American Thought Leaders - Beating Heart Disease: Dr. Aseem Malhotra on What Doctors Don’t Tell You

Episode Date: October 12, 2024

Dr. Aseem Malhotra is a world-renowned British cardiologist and a best-selling author of several books. After losing his father to a heart attack after taking the COVID-19 vaccine, Dr. Malhotra began ...speaking out about the corporatization of medicine, and how it’s making us sicker.“We have well over 60 percent of the adult population now overweight or obese. I would take it further and say that 88 percent of Americans have abnormal metabolic health markers,” he says. “The benefit of a statin over a five-year period based upon their trial data shows that there’s a one in 39 chance it'll prevent you having a further heart attack, and one in 83 chance it will delay your death or save your life. Patients are not told that.”We sat down together to discuss his new film, “First! Do no Pharm,” which examines many factors contributing to the West’s chronic disease epidemic.“There is a false perception out there that medicine is an exact science, like, say, physics or chemistry, when, in fact, it is a social science—the science of human beings. It’s constantly evolving,“ he says. ”You spend $4.3 trillion on health care—highest health expenditure in the Western world—with the worst health outcomes. So, why is that?”Views expressed in this video are opinions of the host and the guest, and do not necessarily reflect the views of The Epoch Times.

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Discussion (0)
Starting point is 00:00:00 We have well over 60% of the adult population now overweight or obese. I would take it further and say that 88% of Americans have abnormal metabolic health markers. You spend $4.3 trillion on healthcare, highest health expenditure in the Western world, with the worst health outcomes. So why is that? Dr. Asim Malhotra is a world-renowned cardiologist and a best-selling author of several books. We sat down together to discuss his new film, First Duno Farm, which examines many factors contributing to the West's chronic disease epidemic. There is a false perception out there
Starting point is 00:00:37 that medicine is an exact science, like say physics or chemistry, when in fact it is a social science, the science of human beings. It's constantly evolving. This is American Thought Leaders, and I'm Jan Jekielek. Dr. Seema Hotra, such a pleasure to have you back on American Thought Leaders. Jan, it's great to be here. America is my second home. So you've been a medical doctor for over 20 years, a cardiologist for over 10 years, and you've only recently found treatment for heart disease? It's been a long journey and process and a deep dive into understanding
Starting point is 00:01:21 what is at the root of heart disease, what is the greater truth, and how can we manage it, prevent it, and even reverse it, Jan. It's taken me time because the current paradigm in that understanding of heart disease is flawed. And trying to overcome that or to change people's minds or to change the medical approach to heart disease, it's not something that happens overnight. Well, so let's talk a little bit about how people view medicine today, frankly. I mean, this is something that really comes out in the film. I mean, there's... Tell me about where people might be going wrong in this area. Yeah, I think to understand the problems of modern medicine, you have to go back to square one. And that is understanding what medicine is. There is a false perception out there that medicine is an exact science, like say physics
Starting point is 00:02:28 or chemistry, when in fact it is a social science, the science of human beings. It's constantly evolving. And to add to that, the father of the evidence-based medicine movement, Professor David Sackett, Canadian epidemiologist now deceased. And this has actually been proven. He said 50% of what you learn in medical school will turn out to be either outdated or dead wrong within five years of your graduation. The trouble is nobody can tell you which half, so you have to learn to learn on your own. Now, most patients or members of the public hearing that would probably be maybe quite surprised, to say the least. But we have to start from there
Starting point is 00:03:15 because part of the barriers to the truth of changing medical practice is really busting that myth that it isn't an exact science. One of the public figures whose face became one of the most famous around the world was Anthony Fauci. And he said when it came to the issue of managing COVID and even around the COVID vaccines, he said, trust the science. And that didn't make any sense to me, because medicine isn't an exact science.
Starting point is 00:03:46 Part of the challenge is that, of course, you want to treat doctors as authorities. We need to. You're putting your life in someone else's hands, right? So this reality plays into exactly what you were talking about. Yeah, absolutely. My role and my job, as well as being a clinician, a practicing cardiologist, obviously, is making sure that doctors can be the best possible doctors they can be. And also to deal and cope with the current challenges we face in healthcare with this chronic disease pandemic. So we have to understand the roots of it. And part of the problem, and there are many problems with the current challenges we face in healthcare with this chronic disease pandemic. So we have to understand the roots of it. And part of the problem,
Starting point is 00:04:27 there are many problems with the system, is that modern medicine is not practicing in a way that it could or should be. You said a chronic disease pandemic. Expand on that for me, please. Well, the biggest drivers on stress on the healthcare systems around the world, especially the Western world, is people suffering from conditions such as type 2 diabetes, heart disease, high blood pressure, which are now
Starting point is 00:05:00 increasingly at a very rapid rate. Interestingly, Jan, as well, the most common chronic disease right now, the number one in the Western world, is actually mental health problems, whether it's people suffering from anxiety or depression. The heart and the mind are interconnected. That's in the world writ large, or the Western world? In the Western world.
Starting point is 00:05:23 In the Western world in particular. That's the number one. Yes. Astonishing. So that is fascinating because one, why is that? But two, also it links to the physical disease. We know that chronic stress, for example, as we point out in the movie, is a driver of heart disease.
Starting point is 00:05:41 And to give people context, having chronic stress, which to be honest, most of us are under because of the way we live and that's why it comes back to also understanding what does it mean to be human how should we be living our lives to the best of you know to optimize our health stress is the same as a risk factor for heart disease as being a regular smoker of 20 cigarettes a day or having high blood pressure or having type 2 diabetes. But people are generally not dealing with it. But now you're talking about chronic stress because of course stress is a positive feedback
Starting point is 00:06:16 mechanism. Of course. Yes, chronic stress, absolutely. Stress in small doses occasionally is of course probably good for us but the chronic stress is the problem. There's a patient that features in the film Tony Royal. Why don't you just lay out his case for me? Yeah, one of the most interesting patients I have ever come across in my life because his story is fascinating but his case study in many ways epitomizes everything that is wrong with the healthcare system,
Starting point is 00:06:48 but also what we can achieve if we get things right. So Tony saw me, I think first came to see me privately almost 10 years ago. His background was he was an international airline pilot with Virgin Atlantic. He was actually very active. You know, he was running marathons, that kind of thing. But he noticed over time that his weight was increasing, especially the belly fat was getting a bit worse. And then in 2014, if I remember correctly, he experienced chest pain. Luckily, not when he was flying.
Starting point is 00:07:20 He'd come back from a flight in South Africa and went to his general practitioner and ultimately got diagnosed with having a possible heart attack. And then it was confirmed when he went to hospital. And there was one of his major blood vessels, one of the coronary arteries had a almost complete 100% blockage that was treated with a stent. Luckily not left with significant heart muscle damage from the heart attack. And he was then put on a cocktail of medications, which is a standard practice in cardiology and in medicine. You know, a couple of blood thinners for his stent, a beta blocker to slow the heart rate down, and a high-dose statin drug, which is a standard
Starting point is 00:07:56 practice. And the other thing that he mentioned in the story is that he was given very little useful lifestyle advice. He was basically told to diet and exercise, which he was kind of doing anyway. He was following the standard dietary guidelines of following a low-fat and a high-carbohydrate diet. And he was exercising. He was running. So he was trying to understand what's happened here. How has this happened? But about a year afterwards, he started to feel very unwell, lasting for several months. He thought maybe he had another condition. He was getting fatigued.
Starting point is 00:08:28 He was having muscle pain. He was having brain fog, erectile dysfunction. And he obviously couldn't fly after having a heart attack anymore. So he went back to his previous job, which was being a maths and physics teacher. So quite good with numbers. But he started looking at the literature on the drugs he was taking a little bit and figured out he thought it was the statin giving him these symptoms. So he stopped the statin.
Starting point is 00:08:51 Within a few weeks of stopping his statin, suddenly his life is transformed back to what he used to feel like. His energy levels are back. His brain fog is gone. His libido has come back. And he's like, wow, I'm not going to stay on the statin anymore. And started to look at the statin anymore and started tend to look at the benefits of the drugs he was taking in absolute terms and found out that you know those drugs weren't that effective the way he was
Starting point is 00:09:12 led to believe and simultaneously also came across some of my work on the fact that people can effectively manage their weight and their health markers for heart disease, from going on a low-carbohydrate Mediterranean diet. So he adopted that, and within three months, he actually lost around 10 to 15 kilograms in weight without restricting calories. Weight circumference came down, everything got better, and he felt great. And he comes to see me in my clinic, having done all this himself.
Starting point is 00:09:48 And I was a little bit shocked, to be honest, when he walked into my consultation room and told me a story that he, without telling his doctor, he came off all his pills, having had a heart attack and a stent just over a year earlier. And he asked me, the main reason I came to see Dr. Malhotra is I'm thinking about doing Ironman competition next. And I was like, wow, okay. So we had a conversation. He told me his story and we went through the medications he was taking. And then ultimately he decided that he wanted to stay off all his meds. And I supported and respected his decision, even though we had a conversation where I said maybe he should carry on with aspirin, maybe
Starting point is 00:10:28 he should take the statin drug and go on a lower dose. But he decided after a couple of weeks that he'd rather, he was feeling so good, his life had transformed. He'd never been in better shape from changing his lifestyle. And that case of Tony Roll was ultimately written up in a medical journal and even hit the front page of the Daily Express newspaper in the UK and was covered on the Daily Mail online as well. And the headline was, ditch the pills to beat heart disease.
Starting point is 00:10:56 So really an extraordinary story of, I'm not saying everyone can do this, I'm not saying everyone should do this, but it's where someone normally is now who's had a heart attack usually it's they are on medications for life and that's the Understanding and thinking of the patients and the doctors that this is the best way to manage it. This guy has busted that myth You know it's very interesting that you say that you were suggesting to him to take a lower dose of the statin because I You know typically associate you as the doctor who doesn't recommend them. So tell me a
Starting point is 00:11:30 bit about that. Yeah, so my approach to this isn't about recommending statins or not recommending statins. It's about being an advocate for true informed consent, what I call, which has become very controversial, ethical evidence-based medical practice. So me being an advocate for that has made me very controversial apparently. But what does it mean? It means giving patients information in a way they can understand and then helping them make a decision, either, and every patient is different, but a decision according to their preferences and values. So if you look at statins, for example, in someone like Tony
Starting point is 00:12:09 Rawls' case, who's had a heart attack or is at high risk of another one, when you break the data down from drug industry-sponsored studies, which we have to take with a pinch of salt, but let's just say for argument's sake, it's true, the benefit of a statin over a five-year period, based upon their trial data, shows that there's a 1 in 39 chance it will prevent you having a further heart attack, and 1 in 83 chance it will delay your death or save your life.
Starting point is 00:12:35 Patients are not told that. So for Tony, that information was made available. He understood it. And he felt, actually, I don't fancy those odds, but also felt that he was empowered with an alternative through a lifestyle that was going to help him and that's a decision he made and and I supported his decision. Many patients when they're given that information think also the same as Tony, but it isn't standard
Starting point is 00:12:57 practice for doctors to communicate that information because we are not conditioned or trained to communicate information in that way despite the fact that we should according to the best principles of ethical evidence-based medical practice. What normally happens is doctors are conditioned to tell patients about benefits of drugs using something called a relative risk reduction which may be in somebody like Tony Rawls' case, 30% less likely to have another heart attack if you take a statin. But when you translate that information into the absolute risk reduction, it's only a small percentage, 2.5%, for example. Explain to me the difference between those two.
Starting point is 00:13:40 Yeah. So in very basic terms, let's just take, I think, a very simple way of looking at it is this information comes from what we call the randomized control trial data conducted by usually the drug industry, where you have two groups of people who are effectively, if you like, clones of each other. You know, let's just say we do a trial of 100 men, and they are middle aged. Say they're 50 years old.
Starting point is 00:14:03 And we have two groups where they are stratified according to the same risk factors. So they may be the same number of people with type 2 diabetes, the same number of people with high blood pressure in both groups, and then you follow them up, and let's say over a five-year period, the people who take the dummy pill, not the statin, there are two out of 100 that suffer a heart attack, right? And the people that took the statin, and that 100 people
Starting point is 00:14:27 you follow up who take the statin, the clones of this first group, only one of them suffers a heart attack. So you've reduced the risk of a heart attack by one in two over 100. So it's 50% less likely. But you've only managed to prevent one person having a heart attack having treated 100 people. And that's the absolute risk reduction. So the relative risk reduction is 50%, but
Starting point is 00:14:51 the absolute risk reduction is only 1 in 100, 1%, also known as the numbers needed to treat. So you have to treat 100 people to prevent one person having a heart attack. Now, this just isn't my opinion, Jan. 2009, in a World Health Organization bulletin, Gerd Gigerenzer, who is a director of health literacy at the Max Planck Institute in Berlin, which is actually where Einstein trained, right, a very reputed guy, he said it is an ethical imperative that every doctor understand the difference between absolute risk reduction and relative risk reduction to protect patients from unnecessary anxiety and manipulation.
Starting point is 00:15:36 So in my view what he's saying is that if doctors are aware of that information and they don't tell their patients that, then they are in effect not practicing ethical medicine and I agree with that. I don't think it's deliberate, it's a in effect not practicing ethical medicine. And I agree with that. I don't think it's deliberate. It's a conditioning, it's the way doctors are trained. But actually, this goes obviously into the documentary a little bit. That conditioning in a way has occurred
Starting point is 00:15:57 for a large degree for the purposes of benefiting the pharmaceutical industry, not benefiting patients. Well, but let's go to doctors for a moment. Like a doctor, you're kind of turning a little bit of the doctor-patient relationship a bit on its head. So you think of the doctor as saying, hey, yeah, I think you need this medication. And you kind of just do it, right? I'm not used to hearing, well, here's your pros and cons. Because there's also this other piece, right? The other piece is that there's these side effects like you described that happen at some frequency.
Starting point is 00:16:29 Tony Royal probably wouldn't have done anything about his treatment if he hadn't experienced the particular side effect that got him to start doing his research, right? Absolutely. I think the way to understand and explain it is that doctors themselves put a blind faith into medical journal literature. And the reality is, and this is what I've uncovered over years, having also been one of those doctors that was blindly following a biblical truth, what's published in the New England Journal of Medicine, or JAMA, or the Lancet, is that that information is basically flawed, corrupted by vested interests. So those doctors who are still following the traditional paradigm are well-intentioned, absolutely, 100%. But they don't realize
Starting point is 00:17:23 that they're being manipulated. So what is the old paradigm exactly when you describe it here? The old paradigm is just partly even doctors exaggerating in their own heads what modern medicine is and what it can achieve. So it's a lack of maybe critical thinking and curiosity. It's a lack of really deeply understanding that medicine is an exact science. It's a lack of understanding that according to somebody I call the Stephen Hawking in medicine, John Ioannidis at Stanford University, the most
Starting point is 00:17:56 cited medical researcher in the world, a mathematical genius, not realizing that, which is his work, that most published research findings are false, and that the greater the financial interest in a given field, he wrote this, the less likely the research findings are to be true. This is not common knowledge amongst most doctors. And in my view, explains much of what's wrong with the healthcare system and why we have not combated this pandemic of chronic disease in the population, which is making people miserable, sick, and increasing death rates. You know, you look at the United States, prior to COVID, there was already like, you'd knocked off two to three years off your life expectancy.
Starting point is 00:18:45 I mean, that's extraordinary. You're going backwards, and you've got more people sicker. You know, I spoke at a conference in Savannah, Georgia, towards the end of last year, and a medical student came up to me who was fascinated with my talk and said, but, you know, I told my medical student friends about this stuff and what's going on, and they were like, no, but America has the best health and the best health and best health care system in the world. And I thought, wow, where's that coming from? Is that a media narrative? Nothing could be further from the truth, Ian.
Starting point is 00:19:15 And that's very sad, because I love your country. I consider it my second home. I have relatives all over the US. And I probably visited this country more than any other country in my life. But you spend $4.3 trillion on healthcare, highest health expenditure in the Western world, with the worst health outcomes.
Starting point is 00:19:34 So why is that? And it's because it's the most commercialized healthcare system in the world. I know a lot of people complaining about the Canadian systems. That's interesting. So that's some perspective here. Absolutely. Of course, people always want to improve on their own system, but I think perspective is important. So let's talk about what's called the social determinants of health. Yeah. So the social determinants of health actually is
Starting point is 00:20:02 probably the big issue when it comes to what influences your risk of disease and your longevity and your quality of life. So let's define it. It's the conditions in which you are born, grow,'s mental health, whether it's risk of cancer, whether it's heart disease, that actually even starts from birth. Right. Just to give you an extreme example, if you are a child that is a victim of severe psychological or physical abuse or even sexual abuse, that can automatically knock off 10 to 20 years off your life expectancy. Because the stress associated with that affects genes that control the aging process. And of course if you're aging quicker, you're going to be more risk of disease. If you are somebody that works in a high demand, low control, low paid job, very similar, effectively a death sentence because of the stress associated with it. So we have to shift the paradigm and
Starting point is 00:21:15 understanding health as well. And certainly estimates suggest maybe 35 to 50% of actual overall health is socially determined. And of course, then the other things that link to that are then going to be poor diet, more risk of alcoholism, for example, if you're growing up in deprived areas, more risk of being a victim of violence. This is important, Jan, for me as a doctor's perspective, because actually trying to improve individual and population health for the purposes of having a progressive functioning society, and even for the economy, because if people are sick, you're going to be less productive and the economy is not
Starting point is 00:21:59 going to function properly, is understanding this. I think most politicians don't get this. Most doctors don't get this. I think most politicians don't get this. Most doctors don't get this. In my view, every single politician, whatever their remit is, whether it's education or housing, needs to put at the forefront of what policies they're going to introduce that's going to be conducive to people's health. What's more important in people's lives than their health, Jan? Seriously, though, what's more important? I'm biased as a doctor, but what human being on this planet who is sane, okay, who is rational, would not say that the most important purpose of their life is to optimize their mental, physical, and social well-being, right? Sustained, authentic happiness,
Starting point is 00:22:39 good quality of life. That's what it's all about. It's very simple. So we have to understand what affects that. And then how can we create structures and systems and environments, right, where everybody can be the best version of themselves and everybody can flourish. In fact, it was Nelson Mandela that said, peace is not the absence of conflict. It's creating environments where everyone can flourish. It's interesting, because what you're describing, it's sort of, first of all, those numbers. Some of you said it's almost a death sentence. It's kind of, it's on average, right? It's not like every single person. That's important.
Starting point is 00:23:14 But the other part is, and this comes through in the film, that it's, a lot of that is reversible if you change some things about what you're doing. Absolutely correct. So that is the positive hope. The people that have done the most research on this, on stress and aging, for example, Elizabeth Blackburn and Alyssa Eppel,
Starting point is 00:23:33 who features in our film, who's the director of psychiatry at UCSF in California, actually showed that they published a paper in Nature, 2012, I think it was, Too Toxic to Ignore, how chronic stress accelerates aging. But what they showed is that pilot studies revealed that even within three months of lifestyle change, adopting a real food diet, moderate activity and stress reduction can actually affect genes that control the aging process, which is fascinating. So it gives people hope and of course that is something that people should be empowered with the end but also again you know the other side of it is
Starting point is 00:24:14 thinking about environments as well is somebody for example who is a victim of us an abusive relationship right isn't going to solve the problem by meditation. They need to remove that external abuse. So let's just think about it also, like, you know, it's not just one solution. You know, kids, they don't have agency. You know, every child deserves the right, in my view, to have a nourishing or to have a mother that is there for them, that isn't trying to make two ends meet, working two jobs and can't even be there to nurture her own child. That's not the child's fault. There's no responsibility for the child
Starting point is 00:24:55 there. So we have to think about that in terms of, well, have we created a fair system where people are actually getting paid enough that they can lead a healthy life? We can take power. We can take responsibility. We need to take responsibility. But the people who also need to take responsibility are also the politicians and the people that can actually exert laws, if you like, or policies that allow people to flourish. Well, let's talk about something that features very largely in the film, which is, you know, as you described, real food. I mean, isn't food real food?
Starting point is 00:25:35 So if you look at the data and statistics in the UK, where I come from in the US, you know, we have well over 60% of the adult population now overweight or obese. I would take it further and say that 88% of Americans have abnormal metabolic health markers, right, which is linked to waist circumference, being pre-diabetic or type 2 diabetic, having pre-hypertension or high blood pressure, having a cholesterol profile that is putting you at increased risk of heart disease. So effectively, the overwhelming majority of people in the UK who are adults and in the US are far from being healthy. And the primary driver from my own research and what data that's out there of that is poor diet. Now, what does poor diet mean? It means eating predominantly ultra-processed foods.
Starting point is 00:26:33 So, you know, 57% of the calorie consumption in the UK comes from ultra-processed foods, which I will define. More than that, probably I think 70% maybe, certainly above 60% of the calories in the U.S. diet come from ultra-processed foods. So what does that mean? It's what's being done to food that changes it significantly from its original form. And there are categories of that. There's that scale that is referenced. Is it the NOVA scale? The NOVA classification. And that comes from Carlos Montero, who's a nutrition scientist in the University of Sao Paulo in Brazil, and I think he's done pioneering work. I know Carlos. We've interacted with each other, and he's followed my work for a while, and he came up with this classification.
Starting point is 00:27:14 I thought it was brilliant. And the class four, the most processed type of food is ultra-processed, but that's what the majority of calories in the American diet is coming from the most processed foods. If it's essentially industrially packaged, if it's packaged food, anything in a packet, right, where you can count five or more ingredients, usually with additives or preservatives, it's ultra processed. And all of the data from a multitude of studies looking at dozens of health conditions all points in one direction. It's going to increase your risk of heart disease, cancer, mental health problems. I mean, one of the things I did for a while is I worked. I was an honorary council member for the metabolic psychiatry at the University of Stanford.
Starting point is 00:28:04 And one of the other things that comes out in the data, which is quite shocking, that if you have severe mental illness, including severe depression, bipolar disorder, or schizophrenia, automatically, that also reduces life expectancy by 20 years on average. 20 years. So why is that?
Starting point is 00:28:21 Again, a lot of it comes down to chronic stress, right? But also the diet that a lot of it comes down to chronic stress, right? But also the diet that a lot of people eat as a result of the stress, which makes them more vulnerable to getting these conditions. So the first thing I advise my patients is to quit ultra processed food. What is real food? What our grandparents used to eat, really, Jan? The staple diet in, for example, Britain, we call meat and two veg every day. JAREDY BALDRY- Well, I'm just remembering this Nova scale.
Starting point is 00:28:52 The category one is the full apple, full on apple. The second one is a chopped apple with the core removed, maybe the skin removed. The third one is applesauce. And the fourth one is the apple pie at a fast food restaurant. Yes. Without naming any particular fast food restaurant. Well, no, but it's very telling. off the awareness of the harms of excess sugar, who's a pediatrician, a pediatric endocrinologist in University of California, San Francisco. He articulates that beautifully in the movie, what ultra-processed food is and why it's bad for you.
Starting point is 00:29:34 There's another thing he says that I thought was really fascinating in there. And that is, you're talking about weight loss drugs, right? There's a huge craze and injectable weight loss drugs right now, right? And he says they work, right? But there's considerations to be had. Yes. So, well, okay, you tell me. Yeah. So he talks about these new weight loss drugs, Ozempic and Vigovi or whatever else that people, everyone does a big craze about. And the reality is, yes, they work, but you lose fat and muscle and you don't really want to be losing muscle. And of course, the cost, he says, if it was given to every American that was eligible for this weight loss drug,
Starting point is 00:30:16 it would increase healthcare costs by 50% and add another $2.1 trillion to what you're spending in healthcare already, and would absolutely cause Medicare to go broke. He said an alternative is if everybody in the United States actually stuck within the recommended intake of sugar, which is total sugar consumption during the day from all sorts of foods not being more than 12 teaspoons. What Rob Lustig says is pretty extraordinary. He said that would actually save American healthcare over three trillion dollars. What it highlights as well, Jan, again,
Starting point is 00:30:53 which is a lack of real understanding and education on diet and disease, which is something that, by the way, we're not trained in even in medical school. Most doctors don't know this. Poor diet is responsible for more disease and death globally than physical inactivity, smoking and alcohol combined. So the low-hanging fruit, the most important thing, and everything has a role to play of course, but the most important thing and what I tell my patients is the biggest impact on your health is going to be fixing your diet and you can't fix healthcare until you fix the food. In the film, you cover a range of conditions,
Starting point is 00:31:27 a range of treatments that were proposed for those conditions. One of them that's just jumping to my mind is Vioxx. We remember it as something terrible that happened a while back. But maybe if you could kind of reprise that for me. Yeah, so Vioxx was a drug that was heavily marketed, a blockbuster drug in the late 90s, produced by drug company Merck as a better alternative to ibuprofen as a painkiller. One of the problems with those anti-inflammatory drugs like ibuprofen is they do have a risk
Starting point is 00:32:01 of GI side effects, gastrointestinal, stomach ulcers, acid reflux, for example. And they said Vioxx doesn't give you that, or it's certainly a lot better. Ultimately, it was found that Merck had deliberately withheld information on the Vioxx, that it increased the risk of heart attack and stroke and death by at least twofold. And they were found guilty of fraud, and they were ultimately fined almost $1 billion in 2011. Of course, Vioxx was pulled from the market. But I think what was really extraordinary, which is highlighted in the documentary, which Dr. John Abramson, who was a Harvard lecturer who was involved in the litigation case, what was uncovered during the litigation process is that the chief scientist of Merck
Starting point is 00:32:40 actually, in internal emails, knew when the drug was being rolled out and was being marketed that it was going to increase people's risk of heart attack and stroke and death and to paraphrase him he says it's a shame about the cardiovascular effect but the drug will do well and we will do well and that's pretty extraordinary and even though Merck were fine they probably made more money from the sales of the drug than they did in terms of the fines they paid. Nobody got fired, no one went to jail, and he got promoted and I think ended up working for another company, this chief scientist.
Starting point is 00:33:16 It was estimated to have killed about 60,000 Americans, which is more Americans than were killed in the Vietnam War. That's just one example of fraud that we know of. But what the movie illustrates is, these are not anomalies. The current system is in place that almost encourages the pharmaceutical industry to engage in a business model which is essentially fraud, deliberate deception
Starting point is 00:33:43 in order to make money, because that is their primary imperative. And most doctors don't realize that those problems in the system that led to the Vioxx scandal have not changed. The primary obligation of big corporations, big pharma, is to make profit for their shareholders, not to give you the best treatment. And that's not controversial, that's just... This is fact. It's part of the current corporate capitalist system, right?
Starting point is 00:34:08 Although, interestingly, not long after America was founded, you could only form a company if you produced a product that was beneficial for society. Of course, we've gone from there to the point now where you can market unhealthy products to children. So the question is, how did that all happen over time, over the last couple of centuries? And it happened because those corporations over time were able to exert more and more power by manipulating the law to allow them to then be in the situation where they are now, where there are no real strong checks and balances.
Starting point is 00:34:42 And what Senator Ron Johnson says, who is a big supporter of private business, and I have nothing against big business or private business if they are selling you something that does what it says on the tin. The problem is this, is that we're getting far from perfect information on many products, but when it comes to health and drugs, the default situation now is that the information that comes from drug companies and medical journals will grossly exaggerate the safety and benefits of their products, which means there's no real true informed consent happening, but also you're going to then cause more harm onto society. Vioxx is one example of just how bad that could be.
Starting point is 00:35:27 And there's also certain kinds of treatments which are not publicized. Yes. Part of also this current model we have in healthcare sustains itself on actually, to a large degree, suppressing the system, suppressing alternatives that are going to be more effective and are going to save you from side effects and that comes back to lifestyle. And I think for me the next phase in the paradigm shift of heart disease is understanding that it isn't just, obviously we know it's preventable, but it's potentially reversible. And I was fascinated by that concept and went to India to meet a cardiologist where he shows, demonstrates with looking at coronary angiograms. That was my
Starting point is 00:36:15 bread and butter. That's what I trained in as an interventional cardiologist before I went down the purely prevention route. And I saw these angiograms where you look at the arteries and I saw blockages being reversed within a few years, which most doctors and definitely most cardiologists don't even think is possible. So the first thing, the fact that it's even happening, forget about why, is extraordinary in itself. And the next question is how has this happened? And it comes through a combination of lifestyle factors which is revealed in the documentary. You're not gonna give me a combination of lifestyle factors, which is revealed in the documentary.
Starting point is 00:36:48 You're not going to give me a bit of a hint here. It's multifactorial, but probably the most effective is related to one's mindset. Mindset change can actually play a profound role in reversal of heart disease? It sounds pretty amazing, but also it relates to the fact that we in the medical profession also have treated disease as almost single organ system problems when in fact everything's interconnected and it does come back to the mind. You know I say that you can't optimize your physical health without optimizing your mental health and vice versa but everything that goes on in the mind in the mindset and stress and how you deal with it will have an effect on the rest of the body. So I think everything goes back to that actually, ultimately.
Starting point is 00:37:31 I can't help but thinking about the quote you referenced at the beginning of the film from your father, in fact. I'll read it here. The ultimate purpose of knowledge is to reverse human suffering. When did your father tell you that? And tell me how it's impacted your life. You know, it's interesting. Probably a few years before he died, we had a conversation because he was getting very more interested, I think, in spirituality himself, especially the teachings of Buddha. So I think that's where really it came from, his sort of understanding of Buddhist philosophy. Well, and how is it relevant here? Well, first of all, for me as a doctor, you know,
Starting point is 00:38:14 my role primarily, my primary duty is to improve my patient outcomes. But that means managing risks of disease, treating illness. But suffering has a wide definition. It can be anything from people being in pain, suffering, loss, grief. But actually the broadest definition, which is where I think Buddha took us, was that it's the basic unsatisfactoriness of human existence or human living. And why that's important is, and one of the things that comes out in the in the movie, is that part of the solution to the current problems we face in healthcare actually comes back to
Starting point is 00:38:58 understanding what it means to be human and acting from a place of values. And what it means to be human also comes down to personal growth and self-knowledge. Socrates, I love quoting philosophers and ancient wisdom, but Socrates said the unexamined life is not worth living. And that actually comes back to understanding what's at the root of our own suffering ourselves. And once one understands that and works on it for personal growth, that actually is conducive to good health. So it comes back to how does one as a human being, individually, and then as a society, reach the highest state of being for the purposes of optimizing mental, physical, and social wellness. Well, I have to say, I absolutely love the film.
Starting point is 00:39:52 Why don't you tell me where people can watch it? Yeah, so we made this independently. We wanted to be free of any commercial influence. We weren't funded by a supplement company or an organic food company or certainly not a drug company. And it's online available for people to download for $9, $9.99. We have to put obviously our own resources and time and efforts into that. So we just really want to recoup costs more than anything else. But for me, it's about creating impact and change.
Starting point is 00:40:21 And the website that people need to go to is NOFARMfilm.com. So N-O-P-H-A-R-M film.com. Okay. Well, Dr. Asim Malhotra, it's such a pleasure to have had you on again. Thank you. It's great to be here, Jan. Thank you all for joining Dr. Asim Malhotra and me on this episode of American Thought Leaders. I'm your host, Jan Jekielek.

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