to social isolation if not ostracism how those who feed the noble coronavirus well to discuss that and now i'm joined by a female heartthrob a consultant cardiologist bestselling author and one of the u.k.'s leading active basically campaign is that i'm a hunter and so good to talk to you thank you very much for your time likewise the sun i know that you are now writing your new book about the link between the worst complications from call it 19 and poor metabolic health and i heard you mention the u.k. prime minister boris johnson as a manifestation of that what exactly do you mean. well it's very important issue of your phrase oxana so this is something i've been looking at so many months analyzing the recess in the dataset and it's quite clear 1st and foremost that people get seem to suffer the worst complications it might seem almost certainly have some underlying condition and when you look at those conditions such as heart disease touch diabetes i put pressure they're already brick seeds in lifestyle and

most specifically what we put in some outs the food that we eat and well you know how this became a bit more. how should i put it it was a got a lot of the way and us 70 you can and internationally of course you know there was a great scare here in britain when our prime minister for sensible i meant. was from some company 19 in my 1st observation is a doc so we observe things you know we always you know think about things from the very basic level when we when we even treat patients we look at our parents think you know. it was quite terrible just to me with my knowledge that boris johnson's weight which we know you know he's had problems with it for a long time he's been open about that in his b.m.i. in the sort of 3536 category so base. what was the link because it's a small sort of mission then you know it's to explain it all essentially i mean very simple terms access gaudi fat basically isn't just a respect to so many. as easy as it appears to be something that

a sexy immune system in an adverse way but i'm sure you would agree with me in that it may be ok for the doctors to observe. a patient's body type but it's certainly consider it implied if not outright offensive to make any comments on a person's appearance especially. you know how he or she looks and i wonder if that's you know this social taboo is one of the reasons why it is so difficult to discuss this elephant in the room that access body fat in fact makes this virus so much deadlier and so much more dangerous yeah it's a good point oksana and i think as doc says we obviously have to be very sensitive in the way that we discuss these particular issues i've treated tens of thousands of patients and manage many people on the street with all the sex and cheating many people with weight issues and not once have i ever had somebody complaining about i

phrased it but it has to be done in a sense to way because you know ultimately there's such a huge proportion of the population 7 brits and most of people on our way were basics and the population so i think you see approach to sensitive way unfortunately i think you raise a very valid point there are certain sections certainly within the media and people who think this is a personal responsibility issue and when they see somebody who is overweight or obese they suddenly automatically come up with the fact they must be greedy overreaching and it was you know lazy and i think that that's absolutely wrong that we shouldn't be doing that because it isn't really a post response but ceased well i think part of the difficulty separating the psychology of obesity and the physiology of it people i rightfully opposed to fat shaming and other forms of myth mistreatment but they often miss the point that. obesity is a serious disease of the adipose tissue and adipose tissue is a vital organ immune organ is well as and the criminal organ so with any other

progressing pathological condition he wouldn't be encouraging people to just accept themselves a lot of themselves the way there are and yet when it comes to obesity that seems to be the message. and also you do raise an important point and i agree with you in the sense that we can't ignore it and but it's about as about how we approach these patients so there's no evidence for example that if you actually shame people and you know you come down very strict on them and stop saying you know that you know making them feel bad about. that is unlikely and so you know in my experience you know it is unlikely to really help and it certainly can actually impair and you know be a barrier to good docs of patient relationships and look at when i would try to pray someone did that but when people say that it's not a personal responsibility what i hear as a former happiest person is that you can do nothing about it when in fact i know for a fact that there is

a lot of things that people can do you know about it and change that probably mean they're relatively short amount of time so let's talk about this responsibility i think when we talk about it we need to be able to define and to define 1st responsibility to do it you know for people to act with pessimist sponsibility need to have the right information you need to have choice you need to have access and it comes to food needs to be affordable if you haven't got the right information oxana say for example you know we can talk about later the dietary guidelines say that people are being misled by for example the low fat movement for very long you know people eating foods thinking it was good for the health think it was going to help in this way it was loaded with sugar it was interfering with their appetite or eating more they feel hungry to them playing themselves and actually the blame lies in what they receive in the way that misinformed we can't really say that because of us responsibility in the food environment we're not so it's well the point is it's so saturated with ultra process you know the analogy i use is like asking a child that grows up in

a sweet shop to not eat sweets we need to you know we need to help people so that they can empower themselves to try and change or die in the right way but i think we should always constantly be aware how one of the. that's why for example diets in general don't work away all starts for many most people some people obviously but the calorie restriction all that kind of stuff and one of the possible reasons from my perspective is you can do this for a certain amount of time this will power issues you can excise well but if the environment is working against you it's harder to sustain and people benefit you got to know what and the environment is always working against you on any issue i want to give you one example i was just at a coffee shop yesterday and there was this overweight guy who was telling off their clients when not wearing a mask in public but while buying a bunch of act laris and i think this is such a poignant illustration of what's wrong with this whole debate because he shall for

attacked it and even self righteous by the fact that wearing a mask without even understanding or willing to admit to himself that his own food choices have a much more dangerous impact on his chances of getting and surviving the this virus is just to the point that. i agree that information and you know good environment the war and how through an environment wouldn't hurt but at the end of the day the decision lies with within an individual us on if it comes at some very basic though if you look at behavioral science the environment has a much bigger impact so yes of course we make our choices but the environment is much bigger impacts on how we behave than this so-called custom it's also those aspects of it and that's very well known welcome i've been a sight cynical some cretins how think that they're doing shows making the difficult choice how the choice will have a much bigger impact on the population than so-called individual counseling or education so that's one thing i would say i think the other thing is that we have

to also be aware some and this is something that doesn't get discussed enough is it for certain sections society who got job insecurity who have very low paid jobs actually. having a healthy diet is is almost unavoidable you know children who are growing up in environments where their parents can't even afford them to get healthy food and they have some to growth or they develop conditions related to obesity so me that's just plain wrong that's a gross injustice so we have to think about that as well in this context the other thing i'd like to raise with you as well oksana is you know you talk about this issue of oppressed responsibly. the information that people have been given for a long time let's talk about the dietary guidelines that changed in the late seventy's and early eighty's and us in the u.k. was all about putting you know the base of the diet starchy foods and we now know these are the very foods that contributes to all these metabolic diseases types of diabetes etc so people get confused and that that's another big issue the food

industry have kind of hijacked information and we've you know this whole culture presents low fi junk food has come on the you know common saturate the city vironment people have gotten sick and that also needs to change but the problem is the the food industry have too much control so that even the dicey guidelines are influenced by them i want to ask you something about this and i asked mary controversy that i mentioned because i find it very interesting i think at the heart of it is ultimately a debate about you know how much courtesy how much discipline the way expect from one another in dealing with a major disease and i see obesity and metabolic health and they might the same context it's ultimately as far as i'm concerned about how much you're willing to put upon yourself or do yourself in order to protect your own house and the health of the people around you because we know i'm sure you would agree with me that obesity khans at a huge huge huge cost to decide is it an appropriate comparison. and i agree

i think that's a really important point around the fact that you know we're all interconnected it was so i mean we know that you know viruses can trouble. around the world within the space of days 2 weeks you know it and so in fact saying that so many people from all different backgrounds right so we're all interconnected in the same way you're absolutely right you know we also have to think about you know for me for example without my work my advocacy i always think about how can i always love my how do i help my individual patient how do i help the population i think about. because really it's it can exit and actually if you know you are going little bit philosophical here but you know for a society to function effectively for people to be you know if you have a good quality of life to have good health to be happy where we are dependent on each other you know we can't really i don't state you can ask people who people can live in to kuhn's and there are some people are extremely happy to be connected to

a completely isolated rest of the stuff doesn't happen so i think the point you're raising and i'm sure i agree with is that we have to pull that the good of the community for everybody we have to think about the way we act and whether it's about where you masts and falling back guidance all about reducing the burden of of obesity but that means it's also all our responsibility to look at the roots of and then that's when you that means speaking out against my health misinformation speaking out against the corruption of science you know one of the things i say in the beginning my talks and that's because misinformation house has become so widespread you know on the stocks there was connote longer practice on this medicine you know we have an epidemic of misinformed boxes misinformed patients you know written in so many issues that i think i think he actually put it in even starker terms he has said that more than medicine is that major threat to public how that's a pretty strong statement but let's discuss it after that and very short break we have to take a minute here right now the trailer on the back just

a few moments they can. elgood forward to talking to you all. that technology should work for people. i robot must obey the orders given by human beings except where such orders would conflict with the 1st law show your identification which should be very careful about artificial intelligence and the point of use the great transfer of the shia. areas jumps in with artificial intelligence where some of the demons. the robot must protect its own existence is existing.

welcome back to worlds apart with i see my whole track consulting cardiologist and best selling author. just before the break we were talking about how one of madison has become a major threat to public health and i'm sure it's gone i mean some doctor is or some nurses working double shifts in hospitals will take that as a as an offense could he actually reconcile both of the statements our clinicians being heroes who are putting their lives on the line but also serving

a system that doesn't have the best interest of patients at heart yeah it's a very it's an interesting one to reconcile so the way i would start off 1st looks on is i think what medicine that you have many great savings but most. what we do which is the really good stuff in modern medicine is the acute care of the emergency treatments treating people with trauma treating life threatening infections with answered audix treating heart attacks with emergency hot stenting for example something i did for a lot of my career but the big issue in health care now is a management and it's chronic diseases and the management of chronic disease is a 1st and foremost primary focus our intervention is drugs and when you look at the data on those drugs i'm i'm talking about drugs you know blood pressure cholesterol pills i'm talking about drugs for diabetes you know for the overwhelming majority of these patients being treated it doesn't give them any benefit whatsoever and they come with side effects at the same time we're detracting from giving them. prescribed lifestyle advice so that's where the

imbalance is but just to put in perspective for you of us the issue around the pharmaceutical industry influence over guidelines and drug prescribing practices has become such a big issue that one of the co-founders of the very eminent respectable cochrane collaboration pizza goetia his own estimates suggest that the 3rd most screening cause of death after heart disease and cancer now is prescribed medications what your prescribe and what your doctor prescribe sphere and he educates about 50 percent of that digges medication to areas and about 50 percent jitsu side effects can i ask you something about metabolic diseases that i could never understand. we are usually taught that this is something that you have for your entire lifetime and yet we know it now for a fact that that's a type 2 diabetes hypertension inflammation a 2nd out immune disease all of that is reversible and reversible in

a relatively short amount of time why even medicine men taining the small term view all through the disease when it's taken from a false and when they actually have the tools to and very cheap tools to give to that patients to you know improve their health in a matter of weeks and months at most i'll give you one word answer and then i'll expand on that money. i interviewed the former. of one of the most british guys impact medical terms of world medicine masi angel and i wrote about this in a guardian article and she said to me the real battle we have in health care oksana is one of truth versus money so you know basically what's happening is the science is there but that isn't enough you know we have to overcome these vested interests that have got a grip over modern medicine the realities of so i can tell you how the overwhelming

majority of doctors go into the profession to do the right thing by their patients a want to help their patients get better but they are being said information which they do not realize is heavily by state in corrupted by the industry and until we change the system at its root it will carry on as it is part of the issue around what why we're not we've got this sounds wrong is also lack of knowledge about lifestyle stuff so for example i didn't get to know anything about basic nutrition and how it impacts the metabolic disease so we medical school but that was almost 20 years ago and of course the signs of all the diseases have become more prevalent and now we're now realizing with you know small studies let's be honest that you can reverse many of these medical disease with the few weeks i see it with my patients and i think that is going to gather momentum it has to governments and because what we've doing isn't not just working is causing huge damage to public health absolutely and i think the doctors and the nurse of the home you mentioned

sometimes the price victims of that you relative recently that i think more than half away an h.s.a. are overweight and these people are now over exerting themselves and missing out on sleep they're working double shifts they're probably eating the junk food that has still and that is still being served in british hospitals and i'm sure in other countries this is jason is not much different it's it's almost like you know in the system is eating its own here is 1st and foremost. yeah absolutely so more than 50 percent your right of doctors and nurses in the n.h.s. are either overweight or obese and that really comes back to the point about the press responsibility issue because you would expect them to be the most educated and be aware of it ok of i the not educated probably more important is the so-called hostile crude environment and you know it's similar if not worse than the high street 75 percent of food coaches in hospitals is considered ultra processed or in health state so it's not a surprise looks on unfortunately and that also goes again there's an element of

lack of knowledge because people have been so this information it's about counting calories it's about you know and it's a balance it's about you know it doesn't matter what you eat as long as you exercise enough and some of these people who are overweight a sadly unfortunately i think blaming themselves thinking it's because they're not doing enough exercise when all they need to do is actually just change the what they eat in fact you know i'm very much center of the frets i said what about say thoughts of detract from the benefits of the lord even look or who is former shadow health minister when market sasha was prime minister and you know he actually said something which i wrote in my i quoted in my last book he says and of these custom doesn't need to do one iota of exercise in order to lose weight they just need to eat less and the one of the reason the basic reasons for that is we actually you know just by breathing for our organ functions or the blood pumping or on the body for ourselves to function we use a pose lot of energy doing the oxen that we did you know at least 161700 calories

just from doing that doesn't mean we should exercise or do some of the activity of course we should both when it comes to weight it's all about what you eat. how much it and what exactly it let's talk more about that because one of the things that all is also difficult to grasp is why nutrition has been such an orphan child of medicine because i mean we've known since hippocrates that we are what we eat and yet do these they people are pretending that that calories are calories they're all . the same is that you can indeed alderaan the poor diet do you also put that on to bastid interest or is it some sort of a i don't know sometimes i think that it's magic thinking that people want to maintain that i can eat whatever i want to damn you know tomorrow either medicine or my sports instructor will help me shut it off. yeah i think it's probably a number of factors i think one of it is we have you know over the last few decades

i think we as a society have exaggerated in our own minds our perception of what many modern medicine can do has been grossly exaggerates it and i think that has detracted from the very basic simple things that we've lost and the way we live we're looking for a quick fix solutions we have this system that we live in this modern capitalist system if you like where you know it's all about you know producing some sort of product and then mass marketing it and then you know selling it and of course you that's also infiltrates of modern medicine as well and that's really one of the reasons why does this destruction has happened to be honest so i think we need to kind of just get back to realizing that modern medicine has achieved some great things but actually when it comes to what has increased our life expectancy what i'm saying also in the last 4 or 5 you know the last sort of 150 is most of it has been public health you know modern medicine can be attributes it's adding maybe 3 and off to 5 year life expectancy over an increase of 40 years in the last

century in hearts and that's again something that people probably find quite surprising quite shocking you know i personally tend to be very harsh overweight people and that's because i hated my own the visit and how much of a cripple me but one of the interesting point that i heard your race is that looking at the external fat is actually very misleading and that people with. suck it tanny as fat deposits that as big butts and wife hips may actually be in a much better mid to ball like position than people with a normal b.m.i. but with lots of this or all fat around their organ say it's not about the parents actually if so how did those fat deposits actually function yeah so absolutely spot on you know the statistics basically tell as you know there are some ethnic disparities but if you're normal be m.r.i. about 40 percent of people who. come for example from south asian origin and this is not a small number of people in the world this is a you know you look at the indian subcontinent the 0 talking about was 2000000000

people around the world. who are vulnerable to this so this is you know full extent of south asians and about 20 percent cocoa asians as well so essentially we're all vulnerable and that's why i also say there's no such thing as a healthy way only a healthy person based on the metabolic health and the reasons for that are not fully understood but basically for those certain people with for genetic reasons they seem to develop these problems these conditions of disease is a much to lower levels of excess body and that does tend to store itself you're right it's called we call it visceral fat it's since the store itself in the liver the pancreas and that's where the problem lies in many people unfortunately just vic just because we're focusing on on b.m.i. who are normal b.m.i. will have the illusion of protection when in fact they actually could be very much publicly unhealthy in very high risk and therefore not identified and not treated properly as well they are how moment that they for me add came when i understood that adipose tissue is it is

a real organ and that it starts functioning differently once you reach a 2nd on how free a level of access that and in fact i think most of us have learned then you weren't here during the spend any cytokines so if yes size producing land made my choice more cytokines damaging cytokines and as a result of that we are essentially poisoning our bodies every single day and then they covet 1000 cons and it makes it all that all the worse but am i right in thinking that at the root of all of that is one substance and that is sugar yeah absolutely so we know from data that's been coming in about people types of diabetes are. much higher risk of death so if you're type 2 diabetic treatment is hospital you have a 3 fold higher risk of death of your type 14 fold higher. probably a combination now where you've got exogenous insulin being being injected insulin itself is actually proton a treat so you know and then you go i look absolutely sugar so high the glucose the

high the risk of death we know that from all infections that that's a diabetes sense in most of the comments section certainly and we say it was code that was actually raised the question is well it's on about the types of foods or eating some of these people are eating and we can you know highlight you know this is something that caused a bit of control so twitter with is you know one hospital trust in london was you know promoting if you like or a congratulate same krispy kreme donuts for giving you know 1500 donuts to stash i'll spittle and for me who understands us dates very well you know people say want don't concho you but actually if you eat one donut then even if you're healthy mentally healthy it will send you a clue because you know you know so they're not ready you should stop labeling their foods pro-inflammatory should call them corrupt calvi and because that's what i actually they they view because i mean from the studies that i have looked at

it's pretty clear that you know a few days on side diet and your risk of. contracting and disease and dealing poorly with it increases substantially but on the good side and this is that the last question to you you made the point that once you make those die there it changes you can turn your buy around then pretty sure the amount of time and i absolutely have side effects where you starting off from absolute you're already medical if you're healthy if you're overweight or obese and it's not rocket science it's about cutting out the us across this foods it's about eating high quality called hydrates it's about eating 2 to 3 meals a day not snacking you know i see patients to you know send type 2 diabetes into remission within just a few weeks of changing their diet and people feel better they just feel better themselves i'm sure you know i hope you don't. you know i still sort of i'm sure you probably feel much better in yourself that you used to do absolutely and that actually much better not only about myself but also about my children because i

don't want to have you know my my children to take care of me when i lose my memory of you to sugar and use dementia for example or i don't want the society of you know 2030 years from now to be responsible for my poor poor health choices so i think that's that's a very interesting combination of both personal and social responsibility but when we talk about. those issues i think people need to keep in mind that it's not only about wearing masks it's absolutely about what you put in the mouth behind that mask absolutely and why one of the things i wrote about a lot of coal you know for european scientists and that sort of telegraph newspaper was actually the message in the u.k. going forward should be the public health message except he repeats it you know each real sued. you know protect the n.h.s. and save lights and that that needs to everybody needs to know that but the problem is we need to now educate people about it what we'll see it is because

a lot of people don't even know what real speed is anymore while they'll tell us the track of this interview contributes a tiny little bit to informing the people anyway we have to leave it there thank you very much for sharing your insights and i'm looking forward to your new book my pleasure thank you example and thank you for watching i hope to see you again next week on well the part. of the.

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