Dr James Muecke is an eye surgeon based in Adelaide who has been working tirelessly behind the scenes to change the trajectory of the health epidemic and the avalanche of diabetes that is becoming so prevalent in our society.
He speaks on low carb down under here.
Dr James founded the organisation Sight for all and is now their patron.
He has been working to have the food and dietary guidelines changed and recently succeeded with a bit of help from his friends ;) in low carb being added as an option on the Diabetes Australia website. In this episode, Emma and Dr James talk about seed oils, eyesight issues and preventative food choices, plus discuss his personal journey.
In November 2019, James was announced Australian of the Year 2020. On being appointed Australian of the Year, he immediately and passionately advocated for a tax on sugary drinks in the fight against type 2 diabetes, which is the leading cause of blindness among Australian adults. He advocated for TV commercials for unhealthy products to be limited to certain hours, and asks supermarket chains to curb their "predatory sales and marketing tactics.
Dr James Muecke is an eye surgeon based in Adelaide who has been working tirelessly behind the scenes to change the trajectory of the health epidemic and the avalanche of diabetes that is becoming so prevalent in our society.
He speaks on low carb down under here.
Dr James founded the organisation Sight for all and is now their patron.
He has been working to have the food and dietary guidelines changed and recently succeeded with a bit of help from his friends ;) in low carb being added as an option on the Diabetes Australia website. In this episode, Emma and Dr James talk about seed oils, eyesight issues and preventative food choices, plus discuss his personal journey.
In November 2019, James was announced Australian of the Year 2020. On being appointed Australian of the Year, he immediately and passionately advocated for a tax on sugary drinks in the fight against type 2 diabetes, which is the leading cause of blindness among Australian adults. He advocated for TV commercials for unhealthy products to be limited to certain hours, and asks supermarket chains to curb their "predatory sales and marketing tactics.
Dr James Muecke is an eye surgeon based in Adelaide who has been working tirelessly behind the scenes to change the trajectory of the health epidemic and the avalanche of diabetes that is becoming so prevalent in our society.
He speaks on low carb down under here.
Dr James founded the organisation Sight for all and is now their patron.
He has been working to have the food and dietary guidelines changed and recently suceeded with a bit of help from his friends ;) in low carb being added as an option on the Diabetes Australia website. In this episode, Emma and Dr James talk about seed oils, eyesight issues and preventative food choices, plus discuss his personal journey.
In November 2019, James was announced Australian of the Year 2020. On being appointed Australian of the Year, he immediately and passionately advocated for a tax on sugary drinks in the fight against type 2 diabetes, which is the leading cause of blindness among Australian adults. He advocated for TV commercials for unhealthy products to be limited to certain hours, and asks supermarket chains to curb their "predatory sales and marketing tactics.
TABLE OF CONTENTS
EPISODE TRANSCRIPT:
Emma [00:00:00]:
My name is Emma Martin, and this is the Lazy Keto Mum Podcast. If you are looking to help with keto and low carb, you have come to the right place. Well, hello, guys. This is Emma. The lazy kiddo mom, as you know, and I'm joined by the most, I think inspiring guest I've had so far. Not taking away anything away, but I know right now, if you could see him, he's got his jaw just fell I am talking to Doctor James Mierke today, Australian of the year a couple of years ago, and now patron of sight for all Hi, Doctor James. How are you?
James [00:00:43]:
Morning, Emma. Good. A little chilly down here in Adelaide at the moment, but otherwise, great things.
Emma [00:00:47]:
Well, winter had to come eventually, didn't it?
James [00:00:50]:
It did, and actually just coming back from a lovely, warm overseas trip. It's a bit of a shock to the system.
Emma [00:00:55]:
Yeah. Your overseas trip looked amazing. I'd love actually ask you, you know, what what you did to say on your lifestyle, but there's a bit of stuff I wanna ask you before that. I'm I'm a little bit starstruck still like talking to you. So I know. I just think I love the message that you share, and I just think that it's so important that people understand about diabetes and and what the health implications are. And that was my motivation for reaching out to you When did you first learn about the fact that the food pyramid might have been a bit skewed?
James [00:01:30]:
Well, actually, being an osteo technologist, and I have been in this game for 33 years. And for all time, I've been dealing with the consequences that diabetes and fix on the eyes, all types of diabetes, of course. And Really, I ever saw my role as being the guy at the end of the line to treat the end stage complications, the blinding complications, the vision threatening complications. I never really thought of my duty to have those lifestyle conversations with particularly with patients with type 2 diabetes, which makes up close to 90 percent of cases, and it's a largely avoidable man made dietary disease. But in late
Emma [00:02:08]:
2018,
Wake up call: blind documentary changes perspective.
James [00:02:09]:
I Had a real wake up call. I was actually filming a documentary, and it was a documentary featuring a series of people and patients who are blind. And I was really interested in probing what it means to be blind. What what is the experience of blindness? And I interviewed for kids who were born blind, and they had amazing stories. I interviewed four people who were slowly going blind at the end of their life due to a condition called age related macular degeneration, which is the leading cause of blindness in this country in Australia. And then I also interviewed 2 people who suddenly went blind in the prime of their life. One was a young woman who had type 1 diabetes she was a high flying corporate executive, too busy to have her eyes checked, and sadly, she is blind to this day. The other was a really powerful story as well. He was a man from a lower socio economic group felt his priority was his family neglected his own health. And he was sailing sadly to have his regular eye checks that he so desperately needed went to bed one evening at the age of fifty with normal sight and and woke up the next morning blind in both eyes and and sadly remains blind to this day. And it was his story that just had such a powerful impact on me. And I and I just thought, okay. What's what's going on here? How's how's this sort of thing unfolding? Why do we have a
Emma [00:03:41]:
100,000
James [00:03:43]:
people in this country with sight threatening eye disease due to their diabetes? why is it now the leading cause of blindness amongst working age adults in this country? And I realized that actually over half of patients in this country with with diabetes, all types of diabetes, well over half, actually, and there's probably close to
Emma [00:04:03]:
2,000,000,000
Neglected eye checks lead to blindness
James [00:04:04]:
people. Now So will over half are not having their regular eye checks, these all important science saving eye checks that could prevent them from going blind. And and His name is Neil, and he's very happy for me to use his name. So Neil had neglected his regular rye checks and, unfortunately, has paid a very, very high price. So there was one thing that I I after hearing that story and and realizing the terrible statistic of of over half of Australianians with diabetes not having their eye check. But I thought, wow, you know, I've got a, a responsibility here to to raise awareness in this country and I actually created the website for an ad featuring Neil, you know, encouraging people to have their eyes checked and killing his really, really impactful story. And that played nationally in late 2018 and and on on free to wear TV. And I was lucky enough the following year to be nominated and and win South Australian of the year. And I I made my speech, and I talked about the Neil story and and the need to have regular eye chairs. And then going forward to the Australian of the year awards, which was in the Australia Bay, long weekend in early 2020. I really thought deeply about this. I thought, well, if I happen to win, and I was certainly wasn't expecting to win. But if I happen to win, do I not have an even deeper responsibility here? What's what's Australia's biggest health problem at the moment. Let's type 2 diabetes. And don't I have a responsibility then as a doc as a straight end of the year to actually raise awareness of this devastating disease. And then lo and behold, I I did win it much to my surprise, but prior to that, I was really doing a lot of reading around type 2 diabetes and found out that it's not only a largely preventable disease. It is also potentially reversible or some people prefer to call or use the word remission. You can actually put type 2 diabetes into remission. So, as I said, I did a lot of the reading and once I received the award, I was launched into this space and it's been an extraordinary journey ever since.
Emma [00:06:13]:
Do you follow the that lifestyle yourself?
James [00:06:16]:
Well, interestingly, so when I received the award and I thought, well, gosh, you know, if I'm gonna I'm gonna be talking about my diabetes and telling people they should be cutting back on their sugar intake. I thought a better, what does it talk, the walk, or walk their talk? And I did. I went into a sugar detox, which was seriously unpleasant, actually. We can talk about that too if you like, but I went into a sugar detox. And then, unfortunately, the COVID pandemic hit, and we went into that first lockdown, which I think was in was in April or May, wasn't it, of
Emma [00:06:50]:
2020?
Sugar detox led to weight loss, discovered fatty liver.
James [00:06:51]:
Yeah. But I I stuck with my my sugar detox, and it was more than just a sugar detox. It was also cutting back on refined carbohydrates and and seed oils, because because I think these are all drivers of metabolic dysfunction. So I went into that first lockdown doing doing a pretty low carb sort of lifestyle, reducing my carbs, therapeutic. But I wouldn't say it's, at the time, was I was calling it therapeutic carbohydrate I just was was really thinking I should just that's what I preach. Is that is that right? even I'm not that preachy about it, but I came out of the lockdown, A couple of months later, you know, none of us had seen many people at that stage, and people were staggered at the amount of weight hard loss. And I wasn't trying to lose weight. You know, you can see I'm I'm I'm thin, I'm tall. I wasn't trying to lose weight. I just simply just just changed what I was doing because I thought it was better for me and healthier for me. And the people coming up to me and whispering my ear, are you okay? Are you unable? They thought I had cancer. I'd lost some I don't know, 10 to 15 kilograms. I had never weighed myself and and and didn't weigh myself back then, but it was, you know, this is distinctly noticeable. I looked some photographs of myself even from 2019 where I was, you know, had a had a pretty round face and and, you know, have a much thinner face now. But what was also interesting actually in that lockdown period or perhaps soon after, I actually had a scan of my back. I I was getting some back pain and I, and I'd actually seen a patient the day before. that had some lower back pain and end up having secondary cancer in her spine. I thought, gosh, you know, I hope I don't have secondary cancer in the spine. so I'm just gonna go and get a scan. Unfortunately, as a doctor, you can do these things reasonably efficiently. Yeah. And, unfortunately, I didn't have any anything nasty. It was just a bit of arthritis, but what I did discover was that I had a fatty liver.
Emma [00:08:45]:
And you you were a slender.
James [00:08:47]:
Yeah. And I was 7 sender. So a fatty liver is a sign of metabolic dysfunction. Oh, I had a fatty liver. I couldn't believe it. I was staggered. And I actually then had that confirmed with an ultrasound of the liver. And it made me really sit up and think and and actually look back at to what I'd been consuming over pretty much much in my lifetime, and and then not surprised why I had ended up with a fatty liver. So I'm what they call toffee thin on the outside fat on the inside. And the fat on the inside refers to the fatty the fatty liver or the abdominal obesity, visceral obesity. I certainly had a bit of a tummy, which I wasn't proud about. And so that that kind of sharpened my resolve to to turn my metabolic dysfunction around.
Emma [00:09:34]:
Fantastic. So I'll I'll I wanna know, like, you've been just been away traipsing through the most beautiful part of Europe. How you stay did you just go health for leather and go, but we're not meeting the Christmas or, you know, wherever your delicacies wherever you were, or did you stay relatively low carb.
James [00:09:54]:
Yeah. Well, I I would say that for the most time, I would be medium carb, you know, low to medium carb. I'm certainly not, keto, and and from time to time, I'll I'll go into a server lower carb mode. and you're welcome to explain the the levels of carbohydrate intake, which each of those reflects. But earlier year, I had another scan of my liver and found out that I didn't have a fatty liver anymore. So that was really exciting to see. I suspect if I the scan a couple of years ago, I might have found that that that the fatty liver had reversed as well. So I was able to reverse my metabolic dysfunction by just simply dropping my intake of of sugar refined carbohydrates and also cutting back or avoiding as much as possible seed oils are a metabolic disruptors. And so, for the most time I sort of hover around that sort of low to medium carb I don't have prediabetes. I don't have type 2 diabetes. If I had that degree of metabolic dysfunction, I think I would go certainly go harder But to me, I can I can remain metabolically flexible. And from time to time, I'll, you know, have a bit of a splurge I even had some ice cream last night, my which is mine.
Emma [00:11:04]:
It's my weakness,
James [00:11:07]:
and and the it's amazing. Actually, I my son wanted some ice cream the night before and and went out and got it. And so it was in the fridge and it was calling my name. I was sitting watching the TV last night, and I could hear it according out to me, and I succumbed. So it just shows you how powerful it can be. But every now and then, you know, I have a a weakness or I I sometimes you just don't have a choice. And, actually, when you travel, and it's a it's a problem. It really is a problem. And we were traveling in Germany and and Northern Europe and you can imagine, and sorry, Northern Europe in Northern Italy. In Northern Italy, you know, you're surrounded by particularly by pastor. And it's it's it's hard. So you you can. I think one of the things that's particularly difficult to avoid is, the seed oils because everything's deep fried in seed oils these days. Everything's cooked in seed oils. And I just had to and whilst I was traveling, just say, look, I can't I can't let trouble me greatly. You know, we we we tried to keep to our carbs to a minimum. We tried to minimize our intake of pasta and tried to intake out and minimize our intake, let's say, of, of, of, of white potatoes, didn't, like, don't think it had any rice at all for the entire trip. So just just trying to to do that to, you know, lessen the impact on on the body.
Emma [00:12:32]:
I love that you've said it like that. because life happens. Like, why are things call us like ice cream, and it is. It's that hole. Tell me, it was Neil who woke up blind.
James [00:12:43]:
Yes.
Emma [00:12:44]:
Tell me how it happens that one minute you can see and the next minute you can't. How does how does that happen in the blink of an eye?
Extraordinary story of sudden blindness and treatments for diabetic eye disease.
James [00:12:54]:
Yeah. That's a pretty extraordinary story. And and I would say as an eye surgeon, a pharmacists that I'd never seen or heard of that particular experience before someone who went to bed one evening with normal sight and and wakes up the next morning blind. and actually tells this harrowing story of the the last thing he saw before he went to bed was his his wife's beautiful face. He wakes up the next morning and opens his eyes and couldn't see and and thought he was dreaming. He goes back to sleep and then wakes up again and he's still blind. And You know, one of my colleagues worked really hard to try and reverse it, but, unfortunately, some people, it's just it's so catastrophic that it's not not reversible. And this is really an important story to tell. It's rare, but it certainly happens There are 2 major blinding impacts of diabetes on the eyes. 1 is when you get blockage of blood vessels in the retina and the retina is the light sensitive layer of tissue that binds the inside of the backs of our eyes. So when you get blockage of the blood vessel, you get a lack of oxygen through the retina. So you get ischemia, and the ischemia triggers the in growth of blood vessels to try and heal that area, which is a skin lacking in oxygen. But the blood vessels are fragile. They're abnormal. They're haphazard, and they can actually suddenly bleed. And that bleeding happens into the jelly, which fills inside the back of the eyes. And that can result in sudden loss of vision, often manifests as as sudden appearances of little floaties and clouds. Sometimes people even describe a sort of reddish cloud as a blood sort of seeps into the jelly. But sometimes it could be massive. actually, it would just happen in the one eye, and that would be a a real warning sign for a patient to go and had their eyes checked by their optometrists or their ophthalmologists who have access to us. And that's it. And then we would assess some But happening in both eyes overnight at the same time is is is pretty unusual, but it, yeah, it certainly happens. And So the other major cause and actually the leading cause of loss of vision and blindness in what we call diabetic retinopathy or diabetes related eye disease is something called diabetic macular edema. Now the macular is the central vision area of the retina. And diabetes can damage the blood vessels causing leakiness of those blood vessels and you get fluid from the bloodstream licking into the tissues of the macular causing blurring and distortion of vision. So that's diabetic macular or demer. And they both have specific treatments to be able to firstly prevent them and secondly try and reverse them if they do happen.
Emma [00:15:33]:
Gosh. So my grandmother had macular degeneration And so that's I understand from pressure in the eye. And that --
James [00:15:41]:
No. No. That's that's glaucoma. glaucoma is when you have a high pressure in the eye, and that can damage the may nerve at the back of the eye of the optic nerve. So macular degeneration or more specifically age related macular degeneration, is an aging degenerative process that affects immaculate, the central vision area. And it is there are several components to it. You know, aging is 1 because it tends to impact primarily on on older people. You can see it in people as young as their fifties, but probably more most commonly would be in the seventies when it manifests. Oh. And, There is so there's a genetic component, and it tends to run-in in families as well. But I also suspect strongly suspect there's a dietary component to it. And, you know, Chris Kenobi, a colleague of mine, an ophthalmologist in the United States and is convinced that the seed oils are a major risk factor for age related macular degeneration. We know that A cigarette smoke is also a major risk factor as well. So I think for many reasons that they're avoiding seed oils is is is a very good thing to do.
Emma [00:16:48]:
Is the short version of that because of the inflammation that they're driving?
James [00:16:52]:
Yeah. I've actually just recently received Chris's book it's called the ancestral diet revolution. And I'm just starting to read it. So I'm I'm not absolutely sure what his theories and and evidence based work is uncovering yet, but I suspect that information has a big part of it. because the seed oils or what we euphemistically call vegetable oils, but they may from seed such as sunflower canola, etcetera. they become oxidized in the bottle. They're polyunsaturated amiga 6 fatty acids. but the big culprit here is linoleic acid component, which become oxidized in the bottle, become more oxidized when we cook and even more oxidized in the body. And it's the oxidized component, which connects actually cause inflammation in in in the body. And I'm sure that's a big part of the the damage that's being done to the macular captioned genetically susceptible people, probably be compounded by smoking and as we age.
Emma [00:17:52]:
Right. Thank you for explaining all that. The the clarity around is phenomenal. Did can I ask you, does cataract have anything to do with our diet? Do you suspect?
James [00:18:03]:
I do, actually. I do. If you look at cataract will happen in pretty much everyone if they live long enough.
Emma [00:18:10]:
Okay.
Cataracts, diabetes, and poor diet's impact.
James [00:18:11]:
That's that's the commonest form of cataract what we call senile cataract, you know, basically refers to it being a growing problem as we age. So if if if everyone leaves to their eighties, nineties, or beyond, almost certainly they will get cataract. But what we do know in people who have type 2 diabetes is they will develop cataract at an earlier age. So I have no doubt that the metabolic dysfunction also drives cataract formation in in diabetes. And I wouldn't be surprised as well if metabolic dysfunction driving age related macular degeneration also plays a role in this. So I I had a strong feeling that diet plays a role in the major causes of blindness in the world, cataract being the lead cause of blindness in the world. A and the leading cause of blindness in poorer communities, age related macular degeneration being the leading cause of blindness in wealthier communities and countries. and diabetes, which is a growing type 2 diabetes is a growing problem everywhere. Now you mentioned before glaucoma high pressure inside the eye, If people have compromised blood vessels in the optic nerve, in in the major nerve, then I suspect they will be more to high pressure in the eye. So I I have a strong suspicion that a poor diet metabolic dysfunction is tied in with all the major binding diseases in this world of ours.
Emma [00:19:38]:
Yeah. That's super interesting. When because it was genetic or, you know, because my grandmother had it, I go and get tested. I get my eyes tested regularly, which you guys, if you're gonna drive test and you're listening or watching this, go and get your eyes test it. And, of course, they do the pressure. They puff the things in in my my eyes. And as I started this lifestyle and went lower carb and got rid of the seed oils, My eyesight started to get better. My free my feet shrank, I need a different shoe size, but also my eyesight improved. And at that point, I'm like, okay. What what what's even going on? And the person checking my eyes was like, I don't even know how this is possible. And I'm thinking, I do. So it's interesting that you're, you're tying all that together. So one of the things you speak about is the supermarket and food ingredients and the amount stuff, stuff that isn't food that's on our shelves. Do you think that the food industry is actually tick taking on board any of the new research and science on this, or is it just such a slow shift to turn?
James [00:20:44]:
It's a huge ship to turn. And if we equate it to the smoking, the harms of smoking, which were pretty clear back in the in the sixties, it took decades to turn that round. And that was just one thing, you know, cigarette smoking, whereas whereas this is a much bigger beast, a much, much bigger beast. And our current Australian dietary guidelines recommends that we should have a high carb eating pattern and reduce our intake of natural saturated fats which we know is flawed, and we can explore that later if you don't. But if we were to suddenly turn sorry, my little cooker clock in the background. It's just -- I
Emma [00:21:21]:
love it.
Move in right direction.
James [00:21:22]:
It's the mechanics. Oh, it's nice. It's the wrong song. Anyway, If, if we were to do an about turn and say, okay, we've got it wrong for the last half a century, we should be minimizing our intake of carbon and actually it's okay to to consume natural saturated fat. If we were able to do that, it would it would devastate businesses, individuals, organizers, missions that agriculture that has dependent for, for the last decade and grown, you know, foods that suit that narrative suit that high carbon narratives. I mean, South Australia's biggest export is wheat. You know, we have a huge orange industry in the riverland. And so, you know, this has to turn around, but it has to turn around slowly. The current dietary guidelines are under review, and I suspect we'll see a move in the right direction, but they're not gonna do a 180 grief fit. I mean, that it it it would it would be devastating also food security for people as well. It's, you you can imagine it would be quite a a thing to do, but I think we need to start moving in the direction of not encouraging people to eat margarines and seed oils. And actually giving them some comfort to to the natural saturated fats such as found in full fat dairy butter, meat, unprocessed meats is is actually not harmful. In fact, the evidence shows that there's no strong evidence to show harms of of those substances.
Emma [00:22:46]:
Let's talk a little bit about meat for a second because I I'm almost carnivore now after 4 or 5 years on this journey, and I actually feel Really good. Like, I broke my knee. I fell down a flight of stairs, actually. I don't know why I'm laughing. It wasn't funny. And I broke my patella. I like to say I broke my natella, but I healed. I went almost carnival, and I healed unbelievably fast. Why why are people so scared of meat?
Red meat demonized, focus on processed foods.
James [00:23:15]:
Oh, it's been demonized for for for decades, actually. And the narrative And it's still to this day. If you go to the heart foundation's website, it's plastered with plant based as best and avoid red meat because it's linked to cardiovascular disease. If you go to the cancer council's various websites, again, red meat is linked to cardio as is to link the cancer diabetes Australia also discourages the consumption of red meat on their diabetes management journal recently. There was a whole article on red meat causing type 2 diabetes eighties. So I actually have written to each of these associations saying, hang on guys. There's no strong evidence that red meat causes type 2 diabetes, cancer, cardiovascular disease. This should not be demonized. This is the most nutrient dense food, which is critical for development in in children and critical, particularly as we get a as we age, the need for protein, and the best source of bioavailable protein that we have. The health benefits of meat, presound the risk of consuming red meat to our health. The evidence is so low as as to be, you're almost laughable. So, you know, why is this being demonized? What we should be doing is focusing on on the real common enemy, which is ultra processed foods. So ultra processed foods, the major ingredients of most ultra processed packaged foods are sugar, refined carbohydrates, particularly highly refined wheat flour, and seed oils. We talked about those before. They're the major component. All three of those bundled up in into this who like substance, which we are now consuming in massive amounts. In the US, 62% of the calories in the the US diet. ultra processed foods. In the UK, it's now over 50%. And in Australia here, I haven't seen the latest stats, but I've no doubt we're edging close towards 50% mark. So these are substances which have been linked to adverse health outcomes, particularly type 2 diabetes, and and yet, it's almost become normalized, whereas eating meat and particularly red meat, you you know, you almost feel ashamed to do it. And there's also a long history here, which, again, we can go into in detail, but it really stemmed around what's called the diet heart hypothesis, which evolved in the fifties with doctor Ansell Kids landmark study, the 6th country study where he showed the more saturated fat you consume the higher risk of cardiovascular disease. But what he didn't show, in fact, at the time, that there are 22 Countries where he could have received the data or could have used the data, which showed no correlation whatsoever. But it became it became dogma, and and it then was taken on at the fascinating history, which Nina Tyshoulds goes into great detail in her book of the big fat surprise if your readers are interested, I would strongly recommend it. But still to this day, the dogma is red meat is bad for our health. and industry has gone on the back of that. Because if you're saying we should reduce our consumption of red meat saturated fats, That basically means we should reduce our consumption of eggs, meat, full fat dairy. So when you take fat out of a food. You take out its flavor and you take out its ability to satisfy you to satiate you. So something has to replace that. And so what replace it with sugar and cut up? So when we consume many, let's say, low fat milks, it's the flavor is replaced by some of those components You know, if you look at most low fat, low cholesterol foods, they replace the the fat with sugar and carbs. And we know that sugar and carbs are not healthy for us. And so this this has suited the processed food industry to a team because processed foods at primarily plant based it primarily focused on those 3 substances, which I mentioned. And this is the process feed industry has been given this amazing gift that they've ridden on for decades now.
Emma [00:27:39]:
It's it is a huge boat to turn around, and gonna think at a ground level. I mean, you would see it probably all the time. People go to their doctor. They get diagnosed with prediabetes or diabetes, and then they they they they maybe start low carb or keto or they cut sugar out. I mean, universally, we accept that sugar isn't good for us, so we know about that. But I think you've really explained it well that it's the combination of all of those things. And maybe they might lose weight or they might feel better and they go to the doctor and the doctor says, wow. Look at you, what are you doing? And they go, oh, I'm following this kiddo, a low carb thing, and the doctor goes, oh, that's gonna kill you. Don't do that. How do we educate those educators?
James [00:28:20]:
Yeah. Well, it's it's fascinating, isn't it? And I think if we look at the sugar component and particularly the fructose component, that's a big metabolic disruptor. People think of fructose as being healthy, but actually it's not And it did I think sugar per se, I think, and it's added to pretty much all processed foods The critical thing here is that it's highly addictive. It's been shown to be as addictive as nicotine. I mentioned earlier when I try to detox from sugar, the symptoms are really unpleasant, you know, if anyone tries to detox from sugar, whammos, it's much harder than detoxing from coffee. So when you have a an addictive element, whether you're just having sugar by itself or if you're having it sprinkled on cereal, stir it into your coffee, or within processed foods, you're basically perpetuating this this addiction, what we call physical dependency then there's also a layer of of our population who have a deeper psychological addictive element to their their their makeup And that may manifest as an addiction to sugar is foods and to ultra processed foods. So so it does make it very difficult for people to reverse that. Now I just forgot your question. Sorry. That I was just about to come around to
Emma [00:29:38]:
-- All good. How do we educate the educate it? Like, do they just have to find that themselves, or what's the answer there?
Eating real food and avoiding sugars, refined carbs, and processed foods can prevent and even reverse type 2 diabetes.
James [00:29:46]:
Yeah. So, again, if you come back to our Adrian dietary guidelines. This is a document which is used very broadly. It's used by cooks from child care through to aged care. nursing homes, hospitals, the defense force, prisons, etcetera, etcetera. And it's used very widely by health educators, you know, doctors, dieticians, nutritionists, health, policy makers. So it's very broadly used. And at the moment, we're telling people to have a high carb eating pattern, but if you realize that over 2 thirds of Australians are overweight or obese. That means over 2 thirds of Australians are metabolic dysfunctional. In other words, they're most likely insulin resistance, which means they are carbohydrate intolerant. So the last thing we should be encouraging people to consume are more carbs. So, yeah, there's an awareness that needs to come here, but we also need that dietary guys on to to start, you know, to move away, as I mentioned, from that. Now if we look at type 2 diabetes, you know, I mentioned before that it's largely preventable and how do we prevent it? Will we can prevent it quite simply by eating real food. In other words, minimize our consumption of added sugars, refined carbohydrates, cedars, and ultra processed foods. If we did that, the vast majority of us would be in a much healthier place. Now if we also look at type 2 diabetes as an entity or creed diabetes, the opportunity to put that into remission by reducing our intake of those substances sugars refined carbohydrates and seed oils and ultra processed foods, many people can actually put their type 2 diabetes into remission. And it is an extraordinary thing to behold when I was actually on the national diabetes strategy, which was in
Emma [00:31:33]:
2020, 2021,
James [00:31:35]:
and that document was released in late 2021. I was able to get remission of type 2 diabetes into that document for the very first time. So that's one thing. It's in the document. The second thing is actually now getting it to all of those health practitioners around the country so that they are aware. And so it it it has to start. 1, with the fact that it's in the national diabetes strategy. There have been colleagues of mine who have been struck off by our medical board for telling people to reduce their sugar consumption. Can you believe that? It's it's it's unbelievable. It's it's it's laughable, actually. So The health practitioners don't need a fear because it's in our national diabetes strategy, and we know there's 3 clinically proven methods to put type 2 diabetes into remission. and and the one that we can just briefly touch on those bariatric surgery, but bariatric surgery entails major abdominal surgery which is both costly and risky on a normal healthy organ. So why would you do that? I certainly wouldn't encourage that as 1st line treatment. and that it's there. And it should have been shown to put time to dimension. So the other
Emma [00:32:44]:
2
Dietary approaches: low calorie, low carb, addictions.
James [00:32:44]:
are dietary approaches. First is what we call very low calorie diets. which are essentially 800 calorie day starvation diets. They're neither enjoyable nor sustainable. They rely on Ultra Process soups and shakes. So I'm not a big fan. I mean, they really work because they're also low carb. And that brings me to the the third one, which is a low carbohydrate diet, which is basically a real food diet just reducing a consumption of of those elements that we talked about before. And it does work. We know there are over 100 controlled clinical trials to show in both prevent and reverse type 2 diabetes. And, the, the Verter study out of the United States, we're now at 5 year mark, showing 50% of people still in remission. So that leaves us with another 50% who weren't able to, to, to stay in remission. And one has to ask the question why that might be. Well, And I look at my patients, I definitely have a a cohort of patients that are not interested, you know, despite the fact that they're having eye injections on a regular basis, despite the fact that they are having bits of their legs chopped off for gangrene. Despite the sense that they hooked up to the dialysis dialysis machine having their their kidneys filtered 4 days a week despite the fact that they're faced with almost certainly a thrombotic episode such as heart attack or stroke and, high, high chance of dementia. They still stick with this. They're not interested in going down that pathway. And it frustrates me, but I don't give them a hard time. I just say, look, you know, this is what's what you're looking at and and we can't we can't shift the dial on those patients. And some people try it and and find it too difficult, which also is disappointed because, yes, it's difficult, but it's not as difficult as all of those complications that I just mentioned. And, you know, there's another cohort, and I suspect the biggest cohort would be patients who, addicted to should we products and ultra processed foods who may have have, you know, psychological components, their addiction, and who use food to to help, you know, to make them feel better.
Emma [00:34:57]:
Well, I think there's plenty of us
x
James [00:35:00]:
Yeah. Well, that's right. And I told you the story of my, you know, the the the ice cream calling out to me, and it's a it's a constant battle. And particularly when the environment that most of us live in, we're literally surrounded by the predatory marketing of the ultra processed food sugary drink and fast food industry. We have played upon virtually everywhere where we go on social media on TV at the bus stop on the tram or train at the supermarket, going to the the service station, petrol station, you're constantly being played upon with marketing buyer, by these industries, which makes it really, really difficult. Now if I'm sitting in an before I went through my sugar detox. So back in 2020, you know, I'd be at the supermarket checkout, and there's a couple of chocolate bars. Actually, they're 2 for 1. And Sure enough, I bought them and I've eaten both of them by the time I've even got home. So, you know, it just is so powerful. And if you have an addiction or if you are physically dependent, then it's very hard to go past that. And of course, the food industry know this really well. And that was, I was actually at the, at the supermarket, you often hear, will avoid those central lines of the supermarket. I was at a, a supermarket recently, and I went to the fruit and veg section. And there was a chocolate stand in the middle of the fruit and veg section trying to prey on people who might be avoiding those central hours in the supermarkets. So, you know, it's it's it's extraordinary. Now now I've I've been away from what we were talking about before, which was, you know, getting that message out there. So it's in the National Diabetes strategy. We actually I've been working with a team to write a guideline for therapeutic carbohydrate reduction, which I believe is with diabetes Australia at the moment. I think being given endorsement by Australian diabetes society. I need to have confirmation on that. And we hope when diabetes, Australia endorses it, we then it'll then go out a month's the diabetes educators, and we can then take it out to the board level to a medical school training. And we can take it out to continuous professional development training for GPs and other health practitioners. So there's and also to dietitians, had a chat with the president of the dietitians association and they're interesting in embedding, embedding it in their training and CPD. So once we actually get that out there, we will see a huge shift in in in the ability to prevent and reverse type 2 diabetes. And I think it's a very exciting time that we are entering now.
Emma [00:37:33]:
Wow. Congratulations on making those efforts, like, little steps forward. They they must feel like small steps, but really, if you think about how far you've been able to bring that with the help of others in the space of what 4 years,
James [00:37:50]:
Yeah. Just over 3, actually. And, yeah, and and on that note, I've had the help of of of lots of others. I've had mentors and and people who've helped to to guide and and and support me and educate me and, you know, big shout outs to all of them, and they all know who they are. There's too many to to mention actually, but This is a journey I started off with reading Jason Phong's amazing book. The diabetes code, and I when I read his book in, that was like, 2019, finding out you could potentially reverse type 2 diabetes naturally with food. And, but then I I as I say, went from there and, and had a lot of support through the last few years of people that have have helped me to also to get those messages out and fine tune my messages. And it's been The and actually to see patients who reverse their type 2 diabetes, my 40 year medical career, it's been the single most exciting thing to deprescribe, demedicate. I don't do it myself. I work in conjunction with the
Emma [00:38:44]:
-- Yeah. --
Ketogenic diet helps patients reverse diabetes.
James [00:38:45]:
eating doctors and the and nutritionists, but or is it a little rat running along a wall?
Emma [00:38:50]:
Looking for food and warmth, presumably. That's for my
James [00:38:52]:
heart for my heart.
Emma [00:38:53]:
We're well said, or we'd be barbecuing that.
James [00:38:56]:
Well, that those people have done that actually in Cambodia and we had it during the the the regime reading tarantulas because there was a a powerful source of protein. Yeah. So, when when I also was able to get this into the national diabetes strategy, I then felt comfortable to have the conversations with my patients. So probably in early 2022, I started saying to my patients with type 2 diabetes. And only the ones that I was actively treating with vision threatening eye disease are you aware that your type 2 could be put into remission? The first 100 patients, perhaps one was aware that their disease could be put into remission. So this was something that they've never heard about. So this conversation, this critical conversation wasn't happening between their
Emma [00:39:37]:
-- Mhmm. --
James [00:39:38]:
practitioner and and the patient. So I then started writing back to the mutual GP and saying, we please explore the potential to put our patients type 2 diabetes into remission using the low carbohydrate ketogenic diet. And The vast majority of those letters were ignored, but a few took took them on. And we then, I recommended a local nutritionist who specializes in in 30 carbohydrin reduction, Michelle Martin, who's been a wonderful support to me. And then I started seeing them come back, and these were patients that see me regularly for eye injections. And it was amazing. I had one woman who was able to reverse her type 2 diabetes and come off dementia and her medicines within a couple of weeks. I had another patient who had typed her diabetes for 20 years who was able to put her diabetes into remission. And one of the ones I really recall was was a a man called Bevin Bruce again. He's happy for me to use his name. He's a a a prominent real estate figure here in in Adelaide. And I watched him. He was having regular and we weren't able to meet him off those injections. And we I sent him to Rochelle, and he was able to put his diabetes into remission and over a series of visits. He'd come off his insulin. He'd come off all his medicines. He'd lost a bunch of weight. I remember him saying I've never felt better, but also the fat. that his vision was getting better.
Emma [00:41:00]:
Wow.
James [00:41:01]:
He was on I can't remember exactly, but probably 6 to 8 weekly injections in both eyes. And I saw him only last week, actually, and I think he's now down to about
Emma [00:41:12]:
16
James [00:41:12]:
weekly injections, and I'm hoping that we'll be able to stop those in the near future. what I've been able to see over that. And he'd been having treatment for some years, and he'd been on a steady state treatment. And we've been able to with the reduction in his carbohydrate intake, I could see a reduction in the macular edema, the swelling of the macular we talked about earlier, and I've been able to ween him off his injections, And I'm hoping to to be able to do that in in the coming months. And this is not a one off experience. I'm seeing this across virtually all of my patients with diabetic macular edema, once they drop their carb intake, it allows the vasculature to heal if it's not too far advanced. And the edema to to help settle in conjunction with those injections, and we've been able to wean them off the injection. They've been able to get some people off injections altogether. This has never been reported before. I've been presenting at some conferences recently. We're just doing currently doing a study, with a number of these patients to to have this out in the, in the literature. So super exciting times, it's it's this is reminiscent in action. So if anyone says, oh, it's it's it's not possible, you know, we had the great good fortune of being able to look in someone's eye and see the damage done by diabetes, but then see it actually turn itself around.
Emma [00:42:29]:
Doctor who presumably starts medicine and then works into specialized care, this must be the most ridiculously exciting time for you to actually see that maybe you might be able to put yourself out of business When it comes to those kind of issues for people?
Injections for diabetic eye disease still needed.
James [00:42:46]:
Yeah. Well, absolutely. I mean, I don't think we'll ever be able to put ourselves out of business. That's what we're talking about. I, health and diabetic eye disease and and the injections that patients are receiving. And there's going to be a cohort of patients, as I said, that they can't put their diabetes and remission There'll be a cohort that also have very advanced disease that injections are helping, but but their eye disease is so advanced the change in dye that's not able to reverse the damage that's been done. So there there'll still be a need for injections, but certainly, I'd love to see. I mean, if you look at the grass, for for injections over the last 2016, we first started using them for for diabetes, eye disease through till the end of 2021. The growth you know, is extraordinary of of the number of injections given in Australia for type 2 diabetes is now up over 140,000 injections every year. So what I'd like to think and that that's at a cost of about quarter of a $1,000,000,000. Now that's just the eye complications. Could you imagine if we then start to To turn that around, we start to see it plateau off and even drop. It's certainly not gonna drop to
Emma [00:43:46]:
0,
James [00:43:47]:
and we're not gonna be be out of a job. And you can see, though, that there is a vested interest here.
Emma [00:43:53]:
Yeah.
James [00:43:54]:
Why would I wanna, you know, jeopardize my income? And and there may be doctors who can see potential, you know, threat to their income or or or to the specialty that they've held there for you know, for decades that this could actually undermine what they've done for a long, long time. So it's it's potentially problematic, but for me, I think having told well, not having told kind of neglected to to tell people that lifestyle is critical here, and the diabetes could be put through remission to now being able to to do that and to see that has been, as I say, the the most exciting thing in my in my medical career. And I want all of my colleagues to at least have the opportunity to to watch a patient put their diabetes into remission. It's it's brilliant. Yeah. Super exciting, and it have not to be enthusiastic about it. And I remember going to a low carb conference in Queensland last year, just feeling that positive vibe, amongst the speakers, amongst the patients, amongst the the audience who are there, you know, it's hard not to be infected by this this positive for this positive, very, very positive message and positive outcome.
Emma [00:45:02]:
I just see. I agree with you. I was there. And, actually, where that first time I heard you speak, and I went, wow, this message, it needs to be shared, and it needs to get out to people who need to hear it. because in general, people are struggling and struggling. So and I think you mentioned preach before, and we do get so excited and so passionate about this because we know what's possible.
James [00:45:25]:
Yeah.
Emma [00:45:25]:
And and it we're all moving in that same trajectory, I suppose. So I just wanted to thank you for sharing all that. And I I wanted to thank you for your openness and your the way you are thinking about moving the health, this oh, I don't even know the words for it. Moving the health statistics of Australia in a different direction of where we've been and congratulations. Did you hear back from those people you said you wrote to?
James [00:45:53]:
Yeah. it it might exchange back and forth back and forth. I actually called a roundtable meeting with all of them to come and actually hear the the the solid evidence and put forward their case so far they've all declined. They wanna continue with the narrative that red meets bad for us. And it's, you know, you wonders what's you wonder what's driving this. And I I have a strong inkling. There's a lot of vested interests. There's a lot of funding by the food industry. Certainly, the heart foundation is funded by the process food industry to continue these narratives that took it there on, and it's deeply disturbing, and so they need to be held to account. They're giving public health messaging that's potentially damaging.
Emma [00:46:35]:
I guess 2 people are so indoctrinated. And when when I first start teaching people about, okay. You need to just start eating more real food and more saturated fat. Don't cut those beautiful little lamb, chop tails off. Eat them. But people are still skeptical. So that that has to come from the ground up. And when there's voices like yours that lend impact and lend weight to the message, that it's so important. And I know you understand just how much weight you carry. So thank you so very much. Was there anything you wanted to add To people who might be listening?
James [00:47:12]:
No. Well, not really. I think we've covered a lot of ground, but I think if you're skeptical, And I was, and I remember in early 2020 when I went through that sort of reduction of carbs, and I started using butter instead of margarine, which I'd used for the decades because we told it was good. You know, congratulate yourself, mom, you know, you're using margarine, going back to using butter and and sort of spreading it on highly refined white bread, spreading it on, hog grain, bread, and feeling kind of guilty in, and, oh gosh, this doesn't feel right. and then to realizations that actually it's so much better for you. And you talked before about being carnival. I don't you know, I'm, I'm a, I'm an omnivore. I I couldn't. I certainly couldn't be vegan. And I think I'd, I'd, I'd, I'd, I'd, I'd, I'd, a range of foods I really enjoy. But I think stick with whole foods, stick with real food, avoid that all costs ultra processed food. I think that's the one thing that that is is a really important message out of all of this.
Butter is better, avoid processed food.
Emma [00:48:12]:
I I agree with you. You know, that's I I don't not eat veggies. I actually my favorite meal is just to pan for a beautiful, huge piece of salmon. Oh, it's the size of my face. Lots of veggies as far as, like, zucchini or I'm growing beans in the garden at the moment. So I'm frying them off with garlic and butter and salt and Oh, yeah. Or making me hungry. Oh, sorry about that.
James [00:48:37]:
I haven't had breakfast. Actually, that's another thing we didn't talk to, which is intermittent fasting or time restricted eating. just because I think we gotta finish up now, but insulin is actually a fat storage hormone. So while, you know, if we're eating lots of sugar and carbs, we keep our insulin level up, and we're we're storing fat. I mean, that's what how we biologically evolve to actually store fat for leaner periods. Now if you don't have breakfast. And for me, it was simply not having my bowl of of weed mix. It was not having orange juice and and and probably not having a banana. basically a sugary breakfast. But when you have it incorporate an element of time restricted eating, and for me, it's 16 hours of fasting. an 8 hour eating window, then your insulin level drops sharply and then you mobilize fat from the stores. So it can be very powerful in in also not just losing weight, but reversing metabolic dysfunction, and it can be used as an adjunct in putting type 2 diabetes into remission.
Wearing glucose monitor
Emma [00:49:33]:
-- phenomenal. I'm wearing a blood glucose monitor at the moment, which for the third time, actually, it's always really interesting watching, you know, I'm eating these huge bowls of Greek yogurt at 2 PM and going, oh, surely, you know, but my I'm I'm you mentioned metabolically flexible about that point 4 or 5 years long where it doesn't affect me as much as it used to. And I guess if everybody, you guys can take a message out of this, just know that at some point, You'll be able to repair whatever's going on on inside. And it and the carb amount will vary for everybody. So, yeah, time time restricted eating is so powerful, isn't it?
James [00:50:12]:
It really is. And as you say, you know, hook yourself out to a continuous glucose monitor. In fact, I'm about to do it. I've I've I have some And I wanna try a range of, you know, I mentioned I don't eat breakfast, but I wanna try a range of breakfast that have been recommended and, and to see what impact they have, see what impact those healthy grains have on our blood sugar.
Emma [00:50:31]:
She can't have one of your breakfast, like an orange juice, some special k and whatever whatever as you mentioned before, go and see. see a ticket photo of the spike.
James [00:50:40]:
I'm gonna be doing that, and I'll I'll be sitting on social media very soon.
Emma [00:50:43]:
Great. Where can people find you?
James [00:50:46]:
If you're interested in in the work of sight for all, which is really about fighting blindness, not just in many of the poorest countries of the world, but also here in Australia, in stream and Aboriginal communities. And we have a number of social media hashtags, but you can sign up to our newsletter site on-site for all s Ightfo r, a w l dot org. But if you're more specifically interested in what I'm doing and the work around type 2 diabetes, then we have, I have Doctor. James Mucci on Instagram, Facebook, and LinkedIn.
Emma [00:51:16]:
Wonderful, guys go and follow along because your health is dependent on it. Doctor Mickey, thank you so very much. You are just super insightful and super enlightening. So thank you for your time and know how busy you are.
James [00:51:30]:
Oh, Emma, thank you also for all you're doing to to help raise awareness. The critical thing here is raising awareness. You're doing an amazing job and your passion is is infectious. And I loved hearing speaking at the conference last year. So you keep on keep on telling those stories because that's the way we're gonna shift the down on this. So thank you. Thank you for including me.
Emma [00:51:48]:
Oh, wonderful. Have a great day.
James [00:51:50]:
You too. Thank you.
Emma [00:51:52]:
You've been listening to the Lazy Keto Mum podcast for what information, you can visit ketocapers.com.au, and I would love to see you. Make sure you hit the subscribe button and share it with anybody you think needs to hear this. Stay tuned for more exciting episodes, and have the most wonderful day.