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Diabetes is one of the leading causes of vision loss and blindness in adults. And who better to explain the connection between sight and diabetes than an ophthalmologist?
Dr. James Muecke has been working as an ophthalmologist in Adelaide, South Australia, for over 30 years. In 2020 he was named Australian of the Year for his work with the nonprofit, Sight for All.
Shortly before this honor, he began exploring the link between nutrition and eyesight. Now he is using his recognition to spread the message that losing vision to diabetes is not inevitable. Diabetes can be put into remission, and vision can be restored with the help of nutrition and lifestyle interventions.
James is currently working on a book that compiles the lessons learned through his work. During this episode, James shares some of his case studies and gives advice to anyone that might be concerned about their vision.
During our conversation, James mentions an image from one of his patients that improved her condition through diet changes. The top is the initial scan, and the bottom is one year later after therapeutic carbohydrate reduction. You can see the complete resolution of macular edema.
Listen in as James, and I chat about:
- How James became interested in nutrition
- The two impacts on the eye in people with diabetes
- Examples of cases where diet changes improved eyesight
- Recommendations for vision checks
- Barriers to lifestyle changes
- The connection between dementia and diabetes
Rather watch this episode on YouTube? Check it out here: Episode 260: Dr. James Muecke
Resources:
The Diabetes Code by Dr. Jason Fung
Connect with James:
Website: Sight For All
Instagram: @drjamesmuecke | @jsmuecke
Facebook: Dr. James Muecke
LinkedIn: Dr. James Muecke
Episode Credits:
Thank you to all who’ve made this show possible. Our hosts are Diana Rodgers and James Connolly. Our producer is Emily Soape. And, of course, we are grateful for our sponsors, Global Food Justice Alliance members, and listeners.
If you believe in making sure that people all over the world should have access to nutritious food, please join my mission through my non-profit, the Global Food Justice Alliance. All sustaining members get early access to ad-free podcasts plus free downloads, and you’ll be helping get healthy protein like meat, fish, and eggs to food-insecure kids. That’s sustainabledish.com/join.
A big thanks to the sponsor of today’s show, LMNT. Do you often suffer from headaches, muscle cramps, fatigue, or sleeplessness? It could be from an electrolyte deficiency, and drinking plain water may not be enough to replenish lost electrolytes. LMNT is a drink mix that has everything you need and nothing you don’t – no artificial ingredients, food coloring, gluten, fillers, or sugar!
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Transcript:
Diana Rodgers, RD
Welcome to the Sustainable Dish Podcast. I’m Diana Rodgers, a real food registered dietitian, author, and sustainability advocate. I co-host this podcast with James Connolly, who was a producer on my film Sacred Cow. I also founded the Global Food Justice Alliance, an initiative advocating for the inclusion of animal-source foods like meat, dairy, and eggs for a more nutritious, sustainable, and equitable worldwide food system. You can check it out and join me at global food justice.org. Thanks again for listening. And now, on to our show.
Diana Rodgers, RD
Welcome back to the podcast, everybody. Today I have with me Dr. James Muecke, which I just found out this last name means mosquito in German, so thank you for that. And I got to meet James when I was in Australia in April. Pran Yoganathan and James took me and my friend Kristen that I was traveling with out to lunch. It was so fun. And it was just lovely to meet you. And I wanted to kind of let everybody know all about you and what you’re up to. So thank you for your time today.
Dr. James Muecke
Oh, thanks, Diana. It was wonderful to meet you. You’re my heroes. And I’ve certainly read your wonderful book and follow all your blogs. So it’s great to be here on your podcast.
Diana Rodgers, RD
Yeah. So you are in Adelaide, Australia. Adelaide area. Correct.
Dr. James Muecke
Correct. And that is the capital of South Australia. Yeah.
Diana Rodgers, RD
Yeah. And you okay, and you’re an ophthalmologist, or Yeah, I wasn’t… do you have an active practice now? Or are you… have you moved on to other things at the moment? We were chatting about what you’re up to nowadays? And I couldn’t remember if you have an active practice these days?
Dr. James Muecke
Yeah, yeah, I actually have a neurological problem with my right hand, which is forcing me into an early retirement. In fact, I’m finishing up in about four weeks time. So coming to the end of my 33 year ophthalmic career 40 year medical career. So all sorts of interesting things ahead. I want to write a book actually.
Diana Rodgers, RD
Oh, excellent. And what is the book going to be on?
Dr. James Muecke
About what I’ve learned over the last three or four years about type two diabetes and the drivers of this epidemic that we’re facing worldwide and my solution to really turn around. So should be interesting. Lots of really fascinating findings.
Diana Rodgers, RD
And I should mention I’m a huge fan of your photography. You just got back from a trip. I actually used to teach black and white photography way, way back when I was a school teacher, and you have a good eye for composition. I just wanted to mention I was following your posts.
Dr. James Muecke
Thank you. Oh, that’s very nice. Yeah, we had a wonderful trip for my birthday, a few weeks ago. So we took a trip to Europe. And I went earlier to Ethiopia in March as part of my not-for-profit work or my nonprofit work, I think you call it and that was just one of the most extraordinary travel experiences and this amazing array of captivating things to photograph. It was just brilliant.
Diana Rodgers, RD
So let’s start with I mean, have you always been interested in nutrition and metabolic health? Is this something that’s a more recent interest of yours? How did this all happen?
Dr. James Muecke
Definitely more recent, I mean, as an ophthalmologist for 33 years, one of the main things so one of the things that we deal with every ophthalmologist deals with is the blinding complications of diabetes. And so I’ve been working with patients with diabetes, trying to prevent them going blind for 33 years. So it’s been an ongoing, it’s been an ongoing, very significant role of my practice and my business. And so this has been a sort of a world that I’ve lived in. But I only really ever saw myself as the guy at the end of the line trading the interstates complications of this disease. So it’s only more recently that I started to ponder the role of nutrition and diet and this is a condition and a thing. I think that really, really now that home for me was back in 2018. So about five years ago, I was undertaking a documentary with my son who is a budding filmmaker at the time. And I wanted to look at the experience of blindness, what it means to be blind. It’s so interesting, as someone who’s been involved in this space for so many years, decades, really, but not truly understanding what it means to be blind. And so I interviewed 10 people: four children who were born blind and their stories were absolutely fascinating, four elderly people who are slowly going blind at the end of their lives due to a condition called age-related macular degeneration, which is really set… My cuckoo clock going off there. Sorry about that. But Yeah, four people at the end of their lives going slowly blind. Macular degeneration is the leading cause of blindness in our countries and in Australia, and in the States. And then there were two people who suddenly went blind in the prime of their lives due to their diabetes. So diabetes is the leading cause of blindness amongst working age adults in the countries. And their stories were incredibly powerful, incredibly harrowing, particularly the story of Neil Hance, or who went to bed one evening at the age of 50, with normal sight and woke up the next morning blind in both eyes, and is still blind to this day. And the story was just so powerful, so harrowing, I actually ended up creating a TV commercial out of elements of the interview, which played nationally in in Australia back in late 2018, trying to encourage people with diabetes with all types of diabetes, not to neglect them or not, not to forget having their eyes checked. And from there, really, I started to think there’s going to be more to this than just doing what I’m doing. And you know, that was important to me to raise awareness about this, but then started just reading more deeply and reading books around diabetes, particularly type two diabetes. And I think one of the really pivotal books for me was was Jason Fungs Diabetes Code, where I actually learned that diabetes could not only be prevented – type two diabetes we’re talking about here, but also potentially put into remission. Just changing diets and that blew me away, that was not something I’d even knew I’d never learned about in medical school. My son who’s now in fifth year medical school, three years ago, and second year, he had an opportunity to do nutrition as an elective. So it’s not even compulsory in our major training grounds, nutrition. So extraordinary to think that and an extraordinary to learn that, as a doctor of that time, probably 36 years in medicine, not being aware that type two diabetes could potentially be put into remission, blew me away. Anyway, lo and behold, I had this incredible honor in early 2020 are being named Australian of the Year, because of my nonprofit work, which wasn’t about type two diabetes and advocacy and raising awareness. It was actually about fighting blindness in some very poor communities in Asia, Africa, also here in Australia, and particularly in our indigenous population. But I thought I wasn’t expecting to win the award, absolutely not. But if I did, perhaps what I should be doing is raising awareness and about the horrendous scenario that we are in with type two diabetes and a chronic disease epidemic. You know, being Australian of the year, our biggest health crisis is type two diabetes, this is what I should be doing. And so I launched myself into the space early 2020. And it’s been an all consuming, fascinating times challenging and stressful journey. And so I’ve been, I would say, it’s been 30-40 hours, every single week, my own time, committed to this, it’s been an incredible journey. So that’s how I’ve landed here in this world. And that’s what I’ll be writing my book about, because my learnings have been fascinating.
Diana Rodgers, RD
I think your story is fascinating, because I’ve met quite a few doctors from different disciplines that have decided to go deeper and look into you know, how did this even start in the first place? Because they spent much of their career treating the downstream effects of bad diet. And, you know, I can think of Dr. Pran Yoganthan, who, you know, he’s one of the few gastroenterologist who’s actually tackling nutrition. Think of that, you know, I have a gastroenterologist locally who, if he can’t diagnose them with celiac disease, there is no nothing he can tell them, other than take this medication. And so he sends them to me, you know, anyone with IBS, or Crohn’s or colitis, and I can usually, if not reverse it, or put it into remission, I can help it greatly, just with food, and it’s, um, you know, so now we have Gary Fekke, who’s, you know, sick and tired of amputations, what are we going to do about all these amputations and so he got interested in nutrition and now you. I think it might be interesting to back up briefly and just talk about how diabetes causes blindness because I think, you know, we hear in in the US, there are now lung cancer commercials on TV, and you see, you know, maybe an older person talking about you know, I wish that I had never started smoking and they’ve got like a trach scar or, you know, they talk about their lung cancer issues, but we don’t see anything about type two diabetes with, you know, all of the horrible things that can happen. So, again, on cigarette containers, there’s the warnings. But there’s not warnings on the back of a candy wrapper about amputations, dialysis, blindness, bedsores, all of these horrible things that can happen. And it is entirely preventable, and largely reversible if you catch it early enough. And so my understanding and I could be wrong is that it changes the blood flow to your eyes and makes your eyes produce smaller, like little capillaries that kind of bring the blood to the eye and kind of dilutes the blood flow. Is that kind of how it works?
Dr. James Muecke
Not exactly. Yeah, I’ll go into that in a bit more detail. But just yesterday, I was driving along home. And I passed two bus stops, both with coke ads. And yet, we’re still seeing motor vehicle accidents, you know, buckle up, all very important, of course, but we see nothing about raising awareness about the dangers of what we’re consuming these days. So in terms of complications of diabetes, and here, we’re talking again, about all types of diabetes, just bearing in mind that two diabetes makes up close to 90%, if not 90% of the cases around the world.
Diana Rodgers, RD
I do often, when I talk about diabetes, get type one people messaging me. So we were talking about all diabetes as it pertains to eye health, but then type two in the aspects of preventable lifestyle-related diabetes?
Dr. James Muecke
Absolutely. In fact, I believe they really should have two different names so that there is…
Diana Rodgers, RD
Yes, right?
Dr. James Muecke
Yes, so two main impacts on the eye. The first is we can see blockage of the fine blood vessels in the retina. So the retina for your viewers is the light sensitive layer of tissue that lines inside of the backs of our eyes. So we can see blockage of very fine blood vessels. And I can go more deeply into that if you want. But let’s just say blockage of blood vessels causing a lack of oxygen flow we call ischemia. And when we have areas of the retina, which are ischemic, there’s an interesting response, which is triggered, it’s almost like a healing response where we have abnormal new vessels, what we call neovascularisation, which basically just means new vessels neovascularisation, in essence, trying to heal those ischemic areas, and they’re fragile, and they can bleed. And the bleeding can be a small amount of bleeding, which might give rise to little floaters in the eyes as the blood cells get into the jelly which fills inside the back of the eye. Or it can be more dramatic. And suddenly, a whole cloud will appear in the vision in one eye. Or in the rare situation, fortunately, of the man I talked about earlier, where he had both eyes with massive bleeds, which took away the vision overnight, which is a very unusual story, of course. So that is what we call proliferative retinopathy. So a proliferation in the retina and pathology, the most common cause of vision loss, and blindness in diabetes is due to leakiness of the blood vessels, and specifically leakiness, all the blood vessels throughout the body, as a result of diabetes can become leaky. And you then get fluid, basically sugary water flowing out of the blood vessels into the central vision area of the retina in the eye, the macula. And that swelling of the macula tissues can cause distortion of vision, blurring of vision. And then ultimately, if it’s lifted progress, it can be blinding. And I unfortunately do have patients who are blind in one or both eyes as a result of that, because it’s not being picked up early enough. So those are the two main impacts. But you know, if the ischemia is so great, sometimes that can also result in incomplete for want of a better word death of the eye. And I have had as an eye surgeon had to remove people’s eyes as a result of complications of their diabetes. Can you imagine that? You talked about having to remove people’s feet and legs from gangrene due to diabetes. It’s it is a very disturbing experience. But what’s super exciting if you’re happy for me to just keep on?
Diana Rodgers, RD
Oh, yes, please. Yeah.
Dr. James Muecke
It’s part of this role, actually, that I had as Australian of the Year, I was invited to be on the National Diabetes strategy. And I was the only one of the entire working group to even mentioned the opportunity for remission of type two diabetes and I managed to get remission in that document for the first time ever. And then that was released in 2021. And once I was comfortable that that was in there. I then started having a chat to my patients. And I really initially just looked at my patients or just had chats with my patients who had sight-threatening complications of their diabetes. Everyone’s at risk, of course. But I really was just looking at the patients who were imminently at risk of losing vision who I was actively treating, and putting needles into their eye laser in their eyes. Yeah, it’s it’s quite confronting, as so just initially started chatting to that night, and I would say, of the first 100 that I spoke to, only one was even aware of their diabetes can be put into remission. So this is a critical conversation that was not even being had at the grassroots level with the nutritionists, dietitians, GPs, etc. I then wrote to the mutual GP of each particular patient, saying We explored this incredible opportunity to put the patient’s type two diabetes into remission. Unfortunately, most were ignored. Some of the GPs took it up often on the insistence of the patient. And then I started seeing patients come back. And I remember there was, I think, probably the first one that took it on board. His name was Bevan. So Bevan came back after he’d been to see the nutritionist that I’d recommended. And so he was having injections every 12 weeks in each eye. And he came back, I remember the first time he came back, and it came off his insulin. And then the next time he came back through your three months later, he was off all his medications. And I remember him saying, I’ve never felt so good. And he felt clear in his mind; he felt he was seeing better. And this was probably a couple of years ago now. And he’s now down to six monthly injections in each eye from initially having injections on a very regular basis. Through the three months, we now down to 12 month, six monthly, and I’m expecting in the next few months to actually get him off injections altogether, which is incredibly exciting thing. And I’m seeing this almost universally in my patients with not just type two diabetes because we know this is just a spectrum. And also patients who have pre-diabetes and other conditions which the diabetes is making it worse such as retinal vein occlusion, there’s a bunch of things that I’ve been dealing with. And so almost universally, I’m finding that the edema, the swelling of the macula is improving in patients once they start to change their diet. And we can talk about the recommendations there a little bit later. And just earlier this week, I had a patient who a couple of years ago, she put her diabetes into remission very quickly, she came off her insulin, within a couple of weeks. It was amazing. And to eat, and I’ve watched her macular edema, she wasn’t having injections. And just for again, for your listeners, the injections are a special antibody, which is injected into the vitreous the jelly inside the back of the eye to seal up those leaky blood vessels, talking about hopefully allowing this willing to reabsorb and the symptoms to improve or at least stabilize. So it’s amazing how it worked. It’s been a revolution for us ophthalmologists and our treatment of this disease. It’s been incredible. But what I think it’s almost, which is more exciting, is actually seeing this condition improve with a change of diet. And I’m almost universally, every patient who reduces their carb and seed oil intake, their sugar intake, we’re seeing this a reversal of their identities. And the one I mentioned who put her diabetes into remission within a couple of weeks. I would love to be able to share the image with you. But in fact, I can send it to if you like but two years ago where she had quite significant swelling of her macular edema. And I was borderline looking at starting injections for her. And now two years later that that’s completely dried up in both eyes as a result of her changing diet. And this has never been reported before. So I’m actually doing a number of case reports and case series about my patients, which hopefully be published soon because this is something we need to get out there. This is remission in action. And I think as an ophthalmologist, we have this incredible fortune of being able to look inside the eye. We can see the damage being done. And we can also see the damage reversing. So it’s super exciting. But you mentioned gastroenterologists. There is a gastroenterologist in Adelaide who just recently at a conference talked about reversal of fatty liver when he applied the same change in diet. We’re also seeing foot ulcers in patients with diabetes improving by changing diet and we think kidney function improving we’re seeing inflammatory joint problems improving we’re seeing mental health and and psychiatric complications improving. It’s across the board we’re seeing these improvements and yet it’s so hard to get this into mainstream. And again, you were talking earlier about you know, this we are in this Medicaid paradigm as a medical students, this was something that was not I was not aware of and but medical school and and the say postgraduate training for doctors is all about medicate medicating, not de-prescribing, de-medicating and travel was sponsored are researchers sponsored conferences are sponsored, you know, this is just become the norm. This Medicaid paradigm that means that, in essence, pretty much every doctor has a conflict of interest. And it’s a conflict of interest, which is… it’s benign, it’s people aren’t aware, but it simply means that you’re not exploring other opportunities to to change disease patterns, or to change progress of disease, such as type two diabetes.
Diana Rodgers, RD
Well, definitely send me that image because I am able, this is not only audio, but it’s also a video. And if we have permission from the patient, we can put it up on the YouTube channel. And I should also mention, James, as you know, for everyone who’s listening, he is watching my face as he’s describing all of this, and I do have a little bit of a horror look on my face as he’s describing this. And for some reason, anything to do with the eye… I wear contacts, and it took me a year to be able to actually put a contact in my eyeball. So the idea of an injection into the eye for me, like there is just no chance I would ever do LASIK surgery because I just there is nobody touching my eyes. So like as he’s describing this, I am having a very visceral reaction. So it’s a good thing I’m not an ophthalmologist.
Dr. James Muecke
It’s also an incentive not to have diabetes if you can avoid it, of course. But it’s I have some patients who are having monthly injections in…
Diana Rodgers, RD
Yes, I can’t even imagine. Can we talk a little bit? I’m just curious, you know, because I know that there are signs of fatty liver before, way before, you know full on type two diabetes happens. At what point do you start to see vision issues related to the swelling that you’re talking about related to metabolic issues? Like is this something that’s very late stage? I’m just kind of curious, like at what point do we start to really see the manifestations in people’s eyes.
Dr. James Muecke
So obviously, the core metabolic dysfunction is insulin resistance. And I’d say takes on average 13 years to develop Type Two Diabetes after you become insulin resistant, it’s in an adult, and children can happen in as little as two years. Now we are seeing it’s called diabetic retinopathy or diabetes-related eye disease may be preferable to some with we actually seen that now in children. Fortunately, it’s rare. And I’m not aware or and certainly haven’t seen any children who have lost vision, and certainly no one has gone blind as a result of their diabetes. But it’s disturbing. We’re now seeing children as young as three with type two diabetes, just when I was in medical school, maturity-onset diabetes was its name, are we now seeing it in children as young as three, which is unbelievable. We have an epidemic of type two diabetes in kids and babies. Extraordinary. So in terms of the high complication, so in general, about a third will have some form of either disease. And about a 10th of the total pool will have sight-threatening eye disease in Australia with about 100,000 people with sight-threatening eye disease at this very moment. So I can’t tell you exactly when it arises. And some people it rises earlier. Others a little later. The story I told you before about the man who woke up blind at the age of 50. He developed type two diabetes at the age of 26. So that was what 24 years later that he was blind in both eyes. But obviously that was weak if we’d looked into his eyes some years before 10, 15, 20 years before, we would almost have certainly seen some form of a diabetes related eye disease. And unfortunately, he wasn’t having his regular eye checks and what we know and again, looking at Australia, I’m not sure if this stats are in America, we have close to 2 million people with diabetes. Again, all types of diabetes, more than half probably well over half because a significant number of patients with type two who haven’t even been diagnosed yet and went to well over half are not having their regular eye checks and that’s why it’s become such a blinding problem in our society.
Diana Rodgers, RD
I don’t know what this because I wear contacts I go in once a year but I don’t know what the standard is for healthy people. With the recommendations or even, you know, a regular checkup with their GP if I know with pediatrics, my children always got, like just a vision check. But it was just a very simple, you know, can you see the letter E across the room kind of thing?
Dr. James Muecke
Yeah, yes, I can just briefly let you know about that. So generally what I would suggest and we have, again, great fortune in our countries of having access to optometrists. And once we reach our early 40s, most of us will need reading glasses. And that’s a great time to go and see an optometrist have an eye check, a vision check, which is essentially a screening opportunity and get a pair of reading glasses. And then if everything looks fine, then every couple of years is probably very wise. And the optometrist can pick up things like glaucoma, which is often called “the blinding thief of sight,” I think it’s sometimes called because it’d be like blood pressure, you don’t realize you have it, and it can slowly nibble away at your vision and ultimately can be a blinding disease. So Glaucoma is a really important one to pick up. And sometimes we the optometrists will pick up changes in the backs of the eyes, early changes, which are suspicious for diabetes have type two diabetes, particularly, and then recommended that their GP test their metabolic function. So with a patient with diabetes, if there’s no sign of a disease, we generally check them every couple of years. If there is early disease, we go then to yearly. But if it’s more serious than that, more threatening than that, we may see them every six months or three months. And then of course, there are patients a whole cohort of patients who are having treatment.
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Diana Rodgers, RD
So let’s talk about the landscape of how difficult it can be to talk about dietary change. I know that the dietetics community in Australia is very similar to America and Canada, in that, you know, we’re taught that a very large portion of the diet should be carbohydrates. And I know personally, if I ate that many carbohydrates, I would… I know that I would be type two diabetic today. But what sort of things? What sort of challenges have you seen in Australia, from your perspective over the last couple of years being someone relatively new to kind of crusading in this space?
Dr. James Muecke
Yes, so this was all this is all going to come into my book. But there’s a series of barriers. There’s a series of hurdles. And one of the really powerful ones is our Australian dietary guidelines, which really is based on your American tight US Dietary Guidelines. And they are a high carbohydrate eating recommendation, recommending up to 65% of our diet or calories should be carbohydrates, and down to 27.5% fats in our diet. If you realize that the core metabolic dysfunction is insulin resistance, as we mentioned before, then you are as a patient with type two diabetes unable to metabolize glucose coming into the body. So in that scenario, if you can’t metabolize glucose nor carbohydrates producing glucose, then you are in essence, carbohydrate intolerant. So the very last thing we should be doing is telling people with diabetes of any sort to consume more carbohydrates. Now in the defense of the Australian dietary guidelines, they say that they are for the average healthy Australian. They’re not for people with conditions or diseases. That then if you realize that their bodies such as diabetes, Australia is recommending people eat by the Australian with people with diabetes it by this rando dietary guidelines are college of GPs are recommending people eat by the Australian dietary guidelines and a number of other health associations are doing similar, then it’s just fueling this problem. So it’s quite extraordinary to me and yet, no one despite my advocacy, no one is shifting on this. And I’ve even met with the overseeing body that is the keeper of the guidelines. And even they won’t move the dietary guidelines 10 years later, under review at the moment, and 2024 is when we should be seeing the new guidelines come out now whether they’re going to shift away from this recommendation that you should consume so many carbohydrates. I don’t know. I think there’ll be some movement but it’s not going to do full circle which is what is needed for the majority of the population. Will you realize that in Australia, over two thirds of adults and a quarter of our kids are overweight or obese. I think now in the United States, 93% of people are metabolically unhealthy. We really need to look at and what we’re consuming. In fact, our poor diet is responsible for more disease and death and smoking, alcohol and inactivity combined. So this is where our focus should be. And it’s pretty disturbing to have meetings with our federal health minister, our state health ministers, and yet, we’re seeing very little movement on this. Fortunately, they’ve recently launched a parliamentary inquiry into diabetes, which finishes the submissions in date as the end of August. So there’s a number of us working busily on this to try and try and raise awareness and lobby the government to make some very important changes.
Diana Rodgers, RD
It’s so frustrating, because we know that people aren’t necessarily going to follow the guidelines anyway. But the guidelines should be right. You know, like, they should at least be like somewhat in the ballpark of correct for a guideline, and then you know, people are going off the rails. That’s their kind of, you know, but even the guidelines are, are completely crazy. When I was working in hospitals, the diabetic conscious diet was 250 grams of carbs a day.
Dr. James Muecke
No, exactly. And all of these bodies, if you look in the States and in Australia, hospitals, child care all the way through to aged care, military service, prisons, they all recommend eating by the Australian dietary guidelines, or the US Dietary Guidelines. It’s the very document, most people wouldn’t be aware, but they do inform health educators, health practitioners, health policymakers, even the food industry. And I’ve been quite vocal about the current Australian dietary guidelines being flawed, and they’re flawed because they continue to discourage the consumption of natural saturated fats, yet natural saturated fats have not been strongly linked to cardiovascular disease. They continue to encourage the consumption of margarines and seed oils. What are you euphemistically call vegetables. And yet, we know there’s plenty of evidence now that these are unhealthy, or these are not good for us. So and then the guidelines continue to discourage the eating of meat, and particularly red meat. And yet, once again, we know that the evidence for red meat causing any form of disease is very, very flimsy. So I have been been lobbying them for several years now saying, We can’t continue to demonize all of these products, because it’s certainly not helping, and possibly making things worse for us.
Diana Rodgers, RD
I wish I had taken more pictures of our lunch that we had at that lovely steak restaurant, where we were indulging in, I think, steak, mushrooms, butter. And there may have been a couple of glasses of wine as well. And, you know, that’s it’s just amazing that there’s been so many advances in so many other areas. And yet, we’re still really in the almost barbaric dark times of nutrition.
Dr. James Muecke
Absolutely. And again, there’s so many forces and so many forces working on this, to keep the status quo because it suits particularly the ultra processed food and sugary drinks industry. And they keep on polluting the literature with very, very, very weak science and often corrupted science. And it’s certainly not helping. And, you know, I often talk in my presentations about the fact that type two diabetes is largely preventable, how do we prevent it and we can avoid the whole conversation of vegan versus carnivore just by saying, you know, eating real food, avoiding added sugar, avoiding sugary drinks, avoiding refined carbohydrates as much as possible, certainly avoiding seed oils. And if we look at ultra processed through food, the key ingredients for many, if not most, ultra processed foods are sugar, refined carbs, particularly wheat flour, and seed oils. So if we avoid those substances and ultra process, they call them foods, but they’re not foods, they’re food like substances. If we avoided all of those, then the vast majority of us would be in a much, much healthier space. Now we’re looking at putting type two diabetes into remission. That’s a more hardline approach. But I think if if we all returned to eating primarily real food, and particularly avoiding these seed oils, that everything’s cooked in fried in these days, when we go to take away or going out for dinner, then surely we would be much, much healthier. And of course, there are other things that we you know, it’s important to mention as well, in terms of avoiding type two diabetes is, you know, getting a good night’s sleep. Exercise, yes is important, and particularly as we age, you know, to ensure that we don’t lose that muscle mass and the risk of sarcopenia with its risks of frailty, fragility force fractures. I also every I don’t have breakfast, so I practice intermittent fasting or time restricted eating And when you don’t have breakfast, you have a 16 hour window where you’re not eating and your insulin level drops quite, quite sharply. And insulin is actually a fat storage hormone. So if your insulin level drops, you’re actually able to mobilize fat from the stores. So that’s another thing that I do, you know, getting out into the morning sun, when I can and encourage that vitamin D production in the body, which is also helpful in proving our metabolic health. So there’s a number of things, you know, beyond diet that you can do to help facilitate this, but it really does start with a healthy diet. And often people change their diet in a lower carbohydrate, low seed oil approach, then they very quickly find that their mental and physical health improves. And we know there are studies that shows within 28 days when people who make those dietary changes, we can see improvement in all markers and metabolic health, what we call metabolic syndrome, in at least half of people independent of weight loss. So this is not related to weight loss. And three years ago, I’m embarrassed to say I found out that I had a fatty liver and then had a scan for some back discomfort. And that showed that I had a fatty liver. And it was amazing that to learn from a radiology colleague that and I’m not there’s no, I’m not casting any criticism against radiologists. But apparently, fatty liver is so common these days that some don’t even mentioned it, that’s if you picked up fatty liver on a scan, then that’s the first thing that we should feed back to the GP saying that this person has metabolic dysfunctional, we should actually do something about this and, and I at that very time, I had done it sugar detox, I dropped my refined carbs, I dropped my seed oils and ultra processed foods. And more recently, earlier this year, I had another scan and I have no fatty liver anymore, which is really exciting to know.
Diana Rodgers, RD
Yes, the liver is so resilient. And it’s easy to reverse things until they’ve gotten unless they’ve gotten super advanced. But it is possible. It’s never too late to, you know, I think there’s a lot of people, I’ve talked to a lot of people who maybe feel that, you know, it’s too late to make a change. And today is never too late to do.
Dr. James Muecke
You’re never too late ever. Exactly, yeah, even for people. And we know that there are people who aren’t able to put their diabetes type two diabetes into remission. But just by making those changes and seeing the improvement in their metabolic health, it can only be a good thing in terms of their risk of complications, and particularly their cardiovascular complications that the dementia, which unfortunately seeing 70% of patients now at type two. So I lost both of my parents, my mother earlier this year to dementia. And so this is a condition, a disease that impacts broadly on the entire family and beyond. And it’s not just something that impacts on the individual. And, gee, I wish more people were aware of what lay away if they allow their type two diabetes to progress.
Diana Rodgers, RD
Yeah, actually question about that. I know that the relationship between Alzheimer’s and blood sugar handling type two diabetes is strong. Is dementia also related as well?
Dr. James Muecke
Yeah, well, Alzheimers is a form of dementia.
Diana Rodgers, RD
Okay So yeah… so I didn’t know, if there were like two separate, like categories.
Dr. James Muecke
The forms of dementia, but this would be what we say vascular dementia, which is due to, again, the same patho physiological drivers that we talked about with the eye and the blockage of the blood vessels and the narrowing of the blood vessels. That’s also happening in the brain. It’s in fact happening throughout the body, hence, damage to the kidneys to find blood vessels in the kidneys, hence, impotence hence, damage to the fine nerves in our extremities. But we also get damaged to the large blood vessels as well. Hence, we can see gangrene due to blockage of the major blood vessels to the feet or legs. And that’s where heart attack and stroke also come in.
Diana Rodgers, RD
Well, how can people learn more about your upcoming book, the work you’re doing, your nonprofit everything?
Dr. James Muecke
Sure, well, there’s my nonprofit called Sight for All and there are a number of social media hashtags that have a Facebook site or Instagram site. I’m sure there’s YouTube and LinkedIn as well. But equally myself, Dr. James Muecke, you can search for me on Facebook, LinkedIn, and Instagram. I’m not on on Twitter. But yeah, so there’s and also you can certainly subscribe to the newsletter, sign up for the newsletter from our website, www.sightforall.org. If people are interested in the work we’re doing and it’s wonderful, I took this journey three years ago, I stepped I’m not away from sight for but just just stepped to the side a bit, which is great in terms of the organization able to really stand on its feet, which is fantastic. But it’s come back now full circle, because this journey I took to see that people could put type two diabetes into remission by reducing their carb intake and their seed oil intake and now starting to see the eye complications, reverse or at least improve. We’re now bringing this back into sight for all and our educational sessions. And it’s a very special thing to experience. And for me, as a medical practitioner of 40 years to see patients de-medicate and ultimately put their diabetes into remission is the most exciting thing I’ve been involved in. And I just wish all my colleagues would have this similar experience. And I know many GPs who really were getting disillusioned with their medical practice, who started to get involved in metabolic health and who’ve been able to put the patient’s type two into remission has been reinvigorated. And it’s certainly incredibly invigorating experience to be a part of this. And I feel very fortunate, in fact, my I mentioned early on that I have a neurological problem with my hand, which was really forcing me into is forcing me into an early retirement. But I’d arranged to retire some time ago. And I’ve just been a delay in finding someone to take over my practice. And in the meantime, I’ve been able to have this amazing experience with my patients. So it’s been very fortuitous and very fortunate for me to have had this truly life-changing experience.
Diana Rodgers, RD
Well, I look forward to coming back and hopefully partnering with you in the future. I fully support all the work that you’re doing. And it’s just really exciting to know that there are other people out there like me, who are questioning the dietary guidelines and all the standard recommendation and actually helping people reverse and prevent these awful lifestyle diseases that that they don’t think they can or they didn’t know they could. So thank you.
Dr. James Muecke
Yeah, and thank you for what you have done as well and to raise awareness about the importance of animal source foods in it not only for our own health, but the health of the environment and the planet.
Diana Rodgers, RD
Yes, thank you. Well have a wonderful day. And thanks again for your time.
Dr. James Muecke
Thank you, Diana.
Diana Rodgers, RD
Thanks so much for listening today and for following my work. If you believe in making sure that people all over the world should have access to nutritious food, please join my mission through my non-profit, the Global Food Justice Alliance. Visit sustainabledish.com/join and become a sustaining member today. All sustaining members get early access to ad-free podcasts plus free downloads, and you’ll be helping get healthy protein like meat, fish, and eggs to food-insecure kids. That’s sustainabledish.com/join. And thank you.
