Would you agree, or where were you on that?

[lip smack] Yeah.

Well, that's the, um...

Well, first of all, back twenty-five years ago, nobody read the medical literature, not even the journalists.

I mean, the doctors supposedly did, but journalists didn't and, and influencers didn't exist back then, and socio- social media personalities didn't exist back then.

So, and if you-- as a journalist, if you did a story, you just called people up and talked [chuckles] to their secretary and made an appointment and then interviewed them, and that's all you did.

You weren't expected to read their papers.

That, that's the crazy part, you know? [laughs]

Learn more about teen accounts and Instagram's ongoing work to protect teens online at instagram.com/teenaccounts.

Really hard-nosed scientists working in, in, in hard sciences, and hard sciences are sciences where you can actually test your hypotheses rigorously.

Everything that I had learned about what you had to do to make sure you got the right answer was considered kind of a luxury in public health, 'cause for the most part we can't do it.

If you have a hypothesis that some aspect of your diet or environment causes a chronic disease, um, you can't, [clears throat] you can't really test that hypothesis and experiment.

You can't randomize people to, for instance, smoke cigarettes or not smoke cigarettes and see, run it out for 20 years and see if the people who smoke get more lung cancer.

So instead of, um, doing these experiments...

I mean, you technically you can do them.

[laughs]

And so I, I think in a lot of different ways you do such a beautiful job of painting the picture of how we've gotten to where we are right now, and how we're largely, as a culture, we're very focused on drugs to address lifestyle-related disorders.

Well, it's funny, I had an epigraph at one point, a quote that I used to begin the very first introductory chapter, and, uh, it eventually got Move to the end for a variety of reasons.

One of the problems was kind of gave the book away right up front, but the quote was from a chef turned journalist who was diagnosed with Type 1 diabetes.

I think it was thirty-one years of age, and he describing to me the conversation he had with his physician endocrinologist, and they're explaining to him what the problem is, what his body's failing to do, and then what they would-- how they were gonna treat it.

And then he says, "Wait, wait, let me understand this.

So what you're telling me is carbohydrates are now a poison to me, and insulin is the antidote, and I should eat the poison and take the antidote rather than just not eating the poison?" [chuckles] And the guy goes, "No, there's nothing about this." It's just his way of thinking.

The doctor says, "Well, you can't think of it like that.

Well, is it evolving beyond the diabetes piece? Is it something similar to what this book is about or something totally different?

Kroger, fresh for everyone.

fat.

And if fat cells are just connective tissue filling up with fat, then it's easy to imagine that when people eat too much, the fat just sort of oozes into the fat cells, into the connective tissue, and you get an excess of fat.

And for the next 50 years, basically people confirmed Fleming's view until the 1920s, 50 years later, when a fellow named Wasserman came along and proved Fleming was wrong and Talt was mostly right.

But by that time, the idea that fat was just connective tissue expanding with fat had sort of settled into the zeitgeist, a German term.

Cantani put it this way.

So Cantani, when he was writing about the nature of fat tissue in 1879, said, look, we're more inclined to accept Talt's theory than Fleming's.

[laughs]

What do you think about all that?

Well, and for the most part, I agree.

One of the reasons I agree is because I've talked to physicians like you.

In fact, for this book, I interviewed you and 120 other physicians, and it's the same experience over and over again.

It helps when the physician themselves is suffering is from obesity or overweight or diabetes or pre-diabetes or metabolic syndrome or pick your chronic disease so that they can try it themselves and see what happens.

I mean, there's a few of our colleagues out there were always lean and then became pre-diabetic like Mark Kukazela or athletes who had pre-diabetic numbers and then tried Keto as an experiment.

So it helps if you can experience it yourself.

what I do all the time.

And so I love how you talk about the, the difference between the researchers and then the doctors, where the rubber's actually meeting the road on a day-to-day basis.

Well, this is...

I mean, there's so many different issues in these...

You know, for the, uh, medical establishment to, to screw up quite so badly takes a sort of, uh, a, a collection of different errors along the way.

So one of them is exactly the one that you're discussing.

I mean, they, they created a, a, a thought construct by which they can rationalize away what you're seeing in your clinic, right? So it doesn't matter how many physicians like you report what you're seeing.

And, and recently we had, uh, David Unwin, who's a kind of British version of you, writing in the British Medical Journal Nutrition about exactly this issue, and saying, what we do is we, we have all these huge epidemiologic cohort studies, they're called.

Which, which one of the three is it? Fraud, is it foolishness, or is it just their paradigm and they honestly, truthfully, earnestly believe that their paradigm is correct and they just can't see the evidence on the other side?

And then where did we take a wrong turn and why was that?

Well, so let me digress also.

The reason I started my career as a journalist, my expertise and my interest has always been technology.

good science and bad science and controversial science.

You become a scientific historian when you do this kind of work because you have to understand the evidence base of whatever arguments that you're discussing, analyzing, and so you have to go back in time to see, in effect, why we believe what we believe.

In diabetes, you end up going back, I ended up going back to 1797, which was when the first claim was made that this was a disorder that could be kept under control.

And it was a British physician named Rallo who was treating, he was a British army physician.

There's no question, right? So

And so you could dine out at all the steak places with impunity.

Yeah, exactly.

And the assumption was he's going to kill people.

This is it.

The LDL is going to go up and LDL did go up.

I talked to, when I was first doing my research, I talked to Pete Aarons, who was one of the leading, probably the leading lipidologist in the world.

He was at Rockefeller university, brilliant scientists.

Yeah.