The Food Medic - S9 EP10 Exposing Data Bias in a World Designed for Men

Episode Date: March 13, 2023

In this episode we are joined by Caroline Criado Perez - a best-selling and award-winning writer, broadcaster and award-winning feminist campaigner.Her #1 Sunday Times best-selling second book, INVISIBLE WOMEN: Exposing DataBias in a World Designed for Men, published in 2019, has been translated into 30 languages and is the winner of the 2019 Royal Society Science Book Prize, the 2019 Books Are My Bag Reader’s Choice Award, and the 2019 Financial Times Business Book of the Year Award.This episode covers: When Caroline became a feminist What inspired her to write invisible women Why cars are less safe for women How medical research and healthcare is based towards men Male bias in PPE design (and nobody cares!!) Progress for women and girls If you loved it you know what to do - leave us a review, a rating (hopefully 5 stars) and share it with someone you know will love it too. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

When does fast grocery delivery through Instacart matter most? When your famous grainy mustard potato salad isn't so famous without the grainy mustard. When the barbecue's lit, but there's nothing to grill. When the in-laws decide that, actually, they will stay for dinner. Instacart has all your groceries covered this summer. So download the app and get delivery in as fast as 60 minutes. Plus enjoy $0 delivery fees on your first three orders. Service fees, exclusions, and terms apply. Instacart. Gro delivery fees on your first three orders. Service fees,

exclusions, and terms apply. Instacart, groceries that over-deliver. Hello, and welcome back to the Food Medic Podcast. I'm your host, as always, Dr. Hazel. It's our season finale, and to finish off what, what for me has been an epic season anyway is a guest who's inspired a lot of my work including writing the female factor our guest today is none other than caroline carita perez a best-selling author an award-winning writer broadcaster an award-winning feminist campaigner her number one sunday Times bestselling second book, Invisible Women, Exposing Data Bias in a World Designed for Men, published in 2019, has been translated into 30 languages and is winner of the 2019 Royal Society Science Book Prize,

the 2019 Books Are My Bag Reader's Choice Award, and the 2019 financial times business book of the year award so a number of awards for that book and i can absolutely let you guys know that it is one of my favorite books if you haven't read it yet you you must caroline was also 2013 recipient of the liberty human rights campaigner of the year award and was named an obe in in the Queen's Birthday Honours 2015. In 2020, she was the recipient of Finland's Han Award for Promoting Equality. In this episode, we dive into the gender data gap and how the world is typically set up for a male body, from mobile phones to car seats. Today's episode is brought to you by Whoop. If you're a weekly listener to the podcast,

you already know what Whoop is because I'm always talking about it. So you probably already know that Whoop is a digital health and fitness coach that specialises in breaking down your recovery, sleep and workouts via a non-invasive wearable device and companion app. But it's probably also worth talking about what Whoop doesn't do. It's not going to ding on your wrist when you get a text. It's not going to call you an Uber. It doesn't tell you the time. What it does track is every heartbeat throughout your day and break down all your data for you so you understand everything you need to know about your body. As a medical doctor, PT and nutritionist, this is the kind of data I love to geek out on. And over the years since wearing Whoop, it's been amazing to see my trends slowly but surely improve.

So I know I'm becoming healthier. I know I'm becoming stronger and fitter. Start tracking your health, wellness and fitness at a deeper level today. Head over to join.whoop.com slash thefoodmedic to get started. You'll get your first month on me. Caroline, tell us more about you and what you do, what's got you here today. So my name is Caroline Criado Perez and I'm a writer and I'm the author of a book called Invisible Women Exposing Data Bias in a World Designed for Men.

And that really is looking at the gender data gap. And the gender data gap is basically the term that I use to describe the fact that the vast majority of information we've collected historically and globally and continue to collect, everything from health data to economic data has been collected mainly in men. And that basically means that pretty much everything in the world from the medical treatment you receive to the car you drive has been designed primarily for men and therefore works better for men so that's that's really what most of my work centers around writing and and speaking and doing podcasts like this and sort of trying to spread awareness of the fact that most things in the world that we sort of assume are designed for everyone

are somehow gender neutral really have been designed for 50% of the population. Absolutely, and such important work. I'm interested to know at what point you became aware or most aware that this was a huge problem and shifted your work to doing this. So it was a gradual thing you know the first step really for me was understanding um the idea of the default male and recognizing that I had it in my own head so that happened for me god it's probably about 15 years ago now so I went to university as a mature student and didn't really know anything about feminism other than I wasn't a feminist

but I had to read some feminist analysis as part of my course and one of the books I had to read was called Feminism and Linguistic Theory and it looked at various ways that gender and language interplay and one of the things that the author wrote about was the generic masculine in language. So things like using the pronoun he to represent he or she, or man to mean humankind. And, you know, I think when people hear things like that, and I know I felt like this, you just roll your eyes and think this is so trivial, who cares? It's just a pronoun, get over yourself, everyone knows it's gender neutral. But she pointed to research showing actually when people hear these words they picture a man and that just completely blew my mind because I couldn't believe that I'd never noticed that before in my own head I suddenly realized oh yeah

I do picture a man and how have I never realized that so you know that was the first moment for me and I started then I realized you know when I hear actually pretty much any gender neutral term to talk about humans, I'm picturing a man. So that was step one. Step two was having had that sort of light bulb moment, I started noticing how often in other areas where we speak gender neutrally, but we're actually talking mainly about men. So, you know, if you want to talk about the economy, the vast majority of data that we collect and how we design the economy is really around the working lives of men. And it doesn't account for, for example, the huge amount of unpaid care work that is mostly done by women and is a huge contributor to the formal economy. And in fact, the formal economy, as we've saw saw during covid would completely fall down without this unpaid labor but we don't account for it when we're considering economic planning anyway lots and lots of other areas that started to add up into this sort of whole system in my head like a kind of gender matrix. And then when I was researching my first book,

that was where I came across the issue of medical data being mainly collected in men, and not just in male humans, but also male animals and even male cells. And that for me, you know, as someone who isn't a medic, was so shocking, more shocking than anything else I'd come across, which was, you know, economics and public policy, where you sort of think, well, that's sort of human designed, you know, you kind of expect there to be bias in those sorts of human cent the bodies of humanity as somehow too niche and complicated to include in our understanding of human bodies just was so shocking to me. women are actually being harmed as a result and sometimes dying as a result was enraging and that was what ultimately tipped me over into writing Invisible Women because you know I'd been building this sort of sense that this is a systemic issue but once I realised that it was even affecting something like medical science which should be completely objective was like a final straw. I completely like feel that

frustration and your shock of coming across that I very much experienced myself and at medical school there's no mention of this and the only kind of important biological differences between males and females that are pointed out are down to reproductive issues and differences. Our ovaries are the only thing that sets us apart. in health and healthcare was pretty shocking because I was a doctor working in a busy acute healthcare department treating both men and women with heart attacks with outdated biased information that was based on studies done on men and so it was no surprise why women don't have the same outcomes as men why more women in the UK die of heart attacks and are less likely to go to rehab and aren't being prescribed the right medication and it blows my mind that it took so long for us to get here for this to be a conversation

and it was reading in your book that prompted my research because I was surely this can't be right surely not and the more and more you uncover is the more you want to dive deeper and it doesn't it's not just in medication trials it extends all forms of health care and it's not just reproductive health and things that affect women although that doesn't get as much funding as it would for men. It extends to everything from mental health, heart health, gut health, across the board. And I think we need a complete restructuring of medical curriculum to understand, you know, because there's so much we don't know. But that was one fascinating part of your book. But it was not the only part that you uncover and highlight areas in our lives and in the world where it's basically set up for a male body and a man.

Can you give us some other examples? Because reading your book, it was almost like every chapter I was like, what? But then it made so much sense as well. It's just it's never been questioned. Sure. Yeah. But I mean, it is in everything, really, because it's systemic. And it's systemic because it is the product of this way of thinking, you know, this bias that we all share where we conceive of men as if they're gender neutral and women as if they're slightly niche variants a sort of subman typical right yeah exactly we're like that man is the the standard

and we're this sort of little i'm just thinking like a little family tree and you've got man there and then you've got little woman coming down there um which is literally you know like on medical posters right you have i'm trying to think which, I think it was like a poster of the nervous system. And of course, you've got the standard male body and then there was a little female pelvis, literally off to one side. Yeah, so all sorts of areas, you know, I've sort of mentioned the economy. is cars and it's also one of the most dangerous examples which is basically that cars have been tested mainly on dummies that represent the average man and that is because that's the dummy that we have there does exist um what is called a female dummy This dummy is actually just a very small version of the male dummy. It's just the male dummy scaled down.

And obviously women are not just small men. Like we are on average smaller, but that's not the only difference. There's all sorts of really relevant differences, like the pelvis, like spinal column flexibility, like muscle mass distribution, which all lead to issues when it comes to car crashes because the car has been designed to protect this particular body so any way that the female body deviates from that body it is not as well protected so things like the seats are designed to absorb the weight

of a heavier body than the average female body. So women tend to get thrown further forward in the event of a crash because they kind of bounce off the seat. Seat belts haven't been designed to accommodate breast tissue. They also haven't been designed to accommodate the female pelvis. So seat belts are designed to sit on the hip bones. And the reason for that is so that the bones catch the force of the crash rather than the soft tissue but because the female pelvis is slightly differently shaped what can happen to a woman and this happened actually to a woman that I spoke to the seat belt slides off the bones and onto the soft tissue and obviously then the soft tissue is taking this huge impact of the crash and can cause catastrophic bleeding so anyway all sorts of design issues like that and they lead to women being overall the latest

research shows 73 percent more likely to be seriously injured or die in a car crash than a man in the same car crash which is just a massive disparity. And the thing that is really frustrating about all of this is that we have known about lots of these disparities for a long time. You know, we've known about the disparities in car crash safety for quite a while. You know, you spoke about what you were taught at medical school that you weren't taught about the differences between the male and female cardiovascular system. But there again, that is the one area of medicine where we have known for the longest that there are these differences. And we know the most about the differences that there are. But we aren't doing much about it so I was just reading a paper today actually about research into the

sex differences when it comes to um heart failure and I read about this study that I actually reported on in Invisible Women which is this you'll know what this is but probably your listeners won't so I'm going to simplify it which is basically a sort of kind of like a pacemaker but a bit more something sophisticated. Anyway I read this meta-analysis that was done of this device which found that the threshold like many things had been set according to a male level and when they looked at all the meta-analysis of all the data of all the studies that are done and looked at the very few female patients that had been involved in them when they put them all together they realized the threshold might be too high for women so i wrote about that study it was it's probably about eight years old

now and a review that just came out at the end of last year just sort of rather casually mentioned that this threshold difference hasn't been incorporated into guidelines you know you just sort of read that and you just think, this is a device that has been shown that women's lives could be saved if we don't have a universal one size fits men guideline. And yet, for some reason, we don't change it. We haven't even done follow up studies to confirm the meta analysis. And I find that incredibly frustrating.

Yeah, I completely agree with you I do see a lot more research emerging in health and healthcare around sex and gender differences and the British Heart Foundation are doing a lot on that with kind of the bias in in heart care for example or cardiovascular care but it's not yet being integrated into practice and you know it's it's one thing just talking about it it's not yet being integrated into practice and you know it's it's one thing just talking about it it's great that we're doing the research and and sharing this information but as you quite rightly said it just casually mentioned it's just casually published but it's not making headlines it's not changing practice and I do notice small subtle

changes and I've medical students like screenshot some of their lecture slides where there will be one lecture slide now that's like in kind of cardiovascular health or like heart attacks that women may present differently. Or as they say, atypically, because again, we are not the default. But it's very vague. It's not very descriptive. It doesn't seem like they're really explaining why and that this isn't just wrapped up in biological differences but also our kind of expectation and social norms of who should suffer from a heart attack and it can't be a woman because it's always an older man gripping his chest and that's what a heart attack looks like and so it's so interesting unraveling all of that and I think having these conversations is so important because it puts at the forefront of people's minds,

especially women who don't think that they fit that type or that patient, to realize that we are all at risk and we all experience the same conditions when we kind of match it all up together. It's not just men who are experiencing or dying from heart disease so I feel that frustration with you you also talk about other parts of health care in the book as well and I'd love to kind of explore that more about the how maybe it's all in women's heads and they're not really experiencing these real physical symptoms and differences in pain thresholds and things like that it's another one of those areas where again yeah the classic paper on on women's pain being dismissed i think came out in the 90s and very little seems to have changed since then where subsequent

studies still show that if a woman presents in pain versus a man presenting in pain the man will get given painkillers the woman will get given antidepressants. And I'm not really sure what you can say to that, other than clearly, these doctors need better training. And, you know, obviously, pain is a very complex issue that we still need to understand a lot more about. And I'm not about to, I mean, I'm not a medic. medic but obviously there is an interaction to a certain extent between pain and your and your mind but that doesn't mean that all women who are in pain are just depressed versus all men who are in pain are actually in pain like I find that such an interesting and stark statistic that you know this disparity between how men and women

are treated when they're in pain and And of course, there are more conditions that women experience that we just know less about. And that's another part of it, you know, that one of the reasons women may be told that their pain is just in their head is because they may be experiencing pain as a result of a condition that is not as well known. So things like, you know, obviously the classic one being endometriosis and how long it takes for that to be diagnosed with women being sent away for years before finally someone listens to them and takes them seriously and says, actually, yes, you do have this physical thing that's wrong with you. So it's a mixture of bias and the gender data gap. I would say the pain issue of a women women who

experience pain often experiencing it because of something that is more female dominated which always means it's less well studied but also that we somehow discount we discount women's experience when they say that they're in pain there was this really quite shocking study, I think, that I wrote about in Invisible Women that played babies crying to fathers. And the fathers rated the babies as more in pain when they were told that the baby was male rather than female, even though it was the same baby a definite bias when it comes to female expressions of pain that somehow we just for whatever reason don't believe women when they say that they're hurting that's so fascinating and quite eerie as well it is yeah you know and I suppose I mean I would have thought that it ties into the sort of social idea that women complain and women whine and all these words that are associated with women, which aren't true. You know, women don't say that they're in pain any more than men do. But there is this cultural stereotype that women do do that, that women are weak, that women cry, you know, all these things that we think women do.

And inevitably, that will feed into the way that people respond to women. 100%. And until that narrative's changed, this will continue. Quick one. I have a new and exciting membership coming out, and I want you to be the first to hear about it. I started The Food Medic over 10 years ago and my mission has always been to bring evidence-based health and nutrition information that's easy to follow and practical to implement. And if you're listening to this podcast, I'm going to make an assumption that you're someone who prioritises their health and seeks out high quality information from trusted sources. So that's why I'm inviting you to join our new and exclusive membership, the Food Medic Hub, which allows you to take charge of your health with support from the most trusted experts in their field. Inside you'll get access to hundreds of easy and healthy recipes, including breakfast, lunch, dinner, desserts and snacks, so you can enjoy nutritious nutritious delicious food every day.

A library of expert written articles on nutrition, health and fitness to help you cut through the noise and implement the latest scientifically proven advice. A rolling full body strength program to keep you feeling strong and energized in your body and with our Food Medic Plus membership you'll also get access to our library of CPD endorsed webinars worth £30 each that dive into the latest developments in health and nutrition with leading experts. Every month, the Food Medic Hub will continue to grow with new recipes, articles, workouts and webinars so that you're always at the forefront of wellness. Whether you're just starting your journey or looking to elevate your health, the Food Medic Hub is your number one support system and resource to achieve your goals in 2023. Head over to www.thefoodmedic.co.uk to join now from £9.99 per month. One of the articles that you wrote during the pandemic was around PPE and how it's, designed for a male body and so I think you're getting messages from

from women working on the front line to say that you know it wasn't correctly fitting them and as someone who has worked on the front line I can also say that those masks are built for a larger face and not for a female face and so you're doing things to try and make it tighter on you to fit it in different ways and I kind of wanted to step into that a little bit to see what you found from your research and what kind of messages you were getting. Yeah I mean I was just inundated with messages from women on the front line telling me that all of their PPE was too big from the gloves to the gowns to the masks to the shields and the face shields one of the things like that was just so ridiculous was I had women telling me that basically the face

shield will get stuck on their boobs when they looked down which is quite a common thing you know you're looking down at someone in the bed yeah and this thing that's protecting you is preventing you from being able to do your job. The masks were obviously the big issue in COVID because that was the number one piece of PPE that was going to be protecting you from this airborne virus. And women were just saying that it was it was too big in order to make it fit. They were having to pull it so tight that they were developing sores on their face or even, you know, it was interfering with their sight because it was coming up too high on their face or when they were pulling it, it would cut into the bottom of their eye.

So it was causing a lot of pain and discomfort, obviously also a lot of concern because women felt that they weren't adequately protected, which would have been terrifying, particularly early on in the pandemic when we didn't know what we were dealing with. So causing pain and discomfort, but also getting in the way of being able to do their job. And when I started looking into the research, I'm afraid that once again, I came across quite a lot of studies going back quite a long time that showed that these masks do not fit female faces as well as

they fit male faces but nothing is done about it when I spoke to I tried to contact several manufacturers only one of them got back to me and they said oh well we designed to the European standard EN 149 if anyone's interested so I went and looked up EN 149 and it doesn't really say anything about fit other than the fit section basically says that it should be tested on 10 clean-shaven persons which I think is a very interesting tell and that's it and it doesn't say anything about the demographics of these clean-shaven persons other than that they should reflect the workforce that they are intended for well the medical workforce is about 70 female so they should be there should be seven at least seven of those 10 clean-shaven individuals should be female but there's there's no real

stipulation for that and i spoke to testers you know like the the labs that do these tests and they were very unforthcoming the other thing that i found which was quite funny was that the the labs that do these tests and they were very unforthcoming the other thing that i found which was quite funny was that the the sort of other tests that's slightly related to fit that's sort of about testing the filtration of the mask is that it's put on um what's called a sheffield head and this is a dummy head that is um called the sheffield head because it's literally the model of the head of a man from Sheffield who happened to work in the lab at the time that they came up with the idea

of the Sheffield head for testing masks. But yeah, so the thing that's frustrating about the whole we designed to the EN 149 is it doesn't actually really say anything. There's nothing in it that prevents manufacturers from designing a mask that fits female workers. There's nothing that forces them to, but there's also nothing that prevents them from doing it. So it's not really the answer. And the answer is just depressingly somebody making it their problem and making it happen. Someone who has the power to make it happen

like the nhs procurement has the power to make it happen but someone would have to actually decide that this was important and so far there just seems to be a lot of resistance to accepting that there's a problem here and all the testimony from all the female medics doesn't seem to be enough you know I tried all sorts of things we tried to get in touch with Matt Hancock I got loads of people to write to their MPs the government just came back saying masks are designed to be unisex what does that even mean faces aren't unisex well that's it that is mind-blowing yeah that you can present with that information I think again the assumption and the default is that we are just smaller men and so it's fine but like you said in the setting of

an airborne virus it could be life or death and it it stops people from doing their jobs properly and feeling safe doing it which is also bad for the patients yeah right if your doctor is having to fiddle around with her mask can't see properly is really in pain she's not going to be able to give you the same level of care as she would if she were improperly fitting PPE that is helping her do her job as opposed to making her harder yeah absolutely I mean it's hilarious but also quite sad when I think back on like really how poorly fitting PPE was and a lot of women are a lot smaller a lot shorter than men as well and your gown would be just trailing on the ground because they're just so huge um it's there's just no excuse really so hopefully someone listening to this podcast can also try hopefully hopefully

someone has the power somewhere to make change but it needs to happen 100 do you think in the past few decades with conversations like this there is progress to close that gender gap and when do you think that it will close if ever? There's definitely progress you know as you said when you look at the number of studies that now consider sex include females do any sex analysis that is increasing it's still far too low but it is better than where we were you know and these conversations are happening and awareness is spreading so there's been progress in that context the next step is the more difficult step of solutions you know having someone actually apply the research and fix these things and again you know that does trickle through

so i mean for example some of the findings from heart failure research have um i mean tell me if i'm wrong and i hope i'm not so something for example like trip the troponin level which is uh i think it's a protein that they measure to show whether or not you're you're having a heart attack or had a heart attack and you know that level used to be set at a male threshold and there was some research that showed actually that threshold was too high for women. And my understanding is that they now do a lot of places. You're looking at me like you're saying, no, that doesn't happen. But they do have this sort of sex.

That research definitely did come out. Whether we're universally using sex thresholds, I can't confirm. But I know that research and I know the British Heart Foundation released it and it has changed that awareness but whether it's being integrated into practice across the board right TBC okay um hopefully some some cardiovascular doctors can confirm yeah maybe someone can write in and say don't worry it's all fine yeah um the guidelines have changed so I think things are slowly getting better. The problem is there's just so much to do.

And we are talking about in every area of life where pretty much everything that you look at, there is a gender data gap. And that has resulted in the design of policy and objects that just don't work as well for women and and they're from the very very trivial to the potentially life-threatening so it really requires you know people in every walk of life taking on the little bit that they can and fixing their area you know so doctors in various different specialities, economists, car manufacturers, you know, phone designers, phones being too big for the average woman's hand. Pianos, right? The piano keyboard is a unisex keyboard based on a hand that size is actually too big for most men as well. And I interviewed actually this pianist who had started using a smaller keyboard. And she had this really beautiful sort of analysis or take, I guess, on why we should care about this. You know, it sounds like something quite sort of rarefied.

Like, really, we've got to worry about piano keyboards when we've got car crashes and heart disease. And she sort of said you know I know it's not life and death but the arts are a really important part of being human and if you have this tool and that's what a piano is for a musician a piano and especially a composer not just a pianist but a lot of composers will use the piano to compose um if you're having a tool that cuts this huge swathe of the population out of being able to create effectively on it you know that diminishes us all and is a loss to to humanity um and i just thought that there was she obviously put it much more beautifully than me but I thought that that was a really um a really important point um and and I think it applies to to everything that we're talking about because a lot of these things that we're talking

about you know some of it is things like medical treatment but a lot of it is about tools that we use of one form or another that have not been designed around either the female body or the female experience and therefore women just don't fit them as well. And so instead of helping us, they hinder us. Yeah. And what does that do, first of all, to women as they navigate their lives, you know, around a public transport system that's been designed around how men travel or cars that have been designed around the male body or you know whatever it is but also how

does it affect all of us in terms of it preventing women from fulfilling their potential because instead of spending a hundred percent of their effort on doing whatever it is they're doing they're spending x percent of that effort navigating and trying to fit into a system that wasn't designed for them yeah that's it I don't need to ask you anything else. You've said it. Okay, great. Let's have a croissant. No, just listening to you there,

it really puts it into context of how widespread it is. And yes, some people might think it's trivial that we don't have keyboards that are catered for a female hand or body but it's not trivial because it extends to so many other things and quality of life and mental health and careers and enjoyment and hobbies and everything else and it just should be fair it should be equal and we should all be able to enjoy these things i guess i'd love to finish by just asking what would be your biggest takeaway from this episode or that you wanted people to take from Invisible Women?

Can I have two things? You can have two things. So the number one thing is to collect sex-disaggregated data. And obviously that won't apply to lots of people because not everyone's collecting data. But if anyone listening to this podcast is collecting data they need to be collecting sex disaggregated data and the second thing is just to remember that men are not gender neutral and I think that's really the key to everything because as soon as you recognize that men are not gender neutral

and stop to think hang on a minute am i positioning men as the gender neutral sex here then you realize well that's ridiculous because they're not and so everything that stems from that assumption is wrong yeah and what stems from that assumption well what stems from that assumption is collecting data on them and thinking it applies to the rest of humanity so that is that that really is the central point to invisible women is that men are treated as if they're gender neutral they're not let's stop doing that yeah amazing before you go i do have three questions for you um they're very quick fire well the first one you may not think so because it tends to stem people what's one thing that you've changed your mind about oh that's very easy feminism I used to

not be a feminist I hated it I thought it was embarrassing and now look at me I love that what's a non-negotiable in your day oh caffeine agree agree I'm there with you on that one and finally we are a food podcast what would be your death row meal oh see that's very that's actually the one that's going to stump me because um i i have very bad acid so a lot of food um well i am food is like a horrific thing for me it's a constant challenge and stress so probably something very bland so i didn't get acid okay a banana although i suppose if i'm gonna die you're gonna die you're not gonna experience it it's gonna be So probably something very bland. So I didn't get acid. A banana. Although I suppose if I'm going to die, I can have whatever I want. You're not going to experience it.

It's going to be straight after. I probably have. Okay, but straight after, I'll have a hamburger and chips because I can never eat that. Amazing. Amazing. Well, let's hope that you can't eat it before then. Let's hope. Caroline, it's been such a pleasure to have you on the podcast.

Thank you. Thank you for sharing all your insights. If people do want to find out more about your work, ongoing work, articles that you're writing, where's the best place to direct them? Probably my newsletter, which is very easy if you can spell my name. It's newsletter.carolinecriadoperas.com or Twitter, which I think has a link to my newsletter. That might be easier. So see CriadoParris on Twitter.

We can pop it all in the show notes and make it easy. Thank you so much. Thank you. What an episode and what a guest. Before you go, I want to quickly flag something that came up in the podcast. In this episode, we discussed troponin, which is an enzyme that's released during heart attacks. And we were talking about the cutoffs for males and females. So I just wanted to come back and clarify that. So to my knowledge, this is not routine practice yet. And so I reached out to a cardiology consultant

to confirm, who did confirm that currently sex-based cutoffs for troponin are not currently used within official guidelines or UK trusts in the UK. If they are, it will be used as part of a trial. So if there are any doctors listening, their medical students, if that caused any confusion, I hope I've clarified that. So for now, that's all we have. And perhaps we need future research to confirm and inform guidance moving forward and hopefully we will have that soon and so I guess that brings us to the end of season nine but don't worry as we are already planning and securing guests for season 10 so if there are any you would love to hear from drop us a message and let us know because we want to make sure we continue to be

one of the top rated health podcasts and with that before you go a little favor from me I would love for you to rate the podcast leave a review and share it with someone you know will love it too it honestly helps us so much to keep doing the work that we do and continue bringing you more episodes just like this one that's all from me see you again on the next season