The 5 Keys to Disease Prevention with Thomas Hemingway, MD

Content By: Ari Whitten & Thomas Hemingway, MD

In this episode, I am speaking with Dr. Thomas Hemingway, who is a board-certified physician and the author of PREVENTABLE5 Powerful Practices to Avoid Disease and Build Unshakeable Health. In this episode, we are going to be talking about those five natural health keys to preventing the most common diseases, the most common killers in our western world today.

Table of Contents

In this podcast, Dr. Hemingway and I discuss:  

  • How most of the top ten causes of death are preventable
  • The five powerful keys to preventing diseases of lifestyle
  • Dr. Hemingway’s top tips to start changing your lifestyle and prevent disease
  • How your actions affect your geneexpression

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Ari Whitten: Hey there. This is Ari Whitten. Welcome back to The Energy Blueprint podcast. With me today is Dr. Thomas Hemingway, who is a board-certified physician and the author of PREVENTABLE! 5 Powerful Practices to Avoid Disease and Build Unshakeable Health. In this episode, we are going to be talking about those five natural health keys to prevent the most common diseases, the most common killers in our Western world today. A lot of good stuff in this episode, and he is a wonderful guy with a lot of wisdom to share.

I hope you enjoy this episode. Welcome to the show, Dr. Hemingway. Such a pleasure to have you.

Dr. Hemingway: Oh, equally, Ari. I’m so pumped to be here. Thanks for having me on.

Dr. Hemingway’s story

Ari: Awesome. You have a unique story. You are a conventionally trained physician but something shifted for you a while back and now you’ve altered course. Talk to me about what you were trained in originally and the events that put you on the path that you’re on now.

Dr. Hemingway: Yes man, would love to. It’s been quite an interesting ride. I originally did my training in standard US medical school, Top 10 School, UC San Diego. Graduated top of my class. Been in typical hospital and clinic medicine for 20 years. I’ve been a board-certified physician. Mostly worked in the ER. In fact, I was chief of an emergency department for a decade. I’m really proud of what we are able to do in that emergency environment. I really feel like, in this country, we do have great emergency care.

If you’re in the throes of an acute problem and injury, for example, or something that comes up suddenly, we’re great at emergency care. What I noticed over the years is, I think it really hit home once I was into my 40s. I’m actually turning 50 next year. I started to see guys younger than I am either dying of heart attacks or having heart attacks in their 40s, sometimes even late 30s. I was scratching my head. We’re doing something wrong in this country. We’re not really getting to the root cause of illness.

We’re really good, like I said, at emergency care and we’re freaking awesome at shelling out prescriptions as physicians, but most of the time we weren’t really getting to the root because actually, heart disease is almost entirely preventable. Yet it’s the number one leading cause of death, not only in the US but worldwide. We literally have hundreds of thousands of people dying per year. It’s preventable. Seeing young guys either have heart attacks in their 30s and 40s or even seeing people die, way earlier than they had to really got me thinking.

I’ve always been somebody interested in natural and holistic means. When I was a teenager, I used to read books by Deepak Chopra, for example, and others that talked about Ayurveda and other holistic styles of medicine. I just thought, “Gosh, we really should be incorporating this more into our every day, not only Western medicine practice, but we should really be getting to the root of illness. Not just putting Band-Aids on and throwing prescriptions at people.” That’s the short version of why I changed my whole trajectory.

About two years ago, I left standard hospital and Western medicine to pursue more a holistic and integrative career.

Ari: Beautiful. Are you still in practice in some way or are you mainly writing books and teaching online now?

Dr. Hemingway: Yes. All of the above. I’m still doing consults, mostly virtual, although I do have a presence. I’m a medical director of a clinic in Florida right now where a friend of mine got this clinic going a few years ago. It’s Integrative Health Center. I do see patients there, both in person and virtually. Where I employ mostly these holistic and functional medicine approaches, I try really hard to not prescribe medication because that’s usually just a Band-Aid fix and it doesn’t often get to the root. Although I will, when necessary, prescribe pharmaceuticals.

I really try not to because most problems can be addressed at a deeper level. Over time, many prescriptions can go away if we follow some basic principles, which I talk about in my book, which I just am passionate about.

Most diseases can be prevented

Ari: You use the word, preventable. Much of this cardiovascular disease is preventable. That’s the title of your book. It’s called PREVENTABLE! 5 Powerful Practices to Avoid Disease and Build Unshakeable Health. I want to dig into what your top five practices are. I think as a broad overview before we get to those more practical aspects of what you’re recommending, when you say preventable, let’s be specific. What are the diseases that you consider preventable?

Dr. Hemingway: Right now, about 7 out of 10 of the leading causes of death worldwide are largely preventable. Number one, across the board, heart disease. In the US and literally every country throughout the world, heart disease is the number one killer. A close second would be a stroke and other brain illnesses, everything from Alzheimer’s dementia, Parkinson’s. Then cancer is usually number three or four depending on what country you’re in. Diabetes is in the top 10 and its complications.

Usually, we’re speaking of Type 2 diabetes, which is basically, nearly 100% preventable. Type 1 diabetes is actually quite rare. Actually, the latest statistic I just saw was, 50% of the US either has diabetes Type 2 or prediabetes. In other words, they have insulin resistance and elevated fasting blood sugar. One out of two people in the US. Those are the ones. There’s also kidney disease, most of that’s preventable. That’s in the top 10. Most lung disease, that’s a top killer. Most lung disease is also preventable.

I think I’ve named about seven already. It’s overwhelming that most of these illnesses that are number one killers worldwide are nearly entirely preventable. There’s obviously some genetic element there but what we’ve learned in the last, I would say decade is that the other layer called epigenetics, which is basically all of the other things, besides what’s in your DNA. It’s what you do every day, what you don’t do every day. What you eat, what you don’t eat. If you move your body if you don’t move your body. What you’re exposed to.

There’s so many toxins out there in the environment now. All of these other things play into, whether or not the genes that we actually have get turned on or turned off. That’s the whole epigenetic phenomenon and that’s responsible for about 90 some odd percent of our illness. Only about 10% or less is actually from the DNA we were given by our parents. It’s actually largely under our control, which I find super empowering.

Ari: This is a topic that I think is widely misunderstood. It’s an extremely important one because in mainstream media, and I think also within conventional medicine, there is often an attitude of, “Oh, it’s genetic. Oh, you have the obesity gene.” “Oh, heart disease runs in my family.” “Oh, diabetes runs in my family.” “Cancer runs in my family.” “Oh, do you have the breast cancer gene? Then you got to cut your breasts off.” Often very frequently in our culture, in this particular time in history, there is still very much an attitude of genetics equal one’s destiny.

What you just said is that, as a generalization, 90% of the disease that we’re experiencing is generally through non-genetic factors. How would you explain to someone who is maybe coming from that paradigm of, “Oh, diabetes runs in my family.” “Oh, do you have the breast cancer gene? Oh, that means you’re going to get breast cancer.” How would you explain to them? How would you talk them out of that paradigm?

Dr. Hemingway: The cool thing is nowadays, there’s actually data to prove this. In fact, some people would say even more extreme that 95, 96, 98% of what illness we come down with is actually what is not on the gene. The genes, our genetic material, our DNA, obviously, we get from our parents but whether or not those genes get turned on or turned off– We can actually study this. There’s processes that turn on and off. This is called regulation of genes through processes, such as methylation, for example.

That’s one that some people have heard of because I think the common health folks that are out there talk a lot about methylation. They talk about MTHFR. They talk about these kinds of things, which are important, but it’s an oversimplification. There’s a lot of processes in the body that get to decide, ultimately if the genes we possess actually get turned on or turned off. Most of that has to do with the things that we do each and every day and the things that we don’t do. We actually have data to back this up. What I would tell people is that, that was the old school.

That’s even how I was trained back. I was trained in the ’90s in medical school and your genes were something, inarguably that was the biggest factor back in those days when we looked at the path physiologic of disease. We always focused on, is there a genetic component to this? I get that because that’s what we saw at the time. That’s what we assumed. Since I left medical school, we’ve been able to– Many times over been able to actually see what the genetic material in the code, the human genome. That’s been done. It’s been done now for a decade.

We actually have all of those genes. Yet when we look at the diseases that are out there, yes, there is some play of the genetics, but most of it is actually in actual practice in the actual folks out there. Most of it is actually not due to the disease. Here’s an example. Say, I have a patient that has the BRCA gene, which is the one that gives you the susceptibility to breast cancer. I have another patient that also has that. One of them develops breast cancer. One of them does not, they have the exact same gene.

What is not usually the same as all the other things that happen in their life. Whether or not they’re doing certain lifestyle practices, whether they’re having good solid eight hours of sleep a night, whether their stress is under control. Whether they’re eating real foods, rather than the stuff that comes in a package with 50 ingredients. These are the things that really make the difference in the end. It’s not just what’s in your DNA. I believe, and I take the approach, it’s very empowering to know that. You can’t just blame your genetic material.

You can’t just blame your parents for everything. Maybe it’s 10%, but many people would say, it’s actually less than that. If you talk to Bruce Lipton, he’ll tell you it’s 1%. 1% of actually what your health looks like comes from your DNA and the other 99% comes from the stuff that you do and the stuff that you don’t do. I personally feel like that’s very empowering. The cool thing is we actually have data to back that up nowadays. Whereas when I was in school, that wasn’t the case. I don’t believe we even had the word epigenetics in the vernacular back in the ’90s.

I certainly never heard of it.

Ari: We didn’t. I remember Bruce Lipton’s book was one of the first books that came out talking about it. I think the main criticism of Bruce Lipton’s work that I would have– I don’t want to detract from all of his contributions, because I think he’s made a monumental contribution, especially at that early phase. When the idea of epigenetics was really revolutionary, he made this contribution of saying, “Hey, it’s not the nucleus in your DNA that’s dictating your destiny. It’s the instructions to the DNA. The signaling that goes into the nucleus.”

I think the mistake he made from my perspective is to reduce all of that down to the psychological, the emotional, what’s going on mentally. He made it about what you believe and what’s going on at a psychological level. There are a lot of followers of his work that I’ve seen who take that paradigm. In my opinion, they extend it way too far. There’s an enormous misunderstanding there, which is these people say, “Oh, what my genes do is a function of what I believe. If I think positively and I have a positive mindset, then that’s epigenetics, that’s influencing how my genes express.”

I’m like, that’s a piece of it, but also how you eat and how you move and your light exposure habits and your thermal exposure habits and your sleep and your circadian rhythm and environmental toxicants. All these other different layers of inputs also have a massive impact on the expression of your gene. It’s a very big mistake, in my opinion, to reduce the entirety of epigenetics down to the purely psychological realm.

Dr. Hemingway: Well put, Ari. I have exactly that same understanding myself is that it’s just one of those factors. I think the oversimplification that you mentioned with just what your mind and your mental space tells your genes, it’s definitely important, but there’s so many other pieces to that puzzle. I’m completely with you that the whole environment, the milieu as we call it. The sciences incorporate that as one component and then all the other things you mentioned are equally important. I couldn’t agree more.

Ari: Yes, 100%. We have all these highly preventable diseases that are responsible for roughly 80% of the chronic disease burden in the Western world, in the United States in particular, 80% of the disease is preventable, they’re diseases of nutrition lifestyle. Your book is PREVENTABLE! 5 Powerful Practices to Avoid Disease and Build Unshakeable Health. There’s five things that you’ve zeroed in on that are key epigenetic switches. Key practices that influence the expression of our genes to help prevent negative health outcomes, help prevent disease.

Take me through those five practices.

Dr. Hemingway: All right. Any good physician that’s been through medical school, I developed my own mnemonic or memory tool [laughs] to help the layperson out there remember what these five things are. It’s FMSGs, so FMSG and then an S at the end, we all hate MSG. That’s pretty normal. If anybody [crosstalk]

Ari: I suspect that this is a more sophisticated pneumonic, but it could be very straightforward. It could be FMSG monosodium glutamate.

Key 1 Food

Dr. Hemingway: Everybody knows what MSG is. I figured that’s an easy way to remember it and we all hate it. FMSG, and then you throw an S on the end. That’s a mnemonic. The first F is no surprise to most it’s food. Food is either your best medicine or it’s a slow poison. You get to make that decision several times a day. Even Hippocrates over 2000 years ago said, let food be thy medicine and medicine be thy food. That’s really the backbone of all health starts with what lies at the tip of your fork.

Just to put it super simply, I think most of us get this part is it has to be real food, whole food that you recognize that literally does not come with an ingredients list. The stuff that you recognize that grows in the field, the vegetables, the fruits, the well-raised animals. If you eat meat and things like that, or wild-caught fish like me in Hawaii, I love fish and I love ahi tuna, things like that. The food as the first pillar is just indispensable. You cannot ever, and this is something I learned both in practice with many patients, as well as in my own personal life.

Especially after 30, I realized that I couldn’t just exercise my way out of a crappy diet. Although we’re told that we can. The calories in calories out thing that we all hear about, nothing could be further from the truth. Food is not just simple calories. It’s not just simple food. It’s much more than that. It’s information. It’s also enjoyment. If anybody’s ever watched me eat, I’m just enjoying my food. I love to be in company with my kids, my family, whoever. I love to just eat delectable amazing cuisine.

I love eating as much as anybody, but if we focus on eating the real food, that’s natural and whole without a bunch of ingredients that we think or don’t understand, or should really be in a chemistry lab, we’ll be much better off. That’s the first one. Food is the best medicine. The second one. That’s the FMSG.

Key 2 Movement

M Ari’s got this already. He’s talked about it briefly movement. Movement is the M and movement can be anything really. I hate when people overcomplicate things because they make it not only unachievable but intimidating.

We all think, oh, to get our movement in, we got to like either go to the gym or we got to get a run in, or we got to– We have all this preconceived notion in our mind of what movement equals. Movement equals anything like right now, I’m talking to you, Ari, and I’m standing up. I can bounce up and down. I’m on a standing desk. I have a standing desk where I am right now, but if I don’t, I put a cardboard box on the table and I make a standing desk because I can move while I work. I also keep, and this is you’re going to laugh, but I literally have a bunch of these things at the base of my desk.

I didn’t even plan this. I just happened to have them all at the base of my desk. I can move little dumbbells in the middle of whatever, every hour. Not only does your performance wane a little bit, but if you do two or three minutes of some movement every hour that you’re working, both your mental performance, everything goes up when you move your body. It doesn’t have to be complicated. It can be as simple as bodyweight exercise with things like burpees or lunges or air squats, or my favorite is the plank.

You do these things, you don’t need any weights. You don’t need a gym membership. The important thing is that you move your body. My favorite actually is just going for a walk. I love that so much. If you can walk after every meal for 5 or 10 minutes, not only will that decrease the spike in the glucose and corresponding insulin, making you less likely to be prone to this insulin resistance that nearly 98% of the population has, but you feel good. It helps with digestion. That’s the M. FMSG. Movement is the M.

Key 3 Sleep

S is sleep. Sleep is so dang critical.

I’ll be honest. I was probably the worst offender in not appreciating the power that sleep can really afford us. I believed back in the day especially when I did my training that I didn’t have time to sleep. I was going to sleep when I’m dead. The whole– I forget what it was. The Cure 4:13 Dream I think was the album, any Cure fans out there. There was literally a song called I’ll Sleep When I’m Dead and I lived by that.

Ari: The attitude that they take into residency in terms of training medical school residents who are becoming doctors in those three or four or five years, there’s that attitude of making them work obscene amounts of hours. This tradition of putting them through this very intense process as a way to challenge them mentally. The downside of this I read apart from on an individual level the personal suffering that the doctor and training endures but I think much more concerning is the amount of medical errors that result from doctors who are sleep deprived.

Who are being put through this. I read an article a few years ago. I don’t remember the exact statistics but there’s an absurd amount of medical errors. People who are diagnosed incorrectly, prescribed the wrong medication, given the wrong treatment which sometimes can be fatal or extremely damaging for the patient. It’s like when you start to recognize that, you realize how stupid this tradition of putting these doctors through this arduous process of intentional sleep deprivation during their training really is.

Dr. Hemingway: Yes, you’ve got that right on. The medical term for that is iatrogenic. We actually cause– “We” collectively meaning medicine we’ve caused that either death or untoward outcome. Depending on what source you read some people quoted as the third leading cause of death in the US and that’s the number that’s been thrown around. That seems a little high for me having been in medicine for 20 years and in hospital medicine both on the different areas. The wards of the hospital as well as in the emergency department where I spent most of my time.

I certainly didn’t see one of three deaths from that but it definitely played into medical error especially in the sleep-deprived folks that are working the night shift. The big joke is don’t go to the hospital on a weekend especially at night because all the A team is at home with their family and the B team is working. That’s not entirely true but just being in that environment with people that may be sleep deprived, the propensity or probability of having a medical error goes way up.

That’s easily studied not just in physicians but lots of data on airplane pilots, for example, and others that have this thing studied. That with just lack of sleep in one night, your performance drops precipitously. Somewhere between 20% and 35% depending on what studies you read that’s literally the drop in your mental abilities and sharpness and acuity in as little as one night missed of sleep. That’s short-term but what we didn’t appreciate I think we all know when we don’t sleep well we don’t feel great the next day.

In addition to that, there’s so many potential long-term ramifications. In fact, the WHO classifies shift work which is what I was doing for many years as a risk factor for cancer. As a carcinogen because higher levels of cancer are seen in these people that work the night shift, for example. That’s because of a lot of things you mentioned circadian biology or the circadian rhythm that comes up a lot with respect to sleep. I’ll be honest I was not trained to value my sleep as you appropriately said. One of the reasons is we didn’t understand it very well back then.

This was 25 years ago. We didn’t know that the most important time for your brain to be refreshed, rejuvenated, to dump out all the waste material that occurs in the buildup is at night while you’re asleep. This whole glymphatic system that we now have a name for that didn’t exist to our knowledge in the ’90s and early 2000s when I did my training. 2012 was when this was discovered by Dr. Jeffrey Iliff and Nedergaard out of the University of Rochester I believe. In 2012 this whole thing called the glymphatic system which is that flush.

It’s like the lymph of the body but it’s in the brain and it flushes out all the toxins that accumulate over the course of the day. You think of the things that you’ve heard of like the beta-amyloid and tau proteins that are involved in things like dementia, Alzheimer’s and Parkinson’s, and other associated dementias. Those things get flushed out while we sleep and if you’re not sleeping that process doesn’t get to happen. That’s just the tip of the iceberg.

There’s so many other amazing things that happen while we sleep which is things like hormonal balance that can be responsible for not only things that we notice like weight gain. If you’ve been up all night you get the munchies. Well, that’s physiology. That’s not because you’re weak. That’s because your hunger hormone ghrelin goes up, but not to belabor it sleep is so dang important. I didn’t appreciate it until about the last decade. I mean I spent many years of my life sleep deprived and I’m not doing it again.

I’ve repented but I now know and appreciate both the physiologic significance and the benefits of having a great quality night’s sleep. You just feel good. I’m coming up on 50 and I feel like I’m a teenager. I have more energy than I’ve ever had before. I got teenage kids that I can keep up with. A lot of that difference for me was with my sleep. I always ate pretty well but I really didn’t value sleep until the last decade. That’s the first S of the mnemonics FMSG.

Key 4 gut health

G is gut health. Gut health was also a topic that I didn’t learn about when I was in medical school.

We didn’t have a good appreciation of what this thing called the microbiota or the microbiome really was. Now we’re really not only starting to understand this better but there’s actually quite a bit of data that looks into this that actually shows the importance of these many trillion bacteria, viruses, protozoa. All these things that live in us, on us within us. The biggest quantity of course is within our GI tract from our mouth to our butt. That’s where these guys mostly live and what lives there is predominantly selected for based on the activities we do.

Many of us just think about what we eat and what we eat is a huge component but also what we do. You mentioned circadian rhythm. Most people have no idea that these guys that live in the dark in your intestinal tract actually respond to light and dark cycles just like we do. Most people have no idea about this. When we respond to those cues and we get outside early in the morning to see that sun come up, not only does that set our circadian clock but it sets theirs too. If we want them to be our best ally, we got to take care of them.

I spend a lot of time in the book talking about how to get your gut healthy not just by simply what we eat which is super important but also what we do because so many things are involved there. I think many people have heard just simple buzzwords out there like 90% of the serotonin in your body is produced by your gut. That’s true. The happy hormone and there’s this connection between the gut and the brain. That gut-brain access. All of that is true but I think what really hit it for me was the studies that have been done.

For example twin studies where you basically look at the makeup of their gut bacteria in twins that are genetically identical. Exact same DNA. You have one twin that’s lean, that’s thin, that’s not overweight and his or her identical twin is obese or overweight. They have the same genes. We can’t just blame that obesity gene that you talked about. They have the same damn genes but what’s different is their makeup of their gut flora the microbiota. They’ve done studies with a transplant, a poop transplant, a fecal transplant of the stool from the overweight twin.

Put it into a mouse that’s not overweight and they give it the same diet that they give this other mouse that’s going to get the fecal transplant from the lean twin. What happens when they get the fecal transplant from the overweight twin they get overweight also, like holy crap. They have the same exact diet as the one that gets the fecal transplant from the lean twin and that one does not get overweight or gain significant weight. Holy crap, this stuff is legit. It’s been well studied and most of us don’t pay any attention to it. I dedicate a decent amount of time in the book talking about gut health.

Ari: Excellent. What’s the last S?

Key 5 Stress

Dr. Hemingway: The last S is stress. As I like to call it the stress optimization. We need to optimize stress in our life. We all experienced stress. In fact before COVID, the landmark studies showed that 80% of us had some significant stress or event throughout the course of one year that would happen in our life. Now post-COVID that number is in the 90-some-odd %. The landmark study looking at stress was in 2012. It was 180,000 patients and what they did– This was super interesting. I haven’t seen it repeated at least to this scale.

They took these 180,000 people and asked them to rate their stress. Do you have mild stress, moderate or severe stress? They got to rate it. Then the second question they asked was do you believe that the stress is harmful to you? That it might adversely affect your health, or do you believe that it could be something positive? Could it be a growth experience? During COVID many of us had to pivot our work because we couldn’t go into a traditional brick-and-mortar place. We had to pivot a little bit. Some of us were like, “Hey, this is a new opportunity to do something different.”

For me, at first I was like, “Holy crap.” My kids are all at home. It’s amazing. I love my kids, but sometimes it’s nice to have a little bit of a break from them. When I pivoted, I’m like, “Oh my gosh. What a blessed time in my life where my kids get to be home with me every single day. I get to be involved in their teaching and all that. I approached it differently. What they found was this top-tier group that had the highest level of stress. Only those who believed the stress was negative or could be harmful to their health, those were the ones that had the negative health outcomes.

In fact, it was like 30 or 40% of them had untoward health outcomes of that group. Of those that also rated their stress high that were in that same tier of the amount of stress. Those that believed that it could be beneficial, it could be a positive experience, a growth experience, the stress was actually protective for them. In other words, they had a lesser chance of developing significant illness or dying early. This is just a phenomenal study. There’s a whole book that was written on this. I believe it was by Kelly McGonigal a few years back.

I don’t remember the name of it, but she really elucidated a lot of these studies shared how powerful the mind is. Not in the much different than Bruce Lipton, but this was looking at things like stress and how we do have a significant role in how that plays out in our body, how we give it meaning. We get to choose the meaning of that stress. I talk about that. I talk about a lot of different strategies we can use to reduce, or just deal with it. Optimize the stress that we have, everything from breathing movement, meditation, mindfulness.

There’s a ton of different things we can be doing, but the cool thing is this also lies mostly under our control. We get to decide the meaning. It’s profound. It’s I think just astounding how powerful we all can be. We get to decide whether these stressful things that happen to us will affect our trajectory in a positive way or in a negative way. Many people have said things like, “Life happens for us and not to us, if that’s the way we decide.” I really believe that we get to choose how that’ll play out.

How to get started with the FMSGS

Ari: I’m curious of these five areas, which are you personally most passionate about and most interested in?

Dr. Hemingway: For me, it depends on if that question is from a physiological scientific approach, or just personally what has made the biggest impact in me. The two that I’m always back and forth about because I’ve just found them be so dang profound is the food that we eat or that we don’t eat and how profound that can be an effect. I didn’t notice this, I’ll be honest, until I was in my 30s. I could literally eat whatever kind of fast food or garbage was available. I’d do my exercise and I didn’t feel like I really noticed much of a difference.

Then as I got into my 30s and 40s, and now coming up on 50, I feel different if I eat food that’s of low quality. I noticed that, and part of that was when I started to pay attention to my gut health. The food and the gut health for me are really just profound and they’ve been– I think it’s so fascinating. The gut health part, I am just super fascinated with some of these studies I mentioned about the fecal transplants and the twin studies and this kind of thing. The connection between the mind and the gut, so-called access that exists there.

I find that personally super interesting that bacteria can actually produce messengers. We can call them neurotransmitters. We can call them neurohormones that actually go to our brain that can tell us, for example, what to crave. If we have the stuff that’s not good for us that we don’t really want in us, the so-called firmicutes, bifidobacteria in us, they can tell us to crave junk food. They literally send messages to our brain that’ll affect how we think about food. I was never taught that. I’m fascinated with that. I’m a nerd and a geek when it comes to that.

I love to talk about gut health. It’s just so profound and there’s so much interesting data out there. The other thing personally, that I love to speak on is just movement because it has made such a big difference in my body. If I’m having a bad day, and if I’m feeling really stressed or something happens– Like actually during the writing of my book, I had three-quarters of it written and I was saving it onto an external drive to send it to somebody to review and some weird quirky thing happened and the whole thing disappeared.

I couldn’t figure out how to recover it. This was like 500 pages worth of manuscript and literally, poof in one keystroke was gone. I was like, I wanted to scream, I wanted to drop some four-letter words, and instead, what I decided to do, I happened to be in Florida at the time where I could walk to the ocean that was close to me. I grabbed my surfboard. I literally went out for 15 minutes, caught two or three waves, and I came back and I was like, “Okay. Now I can approach this with a fresh set of eyes and ears and calm down.”

It made all the difference. Movement for me is one of the most crucial for not only how I feel, but how I can get things done. It gets my brain sharpened and if I don’t move every single day, my wife will tell you I’m kind of cranky. I got to move somehow. The cool thing is now even just a walk does it for me. I don’t have to get in my interval training every day, nor should you. You shouldn’t do it every single day, couple times a week’s fantastic. Anything that moves your body every single day, it’ll just make such a difference.

Not only in your health, but I really feel like in your mind and your emotions and your spiritual health.

Ari: I’m curious. Given that nutrition and gut health are really big for you, personally, those are big passions and areas of interest for you, what are your top three insights into how to optimize food, nutrition, and how to optimize gut health?

Dr. Hemingway: First and foremost is what I was alluding to at the beginning when we talked about food is, eat real food. If it comes in a bag or a box or with a barcode, the three Bs as I sometimes will call them, most of the time we should be avoiding those things. Even the so-called health bars that are out there that are supposed to give us protein or energy. Most of those have some not-so-awesome ingredients, whether they be just a ton of sugar or artificial sweeteners, or bad oils.

Many people have no idea that most of the food that we eat that comes in a package not only is highly processed grains and sugars and gluten-containing, which affects a lot of people, but it also has some really highly processed inflammatory oils, the so-called seed oils. Here’s eight or so of them that we really should try to avoid. Soybean oil is one of the most common. We think, well, soy is a good thing. It comes from nature, but the soybean oil hugely inflammatory. Safflower, sunflower, canola, grapeseed oil.

All of these are so highly inflammatory and most of us have no idea. That’d be my number one, eat real food, be cautious in anything that comes in a bag, a box or with a barcode. If it does, you’ve got to read those ingredients. You got to make sure it doesn’t have bad stuff in there, which is, like I said, seed oils, highly processed grains, flowers, carbs that are really ultra-processed. Just look for the additives. If it says a color and then a number after it, that’s not going to be good. Anything artificial, an artificial color, an artificial flavor, an artificial sweetener, you should leave it at the store, not put it in your car.

That’s number one. The second biggest thing I would say is really the timing of what we eat. The quality of our food is number one, but the timing of that is almost equally important. When I think about this, I just think about what we did thousands of years ago for millennia. Did we wake up in the morning and immediately start shoving breakfast into our mouths? Of course not. We didn’t even have anything. There was no such thing as a pantry. There was not a refrigerator. There was not a convenience store or drive-through or anything like that.

We literally took a few hours, maybe even the better part of the day, trying to either find food that we could gather and eat or go on a hunt. We could not just eat the moment we rolled out of bed. I don’t believe that our bodies were designed to eat 24 hours a day. In fact, the studies right now show that about 16 to 18 hours a day, most of us in the US are putting some form of calories or food into our mouths. That’s just too much. What I would say to that is for most people, you don’t have to feel like you got to go on these super ridiculous two-hour window feedings.

That some people are familiar with the one-meal-a-day plan, the OMAD diet, or whatever. That’s a little bit too extreme. Personally, my goal for every single day is to have at least a 12-hour window where I’m not eating. Eight of those hours already accounted for while I’m sleeping, so that’s easy. Then I just have a couple hours on each end of that. My goal is try to not go to bed within about three hours of having food because it’ll mess up your sleep, anyway. You’re going to have poor quality sleep if you eat right before you hit the sack.

Plus, you need to give your body some time to digest. Digestion is energy-intensive, and you need to have some time to do that. You need to have a break, so that all that beautiful process of the glymphatic system and the refresh, the rejuvenate, the flushing that happens, the autophagy that everybody likes to talk about. All that stuff doesn’t even happen unless we’ve been fasting for a certain period of time, somewhere between 12 and 16 hours.

Overnight, I believe everybody should be able to accomplish a 12-hour window of not eating, and then maybe add to that a couple of hours on either end, if you want to really get the best benefits from that. It doesn’t have to be extreme. I think too many people are looking for 16, 18, these real long windows of not eating, I think it’s too much for many people, especially for women. Hormonally women have different issues with these longer fasts, and so I just shoot for 12 hours. I think that’s achievable from almost everybody I’ve worked with. That’s two.

The third thing I would say is, when you think about your gut, I think now more of us talk about it, but before when I did medical school, the only time I asked people about how they were pooping was if they had an acute abdominal problem. I thought maybe they needed a surgery, or they might have a bowel obstruction or these kinds of things. Otherwise, nobody really ever talked about how often they pooped. If you’re not pooping at least once a day, every single day, you’re not at the ideal optimal level for getting toxins out of your body, for example.

You should be pooping at least once a day, I would say twice a day, and we should talk about it. I think with the gut health movement we are starting to talk about that, but for adequate cycling of all of these bacteria and getting rid of all the toxins, that’s one of the biggest things with the gut. That’s an avenue for us to get rid of waste is to poop it out, and if we’re not pooping for four or five, some people I know don’t poop for a whole week, that ain’t good. That’s not good for you. Paying attention to those simple cues, and then doing the things that will help that one is hydration, one is movement.

If you’re getting out and doing some form of movement for 20 or 30 minutes every day, that’s going to help your poops. If you’re hydrating really well, drinking roughly your body weight and ounces of water per day, that’s going to help a lot, but getting real regular that way is the start. There’s a whole bunch of things that I add to it in the book but I think those three things are easy. People can easily focus on them, and it’ll really move the needle if you start paying attention.

Ari: Beautiful. What about for gut health? Do you have maybe two tips that you can share with people before we wrap up for how to optimize their microbiome or their gut barrier integrity or anything along those lines?

Dr. Hemingway: Yes. The biggest part, I think, for most people is to try not to screw it up, [chuckles] because a lot of the things we do screw it up. If we eat processed foods, that makes us much more prone to having what you referred to as a leaky gut or increased intestinal permeability. That’s something that’s now recognized that 20 years ago when I did medical school, that vernacular didn’t exist. Leaky gut, what’s that? That didn’t even exist.

Ari: Not only that, but they used to–

Dr. Hemingway: Make fun of people.

Ari: They used to make fun of the people in the natural health community talking about leaky gut, and say, “That’s not a real thing,” and blah, blah, blah. “All those crazy quacks and their natural health alternative medicine stuff talking about leaky gut, they don’t understand real medicine.” Now, of course, there’s a huge body of scientifical literature around intestinal permeability. We know that all kinds of common things in one’s diet and lifestyle can induce it.

Dr. Hemingway: Absolutely. We can measure it, we can measure the zonulin levels in the blood. That gives us an idea of the permeability. I didn’t appreciate this stuff until the last decade because it really interplays with almost every other system of the body. We have this huge surface area in our gut, maybe it’s the size of a studio apartment, maybe it’s as big as a tennis court. We don’t know exactly, but it’s pretty dang big, it’s probably the biggest organ when you unfold it, of almost any in our whole body.

What we expose that to makes a big difference. Number one, avoid processed food, especially for most people, gluten can be really sensitizing. The reason for it is that people will argue, “We’ve been eating gluten for 1000s of years, we’ve been eating wheat.” That’s true, but it’s not the same kind of wheat that we eat now. The wheat that we have incorporated into our foodstuffs, at least here in the US is this dwarf leaf that doesn’t look anything like the wheat that they use millennia ago.

It’s so different, the properties, and the processing, the amount of glyphosate, and other pesticides that they spray on it. Most of us could benefit from either being gluten-free or just not having very much gluten in our diet. That’s number one, avoid the processed foods and especially things containing gluten. A lot of people get aggravated with milk products as well. Raw dairy is a little bit better, especially goat milk tends to be a little bit better tolerated. Cheese tends to be a little bit more tolerated for some people than drinking milk.

I don’t believe that there’s one specific food plan for everybody. Anybody who tells you, “This is the food plan,” run away. It’s crap. Everybody is different. We’re all unique, and that’s the beauty of it. We are all unique. There’s some basic principles like try to eat real food and not the processed stuff. I, of course, agree with that, but to say that there’s one food plan that works for every single human out there, BS. We all grew up. If we look at our ancestry from where we came from, we’re going to have different nuanced.

Not only genes, but also there’s some data now showing that the epigenetic characteristics can also be passed down generationally which seems crazy, but we have data of that. We need to pay attention to our roots, to where we come from. What we’ve been eating for millennia. You take the folks from Japan, that for millennia have been eating rice, and none of them used to get fat. You go over there now and they’re all eating McDonald’s and all the other fast foods that we have sent them, everybody wants to be like the US and have all these fast food joints.

Now that they have them in Japan, their obesity rate has skyrocketed, whereas before they’re one of the Blue Zones, they’re one of the healthiest groups of people in the world, and they ate rice every single day of their life. Every person is a little bit different, but if we pay attention to ourselves and our body, have mindfulness about that. We stick to the basic principles of eating real food, and not the highly processed stuff, that’s a fantastic place to start. Looking at the past, what we have eaten.

For example, there’s a lot of talk about probiotics, prebiotics, the foods that contain lots of these, for example, the fermented foods, everything from the sauerkraut, here in Hawaii we love kimchi and the kefirs. If you’re out in Japan and those areas they love the fermented soy products. The tempeh and the miso soup, and all these kinds of things. There’s so many of these things available worldwide. What I love to teach people is there’s actually more that you can add to your diet than take away.

There’s a couple of things to take away, take away the highly processed stuff, take away the high fructose corn syrup. Take away the seed oils, those are three big things you should take away, but think of the 1000s of colorful vegetables, fruits, fermented foods. Think of all this amazing stuff you could actually add to your diet. If you don’t get a sense of that, go to your local farmers market and try to see some of these vegetables, fruits and other things that you’ve never seen before, and every week try to add one thing to your diet.

I focus on adding healthful things as opposed to taking away because nobody likes stuff to be taken away. Especially if you got kids, you take something away from them, they go berserk. We’re just like that we don’t like our stuff to be taken away. So a couple of principles about the things to avoid, and then primarily help people know what they can add to their diet, and this is especially important with gut health.

Ari: I think that’s a beautiful thing to end on. Dr. Hemingway, thank you so much for coming on the show and sharing your hard-earned wisdom with my audience. I appreciate it and tell listeners where they can learn more from you and follow your work.

Dr. Hemingway: Awesome. Thank you so much. The easiest place to find me is either on my website, which is I spell that just like Ernest with one n. Or on Instagram I’m @dr for Doctor drthomashemingway. The book, it’s called Preventable as you said, and I have a website called the, but really everything can be found either on my link tree on Instagram @Dr.ThomasHemingway, or on my website, They can also check out my podcast which is called the Modern Medicine Movement where I love to share these kinds of holistic natural health pearls with the world as well.

Ari: Beautiful. Thank you so much, my friend. I look forward to the next conversation.

Dr. Hemingway: It’s been such a pleasure, Ari, thank you so much. Big mahalo to you and your listeners. Aloha.


Show Notes

Dr. Hemingway’s story (00:53)
Most diseases can be prevented (04:29)
Key 1 Food (15:45)
Key 2 Movement (17:57)
Key 3 Sleep (19:55)
Key 4 Gut health (26:01)
Key 5 Stress (29:02)
How to get started with the FMSGS (32:35)


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