PODCAST Dr Malcolm Mackay on practicing lifestyle medicine, fitness and supervising me!

PODCAST Dr Malcolm Mackay on practicing lifestyle medicine, fitness and supervising me!



 

In some ways I'm a typical bloke so of course I had no plans to consult a doctor but as we all know, happy wife = happy life! I thought that eating spuds only for an entire year might be too far outside the mainstream for most doctors so I decided to look up a plant based doctor who might at least be familiar with the work of Dr John McDougall.

 

I knew of Dr Malcolm Mackay because I had read through the website he created with his wife Jenny Cameron while I was in my research phase. I really liked what I'd read, so it was an easy decision that he should be the bloke to help me through. Little did either of us know just how big this would become!

 

Before long Dr Malcolm and I were appearing on prime time T.V. together as well as all other types of media coverage all around the world.

 

It's not all about me though; we talked about Malcolm's evolution towards plant based eating and how it has effected his career as a doctor. We talked about the health care system in Australia and we talked about his amazing achievements as an athlete. This is a long overdue conversation with a man who I am deeply grateful to have had in my corner over the last year and a half. I hope you enjoy it!

 

Spud Up!

Andrew

 

Stuff we talked about

 

 

CONTENT:

  • 00:07:27 ..... DR MALCOLM MACKAY THE SPUD FIT ACADEMY DOCTOR ON WHOLE FOOD PLANT-BASED DIET
  • 00:18:24 ..... NATHAN PRITIKIN'S DIET
  • 00:27:05 ..... RUNNING
  • 00:34:17 ..... THOUGHTS ON SPUD FIT ACADEMY
  • 00:50:18 ..... DIABETES
  • 01:12:44 ..... TURNING AUSTRALIA'S HEALTH AROUND

 

Dr Malcolm Mackay on practicing lifestyle medicine, fitness and supervising me!

This podcast has been automatically transcribed by a software and went for a minor editing. If you notice any mistakes or wrong word entry please help us fix them by leaving a comment. We made sure to be the most accurate as we can. Enjoy!

 

Andrew: G'day, everyone. Welcome to the Spud Fit podcast, episode 13. I'm your host Andrew Taylor. I'm a crazy weirdo who ate only potatoes for all of last year and I lost a lot of weight and had a lot of Health improvements and had quite a bit of media attention and all sorts of things going on there. So, uh, It was a big year and it this is podcast is one of the things that came out of it. The year wasn't just about trying to lose weight and get healthy. It was about trying to improve myself as a person. And so this podcast is about trying to spend time talking to people that can help me continue to improve as a person in various ways including diet and including Fitness and including being all round better person. So, uh, this today's guest can certainly in already has helped me do those things. His name is Dr. Malcolm Mackay and he is my personal doctor. He is the guy who helped me get through last year. He guided me through provided my medical check-ups and peace of mind that came with them and he gave me my blood tests and uh and just lots of general advice and helpfulness along the way. So yeah, I mean in great gratitude to Dr. Malcolm Mackay he should have been much sooner guess than he has been but uh anyway he's here today to talk with me so yeah, no complaints let's get it done. But first it's been a little while since I have actually done a podcast. It's been a few weeks now and I've been really busy.

It's uh life is busy and. You know, we've got priorities and sometimes I have to come first. This is uh something I've been doing obviously for free you don't have to pay for podcasts. But um, it also means that sometimes it has to take a backseat to other things. We've got bills to pay and we got responsibilities to that need to be met. I need to be a good father and a good husband. And uh, and I I need to also prioritize sometimes the things that are going to help me get the bills paid. So, uh, Yeah, that's uh, that's why there hasn't been a podcast for a few weeks. I would love to do it more often. I'd love to do it every day if I could but uh don't think that's going to happen. It's a it's a very time-consuming thing putting this podcast together. It takes uh on top of the time to organize an interview. It takes quite a few hours to actually put it all together. But anyway, I'm not complaining. I'm just explaining. Uh, the point is that something's got to give. So I'm not a hundred percent sure that I will continue doing this podcast. I hope to, but basically I need to find a way to free up some time so that I have more time to be able to do this one of those things might be starting at Patreon page, a few people have told me about Patreon. It's a it's a page that you can start where where fans of somebody's work can contribute money to support them. So I haven't started that I'm weighing that up whether or not I want to do that. But if I do continue the podcast I'll probably continue it with a Patreon page and see if that can help me, the people that appreciate what I do to uh be able to contribute and help me do it more.

Anyway, that's enough about me. The point is I enjoy doing this. I love doing it. I want to be able to do it more and hopefully I can figure out a way and it's also just an apology for being a few weeks since the last one, but thanks everyone for listening. Thanks for your support. Enough out of me. Well not quite enough. I'll introduce the podcast a bit more but first The Dakkery is the sponsor. The reason I have a sponsor is because it's my wife's company. So the Daiquiri thedakkery.com, in Australia dacks are short for- tracksuit pants get shortened to tracky pants, track pants, tracky dacks. These are the world's most comfortable tracky dacks that are designed by artists and they are made of 100% organic cotton and bamboo and they are the most luxurious tracky dacks you will ever put on your bum. So go to thedakkery.com and get yourself a pair. Now. Back to today's guest. Dr. Malcolm Mackay. As I said, he was my personal doctor. He helped me through last year with all my medical check-ups and tests and etc. Malcolm, the reason I went to him was because I thought it was pretty weird to do and it's pretty weird to do a potato only thing and I didn't think just any doctor would be able to handle that. So I tracked down Malcolm knowing that he was uh, very big on a whole food plant-based diet. So I thought potato wouldn't be too far out for him that he'd be able to support me and I was right he was very supportive from the beginning. We'll talk a lot more about that in the podcast. But just a little bit more about him he's been doing Whole Food plant-based way of eating and lifestyle for well over 30 years now. He's extremely fit as well he's an amazing athlete. So we talk about both of those things. And and we talked about his journey to Whole Food plant-based eating and and his life as a doctor and an athlete, as a whole food plant-based eater. If you want to find out more about him. You can go to his website wholefoodsplantbasedhealth.com.au and it's actually a fantastic website. I send people to it all the time. Anyway, that's enough of an introduction. I've been talkin long enough. Let's get on with the podcast here is Malcolm Mackay.

Andrew: All right Malcolm, welcome to the podcast. It was uh, it's a long overdue one. We should have done this a long time ago. But anyway life gets in the way, but here we are now we're uh having a conversation for the Spud Fit podcast finally, so welcome.

Dr. Malcolm: Thank you Andrew. Thank you for having me on your podcast. And... I would rather have been first because I follow on now from John McDougall, Dr. Gold Hammer, Dustin Rudolph, a whole list of well known plant-based experts.

Andrew: Well in my opinion you belong next to them. So don't worry about that. It's all good. You maybe, you don't have the same name as them, not as many people know who you are, but they should in my opinion. So hey, well not nothing to worry about let's do it anyway.

Dr Malcolm: Okay, Andrew.

DR MALCOLM MACKAY THE SPUD FIT ACADEMY DOCTOR ON WHOLE FOOD PLANT-BASED DIET 

Andrew: All right. So, um, yeah, there are not many, uh, plant-based doctors in Australia. And uh, and this is uh, it's an interesting story to me about how someone from Australia where there's really not much in the way of plant-based anything-- 30 years ago gets into plant-based nutrition at all, let alone, um using it in medicine. So let's just go back to the start of your journey for a minute and yeah, how did how did you come to be interested in eating only plants?

Dr Malcolm: I guess I came from the family that gave a lot of emphasis on how important food was important for the body and mind, mind you it was like protein and meat and eggs and dairy then I went to medical school. And by about third year medicine, we had one cardiology lecturer who talked about the the inevitable process of atherosclerosis. That's all the gun can scarring that builds up in arteries leading to heart attacks, strokes, loss of legs, impotence Etc. and for 20 year-old these gruesome slides of what would in what the inevitable what would happen with Our arteries as I got older it was not a pretty sight and at that point I was getting back into the distance running that I'd been good at when I was at school

Andrew: and how are you eating at that point? What was your diet like? You said you were you know ate healthy foods in your family emphasized good foods and how it's good for the body but like what did that mean to you before that point in time?

Dr Malcolm: I can't remember very clearly. Yeah so many decades. Oh, yeah. No, I don't think my diet would have been appalling, you know, I did tend to like whole grain breakfast cereal. I wasn't all that keen on bacon and eggs my, families that have pushed their, mind me. I was living in a hall of residence in the meat was pretty awful. I wasn't very encouraged in anyway, so I think um, I did have a propensity sort of vaguely towards, you know, whole grains and fruits and letting some vegetables and things I wasn't a pure junk food addict.

Andrew: Yeah. So you were eating most uh normal inverted commas people, in today's society would have considered a reasonably healthy diet anyway, You still had some animals-

Dr Malcolm: probably reasonable but not excellent. And yes, so those that lecture and in the same year or the same semester another lecturer in public health told us about some of the indigenous populations of the world like the people of Highland Papua New Guinea who had a very low fat, very low salt etc diet. they ate, pretty much just sweet potatoes.

Andrew: Yeah. I did some research on them myself before I decided to do my Spud Fit Academy was there's Papua New guinean highlanders were, they were one of the things that I looked into before I made my decision so yeah interesting that that was part of your learning process aswell.

Dr Malcolm: It is very much a part of my journey and you know I don't understand why all the other students didn't get it. Like that the heart disease risk factors were all around us like everyone was eating too much salt, too much fat, too much animal fat, processed food Etc. Too much meat, not exercising enough. And so when I learned about this, Papua New Guinea people living on sweet potatoes and so I thought... so this is not an inevitable disease and from that point on and then I soon discovered through other populations. that was somewhat similar, you know, they might eat something different like rice, but they'll basically eating basic plant-based low fat, starchy food. Not adding all the SOS, the sugar oil and salt. And that led me on a path where when we did other diseases when we looked at diabetes or breast cancer or bowel cancer I would always be thinking I wonder if this is really a worldwide thing, you know, are there people who don't - the populations in the world that don't get as much of these diseases or get none of them. And whenever I looked it was always pretty much the same factors that is the people in the world that ate more meat and dairy and eggs and processed food. All these diseases in great amounts and those people in the world who lived on you know basically lived on the statue plans that they grew often had none of these conditions at all.

Andrew: Yeah, I just find it fascinating that you know, you're in a class of I don't know 100 students?

Dr Malcolm: well it was a small medical school. We started off with 64.

Andrew: Okay. So out of 64 people you've got one that decided to just look a little bit deeper into the research and find out you know, what what the relationship could be with diet and you know, the same like... you may be the only person in the group that took that link between heart disease and you know, the Papua New Guinea in Highlanders and then just went down the rabbit hole with it. I wonder, it fascinates me like you said, I don't know why everyone else didn't go down that path with you. Like it was a strange thing.

Dr Malcolm: I think, you know, when I get information I tend to think it through and process that you know, and if you hadn't sort of thought deeply thought "hmmm... inevitable heart disease? hang on, population without heart disease? mismatched! Think about this!" And I don't think everyone always that have processes the information like that. And I don't claim to be brilliant instead of recognizing this while as a medical school, you know, countless people before John McDougall, Nathan Pritikin, you know, anyone who's look closely the medical literature and Buddah side there by cultural bias and their personal preference would find the same thing. I think some of the other students, you know, some of them I think people sometimes pick this up to some extent thing "Oh, yeah more veggies, but it's like I dive down the rabbit hole right?" I'm just going to eat whole plant foods. I'm just going to eat brown rice and oats and potatoes and beans and vegetables and fruits, but I think other people just you know, only a bit cautious... they don't want to put their hand down the rabbit hole. They don't want to sort give away their cherished, you know, dairy foods and their chicken and things.

Andrew: Um, yeah, it's a tough thing for a lot of people, I guess people feel responsible and it's hard to put words to it but people are confronted by the fact that maybe they're been making choices that are not so good for them despite their best efforts. A lot of the time people think they're doing the right thing and to discover that it might actually be hurting them. It's a hard thing to take in and maybe that's maybe they just resist change because they don't want to admit that they've been doing something that was wrong this whole time.

Dr Malcolm: I think you really onto something there. I consider that I see that in patients that to accept that what they've been doing, you know is not the best thing for their health. And in fact, you know, perhaps led to some of their medical problems is a hard thing to cope with, because you know, it can bring it can carry with it a lot of personal guilt. I mean, I don't think people are guilty patients security of you know, deliberately poisoning themselves and giving themselves acne and diabetes? They just got the wrong information. They just were in the wrong culture. But yeah, people do get very sensitive about it because it raises some guilt like, oh, I've got it all wrong and also grazes like, oh I'm stupid and I think when we often people look at Medical experts; doctors, various people educating and nutrition. And often we pointed them and say well you are being sponsored by meat and livestock or dairy Australia and we often think that it's the money or you just want to get more patients to do bypass operations or stomach surgery on but you know, I think some of the people are rejecting this because they would have to sort of face up to what, that they got it wrong, that their culture got wrong, that their peers got it wrong. And even in there's a particular group of doctors are was a member of this environmental group of doctors. And um, I've had Jenny and I had discussions with some of the sort of committee members and things and they were not at all receptive to the idea that part of Saving the environment would be change into a plant-based diet. And it wasn't because those any money unit or anything else, you know, they weren't dairy farmers It was it was just it was too hard for them to consider that they got it wrong that our culture got it wrong, because etcetera.

Andrew: Yeah, it's a reminded of a saying, I can't remember who it was now, maybe Mark Twain or something like that said this, It's easier to fool someone than it is to convince someone they've been fooled. And I think that probably applies that you know, people just don't want to they don't want to accept that maybe they've been lied to or maybe they've had the wrong information the whole time. So while you're at at the University and studying did you talk to your lecturers or your classmates or anything about what you were doing or what your what you thought was the right way to go as far as dark goes? And if so how did those conversations go?

Dr Malcolm: Yeah. Look, I think I was probably a bit annoying and I probably often been quite annoying in this respect, yes, I would be telling them and it started a bit of a year or two after I discovered it. Someone brought to my attention the books that Nathan Pritikin had produce like THE PRITIKIN PROGRAM FOR DIET AND EXERCISE and that was great because that that reassured me that I wasn't as mad as my classmates thought I was, and that sort of set me on a path to sort of being a great fan and an advocate of the Pritikin diet and boy did I ear bash a few friends and relatives and anyone else I cornered at social function... about, you know ,why the Pritikin diet was the way they should go?

NATHAN PRITIKIN'S DIET

Andrew: Yeah Pritikin's someone who I have heard of lots, but I've not read a lot about myself, but seems to be that everyone who has been doing this for a long time. It always comes back to Pritikin as a one or two others. So what can you tell me enlighten me a little bit about what it was that pretty can did that makes him so special that-

Dr Malcolm: Nathat Pritikin showed so far ahead of his time and just showed such perseverance. There's a McDougal recorded lecture by Nathan pritikin of how he found out about his, the diet and its effects on health. Nathan pritikin was an engineer who was privy to post-world War II data and the the Paradigm at the time was that heart disease was due to stress and so he saw this Paradigm data and he looked at it and he was someone who again just thought things through and said Well look at this. Look at these populations who are being fired bombed in invaded, they're gonna have lots of heart- Oh, no, their incidence of heart disease plummeted. Okay, there's something else going on there. Oh, they're on rations! He thought, And Nathan Pritikin then looked and learned about some of the other populations in the world that are that are heart disease free, like the Tama hamari Indians of Mexico who's incredibly fit, you know this wooden balls for sort of days as a ultra marathon runners. Well their close relatives across the border, the Pimu Native Americans in the u.s. are really fat and sick and have lots of diabetes and disease, So Nathan Pritikin then got heart disease at a fairly early age and he applied it to himself and he emulated the died of some of these, you know, he thought about the wartime rationing. He looked at people like the Tama Hamari and so he went on a starch-based very low fat diet and the Pritikin regression like the strictest form of it is close to either totally or close to a vegan diet and it's got no added oil and it's based on starchy food. So It's pretty close to what we would now call a Whole Foods plant-based diet except that he had he had a maintenance diet that allowed a very small amount of animal products, but still no oil.

Andrew: So it's pretty McDougal-ish then?

Dr Malcolm: yes, but Pritikin was not a doctor and so, you know, he tried to put this idea forward and no one had taken a notice of him in the medical profession be critical. He ended up publishing books. He opened the Pritikin longevity Center. And and he had people working with him and medical people working with him. I actually published some of the data and the incredible results they got in terms of taking people who you know airline pilots who are losing their jobs and reversing their heart disease, you know to getting people off most of their medications and you know, putting their diabetes into remission.

Andrew: Yeah, interesting that's yeah, obviously when you introduced him you said he was an engineer, but it didn't click to me that his actually that's he's an engineer not a doctor or a medical professional or anything. Just yeah, someone unrelated making all these discoveries and doing with this work makes it an extra level of uh of incredible to me. So is there anyone else uh that was part of your research or influenced you in the beginning other than pritikin? was McDougal around then or obviously he was around but was he someone that came across your radar at that point in time or...

Dr Malcolm: McDougal passed across my radar afterwards. Some years after I found Pritikin . McDougal did cross my radar. And I don't know why I didn't sort of grasp onto more of McDougal's material. But he certainly crossed my radar. The Pritikin Health Association. there was in the when I graduated um the pritikin Health Association of Australia had just been formed and it was actually very very active. There were several thousand members across the country. There was a guy called Ross horn who wrote a book about reversing heart disease, who was involved with it. Robert DiCastello's father Ron DiCastello was involved with it as well. And we had a very active branch in South Australia. And uh, you know, sort of this is going back to sort of mid to late 1980s and for several years we had monthly meetings with guest speakers, sometimes myself, but often we had a gut microbiome expert speak to us way back then,

Andrew: that is way ahead of time isn't it? because that's sort of like, that's the big topic these days the gut microbiome and 20 30 25 years ago, 30 years ago even. You were already talking about it then,

Dr Malcolm: likeback then like, Dr. David topping from CSIRO recognize that the human colon was there to ferment food and processed food and involving bacteria, and I remember he made the statement. He said humans are like cows back to front, In other words meant food in the room and up, the front of their Gap, as humans meant their food with bacteria and the latter bit of the intestine.

Andrew: All right, that's interesting. So you mentioned that uh for people that are not from Australia, which is probably a lot of people listening, you mentioned Robert Di Castello's dad, Robert DiCastello is a probably the most famous Australian marathon runner of all time. What these data run onto is that something was there some sort of influence for you because you obviously you love your running was that was he having him involved in that group some sort of influence or was there something about this that you wanted to improve your running performance? Is that part of the reason?

Dr Malcolm: Yeah, it's really about improving my running performance. In fact that was part of my impetus for, as he said going down the rabbit hole and just ditching meat and dairy and oil and going on completely, you know, starch-based whole grains legumes potatoes etc. diet. Also I wanted to improve my running, I'd got back into running. I'd been a runner at school, a distance runner. And it certainly made a difference to my running. I think in 1980. I I ran my first marathon, it was a 239.

Andrew: 239? Oh wow,

Dr Malcolm: and then within a year-

Andrew: first marathon 239? that's incredible.

Dr Malcolm: I had the time, I was running this event with a friend and he wanted to qualify for some event. So he had to run lesson to 40. So I had all the splits written on my arm and I wasn't knowledgeable to enough to know that that was very optimistic so I just did it. Yeah, right. So you were like pacing him trying to help him get to that time. Yeah, I had I just thought, I want to stick to this time. And I think that in that year I also came third in the Adelaide Marathon event for 232 for that one.

Andrew: Wow, I knew you were a good runner. I didn't realize it was that good though. That's pretty incredible. So...

Dr Malcolm: and I really do think that changing to, you know, a starch-based plant-based low-fat diet. I think that that really helped me to you know perform as well as I did in running and later on some triathlon.

Andrew: Yeah, well, especially from what you talked about earlier about heart disease. It makes sense that you know to be an endurance athlete, uh that you need a good strong heart, you need clear arteries that your blood can flow properly and deliver oxygen around your body. And you know, that's a primary importance if you want to be a good endurance athlete so, it makes sense that having all of that working as best as it can would help you with your running and obviously you found that so yeah

Dr Malcolm: and I think it's no coincidence that traditionally the you know, East African runner the Canyons Ethiopians, Tanzania's, traditionally, you know, very much a starch-based diet eating things like garlic, you know, amaze me of all other grain.

RUNNING 

Andrew: Yeah, you know, people that uh people that follow me, on social media or whatever , lately, will notice that I've been getting into running. So, uh, let's talk about running then. Okay, since you're running expert. I'm sort of- for a long time I've had dreams of doing a marathon and you know for most of the times that I've dreamt about it I weighted way too much and I'm still a little bit overweight but you know still dropping a little bit. But anyway the point is that these days suddenly it seems like it's within reach at something that's possible. So yeah, do you have recommendations for me? How do you train? What should we be doing?

Dr Malcolm: You know I got back into Triathlon from about 2006 through 2012 after many years of actually not competing in any endurance events, but I always ran several times a week. I never never quit running ever. But I've also got a bit of life balance in that and my partner likes to go to the gym and she's a swimmer. So we do a couple of swimming squads that week. Jenny's away for a couple of days and so I didn't go to this morning swimming, running instead. I think when you eat a healthy diet when it's anti-inflammatory when you're fueling up on all those carbs when you're not damaging the artery with all that chicken and yogurt and olive oil. I think you can you can get results with a low mileage. You can actually get get results without doing a huge number of kilometers of running. And some of the things I think you need to be consistent and I suppose it might be some weeks where I'm only doing two decent runs in the week and plus maybe a little bit of treadmill warm up in the gym. But if I'm really training for any event needs to be about three times a week. Yeah and you need to put in the fast running, most times when I go running I will put in at least a couple of kilometers, at race pace. Yeah, and so that keeps your body conditioned and teaches your body both, you know, nervous system wires and muscle wires and heart wise to be able to run at that higher pace that you'll be using in a race. I also think that if I'm training for an event, that slightly longer if I'm training for a half marathon, I'll actually run a half marathon a week. And when I was training for the Gold Coast Marathon last year obviously can't go out and run a full Marathon. But for many weeks I would go out and run 30, 32 kilometers as my run for the week.

Andrew: Yeah, right. So you don't shy away from the long runs then a lot of people have spoken to just do like one or two of those 30-plus kilometer runs before-

Dr Malcolm: You know, it depends how competitive you are. Like a lot of people leading up to a marathon will sort of gradually do a couple of kilometers or every week can get up to 30. 30 kilometers also, you know a couple of weeks before hand, but see I'm competitive. So, you know training for a half marathon, for example, I'll be doing twenty one kilometer weekly runs for many many weeks so that I try and get comfortable at that speed.

Andrew: Yeah. I've been I've been running probably three times a week on average and I've got this weird scooter thing. I think you've seen it.

Dr Malcolm: I've seen it. I used to have one as a child, used to ride down the suburb a lot in my little push scooter.

Andrew: So my plan at the moment, I got in the injury from football and it gives me a little bit of trouble. But basically I started off doing... I want to do two hours of training right so I started off doing 10 min running until my knee got a little bit sore and then I'd get on the scooter and do an hour 50 minutes on the scooter. And it's gradually built up to the point. Where now I seem to do about an hour 15 - an hour 20 before I get my knee a little bit sore and it works out to you know, 14, 15 kilometers and then I switch to the scooter for the rest of it. So I figured that I'll just keep doing that until I get up to two hours of running two to three times a week. And um, I just see what happens. You think that could potentially get me through a marathon doing two hours to three times a week?

Dr Malcolm: I think that's- that would be too much long run. Yeah, I'd only do one run of 2 or 3 hour run per week.

Andrew: Okay, so I should stick with one hour of running and then one hour of scooting or just one hour running and leave it at that?

Dr Malcolm: It's up to you whether you bring the scooter in aswell. But um as far as the running goes, maybe do a couple of up to one hour runs and just the one long run per week. The other thing I did in the lead-up to the last one I did was the Run For the Kids Fun Run, 15 km run and part of my training was I'd go out and I'd run with my Garmin watch I would run 5 kilometers, my training run, at the pace I intend to run out for the longer distance.

AndrewSo so yeah, that's him that makes sense. So if I was if let's say I wanted to run a marathon in four hours. I got to work out that pace and try to train out that pace, you think?

Dr Malcolm:  yeah, and I'd be building up to say doing ten kilometers maybe even seen some Marathon probably more like ten than five kilometers at the pace you plan to run the marathon. Yeah, and on race day trying to be really strict for the- In the early parts of the race. So I fell apart in my Marathon last year, the pacing person went out too fast and I felt about I feel comfortable at this. I'll do that. It'll be just fine. And of course I wasn't in a good State for the last five kilometers.

Andrew: Yeah. All right. Yeah, that's not going to be fun I imagine suffering from thirty seven kilometers onwards. Um, all right. So anyway enough about my self indulgent training tips here. Uh, I got a little dog trying to muscle in on the action here.

Dr Malcolm: He's an attention seeker that cadoodle .

Andrew: It's a vicious thing. Isn't it?

Dr Malcolm: He's a carnivore and uh, you know, if you look at the dog's mouth, he's got all these teeth that are for ripping and his back teeth are not grinders they're like dicing tools. It's really funny seeing him eat a carrot because he could like- trying to eat a carrot with a set of shears rather than grinding and he can't move his jaw from the side to side because you know, he's a carnival actually, he's a true omnivore the dog, the dogs are primarily a carnivore that can eat some plant food and I often use pictures of my dog in presentations because my partner Jenny and I do some presentations on the  why what and how of a Whole Foods plant-based diet.

Andrew: Yeah, actually, I went to one a few weeks ago and I was well, I went to most of it, I had to go and take my boy to go and watch his first football game which he ended up leaving because he didn't like it.

Dr Malcolm: Thank you for bringing the potatoes along

THOUGHTS ON SPUD FIT ACADEMY

Andrew: Anyway so let's fast forward a bit then so you've spent 30 years or so as a plant-based doctor trying to get people to eat more plants and stuff and then out of the blue... one morning in early January last year this big overweight depressed guy walks into your office and says, hey I'm going to eat potatoes only for the whole year. Can you supervise me? Well, what what went through your head then?

Dr Malcolm: Quite happy to supervise you but I didn't get it Andrew. Yeah, I didn't get the food addiction, you know, I understand that moderation's a lousy strategy like you never tell an alcoholic drink in moderation and you know, I'm often immorally amused that some of our weight loss experts preaching moderation of themselves, overweigh. But I didn't get it.

And so my first reaction was well, you know, I don't know if you could all the nutrients. "Why don't you eat just a little bit of broccoli spinach a few berries?" I remember even saying that when you came to my office I even said that. It took me a while to get it. I think my contribution and the end to what you actually did was "Well, all right, Andrew it just adding some sweet potatoes."

It just so happened that that in the few weeks before you'd come in my partner jenny was studying doing a graduate certificate of nutrition at Deakin and she had actually drawn up some tables looking at what would happen If you ate, you know, a day's worth, maybe 2,000 calories of a particular food in the day.

How did that food Shape Up? You know do that food look like it would provide all your days iron, all you days protein, how much fiber would it contain? So she drawn up these little charts for several different foods and one of them happened to be potatoes. So when I went home that night and Jenny was able to say "Well look I've got this chart here. Let's have a look at it".
You know, I never thought it was dangerous. I remembered someone a university Professor. I think he was made some public statement like "-that's a dangerous diet to eat potatoes"

Andrew: and wasn't do, that was plenty of people that made those sort of statement, yeah.

Dr Malcolm: I know, I was always a little bit concerned about nutrient deficiencies, but dangerous? dangerous is like drinking protein powder drinks or going in an Atkins diet. That's dangerous, not eating potatoes. Interesting thing that unfolded though in terms of the nutrient adequacy of potatoes was- And I made a good point that I think we should all recognize when we do dietary analyses and try and you know, look at the nutrients their food is that according to the nutrient composition tables potatoes had no fats and they had no vitamin B6. A lot of plant foods have almost no selenium and iodine.

not because they don't have it because not one's mentioned it. And so when you look in a food composition table on a food looks deficient in particular nutrients, especially the micro nutrients things like selenium and iodine, often it's the actual actual database that has the deficiency rather than the food. So your experience with potatoes was I tested your blood and those plenty of B6 someone else did a fatty acid analysis and you will not deficient in omega-3 or omega-6 essential fat. So that that an intro was an interesting point that came out of that.

Andrew:Yeah, like I said, I had a lot of criticism especially early on before I uh been going along enough to show that it was healthy thing to do.
But uh, why don't we just go through some of the criticisms then my personal favorite? Right. I was going to mention names but I'll leave names out of it for now. But uh, my personal favorite was a very prominent celebrity dietitian said that she was worried about me getting bowel cancer from a lack of fiber in my diet. So. What what do you think?

Dr Malcolm: Yeah, I think if I read that I'd probably you know do a facepalm action and look over at Jenny. I find myself doing a facepalm so often when I'm ready reading our local medical media, I think the obvious thing there was potatoes do have dietary fiber and potatoes also have starch and if the celebrity dietitian had gone and looked at the CSIRO produced, um, fabulous animated video called The Hungry microbiome, she would have seen that those resistant starch the starches in food like potatoes are actually the very thing that that powers healthy gut microbes and fights against, or prevents the formation of cancer and in terms of fiber, I think potatoes are moderately high in fiber, but I have to figured it out on Jenny's chart to confirm this but it definitely have some.

Andrew: Yeah and if you're eating only potatoes then as long as you eating enough and you get enough fiber as far as I can tell anyway

Dr Malcolm: Yeah, I would say so as well and um, you know there's the some studies in South African black people who were eating a pretty lousy diet that would amaze me but it was fairly refined maize meal and lots of starches but no meat. None of the things, you know, none of the animal protein foods and they demonstrated a very low incidence of bowel cancer just by the fact that they were eating start and when Jenny and I do some of our plant based presentations we actually show a graph that's been growing up in reference to the resistant starch the starch containing food and there's a relationship from country to country that the the less starch that's consumed in our country of region the more bowel cancer there is.

Andrew: Alright that's another bit of research that I haven't read but that's interesting too. So a lot of people were worried that I was going to possibly get scurvy over the course of the year. Was that something that you ever worried about?

Dr Malcom: Uh, no. No, I know potatoes have some vitamin C and you only have to open up a nutrition composition table to see that you have vitamin C and then it's like protein?! what about protein?! everyone's worried about it?

Why is everyone worried about protein when the only protein deficient people in Australia are not eating because they're anorexic or really sick and everyone else is getting enough protein, never seen protein deficiency without calorie deficiency and nearly everyone's fiber deficient and yet they're trying to choose high protein low fiber foods.

Andrew: Yeah. That's an interesting one. Brings up another point that a lot of people said you know in the low-carb community people obviously said I would have been better off if you chose bacon or eggs instead of potatoes. So that's a perfect segue to uh, ask your opinion on that. What do you think?

Should I have done done bacon only instead of potatoes only?

Dr Malcolm: You know bacon is a Class 1 carcinogen as of last year, World Health Organization. The bacon, the processed meat cabinet in the supermarket, should at least have big Health warnings. This food is known to be a Class 1 carcinogen promotes diabetes and heart disease, you know, I can imagine one day walking through the supermarket and seeing the processed meat all in plain packaging like cigarettes.

Andrew: Yeah, that's uh a good luck with getting that one past. I think that could be that a definitely be a worthy thing to do for sure.

Dr Malcolm: Back to the the bacon and- yeah there seems to be a definite resurgence of this idea of eating a low carb diet which means eating more fatty food and and more protein food and it usually means eating more animal products rather than flaxseeds and nuts, and it's over facepalm even when people aren't really focusing on trying to eat a lot of fat as soon as they start trying to a lot of meat or of trying to eat less carbs, they automatically like eat more chicken and cheese and oil. So many patients who I speak to, you know, the women are all are voiding carbs and eating there for more meat and fat to get thin, the men are doing the same to get big and It's going to be a disaster, you know things some of the cancers this will cause the artery disease that's building up some of these processes take you know, a decade to develop, so we could be faced in Australia with a tsunami of cancer and heart disease in the like from all this low carb high protein business and I'm appalled with some of my colleagues who have jumped on board with it and they look at the my new shoe and they go. We'll look at the kreb cycle and look what insulin does and if you have more insulin your more fat in those cells and instead of- it's a lot of bull really what they talkin about in the real world that's not how it happens at all. And I'm apalled when I read professional say, well, one way you can treat diabetes, one option for losing weight is a low-carbohydrate. High meat diet or higher protein diet. This is exactly the diets that make people sick that led people to get diabetes to start with. It'll give the diabetic person heart disease that will give them kidney failure. Uh, it's actually quite appalling what's happening in nutrition in Australia at the moment and there's no no sign that it's turning around yet.

Andrew: All right. So, how did how did we get to this point then? Why are we in this situation where you know, most of the country seems to think carbs about and you know, you're better off feeding high protein for whatever, you know. Apparently, you know all these different words for low-carb high-fat high-protein eating.

How did we arrive at this point what's happened?

Dr Malcolm: A lot of plant-based experts say that people like to hear good news about their bad habit. Oh butter is back. Oh high-protein Meat's actually good for you. So, you know people are naturally attracted to those rich foods and uh, they like, you know, they like to hear good news about their bad habits.

I also think that this must have been some industry push and industries in the giving medical funding, medical education industry has uh meat Dairy and egg Industries have been advertising a lot harder to um, GPs, the doctors in recent years.

Andrew: All right. So I guess you get you get the industry publications that most of us don't get then, so they they advertise in the doctors magazines do that?

Dr Malcolm: They certainly do like everybody needs milk yogurt and cheese and lots of advertisements and and sponsorship of little programs you can do to get personal professional development points.

Andrew: Really? I thought that was something that only happened in the US. Yeah, um that industry can fund a continuing education.

Dr Malcolm: No, you can go to read publications and on their website. They actually announced how much it would cost to help to get them to put together an education program based around your product whether it's bad pressure drug or a heart drug or food and they'll sort of put together an education program around that and then GPs will be able to do that program online and get professional development points.

But you the industry you the pharmaceutical manufacturer or food industry can actually pay for them to help put a program together.

Andrew: Wow. That's the first I've heard of that. That's mind-blowing. It reminds me of again back to the video. I made about the csiro low carb diet book. I found I can't of off the top of my head I can't remember, but there's a funding body, NHMRC. Yeah, so I found a page on their website where they they say if you want to fund the study, but don't want to do it directly... You can give the money to NHMRC and tell them who to give the money to so then it looks like the fund these coming from NHMRC rather than coming from Cadbury or something, you know, sort of puts a step in between the funder and the recipient of the funding.

Dr Malcolm: My partner journey is a University research-based librarian, is always interested in following up, you know, where the funding come from and sometimes it's really obvious, you know, the like there was a study in Melbourne looking at uh mood and women and found that a Mediterranean diet with red meat improve women's mood compared to a crappy diet.

You can get to sponsor their to Mediterranean diet of meat and livestock Australia in there and but that was declared. Um, so often was searches all declare that they got funding from dairy Australia, for example, sometimes research will have been done with funding and then someone will conduct a meta-analysis where they look at a whole lot of other studies. No funding for that no conflict of interest. But of course, we've spent the last 10 years getting funding and doing work and will be quite in those studies. Yeah, but with this front organizations, yea, this is sort of something that's really growing and that you can have a parent public health public good bodies promoting nutrition and you know, some of it being good for promotion of nutrition like it more fruit and vegetables.

But they can be the subtle funding from industry those oneness big Australian group that we were puzzled because they got seventy thousand dollars a year only from all their fundraising and yet they were able to have offices in most of our Capital Cities and have starved. Obviously there was some big industry funding providing those offices.

So this idea of having indirect funding and having a front for your funding and a funding coming from some Foundation coming from something else. Um, yeah often disguise is the real source of the money.

Andrew: Yeah, and it's funny that they're so out of the open about it, too. They're just happy to say yeah, you can give us funding and tell us where to send it.

I don't know why people don't put two and two together a bit more with these sorts of things. But anyway, another another low carb argument that I get. And I'm sure you've got plenty of times as well as about diabetes and insulin resistance and all of this. What's your take on the diabetes argument then low carbs better for diabetes because uh, you know diabetes is a problem with digesting sugar properly.

So take out the sugar and you got no diabetes. So, how does that- How does that work for you? That's probably over simplified.

DIABETES 

Dr Malcolm:Yeah. Diabetes is a wolf stick to type 2, type 2 diabetes is a- it is a problem where your body no longer responds to your insulin and sugar is not removed from the blood and Carbs are not able to be removed them blood and stored or processed. Um, and so if you weren't on on Atkins and a very low carb diet, your blood sugars would have been normal, but you'd still have the same metabolic problem that your body was unable to process the glucose the carbohydrates.

Andrew: That's a really interesting point actually because you- So what you're saying is that even though your blood sugar would be okay, the reason that the sugar got too high in the first place that the cause of it is not gone. Yeah, that's what you'd still have. Your body's still behind the insulin resistant, you'd still have  many other associated metabolic changes in the body, you know changes to cholesterol and blood pressure and things like that. So, you know, you wouldn't be in good health, but your blood sugar's would be good. Dr. Michael Greger has done a very good video on what causes insulin resistance. Where he puts together research going back to the 1930s that actually points more to fats particularly saturated fats, they get into the muscle cells and then the liver cells and um, if the insulin is the key that unlocks the door that lets the glucose into the sugar into the cell then the saturated fat in particular gums up that lock so that insulin no longer works and I'm puzzled about why doctors don't know a bit about this because I'm sure I learned decades ago that saturated fat tended to block the action of insulin, you know, that's not new information. And you know, you can you can look at things... I like to look at things at different levels. That's like, it's like when we look at cigarette smoking, you know, we can look at animal studies, so animals were forced to smoke. That was pretty cool,  we can look at cell studies. We can look at studies of populations of you know, identical twins who smoked or didn't smoke because etc. and I guess it's the same with diabetes and you can look there, you can look at the population level where you go "Oh so what happens when China used to live on mostly just rice and mostly white rice? Well, they hardly had any diabetes like China had an incidence of less than 1% That was like Back in 1970 1980 now it's like 12 percent plus and maybe half the population pre-diabetic." And that's a lot less rice than a lot more pork and processed food and then you can look at animal studies and uh, you know, I've left some times in the last few years. I remember seeing a report of a study being done at Baker IDI, one of our local research institutes and diabetes and they looking a promising new drug was been tested on mice on a fat rich diet. Like it wasn't my son of high carb diet or sugar diet know those who searches knew how to make those diabetes prone mice. Um, give them type 2 diabetes. They put them on a fat Rich diet and I remember Jenny and I at the time doing a Facebook post instead of saying "look silly mice they should have just gone off their fat rich and they wouldn't have needed the diabetes drug."

Andrew: Yeah. So how you mentioned that you know, you surprised that more doctors don't know about this stuff, so I don't know know about it? How come it doesn't come up more for doctors to know that whole food plant-based diet is the best way to treat diabetes. Do you have any thoughts on how that could be or is it...?

Dr Malcolm: Yeah, we all have confirmation bias. Yeah, we must be aware ourselves that we have confirmation bias, that I will tend to pick out studies that look at the benefits of plant-based diets maybe without knowing it I'm ignoring studies that show that lean beef is good for you. I don't think so though.

You know, sometimes say that Michael Greger could be accused of you know, the nutritionfacts.org person. Could be accused of cherry-picking in the toys and favor plant-based diets and I say well he could be accused of cherry-picking but that's where most of the cherries are. I think um doctors doctors don't know um, you know, um, I don't like to be too conspiracy minded.

There's all sorts of reasons, you know, that confirmation bias is a big one for people reporting on evidence for experts who should be telling the rest of the medical community. About information about personal choices and whether we accept something that's confirmation bias, but. Um in the last couple of years, we've been repeatedly struck by how our medical literature, um, you know, the medical magazines that come out to educate doctors to educate GPS how they continue to miss things.

Um the other day but something about well osteoarthritis like oh arthritis seems to be much less common among Asian and African populations compared to Caucasians. So maybe it's a genetic racial thing, and you go "No, it's probably not it's probably just because the traditional in times in the past. It's changing now."

It was the European people that the or the meat and dairy and the fat Rich diet and so they had more arthritis. Things sometimes don't get published. Like only about a month ago there was a broad study in New Zealand we're a couple of New Zealand, young Zealand doctors who interned with Dr McDougal a few years earlier when they'll still in medical school. They did a study where they took 65 patients from a practice, you know overweight diabetes excerpt and divided them into groups in this New Zealand town and gave the intervention study group all this coaching and cooking lessons and got some of the local restaurants to provide suitable meals there was no restriction of how much they had. But basically it was a McDougal diet, you know whole grains, legumes, potatoes, fruits, vegetables. Not too many nuts. No oil. No animal products. And without any food rationing just with instructing these people on how to do it. These people lost I think it's 11 and half kilos in six months and kept it off for 12 months, and the comment on the research and this was published in a peer-reviewed journal one of the portfolio of the nature group of journals. It was commented that this is the greatest weight loss has been seen in a in a dietary Intervention Program that had no restriction on the amount of food you eat and didn't have an exercise program. Well, that's big news did that appear in the um, lifestyle medicine newsletter in the Australian doctor magazine The Weekly Magazine and medical Observatory that appear either on the online, you know headline version of that on the print version? Not a word. I'm still waiting for the report on it. And I just sort of it's the sort of thing we've been asking ourselves lately. It's not part of a big there's no big conspiracy, but it's sort of like, what's going on here? Why couldn't they see that? Sometimes you do suspect industry influence like when it came out there's a large Swedish study that found that women that at drank more liquid milk like this looked at 40,000 women over a long period of time those women that drank more liquid milk got a higher mortality rate, like they died more?! and they actually had more fractures not less, but they didn't find the same in the yogurt and cheese consumption. So the week the study came out their long-standing dairy Australia advertisement with a picture of milk on the front suddenly changed to Yogurt cheese, and the journal didn't report the study! We still a similar thing happened when it was discovered that the choline, high choline content in eggs led the body to produce TMAO which is an artery toxin and there were lots of egg advertisements leading up to the publication and there was a pause for period of weeks or months when the study came out to the certainly no egg advertisements for those weeks. We sort of assumed the egg industry didn't want to be, you know, put themselves next to a study that showed that eggs had another bad thing about them, but it wasn't reported.

Andrew: Doesn't it make you angry? Oh it does look and I keep reading articles about the gut microbiome a very topical and medicine at the moment and you know a lot needs to be learned about this and I've read some articles where they suggest we could give probiotics or maybe some sort of selective antibiotic or we could do a fecal transplant. That means take poo out of person put into another person a poo transplant. And you know poo transplants do actually have some therapeutic effect on some disease States, but in none of those articles did they seem to pick up the large journal Nature magazine at the beginning of 2014 Publishers study and said, oh look at this and only took three days of eating high fiber starch based diet to turn everyone's got microbes into a sort of fairly friendly good pattern and only three days of meat and cheese and eggs to give them a inflammatory associated with disease type pattern and none of my medical articles I read about the gut micro biome seem to have seen that and then I read articles about prostate cancer. I'm sorry I'm going on about this but lately Jenny and I have been going like "What's going on here?" I mean, we know it's not conspiracy, but like going on why can't the medical profession say this like at least we've recently appreciated in medicine that often it's best not to do anything about prostate cancer. Especially the lower less malignant grades particularly in the older man. It's sort of been found that the interventions are often worse than doing nothing. And so this is a watchful waiting term and you think look 2005 Dean Ornish published his prostate cancer study in a in a high-ranking peer-reviewed journal that showed that he could help the growth of prostate of low to moderate grade prostate cancer in older men and it sort of think why hasn't anyone seen that 2005 article. I sometimes wonder why the authors of some of these medical education, while the reporters, New Scientist is another one New Scientist seems really blind her. They recently had something on dementia and virtually nothing on the link between diet and dementia, which is fairly well-established.
And you sort of wonder why some of these medical Educators medical experts journalists haven't at least Googled their topic and kind of looked at the Gregor video.

 

Andrew: Yeah, I can relate to that from you know again back to my potato thing when everyone was having their say on it and you know for someone to come out and say though potatoes is gonna be iron deficient. All right. Hang on a second. Google is really simple, you know, you could just Google the iron content of potatoes and you would see that I wouldn't be on deficient so to go back to your point about journalists not using just a simple Google search to just check out whether what they're writing is true or not is

Dr Malcolm: Or nutritionists, nutrition experts not opening up a food composition table. You don't even have to buy one. You can look it up online now, like whenever I hear about the Mediterranean diet and you're like three tablespoons of olive oil a day and for 2,000 calorie a day person. There's a quarter of your calories with no iron,

no calcium, no protein, no fiber and I sort of- with issues like the push to eat more olive oil. I said "I wonder why, I sort of keep saying to Jenny, one day one of these Mediterranean diet Enthusiast is going to open up a food composition table and go "Holy hell, this stuff's junk food."

Andrew: Yeah one day but whether they'll actually tell anyone else that they've done that is another thing,

Dr Malcolm: You know, the really positive thing here is that while nutritionist, dietitians and doctors are sort of all heading down a blind alley and hitting the wrong way and they'll get beaten up down there. They'll come out and It'll take them along it up to be a lot of Shame and face-saving and oh, well, we're sort of changed our mind because things have changed now.

It's gonna be very hard for the Heart Foundation to turn round and sort of go. Uh, you know, how we said eggs were alright? well now we know they not only have cholesterol or no fiber, but they also give you increase your blood tmao which is another risk to be... It's hard for organizations like that to do a complete about-face and uh, you know, and sort of save face and keep their credibility but on the positive side what I was getting to is that even if our nutritionist, our doctors are not getting the right information people are finding out about these, people are going online. They're finding out the movement is really big in the u.s. You know, they're finding out about McDougal. They're finding about T Colin Campbell they're finding it out about the hundreds of scientists and doctors in the US, the research being done. Michael Greger called democratization of medical information, we no longer have to wait for to come down from the University to the expert to the doctors to the patient. I mean there's a lot of misinformation you can go and follow, Pete watch season be Brewing bone broth, but it people are finding out about it.
The vegan community in Australia is starting to find out that. They can be healthy as well as saving the animals and I'm seeing an increasingly number of people who have heart disease rheumatoid arthritis high blood pressure who are seeing through the crack in the universe in Doctor Who turns and finding us finding this stuff from the USA.

So that's really heartening that people are finding out while the great bulk of the population of Australia to reverse still heading in the wrong direction a rapidly growing minority of finding out about it. And I say that once people see it, you know, once they see the health benefits of eating whole plant foods you don't unsee it.

Andrew: Yeah, and I love that the the idea that you know, obviously it's got its drawbacks but the idea that doctors and nutritionists are no longer the Gatekeepers for knowledge, you know, people can, if they're if they think that maybe there's another way they can go and find it for themselves and I think it can only be positive even though there's so much misinformation out there. I think if people are searching and you know applying critical thought to what they're reading then they'll end up at the right solution in the end. Yeah, and there's a lot of crap out there but then I sort of agree with you that it's good that people are finding out and able to find stuff even though there's a lot of misinformation out there and it's always been like that. You know, there's always been patients who have got some idea about their treatment or they diagnosis they heard from their neighbor's cousin. It's nothing new to have, you know, wacky misinformation out there.

Andrew: Yeah. You know you you're a part of a rare breed of plant-based doctor. If you had much resistance from a professional point of view? Have you had troubles with recommending eating plants to people? how's that going for you?

Dr Malcolm: Yeah. fortunately, you know, I'm not telling people that they must not take any medications or they must cancel their cancer surgery or whatever and I'm promoting a dietary approach that can actually be fitted to the Australian dietary guidelines. So I've never been I've never been uh pursued by the medical board or fear that I'll be pursued by because this is nothing I'm really doing that's not based on evidence.

As far as colleagues goes. Yes, I have had some kick back. Yes someone I work with who's often sort of brought it to my attention that "Malcolm, you know, I've not everyone's happy about- how can you are about you know, plant-based diet and things, you know, some people not happy about that at all. It's might not be very good for this practice." You know, I see a patient. I remember one particular patient. He was really worried because he had a strong family history of prostate cancer and I ordered his blood test. And I obviously, you know, I'm ethically obliged if someone comes to see me if they're covered in acne and want to do something about it, it would be wrong, It would be unethical for me not to tell them there's a link with dairy foods. Yeah or in this case the man who's worried about prostate cancer middle-aged man, who's you know? Relatives had a relative fairly young age. It would be unethical for me not to tell him that there was strongly associated with diet and the dairy foods in particular was something associated with increased prostate cancer.

So I did, I don't tell him anyway, he went back to one of the other doctors for his results and it got fed back to me that you know, this patient was really complained about you because he said that you told him to stop having milk. So yeah, that's the sort of kick back I get there's something else that happens with patients, you know.

I think I think elucidated someone else and there's the other day. It's like people who are already in the plant based community imagine that someone comes into me, you know, 30 year old lady PCOS, you know that a gallbladder batch still taking acne drugs as if she's a teenager Etc. and you know and people from the plant based community goes.

Think I say, well, you know if you stop Dairy food and chicken and started to eat more potatoes and things and expect that the patient said "Gee doc! I'm so happy really great to have someone to give me this news". No, that's not always the case. You know, I've actually do get I do notice we did this patient satisfaction survey and the branch of the practice I workout had more people saying that they were happy that they were very satisfied to have more keeping healthy information given lifestyle advice given to them. But back to the person who you from the plant based Community would say "gee doc thanks for telling me about it. Never knew that the chees and chicken could do that to me." No! some of them just about something table. There's frown at you the guys that have looking had this steel look that goes right through you.

Although I remember One Man as I was saying to him. "Here's the cholesterol tablet. You've only come to see me for a repeat. But you know, if you eat more of these foods that will go up and more of these foods that will go down" and once the whole time I'm talkin to him he's just repeats "My mother had high cholesterol,

My grandmother had high cholesterol, My mother had high cholesterol."

Andrew: It's like "Just give me the pills doc"

Dr Malcolm: Yeah, "Just stop that dude" you'd be surprised, you'd be really surprised from the plant based community perspective about just how sensitive an issue it is. I'm I'm gonna sound sexist but the 30 year old woman demographic I find the one I have to be most subtle and careful about, I am at people often just speaking in general terms. Like if I'm prescribing the if it's about cholesterol I say to someone, you know, whatever level you cholesterol starts at genetically, you know family wise,if you eat more chicken, I start with chicken because everyone thinks that is healthy. If you eat more chicken fish meat, eggs, dairy, Etc. your cholesterol go up and if you eat more oats and beans and whole plant Foods, it will go down. So you see that's not actually telling them that they're that it's not it's acknowledging that yes It's probably all genetic but it's also sort of just reminding them... It's not saying how much cheese do you eat,  it's just saying, you know, if you more of these foods your disease, your condition will go in this direction, same with acne. I'm not going to tell them like how much cheese do you eat?

And when they say to me when I'm saying to them "You know, dairy Foods or associated with more acne." When they go "I don't eat much Dairy, which means you know that they just have, you know, a glass of milk a day and a tub of yogurt and cheese meal and maybe a bit of whey protein bar, but I don't even try and remind them that when they say I don't eat much Dairy they probably actually quite a lot. Um, I stay away from that and just try and keep it like, you know, I'm not trying to shame you, try and keep it so you're not shaming or embarrassing them. But you're just letting them know giving them that information that you know, um, when when you know that when people eat more Dairy it sort of associated with more acne and then it's up to them to interpret that and I've sometimes even make a note on the patient's file like not very receptive to diet and that's where you mind for me not to not to mention it next time because they actually seem quite cross. What's really surprising and what I've said to uh, and some the other week was that when weeks and weeks or months later the same person says to you... Now I was thinking about changing my diet to help this condition and I'm sort of eating more whole grains now and it's really "What? you actually listened!"

Andrew: That must be really very nice.

Dr Malcolm: It really is very nice.

TURNING AUSTRALIA'S HEALTH AROUND 

Andrew: Alright. So a hypothetical here... tomorrow morning or sometime next week you get a phone call from Malcolm Turnbull the Prime Minister of Australia and he says "Malcolm we need you to take over as Minister for health." What would be your plan of attack?  Is that something you've thought about? How would we turn around the health of Australia with Dr Malcolm Mackay as health Minister? any ideas?

Dr Malcolm: If I was just restricting it to Medicare rebates, I'd rebate doctors for the length of time they spent with patients. I would make an 18-minute consult pay more than a six minute consultation. It's like they keep going on about you know want doctors to spend more time do more chronic disease, management, more counseling and yet the Medicare rebates the same between about 6 minutes and- there's not two between six minutes and 19 minutes It's the same rebate. All right, so I'm fully aware that if I stop and spend a few minutes telling people that you know, what else will make their cholesterol go up and down or help the back knee... It's sort of like I'm doing it in my own time. I'll end up seeing less patients per hour and being paid less, and I think that really needs to be addressed. That's a big disincentive. You know, if you want doctors do more lifestyle medicine the Medicare rebate needs to be a bit more time based, but that that's been very looking at my new ship, what would I do? Well, I'd be understanding that Health was outside of the health system and that the disease management system wasn't really the key to improving the health and the country that while my colleagues all seem very fixed on like cardiovascular risk management will give you a tablet if you cholesterol so not everyone who's cholesterol high will be really clever animal.

Look at your blood pressure on your age and your cholesterol and diabetes and will calculate what your chance is will look up the chat or- And we'll see what absolute risk, you likely to be out in the next five or ten years and then we're on that decision will treat your risk factors with your tablet for cholesterol. Make sure we get tablets for blood pressure and get it down to Target Two tablets. If it's not good enough for three, will treat you diabetes. That's how we look at disease risk management at the moment. And you know-

Andrew: I actually don't have any idea with all of this. Actually getting medication before you've got a major issue?

Dr Malcolm: Yes, that's how we manage risk level. Like, it's like rather than treating the causes, you know, like Ornish everyone else says it like, you know, when mopping up around an overflowing sink without turning off the tap, you know, we're not actually addressing why this person's got instantly high blood pressure and the heading 2 diabetes and cholesterol is high and things, were treating them as isolated things with ignoring the lifestyle.

If I was the health Minister, I would be trying to make it more a more and across Society thing. Like bring it multi-sectorial. I don't know if that's the buzz word for it. In other words. I'd be working against the nutrition side of things and I probably be assassinated really quickly. The big cow would come to my door and beat me up. The man in the cow suit.

Um, no, um, Yeah, I think we should immediately have health warnings on processed meat. There's no excuse for that. I mean, it's a Class 1 carcinogen.

Andrew: Yeah, if it's good enough for cigarettes, it should be good enough other things that fall in the same category as cigarettes surely. Yeah, but as you found out when you're trying to not do moderation and something as in quit addictive eating you had to eat something.

Yeah, and I guess that's why how food gets away with it as well. You know, if you only had me you could live on mostly meat it be better than nothing. You do have to eat. So, you know, that's sort of how we how we get to a point where we don't sort of just say no to process meat or even red meat or dairy. I think we'd be working very hard to sort of bring in some nutrition education for the public and to fight back against the success of. Megan Dairy and I'm saying that with my eyes rolling to myself going, you know, you're not going to win against that opposition. It's like try and bring in a carbon tax and reduce greenhouse gas emissions in a country that has has a huge cult base and see that happen kicked out of office and it'll get reversed.

Yeah, and I've been happened pretty quickly. Yeah, so last question then uh similar question, but. Yeah, you now the head of the CSIRO Australia's biggest science body. Maybe not the head of the whole thing. But you're the head of the nutrition part of it. So what sort of uh studies would you like to see done and what would you be organizing if  in the perfect world you could organize whatever study you wanted? Is that something you've thought about?

Dr Malcolm: No I haven't but um, we need to talk about that. It's a very good point that you know that who funds research does determine what the outcome, I think in the u.s. I can't remember her name. I think it was Marion Nestle, looked into this and found that most research funded by the softdrink and sugar industry didn't find it too bad, you know, most of the studies that are funded by an industry, you know, if you want a university department and you're doing research and get a lot of dairy Australia funding fuel research Department over the years. You're not really gonna be out there on the attack and trying to find a link between, you know, dairy protein and cancer or something like that. The funding source doesn't necessarily mean people make people mean that people are going to cheat on the research, but it's just a sort of design that's going to be done like all the olive oil research done at Latrobe University, that'll be designed to look at the benefits of polyphenols in extra virgin olive oil. It won't be done to see whether the polyphenols in whole wheat or blueberries are better than the ones in in olive oil. If I was ahead of if I was in charge of nutrition at CSIRO... Day one, they'll be no books with the name CSIRO in it unless it's approved by the department and as you know fair bit of committee consensus that the dietry practices that advocated in this csiro diet book in line with the best science.

Andrew: Yeah, that's probably- it's not what the answer I expected. I thought you'd talk about exactly what kind of study you wanted to be done. But yeah, the books of the things that have the biggest influence that csiro does isn't it?

Dr Malcolm: That's how the stuff that comes out as well and I'd be trying to focus, I know it's much easier you can do much more papers, you know publish or perish, if you want to do some research that's relatively straightforward as research can be and where you likely to actually get some meaningful results.

You want to look at some my ??? you know, you want to look at the antioxidant effect on sales of the polyphenol and olive oil or something like that. But you want to do very reductionist focused research. A new the effect of something on a mouse on a fat rich diet. But uh, I think I'd be pushing it towards more actual research out there in the population and thinking of that broad study I mentioned in New Zealand where they actually did a community, community research project where they got people in the community to change their diet and then measure the effects of it. So I'd guess I'd be pushing I'd be sort of thinking look it's so good to be doing more research on the fine details but saying we already have so much knowledge about what makes humans healthy. We should be doing more research on how to implement dietary lifestyle programs. Do what we know makes humans more healthy, like well, if we do this sort of intervention like the broad study or some school-based program, what will the outcomes be? Doctor friends of mine were thinking of doing some study on pregnancy?

And like if we did a project were we intervine in the women who are pregnant and help them to eat a really healthy diet. What will the outcomes being their pregnancy? You know, would less of them- you know what they have better pregnancy outcomes for themselves and their babies and I think we need to do a lot more research like that.

Andrew: Yeah, that's a really interesting point as well because I think. Uh, most people were pretty much everyone really knows that ice cream is not good for you. Right? but people who are hugely overweight and having massive health problems still continue to eat ice cream, even though they know that it's a bad idea.

So, Yeah, the knowledge maybe not ever not many people probably know that whole about Whole Food plant-based diets and that sort of thing, but they do know that they shouldn't be eating ice cream. So to me that says exactly what you were talkin about that just making these healthy habit changes stick is the hardest thing that's the thing is probably most important and even if people don't change to Whole Food plant-based eating, if they stop eating ice cream and chocolate bars that's a big step in the right direction. But so many people can't do it, even though they know they should.

Dr Malcolm: Every step every step you take towards whole plant foods will get better health outcomes. And this is why these Mediterranean diets studies the whole Mediterranean diet thing makes me cringe, but this why the Mediterranean diet studies or all the study and Melbourne are Mediterranean diet with red meat.

Yeah, of course those women got Health you and fed felt better because they just took one step in the direction of eating more whole plant foods in this case hitting more, you know grains and. And they games and fruits and vegetables for example.

Andrew: Yeah, I remember reading about a study a while ago probably kind of find it now but somebody did a study where they went to the third world Africa or somewhere like that where people were starving and they fed them meat for a couple of weeks, and they got healthier and they said yeah there you go meat is healthy.

But it's like hang on meat is definitely better than starving which is what they were before you turned up. But let's not take the as a conclusion that meat is healthy. And I guess that's a similar thing to you know, if we ate a Mediterranean diet with heaps of olive oil that's better than eating McDonald's every day, but that doesn't make it good.

Dr Malcolm: No, thinking nutrition we often do this... It's like, well olive oil's better than butter or lean meats better than fatty meat. Yeah, but it's like when people ask me the question about the oil , which should I- coconut oil, canola oil, olive oil? and it's sort of like, yeah, well ask me which cigarette to smoke...You know, there are some that really mild and low ??? and things, you know, but I'm not gonna recommend you smoke those cigarettes.

Andrew: Yeah. That's a really good way to look at it. All right. Well, we should wrap this up but uh last question back to the the idea of trying to figure out how to make the diet's stick. If you go to patient that comes to you "I really want to change my diet. I'm struggling uh with making the habit change stick." Um, do you have a bit of advice that you would give to someone in that category?

Dr Malcolm: Yes, I think you need to have the information. Jenny my partner and I have a large website which is in part for for patient education patient information. And so I'll often Point them towards that,

Andrew: wholefoodsplantbasedhealth.com.au?

Dr Malcolm: Yeah and our Facebook page, we also use another registered name, which is a plant based Health Australia. It's probably the one we should have used my website start with it's easier to remember... So I point them to my website which has information and links to other people's information like you might say to someone look have a look at nutritionfacts.org, Michael Greger's site. And have a look at Dr Mcdougall.com you know, here's a book.
This book would be most suitable for you. I recommend this particular book.

Andrew:  Can you give us a few books then? Give me five books?

Dr Malcolm: Dr. McDougall the starch solution.
Prevent and reverse heart disease by Coldwell Essistine. The China Study Solution by Thomas Campbell, it was previously published under the name the Campbell plan.
You can buy it as an e-book and it's much shorter than The China Study and sort of covers quite a bit of that information.

Andrew: I haven't read that one. Does that give you a diet tips and things like that?

Dr Malcolm: he does and gives you practical tips as well. It's like the Reader's Digest version of The China Study followed by practical information The China Study solution, maybe some of the ones, and I'd also recommend to people that they have some ongoing support that would be really good if they could find people who are supportive. Maybe come to a plant powered Melbourne meet up. That's the new group, you know that's comes out of the plant pure nation community and Grassroots program idea and

Andrew: I've been to one or two of those. It was really nice to be able to sit around and when I went last I was eating only potatoes and nobody cared.

That was nice.

Dr Malcolm: and then I joined up, then I'd be thinking of using some of the joining up in an online community. You know the verse some huge Google Groups, but here locally. There's a Whole Foods plant-based Aussies.

Andrew: That's a really great group to-

Dr Malcolm: Which now has about four or five thousand people, might even have reached five. My partner Jenny's now they've got five admins including Jenny, but not me because I'd be too strict. I'd be doing too much exterminating.

Andrew: Alright. Well, I think that's a good place to end it. Uh, so read some books go to wholefoodsplantbasedhealth.com and get some support and  yeah you can you can get healthy very quickly.

All right. Thank you. Dr. Malcolm Mackay for joining me on the Spud Fit podcast. And thank you also for not letting me die last year doing my potato challenge. Thank you!

Dr Malcolm: Thank you Andrew. I'm honored to be on your podcast.

Andrew: All right, let's do it again sometime. Yep. Cheers Spud up!

All right, there you have it. Dr. Malcolm. I am forever indebted to dr. Malcolm and isn't he great isn't he? Just a great guy? I'll show you love him as much as I do now. Uh, so yeah there you have it the uh episode 13 of the Spud podcast. Uh, and I am really happy with that. That was a good one.

It was a really great conversation for me. And uh, and I hope you guys enjoyed it too, and I hope you learned something from it. Now I don't actually have any more episodes pre-recorded. So I'm not sure when I will uh be talkin to you guys again. Hopefully very soon. Like I said at the start though, I'm not sure when this is going to happen again because uh, like I said priorities, uh, things have to happen and I can't afford to spend too much time on making these so I'm working on  some different things some ways that I can make this a little bit more streamlined as far as the time that it takes me to do it and uh, and also possibly some uh, some a patreon page. Like I said at the beginning of the episode anyway, thanks everyone for listening.

I forgot to mention that you can join the Spud Fit Academy if you like. If you're interested in doing a potato only challenge for yourself, then go to Spudfit.com and click on the take the challenge Tab and you'll see all the information you need there.

All right. Thanks everyone. I hopefully I'll speak to you again soon. Spud Up!

 

 

Thanks to my wife Mandy van Zanen for the theme music.

 

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