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The Melanie Avalon Biohacking Podcast Episode #102 - Dr. Richard Jacoby

Author of best selling book, “Sugar Crush” and practicing podiatrist for over 40 years with a special emphasis on nerve decompression and diabetic neuropathy. Dr. Jacoby is one of the country’s leading peripheral nerve surgeons, specializing in progressive damage to the nerves that often results from diabetes. Dr. Jacoby is one of the co-founders of the Scottsdale Healthcare Wound Management Center and is the past president of the Arizona Podiatry Association and the Association of the Extremity Nerve Surgeons. He is a diplomate of the American Board of Plastic Surgery and is a member of the American Podiatry Association, the Arizona Podiatry Association, and the Association of the Extremity Nerve Surgeons.



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Sugar Crush: How to Reduce Inflammation, Reverse Nerve Damage, and Reclaim Good Health

8:45 - Dr. Jacoby's Background

10:45 - What Are Our Nerves?

15:55 - the biochemical pathway for the autonomic nervous system

16:45 - is the damage mechanical or in the electrical signaling

18:20 - Polyol Pathway

18:55 - maillard reaction (advanced Glycation End-Products)

20:45 - Asymmetric dimethylarginine

22:40 - MS And Alzheimer's connection to sugar

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The Melanie Avalon Biohacking Podcast Episode #38 - Connie Zack
The Science Of Sauna: Heat Shock Proteins, Heart Health, Chronic Pain, Detox, Weight Loss, Immunity, Traditional Vs. Infrared, And More!

26:45 - differences in opinion on sugars effect on nerves

28:20 - The Way Sugar damages the heart

30:40 - autism

34:45 - cOVID19 and sugar

35:50 - pregnancy and glucose

The Melanie Avalon Biohacking Podcast Episode #17 - David Sinclair

39:25 - metformin

40:35 - poly-pharmacy

43:00 - Berberine

47:15 - high carb low fat

49:40 - can we live on just fat?

55:20 - competition of vitamin c and glucose in the body (ascorbate Competition Theory)

1:00:35 - fruit

1:02:20 - damage to the olfactory nerve

1:04:40 - Gallbladder Diet

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1:08:45 - The benefits Of Wine on arteries

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1:11:05 - the vagus nerve

1:15:00 - Medicinal Signaling Cells

1:16:40 - dietary recommendations


Melanie Avalon: Hi, friends. Welcome back to the show. I am so incredibly excited about the conversation that I am about to have. A little backstory about this. My audience, as you guys know, you're pretty familiar with things like low carb diets, and the importance of blood sugar, and just a lot of topics that people are pretty familiar with. When I received a book called Sugar Crush: How to Reduce Inflammation, Reverse Nerve Damage, and Reclaim Good Health, reading the title, I obviously was expecting that I would be in line with what it was going to talk about but I did not anticipate the amount of information that I learned reading this book. It really just opened my eyes, blew my mind. I know a lot of people when they think of diabetes, they aren’t familiar with things like people having to get amputations for diabetes, and that for example, it's something that I really had no idea what was the trail that led to that.

Reading Sugar Crush, I learned so much about our nerves, how they affect so many things in our body, and how sugar plays a major role in damaging our nerves and leading to so many conditions. So, I'm really excited to dive deep into this conversation. I am so thrilled to be here with Dr. Richard Jacoby. He is the author of Sugar Crush, and he is one of the country's leading peripheral nerve surgeons. He actually specializes in progressive damage to the nerves that does often result from diabetes. I have so many questions for him. I am just so excited to jump in. So, Dr. Jacoby, thank you so much for being here.

Dr. Richard Jacoby: Well, it's a pleasure. I love the enthusiasm in your voice. I'm really excited to get into the weeds on this question of sugar. Where did it come from, how does it affect the nerves biochemically and relate all the different diseases that I've seen? Even I think COVID-19 is a prime example.

Melanie Avalon: Wow. Like I said, my audience is pretty familiar with this. But when they think sugar, they think sugar, they think blood sugar regulation issues, they might think weight gain being the issue, but nerves, very rarely does that even come up. It didn't come up in my head until I read your book. To start things off, though, would you like to tell listeners a little bit about your personal story? What led you to become a peripheral nerve surgeon, and what led you to this--? I don't know if you had an epiphany one day about the connection to sugar, or what did that whole adventure and journey look like?

Dr. Richard Jacoby: Perfect segue into epiphany. That is the correct word. I did have an epiphany. I was running the Scottsdale HealthCare's Wound Care Center. I started it with a couple other doctors about 35 years ago. A gentleman by the name of Dr. Lee Dellon was a peripheral neurosurgeon out of the Johns Hopkins was giving a lecture. He came up or I went up to him after the lecture, I said, “Dr. Dellon, it is an amazing theory that you have.” He said to me, “Well, first of all, why do you podiatrists cut the nerve out in the foot?” I said, “Well, that's what we're taught.” He said, “Well, come down to Johns Hopkins with me. I will teach you my theory. You’ve got to read my textbook,” which is amazing textbook. I did, and I went down there, and I was like, “That was the epiphany.” Here, I was pretty well established in my trade, and surgery done, thousands of surgeries, and here, he's introducing a whole new concept. It was like opening a door, an epiphany. I would never consider nerves per se, as being related to diabetes other than you lose your feeling, and you get an amputation. He said diabetic neuropathy is a nerve compression, very much like the wrist, the median nerve for the carpal tunnel, which is actually a profound statement. That's how it started about 20 years ago.

Melanie Avalon: In the beginning of the book, you tell the story about the epiphanies about amputations and things like that. Like I said, I think so few people think about this. Can we just dive in deep and get a picture of what nerves actually are? I feel like they're very underappreciated, but they do so much in our body. How do they function normally and then maybe we can understand how sugar affects them and makes them go awry?

Dr. Richard Jacoby: Well, I think everybody knows the theory of electricity. If you hit the switch, the light comes on. The nerve is the same thing. It has a generating system of energy that sends electrical impulse from a receptor. Let's use the light receptor, the eye. A photon comes into the eye, trips the optic nerve, and sends a picture with little tiny pixels being built. We know that his sight, and you take it for granted. That's electricity and photons. Well, the foot is the same thing, except there are mechanical receptors. I always like to use this story, I said to a lady one day, and she had lost all her feeling, she had diabetic neuropathy. I said, “If you really look at your finger, and look at those little ridges that we call fingerprints,” I said, “They were not put there by the FBI.” They were put there so we could feel our environment. It’s good for your audience. Just look at your fingers, and feel those little ridges, and press your finger down on the table. You'll feel a variance of pressure, and even with your eyes shut, you can tell the difference in pressure. That's called a Merkel receptor. You can run your finger across your desk or your chair with your eyes closed, and you can tell the different textures. That's what mechanical receptors do, as what photos, receptors do for the eye. Now we have COVID-19, and that particular nerve is the olfactory nerve that's getting affected most with the sense of smell. There's chemicals in the air, we can differentiate those chemicals and we know it is a sense of smell. Or the tongue, the sense of taste. These are all receptors.

I guess my epiphany was that day when Dr. Dellon said, “Why do you podiatrist cut the nerve out which is Morton's neuroma in the foot?” His epiphany came from this really simple concept. It was 1984, he published his first paper on this subject. He had a patient who had diabetic neuropathy, who also had carpal tunnel problem with her wrist. That's the median nerve. If you look at your wrist and right at the base of the thumb there, there's a nerve called the median nerve. You pressed on that long enough, you will get numbness, tingling, and eventually would not be able to have any function in your hand. He fixed that for this lady, and he also fixed her nerve in the elbow called the ulnar nerve. She said to him, “Great, Dr. Dellon, and why don't you fix my legs?” He said, “No, you don't understand. That's a different disease.” But he thought about it. He said, “Wait a minute. Maybe that is a compression neuropathy like the hand, and the wrist, and the elbow,” and he went to the laboratory, won't belabor all these experiments that he did but are amazing. He proved that diabetic neuropathy, which is called diabetic polyneuropathy, meaning more than one nerve is really a compression neuropathy, exactly the same as the carpal tunnel of the wrist.

Now, where I got involved with it and I did thousands of his surgeries, and one day, I said to him-- 15 years ago, I said, “Dr. Dellon, I think there's more to your theory.” He wasn't kind to me when he answered. Now, he's actually up for the Nobel Prize in Medicine. I'm telling him there's something more to his theory. He said, “Why don't you figure it out?” I thought, “Oh, boy, I did it again.” I started reading outside my normal sphere of thinking, and I was lucky, and I found this article written by Dr. John Cooke. If you want to look it up, that's Cooke with an E at the end. He wrote an article on 2005 was called the Uber marker, and it was on asymmetric dimethylarginine. That's a big word. I thought it had something to do with Dr. Dellon's theory. I texted him. The amazing thing was, he called me two hours after he got my text. This was about 2006. He said, “I love your theory, come up to Stanford,” where he was at the time, is a cardiologist by training. He's got a PhD in vascular biology, and he studies one molecule, that molecule, asymmetric dimethylarginine. He said, “I really only study that molecule. So, if you're interested, we'll pursue your idea,” and we did. I tested his molecule on my patients, and I came up with a concept, and I thought, “Oh, wait a minute. This is the biochemical pathway for the autonomic nervous system,” which is the very, very first change you get, and that molecule, I thought was blocking the nitric oxide pathway. It is, but it took 15 years to figure out. That's what this book is really about. How sugar affects the biochemistry and causes the aberrations, not only for the foot or the wrist, but the eye. I think it's autism, Alzheimer's, MS, you name it, it doesn't matter. They're all the same. Nerves operate muscles, and when that chemistry has changed, changes happen to the end organ. That's what the book’s about. So, fire away at me and see if I can answer the question.

Melanie Avalon: Okay, I have a random question about the nerve functioning. Because you're talking about the electrical signals that are sent, and then when the nerves are compressed that I'm assuming the electrical signals, we perceive are being affected. Is the issue always in a mechanical damage to the nerve, and then the signal that comes out is being affected? What I'm thinking of is, some people get phantom nerve signs, and how much of what we experience with our nerves is in our brain, and how much of it is affected by the actual nerves?

Dr. Richard Jacoby: Oh, that’s a great question. Let's look at the electrical circuit. The brain is the central computer, so to speak. The axons, which are the smallest unit of the nerves, are receptors going out to all areas of your body, and they're sending signals from the very most afferent or away from, and sending into the brain, the efferent, and you're creating pictures, and sounds, and sensations, and sense of smell. And then, the emotions getting involved, because we're constantly getting this input. When that electrical signal is interrupted for whatever means, and what we're talking about here is sugar. Let me give the basis on what else sugar does that. This is the known science. There's thousands upon thousands of articles written on this in great journals.

Number one, polyol pathway. That's a chemical pathway that changes sugar into an alcohol sugar called sorbitol. If you overload the nerve with too much sugar, whether it's glucose, and we'll get into the different sugars, or fructose, then you're going to build up too much sorbitol, which causes the nerve to swell. The nerve will then, because of the sorbitol, because it's alcohol will pull water into the nerve nets, the mechanism by which the nerve swells. That's number one.

Number two, the Maillard reaction. Now, I'm not pronouncing that correctly, is really Maillard in Philadelphia, I'm not going there. It's really a cooking term. That's the browning you see, when you mix-- like you baste a turkey. That's what gives it flavor. They're called advanced glycosylated end products. That's really a cooking term, but it's cooking your nerves. If you take sugar plus the covering on the nerve, which is collagen, you're making that very pliable tissue very crispy, and it starts to shrink. If you have a nerve that’s swelling and a covering that's shrinking, we call that Maillard reaction.

Now, that's in contradistinction to what neurologists say. If I had this lecture, and there's a neurologist in your group they would say, “This is nonsense. This is not a curable disease.” I would say to him, “You can cure it, because you're not a surgeon. You only can write for prescription, and you're trying to never tell the patient that sugar is causing problems, and you're giving them a medication in the brain that works in the brain, so they don't feel that change.” Now, when you're in a lot of pain, yes, gabapentin, Lyrica, all those kinds of medications are helpful. But it's like turning off the smoke detector while you're asleep, and you wake up, you smell smoke, and you turn the smoke detector off and go back to bed, you're going to die. You're going to die if you take these drugs, because you'll never change your habits. That's what sugar is doing.

The third pathway. That was the one I thought was not discovered and that is asymmetric dimethylarginine. Now, your audience, I don't know how many are chemistry buffs, but let me try to give you that visual for that on this podcast. Asymmetric, what’s the word means? There's a methyl group instead of being on either side of the arginine amino acid, they're on the same side. Asymmetric dimethyl, two methyl groups, on the same side of L-arginine. Big deal, right? Well, it is a big deal, because that molecule blocks the nitric oxide pathway. When you're trying to convert L-arginine, and as semi essential amino acid to nitric oxide and you're blocking that, you're going to downregulate that molecule to peroxynitrite. What does that mean? Well, nitric oxide dilates blood vessels and peroxynitrite shrinks blood vessels. So, you're going to shut off the blood supply to whatever end organ you're talking about. Whether it's your eye, your toe, your nose, your ear, doesn't matter. Even your gallbladder. It stops the function of that muscle and the end organ receptor.

Over time in the last 300, 400 years, some very good people in medicine started to see these symptoms that sugar was causing, and they named them. Like MS, Charcot, 1860s. Person in autopsy has white spots in their brain. Well, that's what MS means. Multiple areas of sclerotic white spots. How is that a diagnosis? That's an observation. But they didn't know that sugar was doing that. They're still not convinced that sugar is doing it.

Let's take Alzheimer's. We have dementia. In the next 10 years, 50% of the population in the United States over 65, 50% will have Alzheimer’s. What's the first symptom of Alzheimer's? The answer is, is sugar of the olfactory nerve and you lose your sense of smell first, not your memory. The neural network in the brain, which is the hippocampus, has three functions. One, it receives the olfactory nerve impulses, the addiction center, and it also affects long-term memory. That’s Alzheimer’s. It is sugar, is no question about it. The mechanism of action, the way I'm describing it, is a new way of looking at it. I don't know if your audience knows of Dr. Perlmutter. Does that name-- [crosstalk]

Melanie Avalon: I've had him on the show.

Dr. Richard Jacoby: Oh, you had-- He endorsed my book. Never spoken to him. This is really weird. You had him on your show. Now, he would be considered probably the best-known neurologist and the natural field. Would you agree with that?

Melanie Avalon: Yes. He's amazing.

Dr. Richard Jacoby: He apparently called my editor when the book was going to publication, he said, “Brings laser focus to the powerfully detrimental role of sugar and carbohydrates as direct toxins to the body.” That's his quote on my book. But I have never spoken to him. I would guarantee you he doesn't agree with me in the terms of nerve compression, because he's a neurologist. Now, I've read his book, and he's a great writer, and I'm not putting it down. I would love to have this debate with neuropathy. Let's define that word. Neuropathy means a problem with the nerve. That's all it means. He feels that Alzheimer's should be called type 3 diabetes. He agrees with me, but he doesn't agree with me on the mechanism. Now, if we'd said Alzheimer's is type 3, then I guess MS would be type 4, and see how we go on and on? No, there's one type, it’s caused by sugar. Even type 1 and type 2, to me, type 1 is the early manifestation epigenetically of ruining your pancreas from day one. You carry the genes, a lot of genes, you taste sugar, you're done as type 1. In the old days, you die. because there wasn't any insulin. Now, we have insulin, so the type 1s have lived, but it's still the same cause, sugar. Now, I don't want to preach here and I'm starting to do that. So, why don't you ask me some specific questions if I can answer them?

Melanie Avalon: The people in this new mindset about Alzheimer's and the role of sugar, Dr. Perlmutter’s type 3 diabetes opinion and then yours with the nerves is the difference. Yours is that there's mechanical damage to the nerves being caused-

Dr. Richard Jacoby: Absolutely.

Melanie Avalon: -by sugar, and then the type 2 diabetes theory is that the blood sugar insulin dysregulation creates a lack of fuel to the brain cells, is that what that theory is?

Dr. Richard Jacoby: Well, let's go back to Dr. Cooke at Stanford. Now, his first name is John. We've become very good friends. He's now at Baylor, by the way. He headed stem cell and COVID research for the United States. He's probably the leading authority on all of this. Not probably, he is. John's training is as a cardiologist, got a PhD in vascular biology. He's written over 500 articles. You should interview him. He is off the charts.

Melanie Avalon: Yeah, I'd love to.

Dr. Richard Jacoby: Oh, yeah. He’s so down to earth. He said, “Come up to Stanford, I like your idea.” First question I asked him, “Dr. Cooke, I'm confused about this cholesterol hypothesis.” Basically, being a diplomat, which I am not, he said, “It's flawed.” I would call it fraud, but he said flawed, hear in the distinction of the words? He ran this whole-- It was like, I was educated by the brightest minds in the world. It's amazing. For 15 years, I'm having a conversation just like we're doing now, one on one with him. I said, “I'm confused.” He straightened it out for me, here's what he said. “The lining of the blood vessel, which is the endothelium is like Teflon. It's very, very smooth. When you eat sugar, it makes it Velcro.” I said, “So, are you saying cardiovascular disease is caused by sugar?” “Well, that's what we tend to think.” Well, no, it's absolutely true. “What does cholesterol have to do with it?” “Well, cholesterol is a signaling molecule. In other words, if the lining of the blood vessel was irritated by sugar, cholesterol, it comes out of your liver, and by a signal goes to the area of,” we call that in medicine, the lesion, and “patches up the lesion.”

Well, let's go back to 1800s. Guy by the name Virchow spoke five languages. He opened up an artery, and he saw that stuff in the arteries that the cholesterol, and he spoke five languages. He's the guy that named that atherosclerosis, because athero in Greek means gunk, and sclerosis is hardened gunk. Again. How is that a diagnosis? No, it's an observation. What he didn't understand and didn't know in 1863, that underneath that gunk, was a rough spot of inflammation caused by sugar. That's how the word stuck. Then, as we had all these different people get into the game, notably Ancel Keys by the way, and I'm sure you know that name from your podcast, who pushed the cholesterol hypothesis, which is absolutely a fraud. Even that Framingham study which cost billions of dollars, you're trying to tell you it’s fat.  No, it's not. It is sugar. Cardiovascular disease is caused by sugar. Cholesterol is a naturally occurring substance that goes to heal these areas of inflammation. MS in the brain, that's what it is. Alzheimer's, that's what it is. Diabetic polyneuropathy, that's what it is. Autism, that's another controversial point in my book. It's sugar, and that's a little bit more complicated to explain. But we have a pandemic right now.

But let's just talk about autism in a second. When I was writing my book, I looked at that nerve, which is called the hypoglossal nerve. I theorized that what's the symptom in autism? Delayed speech. What nerve operates that for the most part? There's several nerves, but that's the main one, hypoglossal nerve. That's under your jaw just give you a picture. That's where the cable runs. The nucleus is in the back of your brain, and its function is to innervate the tongue, and one of the functions of the tongue is articulation or speech. Well, if you have a mechanical disruption of that nerve, you're going to ask for a glass of water when you're two years of age, and nothing's going to come out of your mouth, so you're going to be a little pissed, and you're going to kick your foot through the wall because you can't express yourself. It doesn't mean you're stupid. You just can't express yourself. Through neuroplasticity, [unintelligible [00:24:28] learn mathematics and music or something like that. That's how these kids become savant and very good at certain things but not speech, because it's delayed. How does that happen?

There's a great article in Scientific American written somewhere around 2000, written by embryologists, and they look their autistic kids, and they looked at their features. They noticed that the ear was 15 degrees rotated anterior-ward and the eyes were a little bit offset. These kids were very good looking but after conception by the way, on day 24, there was a protein that was put down at the [unintelligible [00:25:15], which is the structure, based in the brain where the hypoglossal nucleus forms, and they noticed that space was 1.1 millimeter tighter than a normal development.

Now to me, if you take the nerve and you squeeze it by 1.1 millimeter you're causing, what's the word? Compression. How does that happen? Preconception, if the male and the female are carrying those genes and you spin the roulette wheel, and those genes come up, both the mother and the father-- Let me give you a background. Would you say that most pregnancies would more likely happen after a pizza and a six pack of beer, carbohydrates, sugar? Probably, it would be true. That triggers this epigenetic event. When you trace autism from year 2000, which was 16 births per 10,000, and this year, it was close to 1 in 39, and projected to be 1 and 2 another 10 years, there's got to be something environmentally happening. That answer is sugar, I think specifically, is high fructose corn syrup.

Now, Stephanie Seneff, I don't know if you've interviewed her, but she's the guru on glyphosate, and Monsanto's herbicide, Roundup. She traces it to that in our gut, in the microbiome and the sugar main pathway. That's a whole other segue, and that would take another three hours to talk about. But she has a new book coming up by the way in June on this subject. She helped me figure out some of these dots in my theory.

Melanie Avalon: What was her last name?

Dr. Richard Jacoby: Seneff. Stephanie Seneff. S-E-N-E-F-F and you should interview her. I think she's probably about 80 now. I think she's got three PhDs. One in physics, one in biology, she is the world's leading authority with what I just said. That's a big topic. this is a national disgrace. What does COVID-19 had to do with sugar? If your immune system is down regulated because of sugar, you will expose your DNA to these viruses, which are just particles of information. You breathe them in and you breathe them out every day, but if you're eating sugar and you're blocking your vitamin C, that's part of the book I think, that's another segue, then you're going to allow these viruses to use your DNA to make copies of their RNA basically, and you're going to die. Taking a vaccine, another-- none of these are vaccines, these are genetic modified code that you put into your DNA. They're not vaccinations. Vaccination means you're not going to get the disease from the organism and it’s not true for Moderna and Pfizer. That's another whole issue.

How do you protect yourself? Don't eat sugar. Take vitamin D, vitamin C, maybe melatonin, little zinc, and you'll be fine.

Melanie Avalon: No, I'm loving this. I have a lot of questions. This is just a really random clarification. You're talking about getting pregnant, the connection with sugar, and then how it affects that development of the nerve with the tongue. Is it literally the blood sugar of the woman at the moment of conception or just in general her blood sugar levels?

Dr. Richard Jacoby: I think it's both. Now, we're going back to 2000, so the sugar issue was really not discussed very much. Now, here we are in 2021. If you're eating a lot of sugar in the year 2000, you're not going to-- If you're born in 2000-- Let me give you better numbers. Let's go back to 1974 when high fructose corn syrup was introduced into the American diet, from Japanese by the way. Just to make the math easier, if it's 1974 and the year 2000, and a person is eating a lot of sugar, which they were, then let's say the fertility hotspot is the year 2000, so women are now getting pregnant at that time. So, the numbers were 16 autistic kids per 10,000 in the year 2000. They had roughly, almost 20 years of eating sugar and it’s starting to show up in the genetic code, epigenetically. Has that been discussed in your show, epigenetics, and how that works?

Melanie Avalon: Yeah, I've had quite a few guests on about it. I've had David Sinclair on which was--

Dr. Richard Jacoby: Oh, my God.

Melanie Avalon: I've had him on twice. He's amazing.

Dr. Richard Jacoby: You’ve met some great people. Okay, let's talk David Sinclair. Great book, anti-ageing. This is weird. I just read that a couple months ago. This is why it's so interesting in medicine. David Sinclair, as your audience may know, he is a yeast biologist. The bottom line in his book is yeast replicates 25 times and they're done. Jellyfish go on forever. What are the genes he splices them in there, puts it in mice in makes them grow longer? What are the genes, and what can you do to increase your aging? He talks about rapamycin by the way, on that mTOR theory. But also, on page 74, he talks about his good friend who is a podiatrist and a friend of mine, I shouldn't say he doesn't understand. He doesn't agree with anything that I say. But he's a good friend of David Sinclair. His name is David Armstrong. He's a very bright guy. He is a podiatrist, a DPM, a MD, and a PhD. He is one of the best writers in our profession, but he doesn't agree with this theory. He doesn't agree with Dr. Dellon. I've discussed this with him many times. Why? Because he is all about “research” and research is paid for by Big Pharma. Big Pharma is the answer they always get. Not the truth. That's a big sentence. Not the truth. Nerves are compressed by sugar. To avoid sugar, you're going to avoid these diseases. Big Pharma is allowing you to get the disease purposely, I think so, and they will give you a medication for the itises that they produce.

Melanie Avalon: What about a drug like metformin or something where you're--?

Dr. Richard Jacoby: Well, metformin, then, David Sinclair talks about that. Some people think it extends your life. But I think what it does, it causes neuropathy by the way.

Melanie Avalon: Causes it?

Dr. Richard Jacoby: Oh, yeah. Because it interrupts the-- back to the L-arginine equation. There's another little chemistry, this is what makes it so difficult. Every molecule has a coenzyme. That coenzyme is tetrahydrobiopterin. Big word, but notation is BH4 for your audience to look up. So, BH4, it's made up a B6, B12, folic acid, and vitamin C. When you take metformin, you're messing with that equation. It messes with the blood supply to the autonomic nervous system, and it starts the process. But really, what are you saying when you're taking metformin? You're not telling them that is correcting the disease. You're saying, take metformin, eat whatever you want, and you take more metformin, and eat whatever you want. If that doesn't work-- and this is called polypharmacy, and I remember back when Harvard Medical School probably 25 years ago was pushing this, and pushing it big time. What's polypharmacy? I’ve made up a little mnemonic for that ‘SMART insulin.’ Smart, S, sulfonylureas, and metformin, and then, the R was rosiglitazone, troglitazone, I forget the exact name of that one. When you did all that polypharmacy, then you put them on insulin, never telling them to stop eating sugar. That's insanity. But that's Big Pharma.

Now, we have COVID. Same process, same biochemistry, different tissue. The endothelium of the lung cell gets inflamed, builds up with fluid, can't breathe. Can't breathe, you die. Pretty simple. You've had David Sinclair on. I didn't know that. You had Perlmutter on there, didn't know that. Okay, let’s go through the list.

Melanie Avalon: [laughs] It's a long list.

Dr. Richard Jacoby: How about Fat Chance, Lustig. Do you have him on?

Melanie Avalon: For fructose, no, I really want to.

Dr. Richard Jacoby: Yeah, he's terrific writer. He wrote Fat Chance. Now, his hypothesis is similar to mine that fat is good, sugar is bad, but he would not probably agree with my hypothesis that of nerve compression. But I don't think he's ever been exposed to this thought process, and most doctors haven't. I would just fortunate, because I studied with both Dellon and Cooke. I get that segue. Throw out a couple other names. Maybe I can give you some counterpoints.

Melanie Avalon: I had Wim Hof on, but that's not really nerve--

Dr. Richard Jacoby: Oh, I love Wim Hof. No, that's perfect. Wim regulates autonomic nervous system by breathing, great concept. Well, that's what you're doing. I'd love to do a study on asymmetric dimethylarginine with Wim Hof because it would show that those levels of inflammation would go down and change the autonomic nervous system. Perfect segue. Who else?

Melanie Avalon: Now, I'm thinking about breathing because you're talking about the Framingham heart study. Did you know that the factor most correlated to longevity in that study was lung capacity?

Dr. Richard Jacoby: Did not know that.

Melanie Avalon: That was one of the most mind-blowing things. I’ve learned that when I interviewed James Nestor, who wrote about breathing. I have one really quick question though to backtrack a little bit. Now, I have to ask just because of what you said about metformin, do you know if they're the same issues with the BH4 pathway and everything if you're taking berberine?

Dr. Richard Jacoby: Don't know the answer to that. I'm not saying that taking these things to lower your glucose is bad. But if you're taking them to mask your addiction to sugar, that's dangerous.

Melanie Avalon: Yeah, 100%. Another backtracking question because I want to clarify some things. The three main pathways that you believe sugar is causing the compression issue. The polyol, the French word, the Maillard via nitric oxide, and the dimethylarginine and everything with that. Because I had never heard that before about the excess sugar getting metabolized into the sorbitol. I just wasn't even remotely aware of that. How much sugar are we talking? is it the amount of sugar you're eating, is it a blood sugar level that you have to reach?

Dr. Richard Jacoby: Well, it's pretty much all sugar. Ideally, you should be doing a ketogenic diet. That is almost impossible in the United States, because it's not readily available. But from a physiologic and anthropologic, is that the right word? Sense, what did Lucy eat? She was first primate. Well, this is Don Johanson, did you have him on your show? Oh, you should have him. He is the world's leading authority on who are we and where we came from. Lucy, he discovered Lucy in Ethiopia, and I met him, and he invited me to a conference in New York City, and the question was, what did Lucy eat? She became human. Now, this is the Darwinian theory. I'm not fully aboard on this by the way although I do follow that line of thinking, but there's many ways that we have become human, one of which is diet. When we went from a carbohydrate diet like gorillas, that's all they eat, your alimentary canal is very long, because you're sitting there eating bamboo, it takes forever to digest that. summarizes this conference.

If you’ve a big rib cage, your knuckles are on the ground, and when you start to eat bugs, and fat, and meat, your rib cage gets shorter-- or excuse me, your alimentary canal gets shorter, because you have to digest that and get that stuff out of there quickly within the first 24 hours. You don't need a big rib cage. If you don't have a big rib cage, your ilium, your pelvic bone comes more in the frontal plane, and you start to develop a waist, your knuckles come off the ground, you start to stand up. You have what we call plantigrade position. Now, your head and neck are at right angles, you can see the horizon, your hands are freed up. You can make bow and arrows and eventually atomic bomb to control the world. That's one diet from carbs to fat. Now, the last 10,000 years, the king said, “Hey, you climb up the tree and get me some honey, because I like that.” Most kings were fat. Now, everybody's fat because we're all eating sugar. So, we're going backwards instead of forward. That was the capsule of diet [unintelligible [00:40:05] 3 million years.

Melanie Avalon: Actually, I thought of one more person you might know. Do you know Dr. Benjamin Bikman?

Dr. Richard Jacoby: No.

Melanie Avalon: He just wrote a book about insulin resistance. I think.

Dr. Richard Jacoby: No, haven't read it, but the word ‘insulin resistance’ and ‘metabolic syndrome’ were developed by Gerald Reaven, who is an endocrinologist at Stanford. Dr. Cooke took over his clinic. So, Dr. Cooke is the extension of that whole theory.

Melanie Avalon: Okay. Well, another question because you're talking about the benefits of a ketogenic diet, low carb diet. How do you feel about people who regulate their blood sugar levels on high carb low fat diets, I've had on Cyrus and Robby, who wrote Mastering Diabetes, had on some other vegan people, and I'm just always really fascinated that there seem to be these two opposing camps, often about regulating blood sugar. Can we clarify, is it all carbs, mostly processed sugar?

Dr. Richard Jacoby: Definitely. Well, let's get some common ground. Natural food is what human beings did eat and should eat. I think both camps could agree with that. Now, of those foods, the vegans probably would point to more of no meat, and obviously, all plant-based foods. There are a lot of people do well with that. I think gender-wise, women have more of a capacity to do a vegan-type diet, and men are more adapted to a carnivore diet. But we meet somewhere in the middle, we can do both. I know for myself, I get to be over the carnivore side to feel good. I think that's a genetic thing. In the vegan side, there are a lot of sugary, carbohydrate-laden foods.

Now, let's go to the food pyramid. Another fraud. Eat 6 to 11 helpings up pasta bread on the bottom of that. I think we can all agree that's not the right thing to do. We need to get up to the pyramid top which is where the fats are. We both need vegan and carnivorous fat, because you cannot live on meat alone. You would die. Your kidneys will shut down. If you ate just carbohydrates, you would die. But you can live totally on just fat. Now, where are the sources of fat? From the vegan and the carnivores. You can have fats, avocado, things of that nature on the vegan side, and then you have the fats on the carnivore side. That's where the common ground is, fat.

Melanie Avalon: So, to clarify, because we couldn't live like just fat.

Dr. Richard Jacoby: Yes, always. Well, let's look at the

Melanie Avalon: protein be the only thing.

Dr. Richard Jacoby: Oh, yeah. An Eskimo, if you're living on an iceberg, real going back, you can't grow a garden. There's no vegetables there. They don't even eat fish. They blubber. They eat just fat, and they live. They're perfectly healthy. Now, if you just ate meat, there's a good study of Canadian trappers got stuck in the winter, and they came back to find them, and they were all dead. They just ate rabbits, which has no fat. They all died, because their kidneys shut down, too much protein. Conversely, if you just ate sugar all day, you would be dead pretty quick. Yes, you could just eat fat and live forever. That's not we're boring.

Melanie Avalon: Wouldn't you need to take in protein?

Dr. Richard Jacoby: No, no. You really don't.

Melanie Avalon: You would just recycle your own proteins indefinitely?

Dr. Richard Jacoby: Well, ketogenic diet. The body is designed to only eat fat. That's called gluconeogenesis. You manufacture sugar out of the fat when you need it.

Melanie Avalon: But what about the actual protein? I thought there was one amino acid that we couldn't synthesize from ourselves. I thought L-arginine was an amino acid that we would have to get at some point from diet for the heart.

Dr. Richard Jacoby: Well, semi-synthetic or semi-essential I should say. Semi-essential, I did as Dr. Cooke. He's an expert on that. We don't need that much L-arginine, but we do in this modern society because it's being blocked by that chemistry I talked about. You need more L-arginine to convert over to get nitric oxide.

Now, this is another sidebar to that whole story. It's just weird from my training. Now, as a podiatrist, it seems odd that I'm even talking about these subjects, because you wouldn't think a podiatrist would really be into this, but let's go back when I was in college or medical school in Philadelphia. In those days, we used to do work study programs, does that ring a bell to anybody? In other words, you get about 85 cents an hour to work in a laboratory. Paid labor really what it was. I was fortunate to work with Dr. Michael [unintelligible [00:45:40], Creeth and he was an MD, PhD, biochemist from London, and he was Watson and Crick's research scientist. He worked in that lab, when they discovered DNA. Came to Philadelphia, he was teaching at different medical schools. I became his research assistant, and we were working on PKU, which is a genetic defect of aniline, another amino acid, which cause that staining of the basal ganglia causing retardation. My job was to feed the rats, different shells, which is food. We had food that was-- Remember rats, rats are carnivores, and we're feeding them carbohydrates. One shell had more sugar than the other, but still, it's a skewed experiment. We made our own electrophoresis. Bottom line, we're looking at these amino acids, to see which one was causing this genetic defect, which we did not figure out back then. Which was discovered, actually, that six or seven years ago, and you know what the answer was? BH4. That's what I was working on 50 years ago. That's weird. BH4 was not converting the L-arginine and through another chemical pathway that had phenol aniline. That was the answer to the question. Now, it's been synthesized by a company called BioMarin [unintelligible [00:47:24].

What do animals eat? Let's look at those guys. They're carnivores. They don't eat fat-- or excuse me, meat. That's what they get fat in their diet along with meat. Chickens, they're carnivores. They're vultures. Cows eat grass. They're herbivores. But we feed them corn, and we make omega-6 fatty acids. So, even the experiments are skewed, because they're not eating the food that biologically they would seek out. That's why I think we have such a pandemic. High fructose corn syrup is an 8% of all the food in the United States and meat is 98% corn fed in all traces back to the concept that cholesterol was bad. Let's take Quaker Oats, part healthy. Are you kidding me? It's a play on words. Does it lower cholesterol? That's what they claim, but cholesterol has nothing to do with heart disease. Oats are grains, grains are carbohydrates. Carbohydrates break down to monosaccharides or sugar. That's what's destroying this country.

Melanie Avalon: Also related to the BH4, the cofactors involved with it, and you already touched on this a little bit, but can you talk a little bit about the competition between vitamin C--

Dr. Richard Jacoby: And glucose? Oh, well. My favorite subject. I even have a-- Well, I'm not sure I'll even go there with what I think is really happening, but do you know Gregg Braden?

Melanie Avalon: I do not.

Dr. Richard Jacoby: Okay, he's another phenomenal human being. You should have him since you have all these great people on. Well, Gregg is a geologist by training, which is interesting. I've never met him, but I've listened to and read all his papers. He's a great lecturer by the way. One of his points in his theory is that 220,000 years ago, there was a genetic mutation on chromosome 2 and chromosome 7, and we as humans have 23 chromosomes, and apes have 24, find that rather odd. But one of those genetic changes was we as primates are not able to synthesize vitamin C, which is made from glucose. The reason is because of mutation.

Melanie Avalon: Can I ask you a quick question about that?

Dr. Richard Jacoby: Yeah, mm-hmm.

Melanie Avalon: Why do you think we acquired that mutation? Was there ample vitamin C in the environment or ample glucose in the environment? The glucose-vitamin C connection make an argument for glucose?

Dr. Richard Jacoby: Well, I love the way you phrase that. By the way, we still have the gene, doesn't operate. Something happened 220,000 years ago. Do you know who Aaron Filler is?

Melanie Avalon: No. I’ll write that down, too.

Dr. Richard Jacoby: To answer that question, I'm going to use some of his work. He wrote the book, The Upright Ape. Fascinating human being. Aaron was a PhD student at Harvard under Stephen Jay Gould, another anthropologist who’s well known. He was given a fossil of the lumbar spine, and he was sent to Cambridge to look at it under a Tesla magnet, which was very powerful at that time, and came up with the concept that we were descended from an upright ape in contradistinction to Creationism versus Darwinism.

He has another theory. Aaron, after he got his PhD, since he knew the lumbar spine, so we went to medical school, and since he knew that is now a doctor, he became a neurosurgeon. Since he knew the lumbar spine, then he wrote an algorithm for MRIs to identify nerves and compression. That's where I met him. He just recently got his law degree as well. Can you imagine this? In his book, he does discuss some of these rather unusual happenings many years ago. There something happened, and it was by design or it was just a mutational fluke? I don't know the answer, but I have my ideas. That's a subject for another talk. But glucose is the substrate for vitamin C, and somehow, we can't do it, everybody else can. Guinea pigs can't make vitamin C, some fruit bats, and some primates. But basically, we're the only ones. We can’t do it. Now, we're loaded with sugar, and if you don't have vitamin C, which compete-- Are you familiar with the ascorbate competition theory?

Melanie Avalon: Is it this theory, or is it something different?

Dr. Richard Jacoby: Well, Linus Pauling said that vitamin C was the common cold and cancer, but he was not familiar with the ascorbate competition theory. What that says is that vitamin C and glucose, which are almost identical, except for two carbons, and only modified by insulins. In other words, I use this metaphor. So, there’s a knock at your door yourself, and there's two molecules there, and insulin opens the door and said, “How can I help you, fellows?” It looks at it, and he said, “Well, your vitamin C. You can't come into the cell, but glucose, you can.” So, glucose gets in the cell, and it causes a storm, a cytokine storm, because it causes inflammation. That's where BH4 gets affected, and the conversion of L-arginine into nitric oxide, which has everything to do with COVID-19 by the way. Why that happened and why it's happening more, and more, and more? I don't know why, but I find it very interesting, and I'm writing a new book on that subject. I don't want to give you the bottom line as of yet as I have a little bit more dots to connect, but it's very, very unusual dot. I'll leave it at that for the moment.

Melanie Avalon: I am fascinated by this. If glucose and vitamin C are present, can the cell take in any vitamin C at all?

Dr. Richard Jacoby: Let's go back to the orange juice ads and the food pyramid, eat your fruits and vegetables. Well, fruit is all sugars. There's some vitamin C in there, but not like it was 50 years ago. It's been hybridized, and this is what I don't think people get. I eat my fruits and vegetables. Well, how come you're 250 pounds? If that's true, you're eating sugar, you don't know. Do you need vitamin C? Yes. But the ascorbate competition theory doesn't allow the vitamin C to get into your cell. Let me go back 50 years again, and some of your audience may be that old, but when I was a kid, when we had a grapefruit, we put sugar on the grapefruit, and why? Because fruit is tart. It's not sweet. “Oh, Dr. Jacoby, no it's sweet.” Well, of course it is now, but it wasn't then and never was. You had to put sugar on it. But the public loves sugar. So, if you're selling grapefruits to Safeway, you're going to make it as sweet as can be. That's ruby red. They sell grapes, bananas, all the ones we love for sure. You're really not getting vitamin C the way you should.

Melanie Avalon: If we were to eat that tart fruit, though, that does have some carbs but vitamin C, can we take in the vitamin C? I'm just really haunted by this question.

Dr. Richard Jacoby: Yeah, you can, but you're not going to like it. I think you need a supplement.

Melanie Avalon: The supplement vitamin C. Yeah, that was one of the things that you mentioned in the book, was that our immune cells had 50 times the amount of insulin receptors as other cells, and so when we are more saturated in sugar, they can't get the vitamin C.

Dr. Richard Jacoby: They can't. No, no.

Melanie Avalon: Going back to because you're speaking about damage to the olfactory nerve and the loss of smell, and then the progression to Alzheimer's to clarify, was the damage to that olfactory nerve, the leading cause in the path to Alzheimer's, or is it separate? Are people who have COVID now, are they going to be susceptible to Alzheimer's?

Dr. Richard Jacoby: It's a good question. I think yes, and I don't know if the olfactory nerve sense of smell is going to be reversed, no one knows that present point. But why is the olfactory nerve involved? The olfactory nerve goes through what's called a cribriform bone, which is small aperture. Think of it like a wire going through a wall, the concrete wall. If that nerve is swelling which it is, it's going to cut off the blood supply and the electrical supply. That's why you can't differentiate the smells. That's the mechanical aspect of it. Dr. Perlmutter, you have to understand the mechanics of Dr. Dellon’s theory to understand all the things I'm saying. They were not taught that. Absolutely not taught that.

Now, I'll tell you, there's another big guy and his name is, you'll like this name. His name is Dr. Dick. What do you think his first name is? Peter. I should say that because it's amusing. But he's the number one neurologist at the Mayo Clinic and written a textbook on diabetic neuropathy, which I read. He did predict by the way, that people that had gallbladder disease would go on to have diabetic neuropathy or diabetes. I read that book, and I had my gallbladder out, oh God, at least 30 years ago, not knowing all the things I just told you. That part of my theory, I'm in the wound care center, and I'm seeing patients with gangrene, and knowing that fact, I say, “Okay, let's take a look at your history. Oh, you had your gallbladder out 25 years ago.” Uh-oh, is this me 25 years from now or 30? What's it got to do with anything? Well, the prevailing diet for gallbladder disease is to not eat fat, but what are you going to eat? You're going to eat carbs, the very thing you shouldn't do.

If you eat carbs, sugar, you will irritate your vagus nerve, and it's innervated to a muscle which is the gallbladder, and it won't empty. If it doesn't empty, it'll form a stone which is made up of, you guessed it, cholesterol. It blocks the duct, hurts like hell and you want it out. We do. We cut them out, 800,000 a year in United States. What's the answer? Don't eat sugar. “Oh, Dr. Jacoby, you’re a podiatrist. How?" Well, I'm telling you the answer. I think I have a unique perspective. The only reason is because Dr. Dellon taught me this amazing theory. I took it to Stanford with Dr. Cooke and he’s world's leading authority, and here we are.

Melanie Avalon: Like I said in the beginning, it just blew my mind. I hadn't heard any of this anywhere. I guess that makes sense. I'm reading right now The Alzheimer’s Solution. It's written by Dr. Ayesha Sherzai and Dean Sherzai. Do you know them?

Dr. Richard Jacoby: Don’t know them.

Melanie Avalon: Can ask them about all this, see what their opinions are. This is so fascinating. This is a random question. Do you think a lot of the health benefits of wine are because of the dilation effect on the blood vessels then?

Dr. Richard Jacoby: Probably, the right answer. Now, wine is an interesting quantity. It has a lot of sugar, alcohol sugar but resveratrol as well. Most people like wine, are going to lean, “Oh, it’s got a resveratrol, so that's good for you,” which it is. But you probably have to drink a couple of gallons to get the effect, then you get too much sugar. Do I drink wine? Yes. If you're looking at the wines, and you want to be keto, you want the darkest wine possible, cabernet, and the white wines like Riesling and Chardonnay types, they have a lot of sugar. The dilation from the alcohol probably counteracts to an extent, the compression of the nerve. I don't know that for a fact, but I'd like to believe that.

Melanie Avalon: I'm so fascinated by all of the discussion around wine, and the health benefits, and the studies, and what is the main thing. Is it the polyphenols? Is it the just the social aspect of having wine and the emotional fact? But the more and more I think about it, the more I'm wondering if maybe the main thing is the dilation effect from it.

Dr. Richard Jacoby: Probably, it does help, but it does affect your nerves as what ataxia is and that's what dysarthria is. In other words, when you drink too much, you're going to affect your nerves, and you start to slurp, and your gait is unsteady, which is the effect of the sugar on your nerves. I see a lot of alcoholic neuropathy, by the way.

Melanie Avalon: Yeah. Do you know Dry Farm Wines? Are you familiar with them?

Dr. Richard Jacoby: No.

Melanie Avalon: Oh, you would love them. You would love them. Their company is based in Napa, but they go throughout Europe, and they go to all the different wineries, and then they test the wineries, and test the wines to find wines that are organic, that are low sugar, low alcohol, free of pesticides, and then-- it's the only wine I drink now. If you want to get “health benefits” from wine, drinking the wines they have tested, I love them. I can introduce you to them. They're amazing.

Dr. Richard Jacoby: We all need good wine. Yes.

Melanie Avalon: One other question. You did mention the vagus nerve. I've done an episode on the vagus nerve with Ami Brannon. She makes a device called Zen by Neuvana, which is a vagus nerve stimulating device. I feel it's not a normal nerve-- It's so hard to understand what it is, because it seems to be a whole system and a whole highway.

Dr. Richard Jacoby: The word, vagus means wandering by the way. It does, wanders to every organ system in your gut, the heart, gallbladder, the intestine. It's an interesting nerve for sure.

Melanie Avalon: Is it a single nerve?

Dr. Richard Jacoby: Well, the trunk of the nerve, the vagus nerve then has many, many branches. That's why it wanders all over the place.

Melanie Avalon: Okay. I'm assuming it is highly impacted as well.

Dr. Richard Jacoby: I think so. Yes. The microbiome affects it. You need to get Stephanie on your show.

Melanie Avalon: Yeah, wrote her name down.

Dr. Richard Jacoby: Oh, yeah. She was just interviewed today by Dr. Mercola.

Melanie Avalon: Oh, I had him on the other day.

Dr. Richard Jacoby: Really?

Melanie Avalon: For EMFs. We talked about EMFs.

Dr. Richard Jacoby: He reviewed my book by the way, when it was in the galleys, but he did not comment on it. I like Dr. Mercola, and I follow him. But again, he's a medical doctor. He doesn't get this mechanical connection to biochemistry. I know he doesn't. It's like, “What are you talking about?” Well, that's the connection that needs to be made and has been made. I just connected all these mechanical things with all these different itises. That's what I did. Am I right? I think so. I think I got the biochemistry down. The literature supports everything I just told you. I didn't make any of that up. I just connected. Mercola is good and he loves Stephanie, by the way, and [unintelligible [01:05:07] pathway, and since she is going to have a new book in June, you should get her on before the book comes out. She's a great person. Oh, she's so bright.

Melanie Avalon: The book is about glyphosate? That's the main--?

Dr. Richard Jacoby: And the microbiome. We had this interesting discussion six years ago on that subject, because there are 10 to 1 microbes to every human cell, so we were theorizing that maybe these decisions we make are not our own, but are being made by these organisms sending it up with vagus nerve, and to the hippocampus. That's why we make all these decisions that are bad for us. They're running the show.

Melanie Avalon: I would believe that. I've heard that from different people throughout the years, and I really think that it's something really big.

Dr. Richard Jacoby: How about Joe Rogan? Have you had him on your show?

Melanie Avalon: No, that would be insane. [laughs]

Dr. Richard Jacoby: Oh, he's right up there. He understands all this stuff.

Melanie Avalon: Yeah, that's what I love about him, is that he does. He gets his stuff. I love when he brings on people in this whole sphere onto his show. I just love those interviews. I think they're--

Dr. Richard Jacoby: Oh, yeah. How about Neil Riordan on stem cells?

Melanie Avalon: Oh, Neil? Who is it?

Melanie Avalon: Neil Riordan?

Melanie Avalon: No.

Dr. Richard Jacoby: He's a PhD, world's leading authority on stem cells, and Joe Rogan had him on the show. He has a big clinic in Panama, and I visited that. I'm very, very much into stem cell and regenerative medicine as an antidote to all these inflammations.

Melanie Avalon: I just had-- Do you know Sergey Young?

Dr. Richard Jacoby: I know that the name, but I don't know.

Melanie Avalon: I just had him on. He's an investor in longevity technology, that was really, really fascinating. Like the future of longevity and the healthcare system, and the way that ideally, I hope it does go. It was really fascinating. Yeah. What is your interest when it comes to stem cells?

Dr. Richard Jacoby: Well, I have been doing them for 15 years starting with PRP, now amniotic stem cells, which by the way, none of them are stem cells. The name is going to be changed pretty soon to medicinal signaling cells rather than mesenchymal stem cells. But having said that, they all work. They work through the immune system, and they have the paracrine system. The little nanoparticles of exosomes really are bits of information that go cell to cell, and recharge the bioelectric field if I can simplify it.

I use this in my lectures. Stem cells don't give a rat’s ass what you call your itis. They really don't. Your itis is your caused by-- is inflammation. Sugar is the number one cause. Stem cells go in there and reverse that. It's that simple. But the science behind it is so complicated. It scares people. You have your own stem cells in your bone marrow, but if you're over 50, you're really not going to get an effect from that. We use prenatal cells from a live birth, they're processed in the FDA lab, and they're very, very effective and very safe. That's another discussion for another show.

Melanie Avalon: Wow. That is so fascinating. So many topics. Well, for listeners, like I said in the introduction, there is a full transcript in the show notes. So, don't worry. I know we've been talking about a lot of really deep things, and the show notes are at melanieavalon.com/sugarcrush, and we talked about the diet prescription but your book in Sugar Crush, you do give two basic dietary approaches that people can potentially follow to address all of these issues. What made you decide between the two the one that's more ketogenic, and then the one that's more based on glycemic load, glycemic index?

Dr. Richard Jacoby: Well, interesting, the nutritionist used to work for Dr. Mercola. My editor said, “You can't just say if it tastes good, don't eat it.” I say, “Read the label. Don't eat sugar. Go cold turkey.” But most people can't do that, so they wanted an alternative. I find that difficult. It's like torturing yourself to wean yourself off sugar. You just got to do it. It's just like smoking. You got to get over to the ketogenic side, whether you're vegan or carnivore, either one.

Melanie Avalon: Ever since I first went low carb, I don't know, 15 years ago, I adopted a paleo diet and intermittent fasting but consistent for me has been intermittent fasting. But I do alternate between a low carb high fat diet in my eating window, and then a high carb low fat diet, but it's all whole foods based. It's lean meats, lots of fruit, but I do it paired with fasting. How do you feel about that?

Dr. Richard Jacoby: Well, used a word ‘lean meat’ as if fat was bad. No, I like fatty meat. It has the distinction. “Oh, wait a minute, fat causes heart disease.” No, it doesn't. That's a lie.

Melanie Avalon: For me personally, I get nervous about combining fat. I eat a lot of fruit, and I get nervous about combining--

Dr. Richard Jacoby: Well, a lot of foods has a lot of sugar.

Melanie Avalon: Yeah. [laughs] I don’t know. I go through my keto spins, but then when I bring back the fruit carbs and go-- Oh, it's always whole foods, but I go leaner on the meat side of things and bring back the carbs. I feel like I get the best of both worlds with the fasting all day, and then the fruit at night.

Dr. Richard Jacoby: Yeah, I do the intermittent fasting. Well, it's easy to do intermittent fasting when you're on a keto diet, because you're not hungry anyway. Having said that, did I eat today? No.

Melanie Avalon: You haven't?

Dr. Richard Jacoby: Yeah, I haven't, because I don't think about food. Now, we're talking about food. I'm starting to think about it. But no, I haven't had anything. I put butter in my coffee. I do that routine.

Melanie Avalon: I'm interviewing Dave Asprey this week.

Dr. Richard Jacoby: Oh, another guy. Yeah, our editor at HarperCollins, and I was doing that, and I told my editors that I'm going to do a book on how to get it onto the keto diet, on butter in your coffee and said, “Well, we’ve already signed up a guy,” and it's him.

Melanie Avalon: No way. This was . Oh, that's crazy. [laughs] Oh, it is so funny. I share an agent with him, which is really surreal. So, that's how I got connected to him.

Dr. Richard Jacoby: Well, Dave Asprey, apparently, as you are well versed in this. You know, Nina Teicholz?

Melanie Avalon: She's on my list of people. I have a friend who can connect me to her. I really want to interview her. Big Fat Surprise, is that what she--?

Dr. Richard Jacoby: Yep, and that had an influence on me as well. We're friends, and we're on the same Nutrition Council for the US, which is totally political on the sugar lobby runs this country. Now, she's an investigative reporter, and she came to the same conclusions I came to. She’s a great, great speaker, and she knows her subject. So, you'll have fun with her.

Melanie Avalon: Yeah, I'm excited about her, and I'm about to interview Gary Taubes for his new--

Dr. Richard Jacoby: Gary Taubes, okay, that's funny. Now, Gary Taubes was married to my editor.

Melanie Avalon: Oh, really?

Dr. Richard Jacoby: Yes.

Dr. Richard Jacoby: Yeah, Gary Taubes. He knows his subject on sugar. Does he agree with me on the conversion portion? I never talked to him. I don't think he understood-- I don't know. You ask him that question.

Melanie Avalon: I will. Now, I want to ask everybody this question. I want to go back to all of my interviews. Well, this has been absolutely amazing. Were there any other topics that you wanted to discuss and explore?

Dr. Richard Jacoby: Well, I think I could take you deep into the stem cell world from a very, very different perspective. That is the new, new thing, and that's loaded with political espionage. It works. It works on anything. Big Pharma. It's going to be dynamite.

Melanie Avalon: The stem cells?

Dr. Richard Jacoby: Mm-hmm. Oh, yeah.

Melanie Avalon: Well, we'll have to, I guess, stay tuned for that. Oh, my goodness. Well, this has been absolutely amazing. You're writing another book right now about the glucose-vitamin C--

Dr. Richard Jacoby: Again, a couple of things that I'm doing. One is on stem cells or actually on exosomes, which are nanoparticles. My placeholder for the name is Exosomes: The Quantum Foam Of Biology. Then, I have a believe or not, a screenplay that I'm trying to finish up that takes all of this stuff into a very interesting ending.

Melanie Avalon: Like a drama? Screenplay or documentary?

Dr. Richard Jacoby: It is more of a sci-fi.

Melanie Avalon: Oh, very cool. That's right up my alley.

Dr. Richard Jacoby: Based on all the stuff.

Melanie Avalon: Oh, I love that. I do want to ask another person I interviewed recently was Dr. Jason Fung for The Cancer Code. Do you think that your global compression theory plays a causal role in cancer as well?

Dr. Richard Jacoby: Oh, sure. Sugar, that goes back to Otto Warburg. He got the Nobel Prize. He fed cancer cells fructose, they lived. Took it away, they died, patient lived. That's as simple as I can put it.

Melanie Avalon: So, for listeners, how can they best follow your work? Do you have links that you can put out there? Are you on social media?

Dr. Richard Jacoby: I am and I'm not. I'm still practicing so much.

Melanie Avalon: You’re a practicing doctor, so.

Dr. Richard Jacoby: Yeah. Hard for me to communicate to the world on that. I'd rather just do these kinds of podcasts with people like you that really are terrific interviewer and can take me where I need to go. My website is Extremity Health Centers, and I also have Sugar Crush, the book, which I post a lot of stuff on. But your audience, this listen to the podcast, I think there's a much easier way. My book did come out in audible, which I think they did a terrific job. It's much easier to digest audible than reading it, I think.

Melanie Avalon: I love audible.

Dr. Richard Jacoby: Yeah. Me. Mike Lenz did the audible. I was listening to it, and I told my editor, I said, “God, he did a terrific job. He just rewrote this noise.” She said, “No, you just read it differently.” He read it word for word. I said, “I can't believe it.” I thought somebody else has written it. is that well done.

Melanie Avalon: It’s so funny. Well, the very last question that I always ask every single guest on this show, it's just because I've come to realize more and more each day, how important our mindset is surrounding everything. What is something that you're grateful for?

Dr. Richard Jacoby: Talk to you, number one. I think there's such a network out there that's off the grid, and you mentioned all these doctors’ names, all these people. Their message and my message would not be able to be out there if it wasn't for this, this venue. I'm really grateful for that.

Melanie Avalon: Oh, well, thank you so much. I as well, am so grateful for your work. I just want everybody to read this book, and hear about it, and have their eyes open like I feel mine have been. I really, really looking forward to all of your future work to come, and hopefully we can stay in touch, and I'd love to bring you back on the show in the future for other topics.

Dr. Richard Jacoby: Well, I’d love to do that.

Melanie Avalon: Okay, perfect. Bye.

Dr. Richard Jacoby: Thank you. Bye-bye.

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