Professor Grant Schofield: Public Health – How Are We Doing?

When it comes to matters about public health, who better to talk to than a professor of public health?

Grant is a Professor of Public Health at Auckland University of Technology and director of the university's Human Potential Centre (HPC) located at the Millennium Campus in Auckland, New Zealand. His research and teaching are focused on the well-being and prevention of chronic diseases. He is especially interested in significantly lowering the risk of death and disability from obesity, heart disease, and diabetes. He lives by the motto "be the best you can be.”

This episode covered many topics, including exercise, low carb diet, intermittent fasting, Acceptance and Commitment Therapy, and much more.

Prof Grant Schofield: Public Health – How Are We Doing? Introduction

Well, I always enjoy talking about public health. And who better to talk to about public health than a professor of public health. And whenever I want to talk to a professor of public health, I’m in an extremely fortunate position to be able to connect with Grant Schofield, who is a Professor of Public Health in Auckland in New Zealand. 

And we catch up regularly like I do with some of my other guests, and this was an opportunity to catch up and talk about how our current state of health is, how we would approach improving health. It’s always interesting to get a perspective on the pandemic and a whole range of other issues. So, I hope you enjoy this conversation I had with Professor Grant Schofield.

Podcast Transcript

Dr Ron Ehrlich: [00:00:00] I’d like to acknowledge the traditional custodians of the land on which I am recording this podcast, the Gadigal People of the Eora Nation and pay my respects to their elders – past, present, and emerging.

Well, I always enjoy talking about public health. And who better to talk to about public health than a professor of public health. And whenever I want to talk to a professor of public health, I’m in an extremely fortunate position to be able to connect with Grant Schofield, who is a Professor of Public Health in Auckland in New Zealand. 

And we catch up regularly like I do with some of my other guests, and this was an opportunity to catch up and talk about how our current state of health is, how we would approach improving health. It’s always interesting to get a perspective on the pandemic and a whole range of other issues. So, I hope you enjoy this conversation I had with Professor Grant Schofield. Welcome, Grant.

Prof Grant Schofield: [00:01:10] Hi, Ron. Thanks for having me.

Dr Ron Ehrlich: [00:01:12] It’s always a pleasure, Grant. Always enjoyed talking to you. Listen, you know, medical science, medicine, health, we’re all, you know, 21st-century stuff as we take a step back from all this. Are we healthier than our grandparents as you’re in your position of professor of public health?

Prof Grant Schofield: [00:01:29] Well, I think it depends on how you measure health. You know, just being alive is often a pretty good way of measuring it. So, yeah, on that measure, actually we are. And, you know, really, I think with the progress that we’ve made in the last hundred or so years, because life expectancy, more or less double. Okay. 

Well, you know, what happened we’ve made quite a lot of medical advances, especially in injuries or some illnesses like cancer, we can treat better. We certainly have taken a lot of environmental things that turned out to be quite bad out of the environment on unleaded petrol, asbestos. So yeah, what’s my guess is used for kid’s Christmas decorations. Yes. That’s we’ve done so much better on that. So that’s great.

Prof Grant Schofield: [00:02:11] But the second sort of kept is that as well, you know when we’re alive. Especially in the last 30 years, has our quality of life kept up with an improvement in our quantitative life that public health service morbidity? And the answer is no we haven’t. No, actually, we’ve never this quite long period the longest in human history. 

We’re alive, but our quality of life is impaired because of poor health. And I think for an Australia and New Zealand that’s running at about 12 to 13 years of life last lost to disability due to poor health and for the average, that’s about a third of that is requiring one-on-one care. 

And I don’t think anyone no one really aspires to that do they? I suppose I don’t know if that’s an assumption, but I’ve imagined, you know, just even from clinical work and talking to people in research over the years that, you know, when you talk to people about their lives, I can’t remember anyone who didn’t have in their top three being healthy for the whole time they were alive. So yeah, that’s we haven’t really kept pace with that. 

Dr Ron Ehrlich: [00:03:18] One of the things about life expectancy, which is often put out there as a major improvement, comes down to in the calculations, I guess two or three things. One is childhood morbidity has gone down which would lower the average dramatically right there, wouldn’t it? I mean, if someone was dying in the first five years of life, that would have a significant impact on.

Prof Grant Schofield: [00:03:44] Yeah, Australia is an example of the inequalities and that sort of thing would reduce it to, you know, virtually nothing in Australia, kids die young. But then you look across Aboriginal populations, of course, you thought, wow, man, that’s astonishing, that still happens. And then the real world in the developed world. So yeah, I think pretty much across most of developed society, we’ve got that way down.

Dr Ron Ehrlich: [00:04:05] So what’s our current? What are the major health challenges in today’s world?

Prof Grant Schofield: [00:04:12] It’s non-communicable diseases that are chronic diseases. The other word for that and what do we count off those big four or five things cancer, diabetes, cardiovascular diseases, stroke, Alzheimer’s, dementia and other neurological issues, mental health, including depression and sort of suicide as metabolic diseases, at least in part, and all for some of them like cluster, they’re related. 

And, you know, that’s what’s going to get virtually all of us. So an interesting thing that to me, what’s been really interesting to me, we’ve had this whole COVID pandemic for the last few years. And yes, a new virus and it’ll kill some people and all that sort of stuff. But it’s been compared to these metabolic diseases is that it’s so small compared to the last thing. 

And then I think the unfortunate thing is it’s just that discussion’s just fallen off the cliff. I’ve hardly done any mainstream media discussion around diet, activity, fitness thinking, hot and cold breathing, all the things that I’m interested in sleep from an academic and scientific and practise point of view. No one’s interested anymore on that, at least in mainstream in the last couple of years. I find it astonishing to be the US.

Dr Ron Ehrlich: [00:05:38] I couldn’t agree more. I’ve I kind of when this pandemic started I thought, wow, what an incredible opportunity this is. We have got a global population reflecting on comorbidities. The new word for them, we know normally refer to as chronic diseases, which you just mentioned. What an opportunity to focus on reducing your risk. And here you are, professor of public health, not unlike in Australia, I would have thought they would have been front and centre. Hey, folks, red flags here.

Prof Grant Schofield: [00:06:12] Yeah we tried. Quite early on with that. I was like, man, this is opportunity. When it became obvious that something like a controlled blood sugar or high insulin inflammation, low vitamin D, recently malicious things like high type in the blood were really the primary risk factors for doing poorly out of this. That would be really the discussion I tried to write early on with that. Another professor here, nutritional psychology to the rapids and I wrote a couple of papers together.

Dr Ron Ehrlich: [00:06:39] I’ve spoken to Julia and she’s wonderful.

Prof Grant Schofield: [00:06:42] Yes, she’s a complete legend. But yeah, that’s what I said is completely off into the aether, never to be seen again, hardly read by anyone, and had no public policy impact at all. And you know, like, you know, one of the metrics of public health, they brought us sort of overly optimistic, oh, yes, we can solve this. We can solve that. I’m just going, oh, yeah, now what metabolic health on this guy. Now I don’t. Society sort of lost interest in it.

Dr Ron Ehrlich: [00:07:09] Is it because we’ve been so distracted by the media? Is that part of what it is?

Prof Grant Schofield: [00:07:14] Yeah, I don’t know what that, I supposed I’ve been thinking more of it like, well, you know, you sort of catch a disease, a contagious disease, which basically wasn’t really your fault that you know, it rose. And if something bad happens to you, it could happen quite quickly. It seems sort of scary and out of your control. 

A bit like getting eaten by a shark is something you want to avoid at all costs. With. Whereas current disease is sort of within your control, that’s chronic. This all point of that takes ages. It’s silent. So maybe that’s the difference, as humans, we’d value that acute issue that prioritise it way more than this chronic issue. I don’t know what you think about it, but.

Dr Ron Ehrlich: [00:07:58] Well, I kind of wonder whether, you know, it’s a sad reflection on how we manage chronic disease because you can appear to do a good job hiding behind the long timelines of a chronic disease. You know, you can be an expert, give people anti-cholesterol drugs and treat their cardiovascular disease or give them anti-depressants and treat their depression. 

And it’ll go on for years and years and years. And using that kind of model, we’re treating this pandemic. I just think. But it’s been also interesting from a work perspective, hasn’t it? Because, you know, we spend a third of our lives working and that’s changed a lot in the last 50 years. What do you think the impact of the way we work has had on our health?

Prof Grant Schofield: [00:08:44] I think you’re sort of talking about the fact that at the turn of the 19th, and 20th centuries and Australia-New Zealand, I think between 2 to 4% of people now, 2 to 4% of people are working on the land physically. Back then it was 70 or 80%, so there’s massive production right back in just a short period of time. Of impoverished, anything that involves actual physical effort has just gone away, which is an interesting thing. And here we are sitting around the whole day and equally at risk. 

So the hypocrisy is not lost. But, you know, I’ve always talked about exercise as a sort of purposeful activity as a post World War Two concept, really. It was, you know, for the most part, humans will want it to have a risk because of their, you know, physically strenuous life. And that’s just a distant memory. You know, in a couple of generations, we just forget that even happened. Yeah.

Dr Ron Ehrlich: [00:09:42] You mentioned a few things very quickly in passing about what you consider would reverse those trends. And you’ve mentioned exercise as one and I guess, well, why don’t we just dive into that? Firstly, because I think one of the challenges for us now is I guess building it into our lives.

Prof Grant Schofield: [00:10:01] That yeah, so I’ve been studying this my whole career really and thinking a lot about how you communicate this, what it means, what I like to talk about this as medicine, but the whole field of physical activity and health that really started with. Yeah. That matched peers’ design that had been by accident with the London bus drivers that the epidemiologist Jerry Morris started studying in the 50s and 60s. 

So, men came in and some were conductors and somewhere were who walked around and check tickets and whatnot. So they had an active job a somewhat drivers with sanitary and set there and he noted that I think they are twice the risk of acute myocardial infarction, stroke and early death and all that sort of stuff. So that was the beginning of the epidemiology of physical activity in health and that yeah, there was all sorts of similar types of studies and then, you know, you chuck experimentally that you can get people to have a bit of thing on their health. 

The thing is, what do you do with that information, how they communicate? Because there’s really two levels here. There’s the tell people, the minimum effective dose. So, okay, you’re a complete couch potato. If you accumulate half an hour of data like a day, total of 10 minute-bath or garden will take you there. Well, we know that if you move from being symmetry, that has a positive effect, but it is a minimum effective dose. 

And you’ve got the sort of dose-response up to that, right? Where every extra bit of stuff you do, and then you get it to the more complex domains that is on to training. On the training, I’ve just well, let’s talk to me today, one of these 15 minutes a day. Flexibility programmes I’ve only done one day. But then then there’s all these extra benefits that that if they had and you’ve got the sort of optimisation and then you’ve got the complexity of where you’re at the age of it and that sort of stuff. 

So how you communicate that is me to some and a coherent public way is a really interesting question that I, I still don’t know the answer to it. I think with work off listed in the bar as low as it possibly can and hope that the worst people jump up on it. But I don’t know is there an effect in some medicine that says maybe you should tell people the whole range of benefits and whether sudden stop or is it too complex. You know these are just unanswered questions on public health.

Dr Ron Ehrlich: [00:12:24] I found one of the most liberating bits of information, and I think it came from Michael Mosley. He did a programme on it and he said, that if you do 3 minutes or 5 minutes of high-intensity, intermittent training, your metabolism is up for 24 to 48 hours. If you went for a ten-kilometre run, it’ll be up for six or 8 hours. Is that your understanding of, you know, less is more? I thought that was liberating.

Prof Grant Schofield: [00:12:51] Yeah, I think that’s definitely true. We’ve done their own research, but the high-intensity training and you know, it’s true that very brief doses have a profound physiological effect. But it’s just there’s more complexity than that, right? Because well, first of all, this that there’s always dimensions of fitness that interact. So, yeah, it’s good having that sort of kind of esque. 

There is some muscular fitness there, but then there’s more resistance. Try to stretch stuff that’s independently good for you, especially as you age and lose muscle mass. There’s functional mobility that doesn’t cost. Right? All that. And then there’s actually a profound difference between, you know, almost antagonistic between that low-intensity Zone 2 training, which you can accumulate a lot of volume for that, that it breaks lactate down, it stimulates breaks glucose and insulin down, it stimulates fat burning, and it has a profound effect on mitochondrial efficiency. And that’s not a small thing. 

And you don’t get it from that high intensity that it’s profoundly anti-inflammatory. And those are all good things. And that’s interesting that the high intensity physiologically drives lactate way up acutely. You can even get gluconeogenesis. So glucose comes up, you get a profoundly inflammatory environment. And the acute effect of that inflammation is very, very good. So, you know, both all of those dimensions. 

But to hear the difference between aerobic and high-intensity anaerobic saw is one stop. Now that is different. Just totally different, right? So that’s what we struggle with because this complexity to it and there’s a dose response that you just tell people are just doing nothing because you’re all doing nothing anyway and that’ll be better. 

Yeah, maybe. Or do you tell them that? How they communicate simply that the more complex benefits and you know, optimise your health though you probably want a little bit more than just go for a walk.

Dr Ron Ehrlich: [00:14:55] Hmm. Although walking. I mean, there was a… That’s interesting you mentioned that bus drivers or bus service the conductor bus driver, which I hadn’t heard of but makes so much sense and doesn’t appear to be very much different in terms of intense intensity other than one moves and one doesn’t.

Prof Grant Schofield: [00:15:15] Yeah. Just as part of their normal day. So. Yeah. 

Dr Ron Ehrlich: [00:15:17] Yeah. There was this out of the UK. I think there was a whole thing about walking speed as a predictor of five-year longevity.

Prof Grant Schofield: [00:15:31] Yeah, I mean, that’s actually quite a good thing. You can give people there’s 12-minute walk tests and all sorts of things and yeah, the faster they go, the longer they live. But I think, you know, correlates with cardio risk in general. Yeah. What about a move? I mean, humans are living animals. Living animals, you know, generally have been selected for if they could still function as they age on. Yeah.

Dr Ron Ehrlich: [00:15:55] And your wife’s got you on flexibility which I think apart from strength and cardiovascular fitness and flexibility is we get a bit old is pretty important, too. 

Prof Grant Schofield: [00:16:07] Yeah, to be honest, that’s something I’ve neglected. I’ve been an endurance athlete my whole life and it’s something I really enjoy. In recent years, I’ve started getting more resistance training and I’m 54 so I think I’d benefit from that. But I, my range of functionality both in that compared to those people around my eyesight. 

And so yeah, I do acknowledge I need to do some more work on that and I look forward a generation to my dad and he’s never done any of that stuff. And, you know, I think that’s what’s got him within this, like a functional movement.

Dr Ron Ehrlich: [00:16:37] Yes. And it’s interesting, isn’t it, that that functional movement, which kind of is that every day twisting, turning, bending, stretching, pushing, pulling, as opposed to your long-distance endurance thing.

Prof Grant Schofield: [00:16:50] Yeah.

Dr Ron Ehrlich: [00:16:50] Which, which is very repetitive, but it’s also very meditative too, isn’t it? There’s an aspect to that long-distance running, which is more than just physical, isn’t it? 

Prof Grant Schofield: [00:17:01] Oh, yeah. Oh, I love that stuff for that exact reason. That’s how I think of things. I can just be daydreaming, but not in a relative way, in a positive way, that sort of thing. On the functional moments like that. You’re right, we need that. It’s all up in a big fan of Peter Taylor’s view of the Centenarian Olympics. 

And I was like, well, you’ve got to want to look to 100. What are the sort of things you might want to do to be functional? We lift a suitcase above your head to sort it out, a flight squat down and catch a five-year-old. All the great-grandkids that sprinting towards you and lift them up. Yeah. And these types of activities.

Prof Grant Schofield: [00:17:35] Now let’s work backwards. Well, what do you want to be doing when you’re 70 to manage that and that this had quite an effect on my thinking just even about myself? I don’t know about you know, I go.

Dr Ron Ehrlich: [00:17:47] Totally! I mean I’ve got grandchildren aged from… I’ve got five now, four, one a week away. But the better for and the and actually the two the four and the six-year old do run in and I have to kneel you know, squat down and if they run out me too fast, I’ve got to brace myself for it, you know. But, it’s true. I mean, and I want to be able to get down there and do it.

Prof Grant Schofield: [00:18:13] Yeah. And how cool will that be if you get through the same to their kids?

Dr Ron Ehrlich: [00:18:19] Yes.

Prof Grant Schofield: [00:18:20] Wow, great.

Dr Ron Ehrlich: [00:18:21] That’s right. I think another one was the resting squat, which is an interesting flexibility times. Do you think what do you think of the resting squat?

Prof Grant Schofield: [00:18:33] Oh, this is just a sort of an Asian. Yeah. But did some of those this morning actually again, I suck at them but yeah I feel that’s a really good range of movement through that helps adductor area I should be working quite hard on that so I actually don’t suck as much as I do anything else that because I’ve been working at that, I find that really good, actually.

Dr Ron Ehrlich: [00:18:47] Hmm. I mean, part of what we focus on too is postural stresses and one of those is toilet position, you know, because we are, we have evolved to be in that squat position and it makes a huge difference. So being able to do that, not just to grab your grandkids, but to facilitate a full bowel movement.

Prof Grant Schofield: [00:19:09] Yeah, well, that’s right. It did right. Yeah.

Dr Ron Ehrlich: [00:19:10] But listen, the other one you, I know are pretty passionate about is not just exercise, but nutrition. And when you are as a professor, again, a professor of public health and I know your view on nutrition to some degree, Grant I think I do. You must look at public health messages sometimes, or the food pyramid or the Australian healthy eating guidelines. What do you think of as a professor public health when you read things like that?

Prof Grant Schofield: [00:19:38] Yeah. It’s really frustrating, I think. I sort of felt that with evidence things would change over the time. But you know, in actual fact, I think. Yeah. Mistakes were made for sure. So, you know, some of those I don’t know if they were conspiratorial or just you got the wrong hypothesis. Yeah. 

It’s plausible that because Fitz got twice as many carries for the same amount of wafers as carbohydrate, a protein that energy density could affect eating and obesity and health and all that sort of stuff. It’s plausible that eating fat could turn out to be fat in your blood and therefore accumulate as fat and you and your blood vessels, especially the car in the brain and that sort of thing.

Prof Grant Schofield: [00:20:22] So I suppose those were hypotheses that were with while exploring the distant, which turned out to be true. And then they just made it through barrels of oil up to public health guidelines before that was really settled. And they, food industry got evolved and we haven’t really been able to weed them out. And I had felt that we would make good progress. 

And I suppose we have in a way that I think people understand that vets no longer sort of demonise the way it was, but many of the public pressures, eat lots of guidelines and all this sort of stuff that this sort of switched tack on the planet now was also bad for you and now it’s bad for you because it’s run of the planet. I’m not really an expert on agriculture, but maybe, you know, we can do better there.

Prof Grant Schofield: [00:21:10] So I’ve just sort of frustrated. We’ve been nights of studies recently. One of my master’s students has been going to primary schools and taking photos of school lunchboxes. And then we’ve invented this classification system, I’ve called it the HIST – the human interference scoring system. 

And so it’s just an attempt to try and go, okay, what’s the percentage of whole food? And this and what you’re eating and also percentage of ultra-processed food. And so we just tried to get some guidelines in it. It’s not a perfect system, but I think it moves away from just concentrating on nutrients in general to that level of processing. You know, I felt that might be a way to kids could understand, that parents can understand. 

And you know, if we could get to a set of guidelines, sort of avoided plant versus meat, avoided carbs versus no carbs, avoided all sorts of dogmas around nutrition. And I think the one thing that everyone agrees on is that with shovelling down a lot of ultra-processed food and no one’s going, those Doritos are a health food. So not so far as I know. Anyway, with this a Dorito diet. I’m sure there will be. 

Prof Grant Schofield: [00:22:23] But so often I think I’m going to start advocating much more for, first of all, understanding that the amount of ultra-processed food will eat so people eat. And the second data set target for reducing that say what we can do for healthier and seeing if that’s more understandable. 

And yeah, then you get the next level that becomes political off going. Well, the poor people can’t afford. And processed food. So like, you know, you discriminate against them. And it’s like, well, the problems with our food supply for sure. But we’ve also stopped the beast. 

Dr Ron Ehrlich: [00:23:01] And what were your findings? They, you know, like what percentage of the children’s lunchboxes were processed or ultra-processed?

Prof Grant Schofield: [00:23:09] So ultra-processed was running about 75% to 80%. I mean, what do you think? This is a lower decile schools which as get poorer, whatever you think wrong about what kids’ lunchboxes look like in Australia and New Zealand, I think you’ll find it’s worse than you think. And I think, you know, this is so many. Even when you go to high decile ones, you say things like, oh you know, veggie crisps, you know, made with real vegetables and you look on the back and it’s like a 1% or 2% some ridiculous vegetable extract. Yeah, this 98% ultra-processed rubbish.

Dr Ron Ehrlich: [00:23:44] I think actually it’s interesting to look at this vegan movement and the demonisation of meat which you alluded to and this new term, which I think will be to the 21st century, what ultra-processed food was to the 20th century, and that is plant-based meat. 

Prof Grant Schofield: [00:24:04] Oh, my goodness. Yes.

Dr Ron Ehrlich: [00:24:05] What are your thoughts on that? Well, it’s ultra-processed food. 

Prof Grant Schofield: [00:24:08] It doesn’t meet the basic definition of food. So that the… 

Dr Ron Ehrlich: [00:24:16] You’re an environmental warrior, though, if you are eating plant-based meat.

Prof Grant Schofield: [00:24:21] I don’t believe that. It’s like biofuels like you farm the corn with diesel and petrol and all this sort of stuff. You grow the corn and you take it, drive it to the processing plant and eventually a fuel out of them. You burn the fuel and it’s slightly cleaner. Honestly, really, that’s what it comes down to. I feel that’s in the same category. Can we farm animals better around the world? 

Well, I imagine we can. You look at some of these feedlot-type situations in the midwest of the US. That makes you sick, frankly. And yeah, there are questions about how we feed sustainably and whatever our population. But the main problem I have with the meat that I buy, sometimes it comes in these stupid plastic containers. They’re going to last about 4,000 years before they too slow and they’re not even recyclable.

Dr Ron Ehrlich: [00:25:13] Yes, I find the same frustration. In fact, we try, I’m trying now to go to the butcher with our own containers. And that’s my next, you know, give them the container and say, give me a pound of, you know, give me a kilo of whatever and just put it in this container. 

Prof Grant Schofield: [00:25:31] Yeah, well, actually, a bit good because there’s a whole can, there’s a special issue. I forget the journal but it read endocrinologist Rob Lustig read of that a three-part series on I basically it came out just a little while back and this paper too was around additives and bisphenols and even the stuff that you can time food in. And otherwise, if I should have for the last several years going on to my back then and I was like, oh, and everything the evidence is there probably had to do with immunology. 

I’m sure glycerophosphate are good for you, but how would you even know if I get to say that that review paper really does a super job of understanding? And I’d actually say the level of evidence for the whole range of different things that get into our food supply, but especially like the bisphenols. And so the BPA is really strong inside of it. Right. Could you take your own containers? Could you get the food in those things? That would be a cold world, probably a ways off that we’re right. Yeah.

Dr Ron Ehrlich: [00:26:30] What do you think? I mean, the last two years of have thrown up some challenges from us. What do you think? How do you have you seen these last two years of pandemic? And well.

Prof Grant Schofield: [00:26:45] I mean, I’ve been astonished, I don’t trust the mainstream media anymore, frankly. I go to it and I read stuff, especially around Chimerica. That’s just not true. I mean, we have a particularly interesting thing here. I don’t know what you do in Australia, but here, if you’ve had COVID in the last 28 days and you die, it’s a COVID death. We have homicides because of the COVID deaths. What I would really want.

What I really want to know about the food and the COVID is of a few died from it with no other obvious cause of death. If you had a comorbidity categorise people as actually just you died with it and it was. I think that’s a fair thing to note in the case of a public health epidemic. And then on the other side of it, with the vaccine hub, we don’t, I have no idea what that is because we don’t collect it anywhere the same way we have reported deaths. 

And eventually, you know, one or two here have been upheld by the coroner said there was no other reason that could have happened. So we’ve got this gross mismatch between understanding harm and benefit. And I think it’s in the public interest to be able to understand whatever those numbers are.

Prof Grant Schofield: [00:27:49] If we had done not much in terms of restriction, then perhaps, we might have hit 8% excess deaths from our normal mortality over that period of time. This about midway through the European stuff. So that was available such. Yeah. I don’t know if it’s true or not that site to with it yet. Remember, Michel, it’s a smaller country than Australia. About 5 million people, 38,000 people die here. 

So it’s about 3,000 existence would spend an extra $60 billion over that period on this COVID thing. And so if that’s if we saved all those lives and they wouldn’t have died anyway, that’s about $20 million per life saved, you know, and public health centres, it’s just ridiculous. It’s not class like we wish it quantified that in public I think I well yeah. 

And New Zealand and Australia were prepared to pay about $35,000 to $55,000 a year for a life, for that life being saved. And that’s about where the metric was. That’s a very wealthy country that can afford to do that level of investment.

Dr Ron Ehrlich: [00:28:59] Compared to $20 million. Well.

Prof Grant Schofield: [00:29:02] That makes no sense at all. And in the meantime, we’ve probably hit other hands over and above that, which we haven’t really quantified it with here with ambulance services, they call that another 30% of times almost all of those acute mental health call-outs. 

So, you know, they that food and that’s imaging and other things. So I’ve had an incredibly frustrating the lack of scientific debate and that sort of thing. Yeah. Any contrary opinion or you labelled a conspiracy theorist is does a little bit disconcerting when you regard yourself as a serious scientist. You know, it’s like so yeah. And I probably just doesn’t get it. I should have got my talking about this. I’ve tried to disengage from it completely because it’s bad for my own mental health.

Dr Ron Ehrlich: [00:29:43] Yes. No, I totally agree with you. I mean, I’ve stopped looking at the news to two or three years ago because I and I’ve stopped referring to news outlets previously referred to as news outlets. I refer to them now as media outlets, things like The Guardian, The Sydney Morning Herald

You know, these are just media outlets as far as I’m concerned. And I agree with you, I think for our own mental health, it’s better to disengage. Yeah, because I mean, like, like you Grant is I mean, and you’re, you know, in your position as a public health, you would have been frustrated by the influence of industry. 

This isn’t a conspiracy theory, by the way. This is just a business model. Okay. You would have been frustrated by it, by the influence of industry on public health, but you must have been shocked by the last two years you to be aware of that.

Prof Grant Schofield: [00:30:39] Because we knew about, you know, Nestlé and Coca-Cola and we knew about the car industry. Yeah, the car industry in the US, this was a conspiracy. They were convicted of conspiracy a cartel of Chevron oil, Firestone in the Ford Motor Company to you know by a scuffle in a sort of round it would seem fishy every major US city it’s not a conspiracy theory they did it got people in cars and active and all that sort of stuff. So we weren’t surprised by it. But yeah, the drug companies, that’s next level. 

Dr Ron Ehrlich: [00:31:10] Oh yeah. What has also surprised me is how many people have unwittingly volunteered to support an industry that’s repeatedly been found guilty of fraud. 

Prof Grant Schofield: [00:31:22] Oh, well, that’s right. Yes, they are as well.

Dr Ron Ehrlich: [00:31:24] I so well, I think ordinary, ordinary citizens have become marketing and compliance officers for an industry guilty of fraud time and time again. I just don’t get it. I mean, I think it’s a testament to media, media outlets that they’ve seconded these people. Grant, if you were going to leave us with, you know, like here’s a message for public health, you know, Professor, on how we should improve our health. If you had to kind of give us and I know you’ve already kind of outlined this but leave us with three or four things that you feel the keys to improving health.

Prof Grant Schofield: [00:32:00] That the first ones are sort of slightly off one because it’s not it’s not a personal one, but you don’t get to vote for it or not. You guys are doing that at the moment is that public health should not be a political football that bounces left to right and left comes and goes, Oh, it’s not one’s fault. We’re going to fund these public health products which spend a lot of money do not like. And then the right comes across. All that was all bullshit. 

If I should just decide, hold self-funding anything. Sure, there’s some middle ground which we he found evidence-based decent programmes and that’s a consistent line on the health budget. Can you imagine if they got on broken legs?

You’re just doing that at home and you know, like would be a thing so I think that’s but basic health, which requires us to behave in certain ways, which we tend to say requires government funding and input. And now that’s become a political football that it’s either all over to you or we’re going to pay for the whole lot. But not, you know, property is. It seems ridiculous to me.

Prof Grant Schofield: [00:33:02] Second, my personal… Look, I’m just a big fan of, as you know, moving and understanding the complexity of those dimensions, eating whole food, especially meant to keep the carbs and sugar down if your children are just not getting a good night’s sleep. I’ve really become a big fan of the idea of that sort of lost focus that people will open their phones about 150 times a day and spend these micro times on many of the things I don’t even know that. Don’t you find yourself opening the bloody thing before you even know you have done it, for goodness sake? And so, there’s that aspect.

Prof Grant Schofield: [00:33:44] And then I think I’m really interested in and hot and cold recently and using cold water for some breath and then using sauna. I, you know, I know these are always accessible, but, you know, hot bath does the same thing as a sauna, an effect. It probably is, but more heat stress. So really hot because liquid not yet but it’s a profoundly useful. 

And the last thing I’ve got the most thing I’ve got most recently is that. So a third way that behavioural therapy could accept us commitment therapy or act up in loving that stuff. And it’s nothing new. It’s all this stuff that the Stoics had done, the Buddhists have done for the century. The Japanese psychologist has been doing, you know, 2,000 years ago of just accepting that negative thoughts and ups and downs are a just intrinsic to the human experience and trying to do what CBT said, which is not get them in the first place, is absolutely futile. 

And so, you know, if anyone is looking for that next little step personally. It’s really helped me. It’s helped me with my kids. It’s helped me with coaching that I do both health coaching and performance coaching. It’s just helped in all sorts of aspects us to learn a lot more about acceptance, commitment therapy and it sounds like it’s some whacko Freudian nutjob psychotherapy, but it’s like the exact opposite of that. But useful tools can help that one up. 

Dr Ron Ehrlich: [00:35:07] Hmm. Yeah. Just. Wow. Because I guess one of the things we talk about emotional stress and think, well, you might not be able to change the world you live in or the people that you come into contact with, but you can change your attitude to it. And I’m guessing that the acceptance and commitment therapy is a great tool for doing just that. 

Prof Grant Schofield: [00:35:31] Yeah, negative thoughts come in and you just notice them like a dog. So soon you have somewhere. I don’t know where he is, but he’s there sometimes at the front barking, but, you know, engaging with him. It’s just going to make him more involved if you want to talk to the dog. So, yeah.

Dr Ron Ehrlich: [00:35:43] And you mention that hot and cold, because one of the questions I’m often asked is, is all stress bad?

Prof Grant Schofield: [00:35:51] Yeah, well, this is a great example. So you get it. You’re actually stressing the body with the cold and the shiver response to brown or least beige. The white said this metaphorically, right. You remove glutamate in the brain. That’s great. That is a which is in my column, which is responsible for muscular work is enhanced. 

And then you get that those heat shock proteins and that cellular resilience of that from the heart. These are stressors, but in small doses, obviously still cold water for long enough. It’s going to kill you. The same dissonances that I get so that when saying what doesn’t kill you makes you stronger, that these are small doses.

Dr Ron Ehrlich: [00:36:34] Mm hmm. Fasting is another intentional stress in a way, isn’t it? 

Prof Grant Schofield: [00:36:39] Yeah, well, that’s exactly right. So that brings it up. You know, the thinking of us, you’ve written books on fasting, and I think a lot of that fast. I mean, that’s pretty good. I think postmenopausal women, it’s pretty good. You know, if you if you’re a woman, you know, 10% of women suffer from PCOS, you know, and what are the causes of high cortisol? Yeah. 

If you’re prone to high cortisol already, then, you know, maybe fasting is not for you, but you just want to eat this and, you know, calm the nervous system and brain and return of that to normal and then it can wait is a powerful tool. I’m a big fan of fasting for me, but I know it doesn’t work for. 

Dr Ron Ehrlich: [00:37:16] How how do you incorporate it into your life?

Prof Grant Schofield: [00:37:19] I mean, ideally you must dinner and have breakfast, but that’s there’s not a way that’s going to work for me. So I just have a couple of times a week where I miss breakfast and have a late lunch. And then when I do that, you know, I try to keep it pretty low carb at Whole Foods. 

And then once or twice a year, my wife and I set aside some time and do that for us. So the 2 to 3 day fast and then maybe if it’s going really well on extended up to five, I actually pull a ten-hour day three or four for me. I start to lose sleep quality at that point and it doesn’t seem worthwhile. But yeah, I try to do that once a year.

Dr Ron Ehrlich: [00:37:56] Yeah. And in during that time, it’s just with this having water.

Prof Grant Schofield: [00:38:01] I have that coffee. I am just not up to getting off the coffee… Other people. What they thought.

Dr Ron Ehrlich: [00:38:10] This is about, this is that’s the other thing with Grant is, you know, I kind of think of health as a percentage game, isn’t it? And you know we live in real-world and what percentage of what you do that’s good and what you do that’s bad is in your life. And if it was a 50-50 split, I’ve always thought, gee, that’s really not good enough. 60-40, hmm, I kind of go for 80-20.

Prof Grant Schofield: [00:38:33] Yeah. I mean, I’d like to live. I think that’s my reality, which I suppose is pretty good. I’d like to do better than that. Just, you know, like I sort of want to because I’m a really into the stuff. I love self-experimentation. I like to go quite hard at the hard end of doing it and I still struggle to live in this pathological world and keep on it all the time. And that’s right. You know, it’s one of five things almost really I miss or either. So, you know, I just don’t beat yourself up about that as well.

Dr Ron Ehrlich: [00:39:04] I kind of when I’m really on fire. I’m 90-10, you know, and there’ve been various points in my life where I’m a bit of an obsessive character, where I’ve gone. 

Prof Grant Schofield: [00:39:13] Hahaha no kidding.

Dr Ron Ehrlich: [00:39:14] 100% and I’m a like a social outcast. No one wants to be with me or near me. Yeah, which was another interesting one, you know, about this pandemic and the impact of social isolation. I actually read a report from the Australian, the American Psychology Society, which said. Social isolation was, had negative impact on health equivalent to 15 cigarettes a day.

Prof Grant Schofield: [00:39:38] Well, yeah, well, I’m not surprised about that. I think it depends. Yeah. For me, I’ll buy this slice of life slices because I’ve got a nice house, I’ve got a good family. I’ve got a selection of bicycles. Yeah, mountain bikes, gravel bikes, stationary bikes, road bikes. Got the kids. They always had a grand old time, frankly.

Dr Ron Ehrlich: [00:39:57] Me too. Me too. I hate to say it, but not everybody enjoys it at all. 

Prof Grant Schofield: [00:40:01] I mean, it’s just a position of privilege that I’m in. And it’s ridiculous. And I know a lot of people that I know that are crowded. Yeah. My kids were three, four, five years old. That.

Dr Ron Ehrlich: [00:40:13] Oh. 

Prof Grant Schofield: [00:40:14] Can’t imagine. So, yes, I’ve had it easy. Lots of other people had it much harder. And again, we just didn’t discuss the costs and benefits. So that wasn’t a topic sort of. Hmm.

Dr Ron Ehrlich: [00:40:27] Grant, always. I enjoyed talking to you. Thank you so much for joining us today. I really, it’s always good to catch up.

Prof Grant Schofield: [00:40:34] Yeah, I could go on all day, Ron. As you know, we’re both good, I think with Ron.

Dr Ron Ehrlich: [00:40:37] Well, you know, I always and this is such a treat for me to hear from somebody who’s a professor of public health, you know, because I’d love to. Why aren’t professors of public health, health ministers and leading health departments and all this? 

Prof Grant Schofield: [00:40:52] Well, we in this country, we have some doing that, but not in the way I think.

Dr Ron Ehrlich: [00:40:57] So did you, by the way, did you read that article? There was an article recently in the BMJ, British Medical Journal, The Illusion of Evidence-based Medicine. Did you happen to… 

Prof Grant Schofield: [00:41:10] Yeah, absolutely. That was a really important step forward. I share that with all my students I’ve been sharing around the place. I agree with that. Yeah, we’ve got to the point in medicine where we’ve actually lost we’ve lost it. And the pandemic put that out. You know, I don’t know how it changed that. That’s a famous. But the idea is can you get yourself elected or something. 

Dr Ron Ehrlich: [00:41:30] Yeah. Because it introduced me to or reintroduced me to two terms that I think we should all be familiar with because they are seem to be running our health departments and they are key opinion leaders or KOLs in marketing parlance and product champions. Because I just attended a two-hour seminar, a public forum in Australia for treatment for COVID. Yeah, and it was a two-hour commercial by our leaders Brendan Murphy, Michael Kidd, Paul Kelly, John Skerritt, head of the TGA. It was a two-hour commercial for patent to drugs. 

Prof Grant Schofield: [00:42:11] Astonishing, isn’t it? I’ve realised we’ve lost the plot when I was listening to the BMJ podcast and the BMJ does a pretty good job. This was a while back and there were the two new treatment trials had just finished. Well, they hadn’t even finished the initial trial and they, the UK, the Australian, and the New Zealand Government had already pre-ordered these things for billions. 

I have no idea if that’s ever going to work, let alone be, you know, the harms and yeah. Australia is up there. Yeah. Well, some of it thanks. How much or whatever you want, yep. 

Dr Ron Ehrlich: [00:42:54] Well, you’ll be interested to know that when I was president of ACNEM, Ian Brighthope was writing letters to everybody about in government about just let’s minimise harm and use vitamin D, Zinc, and Vitamin C for aged care. These are people that just would benefit. And we got letters back from the TGA who put in those billions of dollars worth of orders on these new experimental drugs, saying insufficient evidence to even consider that. Thank you for your emails. But know I’m being really serious for uh… Grant. And this isn’t a conspiracy theory. This is just a business model. 

Prof Grant Schofield: [00:43:35] Yeah. And it’s doing harm as well as potentially some good somewhere. Don’t we have that now? Maybe it is somewhere so we need to get that as an open discussion.

Dr Ron Ehrlich: [00:43:44] Yeah, if we could have one, that would be great. Grant, thank you again. It’s always terrific to talk. 


Dr Ron Ehrlich: [00:43:52] Well, as I say, I don’t know why I professors of public health like Grant, who are into sleeping well and exercising in a sustainable and varied way, and eating natural whole food, low carb, healthy fat diet which incorporates occasional fasting into your life, which is part of our entire human journey. And kind of Grant’s approach to public health is so disengaged from industry that it makes it a unique approach to public health. 

Yes, a unique one. Unfortunately, if you haven’t already got this message, and if you’re a regular listener of this podcast, you definitely would have this message that so many of our so-called health experts and I always preface that now that word with so-called health experts and the leaders in our health world in Australia, certainly that would include medical officers, chief medical officers, both federal and state governments, heads of health departments in Australia, the heads of the TGA, which is the Therapeutic Goods Association, the Australian equivalent. 

If you like, to the Food and Drug Administration, heads of the NHMRC in Australia, the National Health and Medical Research Council, which is the well sort of smaller version of National Institute of Health in America. When you look at these organisations, I think, you know, the science in medicine, as we now know, is largely funded by the drug companies. 

And this era of well, certainly one could argue the last 30 or 40 years, but particularly the last two years I’d describe as nirvana for Big Pharma. And when Big Pharma pays for the science in medicine, what we would hope we would have are scrutineers of the science in medicine we don’t. We have groups which actually, without any hint of irony, call themselves the Friends of Science in Medicine. 

Dr Ron Ehrlich: [00:45:55] I wish they would change their name to the scrutineers of the science in medicine, but they find we find that they are in very senior positions making public health policy and ignorance. As I’ve also as a subject that I’ve touched on in this podcast several times, I’ve often happily admitted that I practise ignorance regularly. It’s why I do this podcast because I get to talk to people who know far more than I do subjects, which I ask them questions and they answer them. 

And my ignorance is lessened because of that interaction. And I hope yours is too. Ignorance is a wonderful driver for learning new things, but when ignorance is combined with ego, arrogance and hubris, and particularly when that ego, arrogance, and hubris informs public health policy, we have some serious problems, as we have witnessed not just in the last 30 or 40 years with the epidemic of preventable chronic diseases.

Dr Ron Ehrlich: [00:46:56] So you would hope that if evidence counts for anything, the evidence of the increase in chronic preventable diseases is a testament to public health officials. And when we look at also the science in medicine and we realise the illusion of evidence-based medicine, which is a topic I’ve covered many times, and we also realise how many people have unwittingly maybe you’re such a person, maybe friends or family of yourself, you know, people like this. 

But many people have unwittingly become marketing and compliance officers for an industry, the pharmaceutical industry, which has repeatedly been found guilty of illegal marketing and fraud and has literally cost tens of thousands, in some cases hundreds of thousands of lives. It surprises me how many in the public have unwittingly become marketing and compliance officers volunteering free for Big Pharma.

Dr Ron Ehrlich: [00:47:58] Yep, it’s happening out there. I think we all need to take a step back and reflect on what is important in life, which is exactly what this podcast is about. This podcast is about empowering you to take control of your health and be the best you can be. I hope it’s making a contribution to that effect. I hope this finds you well, until next time. This is Dr Ron Ehrlich. They well. 



This podcast provides general information and discussion about medicine, health, and related subjects. The 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.