Dr Ron Ehrlich – The Elephant In The Room

In today’s episode, I am talking about "the elephant in the room". The confusing and often contradictory public health messages. How these are crafted and why. The science in medicine and who or what informs that. Is that always evidence-based? And the positive opportunities out of this pandemic. As I honestly believe we could emerge from this pandemic reflecting on our entire approach to health care and emerge a healthier society, individuals and a society and a planet.


Dr Ron Ehrlich [00:00:12] Hello and welcome to Unstress. My name’s Dr Ron Ehrlich. Well, today’s episode, I’ve called ‘The Elephant in the Room’ and there are a couple of issues that I’m wanting to deal with. I have obviously like everybody on Earth is thinking about this pandemic and about how it’s being handled and where to from here. And let me say right at the beginning, I think the way the Australian government and New Zealand governments have dealt with this very early on, closing the borders, going into lockdown until we knew what it was we were dealing with, we really weren’t sure the projections were that our health system would be overwhelmed. And of course, we weren’t sure really how severe this illness was and how infective, infected or communicable it was. So, I think the way Australia and New Zealand have dealt with this, I think this the figures kind of speak for itself. And of course, the way the community rallied around that early lockdown has been really, I think, fantastic. I’m really proud to be an Australian. And I think the I think the idea of hand washing. Isn’t it interesting that in 2020, given the billions of dollars that have been spent on health care and given how technically advanced we are, the best advice, public health advice we can be given is the advice that changed health in general, and that was wash your hands. And it also included healthy, well, clean water supply and sewerage. But essentially wash your hands is the best advice we can be given. And I agree with that. And also cover your face when you cough or sneeze. Don’t go out into public spaces and soldier on if you have a cold or flu or even worse, the coronavirus. I think these are all good messages. And I think if vaccine let me also be clear that if a vaccine is discovered, that’s perfectly fine. I’m not an anti VAX person at all. I think there are some challenges there. The timelines for vaccines are usually four years for good reason that they need to be shown not only to be effective, but not harmful. And when we reflect on other coronaviruses so we don’t have a vaccine for the flu, we didn’t have one for the HN viruses. The SARS1 virus or the MERS. And with the flu, we need a new vaccine every year, which is probably a great business model. You can only imagine. I mean, I had did hear estimations of the fact that I think vaccines are somewhere between 40 and 60 or 90 billion dollar a year industry. And if we’re talking about a coronavirus vaccine that needs to be given several times a year or repeated every year, one can only imagine mind-bogglingly what is involved there. But I hope we find one. You know, I’m not anti vax, but I wanted to deal today with this topic is the elephant in the room. And the reason I’ve called it the elephant in the room is because there are a couple of things that I think we need to consider. And I’m trying to make sense of the public health messages that are coming out around this virus, because there is, I believe, so much we could do. This is such an incredible opportunity to improve public health because we have a global population focused on healthcare like never before. And I’m you know, there are lots of conspiracy theories going around about how this is all being managed. I look, as you will see, I’m going to cover some of the issues around the science in medicine and how these public health messages are formulated. And I’ve tried to work out. Look, if there is a conspiracy, who would benefit? So many industries are suffering. Governments are suffering. This is an extremely difficult time to be a leader. So, I don’t envy our leaders at all. They’re doing a remarkably good job. But they are listening to public health advice. So, the elephant in the room is what is the science in medicine? And I’m going to cover that today because one thing I have observed and I know many doctors who are would consider to be conventional doctors following the guidelines that are outlined by the authorities, the NHMRC here in Australia, and are practicing what they believe to be evidence-based medicine. And those doctors that may be using primarily their prescription pad, it I know many of those. And I also know many integrative doctors who are practicing nutritional, environmental and integrative medicine and the two things they both have in common. The one. They both groups have in common is in my opinion, they want the best for their patients. So, I think the science in medicine is a topic for a busy health practitioner. That is a story that is very easy to miss. But once you hear it, very difficult to ignore. And I have in my book dealt with this. I’ve been looking at the science in medicine, the influence of industry on health care since 1993. I have been in practice for over 40 years. And I came to that sort of skeptical view of authorities in the mid 80s when I was being told to use mercury in the filling materials. And that kind of alerted me to the fact that, hey, maybe the official messages aren’t as good as they could be. And I struggle with that through the 80s and formulated my own policy. But then in 1993, I started to look at the broader picture of health care in general. And I’m going to share some of those things with you today. So, the elephant in the room is firstly a reflection on a term that we’re becoming more familiar with co morbidities formerly referred to as chronic disease. And most of those are preventable. The second thing I’m going to deal with is the science in medicine and what this evidence-based medicine truly means, because this is what is informing public health policy. And finally, I want to deal with where to from here. How do we deal with this and future pandemics? Because I honestly believe with the global community, governments, authorities, public, industry, all focused on health like never before. This is an amazing opportunity. I believe we could emerge from this pandemic reflecting on our entire approach to health care and emerge a healthier society, individuals and a society and a planet. Who would have thought we could rest the planet, as we have been doing over these last six or so months. So, I’m an optimist. I’m I am. I suffer from chronic over optimism and enthusiasm. And today’s episode is a longer one. You can listen to it just as an audio file. But we are now also doing this on YouTube. And there are some great, I think, some important visuals to share with you here, but it will work as an audio as well. So, let’s push on with the elephant in the room.


[00:07:44] So I wanted to deal with co morbidities, also referred to as chronic disease. The science in medicine and where to from here. So, there are three parts to this. We’re going to chop them up to make them a little bit more digestible. Or you can listen to the whole lot all in one go. But let’s just start with co morbidities. And what do we mean by that? Well, WHO identifies co morbidities. You may be susceptible to COVID19 if you have a non-communicable disease or a pre-existing condition such as high blood pressure, diabetes, heart disease, heart attack or stroke and chronic respiratory disease or cancer. And you’re going to we’re going to touch on each of those in a moment to put them into a broader perspective. But one of the things that has irked me, particularly during this time, is the lack of discussion about immune function. I mean.


[00:08:49] What about immune function? This is something that we hear so little about. And I think we do have an opportunity here to emerge from this pandemic with a global community focused on health like never before, reflecting on life like never before and familiar with the word co morbidity and focused on its implications like never before. And I think it kind of highlights the way we approach health care in our society. And that’s partly what I’m covering today. But what about immune function? Because in all of the discussions or all of the newspaper reporting, it’s just a question that is hardly even dealt with. I mean, I’ve been looking for some articles in the newspapers about immune function because that’s something that is really empowering. As individuals. We can do something about this and ensure that we don’t contract the complications of COVID19 or even worse, die from it. Healthy people do not die from this disease. So, what about immune function? Well, the only thing I’ve been able to find is an article some months ago when Bill Gates Foundation donated ten million dollars to an Australian vaccine trial and the trial looked at the BCG vaccine because they recognised that the trial is testing an immune boosting vaccine typically used against tuberculosis called BCG. And why? Because over the last decade, we’ve learnt that BCG vaccine seems to enhance the first part of the immune system, making our initial response faster and stronger. We’re trialing it to see if it has an effect, this effect on the coronavirus. Well, if it improves the first enhances the first part of the immune system, that is a really positive thing. And BCG vaccine is most certainly not the only thing that can do that. But honestly, this was the only thing I’ve read in the popular press that I’m looking at that even mentions immune function. And it’s mentioned in the context of a 10-billion-dollar donation to see whether a pharmaceutical product like BCG can be used. I mean, I think we can do better now. Recently in a family discussion, I was pointed to a government website by one of my family who said, isn’t it great that we’ve got an Australian government website that we can rely on? And they pointed me to this website called Health Direct. And the by-line goes free Australian advice you can count on. And the question that it asks are, can you boost your immune system against the coronavirus, COVID19? Now, that is a really important question. And I was very keen to read what the official government advice was, because this is the science in medicine. This is what is informing public health policy. So, I wanted a little bit of an insight, because let me be quite clear. I think the way the government has approached this has been fantastic. I mean, early on to lock down in the way the community back them up. That was really excellent. And we didn’t know what we were dealing with. So good on good on them and good on us. And I and I think in Australia and New Zealand and all the federal and state governments have done an incredible job, number one. Number two, I think the whole idea of hand washing is a very important one. And it’s interesting that after 150 years of medical research and literally billions and trillions of dollars spent on various medical advances in 2020, when confronted with a virus, we the best we could come up with was to wash your hands, which I think is good advice. The other advice was to cover your mouth if you cough or sneeze and if you are in. If you’re not feeling well, don’t go to work. Don’t get on public transport. Don’t go into a public space and don’t go to work. I think that’s all really positive advice and social isolation. Well, physical isolation, I guess, is the way I’d prefer to call it, but it is socially isolating. Okay. You know, we have to we’re living in a real world and there are all sorts of complications with that advice. But here is a question that I think we should all be asking and dealing with. Can you boost your immune system against the coronavirus? Now, the site identifies a major problem that we’re all facing. Many Australians are anxious and stressed about the Coronavirus. COVID19. You might feel a little powerless, but there are a few things you can do to. Help strengthen your immune system and help protect yourself from the many types of viruses, not just the corona virus, many types of viruses, because that’s what an immune system does. None of them involve a hazmat suit. Now, I want to put a plug in here for the Australasian College of Nutritional and Environmental Medicine, because in May and June of this year, for eight weeks, the college put on an online global conference called “Environmental and Viral Disruptors Rising to the challenge, reducing the risk and future proofing humanity”. So, we had seven, eight weeks of content and it fell into the category of personal inner environment, personal environment, home and work environment and global environment and all of those environments impact on the immune function. And what we were suggesting was that by dealing with them, you would reduce the risk and future proof yourself against this and future pandemics. So, the information is out there. Over 70 presentations. And I think you can still access that on the acnem.org site. But I digress. Back to the health direct site. There is the address www.healthdirect.gov.au. “We are a government funded service providing quality approved health information and advice”. It’s federal government. It’s the ACT, the New South Wales, Northern Territory, South Australia, Tasmania and Western Australia.


Dr Ron Ehrlich [00:15:23] I’m not quite sure why Victoria isn’t there, but there it is. It’s free health advice. You can trust. Health Direct information and advice are developed, developed and managed with a rigorous clinical governance framework. And. And. This website is certified on the Health on the Net Foundation. So presumably this Web site, this advice is the same as the advice that the government is being given in the lockdown. And that’s what disturbs me about this is you’ll see and I’ll share this with you. So back to this. Many Australians are feeling anxious. Yes, they are. Do vitamin pills protect you from the Corona virus? This concern me a little bit. No, I’ll come back to this. The other piece of advice was get more sleep. And to anybody that listens to my podcast, you will know or read my book that sleep is the most important part of your day and your entire immune system is affected by a consistently good night’s sleep. So, I totally support that piece of advice. Clean your phone. I mean, washing your hands regularly with plenty of soap and water for at least 20 seconds or using an alcohol-based hand rub if soap is unavailable is the best way to protect yourself from COVID19. And they’re also suggesting that you clean your phone. So, there it is. And they also provide you with links, quite rightly, to mental health support, because this is extremely challenging for many people in our community. But I want to come back to this. Which is do vitamin pills protect you from the corona virus? Because this really is something that I do know about. And this really is something that every doctor and health practitioner who has studied their undergraduate degrees knows about. So, let’s look at the question. Do they do they protect you? How do they improve immune function?


Dr Ron Ehrlich [00:17:22] And they quite categorically say, no, it’s much better to get all the nutrients you need for a strong immune system from a balanced diet. Now, I totally agree with that. The problem is the word balance diet is very hard to find in our modern world. And you really need to be very diligent to achieve a nutrient-dense, balanced diet. Okay. They go on with a couple of exceptions, folic acid for pregnant women, for example, and they finish by saying “most healthy people do not need to use expensive supplements”. Now, most healthy people. I wish we had more healthy people than we do. But as you will see, comorbidities and chronic disease are a major problem in our society and not just for the elderly, for young and old alike. So, a balanced diet and healthy people are a great idea, but not all that common. And while people do dismiss supplements as just some people dismiss it as you just getting expensive urine, as Ross Walker in an episode just a week or a few weeks ago said, it may be expensive urine, but it’s also expensive blood. Then the second paragraph is what really disturbs me. Social media has been infiltrated by claims that megadoses of vitamin supplements such as intravenous vitamin C can treat the flu like symptoms of COVID19. But there is no evidence to back this up. Consuming high doses of certain supplements such as A and vitamin D can in fact be toxic. Now, I have a few problems with this. The flu like symptoms of COVID19 are things like sepsis, pneumonia, a cytokine storm. You may have heard that, but they are basically inflammatory chemicals that the body produces in in response to a real assault, to the system, to the body. So, these are the flu like symptoms of COVID19. And to say there is no evidence to back this up, well, I’m going to share with you the evidence that there is. And then to focus on the toxic effects of vitamin A or D, I mean, you have to take absolutely ridiculously high doses for that. And far more commonly, as you will see, not from social media, but from refereed journals is vitamin D deficiency. It’s really wide spread. The final chapter says vitamin C is water soluble, which means it’s not lethal. But if you consume more than your body can store it simply removed via the urine. So excess vitamin C literally goes down the toilet. So, it pretty summarily dismisses nutritional medicine right there in three sentences. And what disturbs me is social media has been infiltrated by claims that megadoses. Look, let me share with you this. For example, the Journal of Pharmacology Therapeutics in 2018 gave an article which was titled Vitamin C for the Treatment of Sepsis, which is one of the complications of the flu like symptoms of COVID19. The scientific rationale “in experimental Sepsis models, intravenous vitamin C reduces organ injury and improves survival. In addition, emerging evidence suggests that the combination of vitamin C corticosteroids, which is dexamethasone”, you may have heard of that. And Thiamine, which is a B group vitamin, may act synergistically to reverse sepsis induced organ dysfunction, which is one of the complications of coronavirus. These findings are supported by recent observational studies, and randomised control trials are underway to investigate this novel approach to the treatment of sepsis. So, there are so many studies that have been done over many years. Here’s another one via intravenous vitamin C for the reduction of cytokines storms in acute respiratory distress syndrome. One of the complications of corona virus, not social media in the Journal of Pharmacology and Nutrition. Here we review the effects of I.V. Vitamin C on the immune system response. The antiviral properties of I.V. Vitamin C, which are quite well known. And finally, the antioxidant properties of I.V. Vitamin C to specifically address the cytokine storms characteristic of the acute respiratory distress syndrome that occur in the latest stages of COVID9 infectious diseases. Again, journal, not social media. Here’s a 2012 article from the Clinical Endocrinology Journal, an update on vitamin D and human immunity. They’re not talking about vitamin D toxicity. They’re saying that the non-skeletal function of vitamin D because a lot of people think vitamin D is only needed for healthy bones, but it’s implicated in absolutely every aspect of our immune system and our response to chronic disease. It is the non-skeletal function of vitamin C that has attracted most attention for pluripotent responses to vitamin D may, meaning the many responses to vitamin D have been recognised for many years. Our new perspective on non-classical vitamin D function stems from two more important recent concepts. The first is impaired. Vitamin D status is common. Impaired vitamin D status is common to many populations across the globe. So, vitamin D deficiencies is really common across the world. This has been this has prompted studies to explore the him the health impact of suboptimal circulating levels of vitamin D with association studies linking vitamin D insufficiency to several chronic health problems, including autoimmune cardiovascular disease, hypertension and common cancer. 2012 article in the Journal of Clinical Endocrinology, Not Social Media. 2013 article in the Journal of called Nutrients Vitamin D and immune function in vivo data from animals and from human vitamin D supplementation studies have shown beneficial effects of vitamin D on immune function. I mean, really, this is not social media and this is what disturbs me about the science in medicine for informing public health policy. Here’s another one, 2018 and Endocrine Connection Journal. The prevalence of vitamin D deficiencies in intensive care units ranges typically from 40 to 70 per cent. So that’s probably not unlike what is happening out in the population, to be honest. But certainly in. I see ICU units, intensive care units between 40 to 70 per cent of people admitted are deficient in vitamin C, and many observational studies have consistently showed an association between low vitamin D levels and poor clinical outcomes in critically ill patients. Adults and children, including excess mortality and morbidity in such as acute kidney injury, injury, acute respiratory failure, duration and mechanical ventilation and sepsis. This is a 2018 study. This isn’t.


Dr Ron Ehrlich [00:24:57] You might have thought they were talking about Coronavirus here. This was 2018 and a more recent one confirming vitamin D deficiencies and comorbidities in COVID19 patients, a fatal relationship. So, you know, this is this is a real issue. And there are just so many other articles coming out, one just recently, which showed that vitamin D, the vitamin D endocrine system, because it’s part of a whole it’s a really important vitamin. Vitamin D may have a variety of actions on cells and tissues involved in COVID19 progression. Administration of vitamin D to hospitalised COVID19 patients significantly reduce their need for intensive care unit admission.


Dr Ron Ehrlich [00:25:45] It’s also seems to reduce the severity of the disease. And there are lists of, you know, for those that are watching this on YouTube and you want to explore it, or you could visit the site orthomolecular.org and browse over 40 years of articles free of charge. So, this is hardly new breakthrough medicine, the medicine behind the use of vitamins to support immune function, supplements. They’re called supplements because they supplement a healthy diet, hopefully in patients that aren’t that are immune compromised. And this isn’t news. I mean, chronic disease as chronic diseases are largely preventable and they result in billions of dollars of potentially avoidable health care spending, not to mention the untold personal costs. That’s a quote out of the World Health Organisation, 2006. 70% of deaths in our modern world occur from preventable chronic diseases or comorbidities. Autoimmune conditions are the body attacking itself used to be thought of as being 60 or 70. But more recently, there are being there’ve been identified about 100 autoimmune conditions, the third most common type of disease in the United States. And one of the leading causes of death in women over the age of 65. So how are we doing? Generally speaking, putting aside the virus. Heart disease, still the number one killer, as you will have heard from Ross Walker in a recent episode, he quoted a figure of 17 million I am going to show you a slightly higher one.


Dr Ron Ehrlich [00:27:25] But he made the point that, well, heart disease is still the number one killer. Cancer coming in a close second to auto immune, as we said, is third and diabetes number four and obesity number five. These are the big health conditions. But in between two and three, it’s worth mentioning that medications taken as directed are the third biggest killer, actually, of people in the Western world. So, let’s just look at this. Look, I’m recording this on the fourth of September. So, this was the article that I got from the paper today. Eight hundred sixty-eight thousand people have died globally, accounting for about three and a half thousand deaths per day. Now, that is shocking. That is shocking. It’s frightening. But we are more focused on these deaths per day than we ever have been. So, it might be interesting to reflect on what about the other diseases?


Dr Ron Ehrlich [00:28:20] Because cardiovascular disease accounts for 19 million deaths per year, which equates to a rather shocking 52000 deaths per day from cardiovascular disease. In fact, Ross Walker made the point that one every 12 minutes in Australia, somebody dies of heart disease. And in Australia, in Victoria, for example, they usually experience on a typical day about 114 deaths per day or round about three or four of those or more recently, maybe up to five or 10 have been from COVID19.


Dr Ron Ehrlich [00:28:59] But interestingly, in in Victoria at the moment, I think they’ve had about 700 deaths so far this year, but they’ve had 11 typically in any typical year in Victoria, 11000 people die in Victoria alone of cardiovascular disease. And. And they also about 10000 die every year in Victoria from cancer. So, these co morbidities. Cancer, 10 million deaths per year, which equates to 27400 deaths per day. Rather, confronting these figures when we’re used to looking at these daily death rates. Imagine that. Diabetes. This is from the International Diabetes Federation. Diabetes, 4.2million deaths per year, which is 11,500 deaths per day. Quite shocking. And here we are on the fourth of September at this point there have been 737 deaths in Australia, 26000 cases since March.


Dr Ron Ehrlich [00:30:04] So this is basically over the last six months. So, you could maybe double that, I guess maybe for a 12-month period. But just to put it in perspective, and this comes from the influenza special group ISG.org.au. And last year, influenza resulted in 300,000 GP consultations, 18,000 hospitalisations, and between 1500- 3000 deaths occur per year. Now, it’s worth mentioning that while those deaths from COVID appear to be lower. Remember, we have socially isolated. So, one can only imagine how high they would have been if we had treated this like the influenza. I mean, there’s no doubt this is more virulent. But, you know, let’s put it in perspective. There are other deaths that are occurring. It’s worth taking a step back and looking at our health system, because let’s face it, if you’re faced with a crisis, there is no better place to be. I think we have and Ross Walker also said this. One of the best health systems in the world, because it doesn’t matter how rich or poor you are, you will have access to medical treatment. And that, I believe, is a very important basic human right. And I have had the benefit of crisis therapy in my own life, in my family’s life. And I continue. I am eternally grateful to those superb workers at the frontline that provide us with crisis therapy. Part of the problem, though, with our healthcare system is that it’s become a chronic disease management system. And because of the long-time lines of heart disease and cancer and diabetes and autoimmune conditions, I believe this chronic disease management system is a great economic model, but it’s just not a very good health model. And you can hide behind that approach to medicine in chronic disease management. But when it comes to a pandemic, then it starts to expose the weaknesses in the system. I believe we should be looking at the chronic disease causes and focusing on health and wellness to build immune function. This is an amazing opportunity. Now, you know, one of the things that people say is, well, the reason we have so many chronic diseases been because people are getting older. And even when you allow for the increase in life expectancy since the war on cancer has been introduced in 1975 or in the early 70s by Nixon, President Nixon.


Dr Ron Ehrlich [00:32:37] The rate of cancer has gone up somewhere between 25 and 30 per cent, allowing for that correcting for that increase in life expectancy. So, you know, cancer rates have gone up, allowing for the increase in age. But what about kids? Because kids aren’t getting older and kids are the canaries in the coal mine. So how is our kids’ health going? And that picture isn’t particularly good. I mean, here, for example, we have one in four children have asthma. Well, one in three have allergies. One in 10 have ADHD, which is rather amazing. One in 10 have ADHD. And in autism, one in 63 Australian children have autism. And when we look back to 1975, that was one in 1000, 5000. In 1985, it was one in 2500 and in parts of America. And this article is from America. In 2013, that figure had already reached one in 50. So, something is seriously going on and not to mention childhood cancer going up, particularly brain cancers that used to be just blood cancers. But now brain cancers are going up. Diabetes used to be called late onset diabetes type 2 diabetes. Insulin resistance used to be called late onset. But even kids are suffering from type two diabetes. Obesity has gone through the roof.


Dr Ron Ehrlich [00:34:07] We did a programme with Jodie Lowinger and Jeff and the Sydney Anxiety Clinic, and she said that one in four or one in five kids have been diagnosed under the age of 18, diagnosed with anxiety and depression. And that was before this current virus. So, this is a serious problem in our health. Something seriously is going on with our health. Even putting aside this virus and the cost of health care has gone through the roof. In 2010, we were spending about 130 billion dollars on health in Australia and health care that jumped to 185 billion dollars by 2017 and 18. And there was interestingly, there was a study done on absenteeism in Australia. This was a 2018 study which put a figure of 44 billion dollars, the cost of absenteeism or presenteeism. We show up to work, but we’re not really there. So, there’s a whole lot of costs involved. So, when you take 185 billion dollars, which was the 2018 figure and the 44 billion dollars, which was the absentee and presenteeism figure, up to 230 million dollars. And I know we’ve been quoted a figure of somewhere between 189 and 130 billion dollars in additional costs for this Corona virus. You know, we have to start really reflecting on is this system of healthcare working well for us or could we actually be improving our health? And that’s what my podcast is about. That’s what my book is about. And that’s what this podcast is about. And this is why I’ve called this particular episode The Elephant in the Room.


Dr Ron Ehrlich [00:35:47] Does spending money mean better health? Well, look at America. They spend 18 per cent of their GDP. We spend about nine to 10 per cent of our GDP. They spend almost double of that. And their health is really quite appalling. I mean, this was a Bloomberg study done of before the virus of the healthiest countries in 2019. And interestingly, Spain and Italy were number one and two. And it be interesting to see where they are now. Excuse me, Australia comes in at number seven, and I would suggest we probably moved right up the ratings there. But America, our NE and so will New Zealand. They will move up the rating because they were listed a number 18. But America spending double what we spend. In fact, they spend twice as much as almost any other country on health. They come in at number 35, just below Costa Rica, Chile and Estonia, but just above Bahrain and Qatar.


Dr Ron Ehrlich [00:36:48] So spending more on healthcare may not be the answer. I just dropped this in to mention that we hear a lot about debt, but I think we’re going to be hearing a lot about, you know, this other way of looking at the economy called modern monetary theory. A little bit of a butterfly moment there. But to modern monetary theory is takes a very different view of debt. I mean, I think we should. I’m not an economist, but I used to play Monopoly as a kid. And I think printing more money. There’s nothing wrong with that. Provided inflation doesn’t go through the roof. You control inflation. If you have a sovereign currency, printing money makes sense. And modern monetary theory is something you’re going to be hearing a lot about. I believe, as opposed to neo liberalist or a market driven economy where people are so preoccupied with debt, they think they’re managing their own budget or a household budget or a or a corporate budget. And they are very different from managing a global… A country’s budget. And the difference between being a currency user like you and I are and a currency issuer, which is what our Australian government is, is a very different thing. And I think we’re going to be hearing a lot more about modern monetary theory. I think we need to spend more on socially important projects. Education being one. Public transport being another. Community support being another. We need to be looking after people. But I digress. So, the elephant in the room. Okay, that’s a discussion about chronic disease and health care and where we’re at this moment. So that’s an opportunity for me. Just to pause for a moment, and if you wanted to continue on, let’s look at the second part of this discussion about elephant in the room, because this is about in this part, I want to deal with the science in medicine. And I do believe that we have an opportunity.


Dr Ron Ehrlich [00:39:03] I do believe this is an incredible opportunity. I mean, we’re in an incredible period of global reflection, which is painful as any period of reflection is, but it’s also an opportunity to make some major changes to our lives.


Dr Ron Ehrlich [00:39:21] I mean, I think some of the carry overs of this pandemic are going to be positive, and that is we’ve legitimised working more from home. We’ve legitimised the fact that we don’t. I used to hop on a plane and go down to Melbourne for meetings, for board meetings, for the Australasian College of Nutritional Environmental Medicine. And I hated doing that.


Dr Ron Ehrlich [00:39:42] But I went down and I realise now having meetings on Zoom is a perfectly legitimate way of holding meetings. Face to face contact is important. I’m not saying it’s not, but I think what we’ve done is we’ve been on a very steep learning curve about using this kind of technology. So now in this period of global reflection, what an opportunity to improve, improve our health.


Dr Ron Ehrlich [00:40:07] Look at all those chronic diseases that are largely preventable. Why not focus on how to prevent them? And that’s why I wanted to focus on this science in medicine, because I’m concerned. That’s why I was concerned in these co morbidity discussion about what was informing public health policy and the science in medicine informs public health policy.


Dr Ron Ehrlich [00:40:31] And this is a story that is very easy to miss. But once you hear it, is very difficult to ignore. Let me share with you what I’m talking about, the science in medicine. Now, most doctors are focused on disease. The study of pathology, which leads them to the study of clinical pharmacology, the how to use medications. If that doesn’t work, then surgery is the next option, particularly if you have cancer, maybe or if you. Well, there are so many reasons for care for surgery. But there we go.


Dr Ron Ehrlich [00:41:07] And also, radiotherapy is important. This is essentially the tool box of modern medicine. The science in medicine. Now, in addition, obviously, you need to know about endocrinology, how the body balances itself and maintains homeostasis and immunology.


Dr Ron Ehrlich [00:41:25] Very important. And chemotherapy in cancer. Obviously important and probably one of the most exciting areas of cancer. Ironically, I believe, is cancer immunotherapy principles and practice. Now, this is interesting because what cancer therapies are realising is that if they can harness the immune system rather than use the shotgun approach of chemotherapy, which destroys everything, including often the immune system, then maybe we’ll get a better result. And I think that’s an interesting metaphor for how we should be approaching disease. But cancer immunotherapy is one of the most exciting emerging therapies in the science of medicine. And, of course, the tool box for the science and medicine is the prescription pad. And it’s important to understand how drugs interact with one another. So, the doctor’s companion of Mims is there at their disposal.


Dr Ron Ehrlich [00:42:25] So that is what is essentially conventional medicine. The science in medicine. But I would argue that there is much more to the science in medicine and that more is our undergraduate study now. All undergraduate doctors, dentists, health practitioners studied anatomy and physiology. That’s basic. Histology is the study of cells because our body is made up of 40 or 50 trillion cells. So, it’s important to know about cells. And if you know about cells, you need to know what goes on inside a cell. And so that is the study of biochemistry. And of course, microbiology was always studied in the context of disease. But we now know in the last 10, 15 years, we now know that an important out there are almost 10 times more bacteria in our body than there are human cells. So, if we’re going to study histology and biochemistry, we should also study the microbiome. And that is something that has is a very important part of our immune system. So, this is also the science in medicine. But unfortunately, I don’t think it gets enough airtime. In fact, I think most health practitioners and I include myself in this when I graduated, I couldn’t wait to forget about biochemistry, histology, you know, because it was so complicated and I was so solution orientated. And a prescription pad provide you with a simple practice management tool and a simple solution. Often. There are complications, but it appears to be simple and you appear to be doing something good. But this is what the study of nutritional and environmental medicine is all about.


Dr Ron Ehrlich [00:44:11] And biochemistry is a complex issue. You know, now people may have heard about a keto, ketogenesis and all of that. And that’s great because it’s all part of biochemistry. And so, you know, you study about how energy is produced. You study about how energy comes from proteins, how fats are synthesised lipogenesis, ketogenesis and what goes on inside of mitochondria. How ATP is produced. Why you need vitamins to make these biochemical pathways work. There is just so many complex reasons. And if you’re watching this on the YouTube clip, you’re getting a little bit of a taste why most doctors and health practitioners can’t wait to forget about biochemistry and don’t include it in the science of medicine.


Dr Ron Ehrlich [00:45:02] But it is… It is an integral part of the science in medicine. So that’s something that I just wanted to share with you, because it’s much more than biochemistry. It’s much more than the use of a prescription pad.


Dr Ron Ehrlich [00:45:16] And there is a problem with evidence-based medicine, too, because the gold standard of evidence-based medicine is the randomised double blind controlled study. And the and then you take all of those studies and you average them all out. And that’s called a meta-analysis. Now, a randomised controlled study is a wonderful way of showing whether a drug is better than a sugar pill or maybe a drug is better than another drug. But when you’re getting into the real world, randomised control studies is quite a challenge. So, the science of medicine. Well, I’ve been exploring the story.


Dr Ron Ehrlich [00:45:50] When I stumbled upon a book in 1993 called Dirty Medicine, it was written by an investigative journalist, Martin J Walker. And the by-line of the book tells you a lot. In fact, the by-line. So, I’m going to share with you a couple of books that I’ve read on this journey Dirty Medicine, Science, Big Business and the Assault on Natural Healthcare. When I read this book in 1993, it alerted me to something that I was never aware of because I just naively assumed that when things were printed in a in a journal, they’d all been checked and everything was fine. And this was what evidence-based medicine was all about.


Dr Ron Ehrlich [00:46:28] So in 1993, which God can I believe it is, 27 years ago, I started to explore this issue about dirty medicine and how big business affects health care and there was an assault on natural healthcare, because when you get into natural healthcare, you can’t patent and sell these products. And so, these products may make sense, but they don’t make dollars. So, there was one of the first books that I read and that began a journey. And here was another book I read following on from that in 1995 by another investigative journalist, John Archer, called Bad Medicine. How safe is modern medicine? Is this healthcare system letting you down? So, this is why in the first part of my book that I wrote myself “A Life Less Stressed”, I spend the first part of the book exploring this very theme, and I’m sharing it with you because I found it empowering and it’s important. It’s a story that is as a health practitioner. It’s most certainly a story that’s easy to miss. But once you hear it difficult to ignore. As a member of the public, it’s definitely a story that’s easy to miss. And you, I believe, could emerge from this empowered. And I’ll share with you why in a moment. But I move on in 1995. This book was written by a lecturer and an Emeritus Professor of surgery, Miles Little, called “Humane Medicine: A leading surgeon examines what doctors do, what their patients expect from them and how those expectations are not being met”. And the observation he made in 1995 was that human variation and the inability to achieve total control of variance variables make the criteria far too stringent for most medical and particularly clinical everyday research. And let me give you just one example now. If you go back and listen to the wonderful podcast I did with Fred, Professor Fred Provenza, he said something to me which highlights this very issue. And I draw on the humbled Strawberry here because he said the humble strawberry has 5000 active ingredients, most of them we don’t even know what they do. We know it contains some vitamins. We know it contains some Phyto nutrients. We know it contains some fiber, but 5000 active ingredients. How do you do a randomised control study on the effect of a strawberry? Because that is affected by the soil in which it’s grown by the chemicals that are used, et cetera, et cetera. So, you’re getting some sense here of what the challenges of a randomised control study are. And when you look at the human body and you add it to our modern world, varying, controlling one thing at a time for any length of time becomes a major problem. So, this is one of the shortcomings of the gold standard of evidence-based medicine. And I’m clearly not the only one thinking this. So here was another book in 1998 written by assistant professor in NHMRC, Professor Raymond Moynihan. In 1998, he was investigative journalist. At the time, he’s now assistant professor at Bond University. “Too Much Medicine”, 1998. “The Business of Health and its risk for you”. The Science in Medicine. And in 2002. It’s not just the pharmaceutical industry, it’s the food industry. And this book by Marion Nestle, Nestlé. Interesting that it’s yes, it’s spelt exactly the same way as Nestlé, but she wrote a really important book called “Food Politics and How the Food Industry Influences Nutrition and Health”. If you’re thinking about why public health messages are so confusing, that’s why this story of the science in medicine is so important now that a New England Journal of Medicine is one of the most prestigious journals in them in evidence-based medicine. It’s been around since the 1830s. And so, when the Journal editor now Marzia Angle was the Journal, the editor of the New England Journal of Medicine for 20 years, and she wrote an editorial which ended up losing. She lost her job for. And then she went and wrote a book which I read in 2004 called “The Truth about Drug Companies, How They Deceive Us and What to Do About It”. This is the editor of one of the most prestigious journals in the world writing this book. And this addresses this issue as well. Now, one of the most respected scientists in the world is Professor John Ioannidis. And he writes, in 2005, he wrote an article “why most published research findings are false. Now, I just want to put this guy’s opinion into perspective. If you are a medical researcher and you get cited, if you there called citations, if your article is referenced, that is considered a real accolade for you, and if you get two or 300 or even of 1000 or 2000 citations, you’ve done really well. It’s sobering to know that this man, John Ioannidis has had over 250,000 citations. So, when this guy says something, I think it’s worth listening to. Respected. He’s a professor of statistics, professor of medicine at Stanford University. So, what he said was simulations show that most study designs and settings it is in research are a claim. Now, simulations show that for most study designs and settings, it is more likely for research claimed to be false than true.


Dr Ron Ehrlich [00:52:29] Now, that is quite a sobering statement when evidence-based medicine is held up by the science in medicine as being the gold standard. He goes on to make many points about why that might be the case. But probably the most important is when there is greater financial and other interest and prejudice it will compromise and make the research finding less likely to be true. Now, that’s an important point. Now, in 2006, going back to the food industry, this book was another book I read. So, this is a kind of a sharing with you some of my favourite books. Well, these are books that I have been reading over the last 25 years that have informed my attitude to this. And this book is called “Appetite for Profit: How the Food Industry Undermines Our Health and How to Fight Back”. And I’ll share with you how they do that. But here’s another one. In 2006, Professor Ray Moynihan comes back and writes, “Selling Sickness”, how the world’s biggest pharmaceutical companies are turning us all into patients. And he gives the example of how when the cholesterol levels are set, then a panel is formed in the FDA, for example, in the Food and Drug Administration in America. And he made the point that and I’ve noted that since I’ve kept all of my blood tests, so cholesterol norms have come down 20, 30 years ago, a normal cholesterol level was six. Now anything above 4.5 is considered a problem. How did that happen? Well, they form a panel to decide that. And in 2001, of the 10 people on the panel, about seven of them were from drug companies, were representatives of drug companies and then the company there. The panel reformed in 2004. And at that point, every member of the panel was a representative of the drug companies. And actually, the chairman of the panel was connected to about 10 different drug companies. And so, this is how the world’s biggest pharmaceutical companies are turning us all into patients. They don’t go off and advertise, although they do that, they engage thought leaders to influence regulatory bodies that impact on government policy, which is relevant to what is going on today, I believe. And this is why I’m dealing with the science in medicine. Another book came out of Harvard Medical School. John Abramson “Overdosed America: The broken promise of American medicine”, revisiting the fact that America spends more on health care than any other country. And actually, with only five per cent of the world’s population, America consumes two thirds of its psychotropic drugs, anti-depressants, antianxiety medication. So, this is 2008. This is now 12 years old, but “Overdosed America”. So, this is another book. And then this book in 2010 called “Wrong: Why Experts Keep Failing Us and How to Know When Not to Trust Them”. It goes on. And here’s 2010 “Bad Medicine” from British epidemiologist Ben Goldacre, who talks about quacks, hacks and big pharma flacks. And he lobs into nutritional medicine and some of the things that are wrong with nutritional and environmental medicine, science certainly, and are holding it up to be the gold standard of everything. I’m just saying perhaps we need to go back and study our biochemistry, anatomy and physiology. He went on to write this book in 2012 called “Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients” and makes a very important point that if now pharmaceutical companies spend about 75 percent of medical research is funded by the drug companies. So that’s an important statistic. And that relates back to John Ioannidis point about when companies when there’s a financial interest, then then this is affects outcomes. And Ben Goldacre makes the point here that the problem with drug companies spending so much is they are not compelled to release all of their research. So, if they do 10 studies about a drug and eight of them are negative and 2 are positive, they’re not compelled to release the eight negative studies. They can just ignore them and only publish the two that were positive. And in fact, he quotes a Harvard study which looked which looked at statins and said when they looked at the effectiveness on statins in reducing death rates. They found that industry study sponsored studies were 20 times more positive than independent studies. This was for cholesterol lowering drugs, statins. A Harvard study. And they did another study on anti-depressants and found that they were four times more positive when funded by drug companies as to their effectiveness than independent studies. So that prompted him to start the “All Trials” initiative and the “All Trials” campaign, all trials.net is a campaign to force all drug, all trials to be published and made public. And there are over 750 signatories to this. You know, this petition signed the petition, and I’m very proud of the fact that ACNEM, the Australasian College of Nutritional Environmental Medicine is one of those organizations. It’s quite a sobering to go onto that site and check out who has and who hasn’t signed them. And unfortunately, I don’t see the AMA, the NH and MRC, the RCGP or the Friends of Science in Medicine as signatories there. But I could be wrong, but that is a very important initiative. But this book was another excellent book and an excellent read. And doctors and regular regulators need the results of clinical trials to make informed decisions about treatments. But companies and researchers can withhold the results of clinical trials even when asked for them the best available evidence shows that about half of all clinical trials have never been published, and trials with negative results about a treatment are much more likely to be brushed under the carpet. This is the science in medicine.


Dr Ron Ehrlich [00:58:54] Now, to overcome the problems of some of the evidence-based problem of evidence-based medicine, there was an initiative formed in the I think it was the early 90s called the Cochrane Collaboration and one of the founders. There were many founders of that collaboration, but it brought together what they believed to be really much better-quality studies, although I have to say they didn’t give them a rating as to who paid for the study or not. And I’m sure that’s a shame because I think they should. For example, if a drug company pays for a study, it should be given far less weight than if an independent study is done. But I digress. Peter Gotzsche, Professor Peter Gotzsche, one of the co-founders of the Cochrane Collaboration, wrote a book. And I think the heading of the book is sobering in itself and so is the by-line. But here is the heading of the book written in 2013. “Deadly Medicines and Organised Crime: how Big Pharma Has Corrupted Healthcare?” One of the co-founders of the Cochrane Collaboration writes a book like this and I think that speaks volumes for the science in medicine. And this is disturbing. In this day and age, to hear these kinds of things. And when you look in up and you see this is something you don’t hear often enough about. But drug companies are fined, regularly fined, and it is a multi-million-dollar billion-dollar business, pharmaceutical. So, these fines are just considered, I guess, marketing expenses. Well, you know, the 10 biggest fines in history, the 10th biggest fine was 760 million dollars, 762 million US dollars for illegal marketing of various drugs.


Dr Ron Ehrlich [01:00:49] Another 775 million dollars by Bayer, the owner of Monsanto and Johnson and Johnson, who made that mesh that was put into the pelvic floor of many women here in 2019. They weren’t fined for that. They were fined for downplaying the risks of a drug that included some of the risks, included internal bleeding, stroke and death. They downplayed those risks and they got fined 770 million dollars for it. Tap Pharmaceuticals in 2000 got fined 875 million dollars. They pleaded guilty for false price and fraudulent marketing practices for a prostate cancer drug. Vioxx, of course, was a very famous one. And Merck got fined 750 million dollars. Eli Lilly got fines, 1.4 Billion dollars for Zyprexa because they misbranded this antipsychotic drug for the treatment of dementia and Alzheimer’s patients. Another fine of Abbott Laboratories, 1.5 Billion dollars. And then Johnson and Johnson unperturbed in 2013, being fined 2.2 Billion dollars. You know, like you go back and you look in the Johnson and Johnson were fined 2.2 billion dollars in 2013. Quite unperturbed by that. Oh, yeah. We’ll pick up another 775 million dollars fine. No problem at all. That’s part of the marketing. Pfizer, an interesting company, the makers of Lipitor, which have sold that drug alone, has sold 120 billion dollars’ worth of sales. So, you can put this fine of 2.3 Billion dollars in perspective because they were found criminal and civil liabilities for illegal promotion of their pharmaceutical products. That wasn’t the biggest fine. The next biggest fine was in 2015 for 2.4 Billion dollars for a diabetes drug and Paxil Glaxo SmithKline. Now, I’m mentioning these names because you’ll see they’ll crop up in a minute. In another area. But they were fined the biggest fine of all time in 2012 was for 3 billion dollars. And they misbranded unlawfully promoted certain prescription drugs such as Paxil, which is an antidepressant drug, and Avandia, which is a diabetes drug. And unfortunately, they knew about this Avandia drug. They knew that I think something like 20 percent of people died and 50 per cent had cardiovascular disease. They knew about that a year before they took it off the market. So that’s why they got fined 3 billion dollars. So, I’m just making the point that the people that are paying for the majority of medical research have been taken to task and books have been written about this.


Dr Ron Ehrlich [01:03:44] And this is the science in medicine. This is the story that is easy to miss and difficult to ignore. Once you hear it. And institutional corruption of pharmaceuticals and the myth of safe and effective drugs is covered by the Harvard University School of Ethics. So, this is not just Ron Ehrlich ranting on. This is what is going on out there in the real world. And back comes John Ioannidis in 2016 with the report to David Sackett, the founder of the Cochrane Collaboration and in the Journal of Clinical Epidemiology. You’ve heard the word epidemiology a lot in this virus. “Evidence based medicine has been hijacked. A report to David Sackett. This was 2016 article and he wrote, “Meta-analysis and guidelines have become a factory, mostly also serving vested interest. National and federal research funds are funneled almost exclusively to research with little relevance to health outcomes.”


Dr Ron Ehrlich [01:04:49] Now, I’m. This is why I’ve called this elephant in the room. This is why I’ve just I lie in bed and I think, honestly, I shouldn’t sleep. The most important part of the day, you’d think I’d know better. But I know these things. And that’s why it concerns me when I see public health advice, because I know it’s being informed by the science in medicine. And I do believe we could be doing better. And I do believe this is an opportunity. Remember this guy Hippocrates, above all, do no harm. Well, you know, what about vitamins and minerals and this expensive urine and how risky is it? So, I’ve actually through the college and through the help with the help of colleagues at the Australasian College of Nutritional Environmental Medicine, I explored deaths between 1971 and 2019. So, I went to the TGA. This was with the help of Dr. Caroline Glacier, who is a pharmacist with a PhD. She’s in in Perth. And she provided me with this these statistics for which I’m grateful. Deaths between 1971 and 2019 from multivitamins and minerals. Zero. Fish oils. One, someone choked on a big tablet. And then I thought I would explore paracetamol as an example of pharmaceuticals, because if you had to look at the range of chemicals in the pharmaceutical world, paracetamol and aspirin would have to be down the well, you’d think safest end, because they’re over-the-counter. We feed them to our children. You know, this is what is safe. And even there are 185. And I’ve even seen big bigger figures than that. One hundred eighty-six people have died just from paracetamol alone. And the Pharmaceutical Society of Australia. So, they are a pretty conservative group of far. You know, the Pharmacy Guild or Pharmaceutical Society of Australia published this report in 2019 about “Taking care medication related hospital admissions”. So, you know, when you hear about vitamins being toxic, let’s look at what medications do. And that’s why I shared with you those statistics. There were 250,000 hospital admissions annually as a result of medication related problems to a cost of 1.4 Billion dollars and 400,000 additional on top of the 250000 hospital admissions to 400000 additional presentations to emergency departments are due to medication related problems. That is prescription medication. Fifty per cent of this harm is preventable. This is the evidence-based medicine we are all being told. And it’s interesting to look at the guidelines. So, doctors have to follow clinical practice guidelines. This is very important. This is a document from the NHMRC 2014 annual report. But I thought I’d look at it and see who funds these guidelines. And there are about 100 odd guidelines and it turns out that 75 percent of them are funded by either drug companies or not stated or other. So, let’s assume that most of those are with vested interest because the federal government. I mean, there are some philanthropic groups that do sponsor research. I’m not suggesting they’re not. But I would. This is just my estimation. About 75 per cent of the guidelines are funded other than from the federal government. And then this article in January 2020. This was before the Corona virus hit really hard. And this article came out from the Royal Australian College of Physicians, the Journal of Internal Medicine Journal and “Evidence Poor Medicine. Just how Evidence based, are Australian clinical practice guidelines”, and it’s sobering. And this is important because this is what public is informing public health policy. 748 clinical guidelines will be looked at. Only 18 per cent had what is considered a high level of evidence. 25 per cent had a moderate level of evidence, which adds up to 43 per cent of guidelines had only a high or moderate level of evidence, which leaves the others with either a low week or just a consensus between experts. So, this is quite sobering. In fact, they said this is somewhat alarming because many clinicians, many clinicians would reasonably assume that following guidelines means practicing evidence-based medicine, which, you know, in an in and of itself is a bit of a concern. But even with that, this is what has shown up, knowing that many recommendations will not be strongly evidence based. But knowing not knowing which ones they are presents an obvious impediment to the everyday practice of evidence-based medicine. Indeed, they do. And hey, I’m not saying nutritional medicine is any better. The challenge of reforming nutritional epidemiological medicine from John Ioannidis again in 2019, “nutritional science is still largely relies on observational studies. They’re notoriously unreliable due to the confounding factors. So, they need to be largely abandoned. We’ve wasted enough resources and caused enough confusion and now we need to refocus”. So, the point here is this. Yes, evidence-based medicine is fraught with problems. So, what do we have? We have our basic understanding of biochemistry, anatomy, physiology. How do cells work? That’s what we have. That’s what we’ve learnt and common sense about do no harm. What causes more harm? Medication related problems or nutritional supplementation? Which leads me to the beginning of this whole presentation. So, I go on nutritional guidelines. So, here’s where it gets even more complicated because they are confusing.


Dr Ron Ehrlich [01:11:07] Should you be on low carb or high carb? Should you have grains or not? What about dairy? What about the food pyramid? Is that good for you or bad for you? What’s normal blood pressure? Should you all be on statins? Is having cholesterol up a disease or not? Should you be lowering the cholesterol? Why are so many of us on multiple medications, are they safe? Why is there so much cancer? Should I avoid all grains? Should I be taking supplements?


Dr Ron Ehrlich [01:11:33] So nutritional guidelines are pretty confusing, aren’t they? Well, let’s just look at the food pyramid, because it was kind of introduced in 1980. And from that moment on, obesity went through the roof. And here’s a diagram if you’re watching that. Now, nutritional stress is something I talk about in my book. And often it’s you see images of hamburgers and chips and crisps and all that. But I would argue that the food pyramid is probably the biggest nutritional stress we’ve ever been exposed to, which places grains and cereals and rice and pasta, six to 11 servings a day on the as the foundation and tells you to avoid fat and demonise fat. And that morphed in 2011 to the “My Food Plate”, which is pretty much the same. To be honest.


Dr Ron Ehrlich [01:12:23] So to that point, I think it’s again, I’ll get back to some of the books that are very easy to miss. But here’s a great one, which is titled Speaks for Itself. “Death by Food Pyramid. How Shoddy Science, Sketchy Politics, Shady Special Interests have ruined our health and How to reclaim it”. Denise Minger 2013. I thought this was a great book and it really lays out very in great detail these issues. And again, an investigative journalist. And here is also a few others. Gary Taub’s, of course, is an investigative journalist as well and written many books. But this one, “Why We Get Fat” in 2010 and then more recently in 2016, “The Case Against Sugar”. And this is the science in medicine and public health. So, this is why these books and investigative journalists are very capable of exploring the data. And actually, I would argue, maybe even do it more with a more open mind than healthcare practitioners. And they probably have more time. But another one is David Gillespie, who’s actually a lawyer. But in 2008, in an attempt to solve his own weight problem and I guess you would say lawyers are very good at reading careful and analysing texts and data. So, he wrote a book called “Sweet Poison Why Sugar Makes Us Fat” in 2008 and in 2012 “Big fat lies: how the diet industry is making you sick, fat and poor”. Again, the science in medicine and public health.


Dr Ron Ehrlich [01:14:03] And in 1991, the FDA approved the food pyramid. And look what happened to the number of diabetics from that moment. And actually, interestingly, the Heart Foundation and Diabetes Association also approved it. And you would have thought that if evidence-based medicine counted for anything, this trend which showed from the moment that pyramid was approved, diabetes went through the roof, but it didn’t really change anything until actually quite recently. So, 63 per cent of Australians are either overweight or obese. And that’s going to go up to about 80 per cent if current trends continue. And 30 to 40 per cent of children will be overweight or obese by 2025. And interestingly, I attended this conference. This will give you an idea about why nutritional guidelines are so confusing and why food companies are affecting our health, because this was the Australasian and New Zealand Obesity Society. And who was one of the sponsors? The Sugar Research Advisory Council, providing the scientific facts on sugar and health. They wanted to be part of that conversation. In 2014, I’m just sharing with you the programme. I couldn’t believe it. It was a shocker. But here’s another shocker for you. The biggest organisation in the world in terms of nutrition is the American Dieticians Association, the Academy of Nutrition and Dietetics.


Dr Ron Ehrlich [01:15:37] And it might be sobering to know that in 2007 they welcome Pepsi Cola as an ADA partner. So, if you’re wondering why food messages are confusing, the biggest organisation of food and nutritional professionals, formerly the American Dieticians Association, in 2007 welcomed Pepsi Cola in 2007. They also welcome GlaxoSmithKline. Remember them? They are a drug company which got 3 billion dollars, the biggest fine ever in in history. They were welcomed by the FDA as a partner in 2007. And of course, as soon as you have Pepsi Cola. You’ve got to have Coca-Cola and Coca-Cola were welcomed in to this organisation in 2008. And when you look at the list of organisations of companies that are sponsoring the Academy of Nutrition and Dietetics, formerly the American Dietetic Association, you have people like the Coca-Cola Company, Hershey, Hershey, the Hershey Organisation are dairy industry. Well, the National Dairy Council is a major sponsor. Abbott Nutrition. They were one of the big Abbott were one of those companies that had a fine. General Mills, are grains good or not? Well, General Mills are a sponsor. Kellogg’s, you’d want Mars, Mars, the Mars bar people, Pepsi Cola, soy products. A problem or not? Well, maybe they are. Maybe they aren’t. But, hey, the American Dieticians Association is sponsored by them, Unilever, the makers of Ben and Jerry’s ice cream and also margarine. They’re a sponsor as well. Campbell’s Soup, Target, Safeway’s ConAgra. The list goes on. This is the organisation. And here’s another organisation, the American Society of Nutrition, Excellence in Nutrition, Research and Practice, dedicated to bringing together the world’s top researchers, clinical nutritionist and industry to advance our knowledge and application of nutrition for the sake of humans and animals. What a noble group they are established in 1928. And here is a list of their sponsors. Again, one of those, the drug companies are back Abbott, Eli Lilly, McNeill’s nutraceuticals. You’ll be pleased to know Monsanto. Our responses. So are Mars, Kellogg’s, GlaxoKleinSmith are there again. Coca-Cola Cadbury’s Sara Lee couldn’t have a nutritional society without being supported by Sara Lee and the sugar industry. And the list goes on. So, if you want to pause the screen and look at the list of sponsors and then start to get a sense of why nutritional why, why nutritional guidelines might be a little bit confusing.


Dr Ron Ehrlich [01:18:26] You bet. So, what’s the big deal? Look. Okay, if you haven’t got the point, let me give you an example, because you may know I’m a dentist. So, here’s a statement made by the American Academy of Pediatrics Dentistry in 2003. Frequent consumption of sugars in any beverage can be a significant factor in the child or adolescent diet contributes to the initiation and progression of dental caries. That’s in 2003. Basically, saying sugar causes tooth decay. Now, any one of you would listening to this would be nodding your head going.


Dr Ron Ehrlich [01:19:00] Yeah, we know that there’s nothing big about that. So, what’s the big deal about sponsorship? Well, in 2004, Pepsi Cola sponsored the American Academy of Pediatric Dentistry for one million dollars. And in 2004, one year later, here’s what the advice was. In 2003, it was that sugar causes tooth decay.


Dr Ron Ehrlich [01:19:24] But in 2004, it was scientific. Evidence is certainly not clear on the exact role that soft drinks play in terms of children’s oral disease, nutritional guidelines, confusing and contradictory. You’re wondering why and why we need to go back and study ancestral. You know what? What we had evolved to eat, what we were, you know, what is best biochemically for every cell in our body? I digress. Nutritional guidelines. This is part of the same food pyramid.


Dr Ron Ehrlich [01:19:57] It’s all the food played. Australian healthy eating guidelines came out in 2013. I strongly recommend you spend 18 minutes and watch this superb presentation by Dr Maryanne Demasi, who really influences nutritional policy in Australia. There is the link. But if you go if you just Google Demasi nutritional policy, you’ll find it. But ideally you would hope that it was in that the guidelines were independent, evidence based and trustworthy. And I can tell you now they weren’t. They were formulated by the Dieticians Association of Australia who when asked, was there a conflict of interest, said, no, there wasn’t. And I’ll just share with you some of their sponsors as. This was current in 2015.


Dr Ron Ehrlich [01:20:48] The Grains and Legumes Council, Kellogg’s, Abbott Nutrition. Again, Abbott, you know, they were one of the fines. Nestlé, of course, are back. And that’s not Marion Nestlé. That is Nestlé Corporation, Dairy Australia. Campbell’s Soup and Unilever again are back there. And so, when somebody says that grains and dairy are dangerous, are not perhaps ideal. And the Dieticians Association jumps up and down as saying that is dangerous piece of advice. One can’t help but wonder whether a conflict of interest may be part of that story. I think they have since jettisoned their association with industry. I hope so because the responsibility should be to public health. And so, the Australian dietary guidelines, I think it’s worth going and looking at MichaelWest.com.au for an assessment of those. It’s a damning assessment. So, I go back to the science in medicine. It’s more than just the study of disease, how to prescribe drugs and use a prescription pad because the prescription pad leads to pharmacology, which is fraught with problems. And studies have not been done about the long-term use of a combination of drugs.


Dr Ron Ehrlich [01:22:10] When a drug study is done, it’s done on one drug at a time, usually for a few months at a time, and usually on a healthy individual for a limited number of times. But you will be hard pressed to find studies which look at multiple drugs taken over many years on immune compromised people. So, the evidence, the science in medicine, we do not need friends in medicine, in the science, in medicine. What we need are scrutineers of the science in medicine. When I hear people say that there is no evidence to support nutritional environmental medicine, my response to that is that’s the wrong question. The question is, why haven’t you read the thousands of articles? Or even if you haven’t? Why don’t you remember the biochemistry and histology, the study of cells and how they work, the biochemistry that you learnt in undergraduate health care, medicine, dentistry and healthcare. So, this to me is where the science in medicine lies. This is the science in medicine.


Dr Ron Ehrlich [01:23:19] Now, the final thing I wanted to come to finish with is where to from here? Because that’s important. Look, I come back to this Web site and you get the picture that I’m kind of quite upset, upset by it. And yes, I agree with them. Many Australians are anxious and stressed about the Corona virus. You might feel a little powerless yourself. But there are a few things you can do to help strengthen your immune system. There most certainly are. And that’s what I have written a book about. That’s what I feel quite you can kind of tell I feel quite passionate about, and that’s what my podcast is about. And it deals with stress. And people most people acknowledge stress is affecting their life in in a negative way. But I believe in order to understand stress, you’ve got to break it down. But essentially, to me, anything that compromises your immune system and promotes chronic inflammation is what is stress. That’s how I define stress. Anything that compromises your immune system and promotes chronic inflammation. Because chronic inflammation is the common denominator in all disease. And that’s why I have, for the last 40 years of clinical practice, worked on a model within my practice which tries to identify and minimise stress. And I see there being five stresses that are all interrelated, emotional, environmental, postural, nutritional. And yes, I include dental stress. And that’s one that surprises most people. But I included for this simple reason. I’ve been a holistic dentist for 40 years. So, I feel reasonably well qualified to know what I’m talking about. But more importantly, I included for anybody with the mouth who is interested in their health but is never fully connected to. And there are many connections. It’s the gateway to the digestive tract. It’s the gateway to the respiratory tract. It’s the home of the two most common infections and chronic inflammation known to man, woman or child. That is gum disease and tooth decay. We implant more materials than anybody. So, bio compatibility and toxicity are important. It’s there’s a there’s a whole if you followed me at all, you’ll know why that is part of it, but it is only part of it. All of those other stressors impact on it. And if you’re going to identify on one side of the balancing beam, identify and minimise stress, what you have to do is build resilience.


Dr Ron Ehrlich [01:25:47] And the way to do that is to focus on sleep, breathe, nourish, move and think. And there are so many things you can do to improve immune function and pivoting around that are our genes and the way our genes express themselves. So, this is central to my message and what I am on about, not just in my book, “A Life Less Stressed: The Five Pillars of Health and Wellness”, but also in my podcast. So, what I’m saying here is I want to move away from the us and them mentality.


Dr Ron Ehrlich [01:26:21] And this is what I see in healthcare. This us and them. Now, part of us could be we are serious doctors and we use prescription the prescriptions and evidence-based medicine.


Dr Ron Ehrlich [01:26:33] I’ve highlighted for you. Some of the shortcomings in the science, in medicine. So. So I want to move away from the US and them. And the them is another us is. Well, we’re nutritional and environmental medicines, integrative medicines. And the thing I like about integrative doctors is they do actually use the best of pharmaceutical medicine and they use the best of nutritional medicine. So, I want to find out what is the best for people’s health? What is the best for people’s health? Based on good science, not necessarily on evidence-based medicine, because that’s almost a saying. Once you’ve said something is evidence based, you’re absolved of all responsibility, despite the obvious shortcomings of so many scientifically refereed journal articles. So. So I want to move away from the us and them. I think it’s not about alternative medicine. This is about good medicine and what is best for public health. As I mentioned, the thing I hate is when I hear people say, where is the evidence to support the use of vitamin A or D or C or zinc?


Dr Ron Ehrlich [01:27:44] And that’s the wrong question. The question is, why haven’t you read it? Why haven’t you remembered what you learnt at undergraduate level at very least? And why do you display your ignorance so publicly? I get really annoyed about that. And often it’s displayed with hubris. And whatever annoys me even more is when it informs public health policy, as it is clearly doing now. So that disturbs me. I want to find out what is good medicine, what is best for public health. And above all, I want our approach to not just this pandemic, but for chronic disease to be inclusive, collaborative and proactive. And to that effect, I think we could emerge from this virus a lot healthier than when we went in and at ours. And our globe, we’re having a rest. We’re giving nature a rest so we could actually end up healthier than when we started. So, look, I know that was long. Maybe we’ll break that up into three different sections and short little snippets. There’s a lot of material there. But at least it’s been a cathartic experience for me to share with you what I’ve been looking at and thinking about during this very challenging time. I hope this finds you well until next time. This is Dr Ron Ehrlich. Be well.


This podcast provides general information and discussion about medicine, health and related subjects. Content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences and conclusions.


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