Speaker 1: This is Alec Baldwin and you're listening to Here's the
Speaker 1: Thing from iHeart Radio, a chocolate chip cookie, a bite
Speaker 1: of Devil's Food cake, or a gigantic cup filled with
Speaker 1: your favorite soda. Sugar is a simple chemical compound, yet
Speaker 1: so powerful and so hard to refuse. The traditional advice
Speaker 1: about avoiding sugar seems simple put down the doughnut, but
Speaker 1: few people know how much the deck is being stacked
Speaker 1: against them. Food and beverage corporations spend billions of dollars
Speaker 1: to ensure their customers remain addicted to their products, which
Speaker 1: has contributed to an epic surge in type two diabetes.
Speaker 1: In order to reverse these rising rates, my guest today
Speaker 1: believes we need to embrace deep legislative and societal change.
Speaker 1: Physician and public health expert, doctor Dean Schillen is a
Speaker 1: professor of medicine at the University of California, San Francisco.
Speaker 1: He is the co founder of the UCSF Center for
Speaker 1: Vulnerable Populations. I was featured in the PBS documentary on
Speaker 1: Type two diabetes Blood Sugar Rising. As someone with type
Speaker 1: two diabetes, this issue hits close to home for me.
Speaker 1: I wanted to begin my conversation with doctor Schillinger, learning
Speaker 1: how he went from simply treating individual patients to calling
Speaker 1: for a public health war on diabetes.
Speaker 2: I work at San Francisco General Hospital, which is the
Speaker 2: city and County of San Francisco's public hospital, which is
Speaker 2: for the New Yorkers on the call, sort of like
Speaker 2: a small.
Speaker 3: Version of Bellevue.
Speaker 2: And if you had told me thirty years ago that
Speaker 2: I was going to become a specialist and expert in
Speaker 2: diabetes when I was coming out of medical school, I
Speaker 2: would have laughed at you. It was not something that
Speaker 2: I was interested in when I was training. And when
Speaker 2: I started out as a primary care physician general internest
Speaker 2: this Stan Africa General Hospital, I'd say about one out
Speaker 2: of fifteen of my patients had type two diabetes. And
Speaker 2: now I just think about the clinic that I had
Speaker 2: on Monday, one out of two of my patients has
Speaker 2: type two diabetes. So in one generation, we have seen
Speaker 2: an absolute explosion in type two diabetes in America, and
Speaker 2: that can't possibly be managed by endocrinologists. There just aren't
Speaker 2: enough of them on the planet. And truth be told,
Speaker 2: most of diabetes can be handled by family doctors.
Speaker 3: In general interness but it.
Speaker 2: Has become the proverbial bread and butter of my practice,
Speaker 2: and it has also led me to try to combat
Speaker 2: the illness not only in the clinic, but also outside
Speaker 2: in society, this diobetogenic society, to move the fight sort
Speaker 2: of beyond one patient at a time to sort of
Speaker 2: the general population.
Speaker 1: Where'd you grow up, where you from originally?
Speaker 3: I'm originally from Buffalo, New York.
Speaker 1: And where did you go unto grad?
Speaker 3: I went to Brown University.
Speaker 1: And where'd you go to medical school?
Speaker 2: University of Pennsylvania in Philadelphia, Which is interesting because the
Speaker 2: University of Pennsylvania in Philadelphia was home to the country's
Speaker 2: largest public hospital, Philadelphia General. But you know, it lost
Speaker 2: a lot of money, as you can imagine, and so
Speaker 2: they shut it down just a few years before I
Speaker 2: entered the medical school, And so I had never had
Speaker 2: exposure to working in a public hospital as a medical student.
Speaker 2: And you talk about the high level hospitals that New
Speaker 2: York and San Francisco have, and that indeed is true.
Speaker 2: But until you've worked in a public hospital, you don't
Speaker 2: realize the fact that we really operate in a two
Speaker 2: tier medical system, and that a lot of the consequences
Speaker 2: of our social ills end up at the door of
Speaker 2: public hospitals. So if you're only working in private hospitals
Speaker 2: or nonprofit hospitals, you don't see what's really going on
Speaker 2: in society until you set foot in a public hospital.
Speaker 2: And it's really it's transformative as a clinician. And what
Speaker 2: I try I have been trying to do in the
Speaker 2: last few decades, has been to share the stories that
Speaker 2: I've been witnessed to in the public hospitals to the
Speaker 2: general public so we can begin to understand how public
Speaker 2: health happens or doesn't happen in this country. And that's
Speaker 2: sort of what you saw in Blood Sugar Rising.
Speaker 1: And the fundamental difference between the two is what.
Speaker 2: Well, the fundamental difference between the two is the burden
Speaker 2: of disease that we see in low income communities and
Speaker 2: people of color far outstrips that which we see in
Speaker 2: the private hospital. So the reason that the waiting rooms
Speaker 2: are so packed in public hospitals is not just because
Speaker 2: we don't have enough doctors and nurses, but because the
Speaker 2: demand for healthcare is so logarithmically exponentially higher because of
Speaker 2: the burden of disease that comes with poverty. Think about
Speaker 2: what it's like to be a poor person working two jobs,
Speaker 2: the stress that they have in their daily lives, and
Speaker 2: all that is around them in the every corner store,
Speaker 2: every advertisement, every billboard is pushing the food that you
Speaker 2: appropriately described is causing your diabetes. And it's the same
Speaker 2: for people who are poor but really on steroids, no
Speaker 2: pun intended.
Speaker 1: Well, what's interesting to me? You know, I'm some and
Speaker 1: this is just my belief that when you abuse alcohol,
Speaker 1: when you wake up in the morning and you look
Speaker 1: at yourself, you don't like what you see. Maybe if
Speaker 1: you smoke too much, you know it's wrong. Sugar is
Speaker 1: something that is indoctrinated into our lives from day one.
Speaker 1: We have appended the consumption of some sugary product with
Speaker 1: nearly everything we do. Birthday caicks. You don't have a
Speaker 1: birthday salad, you have a birthday cake. Everything has their
Speaker 1: designated sweets.
Speaker 2: I mean, the holiday is just that it's a holy
Speaker 2: day and we are meant to celebrate it as a
Speaker 2: very special and unique day in the year for whatever ritual,
Speaker 2: whatever reason, And so the introduction of sweets into that
Speaker 2: holiday was a signal, a symbol of the sweetness of
Speaker 2: life that we celebrate or whatever the memory is that
Speaker 2: we're trying to celebrate. And you're absolutely right that what
Speaker 2: the food industry and the hallmark industry has done is
Speaker 2: take this natural joy we feel when we consume added
Speaker 2: sugar and essentially make it such that every meal now
Speaker 2: has to have that endorphin and dopamine rush experience that
Speaker 2: we used to only experience two or three times a year.
Speaker 2: And what we've learned increasingly from both basic science and
Speaker 2: behavioral science, is that added sugar, particularly liquid added sugar
Speaker 2: in the form of sugar sweetened beverages.
Speaker 3: Are addictive.
Speaker 2: They have all the characteristics in terms of brain response
Speaker 2: that we see with alcohol, cocaine, etc. And I am
Speaker 2: not exaggerating when I say this. The cravings, the joy,
Speaker 2: the withdrawal, all of these things the food chemists have
Speaker 2: learned and have then implemented into marketing strategies and distribution strategies.
Speaker 2: And for those who are under stress or depressed or
Speaker 2: down and need to pick me up, this is the
Speaker 2: perfect drug. And the modern food system has trained, has
Speaker 2: formed itself, to deliver high doses of added sugar, particular
Speaker 2: liquid sugar on an ongoing basis and we create the
Speaker 2: false belief that this is part of our culture, and
Speaker 2: I think that it indeed is, but it's based on
Speaker 2: a model of addiction and the corporate takeover of the
Speaker 2: food system by harnessing the addictive properties of their foods.
Speaker 2: It's not a level playing field. Your body has natural
Speaker 2: hormones and chemical messages that say my appetite is satisfied,
Speaker 2: I'm going to stop eating. But the food chemists have
Speaker 2: created foods that do not stimulate the appetite suppressant hormone.
Speaker 2: I mean specifically that so that we're being played, so
Speaker 2: that you feel that you and your willpower are inadequate
Speaker 2: in terms of your question as to when we should
Speaker 2: be screened. This is highly controversial, and I can tell
Speaker 2: you what I do in my practice and my practices,
Speaker 2: I take care of low income people who have a
Speaker 2: very high point revalence of type two diabetes. If you
Speaker 2: take the average adult who is a person of color
Speaker 2: in the United States, there's about a twenty twenty five
Speaker 2: percent chance that that person off the street's going.
Speaker 3: To have diabetes at one age.
Speaker 2: That's the average age, so we're talking about in their fifties.
Speaker 2: But we see the incidence of diabetes occurring younger and younger,
Speaker 2: and particularly in people of color. In fact, we're seeing
Speaker 2: it now in children. We're seeing type two diabetes emerge.
Speaker 2: If I had said twenty five years ago, I've got
Speaker 2: a child with type two by diabetes as supposed to
Speaker 2: type one, people would you know, laugh me off the stage.
Speaker 2: But now this is this is just an everyday phenomenon,
Speaker 2: and the rates of type two diabetes and children of
Speaker 2: color has gone up three four fold over the last decade.
Speaker 1: The young man you see in the film who you're
Speaker 1: taking care of, the black guy who's going to be
Speaker 1: lose his foot, Yeah, Montille, Montille. Now he looks pretty
Speaker 1: whippity and pretty lean. So I'm assuming you don't have
Speaker 1: to be morbidly obese to qualify for this.
Speaker 2: Correct, That's absolutely true. I think there is a there.
Speaker 2: Of course, obesity and high BMI is a risk factor
Speaker 2: for the development of type two diabetes. But I have
Speaker 2: plenty of patients, particularly young patients, who have type two
Speaker 2: diabetes who are not overweight. So yes, he developed diabetes
Speaker 2: in his late twenties. He was born in poverty and
Speaker 2: raised in poverty, severe food and security. He grew up
Speaker 2: eating what he told me were syrup sandwiches, which is
Speaker 2: syrup put in between two pieces of wonderbread. For much
Speaker 2: of his childhood, his father was incarcerated. He raised himself
Speaker 2: and his younger brother, and they would drink you know,
Speaker 2: high Sea and the fruit, you know, the powder mixes
Speaker 2: of sugar, sweet and beverages, three meals a day. So
Speaker 2: he was really addicted, if you will, but also overly
Speaker 2: exposed to added sugar, particular liquid sugar. And in his
Speaker 2: twenties he came in at a diabetic coma. And you know,
Speaker 2: in the old days, we would have thought that was
Speaker 2: type one diabetes, the so called autoimmune disease where you
Speaker 2: you know, children, juvenile onset diabetes, where the body attacks itself,
Speaker 2: you know, the pancreas stops producing insulin. But what we're
Speaker 2: seeing now in these younger people is type two diabetes,
Speaker 2: which I like to think of as the body politic
Speaker 2: attacking the child or the young person. It's not the
Speaker 2: body attacking itself, it's our society attacking the body of
Speaker 2: that young person. And that's what happened with Montille, and
Speaker 2: he has suffered all of the consequences of uncontrolled type
Speaker 2: two diabetes. He's now forty, and he just sustained another amputation.
Speaker 1: The sugar consumption in my family as a child was habitual.
Speaker 1: My mother was diabetically. Yeah, it was diabetic, and she
Speaker 1: did had no amputations. But she was really very sick
Speaker 1: from diabetes for many, many years.
Speaker 3: But how old was she when she developed diabetes? I'm
Speaker 3: interested to her.
Speaker 1: I would say that she was identified and treated when
Speaker 1: she was She died at ninety two last year.
Speaker 3: Do you remember how old she was when she was sixty?
Speaker 1: I'd say, okay, probably sixty.
Speaker 2: Yeah, it's interesting because you would say to your doctor,
Speaker 2: I have a family history of diabetes. It's interesting. Many
Speaker 2: of my patients say, oh, this is happening because of
Speaker 2: my genetics. I have a family history of diabetes. And
Speaker 2: I say, well, that's interesting. How old was your grandmother
Speaker 2: when she got diabetes? Oh she was eighty okay.
Speaker 3: And how old was your mother when she got diabetes?
Speaker 2: She was seventy. And how old are you now? Oh,
Speaker 2: I'm forty five. And how about your son who has diabetes?
Speaker 2: Oh he's twenty one. I have patients who tell me
Speaker 2: the story and so say, yeah, you have a family history.
Speaker 2: We are all vulnerable to getting diabetes. But your history
Speaker 2: went from ninety to seventy to fifty to thirty. And
Speaker 2: it's very different to have diabetes at a young age
Speaker 2: than it is to have an old age. And so
Speaker 2: something has gone on in our environment, something pathologic has
Speaker 2: gone on our environment. To unmask this nearly human, universal
Speaker 2: human tendency, we have to acquire diabetes such that it's
Speaker 2: happening at younger and younger ages, with tremendous implications for
Speaker 2: work productivity, raising a family, sexual activity, you know, and
Speaker 2: all of those things. And so it's really you know,
Speaker 2: in the context of the COVID pandemic, of course that's
Speaker 2: gotten all the intention. But what's happening at a much
Speaker 2: more chronic, slow growing, and insidious pace is the diabetes epidemic.
Speaker 2: And the two of them together, of course, were a disaster,
Speaker 2: you know, the so called syndemic of having diabetes making
Speaker 2: you much more likely to die of COVID than you
Speaker 2: see how these two things interact with each other. So
Speaker 2: it's a very important national urgent problem. And you know,
Speaker 2: we've recently had some federal policy work around this that
Speaker 2: I hope will change the conversation such as well, the
Speaker 2: conversation is focused very much on you know what you
Speaker 2: and I have been talking about, which is people's individual
Speaker 2: choices that they make in their day to day lives,
Speaker 2: right the intimates and donuts that your mother served you
Speaker 2: and that you enjoyed. Really much of this exposure is
Speaker 2: occurring in the context of federal policy that in many
Speaker 2: ways promotes the diabetes epidemic.
Speaker 3: Let's take, for.
Speaker 2: Example, the most important nutrition assistance program, the SNAP Program
Speaker 2: Supplemental Nutrition Assistance Program formerly known as food stamps. Something
Speaker 2: like forty forty five million individuals receive SNAP benefits every year,
Speaker 2: and because of the efforts of the junk food industry
Speaker 2: in particular, we have never been able to actually make
Speaker 2: that a nutrition assistance program. Rather, what it is is
Speaker 2: it gives people a little bit of money to buy food,
Speaker 2: including junk food. So last year we spent maybe eighty
Speaker 2: billion dollars on providing SNAP benefits to low income America.
Speaker 2: It's very important program to reduce poverty and food and security.
Speaker 2: Four billion dollars four billion of the eighty billion was
Speaker 2: spent only on sugar, sweet and beverages.
Speaker 1: And any attempts we've made to attach restrictions to that
Speaker 1: money have been rebuffed by even civil rights activists who
Speaker 1: are saying, don't tell us what.
Speaker 3: To eat, right.
Speaker 2: We have the misconception that this freedom to eat in
Speaker 2: some way restricts our freedom of life. And you know,
Speaker 2: we're not saying you can't drink a sugar sweet and beverage.
Speaker 2: What we're saying is that the government funding should not
Speaker 2: be used in a nutrition assistance program. And just by
Speaker 2: way of comparison, with the four billion dollars in that
Speaker 2: same year, the CDC would have spent six hundred million
Speaker 2: dollars on all chronic diseases in America.
Speaker 3: So what is that like?
Speaker 2: A sevenfold greater expenditure on sugar sweet and beverages than
Speaker 2: the prevention of all chronic diseases.
Speaker 1: Doctor Dean Schillinger. If you enjoy conversations on public health,
Speaker 1: check out my episode with doctor Robert Lustig, a pediatric
Speaker 1: endocrinologist who studied the link between sugar and childhood obesity.
Speaker 4: Sixteen percent of all of the corn grown in America
Speaker 4: today ends up as high fructose corn syrup. We have
Speaker 4: boatloads of it, and it's cheap, and because it's cheap,
Speaker 4: it started finding its way into things that never had
Speaker 4: sugar before. Like hamburger buns, hamburger meat, barbecue, sauce, ketchup, salad, dressing.
Speaker 4: I mean pretty much everything you can imagine in the store. Indeed,
Speaker 4: Barry Popkin at the University of North Carolina has just
Speaker 4: done a study that shows that eighty percent of the
Speaker 4: food items there are six hundred thousand food items in America,
Speaker 4: eighty percent of them relays with sugar added sugar.
Speaker 1: To hear more of my conversation with doctor Lustig, go
Speaker 1: to Here's Thething dot org. After the break, Doctor Dean
Speaker 1: Schillinger shares how conflicts of interest in scientific studies and
Speaker 1: lobbying prevent change from within the sugar industry. I'm Alec Baldwin,
Speaker 1: and you're listening to Here's the Thing. Doctor Dean Schillinger
Speaker 1: served as a co chair of a federal Advisory Commission
Speaker 1: on Diabetes policy and Chief Medical Officer for Diabetes Prevention
Speaker 1: for the State of care California, among many other high
Speaker 1: profile appointments. I wanted to learn about his approach to
Speaker 1: advising elected officials and trying to bring about real legislative change.
Speaker 2: You know, we've gotten to the point now where one
Speaker 2: in seven adults on average has diabetes in America one
Speaker 2: in seven, and in communities of color, it's, like I said,
Speaker 2: one in four, sometimes one in three. We can't avoid
Speaker 2: hearing stories of the consequences of diabetes. And what I've realized,
Speaker 2: I've stopped giving talks on the statistics and the p
Speaker 2: values and the you know, and graphs, and I've just
Speaker 2: started telling real stories from my own practice that sort
Speaker 2: of give people a wake up call around like this
Speaker 2: is like really important shit here. These aren't just numbers.
Speaker 2: And this sort of happened to me when I was
Speaker 2: working as chief of the diabetes Prevention Control Program in
Speaker 2: the state of California. So when I started the job
Speaker 2: in two thousand and eight, two and a half million
Speaker 2: Californians had diabetes, and when I left twenty thirteen to
Speaker 2: four million Californians had diabetes.
Speaker 3: So I'm like, gee, I did a great job, right,
Speaker 3: what a fantastic job I did.
Speaker 2: And the reason I wasn't able to do my job
Speaker 2: is I couldn't get into the heads of legislators how
Speaker 2: important this was. And then I quickly learned, probably too late,
Speaker 2: that I needed to tell them real stories. And the
Speaker 2: story that I told them then and I've told another
Speaker 2: regulatory in policy settings was a story of Melanie, a
Speaker 2: lovely forty year old African American woman who had developed
Speaker 2: diabetes just like Montelle in her late twenties and had
Speaker 2: been addicted to a number of things, smoking cocaine, sugar
Speaker 2: sweeten beverages, but the addiction she could not kick. With
Speaker 2: sugar sweeten beverages, she loved seven ups. She just could
Speaker 2: not give up the seven up and she was desperate.
Speaker 2: And I remember on her fortieth birthday, I came into
Speaker 2: clinic and I saw her hospital card, like, it's your
Speaker 2: fortieth birthday, Why are you here? You should be celebrating,
Speaker 2: And she said, oh, don't worry. You know, my girlfriend
Speaker 2: going to take me tomorrow to the water park, my
Speaker 2: favorite thing to do. I'm going to go to the
Speaker 2: water park and do the water slides. I haven't done
Speaker 2: it in fifteen years. I was like, oh, that sounds
Speaker 2: like a great birthday. And then a couple months later,
Speaker 2: at her follow up appointment, she didn't show, but her
Speaker 2: girlfriend showed and I said, where's Melanie And she said
Speaker 2: I it was horrible. We went to the water park
Speaker 2: and you know Melanie who can't feel her feet because
Speaker 2: of her. The nerve damage from the diabetes burnt the
Speaker 2: bottom of her feet while she was standing on the
Speaker 2: hot staircase, and she developed gangreen in both feet, hospitalized
Speaker 2: and had amputations, and then the gangreen spread to her
Speaker 2: body and she died. And this is what I learned,
Speaker 2: you know, at her follow up visit.
Speaker 1: And for those people that don't know, for those people
Speaker 1: who don't have a real sense of the diabetic neuropathy
Speaker 1: where and for some of my friends, that neuropathy came
Speaker 1: on in somewhat rapid surges.
Speaker 3: Yeah.
Speaker 1: I had friends of mine who had along that outer
Speaker 1: pad of your foot, the balls of the feed and
Speaker 1: then the heel. They had a neuropathy like sensation for
Speaker 1: an extended period of time, like let's say a year,
Speaker 1: and they felt the tingling right, and then all of
Speaker 1: a sudden, it seemed like they told me, like overnight
Speaker 1: he went to burning and numbness.
Speaker 3: And then numbness. Yeah.
Speaker 2: You know, the statistic that I think is most compelling is,
Speaker 2: you know, we think of amputees, We think of soldiers, right,
Speaker 2: we think of the Iraq War and IEDs and people
Speaker 2: getting their leg blown off, and that indeed happened in
Speaker 2: the fifteen years of that conflict, twenty five hundred soldiers
Speaker 2: lost a limb and it's a catastrophe. It's devastating. In
Speaker 2: that same period of time, one million people with diabetes
Speaker 2: in the United States lost a limb. And we think
Speaker 2: of amputation as like this most catastrophic thing, but it
Speaker 2: is happening. If you go into low income neighborhoods, you
Speaker 2: see people in wheelchairs. Why are they in wheelchairs? They've
Speaker 2: lost a limb. So I mean, at some point, and
Speaker 2: I think we've hit this point, the discourse begins to
Speaker 2: change around, just like we saw with tobacco use, that
Speaker 2: maybe this is something we need to do in moderation,
Speaker 2: and we have to recognize it's not only we who
Speaker 2: have to change, it's the businesses that are pushing this
Speaker 2: at us that need to change.
Speaker 1: I was told by people years ago when I was
Speaker 1: more active on an ongoing basis in advocacy work in
Speaker 1: the nineties and so forth, the sugar lobby is like borderline,
Speaker 1: like the Mediine cartel. You know, the biggest sugar producer
Speaker 1: I was in Brazil. The great families that are some
Speaker 1: of them Cuban expatriates in the Miami area Great Miami
Speaker 1: Fortunes logged countless millions of dollars in federal subsidies for
Speaker 1: these products. You know, it's almost like they look at
Speaker 1: sugar like oil, Like if we don't have a steady
Speaker 1: supply of this stuff, the country is going to grind
Speaker 1: to a halt. You know, sugar is a heavily What
Speaker 1: do you think about that? In terms of this idea,
Speaker 1: people was talking about putting warnings on candy labels.
Speaker 2: Yeah, I think this is a critical, critical issue. The
Speaker 2: outsized influence in this case of the American Beverage Association,
Speaker 2: which is, you know, in cahoots with the sugar industry.
Speaker 2: It's part of it, and I mean I've had firsthand
Speaker 2: experiences with them.
Speaker 3: I'll give you example.
Speaker 2: So in twenty fifteen, the City and County of San
Speaker 2: Francisco passed an ordinance because we've had this explosion of diabetes,
Speaker 2: that would place warning labels on billboards that advertise sugar,
Speaker 2: sweet and beverages, you know, warning consuming one or more
Speaker 2: of these. The City County of San Francisco that consuming
Speaker 2: one or more of these may contribute to OBEs, diabetes,
Speaker 2: tooth decay, and heart disease.
Speaker 3: Pretty reasonable and this went to court.
Speaker 2: The American Beverage Association sued the city and county for
Speaker 2: breach of their First Amendment rights, so called compelling their
Speaker 2: free speech making them say something that they claimed was misleading,
Speaker 2: scientifically false, and controversial.
Speaker 3: And so this went to of all places.
Speaker 2: Of federal court, the Ninth Circuit Court because it's a
Speaker 2: constitutional case.
Speaker 1: And who were the litigants again, the the.
Speaker 2: American Beverage Association, the City and County of San Francisco
Speaker 2: to plaintiff with you. And so I was asked to
Speaker 2: be the expert scientist to develop a report around, Okay,
Speaker 2: is this warning actually scientifically factual? And I provided that
Speaker 2: report and that case was one but was interesting. In
Speaker 2: the research that I was doing to try to determine
Speaker 2: whether sugar, sweet and beverages were causally associated with these outcomes,
Speaker 2: something sort of interesting happened, which is about half of
Speaker 2: the studies showed that, yes, there is a causal relationship
Speaker 2: between these products and these outcomes, but half of them
Speaker 2: found no effect. I would say fifty to fifty was
Speaker 2: kind of, you know, coincidental. And so after that court
Speaker 2: case happened, I went back and I very carefully went
Speaker 2: through the funding sources of each of these studies there
Speaker 2: were something like sixty studies in a fifteen year period,
Speaker 2: and looked at the funding sources of the scientists who
Speaker 2: had written those coursers. And as it turned out, not
Speaker 2: surprisingly those studies that were funded in some way by
Speaker 2: the American Beverage Association or the scientists had been sent
Speaker 2: on trips to Hawaii or whatever. It was almost universally,
Speaker 2: with only one exception, thirty three out of thirty four
Speaker 2: found no association between their product. No diabetes is zero, right,
Speaker 2: And every study that was independently funded founded, and so
Speaker 2: the likelihood of having an association found if you were
Speaker 2: funded by the industry was basically zero.
Speaker 3: And so I wrote up these findings because that, I mean, everybody.
Speaker 2: Knows there's conflicts of interest, right the chemical industry and
Speaker 2: the tobacco industry. But this strength of the conflict of
Speaker 2: interest essentially entirely determining the result of the study, showed
Speaker 2: how the industry controlling the scientists, controlling and hijacking science itself.
Speaker 2: Being on the editorial boards of nutrition journals, for example.
Speaker 3: Really was unprecedented.
Speaker 2: And so I wrote this up in the Anamals of
Speaker 2: Internal medicine, and needless to say, the American Beverage Association
Speaker 2: responded immediately and quote a scathing letter to the editor
Speaker 2: saying that Okay, yeah, he claims doctor Schellinger claims that
Speaker 2: there are conflicts of interest at play here. He needs
Speaker 2: to understand that they are intellectual conflicts of interest that
Speaker 2: he is subject to. In other words, saying, I somehow
Speaker 2: religiously believe that sugar sweeten beverages are cause of diabetes,
Speaker 2: and therefore that belief is a conflict of interest that
Speaker 2: undermines the scientific study that I did, and intellectual conflicts
Speaker 2: of interest.
Speaker 3: The last time I saw.
Speaker 2: That raised was when the tobacco industry, you know, went
Speaker 2: against the scientists who found the relationship between tobacco and
Speaker 2: lung cancer. So then about a year later, two years later,
Speaker 2: a study came out in that same journal, the Annals
Speaker 2: of Internal Medicine, that claimed that all of the national
Speaker 2: guidelines internationally that said that we should have less than
Speaker 2: ten percent of our caloric consumption from added sugars are fraudulent,
Speaker 2: They're bad science.
Speaker 3: You know.
Speaker 2: It was a very well done systematic review funded by
Speaker 2: the International Life Science Institute, which is the Americ Beverage Association, Snickers,
Speaker 2: Mars Bar, all of these people. And I was asked
Speaker 2: to write an editorial about this study, and I basically
Speaker 2: called them out in the editorial, and then The Atlantic
Speaker 2: Monthly said, well, wow, what's going on with this sugar controversy.
Speaker 2: We're going to have a story about the sugar controversy,
Speaker 2: and they interviewed me, and they interviewed the editor of
Speaker 2: the Anamals of Internal Medicine, an esteemed physician colleague of mine,
Speaker 2: and they said, you know what, why did you publish
Speaker 2: this study funded by the Beverage Association? And she said, well,
Speaker 2: I felt like it was really important to have two
Speaker 2: sides of the story. And I learned that yes, there
Speaker 2: are financial conflicts of interests, but they're also intellectual conflicts
Speaker 2: of interest. So this idea of intellectual conflicts of interest
Speaker 2: is being pushed by the industry and is finding its
Speaker 2: way into scientific discourse and really creating another mechanism for disinformation.
Speaker 1: Now, in the time we have left, I wanted to
Speaker 1: highlight the fact that your wife is a public interest
Speaker 1: attorney who serves a director of the Program and Advocacy
Speaker 1: at Bay Area Legal Aid. So both of you did
Speaker 1: your wife's and your own public service mindedness, your civic mindedness,
Speaker 1: your commitment to helping the less fortunate. Is that a
Speaker 1: glue that drew you to your wife, something you admired
Speaker 1: about her?
Speaker 2: Yeah, absolutely, it's something that I think she's been an
Speaker 2: inspiration for me. She I mean, we often joke that
Speaker 2: we serve the same clients, you know, and I'm trying
Speaker 2: to promote their health and she's trying to promote their rights,
Speaker 2: and in some cases we have shared clients coincidentally.
Speaker 1: That's funny.
Speaker 2: But I grew up in a public housing project actually
Speaker 2: in Buffalo in my early years, and I saw what
Speaker 2: poverty was like, and then we came out of that,
Speaker 2: and I saw how different life was for me, you know,
Speaker 2: once we had some money, and how that impacted my health.
Speaker 2: On the other side of my family, my uncle was
Speaker 2: running science education for UNESCO in Paris, and my aunt
Speaker 2: was a radio broadcaster in Israel for Colistrael. And so
Speaker 2: this idea of communication and science and health all sort
Speaker 2: of I think I grew up with somehow, and so
Speaker 2: I'm able now to try to harness science and communication
Speaker 2: to make the world a better place. And it's extremely gratifying.
Speaker 2: To be able to work in a public hospital where
Speaker 2: you're working side by side with others who.
Speaker 3: Who they're not in for the money. I mean we
Speaker 3: get paid, we get.
Speaker 2: Well paid, but really get to see their efforts returned.
Speaker 3: You know, so many times.
Speaker 1: Over, Doctor Dean Schillinger. If you're enjoying this conversation, tell
Speaker 1: a friend and be sure to follow Here's the Thing
Speaker 1: on the iHeartRadio app, Spotify or wherever you get your podcasts.
Speaker 1: When we come back, doctor Dean Schillinger shares the most
Speaker 1: important change you can make to help fight diabetes. I'm
Speaker 1: Alec Baldwin and you're listening to Here's the Thing. Doctor
Speaker 1: Dean Schillinger co founded a nonprofit campaign, The Bigger Picture,
Speaker 1: to help young people of color tell their stories about diabetes.
Speaker 1: They share how the issue affects their families, their communities,
Speaker 1: and themselves through poetry, song and film. I wanted to
Speaker 1: know what was behind the campaign and how it might
Speaker 1: change the public perception surrounding sugar. Well.
Speaker 2: I mean, I think there are two parts of the
Speaker 2: conversation about diabetes. The first part is the individual patient right,
Speaker 2: get your A one C, get tested, treat your diabetes,
Speaker 2: eat right, exercise, I think we do a really good
Speaker 2: job of that in the United States. The American Diabetes
Speaker 2: Association is front and center where we don't have the megaphone. However,
Speaker 2: is ref framing the conversation about diabetes to be not
Speaker 2: just a biomedical problem at the individual level, but that
Speaker 2: it is a societal problem.
Speaker 3: That needs societal fixes.
Speaker 2: And that's where this Bigger Picture campaign, with these young
Speaker 2: poets of color basically speaking truth to power about what's
Speaker 2: going on, has really changed the conversation away from this
Speaker 2: individual blame and shame kind of narrative to actually, we're
Speaker 2: kind of being victimized here, and it's not just people
Speaker 2: of color being victim but we're all being victimized by
Speaker 2: these insidious practices around the food industry. And this requires
Speaker 2: a movement alec if we are going to change the
Speaker 2: course of the epidemic, and we've begun to see that.
Speaker 2: As I mentioned earlier, it's going to require a social movement.
Speaker 2: And you know that the impact of these young people
Speaker 2: in the Bigger Picture campaign, when they get in front
Speaker 2: of policymakers and bang out a poem in front of them,
Speaker 2: far outstrips the impact that I've been able to make
Speaker 2: as and so.
Speaker 1: I wouldn't have thought that.
Speaker 2: I think bringing together the arts and public health in
Speaker 2: terms of a megaphone around changing the conversation around diabetes
Speaker 2: to be reframed as a social problem that we can
Speaker 2: get our arms around. Is where the money should be.
Speaker 2: It's where the money is. So it's where the money
Speaker 2: should be. And I mean, you have a tremendous megaphone
Speaker 2: at your disposal, and I hope you use it in
Speaker 2: that regard. But there are many gifted members, particularly of
Speaker 2: disproportionately affected communities, who can do a much better job
Speaker 2: representing the experiences of individuals and communities more than the
Speaker 2: public health expert can. So bringing together the public health
Speaker 2: experts with vocal community members, who's.
Speaker 1: Doing the talking and who's delivering the message exactly?
Speaker 3: And what is that message? Yeah, I mean my message.
Speaker 2: If I had said, oh, go do a diabetes campaign,
Speaker 2: it probably would have been far less effective than what
Speaker 2: you heard Obassi Davis and Joker Rosco's say.
Speaker 3: In their poems.
Speaker 2: Joker Orosco's poem, you know he's a kid who grew
Speaker 2: up in Central Valley of California, which is, you know,
Speaker 2: the fruit basket of the world, world growing fruits and vegetables,
Speaker 2: and all the kids exposed to his junk food. He
Speaker 2: can't you know, his family's farming the Bounty of America
Speaker 2: and everywhere in Stockton is just junk food, and everybody's
Speaker 2: got diabetes.
Speaker 1: But you always see, I mean I did for a
Speaker 1: period of time. You always see where they're going into
Speaker 1: the school lunch program and they're taking the administrators of
Speaker 1: the school district, and they're taking the administrators of the
Speaker 1: individual school, and they're saying, you got to get the
Speaker 1: soda machines out of the school. You got to get
Speaker 1: the high fructose vending out of the school.
Speaker 2: How do we not have federal legislation around that?
Speaker 1: I wonder who can defend that? Who wasn't just completely
Speaker 1: in the pocket of the beverage lobby or the sugar lobby.
Speaker 1: You're sitting there saying you want your children, don't condemn
Speaker 1: your children to what you have.
Speaker 2: Right, Well, that's why we need a social movement. I mean,
Speaker 2: we don't have cigarette vending machines in high schools right anymore?
Speaker 3: We don't. That's true that we used to.
Speaker 1: Now one last question, which is that so you're not
Speaker 1: an endoquinologist and I'm assuming you're not a nutritionist either.
Speaker 1: So when people come to you, whether it's the young
Speaker 1: man who lost who was the subject of the film
Speaker 1: who had the amputation, very sad case. And when people
Speaker 1: are coming to you, I'm assuming within your body or
Speaker 1: your network of your organizations you work with in hospitals,
Speaker 1: there's a nutritionists you pass them on to who can
Speaker 1: give them some guidance about what to eat, not eat. Eat.
Speaker 2: Yeah, I provide basic nutritional counseling. Often it's not rocket science.
Speaker 2: When you hear what people are you just have to
Speaker 2: take a good history. You have to hear the story.
Speaker 2: Tell me what you ate yesterday, Tell me what It
Speaker 2: doesn't take long to figure out that they're having four
Speaker 2: bowls of rice with every meal, or you know, having
Speaker 2: three sugar sweetened beverages a day. And you know, a
Speaker 2: lot of this is pretty out there and obvious. But yes,
Speaker 2: we do have nutritionists who work in the outpatient's setting,
Speaker 2: and they're very effective. I think the most effective thing
Speaker 2: that they do is they have the person keep a
Speaker 2: food diary and then they review the food diary.
Speaker 1: Because I'm always saying to people it's an incremental change.
Speaker 1: I said, just give up one thing. I had a
Speaker 1: doctor sit me down when I was fifty years old,
Speaker 1: so it's fifteen years ago, and he said, here's my philosophy.
Speaker 1: He said that is, once you turn fifty, start to
Speaker 1: minimize or completely give up one of each category gradually
Speaker 1: every five years.
Speaker 2: I mean, I do think certainly individual decision making is
Speaker 2: really important, which is what we do with an attritionness.
Speaker 2: At the same time, we have to ensure that when
Speaker 2: the person walks out of their home that within a
Speaker 2: mile or two miles there's some place.
Speaker 1: That's option go, there's oppositation that you can get.
Speaker 2: And the price of healthy food over the last thirty
Speaker 2: years has exorbitantly increased relative to the price of junk food,
Speaker 2: which has declined adjusted for inflation. So the stress on
Speaker 2: the pocket is real. And you know, a lot of
Speaker 2: that is subsidized by the farm bill. Paradoxically, so if
Speaker 2: we could have a farm bill that subsidizes the growth
Speaker 2: of healthy food, which we do not have a program
Speaker 2: to do, we could turn that around to.
Speaker 1: Well, let's just say this, which is when you're ready
Speaker 1: to go to Washington and fight the fight about school
Speaker 1: lunches and vending and lunches, when you're ready to do
Speaker 1: the next charge up that hill. Count me and I'll
Speaker 1: go with you.
Speaker 3: Thanks, So I appreciate it.
Speaker 1: Your kids are how old?
Speaker 3: I have twins who are twenty four.
Speaker 2: They're jazz musicians in New York actually, and then I
Speaker 2: have a sixteen year old daughter.
Speaker 1: So your daughter, And what's the shill in your house
Speaker 1: on a dietary basis cooking at home?
Speaker 3: Yeah, we mostly cook at home.
Speaker 2: Occasionally we order in, you know, when I'm lazy, and
Speaker 2: we have desserts. I mean a lot of fruit, a
Speaker 2: lot of fruit. But well, we'll have desserts every now.
Speaker 2: And that we do not have sugar, sweet and beverages.
Speaker 2: That's something that's very different from my chi. And we
Speaker 2: didn't have the fruit loops that I grew up with,
Speaker 2: you know, the pop tarts that I grew up And
Speaker 2: my kids, my boys are like five or six inches
Speaker 2: taller than me and look a lot better than I did.
Speaker 1: Well, listen, I enjoyed so much seeing you in the film,
Speaker 1: and I was so captivated by the work you're doing
Speaker 1: and your articulation and your just your whole energy in
Speaker 1: terms of you're caring for your your constituents there that
Speaker 1: I was dying to talk with you, and thank you
Speaker 1: so much for doing with us. Okay, thank you, my
Speaker 1: thanks to doctor Dean Schillinger. This episode was recorded at
Speaker 1: CDM Studios in New York City. Were produced by Kathleen Russo,
Speaker 1: Zach MacNeice, and Maureen Hobin. Our engineer is Frank Imperial.
Speaker 1: Our social media manager is Danielle Gingrich. I'm Alec Baldwin.
Speaker 1: Here's the thing is brought to you by iHeart Radio