The Sevan Podcast - #237 - Dr. Aseem Malhotra

Episode Date: December 22, 2021

The author of "21 Day Immunity Plan". Dr Aseem Malhotra is an NHS Trained Consultant Cardiologist, and visiting Professor of Evidence Based Medicine, Bahiana School of Medicine and Public Health, Salvador, Brazil. He is a world-renowned expert in the prevention, diagnosis and management of heart disease. The Sevan Podcast is sponsored by http://www.barbelljobs.comFollow us on Instagram https://www.instagram.com/therealsevanpodcast/Watch this episode https://www.youtube.com/channel/UC59b5GwfJN9HY7uhhCW-ACw/videos?view=2&live_view=503Sevan's Stuff:https://www.instagram.com/sevanmatossian/?hl=enhttps://app.sugarwod.com/marketplace/3-playing-brothers Support the showPartners:https://cahormones.com/ - CODE "SEVAN" FOR FREE CONSULTATIONhttps://www.paperstcoffee.com/ - THE COFFEE I DRINK!https://asrx.com/collections/the-real... - OUR TSHIRTS... Learn more about your ad choices. Visit megaphone.fm/adchoices

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Some shows I'm more nervous before we go live. And some shows like this one, like, wait, that was said in the wrong order. Some shows I'm nervous when they start. Some shows I'm nervous before they start. This show I was nervous before it started. So now that it started, I'm not nervous. Ah, it didn't come out exactly right either.

Shit. Ah, good morning. 7 a.m. Pacific Standard Time on the North American continent, which is a place we call California. Sits on the Pacific Ocean. And today we have a seem Malhorta. I don't even know if I pronounced his name, right? Well, that's the first thing we're going to find out. He's a cardiologist. He's written two books as of recently. One of them is called a statin free life,

which is why he thought he was coming on. And then last night he realized I was having a mom because of a book he wrote two years ago in 2020. It's called the 21 Day Immunity Plan. Oh, I wonder. I better make sure he got the link. That's always. Oh, here. Here we go.

Here is. Oh, yeah, he got it. He should be here any minute. We see eye to eye on this 21 day immunity thing. I said it from day one, early, early, early, early. Remember that cruise ship where there were the people trapped on it. And I think it was off the coast of Japan. The Chinese were talking about coronavirus very early on.

And they were basically the data coming out of there was, is that old people and smokers were dying from this thing. And here we are two years later. And I've always believed that you could fight it off if you just stopped eating sugar. I told my dad this morning, I was like, Hey,

we're going to have this guest on. He's so awesome. The doctor out of Europe, out of the UK, his name's a seam. Did I pronounce doctor out of Europe, out of the UK. His name is Asim Malhorta. Did I pronounce that right? That is correct, Seven.

Oh, awesome. Uh-oh, I have the wrong mic on here. And my dad goes, oh, why is he so great? Does he agree with you? That's my dad. And I said, no, I don't think he does agree with me on a bunch of stuff. And as I read his book, there's a bunch of stuff that we don't agree on some really, really big things, but there's one thing we a hundred percent, I think agree on. And the seam will set me straight if I'm wrong here. And I miscategorize them.

We do believe that by not by eliminating added sugar and what he calls ultra-refined carbohydrates, ultra-processed foods, that you will be at the 95-yard line of your journey to health and that you will see big differences very quickly. Seven, I'm just going to get some earphones just because of the sound. You do you, brother. You do you. Yep, yep. You you yep yep you do you okay easy show man look at that background i think a scene i don't think that's his home but he still found a very uh smart background isn't that nice globe stack of books oh look at that stack is that his new book his new book is called a statin free life um i'm going to i purchased it last night and i'm going to read it and we'll circle Zach, is that his new book? His new book is called A Statin-Free Life. I purchased it last night, and I'm going to read it, and we'll circle back around and have a scene back on. I think it gets released in February of 2022 in the United States, although I bought the audiobook on iTunes last night. And it's called A Statin-Free Life.

Will, do you see that if you will if you're on the show feel free to bring up any images if you go to amazon you type in a seem malhorta oh it's not horta it's hotra a seem malhotra here we go i can hear you better now okay a. Asim Malhotra. Malhotra, yeah. That's H-O-T, hot. That's all you need to remember in the middle. Asim Malhotra. Asim, oh man, there's so many places. I really screwed up with you. I have too many notes. Have you ever done that? You go into a meeting with too many notes?

I usually store them in my head, but yeah, often there's a lot of things that don't get covered. That's why you're a doctor and I'm a podcaster. You store them in my head, but yeah, often there's a lot of things that don't get covered. That's why you're a doctor and not a podcaster. You store them in your head. Asim, did you hear what I said about where our paths align about added sugar and ultra-refined carbohydrates? Absolutely, Seven. And also, I think one thing that you mentioned about some things we disagree on, I mean, there's nothing wrong with that. I mean, how many people do you actually know, even your own family or friends, where you agree 100% on everything? I don't know anyone like that. But I think what's important, and I often these days cite philosophers such as Socrates who said, true wisdom only comes from dialogue. And often what you think you disagree on, actually you don't. It's just misunderstandings of each other. So if there is anything in particular that you feel strongly about, let's feel free to discuss

it as well. I mean, it doesn't just have to be all about what we agree on i think there's some big issues here in terms of how we manage chronic disease how we manage diet related disease what are the best solutions i think ultimately we all want the same thing right yes we want the opportunities for everybody or at least people give people the best opportunity to live healthy, meaningful lives rooted in good physical and mental health and having sustained authentic happiness. That's what we all want, right? So I'm sure people have different ideas about how we get there. But I think getting there needs discussion rather than um what's happening in the world today a lot of hostility a lot of division a lot of confusion um and it's it's sending us the wrong

direction seven i think what's going on in the world right now is just crazy and at the root of that is basically the fact that we are losing um access to the truth and our capacity for empathy. And those two things combined are basically catastrophic if they go in for too long. So anyway, we can discuss that further as we go through the podcast. Yeah, fantastic intro. Asim is a cardiologist. Home for him is the United Kingdom. You've been a doctor for almost 20 years are you yeah qualified 2001 so over 20 years wow congratulations uh and i've made it you just said something that i wasn't going to bring up until the end of the podcast but i will bring it up right now in his book uh the 21 day immunity plan and this is not the major premise

of the book but this is one of the many, many, many gems in there. He says, meaning relationships is the biggest predictor of happiness. And what's funny is, is that's not what the book's about. But I just realized I have three little boys, two four-year-olds and a six-year-old, and I spend almost every day as much of every day as I can with them. And they are the three most meaningful relationships that I've ever had in my life. And I am also the happiest I've ever been in my life. Granted, I'm a happy person almost always anyway. But man, I was like, wow, he's really right. I have these three really deep – when you're willing to get up at 3 in the morning to wipe someone's butt, it's like with no with no remorse or uh you know

what i mean with no resentment i was like even sometimes i'm like who is this guy about myself i'm like i don't even recognize this guy so thank you for throwing that gem in there about relationships absolutely do you have kids i don't not yet no uh seven so um i do love kids i want to have kids? I don't, not yet. No. Uh, seven. So, um, I do love kids. I want to have kids, but, um, I haven't, uh, um, met the right person yet, uh, for somebody that, you know, that, that I feel that I'm ready to settle down, but yeah, no, I do love kids. I have, um, in fact, I'm over in California right now. I'm staying in Mountain View with my cousin and his wife, and they have three kids who are effectively my, uh, my niece and two nephews. And, you know, yeah, they, they bring a lot of joy into my life, just, just hanging out with them, just, you know, doing fun things with them, watching movies,

playing basketball, you know, having, having, sharing lots of laughter. Yeah, absolutely. Are you, are you their cool uncle? I saw that you took your nephew to school on your Instagram. are you are you their cool uncle i saw that you took your nephew to school on your instagram yeah i don't know if i'm i'm the cool uncle maybe possibly i definitely engage with them like to have fun with them do they have a british accent no so they're they're they're brought up here they're they're um so i'm in mountain view right now so they're they're from um they grew up and they were born in in the u.s and it's your brother's kids or your daughter or your sister no my cousin my first cousin couple okay um and uh he's like a double cousin uh because we have relations on both sides of the family my mom's brother just just to premise this there's no suggestion of incest here

so just let me just put that out there for you my mom's brother married my dad's sister so um couple is the younger brother of of uh of my uncle and aunt and therefore we have you know we're effectively brothers basically although he's my first cousin what what ethnicity are you indian origin seven yeah india yeah i was born actually born in delhi i was born in india um but i was about a year old when my parents moved to the UK. And I grew up in Manchester in the north of England. And yeah, I've been in London now for the last 13 years. And when was your first time visiting California? Oh, wow.

A long time ago. I've had very, you know, we've kept very good relations with extended family members. So I've been, I probably came here first when I was maybe six or seven years old. Okay. And I've pretty much come every other year since then. So I've been, I visited California, particularly the Bay Area, San Francisco, probably more than any other city that I visited in the world and traveled to. And I've traveled to a lot of places. Yeah. Sorry, it was actually a loaded question. And you've seen an enormous change in the Bay Area in terms of the Pakistani and Indian communities in Mountain View. I mean, you're probably 20 miles north of me. I'm over in Santa Cruz. And that whole community, I mean, when tech exploded, Palo Alto, Mountain View, San Jose.

I mean, those communities just flourished there. Like, you must feel, do you feel at home there? You're like, wow, I'm with my people. Well, it's interesting, actually, because, you know, we have a very large South Asian community in the UK. And relative to that, it's difficult to say whether there's a big difference. Relative to that, it's difficult to say whether there's a big difference. I mean, that's also partly because in the 70s, there was a huge shortage of doctors in the National Health Service. So a lot of doctors like my parents came over to work in the National Health Service. And it's estimated now probably about a quarter to a fifth of about 25% of NHS employees,

specifically more with doctors, are from the Indian subcontinent. So we have a huge, and of course, there's the historical links between, you know, British Empire and India Guards Independence in 1947. So there's all those links that have been there, you know, historically. And on that, you know, the most popular british food british food is an indian dish called chicken tikka masala you go to an english pub it's more likely than not they'll be serving that on their menu so i felt i felt my uh salivary glands fire up when you said that uh and i and i want to say something about culture here those people uh uh indians um uh pakistanis that is a very great culture and by culture i mean you can take the listeners you can take stuff from these

cultures and make them yours fuck cultural appropriation take the good shit from these people these are amazing communities that california is blessed to have with hard-working people it's very interesting. My boys play a variety of sports. They play skateboarding, which is like the smoking weed crowd. They do jujitsu, which is more of the probably like South American crowd, you know, Latin crowd. And then they play tennis. And that's where their Indian and Pakistani friends are. And I'm telling you, man, like there, if you have kids, you want your kids hanging around with this culture and this culture, they just happen to be, have a certain

look to them, but anyone can steal that culture and borrow and borrow, take, take, fuck, borrow, take, take things from them and appropriate them and own them. I'm bringing them to the Armenian culture. So, um, they're, they're, those people coming to the United States are a huge added value. I think Armenians are a huge added value. I think Armenians are a huge added value too. I think a lot of people are. But I just hate to see it conflated race and culture. Take from other cultures.

Do it. Don't be afraid. Take the good stuff. Your parents were doctors and then you became a doctor. But I'm guessing you didn't go into medicine to do to become it would it be fair to say that you're starting to become an activist yeah so um i so both my parents were general practitioners and i'm sure that had a big influence on me in terms of going to medicine although my parents were very open-minded they just wanted me to be the best person i could be. You know, they supported me, gave me opportunities for a great education.

I went to very good schools in the UK. And at one stage, actually, I was a very sporty person. So I captained sports teams at school and university. I opened the batting. There's a game called cricket, which some of you may be familiar with in England, which is a very popular sport around the world. It's like a religion in India, in fact. So at one stage, I had to decide between, you know,

am I going to pursue a career as a professional sportsman or go down the line of being a doctor and specifically a cardiologist? And I chose a latter ultimately because I didn't believe I was, you know, going to be like you know I think I would probably be able to achieve more things in medicine than I would have been in cricket would have done a cricket um and cardiology was something that fascinated me even since I was a child partly also related to the fact that I had uh my my grandfather who was very close to he died early in his 60s of something very rare it It wasn't traditional heart disease. He had something called amyloidosis, which is a condition that basically a protein deposits itself on the heart

muscle and people very quickly from going to, from being very fit and healthy can deteriorate and die. And, and, and that's what happened to him. But then my older brother, um, he actually got a viral illness. He was 13. I was 11. Um, just a, just a regular viral illness. And then he had a condition called myocarditis. And unfortunately, you know, within a week of getting sick from just a tummy bug, he had a cardiac arrest and died. So for me, there was that initial, you know, that's obviously quite a big event for a family, right? For parents to lose their child, for me at 11 to lose my older brother, that had a very profound impact on us and um that kind of stimulated me a little bit more down the cardiology side of things and

then of course when you go to medical school then you know your interest develops further um so i chose cardiology and um with no regrets whatsoever and in terms of the activism um stepha savann yeah i think uh i've probably been an activist if you like or a campaigner um for the last 10 years um originally i was inspired by um really just doing what i could to combat the obesity epidemic and and i've always been a foodie you know talk about culture um you know we have a huge food culture in in indian subcontinent my dad taught me to cook when i was 16. You know, I had a reputation in medical school as the guy that cooked the best chicken curry.

So I was always very much a foodie, you know, very much a lot of my, like a lot of people, right? Our lives revolve around eating good food, enjoyable food. And for me, when I started campaigning, you know, I was becoming increasingly aware, having qualified in 2001, over several years that our National Health Service was under more and more stress, more pressure, clearly related to obesity and conditions such as heart disease, type 2 diabetes, which were diet related. And things weren't getting better. And it wasn't just about what was happening on population level. I could feel it happening. You know, I could see it, observe it. It was becoming more stressful for doctors and nurses to work as well because we didn't have more resources and, you know, people coming with multiple conditions, more complex, more difficult to manage. So all of that, you know,

becomes more stressful for the whole system as well. And I wanted to do something to contribute to helping reduce that burden of chronic disease. But one thing that occurred to me quite early on is I observed the fact that one, you know, obesity was affecting National Health Service staff as well. So 50% of NHS employees are either overweight or obese, and that includes doctors and nurses. And also our hospital food was particularly bad. You know know it's now the most recent data suggests about 75 percent of food purchase in hospitals seven is unhealthy it's ultra processed it's sugary rubbish basically so for me initially i started my campaign because uh you know i had like an epiphany moment when a patient came in in the middle of the night i was then by that stage

a junior cardiologist doing keyhole heart surgery and we treat heart attack patients in the middle of the night so i remember treating this one patient in his 50s we saved his life with emergency stenting and then the next morning on the ward round when i'm talking to him about taking his pills and stopping smoking and eating healthily he gets served a burger and fries by the hospital. And he looks at me and he says, Doc, how do you expect me to change my lifestyle when you're serving me the same crap that brought me here in the first place? So for me, that was kind of like, yeah, you know, what he's saying, you know, makes total sense. And, and then I actually wrote to a celebrity chef in the UK, I think he's reasonably well known here called Jamie Oliver.

So I just emailed him one afternoon. Actually, I was just sitting in my break, just in the doctor's office. And I just emailed him and didn't expect a reply saying, listen, I've seen what you've been doing and campaigning on improving school food for children to combat child obesity. How about doing something in hospitals? And then I got a reply like six weeks later from his PA, which I didn't expect saying, you know, thank you for contacting us, Dr. Malhotra, Jamie would be thrilled to meet you. Would you like to come and have a dinner with him

at his office and chat further with other doctors? And I was like, of course, you know, I was like, wow. And then things just escalated from there. Then wrote an article in, you know, after our meeting with Jamie, just putting everything together about how ultimately the root of the problem, Savan, whatever people want to discuss about, you know, personal responsibility, the root of the issue seems to be the food environment exacerbated by wrong dietary advice. But really, we need to sort the food environment out. and I wrote this piece which then I didn't again expect became a front page commentary in the Observer newspaper which is very impactful in the UK just to give you some your listeners some context about the Observer newspaper Winnie Mandela said the single most important factor that led to the release of her husband Nelson Mandela from prison was a campaign launched by the Observer newspaper in the UK so that's the kind of impact it had, it has. And, uh, and this piece became a

front page commentary and they put a title, something like, um, I mend hearts. Then I see our hospitals serve junk food to my patients. So quite a, you know, provocative title. Yeah. Um, and then for me, things just escalated from there. Uh, and then I, and then as I, you know, dug deeper into trying to understand the root causes of many of these problems with with poor diet and an ill health of patients and members of the public, you know, there are two conclusions, two sort of areas that I focused on one was too much medicine over Medicaid population, and all of the issues and manipulations of the drug industry that contribute to that to

what I describe as an epidemic of misinformed doctors and misinformed patients but also that also applied to the food industry and all the misinformation that they'd put out and all of you know targeting of children with junk food advertising there's so many factors you know involved in this so then I decided that I was going to campaign to try and reduce that burden. And around the same time, quite shortly after that, I became very familiar with the sugar issue, which by that stage was very quiet. Robert Lustig in the US, as you know, Professor Robert Lustig, pediatrician, had kind of reignited the discussion on sugar with a lecture he gave at University of California, San Francisco, which got millions of views on YouTube. And, you know, I then connected with him when I watched that.

I started doing my own research. I then started publishing the BMJ. So I had a period of the year of 2013 for me was particularly impactful and is still having an impact because I wrote several commentaries in the BMJ, which got press released. And when you press release something, when a journal like the BMJ press release something, it's likely to hit the news. And in that, in those several months, I did commentaries on sugar, I talked about saturated fat, I talked about overprescription

of statins. And they all made, you know, if not UK international headlines in many, in many of these stories. And then that you then take the responsibility of seeing the impact of that and then taking it further and creating movement. And ultimately, for me, one of my, I suppose, personal achievements, if you like, seven is a lot more work to do. But it's a nice landmark is that I was considered the lead campaigner that bought the soda tax in the sugar drinks tax in the UK because of that activism, because of that work. Asim, there's so many things we agree on, so I apologize for just going straight to this one that I'm going to question you on. You talk about misinformation around diet, but then also it seems like you believe that

the government can enforce that, can help that. And I'm in the position of, by the way, at the very end of the book, there's a list of 10 key points for policymakers or for people who want to start activism. And nine of them I agree with wholeheartedly. And he speaks about them very clearly. And one of them is to hold hospitals accountable for the food they serve and some other things that he touched on there. But the part where I feel like, not I feel like, I see and I interpret the problem we're in because of government guidelines. And you're suggesting that maybe they can get fixed by government guidelines, by government intervention. Can you help me with that? No, I understand that.

I understand that. So I think we have to just take a step back and just understand that if we accept behavioral science, public health, if we accept that the environment has a huge role to play in our health and our behaviors, I think sometimes our own egos, certainly people I speak to, I have a huge network of people with very different political views, left-wing, right-wing, centrist, whatever. So I understand where people are coming from. And what I think I have grown to learn learn and we're all guilty of this often you know our own egos um uh kind of usurp sometimes our rationale so we emote um before we reflect right um you know we react before

we rationalize and um if you look at the issue around, if we just pick food, for example, right? So if we accept that, obviously, since the 1970s, 80s, there's been a huge shift, obviously, in the prevalence of obesity. It was pretty much non-existent in the Western world before then, before 1980. So the question is, what's happened?

And of course, you can absolutely, seven, correctly argue the case that government guidelines on diet have been wrong and have fueled this crisis but at the same time what's happened is the food industry have taken advantage of those incorrect guidelines so i absolutely on you you know with you on that and then that's then you know shaped the food environment and then led to you know the oversupply of cheap, sugary, ultra-processed foods, low-quality carbohydrates, which we know, you and I know,

obviously, is a big contributor to chronic disease and weight gain and interferes with appetite control mechanisms and all that kind of thing. But when you look at government intervention, I think we all have to, you know, there's a line I remember, and I don't know, sorry if this is inappropriate, but just's there's a there's a line i remember and i don't know sorry if this is inappropriate but just because nothing's moving and powerful experience for me so i've visited auschwitz twice um which is one of the you know why twice infamous twice but well i was very moved the first time i went there and i went there with um with a friend of mine when i was backpacking as a medical student um through europe and then I went again because we'd visited Poland with two other friends, you know, several years later,

and they wanted to go. And I said, okay, let's go again. It's a very moving, powerful experience. One of the most, you know, emotional experiences one could ever have. Are people like crying there when you're there? Oh, absolutely. I mean, it's difficult not to.

I mean, you think you've gone back in time. I mean, they preserve the place that you literally think you've gone back to the 1930s, 40s. It's just extraordinary, but it's just, they've preserved everything, right? And you can feel people were kept uh captive um there's a there's a quote on the wall and i can't remember who the who actually said this but it's that he that does not remember history is bound to live through it again now when you look at public health successes when you look at like increase in life expectancy over the years like so one of the things i write about in the book seven if you remember so if you look at the average life expectancy in 1850 in the u.s was 40 years old and we've added about 40 years to life expectancy on average since then in the u.s okay and to many since 1860 1850 so the last sort of almost you know over 150 years so the key is, so what contributed to that increase in life expectancy?

And most of it were public health interventions, which were underpinned by regulation, you know, so better, safer working environments, safer drinking water, seatbelts in cars. You can't take a shit in the street. Yeah, more recently tobacco control, seven, right? Tobacco control only happened because of government intervention, right? To combat the excesses of the tobacco industry. And there were three A's we talked about in public health, which I would apply to all processed food and explain that to you further. But, you know, tobacco control, let's not forget, like we take it for granted now.

So I remember when I was a kid, even coming to California, right? So you actually in the US were ahead of the UK because you put laws in to stop smoking in public places. I remember in Europe, you know, it wasn't until the sort of, I think, I can't remember the exact year. I think it was late. It wasn't that long ago, early 2000s,

where we interviewed, you know, we had smoke-free buildings legislation. It was normal even certain places in europe you go you sit in a restaurant people are smoking right and and once it was realized that passive smoking actually itself was harmful uh and the um you know to uh to combat the the so the come out to the three a's so acceptability affordability and um the um availability of cigarettes right that was what the government did to curb through public health advice listening to scientists to reduce the smoking burden the

population and in fact those three things before education had very is important let's not deny education is very important because it also also helps public support laws or interventions that are going to help everybody or give you know people you know reduce the chances of people smoking and doesn't mean we ban smoking by the way people can still smoke if seven i'm sure in the u.s if i've walked around places if you want to buy a pack of cigarettes you can do so we're not banning it but we're just making it easier for people to make healthier choices when it comes to, for example, with food. You apply the same principles to ultra-processed food. You will see on a population level, seven, a huge reduction, I'm sure, in type 2 diabetes and obesity within a few years.

If we had to say, you know, 60% of the U.S. diet is ultra-processed food. You know, these are how I describe it to patients. You know, these are, these are how I describe it to patients. If it comes in a packet and it has five or more ingredients, usually containing additives, preservatives, but those five ingredients are usually a combination seven, as you know, of sugar, starch, you know, starch, unhealthy oils, that kind of thing. So bad. Avoid it, right? Just avoid it.

But this is 60% of, of the calorie consumption in the U S diet is from these foods. I think in your book you said 44, and maybe I heard it wrong. And when I heard that, I'm like, there's no way. It's got to be higher. It's got to be higher. No, yeah. So U.S. is 60%. In the U.K., it's about 50%.

Okay. Because I had read in Mexico, 55% of calories consumed are from soda pop on average. I read that the other day in the headline. Yeah, it is unbelievable. And seven, even if we say that we're against government intervention generally as a principle and i get that you know um because if we agree okay we're all actors we have personal responsibility all that kind of stuff which which i think i could argue the science about how that makes it it's not impossible but it's harder right when you're in food it's like we have to think it's different for kids right you've got

kids right so tackling issues around advertising definitely power for parents all of those things right association of companies like mcdonald's with cartoon characters all of these things have a huge role so so we did that with tobacco i mean even you know dissociating from sport i used to go to cricket matches or soccer games or watch formula One, you know, and they were sponsored by big tobacco at that time. You don't see it now. If you saw it now, you'd think, seven, you wouldn't think that was acceptable. You'd think that's just wrong, right? So I think if we apply those principles, in my view, to ultra processed food, then that from a policy level will have a huge impact, like in the same way. So we know that, you know, when you look back, and you can look at the research on this the biggest decline in consumption of tobacco happened after

taxing cigarettes so raising the price and i remember i've seen so many patients of mine heart attack patients i saw that would come back to clinics and i'd see how they're getting on if you stop smoking and they said dog i can't afford it anymore said really so the price but he said i don't regret it i'm happy that i'm not able to afford it because that's helped me to quit smoking. So I think we just have to just take a little bit of a broader understanding that this isn't about usurping individual freedoms. It's about actually what makes sense from a behavioral science point of view, et cetera. behavioral science point of view etc um and again i'm not saying banning you know we we were not going to ban sugary drink i mean i personally think that would be a great thing to be honest if they were banned but um we know when we ban things it often has the opposite effect you had prohibition in the states see what happened there right or went underground right so yeah so i wouldn't say banning i'm not for that um certain things you know banning junk food advertising i

would support right Right. But in terms of people being able to get these products, if they want to really want to find that's fine. But but actually, let's do something that will make people's healthy choices the easy choice. I hear you. The thing that I have a real the way I agree with you is, is like, yeah, you have and you do talk about it in your book. There's this list of public intervention that has been really successful. And because it's failed with food, now I'm saying, fuck you, and I want to take all my toys and leave the sandbox. And maybe that's not right. Maybe what you're saying is like, hey, let's take another shot at it.

That being said, to support you, I don't think it should be legal to feed your toot put to put uh mountain dew in your baby's bottle and that is something you know there's people who do that that put soda pop in their baby's bottle and the fact that you can't smoke until you're i don't know in the united states let's say it's 18 years old i'm not sure what it is 18 or 21 how can you give your child soda pop i mean that's crazy right and it is crazy but it's so i was just at a thanksgiving dinner and i watched a couple give um coke to a four-year-old and then for the next hour and a half i watched the four-year-old spin out of control they gave a four-year-old sugar liquid sugar and caffeine but they don't even know any better exactly exactly absolutely it was nuts

formula milk itself it's a huge problem right so yeah you know and and people have mothers have been misled to believing it's almost as good as breast milk um and and that then reduces the um duration of breastfeeding which is a big detrimental has a big detrimental impact on on on child development and even probably into adulthood and beyond you know because formula milk formula milk is full of sugar. A lot of formulas are full of sugar. I wrote one of the first pieces I wrote in the BMJ was called the, the dietary advice on added sugars in need of emergency surgery. That was the title. People can look it up and have a read, but my own kind of investigation in that, in that piece,

I discovered that one formula milk, which was being marketed in Europe, had the equivalent of nine, which was marketed for 12 month old babies, by the way, had the equivalent of nine teaspoons of added sugar in it. Oh, my goodness. And yeah. So that's that's life changing, right? If you do that to your baby, like I've heard stories, if you give a young boy too much sugar, his penis and his testicles won't develop properly, that you'll make them hormonally – they won't drop properly. If you – it's like life-changing, right? Life-altering, like you will change the whole trajectory of a human being if you overfeed them with sugar.

Yeah, it's nuts. Will you tell us why sugar is so bad? why sugar is so bad i know that and make sure sorry that one of the things is really i like to talk about too especially in these times is in relationship to the immune system i mean you can go anywhere but if as long as you hit the immune system i'd really appreciate it i mean i've talked ad nauseum to my audience about it yeah no sure um i think well first of all i mean there's a number of reasons sugar in excess you know let's let's put this in context rather than be complete zealots about it. But you are a zealot about it though, correct? You're just saying that to accommodate the audience, right? Well, I am in the sense that I think we just have to just stick some facts. So first of all, there's no requirement that you

don't need any added, there's no nutritional value. So it's not required. You don't need it for the body. There's no reason to have it other than for pleasure, which obviously a lot of us have it. That's, that's why we, we consume it it that's why it's so um it's so prevalent and such a such a big problem because it's pleasurable it's it's like a drug you know the way it hits our taste buds and how we feel with sugar and i'm by the way i'm speaking as a sugar addict which i'll come on to in a second so first of all you don't need it so there's no requirement it's at best it's empty calories even smaller amounts about two teaspoon two teaspoons a day are going to have an issue with um tooth decay now uh to the extent where certainly in the uk the number one cause of uh chronic pain and hospital admissions

in young children sort of age between say six and eleven um is uh is tooth decay and the single biggest driver is sugar. You know, it's one of the few things that we ingest that directly corrodes teeth enamel. So that's when you look at the initial harms. Now when you, you know, without quoting lots and lots of different studies individually, the World Health Organization now advises

that a maximum limit for the average adult, and I'm going to put this in context, should be no more than six teaspoons of added sugar per day as a limit, okay? Not a requirement. But in the US and the UK, the average adult is consuming, and unknown to them, consuming two to three times this amount. About a third of sugar consumption comes from sugary drinks. About six comes from um foods such as you know ice creams and and chocolates and that kind of stuff um but you know a huge proportion almost half will come from foods that people don't even think has added sugar in them like breads and ketchup that kind of stuff so a lot of by the way a soda has 10 teaspoons so if you have one soda you're four teaspoons over your limit right

exactly so okay that's the point right so we've got a maximum limit and just one soda and one candy bar is going to take you over the limit and for kids as well, right? And the reason for that is that all of the science and the data points towards the fact that when you go beyond this limit, and it's going to vary from individual to individual, that's when you start to increase the risk of insulin resistance, right? So this is the body basically becoming resistant to the hormone insulin um and over time and insulin resistance itself which is driven by sugar and probably refined carbohydrates too is the really the root of most of these chronic diseases that we're trying to deal with in the western world so it's heart disease type to

diabetes links to obesity, probably Alzheimer's, as well as even possibly the other links to even musculoskeletal conditions, arthritis, osteoporosis, that kind of thing. Cancer, right? So all of these things are linked to insulin resistance. This is at the root. And sugar is one of the drivers of that

when consumed in excess. So for me as a cardiologist, the single biggest risk factor, if you like, for heart disease and heart attacks is insulin resistance. More than 80% of people who suffer heart attacks will have insulin resistance. Now, how can we measure that? How can we, in a simple way, keep an eye on this, is talk about metabolic health. So in simple terms, is talk about metabolic health. So in simple terms, metabolic health, when it becomes dysfunctional, is really excess body fat, really becomes a risk factor for conditions that lead to insulin resistance and poor metabolic health.

So poor metabolic health is a major issue. So sorry, so the definition of metabolic health is whether you're carrying too much fat on the body? Yeah, in simple terms, um uh seven absolutely it's it's about how your body's able to really deal with the energy you know energy consume and what you expend but as you know most of what drives obesity is really what you're putting in the top end in your mouth you know fitness and we're big advocates for all the health benefits of exercise but um but weight loss is not a big benefit of exercise, right? So there's lots of other benefits then. So when it comes to excess

body fat, most of it is driven by what we eat. Um, and that leads to, um, poor metabolic health, which is now defined, um, in, in certainly, well, before I tell you how we define it, what's really concerning is, um, only one in 12 Americans, uh, sorry, one in eight Americans, okay, actually have optimal metabolic health. Which country is one in 12? Which country is one in 12? Yeah. Well, listen, I don't know.

I'm wondering where you pulled that data from, where that crosswires. Well, no, I think it was 12%. Oh, okay, yes, okay, okay. So 12%, so one in eight. That's why I was, yeah, yeah. I thought you were going to say the UAE or something like that. okay, yes, okay. So 12%, so one in eight. That's why I was, yeah, yeah. I thought you were going to say the UAE or something like that. No, no, so less than 12% or, you know,

one in eight people in the U.S. have optimal metabolic health. All right. Right, which is pretty shocking. And that doesn't just apply to older people. So only one in four adults between 20 and 47 have optimal metabolic health in the U.S. So how do we define it? Well, there are five um markers

if you like so pre-diabetes or type 2 diabetes so you want to have your hba1c less than 5.7 you want your blood pressure to be less than 120 over 80 okay so above 120 over 80 you get pre-hypertension then you get to hypertension by the way all of this don't panic guys all of this is in his book which is a very easy, very quick read. And it's called The 21 Day Immunity Plan. And even if you're perfectly healthy, you've got to read this because this will help arm you to help your loved ones. OK, sorry. Go on. Absolutely. Thanks for that. And he'll explain what blood pressure is and everything. I'm sorry.

Yeah. And I think it's released in the U.S. in February. Oh, no, no, no. Sorry. The 21 Day Immunity Plan is here. We have it in the U.S. in February. Oh, no, no, no. Sorry. The 21-day immunity plan is here. We have it in the U.S. The one that's not being released until February is the statin-free life. But that one you can still get. I bought the audio book last night, and I'll try to have a scene back on in February for the release of that, the paperback version in the United States. But if you get the 21-day immunity plan, you will um all of this stuff that asim is talking about and he'll not only tell you what good good or bad blood pressure is he will explain to you what

blood pressure is so this is just uh the cliff notes version here on the podcast sorry go ahead asim no fantastic so so you don't want to be a pre-diabetic type two you want to have optimal blood pressure then waist circumference very easy everyone. Everyone can get a tape measure, you know, measure it at the belly button. And for a man, it should be less than 102 centimeters. And for a woman, less than 90. Of course, you know, people are different heights. So there's another nice rule of thumb is you want your waist circumference to be less than half of your height. So let's say you're 180 centimeters, right?

You want to be less than 90 centimeters of your waist comfort that's another nice rule of thumb yeah that is nice absolutely and then triglycerides and hdl so um you want your blood triglycerides to be um in uk we say one millimole per liter but i think in the us that would be i think if i'm not wrong 150 milligrams per deciliter and your hdl should be higher than thatiter. And your HDL should be higher than that. So you want your good cholesterol to be higher than one millimole. And another, again, ideally your triglycerides should be less than the HDL. Now, if you have all of those optimal levels, you've got also metabolic health,

and you are probably at the lowest risk of heart disease, type 2 diabetes, cancer, all those big chronic diseases. And what's interesting and what I write about, that's why it's called 21-day immune span. It may sound like a gimmick, but it isn't. And this is something that there is clinical research data on. There is stuff. This is what I experience with my patients, is that from dietary changes alone, you can reverse metabolic syndrome.

So metabolic syndrome, by the way, is having three of those markers in the abnormal range. And that's associated with the worst health outcomes. Now, even if people who are told they've got a normal body mass index, which is pretty much useless, I mean, body mass index, I think we should just, you know, we should just throw in the trash can. Do you really know? I was going to ask you about that in your book, you basically say that it's it I thought you said it's correct um it's only incorrect one in 200 people no so if you are obese so so one in 200 people who are obese have a bmi of over 30 will have optimal metabolic health but actually yes but about a third of people you know who have a normal body mass index will have suboptimal metabolic health, if you like.

Right. So people have the illusion of protection. They just think they're being told that BMI is fine. You know, it's between 18 and 25, when in fact, probably there's a good chance they may have suboptimal metabolic health. It gives them the illusion of protection. You know, I said there's no such thing as a healthy weight. Seven, there's only a healthy person. So like Jason Kalipa, BMI would never work on him. The guy, I think he's, do you know who that is, the crossfitter?

I don't. Is he a sports? He's a crossfitter. He's 5'9", 215 pounds, but there's no fat on the guy. Right. He's just a Persian horse. He's just, he's nuts. I mean, and I'm sure his metabolic health markers are probably all optimized, but if he hasn't checked them, he should.

Okay. all right. How can I get you a cardiologist? But yeah, so that's really the crux of it all. And as I said, so the good news is you can reverse metabolic syndrome within 21 to 28 days purely just from dietary changes. I mean, people can do the other stuff, their moderate activity. I'm not saying don't do it. But just from changing diet, you can reverse those metabolic health markers. And the same dietary changes are also the ones that apply to setting type 2 diabetes into remission, reducing people's need for medication. essentially eliminating ultra-processed food and minimizing low-quality carbohydrates.

And that really is the crux of reversing this metabolic syndrome or improving metabolic health quite rapidly. And the reason we're not combating it, again, is because the environment is, we're fighting this in a food environment where, you know, most of these foods that we're consuming are going to have the opposite effect, a detrimental effect on the metabolic health i'm going to stumble around in the dark here and say some crazy shit and feel free to just be like hey i don't know or um you're too wrong so early early early on i was trying to figure out why why sugar is so bad for your immune system and in a nutshell these this is what I came up with from watching YouTube videos. Basically, your bloodstream is like a freeway. And when you eat too much sugar, you get too much insulin in there

and you get too much leptin in there. And basically, that clogs the freeway and causes a jam in the freeway. And the T cells and the NK cells can't do their job adequately because there's a traffic jam in there. But there's also another phenomenon, which I found fascinating. And I don't know if this is true, but I saw it on YouTube. Your leptin receptors are the ones that transmit information to your NK cells and your T cells. They have a double job, which is fascinating. They get that information, I guess, from the hypothalamus where the library of viruses and bacterias or whatever is stored from when you're born to when you die.

And that they, your hypothalamus somehow tells your leptin receptors, hey, we have an enemy in the bloodstream. And then they notify your NK cells and your T cells, go get that guy, whether it's a cancer, whether it's a SARS-CoV-2. And basically, once you become leptin resistant, you're screwed. Do you have you heard? I never hear anyone. Summarize really nicely. Really nicely. OK, so let's talk about that.

Sorry. OK, and I never hear anyone talk about this. And I'm in people like, shut the fuck up. You're not a scientist. I'm like, I watched 100 YouTube videos. Yeah, no, absolutely. So I think there's a number of things i published um you know research papers on this as well okay in the last in the last couple years around i was sweating like you were going to tell me to shut up and stay in my no no absolutely so so lepsin itself is pro-inflammatory so i think people need to understand if we start from the basics

excess body fat also means chronic inflammation it means that your body feels there is an internal threat and therefore your immune system is kind of activated and dysregulated if you like so if you've got chronic inflammation in the body which excess body fat is one of the substrates for if you like what what is inflammation uh inflammation basically is your um anything where uh your immune system is activated to a external pathogen, something that is considered toxic to the body, and for the purposes of trying to get rid of that toxin. So all of your immune system cells, white cells, all the things you talk about, T cells, B cells,

they can get activated and they can create this, what we call chronic inflammatory state, where they're constantly on alert, if you like, and constantly trying to fight external stresses. And by the way, this doesn't just apply to to Texas body fat, but even stress itself also activates chronic inflammation. Chronic psychological stress does that. the body is also going to what what we believe happens is going to mean that your immune system is not optimized to deal with things like viruses and bacteria okay so that's one mechanism how excess body fat is a risk factor so we look at you know this has been well documented now we know obesity and excess body fat metabolic syndrome etc um you know increases the risk of

of complications from COVID-19. But this is actually all historical. I mean, it's something that doctors haven't really fully, how should I put it? It's not something that we have thought about deeply as doctors, but if you look at and you think about even pre-COVID, if you look at people with excess body fat, they tend to do worse from flu. If you look at type 2 diabetics have much more risk of infection and more like to be hospitalized just by being type 2 having type 2 diabetes and that isn't necessarily because of excess body fat so high blood glucose and as you said already correctly high insulin actually themselves are you know viruses and bacteria will thrive off high blood glucose okay Okay. So just think in very

simple terms, if you're going to eat something, I mean, it's interesting on that. There was one study that showed even in non-diabetics, those admitted to hospital with, with high blood glucose who were non-diabetic, you know, had worse outcomes from COVID-19 than people had normal blood glucose, right? So in theory, what are we saying? Well, we're saying actually in theory, now this now this is not you know i i'm just just getting people to think about this i don't think there's any hard very hard strong data to prove this you know conclusively but essentially if you are um catching any kind of virus or infection let's say covid then the worst thing you can do is eat ultra processed and high glycemic index carbohydrates based upon data that shows that the higher the blood glucose the less likely you are to do well okay mechanistically people you have to hear that right if you're sick do not drink i've managed many patients with

covid in the community yeah okay um and advise them and one of the things i said to them and of course listen we know covid or overall you know, depending on your risk factor profile, is in absolute terms, the risk of being hospitalized and dying is still very low. But still, you know, all of these people, I said, listen, I want you to do these things. And one of the things I said is, for the next few days, just eat nutritious foods, cut out all the ultra processed food, no sugar, minimize any starchy carbohydrates, you know, they all did very well, but with keeping that in mind, knowing what I know around insulin and glucose, et cetera, and those poor outcomes. Yeah. It's, man, it's nuts. What do you think about, so what about the accuracy of,

do you know anything about the leptin receptor? Does the leptin receptor have that duty? I can't find a lot of information on it. Have you ever heard that before, that the leptin receptor somehow has that relationship with NK cells and T cells? I'm sure. Listen, it makes sense. I can't confirm that with you, Seven, right now, but it makes sense. We do know that leptin itself, you know, is pro-inflammatory and you want to be really

reducing chronic inflammation. So it makes sense. I think around other lifestyle things that we can't ignore as well, especially in terms of the relation to immunity. I mean, the immunity plan was really predicated on the whole COVID-19 pandemic and who were the people adversely affected and what could we do about it as individuals. And of course, on a policy level as well.

So, you know, I was asked to advise the the british government the secretary for health contacted me um asking uh me to give him advice on what they should be doing because i was the first person doctored to publicly suggest that our prime minister got admitted to hospital with covid19 because of his weight and that then became a big story um and then the things evolved from there um But one of the other things that I think is important to mention is vitamin D deficiency. So we know there are studies showing that people that died and had severe outcomes from COVID-19, 80% of them had vitamin D deficiency. We know vitamin D, and this is something I had to research. I wasn't aware of it until I'd researched it.

It's so important as a hormone in the immune system. It has a role in optimizing the immune system through various mechanisms. So vitamin D is a big problem in places where people don't expose themselves enough to the sun. So 90% of our vitamin D7 actually is through sunlight, you know, being outside, right? Even 10 to 15 minutes a day of bare arm and leg exposure to the sunlight is, is good enough to maintain your vitamin D levels. But many people in the Western world aren't doing that, especially people sit inside a lot of the time or even working out inside, et cetera,

and then going home and sitting at a desk or whatever else. So we do something we need to think about a little bit more. And if not, then get supplements of course. And generally they are without harm. So people certainly through the winter, I recommend most people in the UK to take vitamin d supplementation and you say in your book that it's too late once you get sick to take the vitamin d there was a trial an rct randomized

control trial that was done looked at hospitalized patients and topping up them with vitamin d and it didn't improve their outcomes but it's probably because it's too late by then you know i don't think i don't think vitamin d acutely probably does anything but over time certainly within a few weeks probably well you know if you optimize your levels within a few weeks which you can do um then at that stage you're in a much better position i mean these are associations so we can't be we haven't got definitive proof but but it's very likely that vitamin D has an important role in the immune system and certainly in helping reduce poor outcomes. But even independent of the immune system, as a cardiologist, I will say that vitamin D deficiency is associated with a sixfold increased risk of developing heart disease. So even from the heart disease perspective, it's very important.

So that's one other area. Now, let's talk about exercise, Sevan. You're the exercise expert, aren't you? Certainly, I'm sure you know a lot more about exercise than I do. But when I look at the, you know, I look at two areas. Of course, I've always looked at heart disease. But if we look at the immune system, what's really interesting? And I'm sure people have their own anecdotes around this.

So moderation is key, getting enough, right? have their own anecdotes around this so moderation is key getting enough right um but overdoing it actually has a detrimental effect on the immune system in the sense that if you look at elite athletes they tend to get four times as many respiratory infections per year um compared to people who do moderate activity right so uh this is if you do more than an hour of vigorous activity a day you're likely. No, it doesn't mean that you're going to be it's going to be a complete disaster. But relatively speaking, your immune system is not going to be as good as someone who does moderate activity, 30 minutes a day, for example. And there's good there's good quite a lot of data on that.

if you compare an elite athlete to someone completely sedentary the elite athletes gets twice as many respiratory infections per year compared to the person who's completely sedentary so the optimum is making sure you're doing something regularly and even 10 to 20 minutes of brisk walking when we talk about t-cells enhance t-cell function so i think the regular keeping the regular activity and not overdoing it when it comes to the immune system is crucial. And of course, we've all been there. I would say I have OCD about exercise seven. I've been, you know, literally every, I'm the first guy in my gym back in the UK. It opens at six. I know here that you have 24 hour gyms, but my local gym in Hampstead opens at 6.45 AMm I'm usually one of the first people to

walk in there to the gym so I'm very disciplined about working out and stuff like that but I've also found during periods of my life when I overdid it you know when I was working in junior doctor for example I remember one time I decided and I was eating a lot of sugar that time I didn't always feeling guilty about it or whatever else and I you know I was a bit stressed out I decided to run at high pace on a treadmill for over an hour. And a few days later, I got the worst battle flu I'd ever had. And it took a long time to get over it. And now when I reflect back, I've realized, especially if you're not getting really good quality sleep, you have to be just careful.

And you know, Seven, as well as a CrossFitter, that your risk of injury increases if you're not resting properly and recovering properly as well. All that being said, I don't want anyone using an excuse that it's 11 o'clock at night and you can't go in the garage and work out for 10 minutes. If you haven't worked out, get in there and sweat. Don't be a sissy. 10 minutes. That's all I'm asking. Many times on Instagram, I've put out a, I've said some pretty, some stuff that I guess seems pretty radical. And one of the things I say is show me one healthy person that's died. And the metaphor that I've used some stuff that I guess seems pretty radical. And one of the things I say is, show me one healthy person that's died. And the metaphor that I've used

or the analogy that I've used, and I've used this with my dad. My dad says, you don't believe in COVID. You don't believe it's killing people. And I said, look, if there's a man on a high wire, a thousand feet off the ground, and I tell him a hundred mile an hour wind is coming, and an hour later the wind comes and he dies

what killed him his stupidity his being on the high wire or the wind like it is not a clear sign of what's going on for 50 and where i've been for 15 years around greg glassman he has told us that the tsunami of chronic disease is coming it's here we're in it don't be dumb stop eating added sugar and refined carbohydrates now we're in it who know who would have ever thought it would have manifested as some virus right and masqueraded as that for my opinion my words and i know that's a bit cavalier but the to to kind of jump on what you were saying the only healthy people anyone has sent me a picture or a news article of who's died from sars-cov2, which manifested as COVID,

is ultra marathon biker dudes. They'll be like, well, this guy's healthy. I'm like, what are you talking about? The Tour de France guys are notorious for hiding in their motor homes because they're afraid that they'll get sick if the wind blows the wrong way, correct? Yeah. Yeah. No, it's interesting, isn't it? I mean, when I saw some of those healthy, I thought, are these guys overdoing it in terms of their exercise? Is that what's made them vulnerable? And the media— And, of course, we don't know their diet. They could be on high-sugar diets as well, right, even though this is a high-fats mix.

It's body fat. I'd be willing to go on a limb that they're living off of goo packs. You're 6'2", 154 pounds, and you're a world-class biker. I mean, I have to guess you're just living off of goo packs. And then on the other hand, the media is posting tons and tons of photos of people. And it says healthy, healthy young boy dies of COVID. And they show a picture of him and they're 16 years old. And he's so obese that his ears are hidden by the fat on his skull.

You can't see his eyes. And, you know, he's clearly 400 pounds and this is uh using words like this yeah it's it's unfortunate uh seven changes the baseline context here these are very tragic of course for all those individuals of and their families but i think again people need a bit of a lot of people we're standing too close to the elephant yes the narrative has been pushed on us for two years uh the fear, the pandemic of fear. And actually, we've lost a bit of perspective here. And that itself is detrimental because fear itself drives disease, right?

So if you're scared of something that isn't going to kill you, that's not good for your mental health. I had family members and friends who got SARS and who knew that there was no chance of it hurting them. They're in perfect health. They don't need added sugar. They don't need refined carbohydrates. And yet, and, and, and they were so cavalier, but when they got it, the media panic came in a little bit and they had, they had a few panic attacks. Sure. I'm like, Hey man, chill, just go for a while. And by the way, uh, once again, the 21 day immunity plan, there's an element in there that there's a section in there that talks about the importance of breathing. If you are alive on the planet and you don't go back to your breath at least once a day, you're missing out on a huge part of your existence. Your fallback anytime you're thinking something goes wrong, you have a free moment, should be on your breathing.

And one of the hacks I can help you guys with that I did is a couple years ago, I only work out – when I work out, I only do nose breathing. And what that does is that lowered my intensity, but now it's back up since I've been doing it for so long. But it really forced me to pay attention to my breathing. And now, like if I'm on a plane and there forced me to pay attention to my breathing. And now, like if I'm on a plane and there's turbulence, I go to my breathing. When I fall asleep at night, I go to my breathing. When my kids set me off, I go to my breathing. It's just a default. And Aseem talks about that and talks about stress. Sorry, I didn't mean to cut you off. No, no, 100%. Really important. Keeping stress levels low. Again, we know that. I think people,

you know, anecdotally, you talk to people, you think about some of the worst illnesses you've had in your life, whether it's bad flu, cold, whatever, you know. Often they're linked to some kind of psychological negative or stress event that's happened, stressful event that's happened in your life. So, you know, these things, life is unpredictable. We can't always avoid, you know, we're all going going to suffer at some point major tragedies in life. So, but I think you can give yourself the best baseline by keeping your stress levels in check. And I'm a big, big supporter and fan of meditation. Absolutely. There is this question that comes up over and over, and I suspect you'll be much more compassionate than my response. What about artificial sweeteners and Diet Coke? And my response is, fuck you, you're not ready.

Like, get out of here. Well, listen, the problem with sugar – I'm guessing you have a – go ahead. Yeah. One of the problems with sugar, Savan, is we have to unsweeten our sweet tooth. Uh-huh. And so I would, you know, I would tell people to go cold turkey on sugar as part of my advice to patients completely and also avoid anything that's sweet to artificial sweeteners

because it's going to make it less likely that you're going to be able to sustain it and then break that addiction. And of course, you know, there is emerging evidence that some of these artificial sweeteners, diet sodas, for example, probably have an adverse effect on the gut microbiome. They also may spike insulin slightly.

So I generally say just drink water. That's my advice. But one thing, sorry, just I forgot, because you mentioned about the pandemic affair and COVID. I think a lot of you know, I'm going to be writing something a bit more about this soon just to put things in context. But I think John Ioannidis, professor of medicine at Stanford, last year on CNN from his own research, had to kind of nicely summarize what the risk of COVID was to different individuals in terms of their age. And he said, you know, he said, if you look at older people, people in hospitals, nursing homes, but certainly the elderly, it seems to be significantly, can be devastating,

much worse than the flu. So let's compare it to the flu in those age groups. In middle age, he said, it's probably quite equivalent, the risk of serious illness and death from COVID in people of middle age, you know, say 40 to 65, is likely similar to the flu. But if you're younger, certainly for kids and very young adults, it's less lethal than the flu. And that's still supported. You know, there's no evidence to suggest it's anywhere close to being as lethal as the flu in people who are in children and young adults. So I just think it's important just for people to have that in context when they think about, you know, about COVID. And if anything, and that was, by the way, before we had Omicron, which appears quite consistently so far to be much milder than the original variant, which Don, I knew this was talking about.

It's amazing how many people I see with their kids masks, or I hear over conversate, over here conversations every day with people say, well, I'm going to be especially careful. I actually have family members who aren't traveling for Christmas because they want to protect their kids. And the thing with me is, is maybe this people can say what they want. When my wife got covid, we didn't change anything. We didn't I mean, my wife doesn't need added sugar, refined carbohydrates. She exercise every day and I got it. kids got it we treated it just like chicken pox like I wanted to get it and it be over with now she had a more severe case than all of us but my feeling is is why not have the child get it now instead of having to deal with it when they're

80 um I got a I got a question for you It's a personal question. You talk about how you got the vaccine and how you got it to try to protect those. You believed it was the right thing to do to protect those around you. Can you walk me through? But what's also interesting, as you said at the beginning of the podcast, is that your brother died of myocarditis or is that correct yes yeah and so you got a uh now you got a a ton of data points and i'm sure what are your thoughts on this whole thing do you wish you still would have gotten it um is that the correct way of thinking should i go out and get it to protect those around me i mean i won't but yeah this is evolving space i mean i'll give you a general overview on this um i will be writing and doing something on this soon to try and put everything together. So I don't want to, you know, until I've gathered all the data to make a more objective opinion on it. I don't want to, you know, I don, first and foremost, I'm very much somebody who's for vaccines in the sense that, you know, your polio, MMR, so many vaccines have estimated to probably save around 6 million lives a year.

Okay. So that's the best data we have on traditional vaccines. With that in mind, and I helped out in a vaccine center very early on. I had both Pfizer jabs quite early on, earlier this year. But for me, it was not big. And I knew about the risks of COVID by that. I'd rationalized things in terms of I wasn't concerned about myself. But as a doctor, and my left arm is covered in scars from race vaccines I've had, you know, we do it often.

We do it to protect others, protect patients. So for me, it was a no brainer from that perspective at that time. But that's also in keeping with a background understanding and acceptance of the efficacy of traditional vaccines, right? So I wouldn't have questioned this vaccine in any way, shape or form. traditional vaccines, right? So I wouldn't have questioned this vaccine in any way, shape or form. But we have to put it in context now that, of course, and for legitimate reasons, we were in an emergency pandemic, if you like. This vaccine got emergency use authorization. So it didn't go through the usual checks and balances in terms of what would normally happen for several years

to look at the adverse effects. And then we're now dealing with a virus which certainly in younger age groups has a very low mortality rate. There's even some question marks now about whether the existence of long COVID actually is there and whether some of it is just a form of PTSD. I think it probably is for some people, but not as significant as people have made out to be. So I don't think personally, I think we need to think a little bit differently about how we manage this in younger people, certainly in older age groups and higher risk people, Sevan. The real world data, which is not as good as our RCT data, because the RCT data didn't show this, but the real world data does

suggest that the vaccine does prevent people from getting seriously ill and dying, which is a great outcome, especially for people who are vulnerable. The question that we need to ask ourselves as we move forward, and I'm sure that data will emerge, at what point does the adverse effects potentially become more of an issue and more harmful than the benefits of the vaccine? And that's still a very big controversial area. But I have some thoughts on this, and I will be writing about this soon. So I hope that's, is that helpful, Sevan? Yeah, that helpful seven yeah by the way the other thing to mention by the way in relation to our lifestyle issue which again isn't getting much um uh of an airing if you look at traditional flu vaccine data um if you're obese okay then the the vaccines actually they don't

they're not a replacement for your immune system they work with your immune system so there's you know if you want the vaccines to be effective you need to focus on your metabolic health as well as in to have the best effect okay obese people tend to have less of an efficacy with the flu vaccine and likely with with the covid vaccine as well if you're obese then you also are more likely to contribute to increasing new strains of the virus because people with obesity hold onto the virus much longer, take longer to recover. So there's lots of good reasons to improve your metabolic health, even from the perspective of making sure the vaccine works as effectively as it can do. And that's where myocarditis, you mentioned that, I think that

is an issue. One thing that's good in terms of from the vaccine perspective is that so viral myocarditis traditionally, which can happen to anyone, you know, one thing I teach my medical school students, one thing that I learned in medical school is a rule of thirds. So in general, a third of people who get myocarditis will rapidly go into heart failure and die like my brother. A third will have some impairment of their heart muscle pump function some damage to the heart muscle the left ventricle and then will recover and then will need lifelong medications and a third will will get sick for a short time and then rapidly recover and go back to normal so that's viral myocarditis now what's

good what appears to be the good news about the vaccine is that it doesn't seem to have caused any deaths as far as I'm aware from myocarditis. That's different heart attacks and that, again, I'm exploring further. But from myocarditis itself hasn't caused any deaths. And most of the people have made a full recovery. However, the recent publication in Circulation showed that in young adults, more than 70% of the ones that had cardiac MRI scans had some degree of scar. Even though their heart muscle pump function was fine and normal, there was a degree of scar left in the heart. And they've concluded, we don't know what this means in the long term. For me, that's a concern. That isn't something completely benign. And we just have to try and understand better what the true prevalence is so we can help people make more informed

choices. I think one of the problems in modern medicine in general, not just with vaccines, seven, it's something I've campaigned on, is often people are, both doctors and patients, are involved in clinical decision-making on biased and commercially corrupted information, which often will exaggerate the benefits of any intervention, any medical intervention, and minimize the harms. And therefore, they are not truly making an informed choice when they take a medication or even undergo a procedure. So I think as long as people have that background understanding and feel that we need to do something in society to make sure that that is significantly improved, then this may also be something that, you know, we use those principles, I think, as we move forward with how we deal with this particular

vaccine, which is very different to other vaccines. And when it comes to transmission, and if there is any reduction in transmission, it's quite small. There's certainly a reduction in symptomatic infection, even from the original trial data, which is quite small. It's not even in the same ballpark, in my view, Sevan, compared to traditional vaccines that we've used, whether it's MR or polio or smallpox, not even in the same ballpark. So for maybe good reasons, because of the immense use of authorization. So I think we can't conflate this particular vaccine with traditional vaccines. So we need to find that common ground and then help people make more informed choices

for individuals, but also the policymakers. Should we be mandating vaccines? In the UK, the medical leadership, the BNA, British Medical Association, the Academy of Medical Ecologists, were very clear that they felt that it was not right, even though they wanted to persuade NHS staff to take the vaccine, they said mandates were too far and we should not mandate vaccines for National Health Service

staff. We have a huge uptake of the vaccine in the NHS, but they felt that mandating it would be a step too far because about 100,000 NHS employees up to this point have refused to take the vaccine. Most of them probably younger age groups, young women, for example. to this point have refused to take the vaccine, most of them probably younger age groups, young women, for example. That shouldn't be a legitimate reason to not mandate it. I mean, I'm against the mandate, too, but it's sort of sad that that's the reason. It is sad.

And I think also there should be more ethical reasons than just like, I mean, now we're back to consensus. And also from a practical point of view, it's counterproductive. Historically, we know that these sorts of coercion policies have the opposite effect. doesn't tell it doesn't make people suddenly say oh i'm going to take the vaccine right and it also breeds more in my view it'll breed more suspicion yes um if this is and this is where you know we talk about government intervention and policy you know i think if if things were done in a democratic and ethical way i I think we'd all be pro-government. But the problem in society and what's happened over the years is that governments, unfortunately, don't always do things ethically incorrect and often are very corrupted by commercial influence. Let me ask you this. The president of the United States spoke last night and he's been speaking all week and he's been saying some things that are pretty hardcore.

I'm paraphrasing, but he's basically saying, hey, if you don't have this is the disease of the unvaccinated. If you don't have the if you're unvaccinated, you're more likely to get severe sickness and death. And whether let's say let's say everything he said right there is true. Do you think that it is completely misleading that he doesn't throw in there um that you can't separate that from being obese from having poor metabolic health i mean why why doesn't he just from where i sit yeah it would it's that that statement is like so flirting with lying without saying, by the way, this is like 99% true if you're obese and kind of not true. Yeah, I think you're right.

I think it's incomplete information, Seven. Yeah, yeah, it's incomplete. Right. Incomplete. But also, I think to say it's a disease of unvaccinated just isn't true because we know the transmission rates are very similar, whether you're vaccinated or unvaccinated. transmission rates are very similar whether you're vaccinated or unvaccinated but it is true that if you're vaccinated and you're obese that you that the numbers show that you have a better survival rate that is true right yeah absolutely it seems to be that case it seems to be okay and like i don't want to say anything positive about the vaccine but but i want to like give like really um

i want to give really honest information. Yeah, and I'm talking to people about the bigger picture, right? The elephant in the room. Yes, yes, which is that you eat too much sugar. Yeah, absolutely. And I think that's been unfortunate. Certainly in the UK, there wasn't enough public health focus on the issue of the link between obesity and poor outcomes.

I mean, seven. There wasn't any in the United States seven there wasn't any in the united states and so there wasn't any in the united states it's not that there wasn't enough there was none i mean i was probably this i was a single person in the uk as a doctor really talking about this at the beginning and i managed and took me a lot of attempts to really keep pushing this in the mainstream through several articles you know bb Sky News, all that kind of stuff. Kudos to them for keep having you on, by the way. Weren't you kicked off of Instagram?

Didn't you have a? No, I had a. So I was. So Facebook censored me for 24 hours. OK. Because I verbatim had quoted a JAMA pediatric study about the potential harms of masks in children. OK. But yeah, I was censored for 24 hours and i came back on but then they did a new story on it because obviously i have a lot of

you know i have a big network with with journalists and i'm a you know i'm a known public health painter so uh rightly or wrongly you know the media um are interested what i have to say and i basically said well you know this is anti-democratic you know i i i felt that it was anti-democratic that with you know that censoring science you know is um is is a very bad thing you know we've started censoring science and it becomes a death of science it becomes the the it's a um the death of truth and that ultimately leads us towards oblivion but maybe that's another discussion for another time but yeah it was unfortunate you go there

as a doctor do you go there or do you have to like do you have to compartmentalize those thoughts like like like i'm sure you've heard about the peter mccullough interview on joe rogan and everyone's talking about it do you even go there like when you hear that the hydrochloric queen plant was burned down in taipei after trump talked about it being a cure, do you have to block that out and be like, okay, that of us, you know, the science cannot be decoupled from the moral and the ethical side of the issue as well. And the biases also come in. So I've got to get to the roots of why is this particular person saying this? And is it just their own intellectual bias? Are they misinformed?

Are there commercial influences at play? You know, you've got to look at all those factors as well. I think if I don't know, but I haven't seen the full Peter McCulloch interview. I've seen disclips of it. I wasn't aware of this plant being burned down. It even made news back then. It was big news when it happened. But, you know, there's, our news cycle is just crazy, right?

Yeah. Yeah. Yeah. But coming back to the discussion around, you know, metabolic health. And so, you know, I'm a single voice, I get something in the mainstream about metabolic health, I've written a book, which is a Sunday Times bestseller. But this is, you know, it's like dropping the ocean compared to all of the other misinformation, and what people are receiving, or the distraction from the important things, right metabolic health it it you know it will hit a few people and that's good you know that movement will grow but ultimately it needs to be you know what was missing every day you have all these commercials on tv7 i'm here in the u.s you know for junk food or whatever else right all the time why not every single day if there was a commercial saying optimize metabolic health avoid ultra processed food it would have huge impact yes but that doesn't happen right so

so it's just the balance is in the wrong place in terms of the way people receive information and then how they act on the information they receive i'd love it if our president said that at the end of every speech if he said uh he says god bless america but he could throw in there by the way stop eating added sugar and refined carbohydrates god bless america but he could throw in there by the way stop eating added sugar and refined carbohydrates god bless america a nice little twist to it yeah so another interesting bits of stats for your listeners to hear just to put this in the bigger context so 90 of the deaths from covid 19 happened in countries with with more than 50 of the population overweight or obese okay so the three worst affected countries u.s bra UK, all with very high obesity rates. OK, so most of the deaths that occurred were in these countries.

The other thing that's interesting is one paper that was written was a kind of modeling study to see what would have been the death rates if we'd had healthier lifestyles. You know, close to optimal, not perfect lifestyles. And they suggested that almost half of the deaths probably would have been prevented or avoided if we had better baseline metabolic health in effect you know accepting that a huge proportion of the people that died were people who are very elderly and frail but once you take those out of the equation you know it's going to be a much bigger impact so you know this was a fast pandemic as a colleague and friend of mine, Darius Mozaffarian, says we had a fast pandemic that hit us, hit a slow pandemic. You know, that combination was particularly lethal.

What's Mozaffarian like? Is he a good dude? Oh, yeah. I mean, I've had lots of chats with him and interaction with him. And, yeah, he's a he's a he's a solid researcher. I see that I am at the end and I feel because I'm Armenian also. I get excited. Well, you should you should get you should reach out to him. I will. There's something here. I found something for us to fight about.

You are you talk about age a little differently than I do. I you do talk about how age. What do you talk about? The four the three things I wish I could find it in my notes. Oh, OK. Here we go. Here we go. Eight.

You say a thinking book ages the biggest risk factor of COVID-19 death. And I write here in my notes, I disagree. And you lay out why you think it is. You say basically the immune system needs to recognize, alert, destroy, and clear. And all of those things wane with age in the elderly. And I don't disagree with you, but here's the part that I'm tripping on. When the data first started coming out of China, one of the things they said, and I apologize if I'm wrong here, but they said that 80% of the people who had died in China were men who were 65 years and older who had been smoking for 30 years or more. And then the second group, smoking for 30 years or more. And then the second group, a leading group of deaths out of China were the women who lived with those men. And I, and I saw it and it wasn't a very big group of people. I forget what the group was several, several hundred. And I remember thinking then, oh shit, they're going to say this is an age thing. But as a, as a friend of ours, I don't know if you remember this guy, but you've definitely met him before. It's a doctor out of,

I think he's a cardiologist also. He's out of San Luis Obispo. His name is Will Wright. I met him through Greg Glassman and became friends with him. And he says the vast majority of patients that he sees are 30 years complicit in their demise. So when I see age being pointed to as a big risk factor, I say, hey, it's a huge correlate. The correlate's there. But how do I know that you're not just dying at 70 because you've been drinking Coca-Cola and Jack Daniels since you were 30 or since you were 20? You have 50 years. I feel like my mom who's 78 and does CrossFit every day and doesn't eat added sugar and refined carbohydrates is bulletproof. Not every day, three days a week.

Simon, it's a good question. I don't think we know the answer to it definitively. It makes sense. And I think if you're a healthy 80-year-old, you're probably going to be less risk of dying from COVID-19 than, say, an obese type 2 diabetic smoking 50-year-old, right? So I think it's irrelevant what you say absolutely absolutely but i think one thing we have to also acknowledge and accept is we're all

going to die yes but at some point you know and one of the things that happens you get older your immune system does tend to deteriorate even if you you know just just as a function of aging compared to someone who's young and healthy fitter so i think that it's just yeah i agree i know what you're where you're coming from is that we shouldn't just say it's age. It should be about healthy aging. And it'd be very interesting. I don't know if anyone has collected data on older people who had complete optimal metabolic health or weren't on any medications. It'd be very interesting to see what the death rate was in those people. I don't think we have that data, but I suspect it would be very, very low. I don't think we have that data, but I suspect it will be very, very low. When Dr. Asim says that only one in eight Americans have good metabolic health, that should be really, really alarming to you. There's a thing that we do in life where we look at everything and there's a baseline. So I'll give you a really, a really superficial example. You can look at three, three boys and if they're all overweight, you'll still see the skinnier one is skinny and the fatter one is fattest. And we're always reassessing and recalibrating in the group

we're in. And there's so much personal responsibility that I feel like so many people who, who can, and especially people who are unhealthy. You need to, you, you need to be the example. Like if you can't do it for yourself, do it for the world. Like if you're one of those unhealthy people start, if you're healthy, thank you stay on the path. And if you're unhealthy, really, really dig in and do something that can profoundly help the people. And, and, and, and let's start swaying those numbers because we're all basically mirrors here. We're just mirroring each other.

And I know it's lonely. I know it's lonely. Man, it's even weird for me in Santa Cruz, California, where so many people are healthy and I go into a Starbucks and I'm like, oh my goodness, if this place catches on fire, who am I gonna save first? I mean, two people can't go out the door at the same time

because everyone's so damn obese. And I think the baseline is all screwed up especially what were you saying 50 of the doctors in in the uk medical professionals are overweight obese absolutely that's why i also i think it's not just an issue of education right it's food environment i mean you know i'm a very disciplined guy seven i consider myself very very disciplined person to do what I've done in my life, right? And even I struggle. So, you know, people who don't have that, you know, if I'm at the extreme end of discipline and we're trying to have compassion for our fellow human beings, we're all different,

especially children, right, who aren't, you know, who aren't real actors in a sense. We can't talk about personal responsibility in children the same way we can in adults. who aren't real actors in the sense, we can't talk about post-responsibility in children the same way we can in adults, then we have to try and, you know, enable, you know, we have to, I mean, encourage the hospital food environment probably is a big driver of that.

There was one study, I think, in UCSF that showed that when they removed sodas from the hospital grounds, they actually measured whether that had an impact on hospital staff. And these are not people who are particularly well-off. So I think it was like porters, cleaners, and that kind of thing. And they showed there was a significant reduction in waste circumference at one year. The only intervention was to remove the sodas from the hospital grounds.

Hey, worst case scenario, they have to walk three blocks to get a soda, but at least you got them to walk. Yeah. Sure. But I kind of think you can't, you know, you can't outrun a bad diet, right? So I kind of think sometimes I know people who've exercised all their life

and they, in fact, it probably has a detrimental effect on their health because they think that they can eat what they like if they're going for a jog or after their run, they're going to have cakes and stuff as a treat. But it probably negates seven, probably negates all the effects of the exercise, to be honest. Yeah, I've been there that, I mean, I mean, I still go there sometimes like I'll eat an extra ham. I mean, I won't do a sugar, but I'll eat an extra hamburger because I think, you know, I'll eat for pleasure. Um, there's a question here in the comments and, and feel free

to wave any of these off. Any truth about the effects of people with, no, not that one. Ask them about the soccer players having heart attacks in the UK and Europe. Have you seen this stuff going around? I'm glad that's been asked. I have links through sports scientists in the UK, some of the most eminent people involved even in the Premier League soccer. And this is being looked into. What I would say is let's not jump to conclusions and suggest or think it's the

vaccine because there are many soccer players who I know, who I'll not name to protect confidentiality, who had collapses or issues who weren't vaccinated. So even before COVID covid i've campaigned on this for young people um we have 12 sudden cardiac deaths per week in the uk so it may be there's a lot of attention happening on these players but actually it's only because of uh focus it's there now that wasn't there a few years ago right and many of these plays even have underlying heart issues like they have genetic conditions like hypertrophic cardiomyopathy uh and maybe that some of it's really so listen it let's let's not discount it but let's just take a step back and say well and and my me personally i don't think there's probably any specific strong link i think if there is concerns about vaccines

and side effects ironically the people who are less likely to experience significant side effects, probably the group are your athletes between age between 20 and 40 as well. It's people like me who want to jump on that bandwagon and believe it's the vaccine's fault. And the reason why I want to jump on the bandwagon and believe it's the vaccine's fault is because of the mandates. If there were no mandates, I would be like, I could be less biased, but basically there's a fire on the other side of the door that I feel, and I'm going to pile anything up against the door. I don't care if it's a Ming dynasty vase, I need to stay alive. And so, and, and, and, and sorry, maybe that's a bad metaphor i'm not

suggesting that the vaccine would kill me but you know what i mean like yeah it's it's becoming harder and harder i want to throw anything at it to make it go away at this point sure sure exactly well it's interesting so you know you've got insight i've got insight where a lot of people are angry about mandates and then the if anything if you think about it emotionally that then breeds more suspicion you don't look for all of the anything to support bias to try and say, this is, um, this is, you know, uh, really bad and it's having a really bad effect. So yeah, that's, that's human nature, but I think that's actually an argument to say why we, again, why we shouldn't be mandating because, you know, we are intelligent humans, um humans who can understand data better than probably most people.

We're not trained that way. And even we are sucked into these biases. You know, what's everyone else going to be thinking? Are you enjoying your stay in the United States? Do you like being here? Oh, yeah. No, I do. I do.

I love being with my – I mean, I love California. I've always loved California. Although, you know, I always tell people it's sunny California. It's got the reputation of always being sunny. Although the weather's not been that great for us. Yeah, but, but no, no, I do. I do. I do love California. I love America. I love the U S in general. I've traveled all around. Um, I'm going to San Diego next week. Oh, nice. Um, I'm a huge fan of San Diego. Love that city. So, um, no, absolutely. And being with family, most importantly, my cousin and his wife

and their kids is for me very soul nourishing because i live alone in the uk um and we talk about meaningful relationships and and um it's so important i mean that one of the big collateral areas of damage in the pandemic has been lockdowns and and the social isolation that's that's happened to people and um whether or not you're pro or for, you know, for lockdowns or against them. And again, there is very controversial science in there. I think most people can accept that social isolation is very, very detrimental to mental and physical health. I don't actually believe that any of the problems, I would even go as far as to say I know any of the problems that we have that are the major problems are from SARS-CoV-2 or COVID. I would say the vast majority of problems have been created by the cure to the problem is not – we're so far out of balance. Is the cure worse than the disease?

Has the cure been worse than the disease? And this is an evolving space, and we don't have the definitive answer to that yet. A lot of people have their own opinions on it. Right. But I think, Sevan, I think this will emerge over the next few years, hopefully, and people will look back. And if nothing else, rather than blaming and finger pointing, we've got to say, well, let's just learn from it and make sure next time we deal with this much better. Right. You're a good dude.

dude uh i i i we have some sort of stat here in the united states where um we have a couple crazy stats that 40 of the people during the last two years have put on 29 pounds or more we have some crazy crazy stat going can you imagine despite the knowledge the information that we knew that this was linked that this is so again right stress food environment lack of um maybe empowerment for many people um you know I suspect there's probably a socioeconomic relationship as well, with some of the weight gain, as you know, people who maybe find it more difficult to afford healthier foods, right? So they were more likely to eat the junk. And then nonsense stuff that seven, I mean, you know, I tweeted about this, it became a new story, because I was so I was, I'll be honest with you.

I was angry. I'm not going to try and underplay my emotions on this. In the middle of the pandemic, one hospital in the UK tweeted out their delight that the staff were going to receive 1,500 for their staff, 1,500 free Krispy cream donuts yeah right in the middle of the pandemic everything we've discussed already i don't need to explain why that's a bad bad idea it it's worse than throwing gasoline on the fire it's worse yeah and in certain countries i can't remember i think it was australasia or new ze Zealand where they were kind of giving out free vouchers for fast food and stuff if you come and get your vaccine.

You know, Jesus. I'm only 40. And I know I'm out of whack here, but I'm only 49 years old. But I do have parents who are in their 70s and 80s. There was another stat that 40% of the people who've died in the United States were in care facilities who had a 13.7-month life expectancy regardless of SARS or COVID-2. That's the life expectancy when you go into a care facility, and those are 40% of my deaths. And I personally – and I know this is a really harsh thing to say for some people to hear. I will let all of those people die to save – even if they were my parents. I apologize, mom and dad, if you're listening to save one child, meaning if there was one child who somehow lost its life because of the quarantine, the mass, the vaccines, but it was to save a hundred million people who had a, who were already

in a nursing home with the 13 points. I can't do it. I cannot, I, I, I put a premium on, on children. It's my bias and I'm, I'm, I'm, I'm fully aware of it. And I hope I can maintain that as I age because I think it's a – I hope even at 80 I feel that way because I think it's a noble thing. I think I took this – I think my – I spent a lot of time in India. My wife spent a lot of time in India. I think my wife took this from India. But basically about 70 weeks ago, 60, 70 weeks ago, my wife basically told us, hey, we're not going to eat one day a week. So every Saturday night we stop eating, and we don't start eating again until Monday morning. And we drink black coffee.

So basically what that does is that's a 24-hour fast, but you get two sleeps in. So if you're lucky, you can get usually like 36 hours out of it, right? You can eat as late as you want Saturday night and you get that sleep, and then you get those free extra hours of fasting when you sleep the next night. It's pretty cool. People ask me all the time, and most of my audience is younger, should I do that? And I'm like, I don't think you should do that. I think you should wait until you're 45 to do that. But, but do you have an opinion on it? Or do you think it's too much what I'm doing or? No, I think it's individual based. Um, a lot of my patients do it and swear by it and they feel better. Um, a prolonged fasting for me doesn't

work. I tried it through different. And I think it also depends exactly. It's interesting where you are at the time. What's your mental state's your you know physical state like uh one thing where i would say that people should be careful about fasting and i've seen this consistently with my patients even with myself is if you're already under a lot of stress fasting can make it worse right so that's the only thing you know and that then can interfere with your sleep and that obviously is not good so uh especially if you work if you're working out if you're stressed and then you fast um and you're not sleeping properly it can be a disaster right yeah and that's interesting because i don't have any stress right so so there you go so maybe a lot easier for you maybe the meditation

all that kind of helps that side of things so i think just put it in context i think it's very beneficial but it's not necessarily for everybody um But I just think, think about your stress levels and your sleep. And if that, those are generally good, then you probably are going to have more benefit from fasting than, than people who are doing it just because they think it's a prescription to add in whilst maybe their sleep isn't that great. They're a bit more stressed out. It can then burn you out. Right. And then, and you, and you'll feel it seven. So it doesn't, you you know i think if most people

um who benefit from fasting will tend to feel better so certainly if they've done it for a few weeks give it some time but if you're not feeling better mentally and physically then it's i would say just it's not for you yeah sunday is uh i don't want to say hard but sund Sunday at 7 p.m. things do get a little challenging. Yeah, so I think during the fast maybe, but I think if it's then seeping into the rest of the week and you're having to deal with the recovery side of the fast or whatever, if you're stressed out, then it's something to think about. Yeah, Monday I feel noticeable inflammation gone. It's like everything is, the whole world is different. My clothes are different. I move different.

Yeah. And I think, you know, there's something interesting in interesting in uh volta longo don't even know about his work so he's a he talks about the longevity diet he does research i think he's at uc davis if i'm not wrong um and he's a researcher into longevity and he thinks that there's something called a fasting mimicking diet which they've shown in animal studies apparently is good for autophagy and cell regeneration and all that kind of thing and he recommends once every six months you should basically do a 800 calorie a day for five day fast essentially wow what's the guy's name again volto longo l-o-n-g-o look him up very interesting stuff he's written about um so i think this is an again emerging evolving space so a lot

of people are doing these things and find that they just they feel they reset their hormones are better afterwards once they've done like a five-day. Some people just do a five-day water fast as well, as opposed to even eating anything. But you can get away with it, he suggests, by if you have 800 calories a day, the right kind of things, which is again, not processed stuff and relatively low carb, that you're actually mimicking fasting. And do that for five days once every six months, apparently it's good for you. and do that for five days once every six months apparently it's good for you basically um after reading your book too if you you could basically if you just ate whole foods if you just ate clean and i mean like truly clean you could basically you don't need a diet no like if you just eat

like cucumbers and liver and and some eggs and tomatoes like you just eat whatever you want as much as you want i'll die you know i always talk about in the context of the original greek word diata which means lifestyle that's it just once you start going down that slippery slope of like okay i'm just gonna have some dark chocolate okay i'm just gonna have some dried fruit next thing you know you're eating rx bars and and then you're like you get a hamburger at the restaurant but you make sure the bread's gluten for then you're fucked up again get a hamburger at the restaurant, but you make sure the bread's gluten free. Then you're fucked up again. But if you just eat just like, you're good. Just the whole foods.

Absolutely. And again, you know, listen, we all like the occasional treat, right? So once you've reset and recalibrated and done it for a few months, then I just say, you know, follow the 80-20 rule, which is kind of what I do. Which means 80% of the time I'm, you know, pretty strict. And then I let myself go a little bit on the weekends. You know, I'll have a chicken biryani. I'll have a salad or pizza. And that's fine. That being said, I use and then and then I'm sorry, I know we're long. I use the carnivore diet to get off of sugar. I had heard for 15 years to quit eating sugar from Greg, Greg, and I almost had completely cut it out. And then the last step was I was looking at Paul Saladino's stuff, the carnivore MD, who did get kicked off of Instagram and who is back on.

And basically I just let myself eat meat and hard cheese as much as I want for a month. And, and that, and I kick sugar. It was hard. It was crazy, but I just said, okay, it helped me. And then now I'm eating back to, I eat a lot of vegetables and fruit now, but, but I kick sugar. How did you do it? How did you, and I still have pizza, but, but not, not even once a week, like once every three months, I'll have a slice will fall in there but i'm pretty um added sugar free how did you do it i just i just i just went cold turkey for a month wow um you didn't give yourself any treat or manipulate my palate absolutely how did

you manipulate yourself you didn't have to like i i tricked myself by saying okay you can eat as much meat and hard cheese as you want did you have any that's a good question i well interestingly i replaced i always used to have a dessert in the evening a bit of cake right before bed so i initially just converted that to like an apple there's a few little things i did where i just whole fruits but got rid of all the added sugar um you know and and that for me was enough um people don't like it when i say this but i'm gonna say it anyway my wife that's how I quit alcohol. My wife said, hey, anytime you want to drink at night, a glass of wine, just have a bite of fruit. Oh, wow.

Yeah. And it worked. Fascinating. For me. Yeah. Yeah. Thank you for coming on. Great show.

I think people are going to love this. We had a ton of live viewers. The book is The 21 Day Immunity Plan. You can get it on Amazon. Great show. I think people are going to love this. We had a ton of live viewers. The book is The 21 Day Immunity Plan. You can get it on Amazon. And I am now going to dig into a statin-free life. And I will invite Asim Holtra back on in February when the book becomes available in the United States. Fantastic. Great to speak to you, Simon. Thanks, man. I hope you have a great day in Mountain View. You're in a great city.