She is also the executive director of the Nutrition Coalition and she’s and adjunct professor at New York University. And talking to her is a true experience, because you learn so much more about guidelines, about committees, about how decisions are made, about how evidence is either accepted or ignored and more importantly how that impacts our lives. I mean on the one hand, you can say how does that matter because I can still make my choices.

But no, these guidelines affect so many people, on so many different levels. And it’s important to hear her message about why that is and important to hear her message about how we can influence this and how we can make sure that these decisions are being based on evidence, and when there isn’t evidence there we need to know that.

And it’s not always success, we’re not always winning the battle to make guidelines more evidence based but as you’ll hear there is a progression towards that. So, it’s a fascinating interview and I wish I could interview her 10 more times, because there’s so much more information there, but I think you’re going to learn a lot from Nina Teicholz today.

So, enjoy this interview and if you want the full transcripts go to dietdoctor.com and you can also see all our other prior podcast interviews. So, enjoy this interview with Nina Teicholz. Nina Teicholz, thank you so much for joining me on the diet doctor podcast.

Nina Teicholz:  It’s great to be here, thank you.

Bret:  Well you have made quite a name for yourself over the years starting with the Big Fat Surprise. Your book really turned the politics and influence behind nutritional guidelines upside down and this has created a windfall of sort of a new way for people to look at the guidelines and to say maybe they’re not as clear cut and evidence based as we thought.

Now talking about the guidelines in a way seems a little counterintuitive for a low-carb community, because the reason people are going low-carb and doing well and feeling better low-carb, is because they’re going outside the guidelines and they realize they can do better than the guidelines, but yet the guidelines are still very important.

So, tell us a little bit about why guidelines are so important and your journey in understanding the faults in the process behind them.

Nina:  Well, it’s such a good question because most of us, you know, even when we were following the guidelines, we don’t even realize they’re important. I mean we don’t go to a .gov website and find out what to eat and I didn’t think they were so influential either, until after my book, I started to– I just got completely fascinated with them, because there was– the guidelines are issued every five years by the US government, jointly by USDA and NHS, and I looked at the 2015 expert report that came out and I read all 470 something pages of it, which I wish upon nobody.

Bret:  How long did that take?

Nina:  I don’t know. But I looked actually at every single study that they were using to justify the guidelines and I realized that there’s no science there. Like where’s all the science that I’ve spent the last decade of my life, reading, studying? None of those studies were in there. And then I went back and looked at previous guidelines and their expert reports and I was like, nobody’s ever looked at any of these studies… what’s the deal with our guidelines?

So, there is this appalling lack of science in the rigorous science in the guidelines and that is something that I think, you know, it’s worrisome, I mean why does a low-carb person care at all about that? So, we have this terrible government policy but you know, I’m low-carb, I fixed my health, I have good foods, my family is healthy and we’re all sort of my little world is healthy, but here’s what I found out about the guidelines.

They control a tremendous amount of– they have this kind of straight jacket on so much of our economy and our professional, medical and nutritional advice. So one way they control, that people should care about is that, you know– the meal your child gets at school, that’s controlled by the guidelines, only 1% milk and 55% carbohydrates and half of those carbohydrates still have to be refined.

So your kid is getting maybe donuts and that’s okay with the guidelines, because they have to include refined grains because they are the only ones enriched and fortified. And one of the things about the guidelines that is shocking is that they’re nutritionally insufficient, meaning they don’t meet adequacy goals. Okay, so school lunches, maybe your kid goes to private school, so it doesn’t matter.

What about if you go to the hospital? That food is controlled by the guidelines. You can find many pictures of people showing their so-called diabetic meal in a hospital and it’s like 75% carbohydrates.

Bret:  I think as a cardiologist, I’ve seen that a million times, it feels like

Nina:  Yeah and you go to the hospital and you get sicker and you don’t have somebody to bring you food, well you’re sort of stuck, right.

Bret:  And the guidelines dictate what the hospitals can serve?

Nina:  Well, it comes down to the guidelines are downloaded by every medical association. So when the medical association establishes what’s in the hospitals, or they can set out recommendations, it’s very hard to then go up against that, but I mean one thing the guidelines are really downloaded by dietician’s society, nutritionist society, nurses, doctors and so they’re just teaching the guidelines.

So, and they’re the ones in control of the diet. The diet summer camp, the diet that you send your kid to. All the cafeteria food, you know, is pretty much controlled by the guidelines and big, big institutions. What about the military, that’s supposed to protect us? There’s a study out that people actually gain weight while they’re in the military.

Bret:  While they’re being so physically active in the military!

Nina:  Well they’re like doing amazing, can’t blame that on lack of exercise.

Bret:  Right.

Nina:  And their whole system for trying to get people healthy are all based on the guidelines. Again, you know they have a stoplight system, red, green and blue, and you know big red stoplight in front of meat, this is going to bring you down, big green in front of pasta, this is energy food, that fuels you for being a warrior.

Well, you know our military is really fighting an obesity problem, and these are the people that we need, or maybe you have members of your own family in the military. Or if you care about, you know, women and infant children, poor people… I mean they get those wicker baskets, there’s no meat in them at all. They’ve gotten rid of meat, no meat, no chicken, no fish, no kind of animal protein.

Bret:  Really!

Nina:  Nothing. Beans and peanut butter is what they’re supposed to live on, and I’m sorry a carton of eggs and some milk and cheese, but there’s no meat in the wicker baskets. So, you know I could go on. It’s very hard even if you’re committed to your diet and you feel like, I’ve got it, and you know, anybody you talk to, any doctor you talk to, you go to your doctor and your doctor is trying to get you off that diet. Or you go to your school and try to get a better lunch program there and they tell you, you know, you’re crazy.

Bret:  So, it all goes upstream to the USDA guidelines.

Nina:  Everybody has downloaded the guidelines to their professional associations and those professional people work in all of our institutions and then they deliver the guidelines and they make it very hard for anybody to generate change. So, you know people who– even medical doctors, who want to teach low-carb diet and they’re part of a large medical practice, they’re forbidden from doing that, they literally can’t do it, because the medical practice fears liability because they’re not teaching the gold standard dietary guidelines.

Bret:  Right, liability and decreased funding that people would pull their funding if your diabetes education program is sponsored by the ADA, you could lose funding potentially by going low-carb, so yeah it is amazing to hear you describe how far reaching these guidelines are, but here’s the thing. Anybody could say, ”Look I went low-carb, I’ve felt fantastic, the guidelines don’t work for me”.

But then how can we say the guidelines are actually truly faulty, and that’s where it took, not a scientist, not a doctor, it took you, a journalist, to come in and say the science is wrong. So, tell us, you’ve been sort of criticized for not being a scientist. Why should we believe you because you’re not a scientist, but yet I think it gives you more strength, as not being a scientist, to come in and say, ”Look at this.” So tell us about how you see your role in pointing out the faulty evidence being used and the evidence being ignored from your background as a journalist.

Nina:  Yeah, this is a field, not just journalists, but people really outside of the area of nutrition science have been able to make progress, because inside the world of nutrition it’s a– there’s a kind of very strong orthodoxy about what is a correct diet and you really cannot challenge that.

One of the things that my book documents is all the scientists who did their own field orthodoxy, and their careers, you know their careers just disappear, research grants go away, and they don’t get invited to conferences anymore, so they’re just sort of ostracized.

And then young people coming up see that and they’re careful to stay closely within the orthodoxy and not challenge it, and so you see that the movement that has been made in this field really comes from outsiders, it’s had to. We’re the only people, who can analyze, and who have freedom to really look at the science. And you would say, well, why a science journalist, rather than–? Why not a PhD or why not a doctor? And journalists are people like, what we do is we research.

Bret:  Right.

Nina:  I mean a doctor would be seeing patients all day, and you know, if I had to spend like 10 years of my life, actually just sitting in a hole, cave and just researching and reading papers, so as a journalist, I have the ability to call up people and interview them, that’s something that’s quite unique. And I can hear about their studies and I can hear the inside story of their study and I can hear about what the real thing– I’m not even going to publish in my book, but I need to know as background.

You just have a unique ability as a journalist to approach with objectivity and you have the time and tools to really do the research. And, you know, when I started I was a vegetarian, I mean I came with zero biases, I didn’t even think I was going to write the book that I ended up writing, I was going to write a book on trans fats.

So, you know, I just think that it’s just– and as a journalist you’re really trained to see all sides, all points of view, I mean, scientists are trained to do that too.

But as you know, you get that in any field, but the question about the guidelines, why did I take this deep dive into the guidelines and find out about the evidence based, was again, it was simply that they’re so powerful, they control so much of our food supply, and you know one thing I didn’t even mention before-hand, but even for low-carb people, the absence of food products we can buy, is because of the guidelines, like every food company wants to have– when you flip over a piece of any kind of packaged food, you look on the food fat panel… that all comes out of the guidelines.

Bret:  Right.

Nina:  And so they’re not making food for us because–

Bret:  They’re targeting low fat specifically

Nina:  That’s right, you want to see below this grams, especially saturated fats. But, I just felt like it was imperative to– if we have this really powerful policy, what is the science behind it? This is just kind of what I do. I like to dig into the science and one of the things is kind of fun about being– although a bit scary and also disillusioning, I’d say about being a journalist in this field is just that so much of nutrition science is so incredibly bad. I mean, I have to like, I don’t mean bad, I mean–

Bret:  So what do you mean by bad?

Nina:  You look at the data, you look at the conclusive– most doctors or people who read studies just look at the conclusions or they look at the discussion section. You really have to look at the data, because the data often say one thing and the scientist who’s trying to survive and do well in his field is saying something that completely denies the data.

Bret:  Yeah.

Nina:  has a conclusion that is completely the opposite. I can’t tell you the number of studies that I’ve read and one of the most famous ones I think it was the Pacific Rails study by Jeremiah Stamler. He did a study and it showed exactly, you know he was a colleague of Ancel Keys, and he really wanted to– a believer in the heart diet hypotheses– that saturated fat and cholesterol are bad for you. And his data showed that saturated fat and cholesterol were actually good for you and he wrote up his summary statement saying basically we’re ignoring this data because other studies show that saturated fat and cholesterol are good for you.

Bret:  Right, and that shows a tremendous bias but also the pressure to sort of adhere with the common theory or the central dogma and not go against it, because as you documented in your book, those people who dare to try and publish something different than what was commonly believed frequently wouldn’t get more funding, or they’d get their grants pulled or… These things are really happening.

Nina:  They really happen.

Bret:  You’re wondering am I reading a Soprano’s episode or is this like true nutrition science and it really did. And that was one of the fascinating points of book. I almost read like a Paige Turner detective novel or something.

Nina:  Yeah, it’s a bit like a nutrition thriller the economists said about it, which I like. And often when I was interviewing people I would– you know, people were so closed about, they were so afraid to talk to me, they were terrified to talk to me, I felt like I was interviewing the mob. You know, I would get off the phone shaking, like…

But it is a kind of, an ugly world in terms of the way that orthodoxy is enforced and I think, coming back to the guidelines, what I found was that they had really– what they had done is they had ignored, since 1980 when the guidelines were launched, they had consistently ignored all of the rigorous clinical trials funded by the National Institutes of Health, you know tens of thousands of people, multi centers trials, that was really the big age of– you know, we had a big age of nutrition trials where people were– like 50,000 people were funded to be in a study. It cost $700 million.

Bret:  Yeah, It’s like the Women’s Health Initiative.

Nina:  Yeah, like the Women’s Health Initiative. In order to inform our food policy, never reviewed, never included in the dietary guidelines reviews.

Bret:  And of course it showed that a low-fat diet had no benefit for cardio-vascular disease or cancer prevention, but was not incorporated into the guidelines. And I mean were you able to ask people in the guidelines committee why this study was not looked at? Could they give you an answer to that question?

Nina:  Well, you know, the statement that all these studies had been excluded is a statement that refers to every successive dietary guideline committee, so I couldn’t ask this dietary guideline committee, you know, why are you ignoring the Women’s Health Initiative results or the Boeing trial results. Same thing – NAH funded showed the same thing, that low fat diet had absolutely no ability to protect against cardio-vascular disease, diabetes or obesity.

So, it’s kind of the collective fault of all these committees, you really can’t blame the latest one, and you know, what would it require then to reject the entire guidelines, I mean that is– I think that would be very hard for a committee to do to turn around and say, ”We’ve just got it completely wrong the last 35 years”, but they’ve done clever things… It’s like, I would say clever for them like they have– In fact when all those studies show that the low fat diet didn’t work, not only that, but the 2015 dietary guideline report says that low fat diets actually increase the risk of cardio-vascular disease.

Well, that’s terrible. We’ve been on a diet that seems to have been increasing cardio-vascular disease in America. So, what they did is, but they can’t say, ”We’re no longer recommending a low-fat diet”, they sort of tip-toe away from it. There’s no press release, there’s no marketing materials to the American public, to say, you know, ”We’re no longer telling you to eat a formal low-fat diet recommendation”, and the reality is if you go and look at their formularies for what they’re recommending, like…

What I mean the formularies like, what’s the breakdown of protein and fat and carbohydrates that they send off to the schools, and say you have to follow this, they’re still low fat, you know, they’re still low fat. So, they’re de facto still low-fat recommendations.

Bret:  So, how does that happen? If you get rid of the low-fat recommendation in the dietary guidelines, why hasn’t that trickled down yet to the downstream effect of the military, of the school, of the hospital?

Nina:  Because what they did was very clever, where they made kind of like a rhetorical shift and they said we’re getting rid of the word low-fat and we’re going to say instead that we recommend these dietary patterns. Meditterranean, US Style, which is basically DASH and vegetarian. And if you want to follow those patterns, this is the amount of carbohydrates, protein and fats that you need to eat and it’s a low-fat diet. So, they’ve just shifted the label.

Bret:  We’re not going to say that we recommend a low-fat diet, but here are the low-fat diets we recommend. Okay, I see.

Nina:  And it’s hilarious because the low-fat Mediterranean diet that they recommend, that’s not the Mediterranean diet that was studied that showed benefits.

Bret:  Right. So, when we talk about the science involved in nutrition, we are frequently talking about the epidemiological studies. The observation of clinical trials, that aren’t meant to make causative conclusions and that makes up the vast majority of nutritional science, and to, I guess, the defense of science, you know PhD students need to crank out a paper for their theses you know.

Scientists and PhD’s need to publish to maintain their grants and their position in the university, so what’s the easiest way to publish studies is to data mine and to do retrospective observation and trials, so that’s why we have the majority of our data. But is that good enough to inform public policy and make a recommendation for what the world should be eating?

Nina:  Well, obviously there’s debate on this issue, and I would say, no, because if you look at the studies of, especially nutrition– nutritional epidemiology is especially weak, because it’s based on data where they ask people from food frequency questionnaires, you know, how many cups of milk did you have in the last six months, or how often do you have milk every week over the last six months, and how many cups of ribs have you had, you know, it’s very—

And those are very inaccurate tools for gathering information about diet and you know, people lie, because, ”I’m not going to tell you, I had you know six candy bars.” And so they take that very weak data and then they try and then there’s– they do multiple comparisons with tons of outcomes and there’s concern about mining the like– P hacking it’s called, but it’s statistically it’s not very valid what they do.

And then there’s all these confounders… you know, are you healthy in other ways that affect your eating and things we can’t even measure and so nutritional epidemiology tends to yield results that are always super weak. The great success of epidemiology is in the finding that heavy smokers, a packet a day smokers have 10 to 35 times higher risk of lung cancer, than never smokers. 10 to 35 times, okay.

Bret:  So, they odds ratio, is usually reported was–?

Nina:  So, that’s 10 to 35, that’s the relative risk or odds ratio. In nutritional epidemiology, you rarely see results that are greater than 1.2.

Bret:  It’s a magnitude though.

Nina:  Yeah, and you know once you factor in something like potential confounding, it’s very hard to take those results seriously.

Bret:  They say they control for smoking, they control for obesity, they control for blood pressure, you know, they try to statistically control for these other factors, but isn’t that not good enough?

Nina:  Well, you know, there’s many things they may not have measured that may affect your health, maybe your exposure to plastics, maybe what you ate when you were a child, maybe they don’t–, people who tend to follow the–, tend to follow their doctor’s advice do a lot of things, like they tend to take their pills more or maybe they go to more cultural events and spend time with their family, all of these things are like, or maybe they sleep better, I don’t even think they ask about sleep.

Bret:  Right, you can’t measure all that.

Nina:  So, and then how do they adjust for it? Do you know that our major epidemiological database is upon which most of our dietary guidelines are based, the ones out of Harvard, the Nurses Health study, so I have an email from the head of that study saying, you know, ”We don’t really accurately measure sugar.”

Bret:  Sugar?

Nina:  So they can’t, they can’t adjust for sugar.

Bret:  Wow, that’s unbelievable! As if sugar matters, it doesn’t matter, don’t worry about it.

Nina:  They didn’t think it matters, they didn’t ask people. And I think that now we really have to talk about the bias of the researchers, which is another kind of bias that enters in– I mean Harvard being really the major publisher of these studies and then the head of that department is Walter Willet and he has become a vegan.

He says he eats meat once or two times a year and he talks at vegan conferences and he really believes in veganism for whatever reasons, I don’t know, but that clearly affects their work. You barely, ever find a paper coming out of Harvard now that is not plant food that is better than animal food. Animal food – dangerous… plant oils, vegetables oils, you know, are better than animal fats. I mean, that it’s almost impossible to see the constant stream of pro-plant publications and not think about the bias of the people who are behind them.

Bret:  And what about industry influence, you know, the cereal makers and the processed oil makers and all the snack foods, low-fat snack foods, do they have a foothold in the guidelines as well?

Nina:  You know, it’s such a pure and perfect process, I just don’t know.

Bret:  Well, I think it’s important to really think are they directly funding it or is it more of an indirect action?

Nina:  You know, there’s so many steps at which the food industry, and I need to add also the pharmaceutical industry, you know– you ought to be asking your local nutrition scientist, why are you taking pharmaceutical money? Aren’t you supposed to be working on your nutrition solution?

Bret:  Right, that makes no sense at all.

Nina:  All, almost all take pharmaceutical money, and so they have an interest in the drugs or the Optifast or the Medifast or whatever meal replacement thing that they work on obesity, they just found out the drugs that contains speed, what it’s called, is legal speed, to help you with weight loss. I mean, you want to know if your local doctor is getting funding from those kinds of companies, or your local nutrition scientist.

So, food companies and pharmaceutical companies and the supplement companies– supplement companies are a big player because, then remember, I said the dietary guidelines, are nutritionally insufficient. They depend, they sell those nutrients, they sell them in refined and enriched grains, and they sell them to consumers. And they say if you’re not getting enough of this because you can’t eat meat, because the guidelines tell you not to eat meat, here are the supplements, so how do they influence our whole process?

I mean at every level they’ve been doing this since the 1940s, was when the first organization was founded by food companies and their major goal was to influence nutrition science. And, you know, they are really clever.

For a start they fund their researchers, they give them grants or they fly them places, or they underwrite their conferences, or they pay for their journals to– or they pay for ads in their journals where the researchers want to publish their journals, and then they up, anyway, so they want to do it at the very, or they endow chairs, and/or they fund a research assistant. You know at Harvard, to go back to it again, and you know a research assistant that’s funded by Unilever, one of the vegetable oil makers in the world.

Bret:  So interesting, that doesn’t directly control the trial, but that type of funding, is the type of funding that would dry up if the trails weren’t beneficial to that company.

Nina:  Exactly. A researcher knows if I don’t come out with a publication that pleases my funder, I’m not going to be able to ever go back and get their funding again, and I mean there’s kind of like even if they’re not involved in the design of the trial or the outcome of the trial, you know that you have to have a trial that does not displease your funder if you want them coming back you know.

Bret:  So it’s clear.

Nina:  Yeah, so then they upstream so then they fund, they advertise in the journals and the journals are the ones that their funding would dry up if they don’t accept these papers or those papers, and then they fund conferences, and then they fund, you know, scientific conferences.

And then, yes they do, they write around the table in the dietary guideline meaning– I mean I’ve spent time in Washington now, and it’s really shocking to me. I mean the food companies are basically all over lobbying on this stuff, and you know we usually hear, I think the impression we get from media stories is like it’s just mainly the meat industry that has manipulated the guidelines and I don’t even understand that narrative because meat has been a big loser.

I mean if they’re such a powerful industry, you know, their results are pretty bad, because they tried to take meat out of the guidelines in 2015 as a healthy food. But every industry is there, you know the beverage, the food industry, the sugar industry, you know, the vegetable oil companies, the grocery manufacturers of America, and so I actually went, I was invited to come to a couple of USDA listening sessions, where they have apparently listened to our point of view, and I was sitting around the table and I was the only person who wasn’t from industry.

So, I mean there are other interest groups, but I think that they really have a place at the table.

Bret:  Yeah, and they really shouldn’t, I mean that’s one of the dramatic things. So, I guess it’s one thing to sit back and point out the problems with the guidelines and the problems with the process, and then there’s another thing to do something about it, and that’s where you’ve sort of shined as an executive director of the Nutrition Coalition.

You’ve really put your hat in the ring and said we’re going to do something to change it and interestingly, it’s where a lot of criticism against you has come as well, to say, you’re just kind of pro meat and trying to push your agenda into the guidelines, when really your message seems to be, ”We’re trying to push science into the guidelines”, and you’re trying to make a difference. So, tell us, how your work at the Nutrition Coalition, is trying to improve this science of the guidelines?

Nina:  So look, after I saw the guidelines and I realized like how little evidence had, they weren’t relying on any kind of rigorous evidence, so I thought somebody has to– this just has to change, and so I founded the Nutrition Coalition and the first thing that we did was we got a– we got Congress to mandate the first ever outside peer review of the dietary guidelines by the national academies of science, engineering and medicine and they appropriated $1 million to do it.

And they said nobody who has served on the dietary guidelines committee can be on the panel that reviews it. Then came out with a decent report, that report said that, you know, sort of an echo of the work that I had done saying this, the guidelines lack scientific rigor, they don’t use proper systematic reviews of the science, like there’s– and in order to be credible, they need to be redesigned.

Well, that’s a pretty powerful thing to say, and so that was a good report to have. Our group, our only agenda is to have evidence based guidelines and we just want the science properly reviewed, you know we want it– There’s sort of a pyramid of science, like up at the top there’s randomized controlled clinical trials, that’s the gold standard because that can show cause and effect and kind of here down below is epidemiology, which only shows associations, which tends to be more wrong than right, when tested in more rigorous trials.

That’s the pyramid, and the way that the dietary guidelines do it, they do it upside down. So we just want a proper systematic review of the guidelines, there’s various standards, there’s various systems of review, Cochrane, Gray, you know, there’s like guidelines for how to do guidelines, and they just need to be followed.

And all we want is evidence-based guidelines. Wherever that evidence goes we will follow, but we have also said, you know, we think here’s where the guidelines do not reflect the current evidence, and one of those is, we think that there should be just regular meat and regular dairy, not low-fat meat and low-fat dairy because we do not believe the science supports the saturated fat recommendations.

We do not believe the science supports the recommendations on salt, that you should eat lower is better on salt. It turned out there’s a lot of science out there to show it’s much more likely to be a J shaped curve, where salt consumption is, you know, a moderate salt consumption, a moderate amount is ideal in terms of cardio-vascular risk, right? Or we could at least say, if there’s a scientific controversy, let’s just back off that recommendation and say we really need to get to the bottom of this.

Bret:  That is a fantastic point, that the level of confidence behind the recommendation has to match the level of security within the science.

Nina:  Exactly.

Bret:  And that’s a complete disconnect right now.

Nina:  Right, and our main argument is like let’s just reverse out of the wrong recommendations that we have and that will help level the playing field for the new science to come in. At least like let’s just not have, you know, according to the principle, at least do now harm, let us not be recommending high carb diets for all Americans.

I mean that’s the other thing, the dietary guidelines are supposed to be for all Americans, but you know we live in a world now, where according to the latest studies 17% of us are metabolically healthy, so that means 83% of us are not and we are not covered by the guidelines.

Bret:  Yeah.

Nina:  So, the work of our group, is really just about trying to promote proper scientific reviews of the guidelines so they are based on rigorous science.

Bret:  So, a lot of that probably has to do with who the committee is, because it’s sort of up to the committee to decide what is rigorous science, where really, like you said, there are guidelines on how to do this, but it appears that the committees, up to this point haven’t been doing it this way. So, I mean, is it just because there are too many people that believe that epidemiological science is good science, or is it because they are protecting their own interests?

I mean I know that’s sort of a hard question to answer with specificity but it boggles my mind why people on the committee don’t realize that the epidemiological evidence is so weak and they need to be looking for better quality of evidence. It just seems really just commonplace and they should understand that.

Nina:  Right, there should– there should just be us. Well, it is, it’s a complex answer and there is no one answer, right, so one thing is, is that epidemiology precisely because, as you said, it’s like, you know, it’s a paper a week, you can just get your mimeograph machine out, it’s pretty much, there’s so much epidemiology out there, it’s become the dominant science in the nutrition world.

So, the dietary guideline committee, like the last one, was more than half epidemiologists. There’s only supposed to be one epidemiologist on the dietary guideline committee, I mean if you look at their– they want to have a variety of different kinds of expertise in the guideline, and now we have more than half.

And there’s groupthink that has gone on, like it goes on in any field, but in nutrition, the groupthink is, you know, towards the plant-based diet. So, we did an analysis of the 2015 dietary guideline committee, it turns out 11 out of 14 of them were or had professed to believe that a vegetarian or plant-based diet or themselves were vegetarian.

Bret:  Well, not exactly balanced.

Nina:  Not exactly balanced, and they are not going– so these are not people to challenge the status quo, and I think that, you know, and the government doesn’t want to challenge the status quo, because you have a system where the bureaucrats– I mean the bureaucrats in charge of the guidelines, the person at the very top of that group, she’s been doing this for 25 years, she’s not going to turn around, they’re not going to turn around and say you know we’ve been wrong.

And they really run this whole process, and then the political people, who you know, the ones that are now, are all put in there now by Trump, they have to decide is the guidelines going to be their top political priority, or they’ll take on the entire pharmaceutical, medical and food establishment to do that. I mean, so the answer is… and these go around, because the 2020 committee has just been announced. The answer to that question is no.

Bret:  Yes, so let’s talk about the 2020 committee.

Nina:  They’re not going to take that on.

Bret:  I mean you did a tremendous amount of work, you being in the UN and the nutrition coalition, so active on social media and in the media in general to say, write to these people to let them know we need better in 2020, that we need to include other people on the guidelines committee and a great grassroots efforts to try and make a change, but it seems like they weren’t open to listening to it, were they.

Nina:  Well, let me talk about the good side.

Bret:  Okay.

Nina:  There’s some good things that we did.

Bret:  I like to be positive.

Nina:  Well, it’s important to understand, like we’re the first group anywhere in the world trying to change the guidelines. We were the first group to come to DC to do anything, I can’t tell you– like I go into congressman and women’s offices and I present sort of the case about why the guidelines haven’t worked and they’ve–

They’ve just never seen this information, and they’re like nobody has ever presented these arguments, so I’m like an argument is, actually people follow the guidelines, and they follow the exercise, you know, the recommendations pretty well, the problem is not that people are lazy and fat and don’t follow the guidelines, the problem is in the guidelines themselves.

And so a lot of people respond to that argument, because many people really have a not too distant memory of their grandfather or something, you know, surviving on bacon and eggs every morning, like you know you’re right, you know, that’s never made sense to me.

So we do have a lot of support but we have to recognize that this is the first step and this is the first time these people have heard any of these arguments, and you know, so I would say, you know, between my giving testimony as USDA and talking to people, they announce the list of topics to be reviewed for the dietary guidelines, this year ahead of time and on that list was for the very first time low carbohydrate diets and saturated fats, and in my testimony I specifically recommended they do that.

Then we sent in a whole bunch of comments during the comment period, we were responsible for half of all the public comments.

Bret:  Really, that’s fantastic.

Nina:  And they kept those topics in. So, that was you know, that means low-carb diets will be reviewed, it means that saturated fats will be reviewed, those are two areas where we feel the recommendations do not reflect the current, most rigorous science. So, that I think is a success, but then we put forward and we worked really hard to promote the kind of– to get on the committee of– especially to really, really top-rate evidence-based policy people.

I mean the two top-people in the world, like John Ioannidis from Stanford University, who is just, I mean he is just the rock star of this, and in Canada, sort of his counterpart in Canada, his name is Gordon Guyatt, he founded the term evidence based medicine. And sort of a descendant of David Sachet, some people may know that name, but they’re like amazing people.

We help prepare their nomination packages, I can’t tell you what it’s like to take down a 600 page resume and try to reduce it to 15 pages, which you have to submit for the nomination and like, they have no conflicts of interest. So, like, they’re the most incredibly qualified people to be on that committee.

And they would act I think, you know as you’re saying, why doesn’t the committee make the right decisions, I think these people could act a little bit like referees in the room, you know, like they could say great point, but the epidemiological study, what is the randomized control trials say? So, we failed in, I mean, we got thousands of people to write Sonny Purdue and we did not get either of those people on the committee and I was told by somebody at the USDA that we didn’t want that level of disruption.

Bret:  Wow.

Nina:  Which means we like don’t want to disrupt the status quo.

Bret:  We don’t want to change.

Nina:  Right. So that not good news, but there is a little good news that they did put on, it’s a 20 person committee now, if anybody wants to– we’ve just put up a blog post if anybody wants to read it on nutritioncoalition.us, and it talks about some of the committee members. I would say that the good news is that there’s a woman, Lydia Bazzano, who has done research on low-carbohydrate diets, is aware of the field and the literature.

Is she a Jeff Volek or a Sarah Hallberg? No, but she is certainly someone who has been in the field and there’s a woman named Heather Leidy, I can’t remember where, but she’s somebody whose research focus is on how increased protein might be able to help fight obesity. So somebody, who is sympathetic to animal proteins.

So, again the yin and yang of all of this. On the other hand there’s a lot of old guard people on the committee who are really committed to calories in, calories out and energy balance people who have– from been promoting the guidelines to people who have been on the dietary guidelines committee before, some of them twice, so that’s what I consider a pretty– and they’re senior, they’re not young.

So, but I think they’re still an opportunity during this period, to try to educate people and try to get good information to them and you know we’ll keep doing that and if that doesn’t work, you know, we’ll have our million metabolically wounded march on Washington.

Bret:  With no shortage of people to fill the seats, I’m sure. But I think you’re right you do need to be congratulated for the positives and for getting saturated fats and low-carb to be topics of interest reviewed, that definitely needs to be encouraged and I’m glad that the lack of outright success of getting people on the committee doesn’t seem to be deterring you, so that’s great. Now in this whole process though, kind of what do you see as your role in the social media, in the war between veganism and meat?

Nina:  I’ve been in a number of conversations with vegans over social media and have come to the conclusion that they’re not open to having a scientific argument, it’s you’ll come back spending time showing them studies… I can think of one doctor in particular, who is just, you know– at least 50 people have pointed out all the science to him and he’s just you know, he just snaps right back to his epidemiological studies and he just doesn’t want to learn.

So now I just literally mute those people, because I feel like it’s a distraction. And I also know that, I mean I have nothing against vegans, I just think that should just start, follow their diet, and that’s fine, and let people who are healthy on different kinds of diets, follow their diets, but it’s been complicated and become more complex now.

The money behind veganism has become much more significant and I mean vegans, in some way, there are many of them who are pure and ideological, but they are being used by a set of corporate interest now and there’s a vast amount of money behind them. So, and that is sort of the animal right activist money, which is massive, the people who just believe we should not kill animals at all.

Pharmaceutical money, you know anybody who’s threatened by low-carb is going to get behind veganism because veganism is sort of the antithesis of the low-carb movement. So, Big Pharma they do not profit if people get healthy from nutrition, you know, average Americanism 5 pills, those pills go away and that’s a zeroed out profit line for those pharmaceutical companies, which you can’t be too cynical about, they need to make a profit… and how do they do that?

And there’s the environmental movement now that’s behind them, saying it’s better for the planet and the chemical companies who are the real polluters, they would love to have an agenda whereby they could blame all global warming on cows rather than their activities. And of course, you know, what I call big carb, but, most of the products in a supermarket are made up of a grain, sugar and vegetable oils.

That’s what most products are made of and all those interests including the supermarkets themselves and all the grocery manufacturers, they depend on people buying those products.

Bret:  And those products are vegan.

Nina:  They’re vegan. I mean, so there’s all of that interest, I think I didn’t realize, I’ve sort of known that there’s corporate, there’s all these ideological and corporate interests behind the vegans, and I didn’t quite put it altogether until this report EAT Lancet come out.

Bret:  I was just going to say that it’s the perfect transition to EAT Lancet, because it points out sort of the vegan movement and you can roll that into the anti-low-carb movement, can exist on a couple of different levels. There’s the ethical and ideological level, there’s the environmental level, there’s the health level and the science applies to the last two, but not the first two, because you can’t really apply science to ethics necessarily, in that setting.

But what troubles me is when they’re all blurred together, when they’re all brought together to try and push an agenda and I think that’s kind of what happened with the Eat Lancet report. So Georgia Ede has done a phenomenal job of dissecting the science or lack thereof, of the Eat Lancet report but it goes beyond the science because there is sort of an agenda, to where I think you’ve really promoted a lot of information that wasn’t known, just by reading the report.

So tell us a bit about the background of the EAT Lancet report and what you see as the motivation behind it.

Nina:  Well, one of the things that I did with that report really was to show that there was incredible financial interest behind it, and so there behind the whole EAT Lancet project, so all these different industries that I just mentioned, you know, the chemical companies, the pharma companies, big food companies, like Mars, Pepsi co, all the junk food companies, they’re all part of this international business council that funded, I think it was a 40 city tour release of the EAT Lancet report, huge amounts of publicity that it got, they funded that whole massive PR effort, including a release at the world economic forum at Davos getting people to–

And Arnold Schwarzenegger speaking out on it in New York. That all takes a lot of money and it all came from those companies, all of whom stand to benefit, if they can, they stand to benefit if they can demonize low-carb, right.

They stand to benefit, if they can blame cows for global warming, so they hold different interests, but they all come down together on this. So, then I also looked at the financial conflicts of interest behind Walter Willet, who is the chief author and really I think, maybe even the architect of this report, but he was certainly the leading scientific author on it and he’s the one head of the heart school public health for over 20 years, just retired, but has become a vegan himself, ideologically motivated I think.

But I decided to also look at his financial conflicts of interest and you know came up with a seven page document and about, you know, that the hundreds and hundreds of thousands of dollars he gets from all the nut industry, over the years, and Harvard gets–

Bret:  Interesting.

Nina:  And so EAT Lancet happens to include a recommendation for like a 500% increase in consumption of nuts, and they’re very closely connected to Unilever, and as I said they have a permanent ongoing scholarship, and Walter Willet publishes with Unilever employees, so they have this very big connection to this vegetable oil giant, Unilever, up until I think just recently, the biggest manufacturer of vegetable oil in the world.

So, I went– there’s just a massive amount of corporate interest into shifting Americans onto this plant-based diet, from a multitude of different interests.

Bret:  It’s going to help the environment and help your health.

Nina:  It’s genius.

Bret:  Yeah.

Nina:  I think that what they have done is absolutely genius, because if you’re not going to become a vegan for health reasons, because actually that’s been the debunked in a nutritionally deficient diet, who could deny that? You should do it for the planet, you know. You should, you know, and that argument is very strong for people, for young people of today that’s a very powerful argument.

So it’s kind of– I didn’t even mention that the Barilla Pasta Foundation, who has– you know, Barilla is the biggest pasta maker in the world, a huge food company in Europe, they’re one of the members behind EAT and the EAT Lancet report and they have this foundation that has been for, three of four years now, funding scientific conferences on why you should eat more carbohydrates, why you should move to a plant-based diet and they’re the ones, I think who came up with this whole double pyramid idea that the pyramid to improve health was also the pyramid to improve reduction in global warming, you know reverse global warming.

So, there was this idea, better for you, better for the planet, like that’s a great catchy slogan. Better for you, better for the planet, so I saw like 50 news stories when they came up with that idea, I think it was in 2015 and I thought, oh wow. This is, so now it’s multiple friends, which is a really smart tactic.

So, you know, the science is really on our side in terms of what is a healthier diet. There are interesting fact, you know, the last dietary guideline committee came out with a vegetarian diet recommendation. They were as I said 11 of 14 of them were following or advising a vegetarian diet at the time. They must have gone looking pretty hard for them. They could find zero randomized controlled clinical trials to support a vegetarian diet for any kind of health outcome.

Bret:  Wow, zero randomized controlled trials for something that’s being promoted as the healthy diet.

Nina:  One of the three USDA recommended healthy dietary patterns.

Bret:  That’s disturbing.

Nina:  Supported by what they called limited evidence which is the lowest grade of evidence that you could grant. So, you know this, you can’t really make a scientific argument for the healthiness of that diet, except for with epidemiology. So, now they have the global warming argument and most of– you know, I’m not a global warming expert but I can tell you looking at the science just a bit, it seems to me a little shaky.

Bret:  Right, and talking to people like whether it’s Peter Ballerstedt, who we had on this podcast, or other people who are more familiar with soil, I guess soil characteristics, science and also ruminant science, it does seem that that science is very shaky and it can easily be twisted.

I mean that’s the other thing, depending on how you measure it, what variables you include and don’t include, it’s easier to twist the message, that’s really concerning, because I don’t think we’re getting the full picture, but the way they package it, certainly sounds very convincing.

Nina:  Yeah, I mean it’s one of the things that is– it’s a tool, that it’s kind of a public relations tool to pretend that the science is settled. You know, that’s what they did on saturated fats and cholesterol now they’re doing it on like this global warming issue. Pretend that it’s settled, this science is so young, it’s so debated, it’s in its infancy really.

And I’ll just give you the one example, you can take a tiny example of when they calculated the global greenhouse gases for animal agriculture they included all of the externalities and all the various kind of knock-on effects, and all the inputs.

When they did it for transportation, they only included the immediate effects, without looking at any of the larger externalities or larger picture, you know, what about the steel that makes the car? So, it’s just an area where the best you can say is that the science is unsettled. So, let us not rush to policy.

Bret:  Yeah, again making statements and conclusions that are out of proportion to the certainty of the evidence.

Nina:  Yeah, I mean just going back to the dietary guidelines, the origin of the guidelines was, making a statement about what the whole populations should do based on very weak evidence and just saying this is our best bet.

Bret:  Yeah, so this has been a lot of sort of the problems and the negatives and the controversy, but I guess there’s some hope too, right? I mean just hearing people being able to find these conflicts of interest and pointing them out, and being able to point out how the science is shaky, I mean there’s some hope that there’s this groundswell, that people aren’t just going to roll over and accept this as fact. I mean do you feel hopeful or optimistic about being able to counteract some of these messages?

Nina:  Yeah, I mean you know it just depends on what day you’re catching me, but I would say, what are we– here’s what to be hopeful for… There’s a huge groundswell of people who are curing themselves by ignoring the guidelines.

They are a potent force, they are passionate, they, you know– I hear from them all the time, I’m sure you do too and they want change and like there’s just nothing I think to people as recovering your health, when you’ve been a lifelong depressive or a diabetic or I didn’t have to amputate my leg after all and so that’s an enormous passionate group of people that is growing.

The science is growing, you know, I mean, really month to month, there’s some paper about, oh you know what Virta’s latest data, on at two years, they maintain their reversal rates on diabetes, and then you know papers are coming out, showing it’s sustainable or it works.

You know the science is evolving and I think that to an increasing number of people, I mean especially medical doctors, who come with a more open mind and are taught about evidence based medicine and they are responsive to the data and they– So I think that’s another way in which we will see the paradigm shift happen.

Bret:  Yeah I think that’s a hopeful statement about doctors, because the flip side is that doctors have been doing things the same way for 20 years and are going to be very reluctant to change, but you’re right with that statement that they should be responsive to data, but more importantly they should be responsive to patient improvements.

I mean because that’s the story I hear from most low-carb doctors, ”Wow, the difference I saw in the health of my patients was shocking to me”, and that’s what carries the snowball effect, that’s what my hope is from that perspective.

Nina:  Yes, I completely think you’re right. I think, you know that I just talked to a doctor yesterday, and he said, and there are many doctors like this, ”You know, I just wanted to give up being a doctor ”because all I was doing was overseeing people’s gradual decline ”and more pills every year and getting worse every year ”and then I discovered this, that I could heal my patients, and that was such a joy to me, that’s why I went into medicine in the first place.”

So, I think that’s going to change and I see the change and you know wherever I go, you know, if I have a book signing and there are 100 people in line, you know, half of them come up to me and the first thing they say is like, ”Well, 50 pounds down.” You know, went on a low-carb diet and some of these are just farmers, and they are– I would say when I started out in 2014, nobody, nobody had like any idea what low-carb was or a ketogenic diet was or had thought about saturated fats.

So, you really see this change sweeping across the land and we do have this fight at a really high level, I think that it involves trying to change the way that influencers think, media thinks, policymakers think, but I think even the moderate success we’ve had so far, and I think that we, you know, I think we will get there, now it’s interesting even when I go into an office, in a congressional office or if I go and meet somebody, somebody in the room will be ketogenic.

Bret:  They will probably say thank you for the work you’re doing.

Nina:  So, it’s just, it’s sort of sweeping the nation and you know DC cannot be a bubble forever, so, anyway.

Bret:  Right, thank you for the work you’re doing, for your advocacy and for rallying the troops and thank you for being the sharp end of the spear, as well. I really appreciate that.

Nina:  I want to say one more thing, just because you brought up the subject of meat and industry and all of that and the attacks that have been made that our group, Nutrition Coalition, does not receive any industry funding, I do not receive any industry funding and so if people are interested in this cause and would like to donate to us, we survive pretty much survive on donations from people and a few rich diabetics, who like- everybody should know this, so, it’s a worthy cause.

Bret:  That was nutritioncoalition.us.

Nina:  Yes.

Bret:  Thank you so much for taking the time. We really appreciate you joining us today on the Diet Doctor podcast.

Nina:  Thank you, it was great talking to you.

Transkription pdf

And he was effectively silenced for years but now has been exonerated and it has fueled him just to teach people more about not only his struggles and what he went through, but it’s helped him uncover a lot of the influences behind what we’re told or how we’re told to eat. And the influences ran deep with industry and religion, and it’s really surprising, sometimes it reads like a suspense novel or a fiction movie to really keep you on the edge of your seat and with conspiracy theories.

But as he and his wife Belinda have shown and talked about many times, it’s there, it’s in writing, it’s in documents that they’ve uncovered. And it’s a little scary but at the same time the message is that we have to open our eyes, we have to be aware of outside influence and we have to question the status quo. And that’s how we move forward and that’s how we learn. As part of his work he’s written a book, Inversion, One’s Man Answer for World Peace and Global Health.

So as you can see by that title, quite ambitious, but he’s well on his way to helping us understand this and giving us the path of how we need to see things a little bit differently and understand the influence put upon us. So hopefully this will be a very eye-opening and enjoyable interview with Dr. Gary Fettke.

Dr. Gary Fettke, thank you so much for joining me today on the DietDoctor podcast.

Dr. Gary Fettke:  Hello, Bret.

Bret:  Well, it’s been a pleasure to meet you, I can’t believe with all the circles we run in that it’s just the first time I got to meet you and it’s like meeting a celebrity, which I’m sure if you would have looked back three, four years ago to think you’d be in this position, it’d probably be pretty crazy, wouldn’t it?

Gary:  I’m just a normal guy, I’ve never meant to become a celebrity. That doesn’t sit well on my shoulders. Even though when I come along to these meetings people want to catch up and chat. What I have just been doing is what I had to do. Just do the right thing. And, you know, I’m fairly stubborn which has been proven over time.

Bret:  Right, which is so amazing. You know, you wonder like why was it you that this happened to? Why was it you who saw that as an orthopedic surgeon you weren’t helping patients in the way that you could? Why was it you who started talking about nutrition with your patients and then got basically silenced and muted by the societies? But because it was you, because you’re stubborn enough, because you’re a fighter, because you believe so passionately, you were the one who was able to push through and come out the other side showing that you were right. So what is it about you that made you survive this process?

Gary:  The first thing is I recognized the issues of sugar and carbohydrate loading, particular in diabetics, relatively early. So if you came out now as a doctor and said, you know, I’m criticizing the amount of sugar in the patients load in the hospitals, you wouldn’t be nearly as much trouble. So first of all I recognized that and then I started talking about it and then I got involved in social media and that’s when I got into trouble because I was starting to become a voice.

And the other thing is that my message was, let’s reduce sugar for patients, particularly in diabetics. You know, I questioned hospital food, but the most important thing was that I wasn’t selling anything. I didn’t have a book, I didn’t have a business that was depending on it. We did start a dietetic service down the track, but that was because no one else was giving that support that was required.

So because I didn’t have anything and I was actually the coal fire and literally looking at the end complications of diabetes and obesity and lifestyle disease whether or not it’s arthritis, as it was evolving in my practice, a significant amount of diabetic foot surgery. So it’s pretty hard to argue against me if I am actually the surgeon doing the amputations, you know, I’m actually seeing the end product and making a noise about it.

So as it turns out, the cereal industry, the Dietitians Association in Australia I think found me as a threat because I actually had an answer for the problem, but it was actually counteracting completely the opposite of what they were promoting.

Bret:  Yeah, let’s talk about that for a second. As an orthopedic surgeon, one of your big money makers, one of the big things that you do on a regular basis is joint replacements in people who are overweight and obese and that’s what has contributed to a lot of their joint disease. You amputate toes and feet for people who have diabetes and non-healing ulcers. That’s what a big part of what orthopedic surgeons do.

So why were you the one to say, ”Wait a second… there’s a better way to do this to prevent all this, to prevent people from getting here”? What did you see differently?

Gary:  Well, like a lot of doctors who have embarked on the low-carb pathway, you do it for yourself first of all. So I am 20 kg lighter than I used to be. I was pre-diabetic, I had a malignant pituitary tumor about 20 years ago, I had psoriasis, I had a sort of inflammatory joint disease. So I ran my own pathway to my own health.

Bret:  Right.

Gary:  So adopting low-carb, as it turns out LCHF now, but it started with the whole sugar issue first of all. So I had the benefits from myself and then I started saying, ”If it works for me it’s going to start working for my patients.” In between times I experimented on the family and on my theta team. So I didn’t go straight to my patients. And it became– it was so obvious that this is what we had to do. Again I started speaking out about it.

I come from a background of actually being proactive on patients taking care of themselves first of all, so if you go back 25 years, I wouldn’t operate on smokers. And I used to give a paper called, ”Where there’s smoke, there’s fire.” For and so the if you looked at the early signs of that it was smoking has deleterious effects on cardiovascular tree, our healing potential, and it’s now completely mainstream that we should be avoiding major surgery in people who are smoking.

So the next thing from that was that I started avoiding doing surgery. In fact refusing to do major joint replacements on patients that were too fat. That’s a politically incorrect term to use now, but that was the scenario. So I drew a line in the sand with patients with a BMI more than 35 and the literature is there that really supports that stand.

Bret:  Because of higher complication rates–

Gary:  Well, first of all if I reduce their weight, they don’t need the surgery. If they do come to surgery, they have higher complications rates. And that’s not just anesthetic, that’s theta time, that’s wound issues, that’s malalignment issues with joint replacements. And longevity– so they don’t tend to last as long.

Bret:  Were your colleagues down the street just perfectly happy to operate on those people that you turned away?

Gary:  I wouldn’t use the word ”perfect”, but they were happy to continue on that pathway. And so I’ve had patients that wouldn’t adopt what I was recommending and go to my colleagues down the road. Now I’m okay with that. But if you don’t offer them the option and the choice to avoid that surgery and the same thing with bariatric surgery nowadays.

We have good options, and when I hear bariatric surgeons saying, well, they tried dieting, I say, ”Have they actually tried LCHF?” And they go, ”Oh, no, that doesn’t work.” And I say, ”Actually it does.”

Bret:  When people say they have tried everything and failed and I’m sure that’s what they say to you when they come; ”I’ve tried dieting and it doesn’t work.” And you say, ”Well, let’s explore this a little bit more.” So what have you seen? I mean I’m sure you’ve seen some impressive changes in people who have adopted LCHF.

Gary:  One of the fascinating things in orthopedics is that people actually– a lot not everyone, they lose their arthritis pain before they lose weight. I have had patients with dramatic improvements in their joint arthritic pain within 10 to 14 days. I can remember a fellow who said, ”I’ve come to you because I know I’m overweight and I’ve got arthritis and I need a joint replacement.”

He said, ”I’ve come to you because I know you won’t operate on me straight away and you’re going to tell me to diet; I just need help.” So he went and saw a dietitian that was completely on board with it and then rang up 10 days later and said, ”I have lost all my arthritis pain.” He’d lost it all.

Bret:  In 10 days?

Gary:  In 10 days.

Bret:  That’s remarkable.

Gary:  So if you actually through that concept out there, then there’s 1000 of N = 1 stories of people losing their pain or disproportionately losing their pain before weight loss. The weight loss comes along and it’s got this added benefits but surely on the long term. But I’m still doing joint replacement on patients who had done LCHF. But they are coming back to me one year down to track or two years down the track they hobble in and they get better quicker. And they are going into training– I often say, you are in training for joint replacement. Do this, try that, get the fitness up, do a bit of exercise.

Bret:  And I think that’s a good point because sometimes we have to be careful about overstating the benefits we can get. It’s not like it’s a cure-all and it’s going to reverse all our arthritis, but it can certainly delay it, it can certainly improve recovery, it can certainly improve function leading into and after a joint replacement.

And those seem like fairly reasonable conclusions that you can draw but when the literature doesn’t exist, when the 10,000 person study about half getting LCHF, half getting joint replacement, when that doesn’t exist yet, but the clinical N of one’s exist, you find it hard to convince other surgeons about what you’re seeing? I mean like once you see it, you can’t un-see it, so why doesn’t everybody see it?

Gary:  Well, that’s part of my talks coming up is about why as a medical community, we are not seeing it. And that’s complex in itself. So what we can do is actually let patients set the example and I go back to the general practitioners. You know, in the orthopedic meetings you keep standing up and saying the same thing. And now I am asked to speak about the topic. You know, at an orthopedic meeting, surgical meetings coming up and I get a voice now.

So there’s an interest there in surgeons; we had a chat beforehand– some years ago I gave a talk on don’t operate on obese patients. And I gave 200 papers, you know, a summary of those and against my argument there were three papers. And so I actually think that if we’re actually operating on obese patients unnecessarily by doing joint placement– Bear in mind that in Australia 90% of knee replacements are done on patients who are overweight and obese.

Bret:  90%! So at least people stop doing that because there goes their income, there goes their livelihood there goes a big percentage of their practice.

Gary:  Look, I did exaggerate that, okay? The last year’s figures it was 89.9%, but let’s say 90%. And 74% of total hips are done on patients who are overweight and obese. And increasingly on young women. So that’s a demographics, that’s from our joint registry. And we’ve got a problem. I mean that’s not an issue for my career, but the next generation of orthopedic surgeons will be operating on those people when their joints fail.

And they are going to fail at a higher rate… we’ve already got that data. So they are going to fail at a higher rate on younger people.. It’s just another layer of the tsunami of lifestyle related diseases it’s going to be upon the next generation of medical professionals.

Bret:  It’s interesting to think about how the demographics are changing unless we can impact it and reverse it which is a big part of your message, isn’t it?

Gary:  I’m just saying if your tire is worn out on the car you’re still going to have it replaced, but if you drive it around carefully and you take a few rocks out of it, it will last longer. And then when you actually have your surgery it’s going to be easier on the patient, easier on the surgeon, easier on the system. They’re going to be in the hospital less time.

Bret:  And that’s an interesting point, a lot of people may not think about that. There’s the question of do you need the surgery or do you not, but also how much time is it going to take, how much is the rehab going to take, what kind of impact is that going to have on your life…? Those are important questions as well that a lot of people probably don’t think as much about.

Gary:  Little simple things, I’ll get back to smoking, that patients who are smokers spend longer time in the recovery ward. The same thing actually goes with obese patients. They have longer time for the anesthetic– longer recovery times. Much heavier nursing problems in the hospitals. Staffing problems, you’ve got to have extra staff on board to move them around and you got higher worker’s compensation breaks because people get back injuries.

Bret:  A snowball effect, isn’t it?

Gary:  Another interesting thing that is coming around is in pain management. It’s not in acute pain, but chronic pain management. It’s the whole role of the ketogenic diet in that. So it’s again anecdotal. But I’ve got patients who were running low-carb and keto and they seem to have less postoperative pain in their surgery.

Bret:  Why do you think that is? Do you think it’s something about the ketones, something about the sugar and the carbs or a combination of both?

Gary:  I think both. I mean I use the example that if you give kids sugar at a party, they get hyper and then a few hours later they–

Bret:  Crash.

Gary:  Another side is what would happen to society if we gave everyone on the planet sugar at one time. Would have anxiety, depression, anger, mental health issues. And guess what? We’ve got all of those. But if we look at it also from the ketogenic aspect of neurodegenerative disorders… That nerves can run just as happily on a glucose load as they can on a ketone load. So it seems to have a beneficial effect in the neurodegenerative disorders. And there are a few papers out there now in pain management talking about ketogenic diets. So again, I use those to my patients; I say, ”I can’t force this upon you, but here’s a non-drug alternative.”

Bret:  Right.

Gary:  And these are all about giving your patients tools to manage their own condition.

Bret:  Right, so you mentioned a non-drug alternative and that brings up another whole big topic that you’ve been very vocal about… So when you’re promoting a non-drug alternative in a culture that is sort of fueled by drug companies and drug money you are going against some very big forces that probably don’t want you to succeed.

And you have turned– not only as a physician but you’ve turned into an investigative reporter, you along with your wife Belinda, to uncover a lot of sort of the beginnings of an anti-meat campaign of people with vested interest in not promoting LCHF. And it’s sort of fascinating and almost unbelievable what you found. So I know it’s a big topic but summarize some of the basics of what you found that shocked you and has certainly shocked a lot of people who you’ve been talking to about it.

Gary:  I think the science behind LCHF is actually sound. It’s biochemistry, it’s the stuff that we learn in the first 50 pages of textbooks. It’s not in the fine print. So I often describe that eating real food, LCHF is if you eat food fresh that’s local and seasonal, then by definition it is low in carbohydrate it doesn’t have added sugars, it doesn’t have lots of carbohydrate in it, it has health fats in it and it has protein in it.

So the definition of real food is LCHF whereas the definition of the standard diet comes out of a paper bag or a plastic bag. And that’s unhealthy. So all I’ve been arguing and all– discussing with yourself and others in the scientific world, is we’re just talking about biochemistry and real food can’t buy definition be unhealthy. And Belinda made this observation when myself and Tim Noakes in particular were under investigation for recommending real food.

She said, ”You guys are going blue in the face, but it’s going to be something else.” So it wasn’t until she started to investigate my case because I was clearly under investigation for a few years. She come across that the expert witness that somehow mysteriously appeared into my case was actually someone pretty high up in the nutrition world who was working for a cereal company at the time.

So how come that the breakfast cereal industry got involved in my case? And it took another three years but towards the end of 2018 Belinda came across 600 pages of internal emails from the Australian breakfast cereal industry and in them it had that the concepts of paleo and low-carb were affecting cereal sales, profits were down and these seven people were to be targeted. Now I ended up being the only Australian doctor on that list who was meant for targeting.

And then actually in the documents it had details as to which media people are going to be working with newspapers and magazines across all forums to actually target those people who are promoting low-carb and paleo. So that’s scary stuff. And this is actually not some load document. This was actually the briefing document to the CEOs of the heads of the cereal industry in Australia.

So Kellogg’s, Nestle, Sanitarium, Freedom Foods and the head of the Food and Grocery Council. Now I am happy to say that because I have actually presented those individual names to send an inquiry, calling them out. And that’s Australia, but those five CEOs, or four of those, report directly to the CEOs here in the US. So this is the cereal industry, you know, the biggest corporates at the bottom of that food pyramid that promote the cereals and grains.

They are actually in a working relationship with the Dietitians Association, they’ve been paid to actually promote the benefits of sugar and cereal. And the Dietitians Association in Australia just like you in the US are the ones that effectively write the dietary guidelines. So here we got the Cereal Industry directly paying the Dietitians Association not only to be involved in targeting of those voices against it, you know, talking about preventive health but they are also the ones writing the dietary guidelines.

So if you think that that started opening Pandora’s box… Now it took some years to work out, but along the way Belinda’s investigation has completely uncovered and effectively unraveling what’s happening with my education, your education and the future of health education along nutrition lines.

So the long and the short of it is we’re going back in history and if you look at the history of the dietary guidelines, they have changed over time… they used to be meat and dairy based and over the last 100 years the dietary guidelines in Western society became cereal biased, anti-meat, anti-dairy and rapidly approaching vegetarian and vegan.

Bret:  So the way people ate before there were guidelines was very heavy based in meat and low in grains.

Gary:  I think the early 20th century one was meat and dairy based. But at it evolved… in 1972 the McGovern report and in 1992 the Food Pyramid and we’re sort of seeing the MyPlate here in the US, but effectively it’s again a cereal based, anti-meat, anti-dairy, approaching vegan vegetarian. And when you look at the history of that, that’s where we have spent a lot of time. So set from the dietetics, the nutrition aspect, the dietary guidelines were started effectively by the Dieticians Association of America…

The American Dietetic Association in 1917. The founder of that Association was a woman by the name of Linda Cooper. Linda Cooper was a protégé of John Harvey Kellogg. So she was working for John Harvey Kellogg, she effectively started the American Dietetics Association, she then wrote the textbooks for the next 30 years for dietetics, which formed the basis of dietetics and nutrition for the world.

First of all the model of the Dietetics Association as well as the textbooks became that not only for the US, but for Canada, the United Kingdom, Australia, South Africa, New Zealand. So the Western organizations all followed suit and effectively the cereal industry was right there at the beginning.

Bret:  We like to think that this was altruistic and just trying to benefit society and tell them the best way to be healthy, but once you have industry involved you can’t assume it’s altruistic anymore. And why should the industry be involved? There’s no reason industry should… with a bias and with a vested interest should be involved in telling people what to eat. But somehow the two got combined very early and have never really separated.

Gary:  Well, they haven’t separated at all. And of greater concern is that the basis of cereal isn’t grounded in science, it’s actually grounded in ideology.

Bret:  Right, so that’s the other risky part. Not only is the industry but now we’re bringing in religion and ideology, another thing that has no place in telling us how to be healthy really.

Gary:  Well, John Harvey Kellogg and Linda Cooper were both vegetarians, both members of the Adventist Church. And the Seventh-day Adventist Church have been right there at the beginning, heavily promoting their concept and they are promoting the Garden of Eden diet, which is vegan.

Cereal based, anti-meat, anti-dairy… Vegan. And effectively they have been influencing the dietary guidelines for 100 years. So the people involved in writing the vegetarian mandate for the American Association and for the Australian dietetics guidelines were effectively all vegan/vegetarian. And the American one eight out of the nine were actually Seventh-day Adventists.

Bret:  Eight out of nine?

Gary:  Eight out of nine were vegetarian, vegan, five of the nine were Adventists and the other person who was neither vegan nor vegetarian nor Adventist was working for the processed food industry. So here we’ve got major influence at the highest levels which has actually come from religious ideology.

And the ideology– they were well-intentioned, I’ve got no problem. This is not antireligious. This is you got the belief, then I’m very happy if you have that belief. However make it grounded. But if you want to start promoting that and influencing that for the whole population make certain is grounded on science and not on an ideology for salvation.

Bret:  But that’s what’s so interesting is that the narrative has changed. Because they can’t say it’s because of religion and because it’s for salvation. Because a lot of people aren’t going to be open to that message, so the message has sort of changed. Now it was health, then it was environment and then it’s ethics. So the narrative keeps changing but I guess one of the points you’re saying is still all comes from that ideological backbone, right?

Gary:  They are not so much pro-cereal as they are anti-meat. That’s the basis of the Ellen G. White’s prophecies And her belief is that meat is one of the– if you consume meat, that is as close to demonizing yourself as you can possibly do and you will not get salvation if you do that. And that’s the backbone of their belief system.

So the terms, ”Meat causes violence, causes masturbation, causes cancer”, those terms are coming around in the early– no, the late 19th century, the 1860s, 1870s, the meat causes heart disease came up in the 1900s. Essentially we worked out that meat doesn’t cause masturbation and the meat doesn’t really cause violence so those messages are the 19th century ones.

So then we got the next message, the meat causes cancer, which continued to come along. And if you look at the data, that’s very poor Association data for a couple of cancers with low relative risk ratio but nonetheless get over marketed. And so that narrative of fat causes heart disease is actually part of the meat causes heart disease. It’s whatever they can use to try and travel that path.

So we’ve now moved back to meat causes cancer. Now the latest one is meat causes environmental harm. It’s all a complete nonsense. But you got to realize that the backing of this is coming from a religious ideology for salvation, not for health.

Bret:  Yes but since we don’t hear much, I mean beside from when you and Belinda started talking about it, nobody was bringing this up about religious salvation, so I think a lot of people probably say, ”that’s not true” anymore. I mean now it’s more just maybe industry and people promoting the environment, but it sounds like you would argue, no, the ideological process is still there.

Gary:  I will argue both. First of all the Seventh-day Adventist Church has been on this bandwagon for a long time ago. People go, oh, they are only a small group, but they are the second-biggest educator in the world after the Catholic Church. The number of schools they have is just at the top of hill, so over 1400 schools and a couple of hundred universities around the world. They’ve got enormous amount of funding. Just in the US they’ve got 28 hospitals in Florida alone.

Bret:  They run 28 hospitals in Florida alone!?

Gary:  And so they have this ongoing message coming through. The other big issue is that they spend a lot of time in the developing world on missionary work and promoting the message, their health message and they use that as the entering wage of the church. So they are not coming along saying, we’re going to give you salvation, we’re going to give you health… come along to our way of eating.”

Which is their big promotional one called The Chip program and it’s been introduced in countries like Fiji it’s just adopting it, the entire country. I mean the Polynesians, the last thing they need is more cereal and grains for their obesity and diabetes epidemic. But it’s also being introduced in the US via insurance companies.

Chip program is being adopted and it’s effectively a vegan program with a background of religious ideology they use as an entering wedge into the church. And so it’s right there, front and central. And the important thing is they are not hiding any of this. If you actually look at this stuff, and last year, in 2018, they published a 20 page article in a Journal called Religion acknowledging everything I’ve just said.

They are very proud of it, they’ve got a health agenda for the world. That’s the religious ideology, they are promoting that because they need to get the message to every corner of the world, ”every tongue”, I think is actually in their–

Bret:  Every tongue!

Gary:  And then for Christ’s return. Now, I’m okay for you to have your belief but it shouldn’t be forced upon the world’s population, both in our eating habits and therefore agricultural practices. The other thing that’s involved, that the SDA are involved in, is that they effectively own the cereal industry of the world. And the soy industry and the alternative meat industry. They were right there at the beginning. The first meat alternatives were in fact invented by John Harvey Kellogg.

Bret:  Really?

Gary:  The soy was effectively brought from China by a fellow, Harry Charlie Miller. He was an Adventist missionary and he started the whole… soy plants in conjunction with Adventist outposts in China. But effectively he brought soy back to the US. And the soy infant formula was promoted primarily by him. And now we say soy and infant formula every day on every supermarket shelf. You’ve got to realize that they were there at the beginning. And so that’s still there. So they’ve got not only their own push at an ideological level, they have also got their own food industries.

Bret:  And now they’re getting funding in venture capital and Silicon Valley involved in backing these fake meat products. And that’s sort of a little more dangerous because now once the money gets involved it can start to snowball. And I saw a Twitter post you made about, ”can you identify which is fake meat burger and which is dog food?” And they looked very similar, didn’t they?

Gary:  Well, you couldn’t pick them. The Silicon Valley have come in on as the tail end of it. I suppose probably not the tail end of it… I will use the term entering wedge.. One of the big issues we see is that the medical education, so the current education model is being heavily pushed, that we need to travel down the pathway of lifestyle medicine. -Sounds great?

Bret:  -Sounds great.

Gary:  You know, let’s exercise more and eat well and get plenty of sleep and sunshine and have good communication skills. But the nutrition side of that is to move towards vegan. And that is in fact most people don’t realize that lifestyle medicine is the Adventist Church. So in all of its different names…

You know, started as the Christian Association of lifestyle medicine and ultimately this moved through a series of name changes pages but it’s widespread around the world… and that has a good message however. It’s about medical education and pushing that pathway. Side by side with that is the term ’exercise is medicine’ which is actually trademarked and one of the initial founding members of that trademark of exercise is medicine is Coca-Cola.

So in this strange relationship we’ve got these two arms coming together in medical education… look up LifeMed, which is education… The co-concept of education now being controlled by lifestyle medicine, pushing a vegan plant-based agenda and Coca-Cola coming in and they started becoming involved with lifestyle medicine in 2010, started coming in significant relationships in 2012 and the funding pedal was pressed in 2014, 2015.

So we’re now seeing this whole rise of the vegan agenda and they don’t realize that the propaganda is being fed by the lifestyle medicine, Adventist church message, Garden of Eden diet with the backbone of the processed food industry led by Coca-Cola.

Bret:  Great marketing.

Gary:  And they’ve come together, but the trouble is here in the US. You’ve got now eight universities are adopting this lifestyle medicine plant-based diet as their medical education.

Bret:  And they don’t understand I’m sure the religious part of it, they don’t open their eyes to the industry part of it. They think this is a healthier way for individuals. I want to give people the benefit of the doubt and say they legitimately want to help patients get better and help people lead healthier lives, but we sort of have to pull back the curtain and show them what the science says and where this is coming from and they have to question why is Coca-Cola involved. I mean these things need to be more front and center.

Gary:  The processed food industry is well- positioned to continue the vegan agenda.

Bret:  Well, they will profit greatly from that, won’t they?

Gary:  We have come across some documents again from the Adventist Church and their food arm food, saying that they’re expecting a 25% increase in their profit because of the adoption of their vegan Garden of Eden diet by millennials.

And so again it’s all about being open in the discussion. I am very happy for you to present… Here is my educational package to teach to my medical students, but I come from religious ideological background promoting this for salvation and I have the backing of the processed food industry which is going to help their profit line. I mean, you wouldn’t buy into that, would you?

Bret:  No.

Gary:  Yet we have got an entire generation out there who are taking up this agenda because it’s based on your animal welfare animal-rights and questionable environmental statistics. And Peter Ballerstedt’s work is just phenomenal. And I’ve said to Peter… What I’m talking about is I don’t trust Peter either. I think he’s got a cold counterargument. And there’s another side of the coin when you look at the whole environmental impact.

Let’s look at both sides of it rather than just taking for granted what you are in cowspiracy of folks overnight. Because that’s clearly an agenda driven one. And you’ve got to realize that that agenda is coming from the garden of Eden diet, Adventists and the food industry Coca-Cola. We are not conspiratorial, we looked at this for a couple of years before… we sought counsel from other people and said we lost the plot on this.

And all we’re doing is having it ratified. And then last year as I said the Seventh-day Adventist church came out very proudly saying, ”We are behind this.” Because they have an agenda, they believe in it.

Bret:  Yeah, and it sort of leads me to think about the Eat Lancet campaign. Because it seems like that was the attempt to now say this is science-based and evidence-based. And that’s what eat Lancet was supposed to be, an evidence-based report to tell us all why we should adopt a vegan lifestyle. But when you dissect it, you can see the evidence isn’t there, their recommendations are not based on high-level quality evidence.

So if anything I would hope that would hurt their mission more once people realize that it was basically a well-funded media campaign that wasn’t based in science, but yet I don’t think their message is getting out there, but that the message has been propagated more as look at this evidence-based approach now to being vegan. And that seems pretty problematic when you start to distort what the evidence says.

Gary:  Scientific evidences are thrown out the window I think nowadays. It’s completely and utterly biased. Eat Lancet had significant funding behind it from the food industry and the pharmaceutical industry.

Bret:  Yeah, why would pharmaceutical industry be involved there? That again that makes no sense except they are going to profit from it, but they should have no seat at the table there.

Gary:  None whatsoever. And it’s disappointing to see that Lancet actually published it in the first place because it didn’t require a lot of review of the articles to rely… Those were just poor articles and very biased. I think it’s worth taking another step backwards to the Adventist health studies which they have quoted over and over of the benefits of vegan/vegetarian. Were flawed.

And so when you actually look into them and they’re quoted over and over… But the Adventist studies were done by people affiliated with the Adventist Church that re-quote their own articles. So those three Adventist studies last time we looked at them had been re-quoted each time by themselves over 400 times. I mean 1200 re-citations by themselves.

So let’s say I write an article and then I cite myself from that article and I cite myself from the article twice. All of a sudden they’ve compounded. But if you keep telling everyone that your Adventist health studies are fabulous… But the first two Adventist health studies, the definition of vegetarian was that as long as you didn’t have meat more than once a week.

Bret:  Yeah, once a week.

Gary:  And the definition of vegan was as long as you didn’t have meat more than once a month.

Bret:  Some people say they’re perfectly healthy on a vegan diet or vegetarian diet. You don’t realize that it still involves some meat by those definition.

Gary:  And when you actually dissect those studies and have a good look at them there are other studies showing that other populations not just Adventists actually outlive them. So right to the quoting of the Blue Zones and Okinawa… I have actually gone back to those Okinawan articles and they are actually eating pork.

Bret:  They are eating pork; they have the Sardinia pig and they are goat farmers and a lot there that didn’t come up in the Blue Zones.

Gary:  There’s a lot of meat actually out there. And I’m all for having community and spirituality and togetherness and sunlight and exercise and rest and living by the seasoned and sleeping by the sun… but don’t tell me it’s because you’ve got a plant-based diet when the other variables are just so important. And particularly that plant-based diets being supplemented with meat.

Bret:  Right. Does it seem like just too daunting though, too overwhelming that there’s too much behind this mission now, too much behind the push, that it’s like we are fighting a losing battle? Or you think there’s something we can do to show people to open their eyes to where this is coming from and help them see the other side of the equation?

Gary:  That’s why we’re having chat today. Because if we both thought it was hopeless we would’ve stopped. I have children, we’ve got a grandson… my future is already determined, but his isn’t. Some of the people listening or watching might have seen that Pixar movie Wally. And I think it’s brilliant, I often refer people to go and watch Wally.

Very, very completely on the mark in that we are as a society right now are fat, we are overhanging in our chairs, we are lethargic, we are sick, we are medicated to the hill. And I honestly think this is completely and utterly unsustainable. And we are about to come over a precipice, you know, it won’t be a social decline, it will be a social cliff; we will go over this, it will be really ugly in the next 10 years. But in that movie, the Greenleaf, that’s my grandson. You know, I’m hoping that he will be armed with health. He will understand he needs to eat real food.

Bret:  To explain that for people who haven’t seen the movie, what do you mean by that?

Gary:  Well, in the movie– now, go and watch it everyone… But in the movie effectively mankind’s been wiped off the planet, we have destroyed our planet underneath us and there is a group of survivors which is still floating around in a spaceship trying to find a spot to actually live. But they actually realize if you actually go back to Earth and you do it right then there’s a future again on Earth.

And so therefore I– Every economic marker, every health marker I look at is we’re going to have a massive change in population health. It’s scary. However I’m not depressed. I’ve suffered from this thing called hyper pragmatism. So I’m just being pragmatic about it; this is happening before us. You can see it when you walk down street, see it in your family or community. See it in the hospitals… We need to do something about it. It’s going to be messy but let’s prepare the next generation for making the difference.

And that’s the education I want to see. And my problem… me and Belinda, we see that the education model that’s been introduced in the US being pushed in Australia. You know, going back some years, I think it was being pushed into my own university and as it turns out my medical students, we’re going to be having this new curriculum thrust upon them. And that’s when I came out and started talking to them about…

Actually that’s sort of nonsense. I’m talking about real food, LCHF, blah, blah, blah. I didn’t realize that I had actually trodden on a hornets nest in my own hospital to my own students. But they were the group that were having this new experimental teaching upon them. That’s all been gone by the wayside, but I think that’s part of why went into trouble…

Bret:  You weren’t just affecting patients, you were influencing the next generation of physicians. And industry is going to see that as a big problem that they need to squash.

Gary:  But where we are now is, you know, have we squashed Eat Lancet as it being questioned? Yes, but that’s only the first phase; it’s going to keep coming. It’s up to everyone to start calling out– let’s call out the science, but see who’s behind it, who’s pushing it, because we’ve seen the results of the last major dietary change intervention, the public health policy.

And that was the introduction of the low-fat high carbohydrate diet. We have had that social experiment for the last 40 years, 50 years. The next thing which is being pushed literally down our throats is the plant-based vegan, anti-meat, pro-cereal… as Belinda says, with a side of Coke.

Bret:  Brought to you by Coke with a smile.

Gary:  And it’s not our fault if you’re fat and sick; it’s because your lifestyle, and that you haven’t exercised enough. Now we’ve got that whole concept ingrained in their psyche; you are fat, therefore you are lazy. Well, it’s not what we’ve been eating, but we have convinced everyone that it’s because they are lazy.

Bret:  Yeah, so we need to get rid of that industry influence and get rid of the religion influence and get rid of the pharmaceutical industry influence when it comes to educating people, educating our future doctors and the public. But how do we do that? That’s a much harder question. Because it’s a free market society and they’ve got their fingers so deep in people’s pockets that they don’t know how to get out of it.

Gary:  And if you stand up against them, you get into trouble. Because, you know, I refuse to follow the guidelines. My patients in hospital with diabetes out of control were being given three serves of ice cream per day. And I said, this is ridiculous and I was told they are the guidelines. That’s sort of the beginning of my journey against the system. I said, well, the guidelines are wrong then.

And they said, those are the guidelines, we can’t change them, we have to do as we are told. And I said, okay I’m going to try and change the guidelines. So what do we do? Well, we stand up, we start questioning. One of the problems in medicine is we are educated on this read, repeat, reward concept. It does not suit us as trainees and as doctors to read something and then question it.

Because then you get into trouble and then you are reported to the medical board because you are saying I can’t recommend ice cream to my patients. And that’s literally what happened. I’ve got reported because I said this is ridiculous… stop serving my patients ice cream.

Bret:  And that is such an important point, the read, repeat, reward, because how are other industries educated? How are engineers taught? They are taught to question everything. To analyze things from different sides, to try and find why one solution is wrong. In medicine we’re not taught that. We’re not taught to be critical thinkers like that.

Gary:  Well, we used to be until 1910.

Bret:  What happened in 1910?

Gary:  The introduction of the Flexner report. So before 1910 we had a much more holistic approach to medicine. And in 1910 Rockefeller of oil and Carnegie of steel commissioned Abraham Flexner to do the Flexner report which is actually to look at the medical education. And it became a two-way fight almost at that time between William Osler, who is one of the fathers of medicine, who believed that we should be not medicating our patients, we should be bedside teachers and bedside carers and he was very much against the experimental and drug model.

But Flexner came in with this agenda to actually change medical education. It’s a fascinating story. And ultimately the Flexner report went through, big-money won out and the model of medical education became one of that let’s lab test and medicate. We stopped the bedside caring, we’ve stopped the holistic interactions. We didn’t stop them completely.

Bret:  Only minimize them.

Gary:  And out of that model, because Rockefeller came along and supported those institutions that actually adopted the model, 50 medical schools around US and Canada were closed in the subsequent years. And those ones that remained effectively adopted that model. And that was to medicate and test.

And along with that, which was a burgeoning time for the pharmaceutical industry, development of drugs was the birth of the modern pharmaceutical industry. So therefore all around 1910 to 1917 we had the birth of the pharmaceutical industry, of the nutrition science which is not science at all… It’s about palatability, marketability, shelf-life profit. We had the two that came together and so I call that generational education.

So since 1910, 1917 we have had the pharmaceutical industry educating us on how to treat our patients. We’ve had the food industry telling us or educating us, I’ll use a softer term, on what to eat. And we’ve lost the ability to think because they then developed the guidelines, the guidelines say, stick within these parameters…

But the guidelines at the best, only are useful for the median group. Let’s say two thirds of the population. That leaves a third of the population out to the side, which the guidelines don’t fit. But you, as a medical, have to prescribe according to the guidelines for the median group. That means potentially we are doing harm to at least one third of the population.

Bret:  Well, you could even reverse that and say if the guidelines were designed for healthy people and now our society is two thirds unhealthy, so you can sort of flip that on your head in terms of who that represents. But I think it’s such an important take-home lesson, whether people can take home from this discussion that, you know, we should not be vegan and we should eat meat or whether it’s healthier or environmentally sound…

The most important lesson is question what you’re told, question the norm, question the guidelines. Because the people who’ve put those out haven’t questioned the influences, we need to do that and whether you agree or not you have to at least ask the questions. And if you then ask the questions and still agree with them, that’s fine, you’ve done your own due diligence.

But we can’t just accept things on face value, we can’t do that anymore, because the role of industry, the role of money, the role of religion is too deeply rooted, that’s what you and Belinda have taught me that those roots go so deep that we just have to start asking the questions and never stop asking the question; that’s the most important lesson.

Gary:  Generational education is you don’t question your teachers. Nor did they question their teachers before. That’s where we are at now. We’ve just been scared and afraid to question our teachers. And you’re absolutely right, question. So if your doctor says, ”I want you to take this medication”, don’t be afraid to say, ”Why?”

And when you adopt an LCHF, low-carb healthy fat lifestyle, the very first question I get from doctors all the time is, ”I’m worried about the patient’s cholesterol.” And the patients get that, they are intimidated by that. And I have one really, really simple reply for the health professionals, doctors and so, ”What is cholesterol?”

And the scary thing is 99% of doctors cannot answer the question. Just say, what’s cholesterol… And unless your doctor can come up with at least five things which cholesterol is there for, then don’t take his advice or her advice. Or at least question, because unless we’re questioning the doctors, then the doctors aren’t going to go and learn. Because they are just following the guidelines. And I did question.

And when you start looking at nutrition science, or ”non-science” or ”non-sense”, it’s a house of cards. And that’s what all my journey has been in the last 10 years. I press the pack of cards and it just keeps falling down. It doesn’t matter if it’s cholesterol, sugar or carbohydrate, it’s fat, or healthy fats or polyunsaturated oils.

Unfortunately everything I press is falling down. And so in my textbooks I’ve come to question. You know, Harrison’s principles of medicine. I remember my father giving it to me on my 18th birthday. Actually it was 18 plus one day because he said he could give it to me on my birthday because I was completely drunk.

And he gave it to me the following morning. I can still remember him out in the back porch. He said, ”Here’s your birthday cards next to the definition of alcohol.” I can still remember that… Very funny. I mean that’s our go-to book. And the editors of Harrison’s last year were paid over US $11 million and declared by the pharmaceutical industry.

Bret:  Oh, that’s so depressing to hear.

Gary:  I don’t mind you being paid but put it across the front cover of Harrison’s; this has been influenced by the pharmaceutical industry to the tune of $11 million. Just put it across there. And then I will know… I will know what hat you are wearing.

Bret:  On the one hand it’s so depressing to hear that influence runs so deep and on get a hand it’s great to have voices like yours and Belinda’s opening our eyes to that influence and giving us the permission to question, because that’s what we need. So I want to thank you for all the information you’re putting out there and although I’m sorry for the struggles you had to go through, I’m glad it was you because you are the right person to come through that and become the spokesman to teachers, to open our eyes and ask these questions.

So it’s remarkable what you are doing to try and help educate people on the right way and help them educate themselves. So if people want to hear more about you and read more about what you’ve written and what you’ve done, where can we direct them to go?

Gary:  I think the best site at this point in time is one that Belinda set up called Isupportgary.com. I know it sounds corny but that’s why she set it up. Because I was under investigation and being hammered by the system. And therefore her research and a lot of this stuff is on Isupportgary.com. I am on Twitter, Belinda is on Twitter, we’re still on Facebook…

That’s Belinda Fettke no fructose that was changed from Gary Fettke no fructose in the midst of all the medical board investigations. And they said, ”You can’t talk about this.” So we literally just drew a line through Gary and wrote Belinda. Because they cannot silence her. And I’ve now have been cleared to start talking about this stuff again. I don’t think anybody wants me talking about it apart from the patients in the community.

Bret:  Only the people who want to get better.

Gary:  Right, we’re still out there.

Bret:  Thank you Gary, I appreciate you taking the time.

Gary:  Thank you, Bret.

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