if you. are going to be on your computer. or. on a welcome to world apart these days people hold very strong opinions about wearing masks especially when it comes to obvious but trim actioning that what they put in the mouth behind that mask has more impact on the call that ankle pandemic and humane respect to social isolation if not ostracism how the school feed the noble

coronavirus well to discuss that i'm now joined by. a consulting cardiologist bestselling author and one of the u.k.'s leading active b.c. can painters that's on the whole train so good to talk to you thank you very much for your time likewise ticks on i know that you are now writing your new book about the link between the worst complications from called at 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 that's great important issues your phrase oxana so this is something i've been looking at so many months on life in the recess and they said and it's quite clear 1st and foremost that people get seems to suffer the worst of it might seem almost certainly have some underlying condition and when you look at those conditions such as such diabetes i took their old really great seats. in lifestyle and more specifically what we put

into a mouse the food that we eat and well you know how this became a bit more. how should i put it it was a lot of the way and us so i mean you can and internationally of course you know there was a great scare here in britain when our prime minister for science and go and it's all spittle was from some come in 19 in my 1st observation as 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 he's autistic it was quite terrible because to me with my background knowledge. 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 you know his b.m.i. in the sort of 3536 category so base. what was the link because he's also a mission then you know it's to explain it all essential i mean very simple terms access gaudi fat basically isn't just a respect to so many diseases it appears to be something that a sexy immune system in an adverse way but i'm sure you would agree have admitted

that it may be ok for the doctors to observe the a patient's body type but it's certainly considered it implies if not outright offensive to make any comments on a person's appearance especially. you know how he or she looks and i want you bad 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 these virus so much deadlier and so much more dangerous yeah it's a good point osama 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 who are deceased replete with all the sex and cheated 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 any say 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 custom responsibility issue and when they see somebody who is overweight or obese they suddenly well it's a massive come up with the fact they must be greedy overeating any must be 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 as 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 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 same you know you know making them feel bad about themselves 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 only they would i would credit person wouldn't do that but when people say that it's not a personal responsibility what i hear as a formal happiest person is that you can do nothing about it when in fact i know for a fact that there is lots of things that people can do you know about it and change

that probably mean they're relatively short amount of time and so let's talk about this responsibility i think when we talk about it we need to be able to define and to define for us responsibility to do it for people to act with press responsibility you 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 and i'm going to one place 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's because of press responsibility in this 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 and general don't work away all starts for many most people some people of 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 time this will power she can excite well but if the environment is working against you it's harder to sustain and people benefit. 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 layers and i think this is such a poignant illustration of what's wrong with this whole debate because he felt protected 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 read that information and that you know would environmental war i how through an environment would have occurred but at the end of the day the decision lies had there been an individual acts on it that comes out something very basic if you look at behavioral science the environment has a much bigger impact so yes of course we make our choices but the environment has a much bigger impact on how we behave than this so-called custom it's possible to see aspects of it and that's very well known well i've been cites mickelson treatments healthy that paired with shows making the difficult choice a healthy 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 we have to

also be a way out son 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 i mean 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 is you know you talk about this issue of office 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 contribute to all these metabolic diseases type 2 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

president junk food has come on the you know common saturate this environment 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. i want to ask you something about this mask growing 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 courage to say how much discipline the way expect from one another in dealing with a major disease and i see obesity and metabolic health and they much the same context it's ultimately as far as i'm concerned about how much you're willing to put upon himself or do yourself in order to protect your own health and the health of the people around you because we know i'm sure you would agree with me that obesity cons 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 interconnects it was so i mean we know that you know viruses can travel around the world within the space of days to weeks you know us 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 with with my work my advocacy i always think about how can i always love my how i help me to visualization how do i help the population i think about a similar because really it's an exit and actually it's you know and i've got a little bit philosophical have 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 week we can't really i don't think you can ask people who people can live in to tunes and there are some people are extremely happy to be addicted to completely isolated from the rest of society not just the stuff doesn't

happen so i think the point you're raising and i'm sure i agree with this is that we have to pull 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 or about reducing the of the date of the city but that means it's also. all our responsibility to look at the roots and that's what you that means speaking out against 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 all these docs can no longer practice on this medicine you know we have an epidemic of misinformed oxes misinformed patients interested in so many issues why's that i think he actually put it they mean even starker terms he has said that more than medicine is a major threat to public how that's a pretty strong statement but let's discuss it after a very short break we have to take a minute or 2 right now but we'll be back in just a few moments they can. be

end of a love story well tensions in the u.s. german relationship determine the fate of nato and if elected will joe biden be america's version of the soviet ruler plenty of pressure to. welcome back to world the party that i see my whole track down south in cardiologist and bestselling author dr mahathir 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 doctors are some nurses working double shifts in hospitals we'll take that as a as an offense could he actually reconcile both of the statements our clinicians being here. who are putting their lives on the line but also serving a system that doesn't have the bath interests of patients at heart yeah it's a it's a very it's an interesting one to reconcile so the way i would start off as a look son is i think what medicine is achieved many great same's but most of 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 heart stenting for example something i did for a lot of my career but the big issue in health care now is a management of 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 and 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 it comes 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 what you doctor prescribe sphere and he actually gets about 50 percent of that digges medication errors and about 50 percent jitsu side effects

can i ask you something about metabolic diseases that i could never understand have we i usually taught that this is something that you have for an entire lifetime and yet we know it now for a fact that that. type 2 diabetes hypertension inflammation out immune diseases all of that is reversible and reversible in a relatively short amount of time why is the medicine men taining this long term view of the disease when it's taken 3 false and when they actually have the tools to and very cheap tools to give to their patients to 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 it 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 value having health care acts on it 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 what a medicine the realities are so i can tell you hand on heart 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 it in corrupted by the industry and so 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 but if you 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 and they cast as staff 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 all. like you know they in the system is a king its own heroes 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

1st 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 so what about say thoughts of detract from the benefits of the lord even look or who is. a 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 obese 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 out of body fat ourselves to function we use opposed lot of energy doing the oxen that we do you know at least 161700 calories just from doing that doesn't mean we should exercise and do some of the activity of course we ship but 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 that. yes to this day people are pretending that calories are calories they're all the same is that you can indeed alderaan a poor diet do you also put that on to bastid interest or is it some sort of or 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 must 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 this 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 heart 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. such kitaen 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 the bow the pira is actually it's how they 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 b. 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 oh 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 the for genetic reasons they seem to develop these problems these conditions of disease is a much truer levels of access. 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 on 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 a new word during this and demi cytokines so if yes size producing land may much 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 the 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 crowds on the street so you know and then you go i looked at cuz absolutely sugar so high the glucose the high the risk of death we know that from all infections the types of diabetes and see 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 a state's

a 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 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 do 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 by around and pretty sure the amount of time and i absolutely have side effects where you starting off from absolutely 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 if 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 i feel 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 dimentia 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 lifes and that that needs to everybody needs to know that but the problem is we need to now educate people about forces fit what real suit 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 and while the part.

join me every thursday on the alex salmond show and i'll be speaking to get us from the world of politics sports business i'm show business i'll see you then. donny and by north it's so many people because they copy him he's so good that even such a bad copy is sending. i'm not here to plug the body and. i'm here to find the next guy. who.

looked up live on canyoning being done the in feltham feedback blog she even done party in. the clicks and moves for the c.e.o. thing is a deflection what is comfortable saying. that is going to be better than i got out for many of her. time he and others like me are going to going to see a lot about. that that you can bank on there's nothing like a. long long while and you know also on the bottom there's a bonus rachel i don't think a lot older. than do a new person and they are turning $100.00 gandhi a new normal gandhi around the phrase christ be ready to go to you then go to mock you then they will join you.