This podcast was born in response to COVID and vaccine disinformation that, while bubbling up for some time, flooded the population with the release of the pseudodocumentary, “Plandemic.” Ever since then, we’ve wondered how to combat the constant tides of pseudoscience masquerading as “natural remedies” that conspiritualists champion, then sell for a profit. One of our earliest champions was the Southern California-based cardiologist, Danielle Belardo, who built up a large social media following even before the pandemic ravaged the world. Not only was she on the actual frontlines of COVID wards, but she’s been leading the charge on providing evidence-based information on her social media feeds, as well as her excellent podcast, Wellness: Fact Vs Fiction.Derek was recently a guest on that podcast, and now Danielle returns the favor, joining him to discuss her thoughts on being a science communicator and a female cardiologist in a male-dominated field, as well as many of the wellness myths circling around social media, including supplements, statins, sunscreen, veganism, organic foods, and GMOs.
-- -- --Support us on PatreonPre-order Conspirituality: How New Age Conspiracy Theories Became a Health Threat: America | Canada Follow us on Instagram | Twitter: Derek | Matthew | JulianOriginal music by EarthRise SoundSystem
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You can stay up to date with us on all of our social media channels, predominantly on Instagram, where we post the most, as well as individually on Twitter.
Matthew and Julian take up the work on Facebook for some reason, but we still can be contacted and seen there.
And of course, we're on Patreon at patreon.com slash conspirituality, where for $5 a month, you can help support us, keep us ad free and editorially independent.
And you can get access to our Monday bonus episodes including our ongoing Swan Song series.
And also I want to flag that if you are listening on Apple Podcasts you can drop a rating and some comments in there.
That would be greatly appreciated.
Now, as for the Patreon bonus, last week on the bonus, I decided to take a break from all of the conspiracy madness and focus on something that is very meaningful to me, which is the music that we use here on the Conspiratuality Podcast.
I realize a lot of listeners may be unaware, Derek, that our distinctive theme song and the vast majority of those great transition musical breaks you insert in production, that all comes from your deep and rich library of original compositions and recordings that I've long been a fan of.
So I just want to plug your Earthrise sound system catalog here, which of course is available wherever fine music is sold.
Of course, we are switching over to the Bitsola rap for our walk-up theme going forward.
It's both a long and serene, concocts exotic cuisine, colorful, tasty, and lean from all the places she's been.
She gets past the junk that crunked abouts that's defunct in every one of our brains, so we become less deranged.
Her presence never goes missed, through obstacles she persists.
She is a fire, inspires me, but inquires.
It's incredible.
That's going to be the hot single of this year.
But thank you, Julian.
I've worked on a new beat for that.
It's incredible.
That's going to be the hot single of this year.
But thank you, Julian.
It is kind of incredible, given that myself and Duke Mushroom recorded three albums, four EPs together.
And the interesting part about the world of music now is that in terms of sales, we don't really sell CDs anymore.
But in terms of streams, our 12 year old album has gotten more streams this year than any other so far.
So it is a pretty, it's a fun and incredible project that just keeps going on.
So yeah, that was this past week's bonus.
And I want to mention that our Swan Song series returns on Monday the 18th with another Early Access bonus episode.
So this would be an interview with Paolo Marino, who's the director of the 2017 film Open Shadow, which followed the works and days of Teal Swan through a non-investigative lens.
Now, for those following the timeline, this was a year before Jennings Brown's series, The Gateway.
I just want to flag that you, I think you coined a new term there, works and days.
I really like it.
Oh, right.
Very new.
Yeah, from Hesiod, I think.
Okay.
There's an interesting overlap between these two projects that I know you're reporting on here, Matthew, because in Open Shadow, I believe Marino, who's the director you'll be talking to, shows Teal holding up her childhood journal pages, and she says they're written in this alien language that allowed her to keep her abuse secret.
Is that right?
Yeah, that's exactly it.
Except she didn't quite say that she wanted to keep her abuse secret.
She was concealing things that she didn't want other people to see.
She was a little bit abstract about it.
But Jennings Brown was actually able to have those pages decoded.
And there's a nice reveal of that on episode 111.
In the bonus episode, we surprise Merino with what Teal was actually saying and get her response.
And she also has some sharp criticisms about John Casby's The Deep End at one point saying, Quote, they forgot they were filming real people, not actors who could go home from the set.
So that's up next in the Swan Song series.
And the way we're doing it is that Patreon supporters get early access to each episode, which will then be made public about a month later.
We also, in our housekeeping section here, have a correction this week.
Julian?
Yeah, we do have a correction.
So, this is just a quick note before we dive into our topics for today.
On our Temple of the Gun episode last week, I covered Rod of Iron Ministries, which is a militant offshoot of the Unification Church.
And the Unification Church had come to be called the Moonies.
People remember that, I'm sure.
I briefly referenced that the Unification Church, or the Moonies, had around 3 million followers worldwide.
And we were then publicly Twitter fact-checked, in a friendly but firm way, on that number by someone who's an expert on the topic.
And this is Elgin Strait, who is host of an interesting podcast called Falling Out.
And Elgin was raised as a Moonie, and the podcast Falling Out covers that church as well as the process of transitioning out of other cults.
Elgin suggested correctly that the oft-referenced citation I was relying upon for that membership number would be from someone called Eileen Barker.
And he said the number is probably closer to being under 50,000, which of course is not a small difference.
It's a huge difference.
I mean, three million is a movement, 50,000 might be a sideshow, unless they all have ARs, of course.
But I think it's discrepancies like this that open a real window onto the murky difficulties of what we're actually doing when we work with cult materials and whether we're biased towards exaggerating or underplaying the issue, whether we're being alarmist or apologist.
And that's kind of the conundrum we're also exploring with The Deep End.
Yeah, it's all the piece of stuff we're thinking and talking about a lot.
I should say here to avoid confusion that Rod of Iron Ministries, which is the offshoot run by Reverend Moon's youngest son, also called the Sanctuary Church, has an even smaller membership.
It's probably in the low hundreds.
But this correction regarding unification church led me down a rabbit hole that opened into the contested territory of terms like cult and brainwashing because it turns out that this Eileen Barker is actually a well-known sociologist who many in the cult research and sociology of religion fields like our esteemed friend John Jalalich
See, as doing a kind of heterodox cult's apologia that downplays the impact of what another prominent researcher, Margaret Singer, explains as the power of undue influence over followers of charismatic leaders.
So, all of that to say, in our correction here, that Barker wrote a famous book in 1984 titled The Making of a Moony.
And then, choice or brainwashing?
Question mark.
Which, it later turned out that this book was partially funded by the church itself.
And Elgin Strait let us know that her estimated membership numbers are likely hugely inflated due to her own biases.
You know, and I'll just add that Barker's legacy is something I personally have to look at more closely because as a cult survivor and researcher, I found her rather offhand kind of cult is a word for groups you don't like take pretty facile.
And her pushing of a nomenclature of new religious movements to replace it has had a huge impact on the willingness of religious studies academics to approach their ethnography with critical eye.
They are very interested in protecting their sources and bringing out the best in people and of course they got into religious studies because they love religion most of the time and so they don't really go in as investigators looking for abuse and of course they have to now more and more.
So, the legacy is that lots and lots of religious studies scholars have kind of stood in the way of analyzing religious groups as cultic, which basically helps legitimize abuse structures as religions in the worst cases.
But I also know that I can personally be rigid about this stuff, and I think something has shifted for me in watching all the hay that's been made over Teal Swan because You know, it's clear that the cult label can absolutely be abused as well as the spectacle around it.
And we're watching the implications of that play out now in real time.
Conspirituality 112, The Science Whisperer with Danielle Bilardo.
This podcast was born in response to COVID and vaccine disinformation that, while bubbling up for some time, flooded the population with the release of the pseudo-documentary Plandemic. - Okay.
Ever since then, we've wondered how to combat the constant tides of pseudoscience masquerading as natural remedies that conspiritualists champion and then sell for profit.
One of the earliest champions of ours was the Southern California-based cardiologist, Danielle Bilardo, who has built up a giant social media following even before the pandemic ravaged the world.
Not only was she a doctor on the actual front lines of COVID wards, but she's been leading the charge on providing evidence-based information on her social media feeds, as well as through her excellent podcast, Wellness, Fact vs. Fiction.
Derek was recently a guest on that podcast, and now Danielle returns the favor, joining him to discuss her thoughts on being a science communicator, Being a female cardiologist in a male-dominated field, and many of the wellness myths circling around social media, including on supplements, statins, sunscreen, veganism, organic foods, and GMOs.
Well Derek, I'm really glad that you got to interview Dr. Bellardo, who I've been aware of as part of the pantheon of Psycomm personalities for a couple of years.
And it's that her Instagram feed has always struck me as this really interesting blend of no-nonsense, white-coat info drops, but also healthy lifestyle vibes.
But I hadn't listened to her podcast, so I didn't get the full sort of Philly, Italian-American straight talk angle.
And it's made me think about these first moments of how an influencer is appealing or not appealing and about who they appeal to.
And you know, there's a lot of folks following her, 250,000 plus on Instagram.
And So it makes me ask these questions about like, well, who does that appeal to?
How does she lean into that appeal?
How much labor does it take?
And what the payoffs are?
And then that makes me think on a personal level about how trust in science communications
It's established in these like instance of affect and you know, you gotta say branding and and feel and I'm thinking about like friend of the pod Abby Richards with her endless cups of tea, you know, and it's kind of feels like the Beatrix Potter coziness zoomer room and then Dan Wilson does debunking the funk and he has this like gentle affect, but he's just also totally deadpan.
And then there's Imran Ahmed, another friend of the pod, just raining fire from London.
And I don't know if you guys know Raven the Science Maven, who raps about antibody yadiyadis for Black Twitter and TikTok.
Actually, her story just the other day has taken a turn.
I suppose I missed the lead up to it, but she's got this long thread now on Twitter about her ordeal with long COVID.
And so that's an additionally interesting addition when the communicator becomes a survivor of the story that they're telling.
And something similar happened with Wolf Genie on Instagram, who is the woman who wrote that piece for Yoga Journal about vaccination being her practice of non-violence.
Then she got trolled by the organic yoga police.
Then she came down, I think her family did as well with COVID herself, And of course, the messaging takes a more urgent term.
So, there's really interesting personal and informational materials that are being threaded together here.
And then all of that makes me think about who I subconsciously trust myself and why.
And that brings me to John Campbell.
Who I watched almost daily through the first six months of the pandemic.
Not because I knew for sure that his data was good, because I'm fairly ignorant, but because there's something in my brain that says, Englishmen of a certain age and education do their best to never get anything wrong.
And, you know, he also reminded me of, I don't know, maybe a more trustworthy era with his printouts and his pencils.
I guess I don't think he's using loom, but he's got this split screen thing where he's speaking at his desk and there's probably a cup of tea in the background, but also you can see his handwriting in the top corner.
So it was kind of like being in school.
And, you know, I liked the fact that he taught at nursing college for years.
And now we know that, like, he's a fucking crank who dog whistles ivermectin conspiracy theories and spreads vaccine hesitancy.
And how do we find out?
Well, Dr. Wilson broke it down.
You know, that's so interesting, Matthew, because I have not followed him closely at all, but I've had...
I must admit there is an implicit thing, right?
Anytime one of his videos has popped up in my feeds, my initial impression is, Oh, here's, here's a doctor doing some good science communication about COVID.
And then every now and again, I've seen something where I'm like, Oh, wait a second, wait, isn't this guy, the conspiracy theorist guy?
Right.
And in my mind, I go back and forth and I'm not sure.
And I never really looked into him too much.
I just hadn't gotten to that point yet.
So it's fascinating to know that you went through that process.
So, but Julian, you are like an avid YouTube user.
I was about to say user, but user is the word.
Right.
And, and, and we're talking about that first 10 seconds where he's making an impression and, and that 10 seconds is being recorded by the AI to affect your algorithm going forward.
It's incredible.
Yeah.
But not only that, it's also being recorded by my set of implicit biases that goes, Oh, trustworthy dude, English accent, older man.
I mean, to me, the crucial point is that I have to be aware that I have a trust funnel that is formed by culture, experience, memory.
It is white.
Its affects are about education or approachability.
You know, and I just have to really look at that clearly, because it's the same drive that lets other people decide within ten seconds that Jordan Peterson or Joe Rogan or Brett Weinstein are worth checking out or believing in.
So, I wanted to just, all of that to say is, you know, what about you guys?
Like, who are you attracted to in terms of comms affect, and where does that lead you astray?
It's bloody important, Matthew.
That's a great question.
You know, I think there are two types that draw me in.
One is like Paul Offit, right?
Eminently qualified, calm, friendly.
He's able to break things down.
He answers questions very competently.
He's honest about where the unknowns are.
That's a really important one for me.
But he does this all in a way that still indicates why certain unlikely outcomes are ill-considered, right?
So he's not just both sides-ing it all the time.
He's actually saying, well, we don't know this, but when people posit this possibility in the unknown space, here's why that's probably not going to be the case, right?
And he did this really expertly as the COVID vaccines were being rolled out and the paranoid panic and conspiracy misinformation was swirling.
Now the other type, which tends to be more charismatic, especially if they combine charisma and strong argumentation that I agree with, at least initially, which is maybe similar to your Campbell example.
Well this is the thing, and it could be initially and about a certain topic.
So they might really nail vaccines, but then six months later they're talking about critical Well, that's the thing, right?
Is that people can be right on some things and dead wrong on others.
Yeah.
Yeah.
So a great example of the second example of the second type where, you know, I tend to overlook some of the red flags because I get swept up in having already bonded with them parasocially over their, their charisma and what they were right about or what I think they were right about.
Um, this is, uh, Zubin, uh, uh, how do you say his name?
It's not Damiana.
It's Damania.
Zubin Damania.
And his friend Vinay Prasad.
Z-Dog, we're talking about.
Z-Dog.
Yeah, that's right.
That's Z-Dog.
And actually, I first... Or is it Z-Dog?
Z-Dog, actually.
No, it's Z-Dog, my brother.
I actually first saw Paul Offit being interviewed by Z-Dog.
So Offit also gave Z-Dog a kind of glow of validation.
And then his friend Vinay Prashad comes on and actually just was watching some of their new episode this morning as I was thinking about this and Prashad is a hematologist, he's an oncologist, he's an epidemiologist and they both did some excellent stuff together during quarantine.
Paul Offit appeared, they had the chops to explain things very well.
But even when I agreed with certain aspects of their approach to being heterodox, over time, I especially saw Prasad get more reactionary.
And their smart, confident guide, like, buddy, buddy, tell it like it is vibes, can actually lead me slightly astray.
And I've come to see that there's plenty going on there that not only flies in the face of what the data shows, but You know, especially with Prasad, is kind of adjacent to a lot of conspiratorial thinking.
Yeah, so I want to propose a test here, because I think it's very difficult to do it according, especially for laypeople, to do it according to the data, quote-unquote, because, you know, we have to sort of understand what that actually means and how to define it.
I want to propose a roganum Roganometer.
Roganometer.
How do you say it, Derek?
Sounds too much like Rogaine.
Well, there's kind of a joke in there, isn't there?
Right.
Roganometer.
Rigonometer.
Rigonometer.
So the rigonometer is going to sniff out testosterone levels or something like that because that's what I get from Zed Dog.
So even though he seemed to be on point with regard to COVID science and public policy, I also thought, I bet you would fucking love to be on Rogan, wouldn't you?
You know what I have to say there too, Matthew, is that one thing I noticed, and I just wanted to comment on this because I noticed it happen in my own psyche, is that as soon as I said those critical things, I wanted to add that I like those guys.
I still like ZDogg, right?
Which shows that in my mind, it's a friendly relationship.
I think well of them.
I think they're good guys.
I like their affect.
Even though what I'm saying is that they may be really wrong on some consequential stuff.
When you like the person, what kind of pass are you going to give them?
Like if that still sort of holds over for you?
Somehow it has penetrated into a way that I think about The way that I think about the relationship that is more personal.
It's like we know each other and that if I'm being overly critical or if I might be being unfair, it feels like it's a kind of infringement against a friend.
Yeah.
More so, even though I know rationally that's not the case, more so than it would be against someone who's not operating on that same frequency in terms of how they draw in followers, right?
That's where we differ, Julian.
So Paul Offit, I've read three of his books.
I've heard numerous interviews.
He is very much more calm and just delivers good information.
ZDogg is the guy who corners you at a party and touches your shoulder as he's talking to you constantly.
And you could smell the alcohol in his breath.
That vibe, to me, has always turned me off.
Being in the DJ circles for a long time, I had a few people around who were like that, who trapped me in the DJ booth and would just talk and talk and talk.
And that type of high energy, and that is also a personal affect thing.
It's not that, because some of the information, as you've said, is very good, and then he kind of, I think, got a little enamored with his own following and started trying to play that up even more.
That's all my own speculation on that, but that's what I had observed.
But that type of Russell Brand energy coming at me makes me immediately want to run the other direction.
Yeah, especially if you're in a DJ booth, which you're in because you're kind of an introvert who wants to do music outside but not have your space crowded.
I mean, fuck that.
So anyway, what I think the Roganometer, that's it, the Roganometer could be one of those like vibrators with a round ball at the top, like the bald head.
And you just flip it on, you make it buzz, it checks for testosterone or whatever.
And then you wave it over influencers to see if they start moaning for more.
And as soon as you get that kind of positive response, you know the person's out.
Is this our first branded piece of equipment here Absolutely, man.
We can get Aubrey Marcus's family to do the fleshlight thing with it.
You know, as an interesting aside here, when you talk about the, uh, Rogonometer, um, you talk about it sniffing out.
Rogonometer, Rogonometer.
Let's do it together.
Rogonometer, Rogonometer, Rogonometer.
Say it three times and your testosterone goes up by four points.
It's funny, actually, because Rogan is very public about the fact that he has low testosterone levels and has been on injectable tea for quite some time.
Right.
Anyway.
Turning to our guest theme.
Yes, thank you.
So, running through the interview with Dr. Berlotto is the reference to the heat that she gets from various interest groups.
You know, like the vegans versus the keto folks and they'll both go at her when they don't like what she shares.
They perceive that she's on the other team even though she was an ally before.
She talks about realizing to her dismay how many people in the nutrition community actually went all in on anti-science attitudes during COVID.
And so, in relation to that, I want to just share a personal anecdote here.
It's not all that unusual, but to me it was noteworthy when it happened, and it just happened like two weeks ago.
And it's about the balancing act that I try to do in my relationship with my parents.
And don't worry, we're not going too much into family therapy here.
I actually get some of my healthy skepticism and rejection of Wu from my dad.
He's a very smart and literate guy.
He's played high-level competitive chess his whole life.
He kind of crashed and burned his university education as a troubled alcoholic young adult, but then he, after a remarkable career, During his retirement in his 60s, went back and got advanced degrees via correspondence course.
One of those culminated in him having to do a verbal defense of his thesis, both in German and Spanish.
Yeah, I mean, just, you know, smart, smart guy.
My mom is also very smart and well read, but she has a different temperament.
She's become an interfaith minister and a spiritual counselor in her 40s.
Now, you know, people are already profiling me based on these differences between my parents.
My mom's been a vegetarian and then a vegan since she was a teenager.
But she's also been devoted to homeopathy and natural cures almost as long.
And the thing that complicates that is my mom has chronic illnesses.
She's had them for decades.
They severely limit her quality of life.
And I can only imagine that part of her embrace of alternative medicine comes first from having these chronic symptoms that medical science either can't diagnose and treat effectively or just, you know, very disrespectfully tell her in a dismissive way that it's all in her head.
And She has a rare sensitivity to most prescription medications such that when she takes them, she often suffers from really terrible side effects.
So she's in quite a pickle with all of that.
And something that I've actually noticed is actually really touching about their dynamic is that as they've grown older together, I feel like my dad has come over to her side on this topic, maybe as a way of minimizing conflict and bonding with her more deeply in her struggle.
And I sometimes therefore forget that he's moved further in that direction.
So that's a preamble to say recently, After my daughter, their four-year-old granddaughter, went through another round of severe constipation after antibiotics to treat another ear infection, my dad asked, have you tried probiotics?
We actually have, but I said to him, you know, dad, I used to be a big believer in probiotics, but more and more, the data seems to show that oral probiotics don't really do what they claim to in the gut.
And besides, most recent research shows that most supplements often don't even contain the ingredients that are listed on the box.
And so my dad shared a compelling anecdote, which is very often how these sorts of conversations go, right?
He had a toenail fungus.
He tried everything and it failed.
Then he took probiotics and the toenail fungus cleared right up.
So I said to him, you know, I'm really glad, first of all, that your condition has gotten better.
That's wonderful.
But I just want to point out that is just an anecdote.
There could be multiple explanations.
And immediately my dad says, Yeah, but they'll never test this sort of thing in a clinical trials because it's bad for big pharma.
Oh boy, there it is.
Right?
And that's the kind of statement that's so familiar, I think, to all of us.
And it's something that's come out of my mouth in the past as well.
It's an expression of a very particular worldview with regard to wellness.
And from inside that worldview, it's easy to overlook just how conspiratorial it is.
It's a generalized assertion about a corrupt industry that has the power to pull the strings from behind the scenes so as to hamstring the noble little guy who actually has the holistic answers.
And it doesn't have to be based in any specific data.
It's just an attitude.
The natural cure is framed as common sense, highly effective, lacking in side effects, but somehow still hard to monetize, even though it's better than what medical science is biased to endorse.
Can I just say, too, Julian, that when he says they'll never test this sort of thing in clinical trials, it's bad for big pharma, coming from the perspective of it's possible that he's moved towards your mother in order to support and find allegiance with her, that the statement like that, which we're familiar with from our demographic, has this other tone to it, which is that, you know, nobody's actually going to help the person that I love.
Right?
And I'm their advocate, and I actually am going to look out for them.
And so there can be this interpersonal layer to things that maybe we sometimes miss, which is that people are trying to protect each other because they've shared difficult experiences or they feel alone together.
Yeah.
Yeah, absolutely.
Absolutely.
And as I get older, I have more sort of space for that.
But you know, in terms of the analysis that I'm doing that can be cold hearted, it kind of overlooks the fact that the supplement industry is huge and lucrative.
It's not the little guy.
Many supplement companies are owned by pharmaceutical companies, but It's also this maverick, free-thinking, holistic, alt-med, organic worldview that really is a kind of honey trap.
You know, at best, it's a well-tuned, misleading advertising genre, but at worst, it's mercenary propaganda that trades in false hope.
And it's designed to appeal to a specific sector of the marketplace.
And it was kind of a revelation for me.
And I realized I am that target market, right?
Like 10 or 15 years ago.
Oh, wow.
This is something I'm identified with, but it's something that's been crafted for me.
And I want to just touch on how in my interview with Alan Levinowitz that will run in two weeks, we touch on just how the wellness industry and companies like Whole Foods and Goop and others craft this entrancing portal into a world where commerce, faux political and environmental we touch on just how the wellness industry and companies like Whole
You're saving the planet and making the world better for other people by buying our products, pseudo-spirituality, and the promise of a purified and privileged medical status all kind of blend together seamlessly through their messaging.
And beyond all of that, there's simply the foundational claim that a campaign of suppression against natural cures has rendered them shut out of clinical trials.
And that's just demonstrably false.
The example I always use is that the taxpayer-funded NCCIH spent $2.5 billion over 17 years running exactly those trials on every alternative medical intervention imaginable.
And they often had practitioners from those fields setting up and running the experiments themselves.
And it still turned out that everything except ginger for chemo nausea failed when examined honestly over those 17 years.
Now, of course, I quickly find out that sharing this kind of information with my dad is not only ineffective, and this goes to what you were just saying, Matthew, it is perceived as offensive.
So, in the case of my dad, I just agreed to drop the subject after one round of him claiming there actually is good evidence for homeopathy and sharing links and then me saying, you know, have you heard of cherry picking and the perils of sort of biased meta-analysis that tries to aggregate tiny positive results from flawed studies?
Of course, this is all very empathic on my part.
Now the point here, beyond me elaborating endlessly on my daddy issues, is that medicine has become deeply woven into the cultural and political landscape of emotionally charged, almost religious belief that is susceptible to conspiratorial thinking.
And even otherwise highly intelligent and rational people can become true believers, regardless of the evidence to the contrary.
Dr. Danielle Bilardo is a cardiologist in Newport Beach, California.
She sees patients for cardiovascular disease, preventive cardiology, advanced lipidology, cardiometabolic health, and weight loss.
Danielle advocates for comprehensive lifestyle change including nutrition, exercise, stress management, as well as traditional guideline-directed cardiovascular care.
She's an advocate for accurate scientific communication on social media, including both evidence-based medicine and evidence-based nutrition science.
Topics pretty important to this podcast, I'd say.
And we get into both of those during our interview.
And I have to thank Danielle because she was an early champion of this podcast, which we greatly appreciate.
She was sharing our posts in our very first months and helped us build a following.
And we in turn have featured a few doctors at her recommendation.
So I was very excited to finally have her on to chat.
And you should definitely also check out her podcast.
Wellness, fact versus fiction.
I personally listen to every episode, except the one from early June when I was a guest.
And that said, you'll find a wealth of information on her podcast through her eyes and mind, as well as those of her exceptional guests.
Danielle, thank you for joining Conspirituality. - Thank you so much for having me.
I love Conspiratuality, one of my favorite podcasts.
So it's an honor for me to be here.
Yes, and this is sort of a part two, as I was on your podcast a few weeks ago, if people want to reference that.
But today we get to focus on your work, which I'm very excited about.
And I want to focus this interview along two worlds that really do intersect.
One is your work as a cardiologist and a medical expert on social media and the challenges you face.
And then the other is your history in the wellness community and how that has affected your professional work and what your own podcast is.
But I want to start with your work as a cardiologist.
In a recent post, you spoke at a conference in New York City and you said that 80% of cardiologists are men, which is pretty interesting because 80% of Our listenership is women.
I say that because it tracks with the fact that conspirituality on the left-leaning wellness aspect is dominated predominantly by women.
That's part of the definition of it.
You chose to pursue medicine not far from where I grew up, actually.
You were in Philadelphia for school for that.
I grew up in New Jersey.
Let's start very basic.
Why did you choose cardiology?
Yeah, so my 80% is actually almost an underestimate.
So I was just being conservative with those numbers.
It's actually, so 9 of 10 practicing cardiologists in the US are men.
Only 10% are women.
And then if you include fellows, like current fellows, it's about 20 to 25% women.
So the numbers kind of slowly increasing, not very quickly, but overall, yeah, it's a really male-dominated specialty for sure.
I chose cardiology because specifically, well, for a variety of reasons, but one of my most favorite reasons about it is that We have so much really, really, really fantastic data now for cardiovascular disease prevention, both primary and secondary prevention of cardiovascular disease, which I love because as a cardiologist, it gives me a lot of tools and a lot of ways to help my patients that can actually
help them prolong their life and help them live a better quality life.
Because it's not just about quantity, but quality as well.
And we have a lot of really great evidence-based tools in our space, both lifestyle and medication-wise.
And so I really gravitated towards cardiology for that reason.
And also, I just love the physiology.
I love the organ.
I love the anatomy.
I love the heart.
So definitely my favorite.
A couple years ago, there was a research that showed that over 50% of enrollees in medical school are now women, which I think is a great thing.
I was thinking about it prepping for this interview.
In my adult life, I have not had a primary care physician who is not a woman.
My oncologist was a woman.
So actually, my experience has been predominantly having female doctors.
Which I personally like.
Again, this is pure anecdote, but there's always been more of a sense of empathy that I've experienced throughout my life, especially dealing with a lot of health problems.
But why do you think cardiology specifically still predominantly focuses on men or has male doctors?
Yeah, that's a great question.
Well, your anecdote actually is supported by some scientific evidence.
There was a trial done where they evaluated, I think it was out of Florida, and forgive me because I'm pretty good with citations and being able to back up my statements with facts, but I cannot remember the name of the research study, but they did evaluate outcomes, patient outcomes, and people admitted to the hospital with chest pain and whether they were treated by a female physician or a male physician.
And the best outcomes, reduced hospitalizations, reduced mortality, reduced duration of hospitalization, was if the patient was treated by a female physician.
And the worst outcomes, if it was a female patient treated by a male physician.
And this isn't to generalize, and I'm not male-hating by any means.
I have had the honor, being in a male-dominated specialty, I've had so many mentors, I continue to have so many mentors that are amazing men in cardiology that uplift women, that support women.
I feel super supported in my specialty, actually.
I'm constantly, I'm a young cardiologist, and I'm constantly invited to speak at national conferences about evidence-based nutrition and cardiovascular disease.
So I feel very supported by men in my specialty.
But there may be something to the difference in the way, you know, maybe communication is or maybe how the patient feels comfortable.
We're not quite sure.
That being said, I know plenty of phenomenal male physicians, plenty of phenomenal female physicians, and of course vice versa.
You know, we all know physicians that aren't great that are both men or women.
So why do I think that more men have continually gravitated towards cardiology?
I think historically it's just Cardiology is known to be all of actually the surgical specialties have a lower rate of women enrollment.
Cardiology is probably the most intense of the medicines of specialties given that heart attacks you know happen you know at all hours of the night so historically it's been known as like less of a great lifestyle for a specialty and so you have to really really want to do it because It can consume a lot of your life and the training is six years after medical school.
And I think that that's changing because now 25% of cardiology fellows are women.
But there are actual reasons why I think women have not gone into cardiology.
We explore this actually in a paper that I was honored to be a co-author of in the Journal of American Cardiology.
College of Cardiology with three phenomenal women cardiologists, Martha Gulati, Janet Han, the paper was led by, and Dr. Abraham.
And so our paper was about cardiovascular society leadership and a path towards diversity and inclusion and why our cardiovascular society leaders have so historically been more men than women.
And, you know, we talk about some of the limitations in our career and what we can do to get more women into cardiology.
And one of the things is that representation does matter.
So you see, what you see is, you know, a lot of times what we want to become.
And if you're a, you know, a young female medical student and you're, every cardiology attending you work with is a man, you may not necessarily relate as much.
you may not necessarily feel that same pull towards the specialty as when you go on, say, pediatrics.
And a lot of your attendings are women.
And I know some of my male friends actually feel the same.
Like they'll feel that way when they're an OBGYN.
I had a male friend who loves OBGYN so much and he felt almost deterred going into it.
And OBGYN is like a phenomenal surgical specialty.
And there's no reason why a man shouldn't feel like they can't be an OBGYN.
But he felt deterred going into it because he felt kind of the same like, well, it's all women.
And, you know, even though he loved the patients, he loved the pathophysiology, he loved all of it.
So I think it works kind of both ways.
We all just have to be open to moving into a specialty we like.
There are some limitations too because training is really grueling, I think, for cardiology.
I think some women, especially because we're in training during our childbearing years, some women feel limitations with the ability to breastfeed when you're in the cardiac ICU and things like that.
There's just various different things that make it more difficult when you go on such extensive training.
That being said, the shift is happening and so I'm happy to see it.
I hope that more women and men both feel the ability to choose the specialty they like regardless of what their difference is in the gender.
One of the early in the pandemic, one of the nice things that I saw was the increasing number of people enrolling in medical school because of the pandemic.
Now this, of course, contradicts so much of what we broker in on the podcast, which is the wellness influencers and the disinformation.
Another refreshing aspect that the pandemic has brought out, though, I believe, is that there are certain genres or domains where people weren't as known on social media.
And I feel like a number of doctors now have much more standing and are much more proactive being on social media, yourself included.
Now, when did you decide to really use social media as a tool to present good information?
That's a great question.
And just to actually, the counterpoint on that too is that unfortunately some of the biggest people, and you know this, spreading disinformation on social media often have an MD after their name, which is the biggest thorn in my side as well.
And I think can really, really make it hard for our listeners and for our patients or anyone to be able to differentiate what's fact versus fiction when it comes to pseudoscience on social media, given that people just who are physicians can sometimes promote misinformation.
I started my social media.
My social media took off a lot when I was in fellowship.
This was pre-pandemic.
My social media kind of exploded because I'm personally vegan.
I do a lot about plant-based nutrition for disease prevention, but I'm very evidence-based.
We kind of talked about a lot of my podcasts, but I certainly do not push animal-free diets for anyone by any means.
I actually am so focused on being evidence-based that I am like I consider myself pretty dietary agnostic at this point, even though I recommend what our guidelines recommend, which is plant-predominant diets, so can include animal products, of course.
But that being said, I had a large vegan following, and so I really had a ton of this intersection with the wellness space, because a lot of people in the vegan community are also in the yoga wellness community.
And so when the pandemic hit, I was shocked when my followers, a lot of them, had kind of really turned on me when I started to say that the pandemic was real and I was coming home from work, you know, after intubating, you know, patients that were my age, essentially, that were really, really sick with COVID.
I was so surprised to see, well, what's happening in the vegan community?
And then when I found you guys and conspirituality, I was so shocked to see, I was like, now it all makes sense because it was the entire wellness space had been infiltrated with this misinformation and disinformation.
And yeah, it was, it was quite a peculiar journey during the pandemic as a science communicator.
Well, that veganism, it reminds me of myself as someone who has a degree in religion, but I'm an atheist and Having written so often about it, when I write an article in favor of atheism, I will get religious people mad.
But then I think there are wonderful aspects of religion.
Mostly when you take away the metaphysics and you focus on community, I think there are great aspects of religion and it's a necessary for humans and then you get atheists who get mad.
And I'm sure some of that nuance comes in too.
I mean, I'm a former vegan and I think it's a great diet for people who can do it well.
It's just not where I'm at anymore.
I totally agree, and the day I knew that I reached true dietary agnostic status was when, in one day, I had vegans screaming at me on social media because I was saying that plant-based diets are not a cure-all, and they don't fix everything, and you know, whatever.
And then the same day, I had keto people screaming at me on social media about how eating a carnivore-only diet is healthy.
They were yelling at me about this.
And I was like, so I have all of the groups hate me, so I was like, okay, I must be doing something right.
Well, I went from veganism into a keto diet, so I've experienced that whole range.
That's mostly what I want to focus on is some of these fact versus fiction that you talk about in the wellness industry, but I also know that I wanted to get you on the podcast Long time ago, but you have experienced a lot of pushback, and we can even get into hate, on social media.
We talked about this on your podcast where I've said we've never gotten, for example, death threats or violent threats, and I do believe that's because we're three men.
Because a number of women that we've had on experience much different pushback than we do.
How have you dealt emotionally with dealing with that sort of pushback that could even spill over into dangerous territory?
I've been such a big fan of conspirituality for so long.
And when you asked me to be on the podcast, like in the midst of the pandemic, I wanted to so bad.
But I had been experiencing quite a few death threats online that were quite scary during the pandemic for recommending evidence-based recommendations.
So masks, social distancing, the vaccine.
And so I instead, I recommended my friend Ali and my friend Jay, who are two male cardiologists who are wonderful, who are my good friends.
And of course they went on your podcast, they didn't get any death threats.
But I was happy that they were able to do it.
But I was certainly a little taken aback by the amount of pushback on the internet during the really tense times of the pandemic, especially pre-vaccine.
And then once the vaccine came out, I think that as physicians, You know there was certainly a huge large anti-vax cohort but you know my view as a physician is listen now that we have a vaccine that's so safe and efficacious you know if someone's choosing not to take the vaccine I see the repercussions of that when they don't get vaccinated and that's their personal choice and that's their autonomy and I think that it's almost toned down the
hatred because like with the mask mandates and with, you know, quote unquote lockdowns, people felt, I think, more of like a stringent sense of control over them.
The thing is, is that those things at that time, mask mandates and lockdowns were necessary.
I can't describe.
So being on the East Coast when the pandemic hit, I I actually first, I have family and friends in Italy and in Northern Italy and Milan who were telling me a month before it really hit in America how bad it was.
My friend who's a hospitalist in Milan and was saying to me, this is not the flu.
Like why am I seeing 30 year old runners, you know, getting intubated and like crashing with this virus.
And I actually was voicing this at work, and a lot of my colleagues at work when I was in my, it was in my last year of fellowship training, were kind of like, well, you know, we'll see.
Maybe it won't come here.
And I was thinking in my head, like, we see it take over China.
Then we see it in Italy.
Like, why would it not come here?
I started to feel this panic, and it hit us in the Northeast bad.
I know my friends in California didn't get hit as bad until later.
But in the Northeast, it got, it hit bad.
So my, in my last few months of cardiology fellowship, my last of my 10 years of medical training, you know, it's supposed to be a time where you're doing an elective.
I was supposed to be doing an advanced lipid elective, something chill.
We all got redeployed to COVID coverage in the hospital.
We had barely any masks.
We did not have, you know, N95s.
If we had N95s, we had to use the same N95 for two plus weeks, reuse it.
And then the N95s had to be submitted back to the Hospital to be cleaned and reused.
We were running out of supplies.
It was really scary.
And us cardiologists, Jay and Ali included, there was cardiology fellows all over the country that were on a group email list and a group chat, actually.
And we had some of our colleagues that were our age in our early 30s that were ending up in the ICU with COVID.
Because, you know, as trainees, so whether you're a nurse or whether you're a resident or a fellow, you really are the front line because you're the ones that are really usually spending the most time with the patients.
Not to say that attending physicians don't.
I'm an attending physician now and you still, of course, spend time with the patients.
But the trainees really are spending the most time with the patients.
So, you know, an OBGYN resident who was on her ER rotation in Texas who was perfectly healthy died of COVID, 28 years old.
And then, you know, one of our colleagues, cardiology fellow in his early 30s, was in the ICU in Brooklyn.
And then, you know, we start hearing all these things and we're like, this isn't the flu.
Like, we don't see this with the flu.
And I turned to Temple for my internal medicine residency in Philly, where we have like one of the most amazing ICUs In the country, led by Jerry Kreiner, who's a phenomenal pulmonologist.
And, you know, I saw flu every season of ICU, of residency, and never, ever did anything compare to this.
Ever, ever, ever.
And we were a tertiary center where people would get shipped in that had bad flu ARDS, and all of these complicated cases, and it was never like this.
And so, When it hit the Northeast we got hit really hard.
It was so frightening.
I literally, not to exaggerate at all, I mean looking back it feels like a different life because now with the vaccine I feel so good.
I look back at it and like we literally went to work every day not knowing if you were gonna die or not.
I mean nurses my age were dying so it was really scary and I think that It was just a really scary time and I would come home and then I would post on my social media about the recommended measures and people would say, it's not real.
And I couldn't believe it.
I never thought in a million years that this pandemic would fracture our country.
I always thought, wait, this is something that we're all against.
This is something none of us want our families or our loved ones to die from this.
I don't want anyone's loved one to die from this.
And I couldn't believe we were fractured over this.
And of course, the pandemic is still not over.
My crew of people are still experiencing right now triple vaxxed, you know, boosted as well.
And they're not dying, they're not going to the hospital, but they're not doing well.
I'm talking like this week, you know, they're experiencing this.
One of the dangers that we flagged and that we're seeing play out is that how the anti-vax Fervor against the COVID vaccines has now become anti-vax against all vaccinations.
As a science communicator, how do you combat that sentiment?
It's so interesting because I actually, as a cardiologist, although I encourage vaccination always, evidence-based recommendations for vaccination, you know, as a cardiologist, we don't provide vaccination in my office.
I'm in a multi-specialty private practice, and we have gastroenterology, endocrinology, psychiatry, and cardiology, of course, but we don't have primary care, and vaccination's handled by primary care.
So, not only do we not provide vaccinations, but we obviously don't profit from vaccination, just to make that clear, too.
But we of course still recommend vaccination.
That being said, you know, until the pandemic, vaccination wasn't on the top of my social media discussion.
When the pandemic came about and all doctors and healthcare providers and science communicators started to discuss online about vaccination and started to get attacked, started to get death threats, things like this, our friends in pediatrics were like, welcome to my world.
They've been dealing with this for so long, and I just want to give a shout out to anyone, whether you're a nurse practitioner, PA, a nurse, or a physician in pediatrics, anyone in Peds, just shout out to you guys because, you know, you guys have been dealing with this community for a really long time, and pediatricians and people who work in pediatrics genuinely are some of the most caring people.
They're some of the most empathetic, wonderful people, and so To think that they also have been going through this for years and that their patients are people who can't make a decision for themselves.
You know, a lot of it goes through the parent, right?
And so how heartbreaking is that, that they've been dealing with misinformation that harms a child?
So they've been going through it forever.
So I can't even compare to the longstanding issue with vaccination.
You know, the anti-vax community.
I certainly think it's kicked up a notch quite a lot, but I feel the most for our friends in pediatrics and primary care who have to have this discussion every day with families.
You know, one of the things we deal with being in the wellness industry is this sense that there are many, and we've talked about this, there are many problems with the American and the Western science model.
I think that sometimes people don't realize that some of the greatest advances in medicine have been due to disease specificity.
you can look at people holistically, but if you look at hand-washing, germ theory of disease, vaccination, like these are all specific interventions that have helped society in so many different ways.
And people get caught in this, well, you're not looking at, you're not looking at the whole picture.
And sometimes with medicine, you can't, like, You need to combat one thing at a time, and that gets lost.
So I want to talk about some of the different people and topics you've talked about on the podcast, but let's start broad.
As a cardiologist, what are some myths that you've found about cardiology heart problems that you've seen in the wellness industry that doesn't actually translate to what you experience as a doctor?
Yeah, great question.
Thank you for that.
I think one of the biggest ones is that people often assume, so there's this dichotomy between anyone that attributes themselves to being functional medicine, which by the way, if anyone listening has heard the term functional medicine, it's not a specialty.
It's not an ABIM certified specialty.
It's a marketing term created by an entire group of people who practice non-evidence-based medicine.
And the idea that functional medicine is this group of individuals who say that they're getting to the root cause and that they're not just throwing medications at things is really inaccurate because a lot of what they tout is really not based in any actual scientific evidence, which we do a bunch of podcast episodes on my podcast about this.
But traditional medicine, as you mentioned, is fractured and flawed as well.
I I say this all the time in this podcast.
So the patients who have fallen for the misinformation or the pseudoscience are the victims.
It's not their fault.
All of us are looking for the same thing.
We're all looking for health.
We're all looking for happiness.
We're all looking for the health of our loved ones.
And so when someone feels not heard by their physician in a traditional health care model, and they feel that their concerns are blown off, then Turning to alternative medicine is sometimes what happens.
And what can happen is that as people feel that they are being kind of brushed off by traditional medicine, they're brought with open arms to these alternative medicine providers who, you know, give them a longer time because it's a different kind of fee-for-service model, they pay cash, it's for an hour, etc.
They feel listened to, and that is valid.
Feeling listened to is important.
It's just that the way the traditional healthcare system is set up, this RVU-based, insurance-based system, primary care doctors are, they are worked so hard, and it's not like they're millionaires.
You know what I mean?
And they have, you know, 15 minutes for follow-up, and it's not them who's dictating this.
It's insurance companies.
It's hospital systems.
It's hospital administrators.
And so it's really tough because I can acknowledge that the traditional healthcare system is fractured and there's an issue, but I can also acknowledge that a lot of physicians in healthcare want it to change as well.
That's kind of what steers people towards the alternative medicine room.
Some of the biggest things we see in cardiology that frustrate me a lot, a lot of it is dietary related.
So that's a lot of why the nutrition myths and misconceptions are really important to me in cardiology.
Some of them are, you know, there's now the liver king who's going on and on about how eating all of these like organs and saturated fat doesn't cause any disease, it's so good for you, etc.
And, you know, we know that eating a diet really high in saturated fat, like really high, like a carnivore or an animal based, fully animal based, really high saturated fat keto diet can make your atherogenic cholesterol go really high and cause significant risk for cardiovascular disease.
On the same token, there's even vegans in the plant based community who believe that if you're vegan and you already have heart disease, you don't need guideline directed medical therapy or statin because you're vegan.
So both groups are wrong.
So the truth of the matter is, is that you need both evidence based nutrition, which we have multiple levels of evidence telling us eating a plant predominant diet, higher in fiber, low in saturated fat.
If you eat animal products, things like fatty fish are great, low fat dairy, stuff like that is beneficial for both cardiovascular health, diet.
diabetes, cancer risk reduction.
There's a reason why our guidelines for American College of Cardiology, American Society of Preventive Cardiology, the American Cancer Society for Nutrition are all similar, right?
It's because the levels of evidence points to the same thing.
But that being said, even though we recommend lifestyle changes, there are times that guideline-directed medical therapy saves lives.
There's times when statins are needed.
They are such an incredible, well-studied, amazing medication.
There are times when they're needed and they save lives.
And the misinformation about statins and cholesterol in the diet and nutrition community on both the vegan plant-based side and the keto carnivore side, really, I see the harms of that every day.
And then the other harm is supplements.
So I see the harm of supplements as a cardiologist all the time.
The naturalistic fallacy, especially here in California, but now I think it's worldwide, But the naturalistic fallacy that everything that's natural is just so much better is a huge problem.
It's an issue because we know that supplements are not regulated the same way that medications are.
Supplements aren't regulated the same way that these medications that go through double-blind randomized controlled trials are regulated.
Their safety efficacy is regulated.
And so we see supplements all the time cause everything from arrhythmias to liver injury to kidney injury and to all sorts of problems.
And so I think those are the two areas that really tend to the misinformation there can really harm patients.
Well, you just answered my next couple of questions all in that answer, which is awesome.
But I want to drill down on a couple of those things because they're on my list and I think they're important.
So let's start with cholesterol.
Actually, after we recorded Me on your podcast, after we stopped recording, I asked you because I have genetic high cholesterol in my family and you had said on social media recently that you think that a true anti-aging protocol involves, well you said sunscreen and we're going to get to sunscreen, but let's go to statins first because you just mentioned them.
So can you talk a little bit about the importance of statins and why do you think they're so relevant?
I don't think universally, you know, everyone needs to be on statins, that's for sure, but I do think that they're a safe and efficacious medication.
And I always like to premise this with the fact that I'm a super lifestyle-focused physician.
My practice is a multidisciplinary practice that focuses, we have two registered dietitians, health coaches, like, we literally focus on lifestyle change.
Not only just me, but our ACC AHA guidelines, first-line recommendation for whether it's hypertension or hyperlipidemia, high cholesterol, anything.
The first-line recommendation is always lifestyle change.
So nutrition, exercise, all of that.
That being said, when a patient needs medications, statins are of course incredible, a phenomenal medical therapy that have been studied extensively.
Who needs a statin depends on various things.
We have two categories we kind of broadly lump people in.
We have what's called primary prevention, so people who have not yet developed atherosclerotic cardiovascular disease.
And then we have secondary prevention, so people who have atherosclerosis already, so plaque in their coronary arteries.
They have either had a heart attack or now we kind of lump people with what's called subclinical atherosclerosis into that category.
So this is people who have plaque on their coronary arteries seen in say something like a calcium score or a coronary CTA.
So, people in secondary prevention, if you already have established atherosclerotic cardiovascular disease, we know for sure that lifestyle, of course, is important.
All of that is very important.
First line.
But we know that statins are going to make that individual live longer and reduce their risk of having a heart attack and is going to help improve morbidity and mortality in that population.
These are the patients that when they come to discuss with me, I'm happy to discuss all their concerns about statins because there's a lot of myths and misconceptions.
I'm actually doing like a five-part cholesterol series coming up on my podcast to explain everything about cholesterol and all of the misconceptions about statins because I get asked this all the time.
These are individuals who we know benefit from it.
So what about in the primary prevention category?
So the people without coronary artery disease, so if someone has something called familial hypercholesterolemia, it's the most common genetic cause of high cholesterol.
About 1 in 500 people have FH.
We generally, our spidey sense goes up for FH.
If you have an LDL greater than 190, you are automatically, we recommend a statin.
Because that is one of the, right in our guidelines, our ACCHA guidelines, recommends starting statin therapy because we know that individuals in this population die of heart attacks earlier.
How else do we determine whether someone should be on a statin in primary prevention?
Anyone listening can go to, you can Google right now, ACC 10-year ASCVD risk calculator.
And this is, of course, not individualized medical advice.
This is just general guidelines that I'm recommending.
But you can Google your 10-year ASCVD risk, which is based on pooled cohorts and lots of data.
This is someone that does not have familial hypercholesterolemia, because as I mentioned, they're in a separate category.
But it asks risk factors like hypertension, diabetes, and for your lipid levels, and it gives you an estimated risk.
Depending on where you fall in that risk estimator, may recommend that you, say if you're diabetic, may recommend that you are on a statin.
So we always recommend people with diabetes are on a statin to help reduce their risk of cardiovascular disease.
Or it may recommend that they're low risk or intermediate risk.
Now with someone who's intermediate risk, we can further risk stratify them by looking at what's called a calcium score.
This is an amazing test that's revolutionized preventive cardiology.
When we look at lipid panels in general, I'm going to go over all this on my podcast too because there's a lot of confusion.
People calling LDL bad cholesterol, HDL good cholesterol.
In reality, the whole good cholesterol myth isn't really true.
You don't need to raise your HDL cholesterol, etc.
We really want to keep your LDL, and even more specifically, It's called your ApoB lipoproteins or atherogenic lipoproteins, as low as we can.
When we look at biomarkers, you're looking at someone's cholesterol in that moment of time.
And you're not necessarily getting the area under the curve.
Meaning, well, what was their cholesterol last month?
What was their cholesterol six months ago?
If you're lucky and you have the patient's records for their entire life, you can kind of see what the trend was.
But even that doesn't give us the full necessary picture of what their cardiovascular risk is.
So we have now what's called a calcium score, and it's a CAT scan that's low radiation, that has no IV contrast, and it looks to see if there's calcified plaque in your coronary arteries.
And based on a lot of research we have from the MESA data, it can actually tell us what your cardiovascular risk is.
So if you have a calcium score of zero, That means that you haven't developed calcify.
Now this doesn't look at soft plaque, that's a different kind of test, but it tells us how much calcify plaque you have in your coronary arteries.
So if you have a calcium score of zero, it means you have no calcify plaque in your coronary arteries and it really recategorizes your risk.
So if you have maybe like an intermediate risk score, then that enters into shared decision making with your physician, whether you should start medical therapy or not, depending on the patient's goals and preferences.
If we do a calcium score now, and the reason why I love it so much is because, you know, we often find calcium scores, this is what we call subclinical atherosclerosis.
So someone who has plaque in their coronary arteries before they've had a heart attack, Now, with prevention, I'm a firm believer in 2022, no one should die of a heart attack.
Because if you get a calcium score, and we see you have plaque in your coronary arteries, we know the exact evidence-based formula to reduce your risk Of having a heart attack.
And that is to get your ApoB lipoproteins, your LDL, below, below 70.
European Society of Cardiology recommends even 55.
To get your hypertension, diabetes, all these things under control.
And we have lifestyle and medical therapy that can help with both.
And so knowledge is power.
And so prevention is everything.
And heart disease is the number one killer of both men and women.
And so, I think it's really important for people to know the right information.
And unfortunately, in the nutrition world, the belief is that, as I mentioned, you and I talked about this too, it's the horseshoe effect, where the two groups come together.
So, the low-fat plant-based community and the keto carnivore community come together in their hatred for statins.
And not all of them, just some.
They're aiming for Satins vaccines, apparently also sunscreen, which we can talk about.
And it's unfortunate because Satins can be lifesaving for the right patient who needs them.
And additionally, the idea that comes out from the keto, anyone that's listening, maybe nodding their head if they've seen all of the keto carnivore advocates who are constantly saying on social media that your LDL cholesterol does not matter, that higher is better, and this goes a lot with the anti-vax community too, there's like a huge tie-in with this, and it's just not true.
We know that high ApoB lipoproteins, high LDL, unequivocally causes atherosclerosis.
I do want to get to sunscreen, but you invoked supplements first.
And as I said, both of us have found our own ways into wellness through fitness, yoga, through the lifestyle and all of those things.
And there's, I mean, you just gave a fantastic overview on cholesterol and statins.
So thank you for that.
But the reality is someone on social media will say, look, I grow my greens in the garden and I'm going to be healthy forever because of it and that's going to trend or that's going to affect people emotionally on a different level because of that, what you said, naturalistic fallacy that's so important.
The idea that supplements are great and only healthy and that Anything that pharma produces is bad because it's been synthesized in some capacity is something that's prevalent and ongoing in this industry.
So talk to me about some of the high-level problems that you've seen with supplements and why people shouldn't fall for thinking that just because they even need a supplement.
We could start there.
A little bit of the root cause, to steal that phrase, of this issue is actually a distrust in physicians and the pharmaceutical industry as a whole.
So I just want to touch on that because I really empathize with historically where that comes from.
Because I'm not going to say it's not valid.
You know, I'm not going to say that there isn't a valid reason to have that historical distrust.
But I'm 35 and I grew up in an era of the Sunshine Act.
Right?
So, I didn't grow up in the heyday of where pharmaceutical companies could take doctors out to dinner, etc.
I have never seen that pharma relationship with physicians because the Sunshine Act came out before I was in med school.
So, for anyone not familiar, there's something called the Sunshine Act where you can Google any physician.
You can go on and Google CMS Sunshine Act.
You can look up my name.
You can look up any doctor's name and see how much money they've taken from pharmaceutical companies.
And you'll see that I've taken zero dollars from pharma, right?
So I'm not recommending statins, which are a generic drug which cost five dollars to make and no one's making money off of anyway, but I'm not recommending statins because I'm paid by pharma and you can see that.
That being said, I think that a lot of the distrust from pharma comes from the idea that physicians are making money from pharma and also that our recommendations and our guidelines are based in pharma-sponsored things.
And I actually think this is really important.
So I do an entire podcast episode that's coming up next, this actually this week.
I have Martha Guladeon, who's the chair of the American College of Cardiology American Heart Association chest pain guidelines.
And the episode isn't actually about the chest pain guidelines.
It's about how in cardiology do we make guidelines, right?
So how do we synthesize, when you go see your cardiologist, or you go see your cancer doctor, you go see your physician, if they're following evidence-based medicine, what are the recommendations based from, and how are they deciding that you should be on this medication?
And the reason why I think that's really important is because you will learn, when you listen to our podcast episode, that no physician who has a conflict of interest or any relationship with pharma can be a chair of a guideline committee.
Some guideline committees outlaw 100% anyone with any pharma interest as a guideline, in the guideline committee at all.
At most, it has to be less than 50%, but some guideline committees are 100%.
No one can be involved with pharmaceuticals.
Then, even if they have top experts that have worked with pharma, they're actually not even allowed to vote on the decision for that sort of drug They're only allowed to inform but not make a vote.
Guideline committees are made of 30 plus of the top world experts in a specific topic, so if it's the cholesterol guidelines or the chest pain guidelines or etc.
Then it's peer-reviewed by hundreds of other physicians.
So the peer-review process for guidelines are reviewed by hundreds of physicians who are experts on the topic as well.
And so the way that a medication recommendation comes about is through a lot of peer-reviewed scientific evidence that is actually not influenced by pharma, where scientific evidence is appraised.
Now, when you look at supplements, right, so any supplement can be released and it doesn't have to have safety data.
It doesn't have to have any efficacy.
And the truth is, is if a supplement was effective, a pharmaceutical company would jump on that and make it into a medication.
And we actually have seen this, right?
The perfect example of this is fish oil.
So fish oil for years and years and years, every pharma company has tried to study fish oil as being beneficial and it's failed.
Time and time again, it never shows any cardiovascular risk reduction, until the REDUCE-IT trial, which is a specific kind of fish oil, which is Vasepa, which is high-dose EPA and no DHA, and that's for a specific patient population that are at risk for cardiovascular disease.
That being said, pharma has studied various fish oils and have seen all of them fail, except for this one specific kind.
If this special supplement like red yeast rice, which I hate so much, is a natural, it's essentially a quote-unquote natural version of a statin, it's an unregulated statin, it's the same as lovastatin, or various other herbals or things like that, if they had a benefit And if they had any signal benefit in trials, they would be taken over and made into a drug by a pharma company or sold by a large company.
But the thing is, is that the low-level evidence or the no evidence that exists for them, the reason why it can be harmful is because, especially with herbals, they can interact with a lot of medications.
They can cause, a lot of these medications can cause liver injury, kidney injury, and abnormal heart rhythms.
Some of these adrenal supplements, which are totally bogus, they include animal steroids in the medications and in the supplements.
You can buy these over the counter.
It's unbelievable to me how much harm can come from supplements.
So I was honored to be the lead author of our latest American Society of Preventive Cardiology clinical practice statement on nutrition.
So our latest nutrition recommendations for cardiovascular disease was a consensus statement with Kevin Hall from the NIH, who's the head of nutrition research there.
Cardiologists from Johns Hopkins like Roger Blumenthal, Martha Gulati, and Aaron Mikos, and all these amazing, phenomenal cardiologists, nutrition scientists from all over.
And for the first time, we included an entire section on supplements and our recommendation on not using supplements for cardiovascular risk reduction or prevention.
Because supplements have become so overwhelmingly popular and can be dangerous.
So when people ask me, what supplements should I use?
Well, I say, you know, it depends on the individual, but generally, you know, a multivitamin is reasonable.
Women of childbearing age using a multivitamin folic acid, of course, is reasonable.
If you're vegan, B12.
If you don't get a lot of sunlight, which I recommend, obviously, using sunscreen and not trying to get any sunburn, vitamin D if you need it.
But other than that, a lot of supplements are just BS.
And if you have a deficiency in something, if you have iron deficiency, if you have B12 deficiency, if you have vitamin D deficiency, you need an evidence-based physician to find out where that came from, why you have a deficiency, and treat the actual root cause by
Because in my practice, I mentioned on my podcast, one of my partners was a gastroenterologist, saw a patient that was treated by a naturopath with iron deficiency anemia for years, just getting supplements over and over, comes to see my partner who does a colonoscopy, he had stage 4 colon cancer.
And so the thing is, is that it delays guideline-directed care, and that is a huge problem.
Look at Steve Jobs, who had access to every physician and evidence-based provider in the world.
He had a type of pancreatic cancer, allegedly, that was the kind that responds well to surgical resection, which is fortunate.
He caught it early.
But per some of the articles online that I'd seen, he opted for the more naturalistic route before finally going towards the more traditional route and surgery and things, and he passed away.
So it's not even an intelligence issue.
It's not a money issue.
It's a getting into the wrong echo chamber issue, and that breaks my heart because the patients are the victims.
A good friend of mine had intestinal cancer, had four inches of his intestines removed.
If he didn't live a few blocks from a hospital, he would have died.
And after the surgery, his wife at the time promoted supplements and meditation and this retreat.
Wow.
And his family was like, you're doing chemo.
And he's like, I'm doing chemo.
And that actually caused a divorce.
And I'm not talking aggressive chemo.
I'm talking 12 rounds in four months because that's how bad the cancer was.
It's in the word.
Supplement means you're missing something and you need to put it back in.
And yet it's become this catch-all.
The fact that it was a $40 billion a year industry and it's only growing and projected to keep going just shows you how far away from You know, if you're taking supplements all the time, then what are you doing with your diet and your lifestyle that you're needing supplementation?
And also the harm and the harm and the risk.
I mean, the way they are not regulated the same way that FDA, you know, to approve a medication, FDA approved medication has to go through randomized double blind trials.
It's just a rigorous process and then goes through so much scrutiny.
Scrutiny and then peer review.
And then for that medication to be included in guidelines goes in even further scrutiny and peer review and all these things.
A supplement literally can be released by an influencer on social media, zero scientific evidence, zero backing.
There's no continuity in compounding of the supplement.
Herbals, I see, the number one thing I see younger people for, because, you know, I'm in Southern California, my practice, is younger people who have brand new arrhythmias, abnormal heart rhythms, like atrial tachycardia or aflutter, Because they're on all of these supplements that have herbals that have these sort of stimulants in them that cause ectopy in their heart.
And so, we removed the supplements and thankfully they improved, but it's just wild to me.
Natural does not equal benign.
There's a great example of that in James Hamblin's book, Clean, which is about the beauty industry, but he shows how he went to Whole Foods, picked up some raw ingredients, made it in his kitchen, and started selling it online.
Now, he didn't sell any, but he was just putting a point that he wouldn't have gotten in trouble.
Talking about myths, then, you've said sunscreen a few times, and that's another one that's huge right now in the wellness industry.
Can you talk a little bit about sunscreen?
So on my podcast, Wellness Fact vs. Fiction, we do a lot of debunking of the medical myths, and one of them I had on is an amazing dermatologist, Renella Hirsch, and she's actually, she did a bit of sunscreen on the first episode.
She's coming back to do a full sunscreen episode because I was so shocked And I don't know if you already knew this, but I wasn't aware that there was such an anti-sunscreen community in the wellness space.
Unbelievable!
I had no idea.
So, because I tweeted, anyone who's listening now and interested, go look at my sunscreen tweet and look at the comments.
There's thousands of comments of people talking about how sunscreen is horrible for you and how the sun is good for you.
And then you had told me about the, you had written that article for Rolling Stone about how people are now like testicular tanning, which is insane or something.
And so all of these beliefs, I had no idea it was such a bizarre thing.
So I will say that, yes, so the American Academy of Dermatology says that both mineral or chemical sunscreen are fine to use.
There's a lot of nuance when it comes to a lot of the misinformation about chemical sunscreen.
We're literally gonna do an entire podcast about it with Renella Hirsch.
But the AAD says, you know, anything that's out in the market now in the United States, Safe and effective for chemical or mineral sunscreen.
Which one you choose is up to you and your preference.
Try to go for an SPF 30 or above.
If you're outside, reapply every two hours.
This is why I think the foundation of my guidelines episode is so important.
People will say, why would you listen to the American Academy of Dermatology guidelines?
And it's like, well, because you're taking the top experts in the world on a subject who are critically evaluating and appraising all of the scientific evidence on skin cancer, all of the scientific evidence on these certain sunscreens.
They're evaluating it through scientific appraisal.
It's going through peer review.
They are not allowed to have industry bias if they're on the guideline committee or chair of the guideline committee, you know, to a certain extent.
And then it's going through even more peer review.
And so as a cardiologist, if I was out there on social media telling people, this is what I say, if your spidey sense should go up, if any physicians out there telling you to go against something that expert consensus says, because why would I as a random cardiologist know more than the top dermatologists in the United States plus the hundreds because why would I as a random cardiologist know more than the top dermatologists in the United States plus the hundreds of peer reviewers that review the scientific evidence They're trying to reduce skin cancer risk, and skin cancer is quite common.
And so, that being said, if you prefer mineral, use mineral.
If you prefer chemical, use chemical.
I use both.
I use either.
It doesn't make a difference.
SPF 30 and above.
And the nuance about the different kinds of chemicals, sunscreens, and the things people are scared about, we're going to go into a deep dive in my podcast because it's just so, so much misinformation on it.
But in generally, I think that people, I think the core of the issue is people not trusting expert recommendations and consensus.
And I think when people listening understand where that comes from, You can kind of have a little more faith in these recommendations, and also be super weary of the people that are making recommendations against all the expert consensus.
Not to go back to the lipid thing, but, you know, when I look at these carnivore diet people saying, you know, LDL doesn't matter, and you can eat like the liver king, eat all these things and it's better for you, it doesn't matter what your LDL is, all these things.
You have to think to yourself, why would this one person know more than every cardiologist in the American College of Cardiology, the European Society of Cardiology, you know, all of these worldwide organizations that have similar consensus statements?
It has to frighten you, and I think that that's the part that The conspirituality that we share in common is the, you know, antithetical thinking that the expert consensus is wrong and out to get them.
And I think understanding that process will maybe, hopefully, restore people's faith.
Yeah, I hope so.
I mean, I deal with it in the media all the time, being like, people are like, the media is lying to you.
And I'm like, do you really think all these journalists are coordinating behind the scenes?
Like, it's so absurd.
But part of it is humans are just not built for social media.
True.
I tagged my wife in your tweet about that because she has been, oh, she just shared an article with me, should you wear sunscreen indoors?
I love her.
Like whenever she drives.
I love her.
Yes, yes.
She is, she's half Thai and in general, Asian women tend to use sunscreen a lot more because of the fairness of the skin.
And she grew up with that.
So that's very important to her.
And has taught me because growing up as a lifeguard in New Jersey, I used to put coconut oil on.
Me too.
Also, lifeguard in New York.
I used to totally put coconut oil on.
I regret it so much.
Yes, yes.
So you learn, and that's the thing about evolution of understanding of science.
And that'll bring me to the final question I have for you, which might be Which I can imagine listeners getting extremely mad about and mad at you, but we have to go there because I think this is super important.
You just had Food Science Babe on your podcast.
Not Food Babe, that should be very clear, because Erin is much more... I will listen to her much more than Vani or whatever her name is.
Absolutely.
So I wrote a book, a novel called Mysterious Distance many years ago, self-published, and it was about agriculture.
And at the time I was very much in the natural farming, you know, anti-ag, and I started doing some research on it for the book.
And I was like, Oh, maybe GMOs aren't as bad as I thought.
I went to prove one thing and then realized, wait a second, as I actually looked at data.
And just yesterday, I've just moved to Portland, and I was working in my front yard here.
I live in a little townhouse complex.
And the woman across the street, who I get along with very well, she's a permaculture expert, and she started yelling about the HOA started spraying glyphosate here.
And so I bring all this up because these were things that Aaron addressed on your podcast about, you know what?
GMOs aren't that bad.
Glyphosate is actually one of the safest herbicides that we have.
The dirty dozen is more of a marketing term than anything else.
So I want to hear your feelings on this industry.
One thing that jumped out was you both were talking about, remember the Organic Growers Association is an association with a vested interest, and so the studies they put out are often in favor of their messaging.
So let's start there.
So, um, and first for anyone listening, I fully empathize with you.
Cause I too thought organic was better than conventional, um, just by default.
Right.
And I also, um, even on my podcast segment all the time, I thought clean, I was totally like, Oh, of course, clean beauty is better than non clean beauty.
I mean, like until I learned actually what the evidence is, but I totally, it's so, I empathize with everyone listening.
Cause I totally have been there.
I mean, I used to buy organic only just by default thinking it was better.
And then, not to go back to guidelines and be such a science-evidence-based freak, but one thing I was wondering, one thing I realized that hit me was like, wait, why don't our cancer guidelines or our cardiology guidelines, like I'm now someone that's chair of the Nutrition Committee for American Society for Permanent Cardiology, I'm like, well, why don't we have organic in our guidelines, right?
Well, it's because the evidence isn't there that it's more beneficial.
The only two studies that look at hard outcomes of organic produce, Bradbury, and I forget what the other one's called, but when you meta-analysis and you summate their evidence together, the results are null, so there's no difference in outcomes.
And that being said, I always say, when we talk about evidence-based medicine, we're talking about evidence-based scientific communication, everything we say is, listen, this is what it is, the best science to date.
Right?
So I can't predict the future, but the science to date doesn't show us that there's any difference in health outcomes for organic versus conventionally grown produce.
What Aaron explains to very eloquently on our podcast is that the dirty dozen is a marketing technique.
So you would need to eat upwards of a child would need to eat upwards of over 400 strawberries a day at the highest ever detected USDA level of glyphosate or of any herbicide or pesticides to reach any sort of clinically relevant toxicity level.
The dose makes the poison, I think is the important point.
If you choose and you prefer to eat organic for whatever reason, go for it.
But if you don't fear conventional produce, if that is what you choose.
Because the health outcomes haven't shown any difference.
There actually is, if your concerns for the environment, we dig into this as well, there's actually more eutrophic potential of the environment and all of these issues with regards to higher land use for organic farming.
So that's not super clear-cut either which ones Better.
Erin, who's a chemical engineer and food scientist, you know, discusses some of the negatives of organic for the environment.
And I think that we have lots of issues with our environment.
And I don't think that organic is going to be the answer for fixing our environment either.
And I think that she explains that quite eloquently.
The health outcomes thing, as I mentioned, you know, there's a reason why none of our guidelines are saying you have to eat organic produce.
It's just not.
And GMOs are really unbelievable in many ways.
They actually allow you to use less Pesticides, in general, because of the way they use.
They help us feed the world, which is such an important point.
And everything is genetically modified in some way, shape, or form based on just like selection of farming overall.
And so a lot of things are.
And so they don't need to be feared as well.
And I think that this is another fear-mongering industry.
And most importantly is relearning what you know about the EWG.
So the EWG is the one that puts out the dirty dozen.
They're also the ones that talk a lot about clean beauty and all these other various things.
They're not a trustworthy resource.
It's not just because they're funded by organic organizations, so that's obviously their MO.
Because when it comes to industry-funded studies and things like that, I have no problem with that.
I want to evaluate the study.
In medicine, tons of studies are industry-funded.
I want to look at the methods and see if the statistical analysis is accurate and things like that.
So it doesn't bother me that they're funded by by the organic industry.
It's that the information they're putting out is just not correct.
It's not based in evidence, not based in scientific evidence.
It's creating fear-mongering because they're profiting from the fear-mongering, right?
So thinking of the EWG and the dirty dozens is not a reliable source.
That being said, choose to eat organic if you want, conventional if you want, but just don't fear GMOs and conventional produce because we really don't have any scientific evidence to show that it's in any way harmful.
And then also organic uses pesticides, right?
And so they use pesticides similar to the supplement industry.
They use pesticides that aren't as clearly regulated as things like glyphosate that have been so rigorously tested and evaluated.
And so they're using pesticides, copper, all these various like natural quote-unquote pesticides, and they often have to use them at much higher levels.
Because you remember GMOs actually help you use pesticides at lower levels because of the way the And so they're using at higher levels.
And so I'm not going to sit here and say that organic is by any means worse for you, but I'm saying that it doesn't mean that this naturalistic fallacy is so misleading.
One thing that really jumped out when Aaron was speaking was that the fear that comes into people's consciousness because they maybe can't afford or have access to organic is that they then will not eat.
Produce and fruits and vegetables.
And I think that just really speaks to the level of privilege that we discuss in the wellness industry a lot.
Because if you have access to these things, and I'm fully with you, I want people to understand that what you expressed is what I lived through.
I mean, my eating disorder very much happened because I was always weighing, is this pure enough?
And I dealt with that for a long time.
And the stress that comes with that sort of thinking is probably more damaging to my body than any quote-unquote conventional product I can put in my body.
When I have the opportunity to buy really fresh organic food, I do it because it's tasty and I like it, but that's where it sort of ends.
And I think that's really important to point out.
And then also, speaking about the availability and accessibility of produce, there's actually some data that shows that nutrients are preserved even better in frozen fruits and vegetables, because they're frozen at a time in which they're at their best nutrient value.
And frozen fruits and vegetables, conventional frozen fruits and vegetables, can have a higher nutrient value than the organic produce you get.
And they are much cheaper as well.
By breaking down all the misinformation about this, I think will hopefully make people feel like, oh wait, I can go out and buy.
I mean, I literally use so many frozen fruits and vegetables.
I'm a vegan and my entire life is fruits, vegetables, beans, things like that.
And I use so many frozen fruits and vegetables because they're great, they're easy, they're cheaper, they're just healthful, nutritious.
I of course use fresh ones too, but For anyone listening, eat your fruits and vegetables any way you can, whichever way you prefer, that you feel comfortable with, whichever way is affordable, and don't listen to the fear-mongering out there that tells you that you have to do it a different way.
And I just want to point listeners to your podcast one last time, because like What I say, you are an expert in things.
I'm not.
I'm just a journalist, but I have people on.
And you make that very clear in your podcast that there are things you don't know about and you want to hear from people who do.
And so all of these episodes, we've been on for a while now, but we've also talked about chiropractic, the microbiome, that episode with Austin was amazing, the tapeworms.
The tapeworms!
Yeah, because I'm sorry, I'm going to keep you on for one more moment because I read The Second Brain by Michael Gershon like 20 years ago.
The enteric nervous system and the microbiome is something I've thought about a lot, especially having dealt with gastrointestinal issues for many years.
And that episode was so important because For example, Austin tells you that there are microbiome take-home tests and you didn't know that.
Now, in the wellness industry, I see these all the time.
I had no idea.
Let's just hear what you learned about the microbiome and some of the myths there from that episode with Austin.
Oh, I cannot believe there's a microbiome take-home test.
So one thing I do know about microbiome, so there's a lot of crossover and I'm very interested in microbiome because there's a lot of crossover in microbiome and cardiology.
And the reason why I'm interested is because I used to think that the science was a bit, before I, when I was in training and I didn't understand how to critically place a pretty scientific research as well as I do now, I used to think that the science was a bit more settled than it was.
And then the more you learn, the more you're like, wait a second.
So the science for the microbiome is in its infancy.
So not to say that it's not important.
It is incredibly important, and this research needs to keep going.
But when I tell you it's in its infancy, the top experts in microbiome will openly admit, we don't know what shift in what population of the microbiome to X, Y, or Z will make a clinical difference with a significant clinical outcome versus another shift.
We don't even know what to do with the data of the microbiome at this point.
And that's the most important thing, right?
We can't just say... I always say to anyone, you can spot pseudoscience when someone mentions mechanisms instead of outcomes.
Outcomes are clinically relevant things.
Does it change your symptoms?
Does it change your disease process?
Does it change your cholesterol?
Does it change your diabetes?
Does it change how you feel?
Mechanisms are, well, the microbiome, there's a lot of fancy scientific words, it's going to change X, Y, or Z, it's going to help your gut health, your leaky gut, and then there's no clinical evidence for that actually improving outcomes.
And so the issue is that, with pseudoscience, is that it sounds really science-y.
But the reason why there is no physician that's going to give you, well, sorry, there's no evidence-based physician, there's plenty of scam physicians that will, but there's no evidence-based physician who's going to do a gut microbiome test on you because there isn't even consensus on what the changes in the gut microbiome at this point really mean.
Right?
And so we know things that can be healthy for the gut microbiome, such as, you know, fiber intake, and, you know, eating an overall healthful diet.
It kind of, at this point, ends there, and it's in its infancy, and the research is important, but no one should be making any extrapolations clinically.
We don't know enough clinically at this point to make any sort of clinical decisions based on microbiome, considering we don't know what changes and what shifts change actual patient outcomes.
Therefore, you know, the home microbiome tests are totally bogus.
And this is so America, right?
Selling a home test for something that the most advanced scientists in the world do not have consensus on the clinical interpretation of it.
