Modern Food, Chronic Disease & Why Functional Medicine Matters Now — Dr Jeffrey Bland

SHOW NOTES

🌐 Website: https://www.plminstitute.org

• Institute for Functional Medicine: https://www.ifm.org

📘 Books:Featured:

• The Disease Delusion

Professional Focus:
Functional Medicine, Systems Biology, Personalized Nutrition, Immune Health, Mitochondrial Health

00:00 – Introduction & guest background

02:10 – Modern food as an existential threat

04:43 – Soil health, yield vs nutrition

08:11 – Nutrient density & secondary plant compounds

16:28 – What is functional medicine?

23:06 – Doctor burnout & re-enchanting medicine

26:16 – The Disease Delusion explained

31:08 – Limits of pharmaceutical research models

34:06 – Immune system & longevity

37:37 – Measuring immune biological age

42:29 – Mitochondrial health & metabolism

50:29 – Lessons from Linus Pauling

54:35 – Hope, meaning, and healing

56:53 – Final reflections

Modern Food, Chronic Disease & Why Functional Medicine Matters Now — Dr Jeffrey Bland

Dr Ron Ehrlich (00:00)

Hello and welcome to Unstress Health. My name is Dr Ron Ehrlich. Welcome to Unstress Health. My name is Dr. Ron Ehrlich. Well, today we really have a special guest, a legend in the world of functional medicine, in fact, arguably coined the phrase, that’s not arguable, is fact fact, but also in the world of nutritional education. He has literally educated hundreds of thousands of practitioners over his very long and distinguished career. My guest is Dr. Jeffrey Bland. He’s widely regarded, as I said, as the father of functional medicine, a movement that has reshaped how clinicians worldwide understand chronic disease, prevention and human potential. Jeff’s a scientist, an educator and a pioneer and was mentored by the legendary double Nobel Laureate, Dr. Linus Pauling. And we discussed that influence in this episode today. And he’s dedicated over four decades to advancing systems biology, personalized nutrition and integrated healthcare.

I first studied with Jeff in 1982 and his influence on my professional journey has been profound as it has, as I said, for hundreds of thousands of others. Today, we explore the ideas shaping the future of healthcare and medicine in this day and age. I hope you enjoy this conversation I had with Dr. Jeffrey Bland. Welcome to the show, Jeff.

Dr Jeffrey Bland (01:25)

Well, I and so enjoy having this opportunity for us to have this conversation. You know, our relationship goes back a few decades. We won’t even say how many, but let’s just say a few.

Dr Ron Ehrlich (01:41)

We can, we can, that’s all right. I think that’s to be celebrated and I have been following your teaching, your writing for all of those decades and look, I mean you’ve spent four decades, let’s call this spade a spade, we’ve spent over four decades analyzing patterns in chronic disease, biological systems, human resilience. Now when you take a step back and look at the world in 2025, what do you see the most defining forces shaping human health today.

Dr Jeffrey Bland (02:10)

I’m going to make what is, think, a fairly strong statement here, and I hope this won’t blow anybody away. I think modern day food, as we’re now eating it in the developed countries of the world, is an existential threat to humanity, not just because what’s in it, but also what’s not in it as a consequence of the way that we’re manufacturing food. It’s compromising our health. It’s shortening our lifespans.

It’s even now been shown to block our ability to continue to reproduce with male sperm counts going down, female frequency of polycystic ovarian syndrome and other infertility issues starting to rise such that it’s been proposed that by 2050 some 80 % of births will be up by IVF because we will no longer have the normal biological process for fertility. I would say over the last decades we’ve altered every aspect of what we consume and it’s changed our biology at the level of genetic expression. The effects on immunity will last for generations unless we stop the process right now. 

And I’m coming up 80 here in just a couple of months. And for me, this is my advocacy. This is what I’ve learned over the last now coming up five decades. I spent my life trying to understand this problem and how I believe we can find a solution based upon the appropriate application of discoveries in nutrition, health science, immunity, and ecology and preservation of the planet. And to me, there’s no second more important advocacy. You know, I’m at the phase of my life where it’s all about pay forward. What can I deliver that might be helpful? I’m sure you feel the same way. It’s not looking back, it’s looking forward. And we need to do something and we need to do it immediately. It’s not just cocktail talk and having something to kind of fill the space with. It’s really serious business to change the way we’re living.

Dr Ron Ehrlich (04:12)

Yes, no, couldn’t agree with you more and it’s the subject of many of my well over 600 podcasts now. But I mean, the focus has, you’re talking about nutrient density really of food and we are part of an ecosystem. I use the word ecosystem as well. Soil is such an integral part of that and the way we are abusing it and losing it is a major factor.

Dr Jeffrey Bland (04:43)

I think you’ve said it beautifully that what happened, I believe, when we made food production the principal value proposition for agriculture, so it became yield. Everything was about tons per acre or whatever measurement per acre. And then we started to look for things that would produce a lot per acre. And so we got into the cereal grains.

And we said, wow, we can really beat these up using the Green Revolution of Norman Borlaug. We can use certain genetic hybrids. We can use all sorts of egg chemicals. And then we can use a lot of NPK fertilizers. And we could make these things extraordinarily productive on a yield basis. And that model then said nothing about nutrition. It said only, what does it weigh when you get to the scales? And that then led into the development of a whole series of foods that were really fabricated foods from thinking of these grains, basically raw materials, like you think of oil as the raw materials for the petrochemical industry. 

And so you can convert oil, crude oil into hundreds of thousands of different products, like you can convert wheat or corn or soy in a hundred thousands of different products by flavoring additives, colorings different technologies to make them pop fizzle or whatever. And that became the driving force for shelf stable foods. Because now we can have stores where you could put stuff up there and it could sit for a year. And you could make it convenient by then putting it into things like microwave ovens or in the freezers, which were not when I was a child having a freezer was was kind of not common. Now to think that you wouldn’t have a freezer would be, you know, that’s crazy to even think about.

I think all these particular food technologies and food processing then became the watchword for how we ultimately measure our success in nutrition. Then people said, well, hold on, but we’re ending up with some things that don’t appear to We better fortify. We started to add certain vitamins and certain minerals to certain foods so they would not be deficient like a vitamin D to milk or

B vitamins to cereal grains. And now suddenly we felt really good because we had fortified stuff, but it wasn’t fortified with all the stuff that was in the original food before we started playing around with it as a technology. And we left behind all the things that were some what are now called the dark matter of nutrition, literally a hundred thousand other nutrients that are found in foods that we take out the flavonoids, the polyphenols. 

I mean, we could go down the list  and they don’t reside in our foods anymore. And now we’re finding, whoa, maybe that was a mistake because maybe they play really important roles in the health attributes of what we eat. So all of this, to me, is part of where we find ourselves today.

Dr Ron Ehrlich (07:41)

It’s interesting to hear you say that because one of my favorite podcasts was with Professor Fred Provenza from Utah University and he said something that stayed in my mind, the humble strawberries that Ron has 5,000 active components. We don’t know what most of them are but I’m sure they’re there for a purpose. You mentioned NPK, nitrogen, phosphate and potassium which is you can grow a good Plant looking plant with that but the human body needs a few more minerals than that doesn’t it?

Dr Jeffrey Bland (08:11)

That’s exactly right. you know, this concept of what happened to the selenium in our soils, or what happened to the chromium in our soils, or what happened to the molybdenum, and we go down the list of these, well, they only need a little bit of it. Yeah, we only need a little bit, but we need more than zero. And so you get into this whole issue of what’s the difference between an organically grown strawberry, let’s use as an example, versus a hothouse grown strawberry.

And the answer has to do with the secondary metabolites that you’re describing, the polyphenols and the flavonoids. And you start to see that there’s a vast difference. First of all, you can taste the difference in flavor. And where does flavor come from? Flavor comes from a whole series of secondary chemicals that the plant makes. It didn’t make them just so they were flavorful. It made them as part of their immune system, as part of their function. 

And when we hot house them and we accelerate their growth patterns by giving them plant hormones and a lot of fertilizer, we didn’t get those things that the plant would normally make if it was in its natural state and had to be protecting itself against an environment that’s not so sheltered as it is in a hothouse. So I think that those principles that are really ecological principles talk about us and our place in ecology and our place in the food system and how we depend upon plants to do the things that they do to feed animals. And then we eat the animals that ate those plants. And then we get the benefits of that total chain of events, either good or bad. And our animals are depleted in nutrients as well because they eat the higher kind of food stocks that come from these commodity subsidies that end up as animal food.

Dr Ron Ehrlich (10:02)

And how do you think this compares, I mean, with when you started your journey in the 70s or 60s and 70s, you know, how does it compare now with that time? Where were we then?

Dr Jeffrey Bland (10:12)

Yeah, thank you. I think we both could probably compare our dance cards and we say the same thing about this. When I started the health food revolution was just kind of getting going. That was the 60s. The health food concept, I think, grew out in the, at least in the United States, out of the post World War II recognition that our service people in World War II were having nutritional problems with the rations they were given.

So they started to fortify the rations with various vitamins. So that was the K rations and the things that became the first really fortified foods. their servicemen were not ending up with rampant nutritional deficiencies like berry-berry, which by the way, some of the soldiers in the Japanese army had serious problems with vitamin B1 deficiency, berry-berry, because they were eating a rice-based diet that was not fortified.

That may have been one of the advantages that we had that their health was really compromised by that. So the concept of fortifying food then led actually to people asking the question, well, why do we need to fortify food? Because we people have been living on natural foods for a long time. And that then led to the kind of the concept of let’s use unrefined foods. Let’s stay with foods that were grown in the ground. Let’s not use highly processed foods.

Now we use the term ultra processed foods, know, these chemicalized foods. So that gave rise then to the mom and pop health food stores that I recall back in the late fifties and early sixties in which there was blackstrap molasses and yeast and yogurt and wheat germ and various alfalfa sprouts and things of that nature. And then later dietary supplements started to come in with more prevalence in the 1960s and seventies.

And it built up this other industry that later in the States became the natural foods industry in the 70s and 80s. It’s now a multi hundreds of billions of dollar industry. But that industry really was trying to go back to basics. And I’m kind of proud to say that in the 80s, the well, those late 70s, early 80s for me, I was a small part in the United States of this organic standards movement to try to get the government to differentiate between organically grown foods and conventional agribusiness grown foods. 

And we fought very, very diligently because there was a lot of resistance. mean, obviously the food industry didn’t want to concede that there might be another class of foods called organic. They wanted everybody to think it was just food. And we eventually won that battle really as a consequence of consumer uprising and advocacy. And now we’re going into regenerative, which is the next level above organic agriculture. These are are ways of trying to bring us back to the preservation of the interface we have with the planet and sustainability and the full-throated value of foods because foods, when they’re grown naturally, provide a whole different array of nutrients that our body really can take advantage of. So to me, the history over my lifetime, and I think I was quite fortunate actually to be born during this period to watch the first pioneers of the natural foods movement kind of in the in latter phase of their life, birthing this revolution and that now watching it grow up in to become a multi-billion dollar industry that really has the ability to put political pressure. It’s still not as big as the traditional food industry. So I don’t want to be overly confident, but it is a strong voice. 

And we’re seeing now with a lot of mothers, particularly with children, who are suffering with all sorts of nutritionally related problems like eczema and asthma and atopic disorders and allergies and the things that digestive problems and even things that might be behavioral nature like ADHD that think it’s a consequence of the way we permit permitted to foods into funny chemicals that are put into foods where you need a chemical tech dictionary to understand the ingredients in foods. And so now we’re going back to say, Whoa, just a minute. You know, these are things that have all contributed to the rash of problems that we now have with with kids and mothers being the most vigorous advocates are really creating the opportunity for this dialogue. this, right in the United States now, we have this movement that’s being highly debated about how are we going to go back to a food supply system that is safe and get away from these ultra-processed foods that we’re feeding our kids and the sugar sweetened beverages that consume 25 or 30 % of their calories. So I think we’re in a revolutionary time of potential change, hopefully for the better.

Dr Ron Ehrlich (15:00)

Yes. Although the vested interests that drive the mainstream narrative have kind of infiltrated almost every level from media to government to regulatory bodies to academia to journals to the cold face of the doctor’s surgery. And it’s a story that’s very easy to miss, but once you hear it, very difficult to ignore.

Dr Jeffrey Bland (15:33)

Yeah. Well, I think you’ve done a superb job of keeping people informed as to how that network, that web has developed and it ties that web obviously ties very closely together with the medical industrial complex. And, you know, some people have said the low profit margin ultra processed foods that are made by the food industry fuel the high profit margin pharmaceutical industry to treat the conditions that result from it. It’s an interesting concept. I don’t believe it’s too far away from reality.

Dr Ron Ehrlich (16:02)

No, no and I’ve often said that our current healthcare system is a great business model, it’s just not a very good health model. But talking about a very good health model, functional medicine I know has revolutionized healthcare and you were an instrumental part in that. So this is a great opportunity actually for me personally and for my listener to hear, how do you explain functional medicine? How does Jeffrey Bland explain functional medicine?

Dr Jeffrey Bland (16:28)

Thank you. First of all, I think it’s really important, at least from my perspective, for people to know that functional medicine is not a list of therapies. It’s not a therapeutic guideline. There are many therapies that exist in integrative medicine and in traditional medicine that can and should be applied in the functional medicine model. Functional medicine is way of thinking about the patient.

It’s not a therapy in itself. It’s a way of assessing a patient looking at for root cause, looking over where the condition came from, not just how we treat symptoms. you know, medicine has been very, very dedicated and focused in the way that it’s developed on, on the pathology of disease focus. And so let’s treat the disease. And then we say, well, there’s also prevention, but prevention has never been properly structured in such a way that it looks like it has the same gravitas as does disease treatment. 

There’s no architecture for prevention that is as formally sophisticated and as compelling as when you treat a disease with a modern surgical or pharmaceutical remedy. We got thinking now, this would be, well, the Institute for Functional Medicine is now 35 years old, so this would be 40 years ago. We got thinking about how would you actually move away from a disease model to a health model and make it as formally well ensconced as is a disease model. So you’d have a formalism that would take you towards health and away from disease. would be as well constructed as is the disease care model. And my wife, actually, Susan Bland, was the person who said to me then this would be the late 80s.

She said, Jeff, you you’ve been traveling around the world and meeting with all these extraordinary people. You come home and talk about these innovators and their thoughtfulness and how they’d like to change health care to be more health focused. You know, maybe we should sponsor a meeting bringing these people in and sit down and have a whiteboard discussion, not talk about reimbursement or licensure, but just what would the ideal health care system look like? And that happened actually. She sponsored, we sponsored the meeting. She organized it was in.

Victoria, British Columbia on Vancouver Island in 1988. That’s right. And we brought in about 42 people from different disciplines that I met and thought were very innovative in their thinking in different disciplines. And we sat down and just kind of did an intellectual meltdown on this process for a few days. At the end of that, people say, hey, this was so enjoyable. Let’s do it again. So we did it subsequent year in 1988-89 in the same place. And it was that year that I had this concept that what we’ve been talking about all this time was a language around function. And I posed the question to the group, said, could we actually be missing a really important point here that health is really defined by function and not the absence of disease? Let’s just ditch the disease model. 

Let’s not talk about prevention of disease because we’re then tethered to disease once we introduce that concept. Let’s talk about how we aspire to resilience to function because if we’re high functioning, the opportunity for disease is going to be very low. And so maybe we turn the equation around. And so I propose this to my colleagues and I think they were very fine. And they said, well, Jeff, that’s an interesting idea. But, know, in 1989, the term function in medicine was not really well received because it either meant geriatric medicine with people that are functionally disabled, so it’d be like structural, or it could be considered psychosomatic medicine. It’s all in your mind, functional medicine, all in your mind. Both of those didn’t seem like the right context to land on. But I follow the literature pretty closely. And I said, you know, I’m seeing more and more articles starting to come out with functional radiology, functional cardiology, functional endocrinology. Maybe we’re going to see a redefinition of what function means in medicine. Maybe we should skate to where the puck is going to use an allegory rather than where it’s been. possibly because we sponsored the meeting, I got the vote of, let’s give it a whirl. 

We started the Institute for Functional Medicine in 1990 with the concept that we were going to then look at function in four different areas that we felt could be quantified. That was physical function, like how your body moves and works, metabolic function, which is related to physiology, cognitive function, how your brain is thinking and working with your body, and then behavioral function. How are you behaving in the world in which we find ourselves? 

And if you could quantify each of those four quadrants, we felt that we could then pull them together into a different context rather than it being a diagnosis, it was a prognosis of function and resilience. And we could quantify a whole new theme of what healthcare looked like from a functional basis. So that was the foundation from which the Institute for Functional Medicine was founded in 1990. You know, I have to say that my wife and I have talked a lot about this over the years. We were, I was told, because I was a medical school professor when we started this and my academic colleagues said to me, Jeff, you know, this is a really interesting esoteric concept, but you’re never going to get health practitioners to go back and open their books and re-study. And they didn’t even like the stuff the first time they studied it, much less having to study it again. And this will never stick. I think there was a legitimacy to their criticism, but I have to say we have now had 250,000 practitioners go through our programs over the last 33 years.

So did find some people that were willing to do that. I think these are the most dedicated practitioners in the world in which they’re really focused on patient health as their principal objective. And they’re willing to work hard to get the skills necessary to be experts in this field. I think for me, looking back now 35 or so years, I’m just amazed really how this has grown up. I would have never anticipated it.

Dr Ron Ehrlich (23:06)

Interesting because I remember speaking to Professor Julia Rucklitz, she wrote a book called The Brain Food and she said it’s perfectly natural for doctors to be skeptical and curious and I said that’s very interesting Julia but my observation would be that doctors skepticism seems to be focused on the first year or two of their course, Physiology and Biochemistry and their curiosity kicks in only once they get into the real stuff which is diagnosing disease and prescribing medications and that’s what medicine is really all about. So this dichotomy between skepticism and curiosity juxtaposed over most medical practitioners a high proportion of burnt out. They feel disengaged, ineffective and exhausted. I wonder how many functional medicine practitioners feel burnt out.

Dr Jeffrey Bland (24:01)

Yeah, Dan, I think you just hit it there. That was very eloquently stated. That was a drop the mic, a little statement you just gave there. My good colleague and friend, David Jones, who was a co-founder with Susan and I of the Institute for Functional Medicine, is a clinician’s clinician. He’s a remarkably good doc. And his, and I’m stealing his language now. He’s the guy that first said this to me. He said, we need to re-enchant doctors with medicine.

What happens is they go in very enchanted about being able to help people and excited about the opportunity. And then what happens, they become disenchanted and they become, they recognize they become kind of sophisticated drug detail salesman. And they lost the whole vitality. You can see it in their eyes. They lost this curiosity, this hunger for going to work and really doing a good job. And he said to me, I think we, ought to be the institute that focuses on re-enchantment of medicine. And I think that’s really the underpinning of functional medicine is to say why we all dedicated a lot of our lives to learning the skills and to deal with the complication of people that are not well is because we felt we could provide a service to them to guide them in a personal way towards decisions that would lead to a better outcome of what their expectations for life would be.

And that’s a high level attribution. It’s a high level expectation, but it’s one that really drove probably most people to want to go into the health sciences and to become healthcare practitioners. So I think functional medicine provides a route towards it. It’s not the only route, obviously. I mean, if you want to become a great surgeon, that’s another route. And I would say that’s great if that’s what you like to do. If you want to be involved with healthcare, however, the functional medicine route is a very engaging way to be re-enchanted.

Dr Ron Ehrlich (26:04)

I think that’s nicely put, the re-enchantment. I was going to ask you, because I know you’ve written a few books, but the one, The Disease Delusion, but I think you’ve already really covered that a little bit. I mean, what was the premise of the book was? Tell us.

Dr Jeffrey Bland (26:16)

Yeah, thank you. think the title, the title of books is always complicated because you try to get something, it’ll be catchy, but then you want to be cautious that it doesn’t miss the point of your book or it doesn’t exaggerate what you’re trying to communicate. So I’ve gotten some criticism for choosing that title. But the reason that title, the disease to lose and was chosen was I wanted people to recognize that disease is not a fixed thing. It changes with time. It changes with with convention. It changes with new technology. 

So what we call one thing years ago gets called something different in the future. know, Robert Sapolsky, who wrote the best selling book, Why Zephyrs Don’t Get Ulcers, said a really interesting thing in his book, The Trouble with Testosterone. He said, you call it can changes, but the way people feel crummy stays the same. And so what we really need to do is find ways of describing better how an individual feels less than well. What is illness in their minds? And it’s not the disease that is really their problem. It’s their unwellness that’s the problem. And then we just happen to land on a label for which we can get reimbursement for what we want to call it. But we now know, let’s use a type 2 diabetes as an example.

If type 2 diabetes was one disease, we would have one drug to treat it because everyone with that one disease would respond to the same drug in a positive way. But that’s not the case. There are now 14 different drugs that have been approved for the treatment of type 2 diabetes because it’s not just one disease. It’s multiple things that present themselves with a patient having dysglycemia and insulin problems and there are multiple factors to give rise to that. And so no one drug covers all those problems. In fact, no one drug treats the real cause. Maybe the GLP-1 agonist drugs are the closest we’ve seen to maybe treat a little bit upstream, but they’re still not fully capable of managing the cause, which is poly-phenomenological. It has many different causes that are based upon the genetic uniqueness of the person and their own lifestyle and dietary habits.

I think that the concept of the disease delusion was to get people away from what we call it and to talk about where it came from. Because once we ask the question where it came from, then it is individualized. It’s precise, not to a name of a disease, I have this disease. Now I have a condition that’s mine and it is unique to my situation and I need personalized intervention based upon its cause, not its effect. That’s the premise of the disease delusion.

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Dr Ron Ehrlich (30:23)

I mean disease of course people get a diagnosis in an appointment and disease isn’t a light switch. Yesterday you didn’t have the disease, today you have it. It’s a process that goes on for many years. Some of the challenges around functional medicine are though the danger of buying into the pharmaceutical model that a randomized controlled trial is the gold standard of showing something works.

Because functional medicine, as you’ve already alluded to, is very comple are many factors. And when we’re talking about nutrients, as an example, isolating one at a time, it doesn’t really fit that gold standard, it?

Dr Jeffrey Bland (31:08)

Yeah, that’s another really important point. I think that what’s called the gold standard for proof of effectiveness of a drug, which is this randomized placebo-controlled trial, was born out of the antibiotic era of the 40s and 50s. Because if you have a specific bug, bacterial infection, and you can then find a specific molecule to which that bug is sensitive. And you can place a name of the disease that’s associated with the infection with that organism. Now you have a very simple model. So you have pneumonia and you have a pneumococcus bacterium, and then you have an antibiotic de jure, whatever the name is, it can kill that bug. And so it becomes a very nice linear model and you can memorize it and recite it on tests.

And so we developed this pharmacology that’s one disease for one cause with one treatment. And that only works for a fairly small number of the conditions that really plague people’s health. And as you already said very, very eloquently, Dan, that the majority of chronic illnesses that we have are not a consequence of one issue.

There is multiple things that are going on. And so the one disease with one cause with one drug model really just doesn’t work. So then you say, okay, if it doesn’t work, then what’s a different model? And a different model, which is gaining more and more support now in basic science and approval of therapeutics is to look at each individual patient as its so-called N of 1 model as a unique individual in which you study their specific etiology or the cause of their condition based upon now the tools that are available and you integrate those tools, which we didn’t have 20 years ago, to come with a unique approach towards that condition. 

And then you look at multiple people with conditions similar to that and you start harmonizing are the most important things that create the heavy lifting and are the most important kind of generalized conditional things that might be used for the treatment of those kinds of complex conditions? And that’s really the basis of systems biology. And that’s the basis of the functional medicine model built on systems thinking, not just one thing against one outcome.

Dr Ron Ehrlich (33:49)

Now beyond the hype, where do you think medicine is really advancing? know, like there’s so much hype out there. Every day we get headlines from different PR companies associated with different drug companies. But where do you think, what excites you about modern medicine now?

Dr Jeffrey Bland (34:06)

Well, I think there are two things and then they’re interrelated. Obviously, there are many other things, but I’m going to cherry pick two that I think are at the head of my list. One is this exponential increase in understanding we now have of the immune system. And part of that has been driven by HIV, well, yeah, HIV, of course, but also SARS-CoV-2. I think we made huge advances over the last four years in all the research that went into understanding the SARS-CoV-2 infection and its relationship to immunological status and differentiation of immune function among individuals. And I think we’ve made more advances in understanding immunity in the last four years, and probably we did in the previous 50 years. And so understanding what factors influence the immune system and how does the immune system actually operate, not just to protect against infection. But as a restoration of the body, a rejuvenation of cellular function at every level, because the immune system is one of only two systems in the body that are in every other system. Think of that for a moment if you would.

Dr Ron Ehrlich (35:13)

I can just repeat that again because that’s an interesting…

Dr Jeffrey Bland (35:14)

Immune system is one of only two systems in the body that are found in every other system. You don’t find the heart in the lungs or the kidney in the liver. Yes, yes, yes. But you find the immune system and system in every organ. And it begs the question, why? Why would those two systems be everywhere? And it’s because those are the only two systems that are communicating 24 seven 365 with the outside world, telling the inside body how it needs to operate. And so, if you want to form an understanding of the root cause of virtually every disease, it starts with the communication of the body with the outside world and how it translates that into enzyme alarm reactions. When the body feels it’s in a state of alarm because it’s in jeopardy, the body will do what it does to protect itself against death. And that is it turns on the immune system into an alarmed state.

And that is the disorders of inflammation, which are associated with virtually every chronic age-related disease. And that immune system activation produces what’s called inflammation. And inflammation is associated with immunosenescence, the aging of the immune system. And the best predictor that we have today in medicine is that what will be the age that we die is the biological age of our immune system. It’s the best predictor.

People with prematurely aged immune systems have shorter life expectancies. And in fact, a study was just published last month, very extraordinary study studying 17,500 people for many years looking at their immunological function and how resilient was their immune system based upon its health and functional age.

And they found that the people that had the most resilient immune systems versus the people that had the least resilient immune systems lived on average 15.5 years longer. Wow. Now, can you think of any drug or any therapy that can deliver 15.5 years of increased life expectancy? I can’t think of one,

Dr Ron Ehrlich (37:32)

And how do we measure biological, you know, the biological age of the immune system?

Dr Jeffrey Bland (37:37)

Yeah, that’s now being done by using the epigenetic age, the so-called methylation patterns of the genes of the immune system. And that can be actually done now procedurally very easily. And there are actually commercial companies that are providing that analysis to provide a biological age using these H-clock determinants of the methylation patterns of your genome. And so this technology is all new. And the problem historically with that technology was yes, we had this information, but it was so complex because if you think of all the genes and all the loci being methylated or not methylated, it was on a single individual was a terabyte of data. I mean, it was an enormously overwhelming amount of data. And so we really didn’t have a good way of analyzing. The second major advance is machine learning and artificial intelligence.

Now we have the chance with the computing power of today to take this data, was previously overwhelming. We didn’t know what to do with it. And to analyze it in seconds to understand what it’s telling us. And now the combination of the technology of assessment with the technology of informatics produces access to information about our body that we never had available for. Now we tie that together. You talked about my aura ring.

That’s one of many different biometric devices I have on my wrist, an Apple Watch, that’s another biometric device. All of that information is fed three, 25, 24, seven into our data cloud and comes back to us telling us about our body in ways that we never had before to make intelligent decisions. These are seismic changes in the way we, person, individuals can own our body and make intelligent decisions, not depending on someone else to do it for us. Now we have 24-7, 365 access to that information. 

This is changing all of healthcare. It’s irreversibly changing it. Nothing that we believed as fact 10 years ago is going to be so clear as fact as we move forward. So many presumptions that we learned as fact that I was tested on, I had to pass the test, by reciting those facts are no longer factually correct, because we have learned about the variability of the way our genes are expressed, the impact that lifestyle and diet has on their expression patterns, that this whole concept that we can remodel our immune system, rejuvenate our cells, that won a Nobel Prize in Medicine and Physiology in 2012 with the Yamanaka Factors. It said that we can convert cells back to their primordial state and rejuvenate ourselves. Look at Dolly the sheep.

Where did that sheep come from? It came from a single post mitotic cell from the teat of a mother from her breast cell was then formed by de differentiating back into a primordial state, the full sheep from that cell. These are transformative things that have occurred within the last 10 years that are sci-fi in their implications, but they’re actually factually being delivered in a healthcare and we now have access to that information as individuals to make intelligent decisions. So the doctor is a primary keeper of all information about us is no longer the way that this system is working.

Dr Ron Ehrlich (41:15)

Yeah, which is actually quite on the one hand to some medical practitioners may be threatening but on the other hand I think it would be rather liberating to bring your patient along with you on the journey then you wouldn’t have the burnout that you that a lot of experiencing. I think with those devices I have to say benchmarking our biometric measures is a real important ongoing thing. One could argue that it’s a double-edged sword because I remember when I was wearing my aura ring, I got to the point where when I woke up in the morning, my wife would say, how did you sleep? And I’d say, just a moment. I just go and check on my watch and she said, take that buddy thing off. Just tell me how you slept. So it could be, but Jeff, you must’ve noticed too that in the last 10 years in particular, maybe the last 15 mitochondrial function and circadian biology has become an important part of the conversation. I mean talk about going back to undergraduate level, that’s histology, the study of cells. Tell us about that evolution. mean metabolic health and mitochondrial health and circadian harmony has become a big part of the conversation now, hasn’t it?

Dr Jeffrey Bland (42:29)

Oh boy, I think again, you’re hitting right at the front edge of where we’re all kind of pursuing knowledge that’s going to help people make intelligent decisions. So for me, genetic metabolism disorders that were inborn metabolism from genetic uniquenesses, things like Leber’s optic neuropathy and various types of neurological disorders that were found in infants were traced back not to DNA mutations in their chromosomes, but to mitochondrial DNA because it turns out that this energy powerhouse of ourselves has its own DNA, not the kind of DNA that’s in our chromosomes, but it’s actually in this organelle called the mitochondria. 

And that was my first exposure. And then I started to recognize that embryologically mitochondrial DNA comes almost exclusively from our mothers because the mitochondria in sperm is principally in the tail of the sperm that falls off upon fertilization within the egg, the female ovum is a huge number of mitochondria. So the mitochondria, the energy powerhouse of our bodies was coming from our mothers, metaphorically and biologically. 

And so when I started to think about this, it then started to help me understand why were certain types of drugs that had adverse effects that were linked to women, to the mother, not to the man. And these were basically antibiotic drugs that were killing mitochondria because the mitochondrion, according to Lynn Margolis’ theory of endosymbiotic theory, are bacteria that swam into nucleated cells millions of years ago and have lived as cohabitants. 

So our mitochondria are actually bacteria living endoplasmically within our cells in a friendship relationship. But certain drugs may be sensitive to the mitochondria because they’re like bacteria, so they could kill mitochondria or at least reduce their functional capability. So all of this started to be kind of interesting to me because this was the time of chronic fatigue syndrome and post-viral fatigue in the late 80s.

And so I started to think maybe these conditions are associated with mitochondriopathies. And by the way, I wasn’t the only person thinking about this. There were many others who just got on my radar screen. And so when we started the Institute for Functional Medicine, I wanted to have a teaching session on the mitochondria. So in 1991, I think we were the first group to introduce mitochondrial health into our teaching curriculum not mitochondrial disease, not these mitochondropathies associated with genetic inborn errors and metabolism, but more what I would call acquired mitochondropathies. Now, when we started teaching that, I have to say we were criticized by a number of the traditional medical world saying there was no such thing as functional mitochondropathies. 

You either had a genetic imperfection in your mitochondrial DNA or you didn’t. Over the years now, however, I’m of proud to see that we were proven right, that there is such thing as acquired mitochondropathies as a consequence of exposure to toxins or exposure to low oxygen environments or exposure to poor quality diets, that these can all alter your mitochondrial function, not so extreme as you would have with the mitochondrial inborn era metabolism, but extreme enough that it creates fatigue and pain and low energy.

And then you start saying, where do those symptomatically, where are they seen? They’re seen in the tissues or the organs that have the highest level of mitochondria. And where are those? The cardiocyte in our heart that’s beating every second of our life, hopefully for a long time, is 75%. The volume of a heart cell is mitochondria. It’s this densely packed mitochondria. Or else do we see a lot of mitochondria?

In our brain, in our neurons. It’s constantly processing energy through oxygen and glucose to make us able to think and act. And that’s a mitochondrial rich tissue. Where else do you see it? You see it very richly in immune cells because immune cells are energy rich or energy demanding cells for their function. In fact, when we have an infection, 50 % of our overall body is being used by our immune system. So these areas in our body that have a lot of mitochondria, the places that we see a lot of symptoms, cognitive fuzzy brain syndrome with the brain, pain and chronic disabilities, low fatigue, myalgia, immunological dysfunctions that make us more susceptible to infection. 

Look at what happened with SARS-CoV-2 in the United States, the poorest outcome of any developed country, because our immune systems were just not up to snuff and we’re not capable of protecting us against that virus. So all these things start to make sense, I think, when you put the pieces together. And now, of course, we’ve been focusing on mitochondrial resuscitation. We coined that term in 1992, mitochondrial resuscitation. How do you resuscitate mitochondria? now many, in fact, we’re going to be focusing in 2026 in the personalized lifestyle medicine institute on that very question.

What have we learned about resuscitating mitochondria using lifestyle nutrition interventions and complex therapies?

Dr Ron Ehrlich (48:19)

I mean it’s interesting to be focusing on mitochondria because that leads to another one of those public health messages that perhaps were a little bit oversimplified but the implications of demonizing the Sun and the importance of the Sun in metabolic health and mitochondrial health in particular. That’s a bit of an issue too, this public health message which is driving one could argue mitochondrial dysfunction.

Dr Jeffrey Bland (48:54)

That’s really well said. you know, it’s interesting, isn’t it, that the mitochondria is a colored organelle. It’s when you look at it, it has a color. And the reason it has a color is kind of rest color is because it’s so rich in iron containing cytochromes that are involved with the energy process, the so-called oxidative phosphorylation. So it’s a mimic in the plant of a chloroplast.

The chloroplast in a plant takes some energy through the chloroplast, which is analogous to the mitochondria in human cells, and it converts it into energy. The mitochondria takes the energy product of the chloroplast, which then produces carbohydrate, fat, and protein, and converts it into energy of our human body. So these are interrelated processes that are tied into our ecological cycle.

The plant reads carbon dioxide to produce carbohydrates. We eat carbohydrates to produce carbon dioxide through this balanced process of chloroplasts and mitochondria system. 

Dr Ron Ehrlich (50:13)

What a system. I mean the yes, I want to ask you because you mentioned Nobel Prize given in 2012 but of course early on in your career I think you had the honor I imagine of being connected with one of the great scientific minds in history Linus Pauling. Could you just share with us a little bit of that? What were the most profound say I don’t know scientific or philosophical insights he shared with you. What did you learn from Linus Pauling?

Dr Jeffrey Bland (50:29)

Well, I would say thank you for asking that question because, you know, we all have certain seminal moments in our life, people that are really principally important for shaping us or guiding us. We hope it would be our parents, but it may be other people along the road. And in my life, it was not just my father. It was also Linus Pauling. Linus Pauling and his wife, Helen, I would say were shapeshifters for me and tens of thousands of other people. So this was not unique to me. I just happened to have the fortune of having my office next to his office for two years when I was on sabbatical at his Institute for Science and Medicine, the Linus Pauling Institute of Science and Medicine. He was a two-time Nobel Prize winner and the only person to have two independent Nobel Prizes in two different fields. One was in chemistry and the second was in peace. And that described the nature of the relationship that he and his wife shared.

He always said that Ava Helen should have won the second Nobel Prize because she was the activist for him to be more outspoken about peace related activities, particularly nuclear weapons and nuclear atmospheric testing. I have a photo reproduction that he gifted me when I left my two years there in 1984, a photo that his wife had taken in Albert Schweitzer’s compound in Africa of Albert Schweitzer, Albert Einstein, and Linus Pauling at the table talking how they were going to get 30,000 signatures from scientists to picket against the use of nuclear weapons in atmospheric testing, which they were successful in getting that done. you know, it’s very interesting in the United States because of his activism, his social activism.

He was then, this was during the McCarthy area in our country, Joseph McCarthy was a senator who was very, I think depending on how you want to interpret him, I think he would be seen as a guy that was very discriminating against people who didn’t think the same way he thought. so Joseph McCarthy was capable of actually preventing Linus Pauling from going to Stockholm to receive the second Nobel Prize by calling him a communist because he was talking about communal thinking and exchanges of information and free elections in Guatemala and all sorts of interesting things that scientists shouldn’t be thinking about. And so he was labeled a communist and was prevented from going to Stockholm for his second Nobel Prize. I knew him and his wife as people of extraordinary substance. you know, his, his, their model for their living and their was how do we make our work? It would do something to help reduce human suffering. I think that’s a very high bar that you say everything of your daily activities should be connected to hopefully reducing human suffering.

And that’s been a model that I’ve tried to strive for in my life. I certainly have not achieved nor will what the Pauling’s did in their lives, but I think we all carry our own little torch for helping to make the world a better place to live. So that’s been my advocacy.

Dr Ron Ehrlich (54:10)

Now just finishing up because I know there’s this whole human story around meaning, connection, the biology of hope if you like because thoughts are things, thoughts are things, neurotransmitters that cause our genes to express themselves and people aren’t necessarily being encouraged to think positively. In fact one could argue it’s part of the business model. How do we as individuals in this modern world rise above that, that narrative?

Dr Jeffrey Bland (54:35)

And you’re hitting really on the pivotal issues of our age. really want to just again, I said drop the knife, but I might, but I’m going to drop it again because I think that’s that’s such an important question. The concept of joy and hope, you know, two really important words that are part of our feeling state that we don’t get enough of often in our lives. Attribution manifests as a consequence of the way we’re interacting with the world in which we’re living and our own personal experiences.

I think the good news is that some of the things that we’ve been exposed to that were traumatic, that marked our genes with bad memories, we’re now learning that they can be reversible and they can be reapplied with better information, new information. I think in part, this may be part of this whole hallucinogen era that we’re going through to look at these hallucinogenic drugs, which may be part of a therapeutic arsenal of treatments that help us to restore opportunities to put better messages where bad messages were stuck. 

And I think that we are a burden society carrying a lot of grief and a lot of deprecation and a lot of feeling of unworthiness. And I think we need to throw that off and recognize that people are worthy of good health. They’re worthy of the remarkable talents that they possess. I’ve never…

met a person when I got to know them that didn’t have some remarkable characteristic that I wish I had more in myself. We just have to find ways of celebrating them and first recognizing them and then celebrating and then giving opportunities for them to be expressed. So I think what you’re talking about is really the health in the broadest, boldest way. And our physiological health is part of it, but our emotional health, our cognitive health, our social health, our behavioral health, they all converge to give rise to how we see ourselves and that we need to see ourselves as worthy of the celebration of our lives. It’s a short period of time. It’s a century. It’s a sand grain on the beach of time, but it is our life and we deserve to be celebrated.

Dr Ron Ehrlich (56:53)

Well, Jeff, that’s a wonderful note for us to finish on. And I want to thank you not only for the, well, probably 50 plus years of work that you’ve been doing in this field and for all of that contribution. And I’d love to want to thank you for sharing your knowledge and wisdom with us here today.

Dr Jeffrey Bland (57:07)

Well, I thank you for sharing yours and with the people that you’re touching. if anyone wants to find me, they can find me at plminstitute.org and all the videos that we produced are really accessible, downloadable. But you’re carrying the torch and I can’t have enough admiration and respect for what you’re doing. Thank you. Thank you.

Dr Ron Ehrlich (57:32)

Well, this really could have been a several hour conversation. mean, I was so looking forward to meeting and talking to Jeff. He has been a mentor and a guide for me in my professional journey over my entire career, as he has for many others. We’ll have links to his website and the Institute of Functional Medicine. There he has written so many books and he has been such an incredible influence on health care in this day and age over the last 50 years.

I hope this finds you well until next time. This is Dr Ron Erlich. Be well. 

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This podcast provides general information and discussion about medicine, health and related subjects. The content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences and conclusions.

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