Sebastian Rushworth MD: Recent Episodes
Sebastian Rushworth MD
Welcome to my podcast, where I interview the most interesting and original thinkers in health and medicine.
Robert Lustig is an American physician and researcher who has written extensively about how our modern food environment is poisoning us. His 2012 book "Fat Chance" was a New York Times bestseller. He recently came out with a new book, "Metabolical", in which he lays out in detail the science of how and why modern processed foods destroy our health. He also explains why the food industry, along with our governments and co-opted scientists and dieticians, are doing their best to keep us eating things that make us fat and diabetic and that cause us to die prematurely.
In this interview I talk to Robert about what it is specifically that makes processed foods so unhealthy, and why there are such strong vested interests involved in getting us to eat unhealthy foods. We also discuss what can be done, both at an individual level and a societal level, to reverse the health crisis wrought by processed foods.
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David Raubenheimer and Stephen Simpson are biologists who have dedicated their careers to trying to understand how animals decide how much to eat and what to eat. They started with insects, and then moved on to small mammals, and ended up looking at humans, and they've chronicled their research in their book "Eat Like the animals".
What they've discovered is that most animals, including humans, have five different appetites - for protein, carbohydrate, fat, sodium, and calcium. One of these five, the appetite for protein, is however dominant, and is the prime determinant of how much we eat.
What that means is that when we're in a dietary environment where the foods we're eating are low in protein, then we'll overeat and consequently gain weight. That is why modern humans, living in a food environment rich in processed foods that are particularly low in protein, are so prone to becoming obese.
In this interview, I talk to David and Stephen about their research findings, and get their opinion on what people should do if they want to lose weight, and also on what societies should do in order to create healthier populations.
In the extended version of the interview that's only available to patrons, we also discuss some experiments that David and Stephen have done that suggest that a diet high in protein and low in carbohydrates, while optimal as a treatment for obesity, diabetes, and metabolic syndrome, isn't optimal from the perspective of maximising longevity in people who aren't metabolically unhealthy. This creates a difficult balancing act, especially from the perspective of public health policy, where one recommendation appears to be optimal for the metabolically unhealthy, while a different recommendation is optimal for those who are already healthy and want to maximize their longevity.
Patrons can get access to the full-length version at www.patreon.com/sebastianrushworth
Support the show (https://www.patreon.com/sebastianrushworth)
Christine Stabell Benn is a physician, a professor at the University of Southern Denmark, and a vaccine researcher with almost thirty years of experience in the field. The focus of her research is non-specific vaccine effects, i.e. all those other effects, both positive and negative, that vaccines have on our immune systems and overall health, beyond their very specific ability to protect against one infectious disease.
What she's found over the course of her research is that the overall effect on mortality varies greatly depending on whether a vaccine is "live" (i.e. contains a weakened but still complete version of the pathogen) or "non-live" (i.e. only contains a small part of the pathogen it's supposed to protect against).
Live vaccines tend to be associated with a reduction in overall mortality that goes far beyond the protection they offer against the specific pathogen. Non-live vaccines, on the other hand, actually seem to increase overall mortality, so that whatever benefit they provide against a specific pathogen is outweighed by their negative overall health effects. This matters, because there has been a trend over the last few decades to replace live vaccines with non-live vaccines.
Unfortunately, when randomized trials of vaccines are run, they usually only look at the ability to protect against a specific pathogen, and thus fail to answer whether the vaccine provides an overall health benefit or not. Vaccine trials are also usually too short, because non-specific vaccine effects can last for years or in some cases even decades.
In this conversation with Christine Stabell Benn, we discuss the current state of vaccine research, how an optimal childhood vaccination program could be created with relatively small tweaks to the existing system, how parents should think about vaccines for their children, and I also get Christine's opinion on the covid vaccines and the annual flu vaccines.
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David Grimes is a physician in the UK who developed an interest in vitamin D decades ago, after he realized that his darker skinned and less sun exposed patients were especially prone to illness. He's written multiple books on vitamin D and its central role in immune function. He believes that the main thing predisposing people to severe outcomes when they become infected with covid-19 is vitamin D deficiency, and argues that many of the people who died of covid-19 could have been saved, if only greater efforts had been made to ensure that they had sufficient levels of vitamin D in their blood streams.
In this conversation I talk to David about how he first came to develop an interest in vitamin D and why our immune systems have evolved to be so dependent on it. We then go through the evidence favouring it's use in the current pandemic, from the observational data to the randomized trials. And finally we go through the practical details surrounding vitamin D supplementation, such as what doses are reasonable, whether it matters if you get it from the sun or from a capsule, and how frequently vitamin D supplements should be taken.
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David Unwin is a primary care physician in the UK. For the last eight years he's been running a long term cohort study in his clinic, in which he treats his diabetic patients with a low carb diet. The study has generated massive amounts of useful data on what happens when patients with type 2 diabetes switch to a low carb diet. And the results have been pretty astounding, with patients going in to complete remission from their diabetes (something which was previously thought to be virtually impossible), lowering their blood pressure, improving their cholesterol levels, losing weight, improving their liver and kidney function, and being able to go off drugs that they would otherwise likely have had to stay on for the rest of their lives.
In this podcast, I talk to David about how the study came about and what the low carb intervention that he gives his patients consists of more specifically. We then discuss some of the common criticisms of the low carb diet and why they really aren't supported by the scientific evidence, and end with a discussion of what doctors and other clinicians who are interested in implementing a low carb diet with their patients can do to make it happen. I enjoyed this conversation a lot and I hope you will too.
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Seamus O'Mahony is an Irish physician who's written trilogy of books that explore the varied ways in which modern medicine is broken. The first book, "The way we die now", discusses how the movement of death in to hospitals in the modern era and a culture of denial around mortality has resulted in horrendous overtreatment of dying patients up until the very moment of death, which robs them and their families of the chance to say goodbye and experience the "good death" that everyone hopes for but few are able to experience.
The second book, "Can medicine be cured?", showcases how medicine has come to be dominated by vested interests and perverse incentives, from medical research that has been corrupted by pharmaceutical companies and a metric driven culture that causes medical scientists to produce an endless stream of useless papers, to hospitals that are run like factories, in which any value that can't be measured is ignored.
The third book, "The ministry of bodies", is a sort of diary, which showcases just how inhumane modern healthcare has become, towards both healtcare staff and patients.
In this podcast, I talk to Seamus O'Mahony about his three books and what motivated him to write them.
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In this episode I talk to Dr. Malcolm Kendrick about his new book "The Clot Thickens". We discuss why the traditional LDL/cholesterol hypothesis of heart disease is wrong, and why the scientific evidence actually supports an alternate hypothesis much more strongly. That alternate hypothesis is the thrombogenic hypothesis, which we go through in some detail. Finally, Malcolm tells us what people should be doing in order to protect themselves from heart disease.
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