Real Food Initiatives for Public Health in the UK [transcript]

Written by Christopher Kelly

Aug. 27, 2019

[0:00:00]

Christopher:    So, Sam, thank you so much for joining me here at the Real Food Rocks Festival in Ambleside. I know where I am now. I know it's like Windermere.

Sam:    Yeah, that's right.

Christopher:    After that I get a bit fuzzy. It's very, very beautiful, and this is an incredible location here. What is this, a stately home?

Sam:    The organizer, Jen Unwin, who is David Unwin's wife, chose it. They're often in the Lake District quite a lot, and they knew of this venue. It's basically a stately home with a fairly large estate attached to it where we can have talks inside the house and then things going on outside of it, vendors and music and family fun and fitness sessions and stuff like that. It has been a great day so far.

Christopher:    My wife said, "Oh, this is the British version of Paleo f(x)," and I can neither confirm nor deny that because I've not been to Paleo f(x) somehow yet. So, as you mentioned, it's very civilized, all very polite, lots of tea and biscuit -- oh, no, you don't have biscuits on Paleo, do you? There are no biscuits, just the tea.

Sam:    Yeah, yeah, just with the tea, mostly probably coffee. We've got duck and goose crackling and stuff like that.

Christopher:    Oh, the food has been fantastic. I had lunch already, and it was amazing. It's such a stress relief for me to be able to walk into a space with lots of different options knowing that I can choose from any of them versus what I see on the road. It's really depressing actually. Five years ago I recovered my health using diet and lifestyle, diet perhaps being the key behavior that led to the rest. I thought, oh, by now, everyone else will have figured this out as well, but nothing could be further from the truth. 

    My family and friends are still eating cereal and margarine. When we stop at motorway service stations, there's nothing but bad choices. You've got Subway, Burger King, Starbucks which is not too bad, I guess, if you stay away from the pastries, and then Waitrose which is what we normally do, but then I'm spending £30 on a bunch of like just for lunch or whatever. Then you still need a PhD on Biochemistry to understand whether the cooked chicken that you've just chosen is an appropriate choice for humans or not. There's maltodextrin, wheat, soy and some highly processed seed oil or something. It's so hard.

Sam:    It's painful.

    

Christopher:    Maybe we need to take a step back here and talk about the purpose of the Public Health Collaboration. Is that the big, hairy aspirational goal to resolve these types of food issues that I'm seeing on holiday here in the UK? 

Sam:    Yeah, it is. The Public Health collaboration was born out of an idea or frustration for myself. I used to run a fitness boot camp business, and I was a personal trainer as well. After five years of doing that, I just became really, really frustrated and annoyed by the sheer number of people that were coming to us, and we'd have to completely reeducate them on what it is to be healthy and how you go about it as well.

    I decided that the only way were going to sort this out is by setting up a nonprofit organization that fully focuses on solving this issue so that we get rid of this problem once and for all, ideally. So, I pitched this idea to everybody that's on our scientific advisory board today, the likes of Dr. David Unwin and Dr. Jen Unwin, Dr. Trudi Deakin, all of whom are here today. They were just, let's do it. They were just really, really enthusiastic. I was amazed that I was able to get all these people together.

    

    In February 2016, we ran an online crowdfunding campaign, doubled our target, and we've just been going from strength to strength from there. We've learned a lot over the past three years in terms of how we should go about things and how to be effective as well on a very small budget because we don't have the funds that many mainstream large charities have today. We're doing this all on a shoestring. We have zero budget for marketing. Everything that you can see here today --

Christopher:    That's amazing.

Sam:    -- is word of mouth. 

Christopher:    That's incredible.

Sam:    We have almost 700 people here today, including everybody. Yeah, all of that has been word of mouth. There has been no marketing budget. It's just all social media --

Christopher:    That's crazy.

Sam:    -- everything like that.

Christopher:    It's not walk-in traffic. We've been staying at the Youth Hostel Association in Ambleside, and I thought there's no way we're going to get into that in July. It's crickets. Actually it's not. It's monsoon and maybe that's where -- it's still really nice right now.

Sam:    Yeah, it is right now. This morning -- 

Christopher:    This morning it was bleak, and we were walking around the town in the pouring rain, trying to find somewhere that was open for breakfast. Literally, everything is shuttered and locked. The boats are all stationary. Everything is closed. We ended up going back to the Youth Hostel to get their slightly sad but good breakfast I have to say.

[0:05:05]

Sam:    [0:05:06] [Indiscernible], right? 

Christopher:    Yes. It's obviously not walk-in traffic, so you've done a really good job then of getting 700 people. That's a really good turnout.

Sam:    Yeah, absolutely. It's incredible. I mean, it's a beautiful location, but it's fairly remote.

Christopher:    Yeah, exactly.

Sam:    In terms of public transport, there's not much.

Christopher:    The Ancestral Health Symposium learned that the hard way, or maybe they don't care. The year that they had it in Bozeman, Montana which was last year, it's just the most fantastic location. I loved being there, but the turnout was a fraction of what it had been in previous years when they have it in a university town.

Sam:    Yeah, it's really difficult. I think it maybe depends on the type of event as well. This is a very low-cost event. It's £10 for adults. It's £5 for children.

Christopher:    Oh, it's incredible.

Sam:    So, it's very low-cost. It has got [0:05:50] [Indiscernible] mass appeal in that it's not focusing on specific things. You've got talks here that do cover all types of things, but the approach that it has got is that it's a family fun day centered around a real food lifestyle. That's fairly appealing to quite a lot of people from varying backgrounds. It's just amazing to see so many people here today enjoying what we've been trying to strive towards for the past three years.

Christopher:    That's going to be my next question. What does success look like for the Public Health Collaboration?

Sam:    I think it comes in many forms for us. There are a few areas that we're trying to make an impact upon right now, one of which being improving the knowledge base of health care professionals working within the NHS. That's probably our priority with everything because those are the people that are giving advice on a daily basis from a place of power.

Christopher:    Authority, yeah. 

Sam:    A vast majority of people will listen to what the health care professional is saying, and they will do it, essentially. So if they are saying that they should be having cereal with skimmed milk for breakfast, generally that's what most people are going to do. Of course you've got pioneers and you've got earlier doctors and things like that that are going to actually read into it and be skeptical and find out, okay, maybe I should be having eggs for breakfast instead. For the most part, people will follow that.

    The way that we're doing that is we have this volunteer ambassador program here in the UK where people train to become PHC ambassadors and then essentially local representative for the PHC. They go out and inform health care professionals within their local area, working within the NHS, whether it be at GP practices or at hospitals or anything like that.

    They try to garner support from those local health care professionals and then in collaboration with those health care professionals, they go about setting up free public meetings for the health care professional's patients as well as the wider public to attend. Then we can inform those people en masse about their food lifestyles and the impact that it can have upon people with varying conditions essentially.

    We started this in September 2017, just coming up two years. We've now got over 150 ambassadors across the country.

Christopher:    That's great.

Sam:    We have varying success because for some people, they've gone out into their area and they've done presentations and things like that but then they just get kicked back. You get so much resistance from some people. On the other hand, over these past two years, we've seen increasing numbers, our ambassadors becoming more and more successful which is absolutely amazing to see.

    Our prime example is this guy, Andy Bishop, in Liverpool. He reversed his own type 2 diabetes. Then he essentially joined the Patient Participation Group at his GP practice. Every single practice in England and Wales has to have a PPG, this Patient Participation Group, and that's a great way for them to get in touch with a practice manager and a health care professional within that practice.

    He just told them his story and then went into all the PHC stuff. He just managed to get their support almost instantly, and now he's running patient groups in about four or five practices in Liverpool now. It's in some of the most deprived areas of Liverpool as well, and he has found success in those areas. It was amazing.

    When we pitch this to other areas and they're like, "Yeah, but it's not going to work in this area;" it's like, well, we've managed to do this and been successful in a place like Kirby which is one of the roughest places in the UK in terms of socioeconomic deprivation.

[0:10:05]

Christopher:    What are the points of resistance then? Is that the main one, oh, this is some special diet that -- I said it. You can either go to Burger King. How much would it have cost me to buy lunch for my family of four in Burger King versus the £30 I spent in Waitrose on some cashew nuts and a packet of ham? Is that the major point of resistance is that this is some elitist diet that we couldn't possibly afford?

Sam:    Yeah, that's one of the arguments that comes up is certainly if this is an elitist type of thing then it's not possible for people that are on low incomes to do which is not the case at all. It's absolutely possible. Also at the same time, it's because essentially at the moment it's going against government dietary guidelines.

Christopher:    [0:10:48] [Indiscernible].

Sam:    Right. We are starting to be able to get over those objections particularly with the amount of support that we're starting to get because, for instance --

Christopher:    Will this be what changes the dietary guidelines?

Sam:    Yeah, that's essentially it because we're in a complete chicken and egg situation. So, what has happened, although we've got these dietary guidelines that we don't agree with right now, what's happening is that Dr. David Unwin, he has got these sugar infographics that put food in expressions of its effect, tablespoons of sugar and how much that affects your blood glucose. 

    For instance, just off the top of my head, a portion of rice of 150 grams, cooked bowl of rice, is the equivalent of having ten teaspoons of sugar essentially. It's the same blood glucose response. He has expressed lots of foods like that. So, if you've got somebody that has a condition where blood glucose is one of the most important factors of their condition such as type 2 diabetes then that's important information for them to understand.

    Now, those infographics that are hosted by the Public Health Collaboration have now been endorsed by NICE which is the government guidelines organization in the UK. Those are the medical guidelines that all health care professionals in the UK follow. So, now, those are endorsed by NICE, so there has been a creak in the door and we're starting to get in which is amazing.

    So, we do have endorsement from NICE which is a massive thing to say to health care professionals. We've got endorsement from NICE for our infographics. That's an easy sell for them. Okay, I can hand those out then. That's fine. So, we've got a link on the NICE website under the type 2 diabetes guidelines to the Public Health Collaboration website basically.

Christopher:    What would you have these local GPs do? They're so strapped for time and resources. It's not like they're going to sit down and spend six hours counseling one of their type 2 diabetic patients on the potential of a real food diet to reverse their otherwise progressive disease. What would you have these GPs do?

Sam:    It really varies in terms of their actual situation. What we recommend is a small group appointment. That's a good starting point so that you get up to six people with very similar conditions, very similar stage. If you get a group of people newly diagnosed type 2 diabetes then instead of spending ten minutes with them individually, if you group them together for an hour --

Christopher:    That's one way to scale.

Sam:    Then you can scale. You can answer one question that everybody will have and everybody hears the answer. Also you get some group interaction and things like that, so that's a really good way to start, doing that.

Christopher:    Do you think it requires a GP to be there at all? Could you pass them off? Your ambassador in Liverpool that's doing a fantastic job, he could probably run that session maybe even better than the doctor because, oh, that question you're asking, I had that question six months ago. Here's the best thing that I found to solve it. Whereas the GP might be like, I don't know, it sounds pretty simple to me. Can you not just read what's on the sheet? I think there's something pretty powerful about someone that has just solved that problem that you're trying to solve.

Sam:    It's funny that you say that. That's essentially what happened at Andy's groups. Andy was still running those groups, and some of the GPs and nurses attended those groups at the start. What they found is that now that they trust Andy -- because there has to be a little bit of over-watching those people at first so that the health care professionals feel comfortable that they're not going to do anything crazy, right? Once you build out that trust which Andy did then he actually found that when the GPs and the nurses left the groups and it was just him and the other patients, they actually opened up more about how bad they've been basically which is really interesting.

[0:15:00]

    It's kind of obvious when you think about it. It's actually being more beneficial that they've left but when starting these groups, you do need to build up trust with the health care professionals and show that you're not going to do anything crazy and go off on a complete tangent with that stuff, just give really [0:15:19] [Indiscernible].

Christopher:    Yeah, you come back two weeks later and they're talking about, I don't know, cryotherapy or some weird thing they read about on the Internet two weeks ago.

Sam:    Exactly. So, it has been an amazing to watch but then at the same time, we've got ambassadors that are GPs and nurses themselves. Yeah, they've been really successful too. It all comes down to the people basically and then them showing the patients and the wider public, they are people too. They make mistakes, so please open up about your mistakes. 

    That has been one of the ways that the most successful nurses and GPs have been, is that they show to their people they're not this higher authority living in this medical heaven where they do everything correctly which is what people used to think. They show that they are people. They make mistakes.

Christopher:    Yeah, we all suck at adulting sometimes as Dr. Simon Marshall said on the podcast recently. I really like that.

Sam:    That's great.

Christopher:    Do you meet, as another point of resistance, this kind of -- I don't know how to describe it. It's like a cynicism. Oh, well they said that fat was no good and now they're saying that sugar is no good. You know what? Damn them all to hell. I'm just going to keep doing whatever I'm doing now. Unfortunately right now what you're doing is eating margarine and cereal, so we're screwed.

    As Ivor really elegantly pointed out this morning, what really happened was the people were doing the right thing and then a load of people showed up, trying to make money out of food that came in crinkle packets. It was margarine. It's basically all this stuff that humans have never before attempted to eat, and they got it wrong.

    What we're suggesting is that we just go back to what you were doing 50 years ago. Is that a point of resistance? Am I just hallucinating that?

Sam:    No, not at all. A lot of people say that. You can understand that point of view that they feel like the academics and things are flip flopping, for instance.

Christopher:    Yeah, or you don't just change your mind too many times.

Sam:    Yeah, exactly. Now you're like, what have you said I didn't trust? As Ivor, you've mentioned there, said what happened is that we're generally doing the right thing. Yet loads of industry funding pointed it in a certain direction, and maybe some misguided scientists as well. We got to this place where we thought we were right. It turns out that we're wrong. So, we're just reverting back to what we were doing originally. It's not really flip flopping. It's realizing that we're wrong and doing the correct thing.

Christopher:    Right. Of course the other really hard thing is when I talk to my dad about this, he's a really cynical old man now, is that my dad used to eat bacon and eggs for breakfast, and he still died of cardiovascular disease. I think what this highlights is it's a bit more complicated than that. What you put in your mouth is important but it's not necessarily the only thing that determines your health outcome.

    I saw a paper recently that financial stress was a 13X risk factor for cardiovascular disease. Compare that to LDL levels of cholesterol, it's a joke. So, was his dad under a bunch of financial stress? I could probably list another 69 things that contribute to the cardiovascular disease health outcome. It seems like you've already got your work cut out with the food. What about all the rest of it?

Sam:    What about social issues and stuff like that, yeah, exactly. You have to say, I guess food is the one thing, to a certain extent, that you can control. Everybody knows the environment affects our decision-making on a day to day basis, but it's something generally that you can't control. Stress sometimes you can't control it. You can try and control it a little bit, but you can't necessarily control the situation particularly if it's financial. If you've been put under a load of debt from being in university and you found yourself working at a Starbucks or something like that; even though you've got a Master's or something like that and you're trying to get a job.

Christopher:    You spend $250,000 on a medical education and you found yourself working as a GP for almost no money doing something that doesn't really work.

Sam:    Exactly, so that stress is going to be massively difficult to control. Food is something that you can control, and that will help reduce your stress. Although it might not completely eliminate it, it will certainly minimize it. So trying to frame it like that, that food is something foundational that we can control although it's not the absolute determining factor of whether or not you're going to develop cardiovascular disease or cancer or anything like that, it's one thing that you can control that could help minimize those chances.

Christopher:    Does the Public Health Collaboration have any aspirations to update food policy? Do you think that you'll ever see -- I mean, how do you feel about this, some people say it's the nanny state thing. I must admit it does worry me, the idea of a sugar tax because you can get it wrong because we have been wrong before. I think it was in Denmark, they tried to saturate fat tax, and it didn't work. Thank God it didn't work because you've got the wrong micronutrient. That sort of thing does worry me. Does the Public Health Collaboration have any aspirations to change public food policy so maybe it's not so damn hard to make a decision when they're going to the supermarket?

[0:20:32]

Sam:    Yeah, absolutely, we're working on that. We have our own dietary guidelines which is the Real Food Lifestyle. That's available on our website in the report. Last time that we spoke, you mentioned that you listened to it because you have it recorded --

Christopher:    Oh, yeah, I do remember that now.

Sam:    -- our version of our healthy eating guidelines. That's what we propose that it should be changed to. The idea is that that's flexible, and it's focusing on the fact that you need a minimum amount of protein, a minimum amount of fat and a minimum amount of certain micronutrients. As long as you're hitting all of those points, whatever real food lifestyle works for you is the one that works for you. If you're able to maintain a healthy personal good health then that's the one that works for you. 

    If you're in a place where you're not maintaining personal good health and you need to obtain it then you should go in the Real Food Lifestyle weight loss which is essentially a low carb real food diet to regain your health and then you can go from there basically. That's what we're proposing. We're trying to push that more and more, and we're starting to get to higher and higher places with the help of some fairly influential people here in the UK. 

    One particular politician, Tom Watson, has been massively helpful, who is the deputy leader of the Labor Party here, who has had his own transformation through -- 

Christopher:    That's what gets people, right? I tried it, and it worked.

    

Sam:    Exactly, you can't unsee that, the fact that this guy, he has lost about 100 kilos.

Christopher:    Wow.

Sam:    It's a lot.

Christopher:    That's insane.

Sam:    Yeah, a lot. He was a big guy. Now he's not. He spoke this year at our conference. It's great to have somebody that high, politically, endorse what we're doing and willing to help where he can, basically. He's opening doors for us where we might not have been able to be before.

Christopher:    That's great. 

Sam:    So, we're hoping to --

Christopher:    So then you've got to vote for Labor.

Sam:    No, not necessarily. There's a lot of political discord at the moment.

Christopher:    Yeah, I'm joking. I actually can't vote at all in the UK anymore.

Sam:    Oh, you can't?

Christopher:    Or in the US. No, I can't vote anywhere. I know that somebody listening to this is thinking that, oh, God, does that mean that I have to vote for Labor now?

Sam:    It depends, I guess. Politics is always a compromise. If a general election came and your most important political point was changing for better food policy then that might be something that you should consider. Until that time comes, there's no [0:23:05] [Indiscernible] thinking about it. For the meantime, yeah, he's opening up doors for us where we can hopefully influence things for the better basically. 

    Hopefully the UK will be a shining light when it comes to public health and show that it's possible to change things for the better, quickly and fairly simply. It's just about giving out the right advice. That's all we're saying. It doesn't take a massive campaign where it costs millions, even billions. Type 2 diabetes, at the moment, cost the NHS £10 billion a year. That's 10% of the budget.

Christopher:    That's 10 billion, with a B.

Sam:    Billion with a B. That's 10% of the NHS' budget. It is the most expensive financial expenditure of the NHS, and only 6% of the population has type 2 diabetes at the moment with 35% living with prediabetes, so just imagine if that 6% became 41%.

Christopher:    Just imagine someone gave you £10 billion that you could use for your marketing budget.

Sam:    Yeah, we'd sort it out in a year, in three months. You've got everybody just following a low carb real food diet that's living with type 2 diabetes, and it will be sorted out in about three months. There will be no drug expenditure, probably a little bit but not much.

Christopher:    What would the nuts and bolts of it look like in a supermarket? If you had a politician involved and they were willing the change at the law, say, in some way, what would it -- the problem at the moment is that we've engineered it too good. We know what makes tasty food. It's that combination of fat and carbohydrates, and perhaps you add a little bit of salt. The net result is ice cream or cheesecake or something that's just completely delicious, and people don't want to stop eating it. What would you do? Would you say you can't sell that? It's like cigarettes. Would you say, "Eating Pringles kills," on the outside of the can? What would it look like?

[0:25:01]

Sam:    It's difficult. I think we have to let this play out a little bit in terms of finding out how we can do things. Yeah, the knee jerk reaction would be, yeah, we should put labels on everything in terms of biscuits can kill or something like that or just playing packaging on stuff maybe. At the same time, we don't want to ram it down people's throats. We want to give people the information and make them realize that they need that stuff. When they come off of it then they won't crave it eventually or not very much to.

    What will happen is that I guess the free market will show that those things aren't selling anymore and so those companies will start to not focus on those products and will focus more on investing in real food producing which is essentially farming. Yeah, I think that's how we're going to have to play. I don't think we should put a policy in place in terms of doing those sorts of things. There are certain policies that we should be putting in place. The sugar run that you have to go through to get to most checkouts these days is insane.

Christopher:    I haven't seen it.

Sam:     Yeah, with the self-service. Do they do self-service?

Christopher:    Yeah, they do. I've realized this. I've been watching a bunch of British documentaries recently. There was one in particular with Hugh Fearnley-Whittingstall on the War on Plastic that I found really interesting. Actually I think it's worse in the UK than it is in the US. In the US we have these, what I would call a hippie supermarkets, these small, independent supermarkets. In Santa Cruz we have Staff of Life and New Leaf. My hat goes off to those two. They're really, really good. 

    Most of the shopping, the food is in the bulk bin section. There's a lot of loose fruits and vegetables. Sure, they have that middle aisle. If you look carefully, you can find the usual suspects, but the sugar run is uniquely Tesco [0:27:04] [Indiscernible].

Sam:    To give people an idea of what that is, in the UK, you've got your self-service checkouts. Do they have that in the US these days? 

Christopher:     Not in either of the two.

Sam:    Not much.

Christopher:    I have seen it but if you're going to the smaller independent ones, it's still traditional.

Sam:    Okay, yeah. Your main supermarkets have got these self-service checkouts where there's one member of staff that's manning ten checkouts where people are doing their own bar codes and stuff like that. This run that you have to go through for the line before, that could accommodate, let's say, 20 people there. So you've got ten going one way and then there's a hairpin and there are ten going the other way.

    Within that, whilst you're waiting in line, there are shelves that are next to you. That is just packed with chocolate bars, sweets, candies, cookies, anything that is instant gratification food that they're going to go, oh, that's two for one. Boom, I'm going to go get that. That will be one thing that I would try to fight for with the no sugar run in our checkout. That is completely unfair.

 Christopher:    You're talking about a literal run. I think everybody is familiar with the idea of putting their sweets next to the checkout, but they've extended that into a run.

Sam:    Honestly, yeah, it's literally like a little rat run.

Christopher:    Yeah, rat run, that was the word I was looking for.

Sam:    That is filled with sugar-laden foods that people, of course they're going to go, okay, two for one or a pound for, I don't know, ten cookies or something like that. Most people will go, yeah, I fancy that now. I didn't look for that initially but now that it's right there, I'm going to go for it.

Christopher:    Perhaps you should keep the rat run but just place the foods that you would like people to eat more prominently.

Sam:    Yeah, you could do that, or you could just take it all off the table, nothing there at all. Because if we were to put those things in place then there's the argument to say, "Well why are you preferring those foods?" Of course there's the health aspect and things like that but then you might have to put policy into place to bolster that. So what you could do is just a blanket nothing in there because it's unfair for people there.

Christopher:    Yeah, I guess if it was supermarkets, it can't be a level playing field. Every time you put something on the shelf, you're making a decision about how likely that item is to be purchased.

Sam:    Yeah, totally. 

Christopher:    Yeah, I suppose this comes down to profit. This is the thing that cost -- there was someone saying earlier, a bag of white flour, a kilo bag of white flour is cheap as dirt literally. If that's my highest profit margin item then that's the thing I'm going to put in the most -- how would you make your food more profitable? I'm not sure.

Sam:    It's going to take a lot of time, and it's a complete system overhaul because this whole movement involves farming methods as well and how things are farmed, how animals are farmed and managed. We generally have more environmentally friendly farming methods than the US, generally. Of course there are very many exceptions in the US as well, [0:30:13] [Indiscernible] the extremes.

[0:30:14]

Christopher:    Yeah, you put grass here. You could just put animals out on the pasture, and the grass just keeps on growing. Whereas where I am in California, half the year it doesn't rain.

Sam:    That's really difficult.

Christopher:    The native grasses, I believe they were native grasses, they went away when invasive species showed up. Now you don't even have proper grass during the summer, so it's super difficult, I would imagine, or much be harder than it is here. That is one thing that you've got going for you.

Sam:    Yeah, definitely. We had the CE of the Sustainable Food Trust, our conference this year, a guy called Patrick Holden who is a great advocate for farming. He's a dairy farmer himself. He has a farm in Wales that has very, very good practices, pasture and everything like that. That's where we want to try and push things as well so that it's better for the land, better for the animals and better for the open air environment as well in terms of carbon sequestration in the grasslands themselves and also the wildlife that grows there as well. For the most part, most cattle in UK is pasture-raised anyway, for the most part. You get silage and stuff like that for the winter months.

Christopher:    Right. We tried it. We asked the butcher, "Oh, is this grass-fed?" He just looked at us funny. What the hell else would a cow eat?

Sam:    Exactly, what?

Christopher:    Go away. Go home.

Sam:    Yeah, exactly. There's none of that really. Even if you're buying the value British meat in a large supermarket, for the most part it has been grass-fed.

Christopher:    What do you think of the idea of a distributed food network? Maybe we're at a point now where we have all these incredible technologies that would allow us to implement a distributed food network rather than farmer grows a bunch of stuff, sells it to Tescos -- I think everything just goes straight to Tesco now. There's not really a middle man. Then Tesco has enormous power over the farmer and can squeeze them as hard as they like essentially. Then people go to the supermarket and then essentially nothing good happens. You've got the sugar run that you talked about. There are the middle aisles. It's really hard to make good decisions in a supermarket. 

    What do you think about the idea of, okay, so I have my garden. It looks like there's enough space for two pigs. Could I raise those two pigs? But I'm not going to need two pigs worth of pork once those get slaughtered. Could I create a technology that allowed me to sell some of that pork on the open, well I say open market, but perhaps sell some of that through some technology, to a friend that lives five miles down the road and they happen to be producing something else that I need? So, we'd leverage technology to -- and so Tescos could go away, right?

Sam:    Yeah, that will be the ideal. That would an amazing environment to be part of, an amazing community, so if you're up for it, go for it.

Christopher:    Yes, that's a good idea, Chris, go ahead.

Sam:    Easy, easy. If somebody was able to take that up, that would be incredible.

Christopher:    I do think there are people out there like me actually that when you say to them, "Oh, do you fancy giving up your job as computer programmer and raising 50 head of cattle," they're like, "Yeah, sure, but how do I make money doing that?"

Sam:    Exactly, how does that work?

Christopher:    Or people that are already doing it, when you say to them, "Oh, could you raise another 50 head," they would say, "Well sure I would love to do that, but where do I get the money to pay for that upfront?" Again, technology could do that. You could get paid before you produce the goods and so those people that are already doing it become more profitable. They get funded before.

    One of the questions I wanted to ask you is that how do you get people into the system before they've got serious problems? There has been a lot of emphasis here on insulin-resistant type 2 diabetes because it is a huge problem and it's very well-addressed by what you're advocating which is real food and then some other lifestyle factors. How do you think you'd reach people before they have such a serious problem?

Sam:    Yeah, this is a really difficult one. We're trying to raise awareness through the public eye, through events like this that have got more public mass appeal. At the same time, what we're hoping for is the fact, because we're getting so many more health care professionals on board, those will be the people that will be informing people before they get to the metabolic conditions, that this is what they should be doing before it's too late.

    Again starting point is prediabetes. Although, in a way, it was potentially pushed for big pharma to get more drugs onto people, so let's come up with a condition that we can get more metformin onto people.

[0:35:06]

Christopher:    Yeah, I was going to say they did that, right? They changed hypertension, and they basically made 80% of British people hypertensive. That's great.

Sam:    Then they get thrown a load of hypertensive medication at people, but that's going to bite them in the long run because we can use that as a marker and a point where we can say, "Look, before I see that you have prediabetes, what you can do is if we can reduce the sugar and starch that you eat and focus on low carb real food then we can get you back down to normal blood glucose levels. Then you never ever have to take drugs for this at all."

    The more and more health care professionals that we get advising that before saying, "Oh, you've got prediabetes, here's some metformin," then we can actually use that condition that they tried to turn into this, now we can sell more drugs to people, we can use that against them almost. I think that's going to help out massively.

    Of course it would even be better to get people instilling good food habits from when they were children. That's something else that we'd love to get involved with. Our hands are very much tied at the moment in terms of the fact that they have to follow the national curriculum which [0:36:23] [Indiscernible].

Christopher:    Could you alter that one? You've got politics on your side.

Sam:    This is it. We want to influence that, but it comes down to getting their dietary guidelines changed. So that's our first port of call. When we change that top level dietary guidelines, everything else falls into place, from school education to diet in the military because that's a massive problem as well, is that our soldiers and military personnel becoming more and more overweight and even obese and unfit which is a defense issue as well. So, just changing that at the top affects all of those.

Christopher:    Okay, this top-down approach.

Sam:    Yeah, so it's a little bit of both because we're doing the ambassador program [0:37:06] [Indiscernible].

Christopher:    Right, [0:37:07] [Indiscernible].

Sam:    We're attacking it at both ends and hopefully.

Christopher:    That's super interesting. Yeah, that's great. There was a really good talk with Dr. Michael Mosley. I think he's probably going to be the type of person that's important for getting the message out there.

Sam:    Absolutely.

Christopher:    Probably most people listening to this don't know who he is but in the UK, he is a very popular figure.

Sam:    And trusted.

Christopher:    And trusted. He did a fantastic documentary recently on antibiotic resistance that we found just absolutely fascinating. In particular he did this thing where he went down into this underground cave system, and they found a bunch of bacteria that were resistant to every antibiotic that they tested on. This is like, uh, what's going on here? These microbes have never been exposed to our antibiotics and yet they're resistant to all of them.

    Basically what's going on is so few resources so far underground that the microbes are just having this little war on each other fighting for their tiny amounts of resources that are available. That was eventually leading to antibiotic resistance even though they've never been exposed to antibiotics. It's like this. Do we know what we're doing? We think we know what's causing antibiotic resistance. I'm not sure you know what you -- anyway, that was a fantastic documentary if you want an introduction into Dr. Michael Mosley's work. He has been working at the BBC for years. 

    At the end of that talk, Ivy had her hand up. Ivy is my five-year-old daughter. She said, "But what about the plant oils?" Everybody just looked at each other. What do you mean what about the plant oils? Oh, I know what she means. She means grape seeds and canola and all these industrial processed oils. "That was a great question. I'm glad you asked." I was like, shit, I didn't even really teach her that stuff. She just learned all that by osmosis.

Sam:    That is so cool.

Christopher:    It is cool. I wonder, could you be doing that? Could you teach this whole era as a lesson in history? In the beginning, humans ate food. Then we got a little bit too good at engineering hyperpalatability, and people make money out of putting things in quickie boxes, and a lot of bad things happened. Now we know that we shouldn't do that. We shouldn't tamper with nature.

Sam:    Millions of years of evolution sorted it out.

Christopher:    Yeah, and this is what constitutes the species of appropriate diet. I'd love to be in that -- is that something that could happen?

Sam:    I hope so.

Christopher:    You just have a bunch of kids that just -- and then of course cooking is a skill that may be -- I don't know. What it's like in the UK? Do they teach kids how to cook in the school too?

Sam:    They do, but they teach them how to cook flapjacks --

Christopher:    Oh, shit.

Sam:    -- biscuits, pasta bake and stuff like that. It's frustrating because maybe you need to learn those skills or something, but at the same time you need to introduce how to eat healthily. If you pitch that to school now, what they think of teaching kids to eat healthily would be not with butter and use plants oils and things like that.

Christopher:    Margarine, skim milk.

Sam:    Yeah, it comes back to sorting out those guidelines at the top and then realizing that, yeah, all these plants oils aren't healthy. These refined grains aren't healthy either and so, yeah, we shouldn't be using them. Making them realize that a lot of Victoria sponge isn't a daily thing. It's a treat. Even if it is a treat that comes up at a birthday party, it doesn't mean you have to indulge in it, because everybody feels like that.

[0:40:21]

Christopher:    I think you've gone too far this time, Sam.

Sam:    Yeah, I stepped over the line.

Christopher:    You stepped over the line. My American wife is like that. Isn't basically every type of event or social gathering in the UK just another opportunity to eat cake? Oh, another cup of tea, more cake?

Sam:    Easy, easy, and just biscuit after biscuit dunking in tea after tea that has got three or four sugars in it. It's absolutely terrible. Yeah, I think if we get enough people to become ambassadors throughout the country, and the idea is that we get an ambassador in every single village, town and city in the country, so the culture that we want to create seeps out throughout the entire country through the ambassadors basically. The only way we're going to do this is with people power. That's what the ambassadors program is all about, and trying to instill in that communities that they're in, everything that we're saying.

Christopher:    How do people become an ambassador? That sounds like a really good way for people to get involved in the Public Health Collaboration, to become an ambassador. Wouldn't you agree? How do they do it?

Sam:    Yes. It's only available in the UK at the moment unfortunately, but we're hoping to expand things to the rest of the world soon. So if you are in the UK, go to the PHC website which is phcuk.org/ambassadors. That's the ambassador application page where you just fill in a simple application form that comes through to me and then we'll set up a time to chat and just make sure we're on the same page about things and inform them about what's actually involved in terms of the time commitment and things like that.

Christopher:    Okay, and your training program, is it an online training program?

Sam:    Yeah, and then there will be physical training days with ambassadors. We're also doing distance learning as well if they're in particular situations, but for the most part it's physical training days that they go, with myself, and take them through the ins and outs of the strategy, what they can and can't say because that's just as important, what you can't say. We don't want people going off on things. We're talking in behalf of the PHC. Yeah, basically if they just apply through the website then we'll get them started.

Christopher:    That's fantastic. I will of course be sure to link to everything that Sam mentioned in the show notes for this episode that you can find at nourishbalancethrive.com/podcast. Or if you poke around inside of your podcast tab, you'll surely find the hyperlinks to everything that Sam just mentioned. Can you just say that URL for us one more time?

Sam:    Yeah, it's phcuk.org.

Christopher:    Excellent. Is there anything else that I should have asked you or --

Sam:    No, I don't think so. I think we pretty much covered all the bases. I'm just really thankful for the organizer of today's event who is Dr. Jen Unwin. It's an event for the PHC. It was her whole idea to do all of this. I just want to give a shout-out to Jen for doing such a fantastic job.

Christopher:    She, herself, is a clinician, isn't she?

Sam:    Yeah, she's recently retired, but she's a clinical psychologist herself. She has done an amazing job today bringing so many people together.

Christopher:    She has. It's wonderful. Is this something that's going to happen -- I've seen this happen in Iceland where they do this amazing event. We're thinking that was just great. We're going to get to come to Iceland every year. Then you see the person that organized it next year. They've had a baby or something. It's like, there's so much work, and it's just not reasonable to expect anyone else to keep doing this every year. I'll ask the question anyway. Is this likely to become a yearly event so that if you missed it this year, you can come back next year?

Sam:    Yeah, I think so. Jen really wants to do it because she's retired now. She wants to contribute even more to the cause that she has done, that she has been involved with already. So, we're hoping it will actually be in annual event.

Christopher:    Excellent. Well, thank you so much for your time, Sam. Thank you to you and Jen for hosting the event. We very much appreciate you and surely we'll be back here next year. Thank you.

Sam:    Thank you very much, Chris.

[0:44:25]    End of Audio

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