The Meat Mafia Podcast

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0:00:03 - Speaker 1
Should we hit it? Let's do it One clap yeah.

0:00:05 - Speaker 2
Yeah, we got cholesterol wrong for 60 years. Where was the apology? We got hormone replacement therapy wrong for 22 years, saying it causes breast cancer, when it doesn't. Where's the apology? We got opioids wrong for 35 years, saying it was not addictive, igniting the opioid crisis. We got peanut allergies wrong for 17 years, telling moms to avoid peanut products for their kids that were young because that would prevent peanut allergies. They got it backwards it causes peanut allergies. Where was the apology?

0:00:36 - Speaker 3
Dr McCary, welcome to the Meat Mafia podcast.

0:00:38 - Speaker 2
Good to be with you, Harry.

0:00:39 - Speaker 3
When you were studying at Harvard, did you ever imagine you would be on a podcast called the Meat Mafia Podcast? I never pictured.

0:00:46 - Speaker 2
I'd be on Meat Mafia. Now we're in Texas. Yeah, I'm unarmed. I just want you to know here, I know it's the Meat Mafia but I'm unarmed.

0:00:57 - Speaker 3
Yeah, we treat our kind well here, even though we have the mafia in our title. We you know.

0:01:03 - Speaker 2
I'm protected. Yeah, you're good, you're good.

0:01:06 - Speaker 3
You're one of us, no, but we're really excited to have you on the show today, connected through our mutual friend, Will Will Bruhn. Yeah, really appreciate the connection, and getting to dive into your work a little bit more has been really enlightening and refreshing, hearing a lot of the topics that you talk about, so really excited to dive into this one.

0:01:27 - Speaker 2
Thanks for having me. It's good to be here.

0:01:28 - Speaker 3
Yeah, so you recently wrote the book Blind Spots, which we'll get into, but I think, just as a starting point for our audience, I would love to just capture through your eyes how you see and view the healthcare system, the medical system, right now, in this moment in time. Where's the trust levels? How do you view the system in terms of how it's functioning, how it's not functioning well? I'd love just your high-level picture of the system.

0:02:01 - Speaker 2
Well, the system attracts really good people, but it is entirely broken. It's stagnant. It's got incremental steps in research that really have not delivered for us. You look at the tens of billions of dollars we spend on cancer. What have we gotten for it? A very low ROI. Chronic diseases are going up.

We don't talk about food as medicine, self-awareness, communication skills, listening to patients. The sort of person that goes into healthcare is an incredible person, sort of kid in high school that is asked hey, what are you going to go into? And they say thinking about being a nurse. They're different from their peers, every single human being in the healthcare world, hospital administrators, everyone is in it for one reason out of a sense of compassion. They want to help other people in need or they want to contribute to that idea.

I think we take these creative, bright, altruistic young people and the culture of medicine, through its training and its own norms and values, beats them down and turns some of them into robots, burns them out, where you're told to kind of bill and code for everything as a doctor and you get on this hamster wheel and you sort of lose sight of the essay that you wrote to get into med school, where probably those essays, and I'm at the Johns Hopkins Medical School. Of the students that come in, 90% want to do medical missions either as full-time, which is a small fraction, or most want to do it in some part of their career or practice. And a lot of that great vision, that mission of why we go into medicine, gets beat out of us by the system. How?

0:04:13 - Speaker 3
do you so? You're a professor at Johns Hopkins as well. How do you teach that to your students as they're entering? Because I imagine the students who are walking through your door are bright-eyed, bushy-tailed, ready to take on the world and still haven't really fully seen the inside of the beast of what the medical system really looks like it's a beast yeah. So how do you teach that to them, knowing what the system is?

0:04:39 - Speaker 2
So there are great mentors in medicine. There are great professors at Johns Hopkins that they should be learning from. Mentors in medicine, they're great professors at Johns Hopkins that they should be learning from. But I think they come in with the big ideas but we kind of tell them well, you have to pick an organ. Here's the anatomy textbook. Here's a picture of all the organs in the body in the Frank Netter Atlas. Pick which organ is going to be your organ, because you have to have one for your life.

And it's like that's not really a great message. What if you're interested in the whole person? What if you're interested in how we deliver care? How broken it is that we have this model where people come in and we tell them eat better, exercise more? We don't even tell them how to eat better. We give them misinformation and then come back in six months with these medications and check back in. And then they come back in in six months and we tell them you're a bad, bad, noncompliant patient and it's like this system's broken. The patients hate it, we hate it. We're doing short, 15-minute visits Now I'm a surgeon so it's a little different.

But this whole primary care interface now has a revolution where doctors are saying I don't want to be on that hamster wheel. I want to go deep. I want to understand things that we're not taught, like the role of general body inflammation, the role of toxins, environmental exposures that cause cancer, not just the chemo to treat it. There's a generation of students and doctors out there right now that cause cancer, not just the chemo to treat it. There's a generation of students and doctors out there right now that are saying can we treat more diabetes with cooking classes than just throwing insulin at people.

Can we treat more high blood pressure with talking about sleep quality and stress management instead of just throwing first line hypertensive after second line? Can we treat more back pain with ice and physical therapy, not just surgery and opioids? Can we talk about food as medicine? Can we not just talk about treating kids with Ozepic? Can we finally talk about school lunches? This is a revolution in medicine. That makes me very optimistic and it's what I describe in the book Blind Spots. It's an effort to say we've got the most medicalized generation in the history of the world, we've got to try something different.

0:06:56 - Speaker 3
When do you think people started waking up to this revolutionary idea that we need to really create some change here in the medical system?

0:07:02 - Speaker 2
I mean, I think you look at the graphs of chronic diseases and you're like we're doing all this stuff. Healthcare is now the largest business in America, bigger than any other sector. What are we doing? I mean, we're not exporting anything really in this sector. We're providing services on our own people. We've got everyone on. You know, the average American is on four meds, the average senior is on more than six.

Chronic diseases are getting worse and yet we've got these blind spots, these things we never talk about food, general body inflammation, the whole lipoprotein world. We've created this simple moniker of HDL is good, cholesterol LDL is bad. Well, it's much more complicated than that and we can be teaching those basic principles in a way that people can understand them. For example, everybody should get an LP little a test. Everybody should get an APO protein B. I would say if they're over 30, you should get an LP little a test. Everybody should get an APO protein B. I would say if they're over 30, you should get an APO protein B, lp little a. You can get it anytime, but next time you get a blood test. Those are two tests that are very good, or at least better predictors of heart disease than all the other stuff we've been testing for.

0:08:21 - Speaker 3
It's so interesting. I feel like a lot of people have woken up, especially in the past several years, to and maybe COVID gets some credit for it but just a shift in thinking has happened a long time. Teaching, practicing are hitting the pause button and saying, hey, are we really doing what's best for our patients here by prescribing away every single illness, or should we be focusing more on the preventative side, which is something you talk about in the book quite extensively? It's layered in there. So I'm curious how do you think about starting to make some of those changes and reorienting the system?

0:09:11 - Speaker 2
It's tough, but enough docs and healthcare folks and people adjacent to healthcare professionals people like yourself podcasters are out there now saying, hey, wait a minute. We're converting America's children into a generation of patients. We're assigning diagnoses to them that are just part of ordinary life. If you're nervous before taking a test as a kid, why would you tell that kid you have anxiety? Like assign them a chronic disease. It's a good sign.

0:09:44 - Speaker 3
I've noticed that every time when I feel nervous, it's a sign that I'm being pushed into some, you know being pushed. I think obviously it's one example of anxiety, but I think it's a good thing.

0:09:54 - Speaker 2
Yeah, I mean there are, you know, boundaries of what's normal, and there can be extremes Used to have sort of extremes, extremes in patient presentations and childhood mental health presentations where you'd say, yeah, this is clearly a disorder. But now these diagnoses are getting slapped around like crazy. Sometimes it can become a self-fulfilling prophecy. And so who's going to blow the whistle and say, hey, wait a minute, we're soon going to have every six-year-old in America on three medications. Somebody has got to say stop. Is pharma going to fund the research? To say, hey, what's? How can we promote communities to address depression instead of throwing antidepressants at people? By the way, I noticed your mic is drifting.

0:10:49 - Speaker 3
Is that creating?

0:10:49 - Speaker 2
anxiety for you.

0:10:51 - Speaker 3
A little bit. I've got to keep the hand there to support it. I'm curious have you studied much of the medical history around when things started to change? Because there were certain points in time where we weren't as sick, where chronic diseases were not as common. So when did things start to change?

0:11:13 - Speaker 2
So it's fascinating. I did study this and wrote about it a little bit in the book Blind Spots, because modern medicine has huge blind spots and my interest, my research team at Johns Hopkins and my interest, my research team at Johns Hopkins the book Blind Spots has always focused on the big topics in medicine that we are not talking about, that we should be talking about and there's a lot of them and we've mentioned some. But this whole modern era of sort of the unquestioned authority of physicians, what we call the white coat era of medicine, started after World War II Because before then we didn't really have a lot we could do as doctors. When we had a lancet, you know, we'd like take some of your blood out by inducing a cut and just try to bleed people thinking their bad humors were getting rid of them. They did that to George Washington as he was dying. They had a lance, said okay, well you're having trouble bleeding, he's got pneumonia.

Let's cut him, let's some. You know half a pint out, I'll take another pint out. Like that was like the only intervention doctors had beyond having an axe to do an amputation and a saw. And what made you a great surgeon is how fast you could do it. Because this is medicine for like most of the world's history. Now there were a couple one-offs. They discovered digoxin could help with heart failure. It wasn't used very well. They didn't know the dose. They figured out what caused scurvy when they did the first ever randomized trial where they had some sailors eat orange peels and lemon peels, other sailors had to drink vinegar, others drank seawater. They had like a six-arm clinical trial and the scurvy, which killed at least 2 million people, it's estimated, crossing the Atlantic and other long voyages. They figured it out. Now, as is typical in the history of medicine, it took like 40 years for it to become widely accepted. But we had a couple level of respect and authority, as, say, a barber or somebody that pulled your teeth. Matter of fact, barbers and surgeons had the same title.

They were called barber surgeons in the UK. And so what happened was in 1922, alexander Fleming discovered penicillin. Someone he or his lab assistant, we don't know who left the window open in his lab and a mold blew in and it was penicillin and it landed on one of the auger gels on the Petri dish and killed the bacteria around it in a circumferential fashion, where every spot of the penicillin mold had landed. And it was probably many consider the greatest discovery in the history of medicine. And that revolutionized things, because now we had the mass production after World War II of antibiotics. Doctors now wore a white coat and they had the power to prescribe and control who got this magical pill. It ushered in the white coat era. Around the same time there was technology in US hospitals. Hospitals went from being kind of like a church, like a safe haven where people would go and recover and get bandages and nursing care. Now they had an iron lung machine, incubators for newborns. It's like a factory it was. People were mesmerized by this technology and so you had this rise where doctors would have this unquestioned authority. They wore white coats.

To get into medical school you had to go to one of the elite schools that didn't even teach pre-med. But it was an elitist culture. It was all white men for the most part. I think this medical school I went to accepted graduated its first woman in the 1970s. Wow, very few African-Americans. And so you had this. Believe it or not, the New England Journal of Medicine had one African-American editor out of 51 just a couple years ago. Wow, a couple years ago. So it was very much this cronyistic inside. But good people went into medicine and they did good things and good stuff happened. But they would sort of hold people forever. They would hold newborn babies born normally they're born at term, they're not premature and they would hold them in the hospital in the 1950s and 60s for an average of 10 days and then it drifted down to three days by the 1970s. I remember my little sister was born in the 1980s and I asked her, I would ask my mom and dad, like when?

is our new sister coming home from the hospital. Well, the doctors haven't released her yet. It's like what are they doing? They're like poking and prying and feeding her formula milk and like it was the medicalization of ordinary life and it was a pendulum that had swung on the side of medical intervention and observation because infant mortality and maternal death had been so horrific and so epidemic for all of human history, up until the advent of antibiotics, for all of human history, up until the advent of antibiotics. So for the first time we were intervening and we swung on the side of over-intervening.

And even in the last 10 years we're now recognizing babies need to be breastfed early. As soon as you know, in the golden hour colostrum we call it is some of the best time for them to receive early feeding. The importance of breastfeeding, the impact on the microbiome, avoiding C-sections when they're unnecessary. That alters the microbiome. Delayed cord clamping 90 seconds is better than 45 seconds in a randomized trial. Skin-to-skin time have the mom hold the baby for hours safely and moms are often exhausted. Some hospitals even now have coaches help just to ensure they're holding the baby safely. But that's the best incubator and there's all kinds of better outcomes we're now rediscovering by going back to sort of the ancient ways of having the moms embrace the babies early.

0:17:37 - Speaker 3
Yeah it's crazy hearing you talk about the changes that have happened and just the standards that we go by now, where you leave the hospital and your baby is there with the doctors and it feels very inhuman or dehumanizing thinking that a mother can't be holding her baby, which has happened throughout all of human history.

0:17:59 - Speaker 2
I mean my nephew was. This is just 11 years ago, 12 years ago, the second he was born. They whisked him away to the neonatal ICU. Now look, antibiotics save lives and sometimes are necessary C-sections save lives, nicus save lives, but there has been overuse described with all of those. And in his case the kid was fine. They said, oh, we have to take him to the NICU because he's having difficulty transitioning. I'm like well, what's that mean exactly? Is that like a blanket term? You slap on everybody? Well, his bilirubin is a little bit borderline. I'm like well, what's that mean exactly? Is that like a blanket term? You slap on everybody? Well, his Billy Rubin is a little bit borderline. I'm like, okay, I'm a doctor, tell me what his Billy Rubin is. They gave me the number. I'm like he's fine. Well, we need to keep him in the. They kept him for three days. He didn't breastfeed, he didn't have. There's something magical about the bonding early on.

0:18:53 - Speaker 3
Yeah, the nurturing effect, the development is happening immediately of a child. You know, when they enter the world, the love they get right out of the womb is something I believe probably stays with them for a while you know, that's an important moment in that child's life, even though it's a short period of time.

0:19:15 - Speaker 2
There's even been research on delayed cord clamping when you know there's no need to clamp and cut the cord the second the baby comes out, and I remember getting the scissors when I was a student. And they're like here, cut the cord the second, you see it, and we clamp it. So it's a little chaotic in there. You know all it's loud and you know there it is and they put the clamps, cut it, you know, and it's like it's cut it and I'm like what are we doing?

Like the cord was pulsating, healthy oxygen, stem cells, fetal hemoglobin, warm blood to keep the baby warm, a warm infusion instead of, you know, cutting it and taking the baby under some French fry light in the corner. Yeah, so they've done. I was going to say they've done studies. Delayed cord clamping actually results in a different myelination of the brain later in life. Wow, there's a study that just came out. I mentioned it in the book Blind Spots.

0:20:11 - Speaker 3
It's really interesting, because my Neanderthal brain is just like. It makes so much sense to delay that. That baby was relying fully on that cord for its sustenance and development for nine months prior to entering the world. Why would you just immediately cut that? It seems like there would be some utility for it to stay on for a period of time before they start nursing from their mother.

0:20:40 - Speaker 2
There's a Dr Arpi Shrivulu here in Texas who I interviewed. She's a real pioneer in the field. She had noticed back in India, where she's from, they didn't have enough NICU beds and they would have the moms hold the babies as their own NICU. And look again, nicu saved lives and I don't want people to resist a NICU for a baby that needs it. But she's implemented this protocol at her hospital and she's seen tremendous results. She's seen tremendous results and on the delayed cord clamping piece she's instituted it as a policy and she said she's seen babies with better blood pressure, better heart rate, more normal heart rate and even more normal glucose levels when a mom holds a baby. Now you think, well, how's the glucose more normal when a mom holds a baby? Wow, and you think, well, how's a glucose more normal? Well, there's less spike in the stress hormones of the body of the baby which affect the glucose level.

What I was going to say is that lifeline of the cord in the first minute or two that provides sufficient oxygen with the fetal hemoglobin where the baby doesn't need all the medical interventions we were doing to babies in the first minute of life. She'll even argue you know, premature babies didn't need to be routinely intubated, have a tube put in for artificial breathing into their lungs immediately and give them high oxygen in the first minute. She says in a beautiful way give the baby a minute to breathe because the baby is getting oxygen through the umbilical cord. Give the baby a minute and the baby will. So she's a very high-level neonatal ICU doctor. I mean as sophisticated in all the modern might of medical technology and science. She is a fellowship trained neonatal ICU specialist and she teaches these residents Babies are born a little premature.

You don't need to like intubate and throw antibiotics blindly and do all these interventions. Give the baby a minute to breathe and let that cord pulsate.

0:22:57 - Speaker 3
And she's based out of India.

0:22:58 - Speaker 2
You said no, she's originally from India but she's in Baylor Scott and White in McKinney, texas. An incredible woman has done a lot of research, I think from her observations overseas, and a lot of research that had come out of doctors doing things differently in the US in the last 30 years. Now there's great research on delayed cord clamping, skin-to-skin time, what they call kangaroo care, avoiding C-sections when possible and how the C-sections alter the microbiome, which is fascinating and I met with the head were you going to say, yeah, I was just going to say I'm curious to dive into that because I feel like that's something that's not often talked about.

0:23:38 - Speaker 3
It's just the microbiome is our immune system center, essentially, and the fact that a C-section which, as a kid, you don't have a choice on, that decision, necessarily it's your parents' decision, but it could massively affect your ability to defend yourself for your entire life, I imagine.

0:23:56 - Speaker 2
Yeah, and I assume your listeners are familiar with the microbiome, but, briefly, it's millions of different bacteria and some other organisms that line the GI tract that are involved in digestion. We're just starting to understand how sophisticated it is. It is training the immune system, producing certain vitamins. It even makes GLP-1, the active ingredient in Ozempic. At low levels can regulate estrogen a little bit and produce serotonin, which is involved in mood and how you feel, and so there's a brain-gut access that we clearly now have a mechanism to explain. And there's a hospital now, shepherd Pratt Medical Center, where they actually are giving a probiotic to treat bipolar. And so there's some amazing new research.

I learned writing the book Blindspots, but the head of the microbiome unit at the NIH I met with her interviewer for the book. It's amazing. There's not enough research on this, but the people doing it are discovering amazing things. She said when a baby is born, when a baby's in utero, the gut is sterile. There's no bacteria in there. So what forms the microbiome early in life is the bacteria from the vaginal birth canal will seed the baby's microbiome, augmented by the colostrum, the early breast milk, skin kisses from grandparents, and that forms a child's microbiome that then blossoms and becomes a garden of different bacteria that live in an equilibrium, blossoms and becomes a garden of different bacteria that live in an equilibrium.

But when a baby is born by C-section, they're extracted from a sterile operating field and what seeds their gut can be the bacteria that normally live in the hospital. And so that's her description of it. It was an incredible description and it does now offer a mechanism why a paper published in JAMA Surgery earlier this year found that children born by C-section were more likely to go on to have colon cancer before age 50. You know, there's a rise in colon cancer before age 50, suggesting there may be a role for the microbiome. Again, c-sections save lives and if the doctor says it's important and must be done, I'd say do it. But the idea that you know, oh, let's pick a day for your C-section, just because it doesn't matter how you deliver a baby and you know, hey, here's grandmother's birthday, let's pick that day to deliver, or the doc's going on vacation, so let's do it before the doc it does matter. It matters not only for the mom but for the baby.

0:26:43 - Speaker 3
It's so interesting and it's a decision that I feel like is often put in the hands of the doctors. For the most part, the parents and the mother can probably want to have a vaginal birth, but for the most part, it's under the discretion of the informed white coat who's telling them what they should and shouldn't do.

0:27:17 - Speaker 2
I truly respect and whatever they say, I've just learned about their judgment and skill and their empathy and their ethics. I would do 100% whatever they say, but I know them. If you don't know them, I don't know what to suggest. But it is known out there that we have our nudges in medicine that get people to do what we may want them to do, regardless. If that's what's best for them, it may be best for us. Again, most doctors do the right thing, or always try to, but it's known if you want to do a knee replacement on somebody who doesn't need a knee replacement, you tell them you've got bone on bone. That's the nudge. Well, heck, if it's bone on bone, I need to get replaced.

For a woman in labor. You tell a woman in labor anywhere in the world that a C-section might be safer for the baby, 100% of them are going to say, well, do it. And so there are times when there's manipulation. There's a great service now called UMA which is almost like a remote second opinion that they'll follow you through the entire pregnancy, and employers are using this service. Now. People get second opinions. There's reputations of OBs that are midwives that do things, have good judgment, yeah.

0:28:33 - Speaker 3
How do you reconcile the incentives in health care? So someone needs a bone-on-bone knee replacement. It's more expensive to get the surgery. The person doesn't necessarily need it. How do we kind of like unpack and pull apart the incentives in health care to the point where it isn't necessarily just like the ethics and morals of the doctors, because I think good people can be corrupted by the right amount of money. I think that is definitely true. So I'm curious just the incentives in healthcare. How do we start to fix some of the issues that are misdirecting people?

0:29:15 - Speaker 2
Well, to be honest, a lot of health care people don't like these perverse incentives that lure us. When I started off as a surgeon at Johns Hopkins, I was told here we want you to do X number of operations per month and I'm like, ok, well, I got my clinic. I mean, whoever comes in and needs surgery, I'm going to recommend it. And if they don't need surgery.

I'm not going to recommend it because you've got some target and we started getting into these little sort of kerfuffles. So there are incentives and some people are going to respond when those incentives are massive. Then you add physician burnout, which is driven by a number of things. They're more likely to respond. We uncovered in not this book, blind Spots, but a previous book about five years ago called the Price we Pay. I uncovered this practice of doctors putting in stents unnecessarily in leg arteries. Wow, and they had these mills, leg arteries and they had these mills.

The opioid epidemic was one little peak into our over-treatment crisis. In medicine we have a crisis of appropriateness. Now there's some efforts to curb that. There's a lot of doctors that are saying I'm not going to get on that hamster wheel of you whipping me every month about what my numbers are and how many RVUs I've built and a pilot doesn't fly a plane and then land the plane and my numbers are and how many RVUs I've billed and a pilot doesn't fly a plane and then land the plane and code the complexity and how many work units and issue a bill. A lot of doctors are saying screw that, I don't want anything to do with that. A lot of our young medical students are like you can take your broken health care system. I'm going to have a subscription service or I'm going to work with employers where patients don't have to pay anything. Their employer pays. I'm going to deliver high quality care. I'm going to spend time with people.

I'm going to talk about food and inflammation and activity and exercise and what's in your fridge at home, and so I'm optimistic. Good stuff is happening and the microbiome is. There's some incredible study on that. Can I pull that up for?

0:31:24 - Speaker 3
you, yeah, absolutely.

0:31:25 - Speaker 2
I don't want to change. The Biggest study in my opinion in the last 10 years in modern medicine got almost no attention. It's done by the Mayo Clinic along with this guy, marty Blazer, who I think is the world expert on the microbiome. I interviewed him for the book Blindspots and they took kids who had received antibiotics in the first two years of life and compared them to kids that were roughly matched to children who did not receive antibiotics in the first two years of life and compared them to kids that were roughly matched to children who did not receive antibiotics in the first two years of life. And in this study of about 14,000 kids they found that kids who took antibiotics, which are known to sort of carpet, bomb the microbiome, especially in the first couple years of life when the microbiome is forming.

That kids who took antibiotics in the first two years of life had a 20% higher rate of obesity, 21% higher rate of learning disabilities, 32% higher rate of attention deficit disorder, 90% increased incidence of asthma and a 289% increased risk of celiac. Wow, something is happening. All these chronic diseases are going up in the modern era of antibiotics. I'm not saying 100%, it was cause and effect, but this is a signal in the data and the kicker in the study the more courses of antibiotics you took as a child, the greater the likelihood of these chronic diseases. Wow, wow.

0:32:56 - Speaker 3
Wow. So do you see antibiotics? There's obviously some miraculous discovery. That happened with Fleming and penicillin and the use of antibiotics has saved lives. But where we're at now, how can we use this technology for what it is? It can be helpful, but also understand that there are two sides to this coin. Where we're what did you say? Nuking the?

0:33:24 - Speaker 2
microbiome Carpet bombing the microbiome yeah.

Yeah, and then you get overgrowth of some bacteria like maybe the more pro-inflammatory bacteria can overgrow. We've seen in adults they take a little simple amoxicillin for some dumb thing, maybe where they didn't need to take it, and then their C diff bacteria, which is a type of bacteria in their colon, will overgrow. After that bacteria kills some and cause C diff colitis. People die from it. Some and cause C diff colitis. People die from it. There's like 30,000 deaths a year of people dying from this overgrowth of C diff after taking a simple antibiotic. And the irony is the latest treatment that medicine has discovered is that you can actually give these people with C diff colitis bacteria an enema or a pill and that will actually restore. It's essentially a probiotic and we used to operate and take out the colon when it was infected because no antibiotic would work on it Again. Antibiotics save lives, but 60% that are prescribed are unnecessary, according to a study.

And Alexander Fleming himself, the guy who discovered Pilsner, after he got the Nobel Prize in the 1940s, he issued a stern warning, which has been largely forgotten, about the overuse of antibiotics, breeding resistance, causing overgrowth and having effects that we may not understand. One of those effects may be altering the microbiome and inducing chronic diseases. So you add all these modern things overuse of C-sections, overuse of antibiotics, people coming in with recurrent little infections in childhood and they get just antibiotics thrown at them. What are we doing to the microbiome? Get just antibiotics thrown at them? What are we doing to the microbiome? That's a question no one has ever asked because we didn't know about the role of the microbiome. So people were living with this dogma in modern medicine that oh, it's antibiotics, you might as well just take them. Probably not going to help, but they won't hurt you Well actually they were learning a lot about what it does, the microbiome.

0:35:36 - Speaker 3
I feel like we've gotten to the point where we're sterilizing a lot of. We're living in a very sterilized world where a lot of people are afraid of germs, just think germs are bad, and they don't even realize that there's good bacteria out there that can promote health and longevity and your immune system. So I feel like there is this turning point in understanding what bacteria is. But do you feel like that is something that we've missed? Just understanding what bacteria is and its role within the body?

0:36:05 - Speaker 2
Great question. I think we have not been able to study the microbiome, because how do you study a billion different bacteria, a billion different bacteria? Dna genetic sequencing, done rapidly, has enabled us to do that research relatively recently. So for the first time now we can take a sample of bacteria from the gut and say here are the 100,000 different bacteria by their genome, and then we can go back and describe them. And there's now research at Harvard where they're saying oh, you've got an allergy. It may be because you're low in this one type of bacteria and we're going to try to supplement now with that bacteria.

Right now probiotics are very hard to navigate because the popular ones are the ones with the best marketing and they come and go and the research can't keep up and the old belts and suspenders. Professors at the NIH are not funding research on probiotics very much. There's a little microbiome center and there's no place in medical school where people are talking about the microbiome or even nutrition. You get more training in pronouns.

0:37:19 - Speaker 3
That's crazy. Yeah, what's the average? The average medical student gets about four hours of nutrition training or something like that.

0:37:28 - Speaker 2
I just talked to our buddy Will Bruhn, who, as you know, graduated from Oklahoma University Medical School recently, and he said that he got two hours of nutrition education. And even that, he said, was not really that accurate, it was more the old school it was. Like, you know, the whole field of nutrition has been a corrupted science historically Food industry telling the universities what to teach? The low-fat diet, the avoid fat. You know meat causes all these chronic diseases, don't distinguish good meat from healthy meats. So maybe it's better if they taught zero, in his opinion, in med school, because it was like misinformation.

0:38:10 - Speaker 3
Right, that's so interesting. Do you feel like most people going through the schooling system are getting quality information? Because, the way you Do, you feel like most people going through the schooling system are getting quality information. Because the way you were describing earlier is, you know, most people are specializing to the degree where they're understanding one function of one organ within the body but not seeing the full picture. And our bodies are this intricate system of you know. All things are connected, so you really do need to understand the nature of the balance between each of the organs. So, yeah, is there like, do you think the specialization is a problem there in how people are being educated to prescribe and treat people?

0:38:50 - Speaker 2
Yeah, you've got these silos at the NIH where you know, if you want to do research, you've got a kidney branch, you've got a cancer branch. Well, what if you want to study the microbiome which crosses all specialties? The Mayo Clinic researchers that published that big bombshell study that no one noticed in the medical field published it in their own internal Mayo Clinic journal Amazing study 14,000 folks in the study and I wondered why did you publish it in the Mayo Clinic? Now, they didn't give me a straight answer, but it's pretty obvious.

The big legacy medical journals didn't they maybe found it too disruptive of an idea. They may have been worried about people saying, hey, this is a real thing. About what people being, you know, saying hey, this is a real thing and it has no specialty. What specialty is the microbiome? Is it gastroenterology? Is it infectious diseases? Is it neonatology? Is it OB? Is it general medicine? Is it internal? So it has no home and we've created these silos and what's happened is we've gotten these blind spots in medicine because it just didn't fit our historic silos. Now, because doctors many of them are smart people and medical students are smart people, they're smart enough to know that when they're being forced to memorize the names of all these useless enzymes or I shouldn't say useless the memorization of them is useless. Being aware of the Krebs cycle is important. You don't have to know the names of the 32 intermediate molecules in the trauma bay when we're taking care of people. We have phones now. You can look it up.

But they keep beating these students down with this rote memorization. They're smart enough to know we're not getting the full picture. We're not talking about menopause. We're not talking about which 100% of women that are in their 40s or 50s will go through. That's like half the population. We don't talk about it in med school. We don't talk about the microbiome. We don't talk about nutrition and the little we get seems to fly in the face of what they hear elsewhere. So they're learning from the Dr Peter Attias, of the world he was with us at Johns Hopkins, a friend of mine and they're realizing our medical education isn't complete. I think I was listening to Z-Dog. Do you know Z-Dog? No.

He's a doc, he has a podcast that's widely heard in the medical field, among health professionals, and he was talking I think he was talking to Peter Attia and Attia tries to articulate. You know, like half of what we learn in medical school is kind of half-baked and half is kind of like maybe outdated and ZDogg jumps in and he goes so it's 100 percent bullshit. And I don't think that's true. We got good people in the system.

But it is an outdated system and medical education is outdated for a simple reason All medical school curricula are controlled by one small private company with a small group of people making the decisions on how every doctor needs to be trained. It's called the AAMC, the American Association of Medical Colleges. And then I think a centralized authority in medicine or in society is not healthy for civil discourse and that's not healthy for science.

0:42:14 - Speaker 3
Yeah, yeah. There's no open conversation around. How are we actually going about teaching this curriculum to the next generation of medical minds? Yeah. The centralization of all these systems. You could take just the education system in general, you could take the agricultural system. The concentration of power is truly an underlying issue in all of them.

And you see how a lot of agendas get pushed through just through the centralization of these institutions that really just keep the control and the information institutions that really just keep the control and the information. I'm curious if you were given the power to, how would you go about fixing the schooling system that seems to be? I'm not sure if it's. It seems like it's probably the most upstream problem we have is how we're educating our next generation of doctors.

0:43:11 - Speaker 2
Well, I will say this To their credit these sort of medical power elites in the central authority that drive me crazy and drove me crazy during COVID, they are, I will say, well-intended, they love this country, they want to do what's right, but they are living in a bubble and they develop blind spots. And COVID was kind of a little peek into how it works with the centralized authority Everyone stay on one message crush the dissent censor through these new channels of social media, anyone veering and suggesting that a six-year-old girl doesn't need six vaccine doses. That was a little peek into how the medical establishment operates and it is with good intention. But there's this bandwagon effect and then dogma takes on a life of its own and then it's how could you dare disagree with the experts? It's like well, you know what Any trained scientist with credentials is entitled to be a part of this conversation.

And when Obama ran for president the first time, he was asked what is your favorite book? And he gave a brilliant answer. He said Team of Rivals, which is a book about how Lincoln would invite people who opposed him, even ran against him, to be on his cabinet and be a part of his sort of the civil discourse, of his decisions. He wanted to be surrounded by people who challenged his assumptions and his beliefs to be better. And in science, just like in government, we need that sort of civil discourse, with the echo chambers of media and social media and everything else.

Now we have a very polarized society and the irony is there's so much that we can agree on. There's so much broken about healthcare, where there's broad consensus. There's so much broken about society, where we should have broad consensus in government. One of the biggest problems in government is a problem where there's broad consensus. In America. We don't talk a lot about it, but it's corruption. Who's for corruption? No one. These are broad but we're almost distracted and pitted against one another, and I think there's actually broad consensus on some common sense things we need to do in health care.

0:45:41 - Speaker 3
Yeah, do you think that our existing system can drive that change forward? Like, is there enough momentum here to start? Like the system in a lot of ways is captured by corporations and like you're saying so. Like is there enough momentum to create some change here?

0:46:08 - Speaker 2
I guess I'm still a believer in democracy and transparency and the other values that are instilled in a democracy, and I think just in my little microcosm of medicine and health care, we're seeing enough people rise up to say, hey, we can do better and we should be talking about these issues. And look at our investment in cancer research. It's giving us a pretty poor return and American Heart Association, out of all places now, is funding an initiative on food as medicine. So this is the group that was out there selling the healthy heart seal if you had low-fat foods on your menu as a mom-and-pop Italian restaurant, and they're making millions from this false dogma and perpetuating the marketing of the low-cholesterol diet. Cholesterol in your diet is not even absorbed in your body for the most part. It's hysterified. It's like 20% gets absorbed At best.

I think it's more like 10% from the experts that I've talked to in this field. Ninety-nine percent of your body's cholesterol is made by your body Right, so this whole push low cholesterol, avoid this. I'd love to have a lobster, but it's high in cholesterol. It's like the greatest perpetrator of misinformation has been the United States government. In healthcare, I mean food, the food pyramid, what we've lived through in the last couple of years.

0:47:43 - Speaker 3
Yeah, we're losing a lot of the nuance which I feel like people are getting more engaged with trying to understand the nuance in some of these arguments getting more engaged with trying to understand the nuance in some of these arguments. But it's like food in general, we just blanket say that you know, these foods are bad, these foods are good. Well, how are they raised? What did the process of making that food actually look like? You know, if you sit there and have a piece of broccoli or one of the like, what do you call the farms? Now that they raise, they'll raise plants in, and it's not even planting these plants in the soil, it's in like a warehouse under some LED light.

And they have like 10 percent of the nutrients that you would get from the plants that are planted in the ground. It's a totally different. It's not even the same comparison. The plants that are planted in the ground? It's a totally different. It's not even the same comparison. Same thing with meat. If it's a cow that's raised on pasture, that's lived its whole life in a field and able to eat what it's supposed to eat, which is grass, you're getting a totally different product than a cow that's in a feedlot eating grains and becoming sick. So the nuance there is. We can't just think about these things as meat is meat and broccoli is broccoli. There's so much more to it.

0:48:58 - Speaker 2
Well, that's why I appreciate you and all the folks out there trying to raise awareness about healthy foods, true foods. We're rediscovering in medicine, through complicated, expensive research studies, the ancient biblical principles of eat whole foods, clean meats, meditation is good for your health and fasting has some benefits. It's like we're rediscovering like, oh, did you hear this new study?

0:49:25 - Speaker 3
Yeah, okay, it's in the Old Testament. Yeah, it's in the Old Testament, right.

0:49:29 - Speaker 2
But we have a nutrient-poor epidemic in the United States and it's hard to navigate right. So that's where we need a lot of folks. We need to recruit everybody, not just medical professionals, to help educate everyone else about what's healthy. The average strawberry I read and put in the book Blind Spots I think it was the average strawberry has been sprayed 12 times, 12 different times, with pesticides. So when you eat a strawberry, is the net health benefit there or is it a net negative? Right Fluoride in the drinking water?

Fluoride has been put in the drinking water because it supposedly reduces cavity rates. I believe it does, because it's bacteriocidal. It's killing some bacteria. Well, what else is it doing in the microbiome then? No one ever thought of that when we started fluoridating our water. Canada only fluoridates. We do. Most of our water has fluoride. In the US and Canada it's a third. In Europe it's 3%. So you know we've seen a bunch of diseases rise in the modern era. Could there be an association? There's been a study in JAMA Pediatrics last year that the fluoride may be building up in a learning center in the brain and result.

I forget where it was, I forget what the hypothesis is, but they found that the IQ scores were slightly lower in kids that were in those areas with fluoride in the drink water.

Now is that a true association or is it confounded by some other? I don't know. I can't say it's cause and effect, but it's enough of a signal to say you should be intellectually curious as a medical professional or anyone and do another study. But we kind of have these giant blind spots we don't talk about, we've accepted anytime somebody tells you, well, the reason you should do this is that I'm the expert. Like that's a flag to run for your life.

0:51:35 - Speaker 3
Totally. Yeah, it feels like we have a pride problem when it comes like our pride is getting in our way. You mentioned the biblical principles of health. I'm like that's kind of it's the most beautiful and simple program you could possibly follow and if you follow it, you're going to be way healthier than people today. But you're, you're gonna, you're gonna thrive and um, I feel like there's a pride problem where we want to innovate in so many different ways, which is great, but sometimes that innovation is steered in um perverse directions. Um, that's more pride centered instead of just giving people the simple answers that you know, if you're eating real whole foods and doing the preventative stuff, the chances are you're not going to end up in a hospital.

0:52:20 - Speaker 2
The most important phrase a person can use, that's an expert, is to say I don't know when the answer is I don't know. And that was obviously and dramatically missing during COVID, when the answer should have been I don't know. People made stuff up and spoke with such absolutism, not just during COVID. This is with the modern medical establishment, the sort of medical elites when they get things wrong, they put things out with such absolutism as if it's evidence-based, when really it's just an opinion. Hormone replacement therapy for menopausal, perimenopausal women. So if a woman in their 40s or 50s starts experiencing menopause, starts on hormone replacement therapy, that is, estrogen or estrogen plus progesterone. Within 10 years of menopause they live three and a half years longer. It alleviates the symptoms of menopause the hot flashes and up to 80 different symptoms of menopause not sleeping well, mood, all kinds of things, weight gain. They are half as less likely to have a fatal heart attack. Their rate of cognitive decline goes down by up to 60 percent. The brain fog and cognitive decline after menopause that many women experience. The risk of Alzheimer's goes down by 35 percent. If they fall or get in a car accident, they're half as less likely to break a bone, which, when women hit age 80, there's like a one in three to one in four chance they get a hip fracture, and those can often lead to immobility in the context of frailty can result in a cascade of events that leads to somebody's demise. That's how many old people die is from falls. Here is an incredible medication. It's been around for almost a century. It has incredible data to support it. Almost every woman should be on it, starting around the menopausal period. In my opinion, women should be on it starting around the menopausal period, in my opinion. Right. I'm not giving medical advice, but people should talk to a doctor that understands these data. Is they perceive that it causes breast cancer? Because one guy at the NIH had an announcement 22 years ago where he told the world that it causes breast cancer based on a study he had commissioned and led, but he didn't release the study results Later, after the announcement, after the media scared the crap out of every woman in the world on hormone replacement therapy and women flush these pills down the toilet or some people wear a patch. There's many ways you can take it. The data come out and it turns out that there was no statistically significant increase in breast cancer, and yet the dogma lives to this day, 22 years. 90%, roughly, of doctors will not prescribe it for fear of breast cancer.

I was starting to turn. There's been some other people speaking about this besides me, writing about it in the book Blind Spots. But I found this guy who put out the dogma and I tracked him down in his retirement and I asked him does it cause breast cancer? He says yes. And I tracked him down in his retirement and I asked him does it cause breast cancer? He says yes. And I asked him about the data. He tries to talk over me with statistics.

I have a master's in research methodology and all I do is research at Johns Hopkins. The vast majority of my job is statistics and research and designing studies, so I'm fluent in statistics. He couldn't talk over me and I pin him down, I show him his own data and finally, after this back and forth, he admits to me yes, there was no increased risk of dying of breast cancer in the women. Yeah, Wow, the tremendous damage In the women. Yeah, wow, the tremendous damage. 50 million women, and many women to this day, are not offered this incredible benefit. No medication has done more for the health outcomes of a population than hormone replacement therapy for postmenopausal women, except for, maybe, antibiotics, wow.

0:56:53 - Speaker 3
It reminds me of cholesterol too. It's like the cholesterol myth gets born into the consciousness of society that cholesterol is going to give you a heart attack and then it's demonized for the next 50, 60 years.

0:57:06 - Speaker 2
We got cholesterol wrong for 60 years. Where was the apology? We got hormone replacement therapy wrong for 22 years, saying it causes breast cancer, when it doesn't. Where's the years? Where was the apology? We got hormone replacement therapy wrong for 22 years, saying it causes breast cancer, when it doesn't. Where's the apology? We got opioids wrong for 35 years, saying it was not addictive, igniting the opioid crisis. We got peanut allergies wrong for 17 years, telling moms to avoid peanut products for their kids that were young because that would prevent peanut allergies. They got it backwards. It causes peanut allergies. They got that. Where was the apology? When modern medicine uses good scientific studies, we shine as a profession. We help a lot of people, but when we wing it and go from the gut and rule with opinion and put it out there as absolute with scientific evidence when it's not, we have a lousy track record, and so people need to know the truth about these areas of health, which is why I wrote the book Blind Spies.

0:58:01 - Speaker 3
It's exciting and I'm so glad that you put this book together, because I do feel like it's going to do so much good and so many people are waking up and really starting to take their health into their own hands, which I view as a positive sign. I know you mentioned earlier that you're optimistic.

0:58:18 - Speaker 2
And.

0:58:18 - Speaker 3
I share that optimism. I think people are resilient, people want what's best for themselves and their families and ultimately, being healthy is the foundation of all that. So your book is, I know, is going to change a lot of lives and just inform people in a way. So your book is, I know it's going to change a lot of lives and just inform people in a way, maybe not give them 100 percent of the answers, but at least make them think critically about the advice that they're being given and the advice that has been historically given and been wrong. I think is just a perfect case study into just being more critical about the information that we're consuming and acting on.

0:58:50 - Speaker 2
It's good to ask questions. The book has changed my life, doing the research for it in my understanding of health.

I've developed these amazing relationships now with some of the top scientists who felt in medicine that they have amazing research but nobody is listening and I wanted to give them a platform. You know a lot of the backstories behind the medical dogma that lives to this day. It's wild, it's crazy, it's eye-opening, it's shocking, it's exhilarating. It's just these wild stories, like this guy who put out the myth on hormone replacement therapy in breast cancer, and I like telling stories. I remember Lin-Manuel Miranda who wrote the musical Hamilton. He said if I just tell you what happened and why something is the way it is today based on this historical thing that happened, it's boring. Nobody is really interested in why the capital is in DC, but if you tell the story of there was a room where they made the decision and they shut out this other guy, burr.

1:00:08 - Speaker 3
Burr was the. Is it William Burr? I can't remember now, yeah.

1:00:10 - Speaker 2
But he was the A Burr I want to say, yeah, but he was out. He was shut out of that meeting and he wanted to get in. He was fuming and in the meeting they made a deal where they would put it in DC. If you tell the story, no one will ever forget how DC was made the capital of the United States, made the capital of the.

United States, and it was a compromise between New York and rural Virginia. New York because Hamilton believed in the business society and financial markets and Jefferson believed in the agrarian society, and so they compromised by choosing the swamplands off the Potomac.

1:00:50 - Speaker 3
The classic feud between the agrarian society and the modern financial society.

1:00:56 - Speaker 2
Yes, aaron Burr, oh, aaron Burr, that's right, that's right, yeah, yeah, it's exciting.

1:01:02 - Speaker 3
I think that there's so much that your book is going to do and we're just really appreciative of you coming on this podcast and sharing some of your wisdom with us. Where can people get the book, get their hands on it? I know you guys are in pre-order right now, but where's the best place to send people?

1:01:19 - Speaker 2
It's available everywhere. By the time this podcast is live, because I know you got to polish it or whatever you do to post it, it's going to be. The book is available everywhere. It's in bookstores, it's available everywhere books are sold. So thanks for your interest in it.

1:01:35 - Speaker 3
Amazing. Thanks a lot, marty. Great to see you, harry. Thanks, appreciate it, thanks.

Transcribed by https://podium.page