Morning Wire - Dissecting Medical Establishment "Blind Spots" | Saturday Extra

Episode Date: September 14, 2024

As Americans begin to realize the medical establishment is not the free marketplace of innovative ideas it was once thought to be, Doctor and New York Times best selling author Marty Makary maps out a way forward in his new book “Blind Spots.” Get the facts first on Morning Wire. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Forever. I just love my job. Get tickets now. The Devil Wears Prada 2 in theaters, May 1st. Directed by David Frankel. One of the biggest takeaways from RFK Jr's remarkable run as an independent is that Americans are deeply interested in an overhaul to our approach to health. The wall of censorship around COVID tipped many people off that the medical establishment isn't the free marketplace of innovative ideas that we trust it to be. But it doesn't have to be that way.

In this episode, we speak to a renegade physician who's made a name for himself for thinking outside of the box about his new book, Blind Spots. I'm Georgia Howe with Daily Wire Editor-in-Chief John Bickley. It's Saturday, September 14, and this is an extra edition of Morning Wire. What's the secret sauce behind wildly successful businesses? It's not great products or brilliant marketing. It's the unsung hero, the business behind the business. For millions of entrepreneurs, that hero is Shopify. Shopify boasts the number one checkout on the planet.

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Dr. McCarrie, thanks so much for coming to our studio today. Great to be with you, Georgia. So I started your book yesterday. I've already, I told you, recommended it to about five people. It is such a great read. There's a lot to cover in it. But I just want to give our audience an idea of what you mean by blind spots. So you start out the book talking about the peanut allergy example.

Can you just briefly tell us about that so people kind of know what you mean by blind spots? Well, there's a lot of areas in medicine where we need an entirely new approach. And if you look at our track record with peanut allergies, for example, we thought we were preventing peanut allergies by telling people to avoid peanuts early in life. the American Academy of Pediatrics put out this recommendation about 24 years ago, telling all mothers and young children to avoid peanuts around the kids. And it turns out peanut avoidance didn't prevent peanut allergies. It caused peanut allergies. And so we saw this rapid rise, ushering in the modern day peanut allergy epidemic. We saw severe allergies, the type where

a kid can go into anaphylaxis or can't breathe, just being around a peanut. This was a new type of peanut allergies, and it was all ushered in by this dogma that you should avoid peanuts altogether. The medical establishment got it perfectly backwards, and that's because they didn't use good science. They just went on a gut feeling. When the study finally got done and was reaffirmed in the New England Journal of Medicine recently, it showed that they were completely wrong in that recommendation. Now, how many years were they telling mothers not to give their kids peanuts? 15 years. The first study that pointed out that it was the wrong recommendation was in 2015,

about nine years ago, but more studies have come out since. But the dogma still lingers, because pediatricians put out this sort of easy to remember saying that when the child is one, you can start introducing certain foods. And when the child's two, you can introduce milk and eggs. And when the child's three, you can introduce peanuts. Well, that was all nonsense. The so-called one, two, three recommendation. We now know from the best evidence that to prevent many of these allergies, you want to introduce these things early in an infant's life as early as three, four, five months of age as soon as a child can take oral intake, not in substitute of breast milk, but in addition to. And of course, we don't want kids to take peanuts whole. That's a choking risk.

It's peanut butter, peanut-related products. Many countries around the world have done this. In Africa, they boil peanuts in soup, and there are no peanut allergies, zero in Africa, except in the few Americans that visit Africa. So in your book, you talk about some famous blind spots in medical history, but what do you think are some of the biggest blind spots that are lingering now kind of waiting to get the lid blown off? Well, we've got to take a whole new approach to health. Our system is so broken. So a new generation of doctors are now thinking differently. Maybe we need to treat more diabetes with cooking classes instead of just throwing insulin at people. Maybe we need to treat obesity by talking about school lunch programs, not just giving ozempic to every child. Maybe we need to treat more high blood pressure by talking about the quality of sleep and stress management, not just throwing anti-hypertensive mezzapy.

people. We have the most medicated generation in human history, and we can keep throwing good money after bad into this broken system, or we can take a new approach, talking about food as medicine and general body inflammation and things that increase inflammation and reduce inflammation, and talking about the health of our microbiome. You know, the best way to lower drug prices is to stop taking medications we don't need, and the best way to reform health care is to focus on health, not just playing whack-a-mole with disease and chronic disease treatments. So I consider myself to be pretty medically savvy, but the third chapter of your book, that's about the microbiome, I found very shocking in terms of just the long-term effects of

antibiotics. Can you just give our audience some background on first just what the microbiome is and some of the new things that we're learning? Yeah, so the microbiome is this brand new field of research that's exploding. The microbiome itself is that, the bacterial garden of different bacteria that line the intestinal track or the gut. And these bacteria help with digestion. They train the immune system. They even produce serotonin, which goes to the brain and changes one's mood. So we're learning a lot of how the microbiome affects overall health.

We're also learning about things that damage the microbiome, like processed foods and antibiotics, even being born by C-section versus through a vaginal delivery. So that was actually a part that was very interesting to me when you talked about the C-section associated illnesses later in life. How does being born by C-section predispose you to illnesses decades later? Yeah, so first of all, C-sections save lives, and they're oftentimes necessary, but they're also massively overused. And what we've learned in clinical medicine now is that when a baby,

So a baby in utero has a sterile gut. The microbiome that garden of millions of different bacteria that live in harmony throughout the gut lining is seeded by the bacteria in the vaginal birth canal. And when a baby is born vaginally, those bacteria then form the microbiome and it's augmented by bacteria from breast milk and from the skin. But when a baby is born by C-section, a baby is extracted out of a sterile operating theater. And What may see the sterile gut is not the normal bacteria from the vaginal canal and breast milk. It may be bacteria that normally live in the hospital, altering a child's microbiome potentially for life. And when a kid gets antibiotics, oftentimes unnecessarily, that also alters the microbiome. And it's no wonder now that we're starting to see research suggesting a link between people getting colon cancer early in life before age of, 50 and being born by C-section. That study just came out months ago in our journal JAMA. There's also this observation that a lot of diseases are new, and they correlate with this modern era of altering or messing up the microbiome. Ulcerative colitis, Crohn's disease, these inflammatory

bowel conditions were undescribed before the advent of wide use of antibiotics and the modern era of C-section deliveries, suggesting that we've ushered in a new host of chronic diseases. And probably the kicker study that is one of the most significant studies that was massively overlooked in the modern medical establishment was a study out of the Mayo Clinic a few years ago that I detail in the book where the researchers looked at a large population of children, 14,000, and looked at those who had received an antibiotic in childhood compared to children who did not get an antibiotic in childhood. And they found kids who took an antibiotic in childhood had much higher rates of obesity, asthma, learning disabilities. And if you remember, there's that serotonin

connection between the gut and the brain. So this association was dose dependent, which means the more courses of antibiotics the child had in their childhood, the greater the risk of these diseases. to the point where celiac disease was almost 300% more common among a child who had had an antibiotic in their childhood versus a child who did not, suggesting this strong link between the microbiome and all these chronic diseases we chase in modern medicine. So one thing that struck me is that if we now know that the microbiome is linked to all of these chronic diseases, things that are becoming very common, why do we not hear more about the microbiome in our primary? care checkups. Look, it's in one of the blind spots of modern medicine. It's one of the areas that has not received appropriate research funding. Who's going to fund research on the microbiome?

Big Pharma, the American Academy of Pediatrics, NIH. No, these are, all of these forces in healthcare are either set in their traditional ways or they're funding research that drives drug development. So this has lived in a giant blind spot along with food as medicine and the role of inflammation in the body. A lot of diseases are tied to inflammation, heart disease, and maybe even cancer, as suggested by that one study. So I was really glad that in your book, you addressed the old cholesterol dogma. This is partly because I'm a huge proponent of my carnivore diet or a carnivore plus cheating diet, and I'm sure my colleagues are sick of hearing that. But it's just a great example of how bad and even dangerous advice can get propagated for decades. Can you briefly explain some of the truth about

cholesterol and how we got panicked about eating fats and what it shows us about the culture in medicine? Yeah, so there's this old dictum, and it's interesting, medical dogma can take on a life of its own, and it can become sort of the high law of the land. And so we got the low-fat diet wrong for about 60 years. This was the number one health recommendation we as doctors gave to patients when they came in to see us. When we talked about, general health prevention. That's the first thing people went to. It turns out that high fat diet was studied three times with major studies and was never found to be associated with heart disease. We now know it's the refined carbohydrates or the simple sugars that oftentimes is put into food

to replace fat to retain the flavor. That's what drives a lot of the general body inflammation. even cholesterol, which is a little bit of a separate topic, cholesterol that you eat is not even absorbed by your gut. Over 90% of it goes right through your gut and is not even absorbed. 99% of your body's cholesterol is produced by your body. So this idea that you need to avoid this food because it's got cholesterol or Cheerios are good because they're low in cholesterol or may help lower your cholesterol or whatever the claim is, it's ironic because the cholesterol is bound to something called an ester. It's esterified, which means it's too bulky to be absorbed when you eat it through your diet. So what we should really be talking about is ultra-processed foods,

refined carbohydrates, things like simple sugars, things that are not bound to fiber. So your body absorbs it so much quicker and your insulin level spikes, not like complex carbohydrates, like the kinds found in fruit and vegetables, they get absorbed slowly as they go through the GI tract. and like the kind that are bound to fiber, which means it's going to go down the tracks slowly and be absorbed with a lower spike of your insulin levels. How did we get it so wrong for so long? And what was the initial impetus for putting out all this advice to avoid fats? It was really one guy, this guy named Ansel Keys in the 1960s.

After President Eisenhower had a heart attack, the country wanted to know what caused the heart attack. And so he rose to the occasion and said very publicly that it was he had had too much fat in his diet. Well, it was a theory and it was supported by a really sloppy epidemiological study that he put together. He had looked at about seven countries and said, the more fat they ate, the higher the rates of heart disease deaths. Well, he left out a lot of countries. And if you include the full set of 22 countries, there was no association. And so it was a very sloppy study and a cost and effect could not be derived from that study, but the bandwagon effect took place.

The herd mentality in medicine latched on to this idea that fat was bad for you. And for 60 years, it really became the medical dogma that dominated the American Heart Association. And, you know, they made a lot of money from it, too. The American Art Association sold a little healthy heart seal to restaurants. So every little Italian restaurant would pay the Heart Association a licensing fee to represent what foods were low in fat and cholesterol. The whole thing was a giant scandal. But you don't see an apology. And that's where I think there's a lesson for today.

Just like with COVID, you don't see the humility to say, we got this wrong. We're sorry. And I think in medicine, you've got to tell people, I don't know when the right answer is, I don't know. Now, in your book, you purposely avoided addressing COVID because you said it was just still too polarizing. I think for a lot of people, that was the issue that opened their eyes to some of the problems in the medical establishment. Do you think post-COVID people are now more ready than they were before to ask questions and scrutinize the medical establishment? I think there is a healthy tendency to ask questions now because COVID was a little sneak peek into the paternalism that we see. in modern medicine, the just do what I say, don't ask questions, attitude. And it's not the first time

we've seen it. When home pregnancy tests were developed, doctors fought the move to make these available directly to women. Women can't handle this information on their own, was their mindset. Same thing with HIV testing. You couldn't get the results of an HIV test without a doctor's visit, without a doctor sitting down and giving you the results. You know, that ultimately changed. We saw that same paternalism with COVID home testing. Chantanunundi, a doctor that I work with, and I wrote a piece calling for home testing for COVID, and we were given the same response. How dare you? People can't handle this information. Eventually, that's what we moved to, but people are now asking healthy questions,

and I think it's good for them to know that when modern medicine uses good scientific principles, we help a lot of people as doctors. When we wing it and rule by opinion and force people to do things when there's no scientific evidence to support it, we do a lot of damage. We generate an epidemic of mistrust. And if you look at our track record where we rule by opinion, it's pretty lousy. We got the low-fat diet wrong for 60 years. We ignited the opioid epidemic by saying it was not addictive. For 30 years, we got that wrong. We got peanut allergy recommendations wrong for 15 years. We got hormone replacement therapy wrong. We still get it wrong for now 22 years. And some might say that the entire COVID pandemic was avoidable, had the medical establishment

not been promoting messing around with bat coronaviruses in a laboratory. The entire nightmare could have been preventable if you believe in a lab leak, which is what I do believe is the origin of it, why is it that a small group of people get to decide what risks the world should take? And more broadly speaking, how is it that a small group of people get to determine what research we fund at the NIH? Or why is it that a group of pharma executives get to decide how much money research institutions get and for what purpose? So we've got to start talking about health, not just dogma. And unfortunately, medical dogma still looms large.

Last question. I've heard the phrase before that science progresses one funeral at a time. Do you think that new doctors coming into the profession now have a healthier mindset around this? Or do you think paternalism is something that we'll see with this current generation as well? So there is a struggle in modern medicine today. The struggle is between the rank-and-file doctors. The young generation also is part of this group of physicians who is thinking differently. They're kind of fed up with the status quo and they want to think about health in a healthy way and they have humility when they approach problems.

They know how to say, I don't know and that's the right answer instead of making something up. And then there is the organized medical elite, a small group of physicians who believe that medical recommendations should be centralized. And this tension is alive and well. We see it almost every day in our research articles that come out in studies and what we're allowed to work on and talk about and discuss in medical journals. So I am encouraged by a young generation of doctors now who are coming in with a whole fresh new approach. They see a broken healthcare system and they don't want to have anything to do with it. They want to try new things. They're entrepreneurial. They want to do primary care because they see the benefit of spending time with people. They want to get deep into

certain areas of research that prevent disease, not just treat it. So I am encouraged by what I'm seeing today. All right. Well, Dr. McCarrie, thank you so much for coming on. Great to be with you, Georgia. That was Johns Hopkins, Dr. Marty McCarrie, discussing his new book, Blind Spots, available September 17th. And this has been an extra edition of Morning Wire.