Most specifically what we put in some outs the food that we eat and well you know how this became a bit more. How should i put it it was a got a lot of the way and us 70 you can and internationally of course you know there was a great scare here in britain when our Prime Minister for sensible i meant. Was from some company 19 in my 1st observation is a doc so we observe things you know we always you know think about things from the very basic level when we when we even treat patients we look at our parents think you know. It was quite terrible just to me with my knowledge that Boris Johnsons weight which we know you know hes had problems with it for a long time hes been open about that in his b. M. I. In the sort of 3536 category so base. What was the link because its a small sort of mission then you know its to explain it all essentially i mean very simple terms access gaudi fat basically isnt just a respect to so many. As easy as it appears to be something that a sexy immune system in an adverse way but im sure you would agree with me in that it may be ok for the doctors to observe. A patients body type but its certainly consider it implied if not outright offensive to make any comments on a persons appearance especially. You know how he or she looks and i wonder if thats you know this social taboo is one of the reasons why it is so difficult to discuss this elephant in the room that access body fat in fact makes this virus so much deadlier and so much more dangerous yeah its a good point oksana and i think as doc says we obviously have to be very sensitive in the way that we discuss these particular issues ive treated tens of thousands of patients and manage many people on the street with all the sex and cheating many people with weight issues and not once have i ever had somebody complaining about i phrased it but it has to be done in a sense to way because you know ultimately theres such a huge proportion of the population 7 brits and most of people on our way were basics and the population so i think you see approach to sensitive way unfortunately i think you raise a very valid point there are certain sections certainly within the media and people who think this is a personal responsibility issue and when they see somebody who is overweight or obese they suddenly automatically come up with the fact they must be greedy overreaching and it was you know lazy and i think that thats absolutely wrong that we shouldnt be doing that because it isnt really a post response but ceased well i think part of the difficulty separating the psychology of obesity and the physiology of it people i rightfully opposed to fat shaming and other forms of myth mistreatment but they often miss the point that. Obesity is a serious disease of the adipose tissue and adipose tissue is a vital organ immune organ is well as and the criminal organ so with any other progressing pathological condition he wouldnt be encouraging people to just accept themselves a lot of themselves the way there are and yet when it comes to obesity that seems to be the message. And also you do raise an important point and i agree with you in the sense that we cant ignore it and but its about as about how we approach these patients so theres no evidence for example that if you actually shame people and you know you come down very strict on them and stop saying you know that you know making them feel bad about. That is unlikely and so you know in my experience you know it is unlikely to really help and it certainly can actually impair and you know be a barrier to good docs of patient relationships and look at when i would try to pray someone did that but when people say that its not a personal responsibility what i hear as a former happiest person is that you can do nothing about it when in fact i know for a fact that there is a lot of things that people can do you know about it and change that probably mean theyre relatively short amount of time so lets talk about this responsibility i think when we talk about it we need to be able to define and to define 1st responsibility to do it you know for people to act with pessimist sponsibility need to have the right information you need to have choice you need to have access and it comes to food needs to be affordable if you havent got the right information oxana say for example you know we can talk about later the dietary guidelines say that people are being misled by for example the low fat movement for very long you know people eating foods thinking it was good for the health think it was going to help in this way it was loaded with sugar it was interfering with their appetite or eating more they feel hungry to them playing themselves and actually the blame lies in what they receive in the way that misinformed we cant really say that because of us responsibility in the Food Environment were not so its well the point is its so saturated with ultra process you know the analogy i use is like asking a child that grows up in a sweet shop to not eat sweets we need to you know we need to help people so that they can empower themselves to try and change or die in the right way but i think we should always constantly be aware how one of the. Thats why for example diets in general dont work away all starts for many most people some people obviously but the calorie restriction all that kind of stuff and one of the possible reasons from my perspective is you can do this for a certain amount of time this will power issues you can excise well but if the environment is working against you its harder to sustain and people benefit you got to know what and the environment is always working against you on any issue i want to give you one example i was just at a coffee shop yesterday and there was this overweight guy who was telling off their clients when not wearing a mask in public but while buying a bunch of act laris and i think this is such a poignant illustration of whats wrong with this whole debate because he shall for attacked it and even self righteous by the fact that wearing a mask without even understanding or willing to admit to himself that his own food choices have a much more dangerous impact on his chances of getting and surviving the this virus is just to the point that. I agree that information and you know Good Environment the war and how through an environment wouldnt hurt but at the end of the day the decision lies with within an individual us on if it comes at some very basic though if you look at behavioral science the environment has a much bigger impact so yes of course we make our choices but the environment is much bigger impacts on how we behave than this socalled custom its also those aspects of it and thats very well known welcome ive been a sight cynical some cretins how think that theyre doing shows making the difficult choice how the choice will have a much bigger impact on the population than socalled individual counseling or education so thats one thing i would say i think the other thing is that we have to also be aware some and this is something that doesnt get discussed enough is it for certain sections society who got job insecurity who have very low paid jobs actually. Having a healthy diet is is almost unavoidable you know children who are growing up in environments where their parents cant even afford them to get healthy food and they have some to growth or they develop conditions related to obesity so me thats just plain wrong thats a gross injustice so we have to think about that as well in this context the other thing id like to raise with you as well oksana is you know you talk about this issue of oppressed responsibly. The information that people have been given for a long time lets talk about the dietary guidelines that changed in the late seventys and early eightys and us in the u. K. Was all about putting you know the base of the diet starchy foods and we now know these are the very foods that contributes to all these Metabolic Diseases types of diabetes etc so people get confused and that thats another big issue the Food Industry have kind of hijacked information and weve you know this whole culture presents low fi junk food has come on the you know common saturate the city vironment people have gotten sick and that also needs to change but the problem is the the Food Industry have too much control so that even the dicey guidelines are influenced by them i want to ask you something about this and i asked mary controversy that i mentioned because i find it very interesting i think at the heart of it is ultimately a debate about you know how much courtesy how much discipline the way expect from one another in dealing with a major disease and i see obesity and Metabolic Health and they might the same context its ultimately as far as im concerned about how much youre willing to put upon yourself or do yourself in order to protect your own house and the health of the people around you because we know im sure you would agree with me that obesity khans at a huge huge huge cost to decide is it an appropriate comparison. And i agree i think thats a really important point around the fact that you know were all interconnected it was so i mean we know that you know viruses can trouble. Around the world within the space of days 2 weeks you know it and so in fact saying that so many people from all different backgrounds right so were all interconnected in the same way youre absolutely right you know we also have to think about you know for me for example without my work my advocacy i always think about how can i always love my how do i help my individual patient how do i help the population i think about. Because really its it can exit and actually if you know you are going little bit philosophical here but you know for a society to function effectively for people to be you know if you have a good quality of life to have good health to be happy where we are dependent on each other you know we cant really i dont state you can ask people who people can live in to kuhns and there are some people are extremely happy to be connected to a completely isolated rest of the stuff doesnt happen so i think the point youre raising and im sure i agree with is that we have to pull that the good of the community for everybody we have to think about the way we act and whether its about where you masts and falling back guidance all about reducing the burden of of obesity but that means its also all our responsibility to look at the roots of and then thats when you that means speaking out against my Health Misinformation speaking out against the corruption of science you know one of the things i say in the beginning my talks and thats because misinformation house has become so widespread you know on the stocks there was connote longer practice on this medicine you know we have an epidemic of misinformed boxes misinformed patients you know written in so many issues that i think i think he actually put it in even starker terms he has said that more than medicine is that major threat to public how thats a pretty strong statement but lets discuss it after that and very short break we have to take a minute here right now the trailer on the back just a few moments they can. Elgood forward to talking to you all. That technology should work for people. I robot must obey the orders given by human beings except where such orders would conflict with the 1st law show your identification which should be very careful about Artificial Intelligence and the point of use the great transfer of the shia. Areas jumps in with Artificial Intelligence where some of the demons. The robot must protect its own existence is existing. Welcome back to worlds apart with i see my whole track consulting cardiologist and best selling author. Just before the break we were talking about how one of madison has become a major threat to Public Health and im sure its gone i mean some doctor is or some nurses working double shifts in hospitals will take that as a as an offense could he actually reconcile both of the statements our clinicians being heroes who are putting their lives on the line but also serving a system that doesnt have the best interest of patients at heart yeah its a very its an interesting one to reconcile so the way i would start off 1st looks on is i think what medicine that you have many great savings but most. What we do which is the really good stuff in modern medicine is the acute care of the emergency treatments treating people with trauma treating life threatening infections with answered audix treating heart attacks with emergency hot stenting for example something i did for a lot of my career but the big issue in health care now is a management and its chronic diseases and the management of chronic disease is a 1st and foremost primary focus our intervention is drugs and when you look at the data on those drugs im im talking about drugs you know Blood Pressure cholesterol pills im talking about drugs for diabetes you know for the overwhelming majority of these patients being treated it doesnt give them any benefit whatsoever and they come with side effects at the same time were detracting from giving them. Prescribed lifestyle advice so thats where the imbalance is but just to put in perspective for you of us the issue around the pharmaceutical industry influence over guidelines and drug prescribing practices has become such a big issue that one of the cofounders of the very eminent respectable cochrane collaboration pizza goetia his own estimates suggest that the 3rd most screening cause of death after Heart Disease and cancer now is prescribed medications what your prescribe and what your doctor prescribe sphere and he educates about 50 percent of that digges medication to areas and about 50 percent jitsu side effects can i ask you something about Metabolic Diseases that i could never understand. We are usually taught that this is something that you have for your entire lifetime and yet we know it now for a fact that thats a type 2 diabetes hypertension inflammation a 2nd out immune disease all of that is reversible and reversible in a relatively short amount of time why even medicine men taining the small term view all through the disease when its taken from a false and when they actually have the tools to and very cheap tools to give to that patients to you know improve their health in a matter of weeks and months at most ill give you one word answer and then ill expand on that money. I interviewed the former. Of one of the most british guys Impact Medical terms of world medicine masi angel and i wrote about this in a guardian article and she said to me the real battle we have in health care oksana is one of truth versus money so you know basically whats happening is the science is there but that isnt enough you know we have to overcome these vested interests that have got a grip over modern medicine the realities of so i can tell you how the overwhelming majority of doctors go into the profession to do the right thing by their patients a want to help their patients get better but they are being said information which they do not realize is heavily by state in corrupted by the industry and until we change the system at its root it will carry on as it is part of the issue around what why were not weve got this sounds wrong is also lack of knowledge about lifestyle stuff so for example i didnt get to know anything about basic nutrition and how it impacts the metabolic disease so we medical school but that was almost 20 years ago and of course the signs of all the diseases have become more prevalent and now were now realizing with you know small studies lets be honest that you can reverse many of these medical disease with the few weeks i see it with my patients and i think that is going to gather momentum it has to governments and because what weve doing isnt not just working is causing huge damage to Public Health absolutely and i think the doctors and the nurse of the home you mentioned sometimes the price victims of that you relative recently that i think more than half away an h. S. A. Are overweight and these people are now over exerting themselves and missing out on sleep theyre working double shifts theyre probably eating the junk food that has still and that is still being served in british hospitals and im sure in other countries this is jason is not much different its its almost like you know in the system is eating its own here is 1st and foremost. Yeah absolutely so more than 50 percent your right of doctors and nurses in the n. H. S. Are either overweight or obese and that really comes back to the point about the press responsibility issue because you would expect them to be the most educated and be aware of it ok of i the not educated probably more important is the socalled hostile crude environment and you know its similar if not worse than the high street 75 percent of food coaches in hospitals is considered ultra processed or in health state so its not a surprise looks on unfortunately and that also goes again theres an element of lack of knowledge because people have been so this information its about counting calories its about you know and its a balance its about you know it doesnt matter what you eat as long as you exercise enough and some of these people who are overweight a sadly unfortunately i think blaming themselves thinking its because theyre not doing enough exercise when all they need to do is actually just change the what they eat in fact you know im very much center of the frets i said what about say thoughts of detract from the benefits of the lord even look or who is former Shadow Health minister when market sasha was Prime Minister and you know he actually said something which i wrote in my i quoted in my last book he says and of these custom doesnt need to do one iota of exercise in order to lose weight they just need to eat less and the one of the reason the basic reasons for that is we actually you know just by breathing for our organ functions or the blood pumping or on the body for ourselves to function we use a pose lot of energy doing the oxen that we did you know at least 161700 calories just from doing that doesnt mean we should exercise or do some of the activity of course we should both when it comes to weight its all about what you eat. How much it and what exactly it lets talk more about that because one of the things that all is also difficult to grasp is why nutrition has been such an orphan child of medicine because i mean weve known since hippocrates that we are what we eat and yet do these they people are pretending that that calories are calories theyre all. The same is that you can indeed alderaan the poor diet do you also put that on to bastid interest or is it some sort of a i dont know sometim