I posted the 20 best foods on earth. Many people saw it. The reply section exploded.
The carnivores said I included too many vegetables. The plant-based crowd said I included too much meat. Someone told me spinach was poisoning people. Someone else told me I should be in jail for recommending beef liver.
I listened to all of it. Went back to the data. This is Version 2. 40 foods. Updated.
Spinach is gone. Fermented foods are in. Organ meats expanded. Every plant on this list is low-oxalate or cooked to reduce antinutrients.
No tribe won. The science won. 🧵
This pyramid has been around for years. Most health professionals know about it. Almost none of them will share it with their patients.
Why? Because food is the most controversial topic in medicine. More divisive than statins. More political than vaccines. A doctor who tells you to eat more red meat risks their reputation. A doctor who tells you to cut carbohydrates contradicts the dietary guidelines. A doctor who says seed oils are a problem contradicts every processed food company advertising during the Super Bowl.
So they say nothing. They hand you a pamphlet from 1992 and move on to the prescription pad.
The pyramid is simple. The base is protein, fat, and whole-fat dairy. Animal foods. The foundation.
The middle is low-carb vegetables and fruits. Real plants. Not processed plant products.
The top is the smallest portion. Starchy vegetables, nuts, seeds, berries. The foods with the most carbohydrate load get the least space.
And outside the pyramid entirely: bread, pasta, corn, sugar, rice, beans, high-sugar fruits. The foods the USDA told you to build your diet around for 50 years.
Here is why this matters metabolically.
Every food you eat triggers an insulin response. The higher the glycemic impact, the harder your pancreas has to work. Do that for 20 years and you get insulin resistance. Do it for 30 years and you get Type 2 diabetes. Do it for 40 years and you get heart disease, Alzheimer's, and cancer.
93.4% of Americans are metabolically unhealthy. They followed the food pyramid. They ate the whole grains. They drank the orange juice. They avoided the red meat and the eggs and the butter.
The foods at the base of this pyramid are the ones with the lowest glycemic impact. The ones outside the pyramid are the ones driving the metabolic disease epidemic.
That is not a coincidence.
The Top 40 is not a diet. It is a menu of options.
If you are keto, everything on this list works for you. If you are paleo, the same. If you are carnivore, Tiers 1 and 2 are your world. If you eat plants, Tier 4 is built for you with the oxalate and lectin risks already removed.
The point was never to tell you what tribe to join. The point is to give you 40 foods that are metabolically safe, nutrient dense, and ancestrally proven regardless of what you call your diet.
Real food does not need a label. And it does not need a tribe.
What changed from Version 1 to Version 2.
Spinach removed. 970mg of oxalate per 100g. For kidney stone formers, that is a real risk. Replaced with kale (13mg), romaine (near zero), and zucchini (near zero).
Fermented foods added. Sauerkraut, kimchi, kefir, natto. Your gut microbiome is Pillar 3 of the 7 Pillars of Root Cause Health. You cannot fix metabolic health without fixing the gut.
Organ meats expanded. Beef heart added for CoQ10. Liver stays at number 1 because nothing on earth matches 27 essential nutrients per 100 calories.
Every plant on the list is now flagged as low-oxalate or marked as "cooked to reduce antinutrients." Because dose and preparation matter more than the food itself.
You asked for this. I listened.
Your doctor spent 8 years in medical school. They received an average of 19.6 hours of nutrition education across all 8 years.
19.6 hours. On the single most important input to your metabolic health.
Then they entered a system where the food companies fund the research, the dietary guidelines, and the medical education. Where a cardiologist can prescribe a statin in 7 minutes but cannot tell you which foods lower your fasting insulin.
They are not bad doctors. They are products of a system that was never designed to teach them what actually makes people healthy.
You have to learn this yourself. This list is a starting point.
40 foods. Five tiers. Zero processed ingredients. Zero tribal allegiance.
Keto, paleo, carnivore, Mediterranean. Stop arguing about the label. Start eating from this list. Your fasting insulin, your inflammation, your gut, and your metabolic health will tell you what is working.
The science does not care what you call your diet. It cares what you put in your body.
The truth heals.
Co-founders, Neo | HealthTruth
Dr. Philip Ovadia, Cardiac Surgeon @ifixhearts
Dr. Aseem Malhotra, Cardiologist @DrAseemMalhotra
Dr. Robert Cywes, Metabolic Surgeon @carbaddictiondr
Prof. Tim Noakes, Head of Science @ProfTimNoakes
The healthy pyramid to reverse metabolic disease, type 2 diabetes, insulin resistance, obesity etc
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In 1985 two scientists won the Nobel Prize for proving something that should have changed medicine forever.
Brown and Goldstein showed that your immune system cannot even see normal LDL. Native LDL floats through your blood and your body ignores it. The scavenger receptor is locked. No recognition. No uptake. No disease.
But when LDL gets oxidized by inflammation, seed oils, high blood sugar, or cigarette smoke, everything changes. The scavenger receptor unlocks. Your macrophages recognize it as a threat. They engulf it. They swell. They become foam cells. And foam cells are what build the plaque inside your arteries.
That is not a theory. That is Nobel Prize winning science from 40 years ago.
The disease does not start with how much LDL you have. It starts with what damages it.
Yet here we are in 2026. Doctors are still measuring total LDL and prescribing drugs to lower it. Nobody is asking what oxidized it in the first place.
The Nobel Prize answered the question. Medicine ignored the answer.
For years I asked the same question. If my cholesterol was normal, why did my arteries fill with plaque?
The Nobel Prize answered that question in 1985. Heart disease is not caused by how much LDL you have. It is caused by oxidized LDL. When LDL gets damaged by inflammation, high blood sugar, or seed oils, your immune system attacks it. Foam cells form. Plaque builds.
But here is the part nobody talks about. Some people’s bodies protect their LDL from oxidation better than others. And the difference comes down to one enzyme you have never heard of.
It is called PON1. It sits on your HDL particles. Its only job is to prevent your LDL from being oxidized.
Some people have strong PON1. Their LDL stays clean. Protected. Their risk stays low even with higher LDL numbers.
Some people have weak PON1. A genetic variant they never knew about. Their LDL oxidizes faster. Plaque builds faster. And nobody ever tested for it.
Same LDL number on the lab report. Completely different outcome.
Here is the good news. PON1 activity is not fixed. Research shows polyphenol rich foods like olive oil, pomegranate, and berries boost PON1 activity. Smoking destroys it. Seed oils suppress it. Chronic inflammation weakens it.
Your genetics set your baseline. Your lifestyle determines whether it holds or collapses.
Your doctor counted the cars on the highway. They never checked which ones are on fire.
I spent 12 years under medical care before my heart attack. Seven blood panels. Every one flagged my LDL. Not one doctor tested my homocysteine.
Homocysteine is an amino acid that, when elevated, cracks the lining of your arteries and drives the oxidative stress that turns normal LDL into the oxidized form that causes heart disease. It is one of the most dangerous markers in cardiovascular science. And most doctors never order the test.
What controls your homocysteine? An enzyme called MTHFR.
When MTHFR works properly, it converts homocysteine into methionine. Cleanup happens. Arterial walls stay smooth. Oxidative stress stays low.
When MTHFR is impaired by a genetic variant, homocysteine builds up. It cracks the endothelium. It inflames the arterial wall. It creates the exact environment where LDL oxidation accelerates and plaque forms.
Up to 40% of people carry this variant. Most will never know. Their doctor will test their LDL, write a statin prescription, and never ask why their arteries are inflamed in the first place.
Here is what you can do about it. Methylated B vitamins, specifically methylfolate and methylcobalamin, support the MTHFR pathway even with the variant. Reducing processed food lowers homocysteine. So does managing stress, healing your gut, and eating nutrient dense whole foods.
A simple homocysteine blood test tells you whether your cleanup system is working. It costs almost nothing. Ask for it by name.
The gene loads the vulnerability. Your lifestyle decides whether it activates.
Every 4 seconds, someone on this planet dies of heart disease.
9.24 million people a year. More than every cancer combined. The number one killer in human history.
There is a test that can see this disease building inside your arteries years before it kills you. It costs $120. Takes 10 minutes. No needles. No contrast. No fasting.
Your doctor has never ordered it.
I had a heart attack at 52. I survived. I should not have. Twelve years under medical care. Seven blood panels. Every one flagged my cholesterol. Not one doctor ordered this scan.
What I am about to tell you will make you sick. 🧵
A CAC score of zero in a person over 40 has a 98% negative predictive value for coronary artery disease. That means if you score zero, there is near certainty you will not have a heart event in the next decade.
It is one of the most powerful findings in all of cardiology.
It also eliminates the justification for prescribing a statin.
87.5 million Americans are now statin eligible under the 2026 guidelines. If every one of them got a CAC scan first and scored zero, the prescription disappears. That is not a small revenue problem. That is a $30 billion a year problem.
Dirty secret number two. Statins increase CAC scores.
Multiple studies have shown that people on statins see their coronary calcium progress faster. The industry calls it "plaque stabilization." They say the drug calcifies the plaque to make it harder.
So the drug that is supposed to protect your heart makes the only direct measurement of heart disease look worse every year. And they call that progress.
(Saremi et al., Diabetes Care 2012)
(Puri et al., JACC 2015)
I posted a list of the 20 best foods on earth for metabolic health. Nobody argued about the meat.
They argued about the vegetables.
Spinach was the lightning rod. Broccoli drew fire. The replies were smart, passionate, and split right down the middle.
Half the audience said plants are essential. The other half said plants are poison.
They are both wrong. And they are both right. Here is why. 🧵
Plants are not trying to be eaten. They cannot run. They cannot fight. So they evolved chemical defenses. Oxalates. Lectins. Phytates. Goitrogens.
These are real compounds with real effects. They are not a myth. They are not a conspiracy. They are biology.
The question is not whether antinutrients exist. The question is whether they matter for you. And the answer depends on dose, preparation, and your individual biology.
That is root cause thinking. Not "plants good." Not "plants bad." Context.
Oxalates. The real issue nobody talks about.
Spinach is one of the highest oxalate foods on earth. 970mg per 100g. So are chard, beet greens, and almonds. In high doses, oxalates bind to calcium and form crystals. Those crystals can cause kidney stones, joint pain, and urinary symptoms.
One person in my replies said she spent decades with an overactive bladder. Her doctor told her it was because she was overweight. She found the real cause on X. It was oxalates. Nobody in the medical system ever mentioned it.
That is not a fringe case. That is a root cause failure.
I want you to look at this chart and tell me what you see.
20 years. Seven diseases. Every single line is going up.
Alzheimer's up 260%. Parkinson's up 150%. Fatty liver up 125%. Diabetes doubled. Obesity up 42%. Cancer up 16%. Heart disease went down then came right back up.
Trillions of dollars. The most expensive healthcare system in human history. And not a single metabolic disease is improving.
Something is causing all of them. The same something. And nobody is stopping it.
🧵
700,000 Americans die from heart disease every year. Number one killer for over 100 years.
Alzheimer's deaths up 134x since 1960. 38 million Americans have Type 2 diabetes. 96 million more are pre-diabetic. That is 134 million people. Almost half the adult population.
These numbers are not stabilizing. They are accelerating. In the richest country on earth.
The system is not failing by accident. It is failing because it is treating the wrong thing.
Life expectancy by region. 1984 to 2019. Pre-COVID.
The Northeast climbed to 80 years. The West to 79.5. The Midwest stalled and started declining. The South is going backwards. Mississippi is at 72.8 years.
7.2 year gap. Same country. Same healthcare system. Same FDA. Same guidelines.
The regions with the highest obesity and highest diabetes rates die the youngest. The gap is not closing. It is widening.
We are not getting healthier. We are dying earlier. Despite spending $4.5 trillion a year on healthcare.
I was on a tennis court in Darien, Connecticut. Tokoneke Tennis Club. My friend Mitch had called and asked if I wanted to hit some balls. I said yes the same way I had said yes to tennis a thousand times since I was six years old.
I grabbed my racket. Walked onto the court. Same optimism. Same stubbornness that had carried me from Johannesburg to Wimbledon to a world ranking of 117.
I was 52. I had everything. An amazing wife. Three incredible children. A successful business. I played competitive tennis multiple times a week. I was the fittest person in most rooms I walked into.
I was invincible.
For about ten more minutes.
One stroke. One forehand. Maybe a backhand. I do not even remember which. Mitch and I had barely warmed up.
And I could not breathe.
Not the way you get breathless after a long rally. Not the kind where you bend over and recover in thirty seconds. This was my body refusing to give me air. Like someone had put a hand over my mouth and nose and was not letting go.
I sat down on the bench. The sun was out. The courts were quiet. I waited for it to pass.
It did not pass.
There was a pressure in my stomach. Not pain exactly. Like acid reflux. Something sitting there that should not be there. I had played thousands of matches in my life, on courts all over the world, and I had never felt anything like this.
I did what every person my age does. I pulled out my phone and Googled my symptoms.
My daughter Rebecca needed to be picked up from soccer practice. That is how normal this day was supposed to be. Tennis with Mitch. Pick up Rebecca. Go home. Have dinner.
So I drove to the soccer field. Still not breathing right. Still feeling the pressure. I picked her up and I did not say a word to her in the car.
You do not want to cause alarm when you are not sure what is going on. You are her father and you are supposed to be the one who is okay. So you say nothing and you drive and you breathe as quietly as you can while your daughter talks about her day.
I got home. I told Melanie. She looked at me the way a wife looks at her husband when she knows something is wrong before he finishes the sentence.
The three companies that control 80% of every prescription in America made 1.1 trillion dollars last year.
That is bigger than the entire economy of Switzerland. Or Poland. Or Sweden.
And here is what almost nobody knows. They own every step of your prescription. Let me show you the machine.
Look at this.
CVS owns Aetna the insurer, Caremark the middleman, and CVS Pharmacy. UnitedHealth owns UnitedHealthcare, OptumRx, and Optum Pharmacy. Cigna owns Cigna Healthcare, Express Scripts, and Accredo.
The company that insures you owns the middleman that prices your drug and owns the pharmacy that sells it to you. Every layer profits. Except you.
Meet the PBMs. Pharmacy Benefit Managers. The most powerful companies you have never heard of.
They decide which drugs your insurance covers, what you pay, and which pharmacy you use.
When your insurer negotiates drug prices, it is negotiating with a middleman it owns, who steers you to a pharmacy it also owns. They are not negotiating for you. They are negotiating with themselves.