Key Moments
Fatty Liver Expert: Stop Eating These “Healthy” Foods - Dr David Unwin
The Diary Of A CEOKey Moments
A UK doctor reveals that many 'healthy' foods like white rice and bananas contain hidden sugars equivalent to multiple teaspoons, contributing to a 'pandemic' of poor metabolic health and type 2 diabetes in young people.
Key Insights
93% of patients with pre-diabetes achieved normal blood sugar levels after adopting a low-carb diet.
For every year someone has poorly controlled type 2 diabetes, they lose approximately 100 days of life expectancy.
White rice (150g boiled) can contain the equivalent of 10 teaspoons of sugar, and a standard bowl of unsugared cornflakes contains 8.
Ulta-processed food addiction, similar to drug or alcohol addiction, may affect around 14% of the population.
In the UK, healthy life expectancy has fallen by roughly 2 years over the last decade, with the average person spending up to 23 years in poor health.
A simple test for metabolic health: your waist circumference should be less than half your height.
The alarming rise of type 2 diabetes and poor metabolic health
Dr. David Unwin, an NHS GP with decades of experience, expresses deep concern over the 'pandemic' of poor metabolic health, particularly among young people. He notes a significant shift since he began practicing in 1986, when type 2 diabetes was virtually non-existent in those under 55, and obesity was rare. Today, he sees patients under 25 with poorly controlled diabetes, a situation he describes as a 'scandal.' This epidemic is linked to lifestyle and dietary choices, leading to a loss of life expectancy. For instance, each year of uncontrolled type 2 diabetes can equate to a loss of about 100 days of life. Insulin resistance, a precursor to type 2 diabetes, is driven by the body's inability to process excess sugar, leading to fat accumulation, especially in the liver. While a healthy liver is reddish-brown, a fatty liver turns yellow and enlarged. This fatty liver then impairs insulin's function, creating a vicious cycle where the pancreas must produce more insulin, eventually leading to its collapse and the onset of type 2 diabetes.
Unmasking the sugar content in everyday foods
A key revelation from Dr. Unwin is the often-unseen sugar content in foods perceived as healthy. Through a visual demonstration using sugar cubes, he illustrates that a standard bowl of plain cornflakes can contain the equivalent of 8 teaspoons of sugar, a medium potato can hold 9, and a ripe banana around 6. Even white rice, often considered a staple, can pack 10 teaspoons per 150g serving. This hidden sugar load, when consumed regularly, contributes to the insulin resistance and metabolic dysfunction he describes. This contrasts sharply with common assumptions, where a host of common foods are misunderstood regarding their sugar impact. For example, orange juice, despite being derived from fruit, delivers a rapid sugar hit without the fiber of whole fruit, leading to sharp blood sugar spikes and subsequent hunger. Similarly, dried fruit snacks often have a sugar concentration of 60-70%, making them essentially candy. Dr. Unwin emphasizes the importance of understanding glycemic load, which considers portion size, to accurately assess a food's impact on blood sugar.
The critical role of insulin and the dangers of insulin resistance
Insulin, a hormone produced by the pancreas, is crucial for regulating blood glucose. When we consume carbohydrates, they break down into glucose, which enters the bloodstream. Insulin's job is to escort this glucose into cells for energy or store it as fat if not immediately needed. However, excessive carbohydrate intake, particularly from processed foods and sugary items, can overwhelm this system. Fat accumulation, especially in the liver, leads to 'insulin resistance,' making cells less responsive to insulin's signal. To compensate, the pancreas produces more insulin, leading to high circulating insulin levels (hyperinsulinemia). Dr. Unwin explains that high blood sugar itself can damage the artery lining (glycocalyx) within hours. Furthermore, chronic hyperinsulinemia can inhibit apoptosis, the process by which damaged or cancerous cells self-destruct. Fructose, a component of sugar, is processed in the liver, converted to fat, and can be directly consumed by certain tumors for fuel. Diets high in added sugars also elevate inflammation markers like C-reactive protein (CRP), which is linked to tumor progression.
From personal epiphany to patient success
Dr. Unwin himself experienced this metabolic dysfunction, developing a 'dad bod' and fatty liver due to a significant biscuit habit. His perspective drastically shifted after a patient confronted him about never being told that common carbohydrate-rich foods like bread and cereals were essentially sugar. This encounter, coupled with his wife's background in clinical psychology and her discovery of low-carbohydrate dietary approaches, spurred him to experiment. Despite initial resistance from his partners, he and his wife, Jen, volunteered with patients. The results were remarkable: significant improvements in liver function, weight loss, blood pressure, and, crucially, HbA1c levels (a measure of average blood sugar). He found that 93% of pre-diabetic patients achieved normal blood sugar on a low-carb diet, and 73% of those with type 2 diabetes could achieve normal levels if treated early. This experience led him to transform his practice, focusing on behavior change and dietary interventions rather than solely relying on medication.
Addiction to ultra-processed foods: a modern epidemic
Dr. Unwin highlights that for a significant portion of the population (around 14%), the struggle with certain foods, particularly ultra-processed ones, can manifest as a genuine addiction. This isn't merely a lack of willpower but a complex physiological response. He shares compelling anecdotes, including a patient who resorted to eating bread from the bin, even after it was treated with detergent and bleach, to satisfy an intense craving. This demonstrates the power of addiction, which can override intellect and self-preservation. This addiction contributes to the 'sick years gap,' where individuals spend decades of their lives managing chronic illness. Both the UK and US face significant challenges with large health span to lifespan gaps, meaning people are sicker for longer.
Strategies for behavior change and regaining control
Dr. Unwin, drawing on his wife Jen's 'GRIN' model (Goals, Resources, Increments, Notice), emphasizes the importance of specific, actionable steps for behavior change. This involves setting clear health goals, identifying personal resources for support, making small, consistent behavioral increments, and actively noticing the positive effects of these changes. He stresses honesty about one's problem, identifying specific trigger foods, and developing a plan for abstinence or significant reduction. For those struggling with addiction, he advocates for gentle support and tolerance from loved ones, as policing or judgment can lead to deceit and further isolation. His wife's book, 'Fork in the Road,' aims to help individuals navigate these choices for the benefit of charity.
Testing and optimizing health: a proactive approach
The conversation touches on the growing field of health monitoring and optimization. Dr. Unwin advocates for low-cost methods like the waist-to-height ratio as a simple indicator of metabolic health. He also discusses the importance of supplementation, particularly magnesium, due to soil depletion and medication interference. He notes the difficulty in measuring magnesium levels accurately through standard blood tests, suggesting supplementation and observing its effects. The discussion also covers advanced health testing, with mention of companies offering comprehensive scans and blood work, providing actionable insights. However, the emphasis remains on ensuring that any testing leads to clear, actionable steps rather than simply causing fear or anxiety. He highlights that individual experimentation, often guided by self-monitoring tools like continuous glucose monitors, is key to understanding one's body and optimizing health.
The link between diet and cancer prevention
The conversation turns to the significant, yet often overlooked, link between diet and cancer prevention. Dr. Unwin cites studies showing increased cancer risk associated with consuming sugary drinks. For example, drinking 100ml of sugary drinks daily increases overall cancer risk by nearly 20%. High consumption of sugar-sweetened beverages is linked to a significantly higher risk of endometrial cancer and can shorten telomeres, the protective caps on DNA, leading to accelerated biological aging. He reiterates that chronic high insulin levels can inhibit apoptosis, and that fructose can be utilized by tumors. The discussion underscores that while treating cancer is vital, prevention through diet is equally, if not more, important, given that diet is considered the second most common cause of cancer after smoking. The idea of conducting a 'premortem' – imagining receiving a devastating diagnosis and reflecting on lifestyle choices – is proposed as a powerful motivator for making healthier decisions now.
Mentioned in This Episode
●Supplements
●Products
●Software & Apps
●Companies
●Organizations
●Books
●Drugs & Medications
●Concepts
●People Referenced
Low-Carb Lifestyle & Behavior Change Cheat Sheet
Practical takeaways from this episode
Do This
Avoid This
Sugar Equivalents in Common Foods (in 4g Teaspoons)
Data extracted from this episode
| Food Item (Serving Size) | Host's Initial Estimate | Correct Teaspoons of Sugar Equivalent |
|---|---|---|
| Corn Flakes (unfrosted) | 1 | 8 |
| Large Potato | 1 | 9 |
| 150g Boiled White Rice | 1 | 10 |
| Ripe Banana | 1 | 6 |
| Chocolate Bar (standard milk chocolate) | 3 | 7.5 |
Probability of Normal Blood Sugar with Low-Carb Diet
Data extracted from this episode
| Health Status at Intervention | Chance of Normal Blood Sugar (% Resolution) |
|---|---|
| Pre-diabetes | 93 (lasts for years) |
| Early Type 2 Diabetes | 73 |
| Established Type 2 Diabetes (after 5+ years) | 50 |
UK Healthy Life Expectancy Trends
Data extracted from this episode
| Statistic | Change (Last Decade) | Current (2024-2026 data) |
|---|---|---|
| Healthy Life Expectancy | Fallen by ~2 years | Men: ~60 years, Women: ~60 years |
| Years in Poor Health/Sickness | Rising | Up to 23 years (nearly a quarter of life) |
Common Questions
Every year of poorly controlled Type 2 Diabetes can lead to a loss of 100 days of life. It also significantly increases the risk for at least eight forms of cancer, extending beyond just cardiovascular issues.
Topics
Mentioned in this video
Dr. David Unwin's wife, a clinical health psychologist specializing in the role of hope in disease. She encouraged him to explore the low-carbohydrate approach and developed the 'GRIN' model for behavioral change. She also battled ultra-processed food addiction.
Author of 'Escape the Diet Trap,' a book that medically supported the low-carbohydrate approach for insulin resistance and Type 2 Diabetes, influencing Dr. Unwin's practice.
A close friend of Dr. Unwin, associated with the growing field of nutritional psychiatry.
A researcher at Edinburgh University doing significant work with the ketogenic diet in relation to bipolar disorder and other conditions.
The founder of Spotify and the individual who started Niko Health, a health testing company.
Co-founder of the Public Health Collaboration charity with Dr. David Unwin.
Nominated by Dr. Unwin as the ideal representative for humanity to make contact with an intelligent alien species, praised for his passion for the planet, biodiversity, and sustainable agriculture.
A diet book by Dr. John Briffa that Jen Unwin found, which documented the low-carbohydrate approach to insulin resistance and type 2 diabetes, validating Dr. Unwin's patient's claims.
A self-published book by Jen Unwin, focusing on helping people with food addiction, with all proceeds going to charity. It frames dietary choices as navigating a 'fork in the road' toward a better health journey.
A blood test that measures the average blood sugar level over the preceding three months. Dr. Unwin used this to monitor the spectacular improvements in his patients on a low-carb diet.
A very low-carbohydrate diet that can lead to significant reductions in hunger and improved clarity of thought, often described as a 'superpower' by adherents.
A type of therapy that Jen Unwin, Dr. Unwin's wife, streamlined into a practical "GRIN" model for rapid behavior change.
An inflammation marker discussed in relation to cancer. Diets high in added sugars chronically elevate CRPs, which are heavily correlated with tumor progression and metastasis.
A type of cholesterol, referred to as 'bad' cholesterol, which the host sought to reduce with a fiber supplement based on blood test results.
A device worn to continuously monitor blood sugar levels, providing real-time feedback on dietary choices. Dr. Unwin uses one personally and recommends it for patients to understand their body's response to food.
An AI-powered tool developed by Stanto that helps users create social media content by analyzing their feed, tone of voice, history, and best-performing posts.
A coffee company that flash-freezes precision-brewed coffee at 10 times strength. The host is an investor and sponsor, praising its flavor and convenience.
Conversation cards created from guest questions on 'The Diary of a CEO' podcast, designed to foster deeper connection in romantic relationships, teams, and families.
A product available in shots that mimics the effects of a ketogenic diet, providing focus and energy. The host, Stephen, is an investor in a company that produces them and finds them highly beneficial for productivity and cognitive boost.
A class of new drugs, one of which Dr. Unwin prescribed in a low dose to a patient struggling with food addiction. These drugs help reduce cravings and 'noise' in the head.
A mineral that is difficult to get enough of in the modern diet due to soil depletion, often requiring supplementation. It's important for muscle function and sleep, and different forms (citrate, glycinate, thriionate) address different needs.
A vitamin commonly deficient in people, especially those indoors or with darker skin. Supplementation is recommended given insufficient sun exposure in modern lifestyles.
A supplement taken by the host as part of his daily regimen.
A supplement taken by the host to help reduce LDL cholesterol based on blood test results.
A general supplement taken by the host to cover potential nutrient deficiencies, but Dr. Unwin cautions against over-supplementation without consulting test results.
A supplement that the host discovered he was deficient in through AI-processed blood test results.
The company that produces the exogenous ketone shots, in which the host, Stephen, is an investor and co-owner.
A retail chain where Keto Labs' exogenous ketone shots are now stocked, making them more accessible.
A company in which the host is an investor, that created a tool called Stanley for AI-powered social media content creation and inspiration.
A partner and sponsor of the podcast that provides health testing services, used by the host for blood tests.
A health testing company, invested in by the host, that offers comprehensive body scans and immediate blood test results for £299, aiming to democratize access to health screening.
The music streaming company founded by Daniel Ek, who later started Niko Health.
The UK government body providing data, cited for statistics on the declining healthy life expectancy in England.
An organization mentioned alongside the ONS for providing data on the widening 'sick years gap' in the UK.
A British charity co-founded by Dr. Unwin and Dr. Rangan Chatterjee ten years ago, dedicated to providing clearer public health advice, especially regarding low-carb approaches. It offers infographics in 35 languages.
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