Omega: What food mistakes did you make in the past that helped inform your current diet and recommendations?

Mark: Like most people, I believed that I should be eating a low-fat diet high in what we used to call complex carbs, like bread and pasta, which actually act just like sugar, or what we called simple carbs. I thought pasta was a health food and whole wheat bread was healthy. As I got older, I realized my body was getting flabbier, even though I was exercising. I began to look at the research on how our weight and metabolism works. Insulin is driven by all these starches and carbs, so I changed my diet to be lower in refined sugars, starches, and carbs, and I added foods that were higher in fat. It worked. My body leaned right up without really exercising. I realized that I was a very mild case of what’s been happening in America on a mass scale, and that’s really why I’ve focused so much on addressing the issue of what I call diabesity—insulin resistance that drives us to be overweight and causes diabetes, heart disease, cancer, and dementia (also known as Type 3 diabetes).

Omega: How has going through your own health struggles with chronic fatigue syndrome helped you in working with your patients?

Mark: I think it gave me a lot of compassion for patients who struggle with illnesses that are complex and confusing. As a patient, I know how daunting it was to get doctors to understand that I wasn’t making it up—that there really was some underlying cause that they couldn’t find. So now I work hard with my patients to find the root cause based on functional medicine, whether they're dealing with depression, dementia, or ADD. It’s really clear that we are living in a society that is not good for our brain. Most brain injury or damage is because of our diet, environmental toxins, chronic stress, or a whole series of insults, both self-imposed and related to the world we live in. I literally experienced symptoms of depression, ADD, and dementia all at once.

Omega: Can you talk about why some researchers are now calling Alzheimer’s disease Type 3 diabetes? What’s the link between Alzheimer’s and diabetes?

Mark: We know from the research that diabetics have four times the risk of getting dementia. The insulin-resistance mechanism has been identified, and insulin receptors are located in same part of the brain that supports memory. In addition, inflammation is a huge factor when it comes to Alzheimer’s. The thing that drives inflammation is sugar, carbs, and high levels of insulin, so that’s why doctors are focused on that. There's not just one cause of Alzheimer’s. Dementia is a symptom, and really there’s no such thing as dementia. There are dementias. Each has different causes and needs different treatment, and the treatment has to match the cause not the label. In fact, there may be dozens of different factors or causes that contribute to dementia.

Omega: In your book Eat Fat, Get Thin, you debunk the myth that eating fat makes people fat. Can you talk more about the difference between good fats and bad fats?

Mark: There’s no such thing as an essential carbohydrate, but there are essential fatty acids. The body doesn’t actually require carbohydrates to function or live. It requires amino acids and fat, and you can actually make sugar from protein if you need to. I’m not saying we shouldn’t eat carbs, but people are very confused about fat. For so long we’ve been told to eat low fat, but it’s actually led to the epidemic of obesity, diabetes, and heart disease because our bodies require fat.

Bad fats are saturated and trans fats, like shortening, margarine, and hydrogenated fats, that are found in processed foods. Trans fats have been linked to diabetes and heart disease. Good fats include the omega-3s, which is what a lot of your brain is made up of, and can be found in things like fish oil, and monounsaturated fats, which are found in things like olive oil, avocados, nuts, seeds, and eggs.

The reality is that fats are complex. Butter is 60 percent saturated fat but also has polyunsaturated fats. Olive oil is mostly monounsaturated, but it also has 20 percent saturated fat. So it’s not like anything is 100 percent X or Y.

Good fats are encouraged because we’re not worried about cholesterol anymore when it comes to heart disease—that’s really been discredited as a theory. Saturated fats and refined vegetable oils are controversial. Vegetable oils can be toxic when consumed in large amounts and when they are heated at high temperatures. Saturated fats are still a big question that’s being discussed in the literature, but there’s a lot of evidence that they're not really linked to heart disease.

Omega: You’re not encouraging people to put butter on everything, per se, so how do we bring more fat into our diet in a way that manages these different fats?

Mark: I tend to focus on foods instead of fat. If you focus on good foods, you don't have to worry about good fats versus bad fats. The foods I focus on are nuts and seeds—nuts such as almonds, walnuts, pecans, and macadamias, and hemp, chia, pumpkin, and sesame seeds. The other foods I recommend people focus on are avocados, extra virgin olive oil, fish, sardines, wild salmon, and coconut oil. Avoid large amounts of meat, and buy grass-fed meats if you can afford them.

© 2016 Omega Institute for Holistic Studies