Episode Summary: Nick and Chris Knobbe, MD discuss seed oils & their health consequences; different types of seed oils (soybean, corn, sunflower, etc.); omega-6 fats like linoleic acid; fatty acid metabolism and oxidation; obesity, diabetes & metabolic health; processed foods vs. whole foods; mitochondria & oxidative stress; and more.

* See this article for more information, including data from some of Dr. Knobbe's lectures.

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* Episode transcript below.

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

Chris Knobbe 4:54

Yeah, sure. Next, so I'm a traditionally trained Physician and ophthalmologist, and I really got into this out of my own suffering started with arthritis way back, oh, 30 years ago. And that eventually led me about 1213 years ago to to investigate that, and try not to go into too much detail here. But so I really, I guess the, my arthritis led me to Loren Cordain's book The Paleo answer. And from that, I determined that basically processed foods, refined flour, sugars and vegetable oils, were driving most all of the chronic diseases. And, and so, but there were things about Canadians work that I didn't really agree with didn't understand. And I just kept researching. And eventually, a couple of years later, I came across the work of Weston Price. And really began to connect the dots between processed foods and, and chronic disease in a deeper way that made more sense to me. And that year neck, then I hypothesize that processed foods and vegetable oils, sugars, refined flours, all that might be driving age related macular degeneration, I'm an ophthalmologist at age related macular degeneration, or AMD is the leading cause of irreversible vision loss and blindness and people over the age of 50 worldwide. So I spent about a year and a half, or maybe almost two years investigating that while I was still in practice. And in February of 2015, I was so convinced that that hypothesis held water that I left practice and pursued that full time. Um, so that took about another year and a half of of investigation basically, from that we, you know, we, we looked at data of processed food consumption tracking, proxy markers were processed food in the form of sugars and vegetable oils, and the data and 25 nations supported that hypothesis. So I went public with that, in 2016, published a paper published a book started a nonprofit foundation, and but eventually, you know, the, I kept researching all of this. And the one thing that kept occurring was that in my research was that it was the highly polyunsaturated vegetable oils that seem to be the major drivers of almost of overweight and obesity, chronic disease. And by chronic disease, I mean, diseases like coronary heart disease, stroke, cancer, diabetes, metabolic syndrome, Alzheimer's, dementia, autoimmune disorders, the list goes on. And so I went public with that in 2019. And this is kind of where my, where I've been spending the majority of my time over the last five years or six years really is is, is processed foods and vegetable oils in chronic and chronic disease and overweight, obesity and chronic disease. So that's, that's basically my story now. And

Nick Jikomes 8:46

so, you know, when we think about chronic disease, all of the diseases of modern civilization, the things that we're commonly sick with today, that our hunter gatherer ancestors were almost never sick with things like obesity, diabetes, different inflammation driven conditions, you know, all the things that you mentioned, most people in my perception, most people agree that our diet is a big factor in this, and that what's wrong with the diet has something to do with processed foods, whatever exactly those are. But, you know, I want you to get into sort of your explanation for this. Can you start off by just unpacking this graph here and defining very clearly two terms, at least one is What are ultra processed foods? Exactly? In your view? And what are seed oils?

Chris Knobbe 9:34

Oh, okay. And I didn't realize I guess we have the graph up there. Yeah, yeah. Yeah. Okay. I meant to stop sharing that and come back to sharing it. Sorry about that. But um, so, so processed foods really, first of all, are made up of four basic things and it's refined flours, refined sugars, vegetable oils, and trans fats and they're saw the you know, so called mystery ingredients to kind of, you know, the, the ingredients that the Met the food scientists concoct in order to give flavors and such.

Nick Jikomes 10:14

So that would be like artificial sweeteners and colorings and yes, yeah, all

Chris Knobbe 10:18

those kinds of things. But if you, but you know, I don't know that those those things are the primary province. It's the, it's those four big components, the refined flour, sugars, vegetable oils, and trans fats that are really the main problem. And if you go clear back to Western prices research in the 1930s, you'll, you'll find that he connected the dots between people consuming these foods because they end and chronic disease because these foods are nutrient deficient. So price found that that the population still consuming their native traditional diets, meaning they had no processed foods, those those diets contain 10 times more fat soluble vitamins, that's basically a D, K to an E, and four times more water soluble vitamins, that's all the B vitamins and C and one and a half to 60 times more minerals than did the American diets of his day. In other words, there was already that much that much processed food that was in the 1930s to the 1930s. Right. Okay. And so it's only gotten much worse since the 1930s, obviously, and so has, you know, are overweight, obesity, and, and all the chronic diseases ramped up just exponentially.

Nick Jikomes 11:46

So a question there would be, if he was making those observations in the 1930s. And the nutrient deficiency in the US food in the US at that time was already that that bad, that nutrient deficient? Why didn't the obesity epidemic start in the 1930s?

Chris Knobbe 12:04

I think it did. You know, we but there's no data to support that. But it was increasing. And but again, the the food consumption, the processed food consumption was far lower in the 1930s. And all of the evidence, points to that. But the main thing that's changed between, you know, that was relatively pretty low in the 1930s was vegetable oils, the seed oils, that was really low. And but if you look at the data, beginning in the 19 centuries, were just regarding overweight, obesity. So Scott Alan Carson's work on prisoners, men, so men aged 18 to 80. In the 19th century, their obesity was 1.2%. So if we just use 19, the year 1900 as a starting point, well, the next actual data is nine is 1960. And in 1960, our obesity in the United States was 13%. So we went from 1.2%, in 19 1900, to 13% by 1960. So the 1960 is when most researchers think we didn't have a problem. But clearly, the problem was already their neck, it was just expand, it was just expanding. And you know, so then others will say, Well, you know, the problem began with the, the US government's recommendation to go low fat and 1980. And that's when it exploded, because it did in 1980. Obesity was only about was not only but it was about 14%. And then by 2016, it's 14 or 2018 42 and a half percent obesity.

Nick Jikomes 13:56

Yeah, I think, correct me if I'm wrong, but like one way to sort of think about that is, you know, this, this has been my observation a lot, a lot of people look at that explosion around 1980. And then they treat like the 60s, the mid 20 century as the baseline. And you can treat it as the baseline if you want to start there. But what you're saying is, if you go back to 1900, and before, you know, 13%, should have been considered a very high obesity rate compared to the deeper history that we have. Exactly.

Chris Knobbe 14:24

That's exactly right. Yeah, you don't want to use 1960 or 1980. As a baseline. That would be ridiculous. Because we already had a huge amount of processed foods in the food supply by that point. And obviously, that's what the people are eating. So if you want to go back, you know, with any sort of hypothesis, you want to proffer regarding any kind of condition or disease, you want to go back to a time when that hopefully that disease was extremely rare or didn't exist, and then see what changed and that's why you need to We'll clear back like we've done clear back into the 19 century as far as you can go. And look at these food consumption patterns in relation to obesity and all the chronic diseases. So that's kind of as you probably know, that's really what I that's what I do. But you know, the seed oils real quick, I'll just mention while we're here that, and we I've got graphs I can show and we could look at the data, but the seed oils were really introduced in the United States, right after the American Civil War about 1866. And 1900, they were still only about one gram a day. 1909, nine grams a day, 19 6019 grams a day, 2010 80 grams per person per day, 80 per day, 80. So 80 grams of fat is 720 calories, it's nine calories per gram. So that that that works out to be about 32% of us caloric intake. Now, there's going to be some losses there. But you know, on you're still looking at about a fourth to possibly a third of the American diet is made up of vegetable oils. And those did not exist for almost all of history until after the American Civil War.

Nick Jikomes 16:18

Now some sometimes sometimes you use the term seed oils, sometimes you use the term vegetable oils, is there a difference there? And is there a Preferred Name or one that is misleading in some way?

Chris Knobbe 16:30

Yeah, so the vegetable oils would really be all of the edible oils, essentially, or, you know, you basically throw almost all of them into that category. So so the so if I break that down, you can look at the the seed oils, really, and then fruit oils and tropical oils, I would break those down into so the seed oils, which are the really highly polyunsaturated ones, the ones that are really high in Omega six, that would be essentially corn, canola, cottonseed rapeseed grape seed, sunflower, safflower, rice, Bran, peanut and sesame oils. Those are the primary so called seed oils. And then you have the fruit oils, which would be olive oil, and avocado oil, and those are much lower in Omega six. And then you'd have the tropical oils, which are really palm, palm kernel, and coconut. And those are even lower in Omega six, like the coconut and palm kernel are the lowest. Out of all these oils I just mentioned there are 2% Omega six linoleic acid, which is linoleic acid is the primary Omega six fatty acid in any kind of fat, any kind of natural fat. But anyway, 2% with coconut palm kernel oils, whereas, you know, oils like canola oils around 20%, soybean oil is around 56%. Safflower oil is like 78%.

Nick Jikomes 18:06

So these things, so seed oils, cooking oils, where they are a type of vegetable oil, where we have extracted the oil from the seeds of the plant through industrial processes and the in terms of the content of this oil, it's high in Omega six polyunsaturated fats. Is that a fair basic description? That's exactly right. And what what are these Omega six fats? And how are they different from other fats? And what do we what are some of the key things that we need to know about them as we go through this discussion?

Chris Knobbe 18:37

Yeah, so there's, there's three basic fats, there's saturated fat, which has no double bonds, there's mono unsaturated fat, which has one double bond. And then there's polyunsaturated fats, which have two or more double bonds, and those would be omega six and omega three fats. So the Omega six fats, you know, have at least two double bonds and the Omega threes have three double bonds. So that so the double bonds make those fat fatty acids, they're called the people who just call them fats, but the double bonds make those fatty acids subject to oxidative attack. And so that's what so they're unstable. The more double bonds you have, the more unstable that molecule is, and oxidation is dangerous. So if people want to think about you know, oxidation is the equivalent of rusting, like the equivalent of metal rusting and when a fat goes rancid, like when you leave fish sitting out and it goes rancid as stinking, that's because those primarily at omega six omega three fats that have oxidized and so they begin to stink.

Nick Jikomes 19:47

And so yeah, so that so when you smell fresh fish versus rotten fish, it's I think everyone knows the difference there. One of them smells very unpleasant, and one of them doesn't. And I, the way that I think about out this and tell me if this makes sense. So those those fats get oxidized. We naturally perceive old fish as smelling bad. It is a Versiv. Presumably, whoo. There's an evolutionary reason for that our senses are telling us don't eat that thing. Right. And so what what is what is actually bad about the oxidized polyunsaturated fats?

Chris Knobbe 20:24

Well, yeah, so good question, Nick. The What's bad is the fact that those the oxidized molecules are when that when those when those polyunsaturated fats undergo oxidation, they end up producing what are called advanced lipid oxidation in products or ales. And those advanced lipid oxidation in products are things like four hydroxy known and all melon dialdehyde, carboxymethyl, pyrole, AquaLine, 913 Hode, which is hydroxy Okta, DECA dynamic acid, nobody wants to ever wants to hear that again. And there's literally hundreds of others, and that these lipids scientists, you know, would name as chemicals, but they don't really have ordinary names, like I just gave for the others. But these, these advanced lipid oxidation end products are very dangerous to consume. They're, they're the equivalent. So let me draw the analogy that they're the equivalent of smoking, of burning tobacco smoking, in other words, and so when you when you burn tobacco, you know, you start off with a dried tobacco leaf and you burn it, and you end up with more than 6000 chemicals. And inside, you know, from that you end up with all sorts of mutagens and carcinogens. And right, everybody knows this. And it's the same thing when fatty acids oxidized, you end up with all these advanced lipid oxidation in products. And these are also dangerous, just like the end products of burning tobacco. And so Collectively, these advanced lipid oxidation in products are cytotoxic, Geno, toxic mutagenic, carcinogenic, atherogenic, thrombogenic, obesogenic and diabetogenic. So they're so these, you know, this covers the covers the gamut of almost everything that goes wrong in, in chronic disease. Now, this is not the only reason. But we can we can talk about oxidation in more detail. But that's just one of the things that goes wrong when we know when fats oxidized and even before you eat them. But if you when you eat these, these fats, Nick, the Omega six fats, well, any any of the polyunsaturated fats, ultimately, your body will accumulate these, and what ends up in your cell membranes and inner mitochondrial membranes and in your body fat, for example, all of those reflect what you have been eating in terms of the ratios of those fatty acids over the past three years. And so, so it would be nice if we didn't accumulate these Omega sixes, but we were meant to, because they were they normally in natural foods, they, they exist in various small quantities. And so we needed, you know, the Omega six linoleic acid and Omega three alpha linolenic acid, those are the two essential fatty acids, we need those for a number of processes. And, and so those are called essential fats, but but with every single thing that we consume, there is a sweet spot essentially, for for that there's a dose that's appropriate for that. And when you get a high dose of omega six linoleic acid, it accumulates in your body. And this sets up this, this biological Mulu. That's right for oxidation, and ultimately to cause harm within the body.

Nick Jikomes 24:13

And so you started to talk about this, but I just want to explicitly lay this out for people when we consume fatty acids. Where are those fat molecules going in our bodies, how much of them like some of it go into triglycerides that we have as stored body fat, some of its going to the phospholipid bilayer of our membranes? Are there any other places and how much is kind of going to these different areas? Well,

Chris Knobbe 24:40

I it you're going to, if you don't burn it, you have to store it, and you're going to store it everywhere that you have fat. So cellular membranes, inner mitochondrial membranes, your atopos in your brain and In your retina, every place that has fat, you will, you will begin to accumulate fatty acids that are reflective of what's in your diet. And so that's what sets us up. You know, for disaster. If you consume too many carbohydrates, let's say, you know, you, you know, when if you consume a huge bolus of carbohydrate, for example, what you'll do is you'll, you'll top off your glycogen stores, in your liver and in your muscles. And once those are all full, then you'll need to do something with that extra glycogen, right, that extra carbohydrate, and your body can convert that into fat. In fact, it does all the time. This is why at one point way back. And by that in the 1920s, researchers thought that we didn't actually need any fat at all in the diet, because they knew already by that point that we could convert carbohydrate into fat. And, and, but your body preferentially takes those takes those carbohydrates and converts them first into saturated fat and second into mono unsaturated fat. But you cannot make the Omega six linoleic acid or omega three alpha linoleic acid, those 218 Carbon Omega six and omega three fats respectively. This is why the those are essential to the to the body.

Nick Jikomes 26:30

When you know when we look at the diets of traditional hunter gatherers of different kinds, and we look at the ancestral diets that humans had the things that we were eating before we had obesity epidemics, and skyrocketing rates of diabetes and all of this sort of chronic inflammation that we have today. What was what did the fat profile those diets look like compared to ours? What percentage of their calories were Omega sixes for example?

Chris Knobbe 26:57

Yeah, that's the really interesting question right there because, and I've looked at this in a number of ancestrally living populations. So Hunter gatherers, subsistence agriculture, us and, and horticulture us and no matter what population you're looking at, whether they're extremely high fat, like the Inuit, which ones called Eskimos, or the extremely low fat diets of like the Papua New Guineans have Touka cinta or the, you know, the Japanese or the Okinawans, which again, are a subset of the Japanese. But no matter what any of the any of these diets, if they're ancestral, in other words, they don't have any seed oils, they don't have processed foods, they don't have seed oils. All of those diets are under 2% Omega six linoleic acid, that's the opposite of calories. 2% of total calories. Exactly. And then what are we at today, and we're at by 2008, we are at 11.8%. So we were at, I might have a graph handy here for that. But I'll show you this real world real quickly. This is our vegetable oil consumption, because this will kind of fall into place. You can see here that we for those who can, you're able to see this, at 1865. We had zero vegetable oils in our diet 1900. This is where we were about one gram of vegetable oil is 1909. We bump up because soybean oil. So first, we just had cottonseed oil, and then soybean oil came into the food supply in 1909. And that really bumped up consumption to nine grams a day. Over here by 1960. As I mentioned, we're at 19 grams a day. And by 2010, we're at 80 grams per person, per day. And this is so and I'll just mention while we're on this, so in 1900. And we didn't really go through this yet, but this is that was a time when there was virtually there was no heart coronary heart disease, essentially. There was no macular degeneration there had never been a case of Alzheimer's or dementia. That wasn't syphilis related.

Nick Jikomes 29:09

I want to dwell on this for just a second because it's it's it's almost like alien to think about this, given how we live today in our state of health and disease. When you say 90 100 There was like virtually no coronary artery disease, coronary heart disease. People you're saying that adults were basically not having heart attacks and things like this? They

Chris Knobbe 29:30

weren't That's exactly right. Nowhere in the world there was there was eight. There's either eight or nine papers. I think it was in the entire 19th century 18 119 100 on coronary heart disease. There was only two of those wrong thrombotic coronary heart disease which is the equivalent of a heart attack. Sir William Osler, the most famous probably famous physician of all time, one of the founding partners of Johns Hopkins Hospital in Baltimore, reviewed his own personal history in 1897, for example, and he had witnessed about a half a dozen cases of angina he had never witnessed a heart attack. And in 1908, he gave a presentation in London, England, and he had witnessed an additional 208 cases, I think it was of angina, it still never witnessed a heart attack. In 1919 12, I think it was 1911 or 2012, James Herrick physician, published the first known case of my myocardial infarction heart attack in the United States, it was documented with autopsy evidence, nobody even took it seriously for until about 1922. Because they didn't know what heart attacks were. They didn't know what coronary heart disease was. Yeah,

Nick Jikomes 31:01

that's just, I mean, this is why I have to think about living at a time where like, no one would have even known what a heart attack was, but like today, you know, everyone knows multiple people in their life that have kids

Chris Knobbe 31:10

know what Heart attacks are, because that's how common they are. And or at least, you know, heart disease. You know, kids could could, you know, vaguely understand that. And, yeah, but so, but by the 1930s, coronary heart disease became the leading cause of death. And in fact, here's, here's a graph on that, then you can see, there's the red line there with, those are heart disease deaths. Now that's total, that would include the given that it's just heart disease deaths, that would include those that are valvular. You meaning, you know, coronary heart valve related deaths, but you can see that there was a, they were extremely unusual back in 1900, any kind of heart disease death that exploded over the next century, right. And you can see that it's it,

Nick Jikomes 32:07

go ahead, I'm just gonna say, for those that are just listening and won't be seeing the, the graph here, you know, the vegetable oil line that we're looking at, basically, you know, a little bit before 1910, early 1900s, you see, it kind of go up quite a bit. And that's, as Dr Kenobi said, that's when soybean oil kind of came onto the scene, and and then it continues rising, but then in about 1960, it goes up steeply again, and then rises, like even more quickly to the present day. And you're overlaying the heart disease deaths with that. And these two things are, are correlated quite clearly.

Chris Knobbe 32:41

Right, yeah, you see this really strong correlation between the vegetable oils and the heart disease deaths, up through about, you know, nine, you can see here that after about 1980, heart disease deaths start to drop off. And this is I used to think this was, you know, due to bypasses, and procedures and medicines, but it's I think it's primarily due to the fact that smoking has dropped dramatically. But you can see through the entire century of 19 1900 to 2020, you can see that are 2010, as far as the data goes on that saturated fat, virtually almost a flat line.

Nick Jikomes 33:20

Yeah, the entire page, the entire period from 1900 to the mid 1900s, where heart disease was going up, clearly, saturated fat was basically flat the entire time.

Chris Knobbe 33:31

Yeah, and this is our public graph from a paper in 2017. And so, yeah, so you can see there's that saturated fat increased about five grams late, you know, around 2000, it's come up with just a little bit, but virtually a flatline. So I'm gonna go back, go ahead and

Nick Jikomes 33:55

go ahead. And I'll just gonna say like, so someone could look at this and say, Okay, this is a very intriguing correlation. It's a very striking association between heart disease and vegetable oil use in the United States, but it's just a correlation. Are there any randomized control trials or any mechanistic preclinical experiments that tell us how something like Omega six fats and vegetable oils could cause heart disease?

Chris Knobbe 34:22

Yeah, so you know, James de Nicola Antonio published a paper with one of his colleagues just a few years ago, and it's basically about the oxidized linoleic acid hypothesis as the primary mechanism of coronary heart disease. And that is an excellent paper for anyone to read who's interested in digging into this, but it's, you know, to me, it's, it's very clear and simple that in my view, coronary heart disease does not exist. So without vegetable oils, if you look at all of the ancestrally living populations who don't have really any significant heart disease, I mean, they might have rare cases of myocardial infarction. But they don't have any significant coronary heart disease, and they don't have vegetable oils and every population that has coronary heart disease, they're consuming vegetables. And so and what, you know, how does this work? mechanistically? Well, I think that, you know, in a very, in a very, maybe simplified view that it is oxidized LDL, low density lipoproteins is what is taken up into arteries to begin and propagate atherosclerotic plaques. And LDL in its native state, meaning when it's an oxidized is not taken up. And so how, you know, how does LDL oxidize? Well, it oxidizes, because of the fact that it takes up linoleic acid. And the and then, and then that, again, oxidizes because of the fact that it's the multiple double bond, and it's very prone to oxidation. And then the there was a rapidly pulled out of the circulation and are deposited into these plaques, which causes this atherosclerotic plaque progression. And so, so I, I think it's almost impossible to produce coronary heart disease without vegetable oils.

Nick Jikomes 36:34

I see what so so, you know, it's the oxidation of some of these fatty acids, that creates a lot of the problem. And yet, so the Omega sixes are essential fatty acids, as are the Omega threes, meaning our body can't produce them naturally, we have to get them from diet. So so far, we've been talking about some of the some of the ways that too much Omega sixes can be bad. How much do you need? And what happens if you're deficient in Omega six is going in the other direction? What is the set? What are they doing that is essential? Well, how much is essential? Yeah, like what is the essential function that they're actually doing for us?

Chris Knobbe 37:14

The essential functions are probably Myriad. But what we what we see in animals who put on who have been put on a 100%, fat free diet, and there's been a few humans, that were also subjected to the same because of intravenous feeding, or some kind of feeding for with entirely fat free diets, or almost entirely fat free, but what happens in animals is is that they, they they develop rough coats, red eyes, deterioration of all of their external surfaces, deterioration of their gut inability to absorb nutrients properly. So then they become sick, and they built, they'll eventually they'll die without Omega six and a small amount of Omega three fat but so they so we there, this is why the researchers Burr and Burr I can't think of their first names, but they were husband and wife way back in the 1920s. When back in the time, as I mentioned that this was the time when they when researchers felt that we didn't require any fat in our diet whatsoever. And they, they completely extracted all the fat out of out of foods that they put various animals on mostly rodents. And and it's a very complicated process that has to be done in a lab to actually remove all of the fat because if you don't remove it all, you'll end up with Omega six linoleic acid and Omega three alpha linoleic acid in the fat because all natural fats contain it doesn't matter if it comes from you know, if you're talking about white rice, or oranges, or apples if they've got fat, and all of those have fat, and they will contain Omega six and Omega three. So so we only need a tiny amount. And so Burr and Burr figured out that animals could not survive on a fat free diet of a become sick and event and they would die prematurely. All right, but it takes it takes a while because the you have to eventually you have to remove you know you you have to use up all of your stored Omega six and Omega three in your own body before you become severely deficient, right. So it depends on how much you have in your body to begin with. All right, but if you look at I've got a graph here. You can see that Americans in 1865 we modelled their Omega six consumption, they were at about 2.4 grams of omega six linoleic acid per day and That's about 1.1% of calories. But animals and even humans don't need more than about point 5%. And there's been an argument made by ancestral researchers that we need only as little as about point three 5% Omega six linoleic acid that were hunter gatherers are consuming. Okay,

Nick Jikomes 40:27

so what you're saying is, hunter gatherers are estimated to consume never more than 2%. And we probably only need at most point 5% of our calories that come from these Omega sixes. That's right, we might

Chris Knobbe 40:42

need a little bit more than point 5% as infants. And but after, after infancy, probably no one needs more than point 5%. And we certainly don't need anything above about 1.6 to 2% is excess. And as I mentioned early on, you know, there's a sweet spot or optimal consumption of every single nutrient there is, you know, water, oxygen, iron, copper, molybdenum, you name it, they all are need, they need to be consumed at an appropriate dose. Yeah, too much, or too little, exactly. Exact either way, is dangerous. And so if we go back to this graph, you can see that there again, we were at 1.1%, Omega six, in 1865, when we didn't have any chronic disease, and in 1909, that had doubled to 2.23%, or two point, it gone from 2.4 grams that I'm sorry, that should say, 4.8 grams. That's a misprint there. By 1999 1999, you can see we're at 7.21% of our diet as omega six, or 18 grams a day and 2008 11.8% of our diet is omega six, and 29 grams a day. And you can, if you, you know, overlay our obesity, or coronary heart disease, our cancer, diabetes, metabolic syndrome, Alzheimer's, dementia, macular degeneration, all of them are intimately related to this right here, they're related to that seed oil consumption, and to the Omega six consumption,

Nick Jikomes 42:32

I want to ask you something about this graph. It's triggering me about something else that that I've been researching. So for those that just listening, right, we're looking at the percentage of calories that come from omega six fatty acids over time, and you know, you go, you go back to the 1800s, and forward to the present, and it's just the line going up into the right, but at about 1999, right at the turn of the millennium, that goes up even faster. So the slope of the graph gets much steeper. What's interesting about this to me, Dr. Kenobi, and I'd love your take on this is, I know that from about 99 2000, to present, our total caloric intake wasn't really rising anymore, we were no longer consuming more total calories. In fact, you know, some of our nutrition, our total fat consumption, and I think our carb consumption, you know, either plateaued or even sort of drop off around this time. And yet, we know that the obesity epidemic kept getting worse. And so do you think that this is a key piece of that puzzle there that even though we weren't continuing to eat more after 2000, we were continuing to eat more seed oils?

Chris Knobbe 43:35

Yeah, that's exactly right, Nick, and I've got graphs on that too. But I can, most of this is in my memory. And this is these are key points that you're bringing up. And you're exactly right in right around 1999 or 2000. caloric consumption started to just slightly declined, whether you look at total total calories available, or and or calories consumed, began to decline at right around 2000. Again, while obesity was obesity was I forget what it was 3030 some percent in 1999. I think it was 31%. And then we're at 20 2018. We're at 42 and a half percent right. But but the calories didn't go up. Yeah. And the if you think well, but it was the sugar, no, that after 2000 are either 1999 or 2004 Right in there, depending on two slightly different datasets. Sugar has been on the decline in the United States. And so again, sugar on the decline while obesity goes through the roof and diabetes going through the roof, by the way, and and then you said Well, it's the carbohydrates. Well, carbohydrates, at least from 1997 through 2013. been declined also. So you have total calories, carbohydrates, and sugar all declining, while obesity and diabetes go even at a more vertical ascent? Well then what is it in other nations to?

Nick Jikomes 45:18

Yeah, what do you think's going on there? mechanistically. So if diabetes is insulin resistance, type two diabetes is insulin resistance. insulin goes up after blood sugar goes up, and blood sugar goes up after we eat carbohydrates. So if carb intake did not continue rising, but diabetes did continue rising, how can we explain that?

Chris Knobbe 45:38

Oh, I can explain it easy. Um, so. So for those who want to investigate further I, I went over the pathway between oxidation and insulin resistance in a presentation I gave at the ancestral health symposium in 2019, which was at the University of California, San Diego. And basically, what I'm going to keep this pretty simple, and you can you if you want me to get more in depth, I can. But I think it's really difficult for people just listening. But in a nutshell, when you consume high omega six, you damage these molecules called cardio Lippen, which are key players inside the inner mitochondrial membrane. And that inner mitochondrial membrane has to hold a proton gradient, the protons are hydrogen ions. And so that the inner mitochondrial membrane, the way it produces energy is you pump these hydrogen protons inside the membrane, and that builds up a gradient. And so when the when they say that has power, and when those hydrogen protons come back through the membrane, they go through ATP synthase, that's the final step in the electron transport pathway. And when they come through there, that that converts ADP adenosine diphosphate, to ATP, adenosine triphosphate, ATP, the energy currency of the cell. And so but what happens when you have consumed a high omega six diet is it damages that cardio lip and causes the membrane to become leaky, and or changes the curvature of it. And that causes failure of that membrane, it allows for one thing, those protons to leak out of the inner mitochondrial matrix, and, and therefore you cannot produce energy. And then the very next thing that happens is that you increase the reactive oxygen species, and that causes the cell to become sick, this the cell then becomes insulin resistance, it's a very next step. And if you think this, the cell is a microcosm of the entire body, so when the cell becomes insulin resistant, the entire body becomes insulin resistant. And this is exactly why it's not about carbohydrates. And it's not about sugar. Sugar may cause this in extraordinary doses to some degree, but it takes, like the doses they're using are like 60% of the diet. It's insane. Makes no sense. There's no nobody in the world consuming that much sugar. But anyway, so so you can you can explain all of this, or at least I can, I believe through a high omega six died, you all you need, don't eat any sugar, and you don't need high carbohydrates, all you need is substantial vegetable oils, and you will drive mitochondrial dysfunction, which is what I'm talking about through oxidation. And you will drive insulin resistance, which will cause your blood sugar to go up and it doesn't matter what your macronutrient ratios are, that's irrelevant. Is there?

Nick Jikomes 48:59

Is there preclinical evidence demonstrating that, that if you have a very high omega six diet that you can cause insulin resistance without? Well,

Chris Knobbe 49:05

it's all animals? Yeah. In animals, they absolutely have proven that. And I reviewed that in those studies. And this is why they see you there's an there's several studies in very good studies in animals where they gave the animals ISO caloric diets, and all they varied was one thing. They'll make a six linoleic acid, everything else was kept equivalent calories, fat, carbohydrates, sugar, or even no sugar, zero sugar. And the animals given the 19% Soybean oil diet, for example, become massive, you know, which, even on again same calories as the rodents given Chow, which is what 1% Omega six linoleic acid versus the rodents giving given 19% Soybean oil which is about less Haven't percent Omega six linoleic acid and in fact, lower than typical Americans, those rodents on that die at the high omega six, they become massively obese. There's only one difference. And even when they have zero sugar, zero sugar, yeah, they are morbidly obese. It's the equivalent that in a think of those eight months time that they they become the equivalent of a 277 pound male versus the rodents on Chow would be the equivalent of 170 pound man, this is a difference.

Nick Jikomes 50:37

So you're saying you're saying basically, researchers have a bunch of different groups of mice, each one gets a different diet, they all have the same number of calories, they're all eating the same number of calories each day, but they're just varying the fat profile and the macronutrient profile of these diets. You're saying that the mice who get the high soybean oil diet, which is giving them high omega six fats, at roughly the levels that you know, a lot of Americans are eating today, those mice get obese, and they get sick compared to the other mice, even though the other mice are eating the exact same total amount of calories? Exactly.

Chris Knobbe 51:12

Yeah. Yeah.

Nick Jikomes 51:16

And so a key thing here is, is mitochondrial function, the mitochondria are the little organ organelles in our cells that create the energy, the ATP molecules that power everything. And if you mess with their ability to do that, the cell is just going to basically get sick in almost any way you can think of, because it's not gonna be able to effectively and efficiently produce its energy. Is that a fair kind of summarize summary that that

Chris Knobbe 51:41

is perfect, Nick. By the way, I should have told you this at the beginning. I'm sorry, but But you could please call me Chris. No, I don't let anybody call me Dr. Rad to mention that neck.

Nick Jikomes 51:52

All right. No worries, Chris. What about what is the connection between omega six fatty acids like linoleic acid and inflammation? Why do people say that the Omega six is cause inflammation? What's going on biochemically? There?

Chris Knobbe 52:05

Yeah, they do. That's another so there's really I always I tell people that there's, there's there's basically four pathways through which high omega six diets drive, overweight, obesity and chronic disease. And it's that they are highly, the seed oils are highly pro oxidative proinflammatory. Directly toxic, which we've already talked about that, that through the advanced lipid oxidation in products, and then they're nutrient deficient, they don't contain vitamins A, D and K two, like you would get in traditional animal fats like lard, butter, and beef tallow. So So in terms of the pro, you know, Omega six is being pro inflammatory. They absolutely are. And, you know, before I describe that, which, basically, everybody agrees with this, or nobody even argues that at all, that the Omega sixes are pro inflammatory. But but they but I want to just put this into perspective, the oxidation that we were talking about, I think, is 10 fold, maybe 100 fold more dangerous than the inflammation. Oxidation is incredibly damaging to the body. And this is something it's much harder to understand, which we just talked about what it does to the mitochondria, for example, and how it leads to devastation and mitochondrial dysfunction, which could lead to obesity and diabetes and, and cancer. But, but so but you have the inflammatory pathway to well, so how do we get there? So omega six linoleic acid is is an 18 Carbon fat that is converted by elongate and desaturate enzymes into 20 carbon, arachidonic acid, and that arachidonic acid then can gives rise to inflammatory prostaglandins, eicosanoids leuco, trains and thromboxane these are collectively vasoconstrictive and inflammatory and cause clotting. All right, so So

Nick Jikomes 54:21

vasoconstrictive means you're gonna have higher blood pressure when those things go up in Flint and Flint, inflammation is inflammation. I think everyone kind of has a sense for what that is. And then they're also clotting factors. Yes. Yeah.

Chris Knobbe 54:33

So you so you're in other words, you're putting yourself at risk that day when you can say vegetable oils for heart attack and stroke that day. And this is one thing that we can we can get into this you know about recovery from vegetable oils but But you put yourself at risk, you know, right away when you can see vegetable oils for these reasons. And then you know, just on the flip side, the omega threes then they They're the opposite They're there, you know, the Omega three alpha linolenic acid, and then the downstream metabolites, the longer chain Omega threes, EPA and DHA 20 and 22 carbons respectively, those eventually they give rise to it, you know, anti inflammatory prostaglandins, medicines, protections medicines. And so they're ultimately, they prevent vasoconstriction are the you know, or they'll produce vasodilation. They, they, they prevent inflammation or reverse it, and they are anti clotting, essentially. So, so they have the really the opposite effect. And this is where this is just like this is boilerplate stuff in pathophysiology. Everybody knows that these are well accepted mechanisms.

Nick Jikomes 56:03

So I have a question for you, which is this, you know, basically, everything that we've just talked about, you just you just gave us a nice crash course on omega sixes versus omega threes, as you just said, like, everybody knows this stuff, who's you know, who studied this area of biology? Why? If I go, if, but if I go to the grocery store, I will see all sorts of bags, all sorts of boxes, that have the American Heart Association's Heart Healthy stamp of approval on them for the specific reason that they contain, what they call heart healthy polyunsaturated fats. What is they can't just be making this up out of nowhere. Why is it that the AMA is calling these things heart healthy, if what you're telling us is basically the opposite. For

Chris Knobbe 56:52

one reason, they lower cholesterol. And that's it. And I've I've, you know, started with this early on in a number of my presentations that, that, yeah, the American Medical Association, Harvard School of Public Health, Tufts University nutrition department and Mayo Clinic's nutrition department, Cleveland Clinic, American Heart Association, on and on all recommend seed oils, and they all recommend them because they improve, they in quote, prove, and I'll put this in, I should put this in single quotes, improve our cholesterol, meaning they lower our cholesterol. And so they therefore are deemed as good well guess what, you know. Anything that's highly pro oxidative, will or not anything, but a number of things that are pro oxidative will also lower your cholesterol but so that as I was we talked about early on, when your LDL cholesterol oxidizes, it's taken up out of the bloodstream into the vascular wall. And the reason that it is probably is because when the LDL is oxidized, it's extremely dangerous. And so those are rapidly removed from the blood. And that so it does, potentially lower your cholesterol. Now, it may also be that some of the LDL that is oxidized is still there, but it doesn't measure as normal LDL either. Because when it's oxidized, it looks different in terms of the testing. So it may also to some degree still be there. And yet, it's just not being measured properly, as I understand it, because of the fact that it is oxidized,

Nick Jikomes 58:46

based on everything I know. And I've learned, you know, over the past few years, about metabolism, about cholesterol about the history of medicine. A fair summary of what many people including you, I think would say is the standard story that we've been told about the relationship between cardiovascular disease and cholesterol is wrong, or the very least, very lacking in the appropriate level of nuance. And it's simply not true, that lowering your cholesterol is going to be good for everyone all the time. Is that accurate? And if so, why? Why is the story persisting with such vigor?

Chris Knobbe 59:30

You know, I because orthodox allopathic medicine, and I was trained in their Institute, you know, in their institutions. I'm a graduate of University of Colorado School of Medicine, which is an allopathic School of Medicine, of course, and traditional medical school. That you know, they have been, they have been, you know, supporting this theory, this hypothesis or belief system that, that you know, cholesterol it Sal drives coronary heart disease. And so it just needs to be lower. And of course, the research shows over and over. And I think this gets to be a, you know, to me a boring topic, Nick but because I just I feel like we've you know, we've gone over and over and over this but, but no matter how low you make the cholesterol, you can't prevent coronary heart disease if the if that if those if that LDL is oxidized, so they're missing the main point of, you know, the fact that what, you know, why is it so hard for them to look at this and just see that, you know, all of these ancestrally living populations, whether it's the Inuit who consumed almost, you know, almost carnivores or whether you look at Papa New Guinea, Ian's took a center who were consuming almost nothing but sweet potatoes, or you look at South Pacific Islanders who live off of fish, starchy tubers, fruit, and fruit, mostly in coconut and the half of their diet, coconut and on and on all these diets that don't contain vegetable oils, they don't have heart disease, right. And, and, you know, typically their, their cholesterol levels are, really, they're pretty low, just like the Maasai warriors of Kenya and Tanzania, they, you know, they were found out their cholesterol is pretty low. I think it's, you know, I forget the numbers, but it's under 200. I think it's 160 or 180, or something like that is what it was, when Georgia man studied them back in 1972. And everybody's scratching their head, how can they consume 66% of their diet as animal fat and have no heart disease? No, at least no. Coronary heart disease that engines heart attack or congestive heart failure, right. And so, but it's, you know, to me, it's just very simple, they don't have vegetables, they don't have a very lo