Dr. Jay Bhattacharya, Max Lugavere, and Gina Florio dissect COVID-19 risks, noting age and obesity as primary mortality drivers where morbid obesity adds a decade of risk. They critique lockdowns as inhuman policies harming the poor while protecting the wealthy, comparing them to failed abstinence education rather than effective harm reduction. The roundtable condemns coercive vaccine mandates and arbitrary restrictions like gym closures, arguing these measures violate individual liberty and exacerbate health disparities. Ultimately, the discussion emphasizes personal responsibility over government control, warning that politicized science threatens free speech and democratic freedoms. [Automatically generated summary]
I'm Dave Rubin and we've got another Friday panel bonanza for you.
Today we'll be discussing the importance of living a healthy lifestyle in a time of COVID.
And joining me today, our host of the Genius Life podcast and author of Genius Foods, Max Lugavere.
Fitness trainer and health coach, Gina Florio, and professor of medicine at Stanford University and a research associate at the National Bureau of Economic Research, Dr. Jay Bhattacharya.
All right, Doc, I'm going to start with you because we're hearing a lot suddenly in the last couple of weeks that body mass index and obesity have a lot to do with mortality rates related to COVID.
And I heard you on Megyn Kelly's podcast a couple of weeks ago, and you were talking a bit about this.
Can you, can you kind of fill us in on how important body mass is related to staying healthy right now?
I mean, it's important for staying healthy just generally, just apart from COVID.
For COVID, I mean, the single biggest risk factor is still age.
So every six or seven years of age, you're double your risk of death conditional on getting COVID.
So age is the most important thing.
Just to give you some sense of how important body mass index is, if you go from normal weight to overweight, that's like adding maybe a year So, like, I'm 52, that would mean I'd have the same risk as a 53-year-old if I were overweight.
And then, if going from overweight to obese, that adds about, let's say, five years.
So, I'd go from, like, 52 to 57-year-old risk.
And if you go to morbidly obese, that's like 10 years of risk, something like that.
So, it matters.
It certainly matters.
I mean, but as we said, it matters for so many other things, too.
Yeah, Max, since I've had you on a couple times talking about health and you kind of helped me straighten out a little bit of a little bit of my eating habits and the rest of it.
I'm guessing this doesn't surprise you that that some of this is connected to body mass and weight.
No, I mean, obesity and overweight in this country are huge problems.
I mean, the latest statistics suggest that two thirds of people are either overweight or obese.
And, you know, the BMI is a is a is a It's a metric that people love to hate on, right?
Because it basically, we arrive at it via a simple calculation using your height and weight.
And so there's been, at least from my vantage point on social media, this pushback to all of this really, what I think is very empowering evidence to show us that by achieving a healthier body composition, we might become more resilient, you know, against pathogenic threat.
but a lot of people like to argue that the BMI is an imperfect unit of measurement. And that's true,
that is true because it doesn't incorporate, it doesn't really paint the full picture of
your health. But no single marker, no single number that a doctor can measure on any lab
does. It doesn't account for lean body mass. So if you love to go to the gym,
it's not going to be able to tell you that you have more or less lean body mass. But the truth
is that when you zoom out at the population level, the BMI is actually very useful because most
people are not outliers, right? Most people are of average body composition and average in this
country now unfortunately, is about a third of the population. So it's not a huge difference.
I remember 20 years ago when Shaquille O'Neal was a huge NBA star, huge, no pun intended,
but I think according to his BMI, he was morbidly obese, and yet here he was,
obviously in prime shape, running up and down the court.
So of course there are those outliers.
Gina, you're a fitness instructor.
What can people be doing right now?
Because I've noticed a lot of people, it seems to me that a lot of people basically either got better, got healthier in the last year, or just sort of went off the deep end the other way.
I mean, it's no surprise that we've ended up here.
I mean, I think it was even in the 1950s, the National Institutes of Health Declared that obesity was a national pandemic in a way and it was a metabolic disorder of the age, they said.
And so now we've arrived at this very unique place where I also think that our culture has prepared us to accept obesity as the norm now.
And I think that's something that we definitely need to talk about because if you see what's happening in digital media publications on the cover of magazines, we're now being told that obesity is not only beautiful.
But we're actually being told that obesity is healthy.
There was a cover of Cosmopolitan where a morbidly obese yoga teacher was doing a yoga pose and the headline was literally this is healthy with an exclamation point.
So I think what we're also seeing is a very interesting moment in American culture where we have been taught that it's somehow offensive to even talk about obesity rates and talk about the effects of obesity.
It's, you know, especially as people in the health industry, it's almost a lose-lose for us because nobody wants to hear the statistics because people have been conditioned to believe that it's rude to even bring them up.
Dr. J, I'm guessing that you probably struggle with the degree of that, that people are so leery of everything right now, depending on where you get your news and what podcast you listen to.
And if you, obviously, if you watch CNN, you're getting very different information than I mean, I think there's, I really regret that it's a political issue.
I mean, I didn't realize it could become a political issue.
COVID has become one, which is just mind boggling to me.
And obesity certainly also shouldn't be a political issue.
Things that we all knew to be true 10 years ago now are just up for debate.
I mean, I think there's, I really regret that it's a political issue.
I mean, I didn't realize it could become a political issue.
COVID has become one, which is just mind boggling to me.
And obesity certainly also shouldn't be a political issue.
It is absolutely the case that if you are overweight or obese,
you are at higher risk for a whole number of chronic diseases and conditions.
It's healthier to address that.
I mean, so that's just a medical fact.
I guess maybe if I try to think about a reason for this, well, we don't wanna stigmatize disease.
We don't wanna stigmatize people who have a disease or condition.
You want to provide them with resources to address those kinds of conditions without shaming.
I think maybe that's what the culture is trying to address, but you should be able to do it while still squarely looking at the fact that if you gain too much weight, you put yourself at higher risk for bad medical outcomes.
I ask you some version of this every time I have you on the show, but for somebody that's watching this right now that maybe put on a couple pounds during this or is not feeling great about their weight, but maybe they don't want to bust all into a new fitness routine or whatever, what are some of the little things that they can do to start adjusting to be healthier?
Yeah, I mean I think the biggest problem with the standard American diet, which is what most of us are hooked on, like an IV drip, is that it is just saturated in what are called ultra-processed foods.
Foods that are generally, their protein content is diluted, so they're minimally satiating, they're dehydrated, and they provide no dietary fiber.
So those three ingredients right there are what make a food satiating.
And unfortunately today, 60% of the calories that we're consuming come from the inverse of that, foods that are highly calorie-dense and minimally satiating.
So, the advice that I give people, I mean, we can get into the nitty-gritty about low-carb, low-fat, whether or not plant-based is the right diet or a more animal-centric approach, which I believe is the more appropriate and biologically sound approach.
But ultimately, anybody will benefit from minimizing the consumption of ultra-processed foods and shopping around the perimeter of their supermarket, which is where they'll tend to find the fresh, perishable foods.
You know, foods that have single ingredients.
Those are the foods that are more likely to fill you up.
There was a study performed, I believe it was 2018, at the National Institutes of Health by a well-known obesity researcher named Kevin Hall, who found that when people eat predominantly ultra-processed foods, which is what Americans are eating, they naturally will eat themselves to a calorie surplus of
about 500 calories a day.
If you do that every single day over the course of a week, that is a pound of weight gain,
which can easily push you into the territory of being overweight or obese.
So I think if people were to make one single change, it's to look at the food quality,
you know, look at the foods that you're eating and make sure that they are of that
So in the midst of all this, Gina, they also closed the gyms.
And I'm here in L.A.
where my gym is still closed right now, even though Newsom, our governor, is telling us that on April 1st, April Fool's Day, of course, we're going to start opening up some stadiums or something.
It does because it hinders people from being able to live a lifestyle that's going to help them move forward and take care of their health because, you know, there's there are many things that we can do when it comes to daily lifestyle and diet and exercise.
But I mean, the biggest thing for me is just the fact that people are stuck inside their homes and that people are encouraged to not go outside and see the light of day.
I mean, I think one of the biggest issues that most Americans face is that they spend, on average, like six percent of their life outside.
We're stuck inside all day from 9 to 5.
We're under the fluorescent lights.
We never see the sun.
I mean, the sun is our biggest source of energy.
It boosts serotonin.
It boosts testosterone levels.
It improves our mood.
And there's so many things that being out in the sun does for us.
And all of a sudden, we're told to stay inside.
And when you go outside, cover half of your face.
And we need the sun to regulate our sleep-wake cycle.
And the quality of sleep that you get also really affects your health and your weight.
It's just, it's frustrating that I see all these people self-isolating and staying at home and not getting outside, and of course we're gonna be more unhappy.
We're going to gain more weight and we're going to choose to eat all these ultra processed foods because we're in a bad state mentally and emotionally.
basically they think if you have rats and you put them in cages apart from each other,
they won't infect each other. That is essentially the sophistication I think of this. I mean
the models themselves have these little sins where you make people not interact and yeah,
the disease doesn't spread. But the problem is everything else about human life, right?
So we have to be in interaction with other. We have to be like being in isolation is psychologically
incredibly damaging. And we can't do it. We just cannot do it without suffering severe
consequences. In the early days, we even knew in the early days who's really at risk. It's
the older population, you know, and certain people with certain chronic diseases. We should
have done everything we could to protect them while still trying to maintain normal life.
Instead we panicked everybody. And what's happened is young people, young you all, have
a higher risk. You think of COVID as a more risky thing that actually is for you.
And so you don't go out.
I'm not you all, I mean, obviously, but like a lot of young people I've seen, whereas older people, they, in some sense, they underestimate their risk and they take more risk than they should.
Instead of like this good, accurate public health understanding of who's really at risk, if we'd given people that tool, they could have managed it, their lives around that, around that risk more appropriately.
Instead we panicked everybody.
And we get this unfocused, these unfocused lockdowns that have caused absolutely devastating harm.
I've been, I've, I've likened it in the past to abstinence education versus safe sex education.
I've seen other people do the same thing, you know, from the get go, it should have been harm reduction, you know, arming people with the information that they needed to make informed choices, letting people know that if you have comorbidities, you know, the average, there was that study that was published over the summer that found that the average person to die with COVID-19 Had 2.6 comorbidities, 2.6 other conditions on average.
The data surrounding age and obesity and all these other figures should have been laid out there for the public so that they could then make their own choices.
People who are older, stay home, quarantine, do what you must.
But yeah, that to me, Jay, was exactly, I think, The difference between safe sex education and abstinence education, the latter, we know, doesn't work.
When you tell people to just stay abstinent, what do they do?
Do you guys think, Gene, I'll start with you, do you guys think that this has fundamentally changed the way people trust or don't trust the experts, the scientists, our government officials?
I'm meeting a lot of people, especially here in Los Angeles, Max, you're here too, where it's like people that were not political at all before this thing began are becoming very political because they realize that you have to, in an odd sense, you have to be political if they won't let you go to work.
Yeah, I actually noticed that too in my own circles.
I find so many more people who are suddenly interested in politics and who are suddenly interested in getting involved.
Because I think what we've been seeing is an incredible frustration and distrust of experts, right?
So first Dr. Fauci said, there's no need to wear a mask.
You don't need to wear a mask and people fiddle with it doesn't really work.
He said that and the next thing you know, he's saying everyone must wear a mask.
And the next thing you know, he's saying people need to wear two masks.
We're sort of sitting here asking, okay, hold on a second.
So if the safest thing is to wear two masks, why didn't you tell us that from the very beginning?
Why are you withholding that seemingly important information?
And so now you have a lot of people who maybe aren't on either political aisle, but they're suddenly getting frustrated because what these lockdowns have done is ruined many people's lives in a very real way, shut down businesses.
It's hard to put food on the table for your children.
And people have lost their livelihood and there are real tangible consequences.
Just that I think there's just like an exhaustion at this point.
This is sort of what we were talking about before, but like, there's just like this exhaustion of listening to experts because then people look at the tweets from a year ago and it's like, wait a minute, you were telling me to go outside.
There's a dissonance that, to me, feels political.
It doesn't feel like it's grounded in science.
And so the fact that politics have sort of somehow been able to seep in and intervene and play a role here, and you see the statistics about people, you know, on surveys, rates of anxiety, depression are just shooting through the roof.
people are comfort eating, you know, leisure time, physical activity is at an all time low.
It's just really disheartening and counterproductive to what we should all be rallying behind,
which is keeping people safe.
But these efforts actually, these mandates seem to be counter to that.
And to me, it's very frustrating.
So you're right, I've been sort of stepping my foot forward a little bit.
Yeah, there are just endless benefits to exercising regularly.
I mean, down to how you sleep, down to bone density, down to sex drive, down to boosting serotonin and just feeling so much more clear-headed, down to self-confidence.
And, um, it's, it's an immensely important part.
It's a fundamental part of health.
And, you know, even more than just exercise, going to the gym and lifting weights is something that we call non-fitness movement.
Just getting 10,000 steps a day, just going out for a walk, Oh, for a walk first thing in the morning for 30 minutes, um, you know, move around maybe even like cooking is non-fitness movement, right?
Doing these things that just encourage a kind of lifestyle and habits that are going to last you in the long run.
And with this, the self isolation.
There's just no way to do that.
You know, there's, there's no way to actually engage in these things.
You can't even, you know, even going to take a dance class, all of these things that, that contribute to holistic health and, and a really strong mental capacity.
We're missing that.
And it's no wonder, it's no wonder we're seeing rates of anxiety and depression spike.
Um, you know, on top of people just not getting outside, never seeing the sun, being totally isolated, not seeing their friends, not being able to do the things they love.
and even down to starting new hobbies.
Those things are so good for our brain and for our mental health.
It keeps us engaged, it keeps us excited, and it helps us move our life forward.
And it's really sad to see people literally sit in their home and deteriorate.
I think the psychological damage really can't be overstated.
Like one in four young adults this past June in a CDC survey Seriously considered suicide in the United States.
One in four.
That should have ended the lockdown right there.
I mean, just think what we've been doing to our young people.
It's just it's mind boggling.
Of course, the isolation affects young and old alike.
But actually, you know, the other thing about the lockdowns, it's sort of underappreciated is is how I mean, I think of it as trickle down epidemiology.
It's protected people who can afford to have jobs that have Zoom, but it hasn't protected poorer people.
You know, working class people in L.A.
County, like places like Santa Monica or or Beverly Hills, have one third the number of covid deaths per capita than poor parts of L.A.
You know, Compton, you know, Watts, one third.
I mean, it's it is really one of these things where it's it's protected the rich at the expense of the poor.
And I mean, ironically, I think in the ways you all are saying harm the rich.
With the psychological isolation, it's just a catastrophic policy for health.
Doc, where are you at with, excuse me, where are you at with vaccines now?
Because, you know, Joe Biden last night basically was saying, you know, that everyone will have at least the opportunity to be vaccinated by May 1st.
Again, that's a year plus three months past two weeks to flatten the curve.
And then he said, if basically everyone behaves that by July 4th, you can have small gatherings in your backyard.
But it's like, People are already doing it.
And the more that they keep pushing this, it seems to me, they're just gonna keep saying things and just more and more people are just gonna ignore it.
But where are you generally speaking with vaccines?
Yeah, do you guys all think that everyone should be vaccinated?
I mean, it seems to me that the push now is not just we're gonna vaccinate the older people and the other people at risk, but now it's gonna sort of be if you aren't vaccinated and if you don't have a card or something to prove you're vaccinated, either we're not gonna let you on a plane or, I mean, you can really go down a rabbit hole with this stuff.
But Max, what do you think?
Should everybody be vaccinated?
Even the 40-year-old healthy person that's taking care of themself?
For me with the vaccine, yeah, I think the biggest thing for me is that it's being used as a threat.
And that's what I really don't like, is that we're now being told by leaders and politicians that if you don't all get this vaccine, we're never going to be able to open again.
We're never going to get back to normal.
Well, that's that's not what the vaccine should be used for, is to threaten people and say that we all absolutely must take it.
I mean, I'm in the same boat as Max.
I personally know that I don't need the vaccine, but if you feel like you need it, if it's your choice to go get it, more power to you.
I'm not going to stop you.
I'm not going to say I'm not the anti-vax person either.
But the whole point is that we should all have the choice and we should all have the choice if we want to take it.
And if we don't want to take it, that's fine, too.
So the biggest problem for me is that it's being used as a threat.
And that's what really upsets me, and I think that's where we see the biggest problem, is that Biden's saying that if you all behave like good little children, I'll let you go have a July 4th barbecue.
I'm like, well, no, buddy, that's not the way that it works.
Not in America, no.
Not if we follow your orders, and if we behave in the way that you want us to, then we're allowed to go live our lives the way that you are allowing us to.
So I think that's the biggest thing for me, is that it's being used as a threat.
I mean, I think that's really, again, it's a public health mistake, right?
You can tell people for whom the vaccine is a really good idea, that it's a good idea, in a trustworthy way, present them the evidence, and then let them make good choices around that.
That's what good public health does.
I'll give you one thing.
I think it's something on the order of half the country has already been infected with COVID, right?
So if you just account for asymptomatic infections and just, I mean, I've done some calculations, say roughly half the country.
Why do we have to have everyone vaccinated if half the country's already been infected with COVID?
I mean, it just doesn't make any sense.
Actually, it's very, again, it's one of these things where it privileges the rich.
It's the relatively well-off that are more enthusiastic about the vaccine.
Vaccine hesitancy is much higher among the poor.
And we're going to create a segregated class of people that, oh, you're not vaccinated, so you can't go into a theater?
I mean, that doesn't make any, when in fact, they're probably already immune.
Because they had some asymptomatic infection.
It just doesn't make any sense.
It's bad public health policy.
Instead, we should be using the vaccine to protect the vulnerable.
And for people who are scared about COVID, again, the vaccine is a fantastic idea.
There are classes of people for whom the vaccine hasn't been tested.
Like children, it hasn't been tested.
And frankly, I'm not going to let my children have it until it's been tested.
Frankly, even then, I might not want it, because COVID might be better for my kids than the vaccine.
For me, it's I'm going to I'm probably going to get I'm older than you all.
Health care workers, you know, frontline workers, I think should be able to make that choice and, you know, and do a cost risk benefit analysis, you know, like individually.
But also, you know, where is the messaging from our officials that, you know, pounding home that like we need to get in we need to get in better shape as a nation?
I mean, that messaging is nowhere to be found.
It's just, you know, MIA, and I think that's really sad.
Also, because vaccines traditionally work less, they're less effective in people who, you know, have comorbidities, who are overweight, who have, you know, chronic low-grade inflammation, things like that.
So, that to me is, you know, I'm still disappointed.
Yeah, so I got one more for you, because everyone knows I try to end all of the shows with something hopeful.
And actually, there's been quite a bit of hopefulness here.
And we know that these lockdowns are ending, even if it's taking a little too long.
But I'm curious for all three of you, is there anything in the past year that you're that you're thinking fundamentally shifted on?
Because I'm finding that a lot of people are thinking about things in a new way and thinking, oh, maybe the government Can't do everything for me, can't fully keep me safe, all of these things, which I think is a net good thing, even though it still feels a little scary right now.
I'm curious if you guys had any fundamental shift.
Yeah, I mean, to me, it just drives home that, you know, personal accountability isn't something to be underappreciated and that we each need to take steps in our own lives to procure better health for ourselves and to educate those around us, you know, to be sort of the beacons In our own communities, whether that's in our families, to our friends, on social media, to lead the way.
The best way to teach is to lead by example.
And so that's personally what I try to do.
And I think the tools are out there, you know, compared to prior generations.
We, you know, we're more invested in our health.
We're more invested in our, you know, personal development.
We, you know, science is fairly ubiquitous.
You know, everybody has access to scientific publications for the most part, or at least abstracts, or at least You know, journalistic interpretations of that science.
And I think, you know, there's no time like the present than to seize the reins of your health and to, you know, whether it's small steps or big steps to, you know, to really like engage with it.
Because once it goes, you know, it's something that's, you know, your health is like chronic.
An ounce of prevention is worth a pound of cure, is what I think.
You know, to just close with a John F. Kennedy quote that I really love, you know, the time to fix the roof is when the sun is shining.
And I think that if there's anything that the past year has shown us, it's that.
I did not realize how fragile the consensus around free speech and free expression was, even within science and scientific discussion and within public health.
I mean, I think one thing that's come Very, very clear to me is that it is actually quite fragile.
Indeed, the people that speak out against a consensus, even when the science is loudly pointing in one direction, are liable to get pounded down.
There's a lot of danger around that in the future of science, scientific discussion, frankly, in the future of a free society.
And yeah, I think that's something that's not going to end with a lockdown, unfortunately.
Using the insurance that I am paying for, why are you making me wear the seatbelt?
I mean, it's the same thing with the mask.
What does this have anything to do with the government?
So I don't know.
That's definitely not hopeful, but I'm at a point where it has honestly gotten me to the point where I'm so hyper aware of government interference and the government overreaching and telling us how to live our lives and telling us to do this and that for a reason that I honestly can't wrap my head around.
And that's where I'm at too.
I mean, that's definitely not hopeful, but it's made me so much more aware You know, it kind of is hopeful, though.
You woke up to liberty in the midst of all of this, and I think a lot of people did.
So I think that's a perfect place to stop.
I'm going to continue without you guys for a minute or two, but Dr. J, Max, Gina, I thank you guys.
We're going to link to all your stuff down below.
And stay safe, and I hope to see you guys in actual real human life one of these days.
Thanks, Dave.
By the way, guys, I should mention that Max over there just joined Locals, and it's maxlugavere.locals.com.
So if you want some advice on eating and brain health and all sorts of good stuff, maxlugavere.locals.com.
You know, guys, I did a Periscope before we started this thing, a little live video streaming.
On Twitter, which by the way, we are adding that functionality to the locals app.
It is coming soon.
We already have live text chat in there, but we're adding live video streaming.
But anyway, I did a Periscope a little bit before where I had to, I had to apologize to the people of the world because, you know, Joe Biden last night was saying, you know, this thing about May 1st, if everybody's vaccinated and you behave, And keep listening to us, even though we keep moving the goalposts, that maybe at that point you can have a couple people in your backyard to celebrate Independence Day, which Independence Day is all about being free from these tyrannical leaders, but maybe we can do it in four months from now, which is about 16 months after two weeks to flatten the curve and that whole thing.
But anyway, I was watching that and then, well, We had a dinner party at our house last night.
We had eight people over for dinner.
We had chicken and salmon and bok choy and farro, and we served small ice cream sandwiches at the end.
And everyone that came over could be dead right now.
I have no idea.
I haven't heard from anybody today.
And look, the point guys is that go ahead and live your life.
You don't need me to tell you.
And you actually don't need experts in a way to tell you that like make whatever choices you think are right
for you and your family.
That's the only way society is gonna get fixed.
Like if it's not obvious to you at this point that the top-down way of looking at pretty much everything,
not just the pandemic, but government in general and all of the institutions and everything like that's why
I'm enthused right now.
You know, like I was a little, I was a little dour earlier in the week about things because you just hear about they're coming for Pepe Le Pew and they're taking out Dr. Seuss and Mr. Potato Head and this movement of destruction.
It's here.
It's here and it's going to keep coming.
There's no doubt about that.
But what we talked about there at the end that people are waking up to what liberty means like and what freedom means and the best thing the only thing you can do in a way in the midst of all of this is just figure out what works for you and the people that you love and the people that you're around in your local community.