Dr. Aseem Malhotra: From Vaccine Pusher to Vaccine Debunker—How I Changed My Mind About the COVID-19 Jab
“Once I had spent time critically analyzing the data on the COVID-19 vaccines, it became very clear to me that the efficacy of this particular novel technology … was very, very poor, certainly in comparison to traditional vaccines. And the harms were unprecedented,” says Dr. Aseem Malhotra, a highly-published cardiologist and one of the most well-known doctors in Britain.
He was an outspoken proponent of the COVID-19 genetic vaccines until July 2021, when the tragic and sudden death of his 73-year-old father caused him to take a deeper look into the data.
“We know now that the original trials—the gold standard randomized control trials—that led to the approval by the regulators of the vaccine in the first place revealed you were more likely to suffer a serious adverse event from the vaccine than you were to be hospitalized with COVID,” says Malhotra.
Dr. Aseem Malhotra, such a pleasure to have you on American Thought Leaders.
Dr. Aseem Malhotra:
Jan, it’s a pleasure to be here.
It’s been a couple of months since we interviewed right after you had basically come out with this groundbreaking paper looking at COVID-19 misinformation. And I’ve learned a lot over the last few months by speaking with you. But you weren’t always someone who was committed to exposing COVID-19 misinformation, or perhaps you were committed, but in a very different way. Please tell me about that.
Yes, Jan. What I would say is I come back to the basics of being a good doctor to understand where I went with the Covid situation. Throughout my whole career, I want to improve my patient outcomes, which means I have to be the best possible doctor I can be. But essential or crucial to doing that is to use the best available evidence on any intervention to make a clinical decision, and to incorporate individual patient preferences and values.
In other words, informed consent. To do that properly, one needs to be able to give patients information in a way they can understand in terms of benefits and harms of anything that you do, whether it’s a prescription of a drug or even whether it’s adopting a particular diet or a lifestyle. That’s my background in terms of what I am a very strong advocate for.
We call it ethical evidence-based medical practice. It should be the default and the norm for most doctors, but because of system failures, it is not. That’s something we can discuss in more detail. Once I had spent time critically analyzing the data on the COVID-19 vaccines, it became very clear to me that the efficacy of this particular novel technology, the mRNA products, was very, very poor, certainly in comparison to traditional vaccines. And the harms were unprecedented.
I was able in my paper to break that down in ways that people could understand in terms of benefit and harm. The conclusions were quite clear that it needed to be withdrawn, completely suspended for everybody, young, old, vulnerable, non-vulnerable, until an inquiry was launched to understand properly why we got it wrong, how we got it wrong and what we need to do moving forward, which I also elaborated on in my piece.
You’re an incredibly well cited doctor in the scientific literature. That’s one thing I’ve learned. You’ve written, you’ve published a lot and people have used what you’ve published a lot. When it came to the COVID-19 vaccination approach, at the beginning, at least you seem to approach it non-critically. I want to dig into that a little bit, because you had a transformation. Why is it, do you think, given your general open mindedness, at the beginning you didn’t have that open mind, but instead you gained it along the way?
To elaborate more on your question, I was one of the early adopters of the vaccine, the COVID-19 vaccine, the Pfizer vaccine in particular. I had two doses of that at the beginning of 2021, because I helped out at a vaccine center. Then, I went on Good Morning Britain about a month later to try and help tackle vaccine hesitancy. But it was based upon the information I had at the time, which was this—traditional vaccines are some of the safest pharmacological interventions in the history of medicine.
My arm is covered scars from vaccines that I’ve had. So, I could not conceive of the possibility of any significant harm with the information that was available at the time. But the evidence changed, and this is crucial, certainly in medicine, and I’ve seen this throughout my career. I am somebody that will talk about it, going from being a big prescriber of statin drugs to then understanding the data better and realizing statins weren’t so great.
As the evidence changed, I then had to change my view and my opinion. Does that mean if I go back in time, would I have done exactly the same thing again, given the information I had then? Yes, I would. I have no regrets taking the Pfizer vaccine and even promoting it with the information I had available at the time. That’s really important to understand. Now, of course, there were people who were hesitant at the beginning and a lot of those people, I remember having discussions with them, were going more on their intuition rather than any good evidence.
“Okay, it’s new. We’re not quite sure, we’re low risk.” My situation was a little bit different to many people because I’m a practicing doctor. So for me, taking the vaccine was never for protecting myself. It was only under clearly at that time a false belief, that I was going to protect my patients. That’s where we were at the time. Things obviously changed massively as the information came in about the harms of the vaccine, and a personal circumstance with my dad dying unexpectedly.
Tell me more about that please.
Yes. My father, on July the 26th, 2021, 5:00 PM, I remember it very clearly, called me and said he had chest discomfort, chest pain. I’m a cardiologist first and foremost. What he was describing, the history sounded typical of something that sounded like it’s likely to be coming from the heart—angina, a symptom representative of reduction of blood supply in one of the arteries of the heart or one or more of the arteries of the heart muscle.
I asked him to call an ambulance. He wasn’t in a lot of distress, so I didn’t think it sounded like a full blown heart attack, but it needed investigating. Long story short, he called some neighbors over who were doctors. I went in the shower to change, because I live in London. He’s in Manchester about 200 miles away, so I get on a train to come up and see him.
In that time he had a cardiac arrest. The ambulance didn’t turn up for 30 minutes and he tragically died. It was extremely shocking for everybody that knew him, because my dad was super fit and healthy. He was 73, and he walked 10,000 steps during lockdown. I knew his cardiac history. He’s one of the healthiest guys in his community for his age. It didn’t make sense what happened.
Then, the post-mortem findings revealed two very severe narrowing in his corona arteries. Out of the three major arteries, two were severely narrowed. That was the first flashpoint, on reflection, that made me realize that my father likely was a victim of the mRNA vaccines, as in a side effect. That’s what killed him.
I didn’t know that at the time, even with the postmortem findings. It was only a few months later when bits of data started to emerge that clearly showed that the mRNA vaccines increase coronary inflammation. In other words, they accelerate one of the mechanisms of harm, not the only one. But one of them is that it most likely causes acceleration of coronary artery disease. You may have a bit of mild narrowing. It’s not going to cause you a problem for 10, 20 years, but suddenly it becomes severe, and you have a heart attack in a year. That’s what we’re talking about.
I want to jump back a bit. One of the things that struck me was this revelation that there was no actual data that Pfizer specifically had about reducing transmission. This was just a mantra that was repeated again and again by people who either thought they knew, or perhaps they did it cynically. I don’t know.
But you mentioned you were looking at the beginning at the available data and you mentioned that you got the vaccine, because you believed it would prevent transmission of the disease to your patients potentially. But as we’ve learned, there was actually no data on this. How is it that you came to believe that?
Yes, I’m glad you’ve asked that question. It’s a great question. This discussion has been slightly distorted recently about they didn’t test for transmission. There is an indirect effect of it affecting transmission potentially. If it prevents infection, then you’re not going to transmit it. That was the mechanism that was most likely thought to be the case. The problem arose, because very quickly within a few months we knew it wasn’t really preventing infection either.
Now it could be either one of two reasons. The original data, which suggested that one in 119 people in the rundown mass control trial was prevented from getting infected. One in 119, which is a lot less than what people were led to believe in terms of the absolute reduction of risk of infection. Either that was false, and it wasn’t even 119, and it was just not there.
Or an equally, maybe more plausible explanation is the original vaccine that was created was designed to do something not brilliant, but something against the original ancestral strain of the virus, which mutated quite quickly within a few months of the administration to people and populations. Therefore, what we were then dealing with a few months later was a new strain of the virus, which was never going to give you any protection from the vaccine from infection anyway.
There’s a number of possibilities. But either way, people weren’t told the information in a truthful way at the time, and it did not evolve with time. You end up getting this whole perception of extreme benefit, no evidence of any significant harms, and it’s going to prevent transmission. You must take it to protect others.
Jan, probably even when the evidence was available to the FDA, and to the MHRA in the UK, Pfizer knew that it was never going to have any significant effect on preventing transmission anyway. And that’s the lie that was perpetuated. The evidence to overcome that was available well before they started to slowly phase out mandates.
One of the things that came out reading Dr. Joseph Ladapo’s recently published book is that the way that budding doctors in medical school are taught about vaccines is something in the realm of what you said earlier. They’re a panacea. They are the safest thing ever. They work, and the harms are negligible.
For some reason, this particular drug is treated very, very differently and put on a pedestal compared to everything else, because of the history and the education that all of them went through. I thought that was really fascinating. I wonder if you think that, because remember there’s still a lot of doctors out there that believe the story that you no longer believe.
Yes, absolutely. There’s an indoctrination, based upon legitimate reasons, that traditional vaccines are very effective, and are estimated to save four to five million lives a year globally. Therefore, anything with the name vaccine attached to it is something pure and good and should never be questioned. You’re absolutely right.
But unfortunately, and we’ve seen in this particular instance, nothing could be further from the truth. We’re talking about one of the most poorly efficacious pharmacological interventions in the history of medicine with the worst side effect profile, but also being the most lucrative and profitable. When you try and join those dots together, the picture that it paints is extremely ugly. It’s a real indictment of our whole healthcare system.
You did a very comprehensive review of risk-benefit, which somehow we completely forgot about and the whole medical system forgot about at the beginning of the pandemic. Why don’t you just lay it out for me quickly.
Yes. When you look at the absolute benefits of the Covid vaccine and looking at what good it’s doing for people, the only real evidence we have around that is on preventing people dying from covid or hospitalizations. I was able to look at that real world data in the UK, which you could probably apply to many other parts of the world, looking at vaccinated versus unvaccinated in Covid deaths during a wave to see what benefit the vaccine was having in preventing Covid death.
During the Delta wave, and by the way, this information is not corrected for what we call confounding factors. What that means is the information I’m about to tell you is still likely an exaggeration. Because if you look at people in the real world over 80 that took the vaccine versus the ones that didn’t, the ones that didn’t tended to be more vulnerable or less healthy, which meant they were already more predisposed to having a poor outcome from Covid.
But if you don’t correct for those factors, and just look at the age during the Delta wave, you had to vaccinate 230 people over the age of 80 to prevent one covid death. If you’re between 70 and 80, it’s 520 people. If you’re under 70, you’re starting having to vaccinate thousands of people to prevent one covid death. What does that mean?
In a consultation in keeping with the principles of ethical evidence-based medical practice and informed consent, if you had come to me and you’re in your 50s and you say, “Dr. Malhotra, tell me, I’m not sure about whether to take this drug or this vaccine.” I wouldn’t be black and white.
I would say, “Okay, the data tells us that the benefit for you taking it and preventing you dying from Covid is one in 2000.” You’d say, “What are the harms?” “Based upon the best quality evidence, Pfizer and Moderna’s own randomized control trial data, the risk of a serious adverse event from the vaccine, meaning disability or life-changing hospitalization, is at least one in 800.” Now Jan, if I gave you that information in that way, is that something you’re going to be very keen to take, that vaccine?
You know the answer, absolutely not.
Absolutely, yes. This information was never conveyed to the public, even though we have that information now. That’s what I attempted to do with the paper is to actually break it down for people—not saying the vaccines don’t work or the vaccines are great, but what is the actual benefit of the vaccine and what are the known harms based upon the best quality data? Not speculation. And it became a no-brainer for me.
The conclusion ultimately is that when you also look at Omicron, and you bring the more recent, the less lethal strain of Covid for the over eight-year-olds, you need to vaccinate 7,300 people to prevent one Covid death. The harm of the vaccine remains constant, but the risk of Covid goes down. So, it’s very clear, unequivocal. In normal circumstances, Jan, we wouldn’t even be debating this, and the vaccine would have been pulled a long time ago.
It probably should never have been approved in the first place, because we know now that the original trials, the gold standard randomized control trials that led to the approval by the regulators of the vaccine in the first place revealed you were more like to suffer a serious adverse event from the vaccine, than you were to be hospitalized with Covid. It’s extraordinary.
How does one explain this? One has to first and foremost understand the various interests involved in influencing information that doctors, patients, members of the public receive on a daily basis when it comes to their health. In this case, let’s look at the pharmaceutical industry. They have a legal responsibility to produce profit for their shareholders. They do not have any legal requirement whatsoever to give you the best treatment, although most people would think that to be the case. The real scandal is that regulators such as the FDA fail to prevent misconduct by industry.
I’m going to come back to that in a second. Doctors, academic institutions and medical journals collude with industry for financial gain. Most of the top 10 drug companies have committed major fraud, hiding data on harms, illegally marketing drugs, totaling at least $13 to $14 billion between 2009 and 2014, mostly in the United States. But when all of those crimes, let’s just call them out for what they are, when those crimes were committed by these companies, they still end up making more profit from the marketing and sales of those drugs, than they did when you minus out the fines that they had to pay.
Nobody got fired, no one went to prison. You’re talking about damage and harm up to tens of thousands of deaths. One of the most egregious examples is the Vioxx scandal. Drug company Merck launched a drug in 1999 which was supposed to be better than ibuprofen as an anti-inflammatory, because it was marketed as being less of an issue to the stomach, less likely to cause stomach problems or stomach ulcers, for example.
It later emerged that it doubled the risk of heart attacks, and it probably caused the death of around 60,000 Americans from heart attacks. But it wasn’t a mistake. It emerged later on during the litigation process that the chief scientist of Merck knew this not long after the drug was rolled out in an internal email. “It’s a shame about the cardiovascular effect of this drug, but we will do well and the drug will do well.” I now present that information at conferences, I put it up and there are gasps from the audience. I ask people, “How do you explain that?” And there are all sorts of shouts from the audience, “Criminal,” that kind of thing. Yes, you can call it criminal if you like.
My hypothesis is something different based upon evidence is that the legal entity that is the big corporation, these multinational corporations, in this instance Big Pharma, very often because they puts the financial need ahead of the human need, it will deceive others for profit. We have a word for that. It’s called fraud. They actually function like a psychopathic entity.
This isn’t my definition. This is the definition from Dr. Robert Hare, forensic psychologist, preeminent expert in his field on the original international psychiatric definition of a psychopath. It says that these companies often behave like that; conning others for profit, being unconcerned for the safety of others, and having the inability to experience guilt. These are all the different criteria that one applies to the definition of a psychopath.
If one understands that over the last 20 or 30 years, probably rooted in well-intentioned, but misguided neoliberal economic policies started by Margaret Thatcher in the UK and Ronald Reagan here, you’ve had increasingly unchecked power from these sorts of entities over our lives. Most of the funding for the regulator in this country comes from the pharmaceutical industry. Universities are supposed to be guardians of the truth and represent the moral conscience of society. Most of university research, medical research now comes funding from the drug industry.
If you just think conceptually about an entity controlling our lives, that has more and more control over our lives, and that over a period of time functions like a psychopath. It doesn’t take a rocket scientist to figure out what impact that’s going to have on society’s mental and physical health and how it’s going to undermine democracy, because they deliberately suppress information that people want to know about for those purposes.
Therefore, we’ve got anti-democratic institutions that are really controlling or influencing our lives. The reason we’ve not combated it, Jan, is because most doctors and the public are not aware of this problem. They don’t even know that they don’t know.
How can one expect doctors, medical practitioners or society at large, who tends to more often than not trust the system, to open their minds on this sort of thing? Even for you, it was difficult with all your knowledge and all your work.
What we are dealing with now, the psychological phenomenon to get this information into the minds of most members of the public and doctors and policy makers with the cold hard facts is understanding that there is going to be two elements and barriers to that process. Part of being a good doctor is being a good communicator and being a good communicator is being able to give information to different patients in ways that they can understand.
We have to challenge ourselves to make sure that when we have conversations with people, we are doing our very utmost in that communication to be able to get through to them, whoever they are. That’s something that we need to keep doing, as opposed to just polarizing the whole discussion and saying, “I’m right. You are wrong. This guy’s an idiot.” This is not very productive. In fact, that’s actually how this has played out in America.
I’ve noticed this debate in the last year-and-a-half. It’s been very polarized. It’s become politicized. There are different camps. Those camps need to start talking to each other. But before we communicate or try and get through to somebody with a different perspective than us who’s not aware of what we know, is thinking about two psychological phenomenons. One is the background of fear. Fear clouds critical thinking.
Most of us to some degree are still afflicted with this PTSD, post-traumatic stress disorder, from the beginning of the pandemic where this novel virus, and these pictures coming from Wuhan, and of intensive care units in Italy with people dying, scared people beyond their imagination. What that means is then your ability to engage in critical thinking to try and understand things is definitely impaired. Then the other aspect is this phenomenon called willful blindness.
We see this in historical events, and I’ll give you a few examples in a second. We’re all capable of this in different circumstances, and we probably already have done this in our lives in different circumstances. This can apply to individuals and families or spouses turning a blind eye to the fact their partners are cheating on them; to institutions, whether it’s the likes of what happened in Hollywood with Harvey Weinstein or with Jeffrey Epstein; or even to countries like what happened in Nazi Germany. This is when people turn a blind eye to the truth in order to feel safe, avoid conflict, reduce anxiety and protect prestige. Changing one’s mind is one of the most psychologically terrifying experiences anyone can go through.
To quote the Canadian American economist, John Kenneth Galbraith, “Faced with changing one’s mind, and proving there’s no reason to do so, almost everybody gets busy on the proof.” This is what we’re up against, but it doesn’t mean it’s a barrier that we can’t overcome by persistence, by empathy, and by stating the cold hard facts.
When I came out with this paper, I also wanted to create a safe space for doctors who are still in a situation that I was in when I took the vaccine and in effect promoted it or reassured people. It’s okay to change your mind, it’s okay to say the information has changed, and it’s okay to talk about it. That’s the challenge we have right now, Jan, to be honest. A cousin of mine pointed this out in the states a year ago.
He said, “If people really knew what happened, that their uncle or their kid died unnecessarily from a vaccine that should never have been approved, you can see how that can go very, very badly wrong in terms of people getting violent.” It would be understandable for people to have those emotions, but that is not going to take us further forward as society, and we have to all say, “Okay, this happened. It was a mistake.”
These were the structures in place that have been building up for years that we all have not collectively addressed properly, that allowed this to happen. The only way we’re going to overcome it and move forward constructively is if we all work together and go back to the very basics about honesty and transparency. What about basic human values that we seem to have forgotten around the sense of the importance of speaking the truth?
There’s another complicating factor, though. This is around the work that Laura Dodsworth has done in the UK exposing the so-called nudge units in the UK government that actively tried to make people more afraid to elicit behavioral responses, i.e. vaccine uptake. And then, there were similar such operations with other governments that aren’t nearly as exposed.
What we do know is that there was a lot of government and industry and Big Tech collaboration, especially in the media around these censorship regimes. They also they spent $1 billion in advertising in the U.S. promoting vaccine uptake. One of the biggest lessons for me in the last few years is that some portion of society is profoundly influenced by this seeming consensus across these large megaphones in society. To me that explains why the level of fear was so high.
But it almost seems like that same system can spring into motion again.
Absolutely. I’m a numbers person and again, I like to empower my patients and make them more health-literate, which means giving them information that allows them to think about how they can live the best possible life they can live mentally and physically. One way of doing that is to help people understand the numbers.
For example, around the fear that was imposed by Covid, it was very interesting. One Gallup poll revealed that 50 per cent of American voters thought that their risk of being hospitalized with Covid was 50 per cent, one in two, when it actually was far less than 1 per cent. It’s extraordinary to think about how that influenced their behavior.
Whereas, if we had reassured people and said, “Listen, your risk is so and so, then psychologically they would’ve been less fearful, and in a better state mentally as well. Without understanding the numbers involved, the public is vulnerable to exploitation of their hopes and anxieties by political and commercial interests.
There absolutely was an exploitation of the population through this fear narrative that was completely and totally unnecessary. But I think some of it, Jan wasn’t malicious as well. I think it was incompetence. I have been in touch with two people who are quite senior in terms of their access to information at government level and know what’s going on in China. One of them is Chinese, I won’t name her, but she’s a Chinese broadcast journalist.
Another one is a friend who has very close ties to the Chinese Communist Party. One of the interesting things I discovered is that, and this is something we saw reflected in the British government, in health policy makers and I’m sure in the states as well, is that they also had an exaggerated fear themselves of what Covid was going to do.
Up until recently, we have seen Omicron, which we now know is no more worse than a bad cold. We see pictures a few months ago from China of police officers or security personnel wearing hazmat suits in a military style operation controlling the population. And I said to this journalist, “What’s going on here? This is Omnicron. What are they doing? Whose response was this?”
He said, “Aseem, you’ve got to understand most of the Chinese populations still think Covid is like Ebola, touch it and you will die.” When you look at the pandemic response in terms of lockdowns, the WHO already had a contingency plan that if such a virus was to affect the world, are lockdowns a way forward, is this the right way to go? And the answer was no. It was no. They changed their mind because of China.
China convinced the world that strict, stringent lockdowns in Wuhan contained the virus when it never did that. It spread throughout the whole of China. So, there were mistakes that were made. I don’t think they were malicious. I think they were rooted in incompetence, and then it was exploited by those commercial interests.
Then, you create this situation where ultimately what seems to have happened during the pandemic, certainly from a financial point of view, is you have an elite rich who have gotten richer, whether it’s the likes of Bill Gates or Mark Zuckerberg who’ve added billions to their fortunes, while the rest of the public actually has suffered in a way that is just unprecedented in terms of their mental and physical health. That in itself really needs to be scrutinized properly to try and understand what we did wrong and what we need to do to change systems so this never happens again.
It’s obvious that the CCP is a psychopathic entity, but I’d never quite thought of it in the context that you described.
The solution to that from a conceptual point of view is, “What’s the opposite of psychopathy?” It’s compassion and altruism. The problem we’ve got and social media makes us worse as well, is that people are increasingly losing access to the truth and a capacity to act in an empathetic way. And that combination together is devastating for society. Guess who Facebook partnered with early on in the pandemic to decide and control vaccine misinformation on their platform? Merck.
Merck and Facebook, you can look this up. They committed $20 million each to control vaccine misinformation. Merck, all right? It’s beggar belief. A year ago when I went on GB News after my dad’s death, there were bits of data that came together that suggested the vaccine was causing coronary events. I went on GB News and I posted it on LinkedIn. I’ve been on LinkedIn for a while. Without any appeal I was removed. I’m permanently banned from LinkedIn now, so I thought this was interesting. I went and looked it up, LinkedIn is owned by Microsoft and Bill Gates. Say no more.
What is the connection?
First of all, during the pandemic, we didn’t talk enough about obesity, and that didn’t get enough of an airing. It didn’t get enough of an airing in terms of giving people actual tools through their diet of how they can rapidly reduce their risk of having poor outcomes from Covid within weeks. Right. Very powerful. Who’s controlling the narrative or who’s influencing the narrative? Bill and Melinda Gates Foundation is heavily invested in stocks in McDonalds, Coca-Cola and the pharmaceutical industry.
Bill Gates was not interested in discussing anything about chronic disease management through lifestyle. He certainly has been a big proponent of the vaccine and mandating vaccines and influencing the WHO and funding media organizations to ultimately suppress information that the public need to know about when it comes to the vaccines.
Now, I don’t know Bill Gates, I’ve never met him. If I was to give him the benefit of the doubt, I think that he’s very misguided probably in his understanding of medicine. It’s not engineering, it’s not an exact science, and I’m pretty sure he doesn’t have a basic understanding of this particular technology and the harm that it’s done. If he does and he’s still promoting or perpetuating this misinformation around it, then obviously that doesn’t reflect very well on him as a human being.
Briefly, please tell me about exactly what you mean by lifestyle choices leading to better outcomes? I’ll just mention one that I became aware of and I was just kind of shocked. It’s obvious once you think about it. It’s just simply like that people that had decent vitamin D levels, irrespective of the level intrinsic risk based on that age gradient, had much better outcomes.
Orders of magnitude greater outcomes, if you had just popped your vitamin D. It feels to me like it’s kind of criminal that we didn’t know that.
Completely criminal. I wrote papers on it, I published in newspapers, I was on TV, and I wrote a book about it. I advised the head secretary for health, because I was the guy in the UK that came out and said, “Boris Johnson likely got sick and got hospitalized with Covid because of his weight,” once he was out, of course. So, this is something I know very, very well.
But coming back to the lifestyle, I’m glad you’ve asked that question, Jan, because it probably brings us onto the statin discussion as well. As a researcher and a cardiologist, my primary interest was always in combating heart disease. Why have we not managed to eradicate heart disease, despite all the so-called amazing scientific evidence we have in terms of what we should be doing? It’s still the biggest killer in the western world. A lot of my root cause analysis was to look back at the theories around cholesterol and the use of statin drugs, then break all of that down.
I published so much on that over the years, so I know a lot about this area. 80 per cent of heart disease, about 80 per cent is influenced by lifestyle, but more importantly it is environment that encourages certain behaviors. Maybe up to 20 per cent is going to be because of genetics, but you can have a massive impact on heart disease purely from a lifestyle approach, both in prevention and even potential reversal. What does that mean?
The root pathophysiological underlying factor behind heart disease is something called insulin resistance and chronic inflammation, and they overlap. Insulin resistance basically means your body becomes resistant to the hormone insulin over time, to the effects of the hormone insulin. That in itself is the number one driving factor behind heart disease, and it’s responsible for about half people developing high blood pressure, and it is a precursor to type 2 diabetes. These are really the biggest conditions around the world, and also linked to cancer and dementia.
If we combat insulin resistance, genuinely combat it, we would probably reverse heart disease. We would reverse the obesity epidemic, we would reduce cancers, and we would reduce dementia. That’s significantly clear. So, the question is how can you do it and what do we do about it? Through my individual work with patients and the data that’s available, the good news, and I’ll come onto to that, Jan, is your markers related to resistance in your blood or the risk factors associated with it can be improved or reversed within just four weeks of changing lifestyle. Four weeks. What does that mean? The most important of those lifestyle factors is diet.
The big problem, as you know with obesity in UK and the U.S., and when I looked into the whole understanding and the misguided approach to heart disease, certainly since the 1970s, has been this over obsession with focusing on lowering cholesterol. In fact, one of the former editors of the American Journal of Cardiology, William Roberts, in 2011 wrote, which I countered in my book A Statin Free Life, he wrote, “It’s the cholesterol, stupid.”
In that paper, he says, “You can be an obese, smoking, type 2 diabetic, sedentary, and as long as your cholesterol is low enough, you will never develop heart disease.” Nothing could be further from truth. It’s absolute nonsense. There has been this focus in cardiology that the main way of combating heart disease is to lower cholesterol through diet and drugs.
So, I broke down all of that data and basically showed through peer-reviewed research in high-impact journals with other cardiologists that first of all, there is no relationship at all or very little relationship between lowering LDL, so-called bad cholesterol, and reducing heart attacks and strokes.
Statins are probably one of the most prescribed drugs in the history of the world, and the most lucrative. It’s a $3 trillion industry prescribed to 1 billion people globally. The overwhelming majority of those people prescribed that statin drug will not be told or be aware that it’s not going to prolong their life by one day, based upon industry-sponsored research.
And a best case scenario for them is preventing a non-fatal heart attack or stroke, one in 101 per cent. And a link to that has been this low fat food approach exploited by the food industry. It was flawed science at the beginning; lower the fat, lower cholesterol, then prevent heart disease. We increased our consumption of refined carbohydrates and sugar and low-fat marketed foods, which are going to have the opposite effect on your health, because they’re full of sugar and refined carbs, which exacerbates insulin resistance.
It’s a mess. So, I spent a lot of time before on all of this. This is what I’ve worked on for many, many years, trying to shift that paradigm to the things that you should be focusing on which is eating real food, and minimizing consumption of low quality carbohydrates; your breads, your pastas, and your rice.
Moderate exercise. You don’t have to overdo it, a brisk walk 30 minutes a day. Pretty powerful. And last but not least, and one that’s probably the most neglected, but the most challenging in modern society is chronic psychological stress. If you look now at chronic psychological stress as a risk factor for development of heart disease, it is equivalent to having either high blood pressure or type 2 diabetes or being a smoker.
The chronic psychological stress works as an adverse effect synergistically with all the other factors, because if you’re more stressed, you’re more like to hit the junk food and be more sedentary. It is just a vicious cycle. The most fascinating bit of research that I discovered, which I then implement with my patients when I advise them is that heart disease reversal, which is unheard of still in most cardiology circles, means the narrowing of the arteries.
Okay, actually having those narrowings reverse. The only good data we have, it’s not the highest quality level of evidence, but it’s still interesting, is from India, which showed that in patients who had moderate to severe coronary artery disease who went underwent a healthy lifestyle program, the only intervention by far that was likely responsible for reversing heart disease was doing 40 minutes of meditation a day.
Listen, modern medicine has done a lot of great things, not as much as what most people are led to believe. If you look at increase in life expectancy in the last 150 years, we’ve added 40 years to our life expectancy since 1850 to now on average. You can attribute about three-and-a-half to five of those 40 years to modern medicine.
Most of it has happened through public health interventions, safe drinking, seat belts in cars, and smoke-free buildings. The single biggest intervention on reducing death rates from heart attacks in the last three, four decades is from reduction in smoking. Taxing cigarettes was the single most important intervention in the last several decades in reducing death rates from heart disease.
Now, where am I going with this? It links back to our discussion about Covid and the vaccines and the drug industry. We need to improve people’s mental and physical health, which is something that most people want. If you ask people in international surveys what’s most important to them, they say that the most important thing is their health, followed by a happy family life. Health is still the most important issue for people. If we’re going to improve people’s health, it’s not going to happen without changes in the law.
On a population level, it’s going to be very difficult, because we currently have laws that allow industries to in effect kill for profit. When it comes to even the foods that we eat, it’s just like what tobacco did. With the food industry, there’s increasing evidence that the food industry is deliberately putting ingredients together in certain packaged foods that most of the American population are taking on a regular basis that are designed to encourage overconsumption, and that is addictive.
We know that the sugar industry suppressed information on the harms of sugar for a very long time, just like tobacco did with their cigarettes. It’s the same problems again and again and again. We need to address the root cause of the problem, which is the legal entity that is the corporation, and that really is the major problem. Corporate power, addressing corporate power needs to be a public health priority.
It’s just that we’ve normalized certain aspects of our lifestyle that has stopped people really thinking about this in a way that’s going to help them. Ultra-processed food is now more than 50 per cent of the calories in the British diet, probably close to 60 per cent of the calories consumed in the American diet. Ultra-processed food is essentially high-glycemic index carbohydrates that increase glucose in insulin, which are responsible for driving heart disease, but also are another major risk factor, after age, for Covid outcomes being bad.
It’s beyond obesity. Obesity is actually a marker of a much bigger problem. I was taught it is the tip of the iceberg in terms of diet-related disease. Poor diet is responsible for more disease and death globally than physical inactivity, smoking, and alcohol combined. In terms of a lifestyle aspect, the most important thing you can do first and foremost is change your diet. Just from changing a diet alone, within four weeks, you can reverse these risk factors.
What’s the problem with the diet? Ultra-processed foods. In very simple terms, if it comes out of a packet, any packaged food, and it has five or more ingredients, and it’s ultra-processed, don’t eat it. If you go to the supermarket, the shopping mall, and you pick up a loaf of bread and you can count five or more ingredients, it’s ultra-processed. Don’t eat it.
It’s toxic to your body. It’s going to encourage over consumption, and it’s not nutritious. That’s it. Just eliminate those and the low quality carbs and drinks, the sugary drinks, juices, that kind of stuff. I asked my patients, and they say, “Hold on. We’re used to all this stuff, blah, blah, blah. I’m going to be miserable.” “No, just do it for a month. Can you do it for a month for me?”
And people are staggered when they come back, not just in terms of their health markers getting better, they also feel better. I believe in the best of what life has to offer in terms of quality of life. If you are trying to help a patient, but you’re not going to improve the quality of their life, there’s no point from my perspective, and it’s not going to be sustainable.
It’s a win-win when I’m improving their heart disease risk factors. They come back and they say, “Listen, doc, I’m sleeping better. I’ve got more energy. I feel better. I can carry on doing this.” That’s what I would advise people to do. The challenge we have, Jan, is even though we tell people to do this, if the food environment is working against us, people are going to relapse. This is predominantly an environmental problem.
Yes, empower patients, which is what I do. But we’re not going to achieve very much on our population level until we actually get governments working for the health of the people, not working for the health of those very industries that are getting you hooked and addicted to sugar and ultra-processed foods.
You’re on the second point that I wanted to touch on, which is what some people describe as regulatory capture by industry. And there are other ways of describing this public-private partnership.
Yes. As a qualified doctor for over 20 years, my primary responsibility is to seek the truth, and to help my patients to look at evidence. Markets in healthcare do not work for the interests of the patient. Let’s give you the example of the United States. You have some of the highest spending in the world on healthcare, $3.5 trillion. 18 per cent of your GDP is spent on healthcare, with some of the worst outcomes in the world. I can show you a graph across different states in the U.S., where is an inverse correlation with the amount of spending in the state and the healthcare outcomes.
The more the spending and costs go up, the more the quality goes down. Financial incentives should never become part of the doctor-patient discussion, because there is an asymmetry of information. The doctor can wittingly or unwittingly exploit their knowledge to make sure that patients get tests they don’t need, get treatments they don’t need, and that causes harm.
Commercialized healthcare systems are actually damaging to both rich and poor. The rich people suffer because they have overtreatment. I’ve worked both in the private and the public sector. I see patients that come to me privately and I see the kind of stuff that they’ve spent money on, ridiculous tests they didn’t need, and drugs they didn’t need because they had money. It damages the rich, and they get exploited. Then, poor people don’t get access to necessary care. We just need to go back to the basics.
I believe there is a lot to be learned from ancient wisdom. Look at people like, for example, Socrates and the Buddha who were around 2,500 years ago. They seem to have it sussed out quite well in terms of how we should be living our lives for the goodness of our mental and physical health.
Even though we’ve advanced technologically in the last 2,500 years, Jan, we haven’t progressed psychologically. In recent years, I would say we’re regressing psychologically. If we go back to the very basics of being honest and truthful and having true dialogue with people and being empathetic, then society will be much better off.
Dr. Aseem Malhotra, such a pleasure to have you on the show.
Thank you, Jan.
Thank you all for joining Dr. Aseem Malhotra and me on this episode of American Thought Leaders. I’m your host, Jan Jekielek.
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