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This is The Referral, with me Dr Curran, and the whole point of this podcast is to debunk myths and have chats with interesting people, world leading experts, scientists, doctors, to give you actionable information that can hopefully improve your life, make you happy, make you healthy and counteract the absolute tidal wave of nonsense misinformation out there from all of these charlatans that, at best, are giving you pseudoscience and, at worst, are actually worsening your lives and making your bank balance a bit lighter. And today's guest epitomizes exactly what this podcast is about, debunking absolute bullshit and nonsense. We have James Smith. He is 1 of the fastest growing personal trainers online with millions of followers across social media, and actually he's been described as the Gordon Ramsay of the health and fitness world. Forget Gordon Ramsay, this is the 1 and only James Smith.

Everything he does is science-based. He debunks these fake wellness gurus and influencers who tell you treacherous ways to lose fat and lose weight. None of that. People are always asking me random questions, so it's only fair that I allow my guests to do the same.

I knew you knew a lot about bums, so when we were like, ask, ask you a question, I was like, it's got to be bum fun.

It's got to be bum fun.

And now it's time for you to ask me any questions you'd like. Now if you'd like to get in touch as well, drop a note at thereferralpod.com. Also coming up, if it ducks like a quack. Now, I feel really strongly about this because this is where I bust myths and some of them are going to blow your mind. Carbs are nothing magical, they're also not demonic, so include them as part of a normal diet.

But first, what the health is going on? A quick glimpse at all the latest news in the world of science, medicine and health. This is groundbreaking stuff, and a world first. A paralysed man is walking again thanks to Bluetooth. Allow me to explain.

So when Gert-Jan Oskam broke his neck in a cycling accident in China over 10 years ago, he was told he would never walk again. Well, he is. So first neurosurgeons implanted electrodes in his brain which registers his neural activity, when he tries to move his legs, his thoughts basically. Those readings or those thoughts are processed by an algorithm which converts them into pulses which are then fed into electrodes in his spine. So the device in his brain connects via Bluetooth to the device in his spine.

Those pulses which reach the spine activate nerves, which switches on the muscles which are used for the intended movement, like moving his legs. Basically, It's a thought-controlled Bluetooth device that connects the brain, which regions of the spine that control movement. It's a digital bridge which bypasses a spinal cord injury. The wonders don't end there. When the device was switched off after use, Jan Oskam still had some function in his legs and scientists believe that the connection formed between the spinal cord and the brain helped to regenerate some of those nerves.

Dogs in scrubs. What the hell am I talking about? Well, science has confirmed that dogs officially need to be employed in the hospital. This new study makes fur babies evidence-based. In the Shizuoka Children's Hospital in Japan, they were trained full-time dogs that were used in the children's hospital for a number of duties.

Now these aren't your average puppers, They are fully trained therapy dogs which do a number of things. They visit patients' bedside, they walk with the children to surgery, they cuddle them when they're stressed to make them fall asleep. The study surveyed 431 medical professionals and 73% rated the dogs as highly effective at increasing patient cooperation during examinations and procedures. And if you've ever worked with children in any capacity, you will know how difficult they can sometimes be. And this is a little bit sad, maybe with a silver lining, but they were also noted to improve palliative care in children with terminal illnesses.

Now dogs aren't going to cure any diseases as far as we know right now, but this model of dog service use in children hospital is potentially a model that we could use as an adjunct to traditional care to improve patients quality of life and symptoms potentially. And if you're wondering which breeds were employed in the hospital it was golden retrievers, lab retrievers or a mix of both because these dog breeds specifically love to please their owners and patients.

I'm Cameron Esposito and I have a lot of jobs. I'm an actor, you've seen me on ABC's A Million Little Things. I'm a stand-up comic, best-selling author, but I am no expert at survival. On my new podcast, Survivor Die Trying, we're going to learn together From shark attacks to tsunamis and bad breakups, this is your one-stop shop to prepare for the absolute worst case scenario. Join me and some special guests on Survivor Die Trying, a comedy podcast that prepares you for anything.

Listen and follow wherever you get your podcasts.

Imagine trying to find an undigested seed in a heap of steaming shit. That is how hard it is to find good, accurate health information online. But thankfully, there are those online who can sift through the bullshit and come up with the treasure amongst the trash. James Smith has been a personal trainer for 9 years and he's written 3 books which has seen him become a Sunday Times bestseller. In addition to his books, he's got a podcast and his own personal training app.

Ever since he started, he's been swimming against the waves and calling out bullshit left, right and centre, which is probably 1 of the reasons why we get along so well. James, thanks for being here today.

Thank you very much for having me.

I mean, you've now been doing social media. I've been following you since about 2018, I think it was. You obviously are someone that divides opinion, polarizes people, but actually what you're saying is not a polarizing opinion, it's fact. For example, 1 of the first things which stood out to me was calorie deficit, calorie fucking deficit. And he had the t-shirts with the CFD, all of that stuff.

And he kept plugging it. And for me, you were saying that in an era, this is like kind of that 2010s era, where people like V shred were at the peak of their game and they were really subscribing to that somatotype model, you know, people are ectomorphs, endomorphs, mesomorphs, whatever, and AthleanX and all of these people who were ripped and in great shape, flexing their authority bias and people were buying into that. These are seasoned bodybuilders and fitness professionals almost pushing that dogma even more. And then you come out of nowhere, you know, someone is a personal trainer in a gym in Australia saying, no, it's not all of that, it's just this. What kind of reception did you get when you first started you know trying to reverse that traditional bullshit?

Yeah at first it was not a lot of response to answer simply then I remember I didn't have a camera I didn't know how to edit My laptop was like a 2011 MacBook, so my only option was to go live. So there's a period of like, maybe a year in 2017 where at 3 p.m., I'd be at the gym all day with my clients, I'd walk home, 3 p.m. Is 6 a.m. In the UK during the summer, you gotta go live, and if you wanna get some engagement from that live, you've got to do it and say it in a certain way. So I was like, what can I have as a clickbait title?

What could be like almost anti-establishment? What people would believe? What can I say that's going to be controversial? What could be something that gets them to tag their friend in. So I'd think about it and I'd be like, okay, cool, go live, boom.

And it was like a peace to camera assault. It was a moan, it was informative. I was trying to be educational with it. And I was just trying to educate people because there were big periods in my life that I could have done with that information. I did an insanity workout when I was younger.

You heard of that? Dooper, Shaun T.

So I was jumping around,

front row,

sweating, trying to get in shape. And like, it seems insane now, but no 1 told me, and everyone's like, well, you're a fucking idiot. Well, I obviously was. No 1 was like, eat less food, don't worry so much about the exercise. Because I was training rugby like 3, 4 times

a week.

But then 2 for Tuesday's pizza, I was like, it just never occurred to me. And if someone had just tapped me on the shoulder when I was

18, 19, 20,

hey mate, maybe don't eat till like 2 p.m. And then continue your current diet. And with what you're doing with rugby, you'll probably lose a bit of weight. I wonder if that doesn't work. I don't know.

Try eating better, which I wouldn't have done at uni, or go to 1 meal a day. Something like that, something so crazy. Or mate, have a protein shake before rugby training, 1 big meal with your mates after, Domino's pizza, whatever. I never treated The amount of weight I had is like a currency or a bank balance because all of us, every day we have to think about finances. That's why rich kids have a distorted reality of the world.

They don't actually have to manage their money. They never have to worry about it running out. We have like a polar opposite with composition. And yeah, for a long time, I just, I never really thought of it like that. My knowledge and standpoint for so long was all about exercise, do more exercise, run more.

I'd get up at 6 a.m. And go for a run before work. It's miserable. Do you know how miserable that is? Like, you've just brushed your teeth, you're dehydrated, you're going out and trying to run 3 miles before going to the office.

Like when you can empower people with the knowledge, like, hey, there are so many different ways that we can elicit an energy balance deficit, then people become empowered. Because when they actually understand it, they're like, what, so I don't have to run before work? Mate, go for a walk on your lunch break, reduce the amount of calories coming in here, we're gonna give you some more protein at night.

But the problem is, you know, even though you broke that mindset of people of thinking beyond, I need to do intermittent fasting, I need to do keto to lose weight, I need to think about my insulin resistance and starvation mode and all that. You, Dieron, and a bunch of other creators started to bleed in more science into that fitness space, which is all about just person opinion and anecdotes for a long period of time. But now there seems to be a new wave of pseudoscientists who blend in misinformation with kernels of truth. For example, there's a whole spate of people in supermarkets, topless or whatever, looking at, picking up foods and whatever out of the shelves and commenting on them and then quoting studies. Like there are 5 scientific journals published every minute.

So in, you know, in the kind of universe of like publications, you can find something, whether it's like a cell study or a mouse study, that will suit your point that you're making. But Now there are all these now doctors, so-called doctor, I don't know if they're doctors, but who have gone rogue, and then promoting all these like really batshit ideas. What's the solution?

I've seen this, there's a lot of people and they just put like a PubMed code. They're like PMID

009241. And it's like 20 years old.

And you're like, bro, what, you think I'm gonna, that's your way of saying that you're smart. What am I gonna do? Like screenshot your fucking video, go onto PubMed and be like 002419, you know? Then what, I'm gonna read through every single part of it, scroll down to the conclusion. Sweeteners, for instance.

I've always been banging this drum, like artificial sweeteners, I don't think are bad.

I'm for

it. And even if they were bad, or they're bad for gut microbiome, whatever, I'd be like, it's probably still the better of 2 fucking evils, right? So let's, then people are like, yeah, but this study says that it shows you'll get cancer. And I'm like, in rats?

In rats, in cells, in vitro.

Are you a fucking rat? And then I do videos, I'm like, but This is where I like to think that my expertise come in. I'm like, okay, how can I take this point? How can I bring the solution, but present it in a way that people enjoy watching it? So I'm like, hey guys, you know, I just really want to apologize.

Everything, you know, I've been saying artificial sweeteners are safe. I've been saying that, you know, you can drink Coke 0, but the truth is that you should never, ever, never consume these things if you're a fucking rat. You know, like, and then people are like, you can take them along with it, have some fun with it, and then their friend who's like, ooh, full sugar's better, they tag them in the comments.

And then

as that's happening, I'm like, cool. I've been subservient to my audience with something that is gonna benefit their life. And at the same time, give them a little chuckle because, you know, I said this to you before, nothing makes me more excited than having a content idea about something. Like I did a video on creatine. I watched the 3 top videos from the 3 smartest people that I respect, because I can respect someone and completely appreciate how smart they are, whilst at the same time think they're fucking boring.

And that was Probably the biggest breakthrough revelation for me was maybe 2014, 2015, looking at the top dogs in the industry going, more muscular than me, smarter than me, more experienced than me, but all you cunts are boring.

Yeah, they can't get that audience retention to follow along. But you mentioned the sweetness thing. There was something very recently, the WHO, World Health Organization, you know, coming out in their report based on, you know, their empirical evidence that sweeteners, the non-nutritive sweeteners, or the artificial sweeteners, are not good for long-term fat loss. What's your like hot take on that?

This reminds me of when people in the fitness space, you talk about sweeteners and sweetened beverages, They go, just drink water. And you're like, fucking no brainer, mate. But the truth is that person wants a cold, fizzy, refreshing drink that tastes sweet. They want it because they've always fucking had that. Then when they go to lunch, the psychological pain of picking up a water just reminds them they're on a diet.

So I've got Coke 0 in my fucking bag right here, just in case I fancy something fizzy. So what we need to do in so many situations is to do food swaps because we've seen what happens. Everyone should have anecdotal imperial evidence of what happens when you replace the foods you eat with healthy foods, you don't stick to it. Instead, we should be looking to swap foods for slightly better versions. There's something that I did a video on maybe 7 years ago, I called it food intensity scaling, where I said, identify all the foods in your diet instead of swapping out a donut for broccoli or whatever.

I was like try and find something that is lower on that scale So for instance if you said James What's the food you could easily consume a thousand calories of I say ice cream, but you wouldn't just say ice cream You say what is it? Okay, fish food Ben and Jerry's fish food. They go, cool. Now, I'm not saying don't eat ice cream. What I'm saying is, if we swap the Ben and Jerry's fish food for a Haagen-Dazs vanilla, would you still enjoy it?

Yes. Would it help you eat less? Yes. Therefore, let's try that. Maybe even, you like pizza on a Saturday.

Cool, Everyone likes pizza on a Saturday. How about a burger and chips? Why because that's a reduction in calories you still get the hedonic food from a fast-food take away Whatever it is then over time you pick these things people have done this for years when you go from Normal potato fries to sweet potato fries in some respects you might consume less. So like we're actually doing these kind of like food intensity swaps and 1 of those that may not be easily to spot in a massive study is when you take someone that drinks fucking, I had an Uber driver the other day telling me how much weight he's gained since he started driving Uber. I said, mate, just, and he was like, oh, so the sweetened ones aren't bad for me.

I said, mate, you swap in those fizzy drinks for a sweetened sugar-free version, couple hundred calories a day.

When I was in med school, I was very near a gym. I'd skip lectures, go to the gym, I'd have fun, You know, I'd go with my mates. It's like a kind of almost like a little, you know, an hour or 2 where you hang out with your mates, you do some weights or whatever. It feels good. And I didn't necessarily do the gym for weight loss.

It was just for fun. And I liked the fact of, you know, getting stronger. I was swimming and playing cricket then, so it was like, help me bowl faster, you know, if I lifted more weights, I had more kind of strength in my shoulders, etc. So I did it for functional and fun purposes. But this kind of fat loss world, almost, the fitness industry with all the supplements, authority bias of random people telling you to do this, this and this of fat loss.

I mean, it's almost now covered the point that there's actually so many other things that prop up your health, not just your weight.

So 1 thing that I used to do when I went to the gym when I was younger, I used to work a 9 to A5I used to work in Oxbridge and I lived in like Ascot. There's loads of traffic. I'd sit in like fucking 40 minutes of traffic a day. I realized if I woke up half an hour earlier, I missed all the traffic, but I got to work an hour early so I then was like fuck I'll get gym membership next to where I work Seem kind of counterintuitive so got up half an hour earlier, which wasn't what went to bed half an hour earlier Drove all the way to Oxbridge 0 traffic, and it was a more enjoyable drive. I've reduced my stress

Yeah,

get to the gym and then it meant when I left the house I was wearing gym gear suddenly my world was nicer getting a suit and leaving the house knowing you're about sitting traffic It's fucking shy. So then I get there go to the gym. It didn't matter an hour before I needed to be at work So I train and I'd be so happy I didn't sit in traffic this morning. I'm so productive. I've got half an hour of my flipping life back.

Suddenly I had a place to just escape a job I didn't enjoy. I now had to sandwich my morning between something I enjoy going to work, something I enjoy going back to work and then I can go home Yeah, I this was the first time in my life. I actually had a third place. I had my work I had my home and I had the gym

but not in the sense that your goal was fat loss

No, fat loss. Okay,

release from stresses of life.

I just knew it was good for me. I didn't know what I was doing, didn't know how to squat, didn't know how to deadlift. I was probably like 21, 22. I know that at 22, I couldn't deadlift my body weight. And I think that maybe younger listeners need to appreciate that at 30, I was considered 1 of the like nation's most in-demand personal trainers But at

21,

I couldn't deadlift my body weight. Yeah, didn't know how so going to that place. I'm in that third place For so many people I talked to about getting into fitness That's what I'm saying have another place you can go to. Like, just going in there and having some time to yourself is worth it already. Then we can optimise, then we can give you a programme, then we can give you something to work towards.

I would actually get someone to embrace that before calories, everyone's like, Because I'm the calorie deficit guy, everyone's like, oh, you count calories, my fitness power, I'm like, that's just a really effective tool. And it doesn't work for everyone, but it worked for me. So again, it's personal bias.

Calorie deficit is obviously like a very simple concept to say, but even like the sustainable changes, you know, Like if someone does want to lose weight, not that they need to, if whatever, if there are, you know, normal way to end their training, but, you know, people are now trying to rush that process as being the primary thing they want to achieve. And that's why more and more people are using things like a Zempick off-label to lose weight. And I think you said you were about to use it at 1 point but you...

So and again so you've got a semaglutide, you've got a zempic, you've got saccender.

So the semaglutide is the active ingredient in a zempic at a higher dose than what they'd use for diabetics.

So I remember straight away, I was talking about all 3 of these in a YouTube video, and someone was like, they're different. One's 1 a day, one's 1 a week. And I'm like, guys, I'm just doing it. Just

doing it.

The point I was saying is we've now got injectables that kill hunger, but this is the interesting thing about this. First of all, yes, I was gonna do the video I was gonna get Shreddy Kruger then at the end be like guys like gaunt as fuck I tried the injections whatever but I checked out the side effects.

Yeah, and

I was like fuck that I'd rather do a video about something else 1 of the key things that I actually quite like about these weight loss injections is, for so long, everyone's saying their metabolism's broken.

You know, oh, James.

Yeah, James, you know, I've yo-yo dieted all the years, my metabolism's broken. I've got a slow metabolism. Oh, you know, my thyroid wasn't good 5 years ago, all of this shit. I go, if I give you this injection, you will lose weight. And guess what?

This injection doesn't impact your metabolism. What it does is it stops you fucking eating. 3 weeks later, they're like, I've lost a stone, I've lost 2 stone. And I'm like, yeah, that broken metabolism of yours just churned through calories and you lost weight. Why?

Because you stopped putting things in your mouth.

I mean, the thing is I deal with bariatric patients. I've done, you know, surgery on bariatric patients in the past. And for me, obesity is, it's quite a complex topic, obviously, in the NHS anyway, the criteria for having bariatric surgeries, you need to be above BMI 40 or above 35 with conditions like diabetes or other metabolic conditions which, you know, are not in the best control. So then they have, you know, various bariatric surgery, Roux-en-Y bypass, gastric bypass, sleeve gastrectomy, you cut a bit of the stomach, all these sort of things. But actually, those are very difficult to reverse if you do like a surgical operation on someone.

Rewind-wide bypass, you're literally taking the small intestine and re-plumbing it. You are rewiring the plumbing inside, which is very difficult to reverse and has obviously significant complications if things do go wrong. So actually having the injection for that subset of people who are very overweight, obese, with metabolic conditions, it's a game changer. But I'm now seeing, and I saw a patient maybe last year who was using the Ozempic off-license for weight loss. This person was in pretty good health, actually.

But the reason for taking it was that they wanted a six-pack before their wedding, and they came in with pancreatitis, an inflammation of their pancreas, because that's 1 of the risks of a Zempik. Not to mention obviously with the dramatic weight loss, if you're doing it in someone like yourself and you took a Zempik, yes, you'd lose weight, but would the body composition change be favourable for you? Like the amount of muscle you'd lose and the bone density loss, would that pay for the cost of fat that you'd lose? Is that worth it for you?

It would increase my chance of injury. It would make me feel worse. It would give me like, it would only just increase the amount of problems. I thought for 30 days I could eat it but like you say I think it's great that we're not having to perform surgery on people but the reason I'm kind of anti these jabs is because right now the listeners I reckon 90% of them don't need it and want it

10%

of them need it can't get it yeah So like the talk into the larger audience here,

you and I have both come across lots of nonsense online What would be the 3? Worst things or trends fads Thing statements that people have said online in your career online

Any single thing they say promotes health. Okay. I hate it because so many people think they just need to do that thing.

That 1 thing can change your life.

Like let's say there are 10 pillars. Yeah. Sleep, sunlight, stress, relationships, nutrition, training, strength, whatever it is. I hate it when people go in on 1.

1, yeah, because you need the, you know, enough cement in all the pillars to hold up

the roof. We need to sit back and say, tell me about your life, because most of the time, people tell you the things that need to change. I had this

where I

came back from Bali, I'm in Australia, and I Had a bit of pain around by my kidney So I might need to go to the doctor. So I go to the doctor They get in there and sit down I go I've got this pain by my kidney. I don't think it's my kidney. I think I pulled a muscle and truth be told, I've been going out way too much. I haven't been sleeping enough.

I've been partying a lot and I probably just need to have a few weekends off the piss, but I'd like you to check this. This is my kidney. And he goes, he goes, if it was your kidney, you'd fucking know about it. He goes, you wouldn't be here. You'd be like, if you had a kidney stone or something, you'd be-

Oh yeah, you'd be on the floor in agony.

He goes, I'll have a look. But he goes, you pulled a muscle. And as far as what you need to do, you've already told me as you walked in.

Yeah.

He was like, go do those things. And I was like, cheers mate. And that was it. And so many, rather than coming in someone and going, spirulina is the best fucking thing ever or greens powder or whatever it is. Hey, tell me about your life.

Probably should go to bed earlier. I do skip the gym quite a lot, but to be honest, I prefer playing tennis. You know, and you're like, cool, well, how about set yourself a bedtime? How about train once a week with a good programme that incorporates everything? And how about booking 2 tennis matches a week with people that you like and have a revolving booking at that court that you go to?

Oh, is that enough? Well, yeah, do that for the next few months. If you're still not losing fat, then we'll look at your calories.

See, this is why I followed you on social media, and this is why you've done so well, because it's not polarising opinion, it's just facts. And you are prioritising facts over feelings consistently, and that might ruffle a few feathers that might, you know, but those are the people that would never subscribe to the facts anyway.

This is the beautiful thing, right?

That's the beauty.

I pick fights with people that will never do business for me.

And who are never going to win as well because you know, it's evidence-based. Even though it might not sound evidence-based, it is evidence-based. And James, I think we're going to be having a lot more chats. So James, you've got a question for me today. I think it's going to be a rogue 1, but you know, I'm game.

Let's go. Oh no.

No, no, no. Just, just 1 I'm genuinely curious about. Yeah. When it comes to anal sex. Yeah.

What is a practitioner's advice? Do you tell people not to do it? Is it healthy? Is it something we've seen in history? Is it something from watching too much porn?

Are there hygienic issues or complications when it comes to bum fun?

Yeah, so there's lots of layers in that conversation. It's not something I've been routinely asked. Routinely. Yeah. I think...

Because I'm actually genuinely curious about this, right? Because in some circles it's held in a connotation of being a bad thing and some people they're saying it's a good thing. We have a G-spot in there apparently.

So the male G-spot has been commonly thought to be the prostate. It's involved in the release of prostatic fluid, which is then a component of semen. And, you know, even in men who are dead and their partner wants to secure some semen, they can, you know, do it like a bull where they get some electrocution device and zap some electricity into the prostate to stimulate it to contract so they can, you know, the dead corpse can ejaculate and they can collect it or they can...

There was a successful case of this in Australia recently with someone who was a snowboarder. He went deep-sea fishing and he drowned whilst, what's it called where you hold your breath for a long period of time? Free diving.

Free diving, oh right, okay.

Really tragic, beautiful relationship, wife, and she's going through the grieving process of a partner is only like 30. Yeah,

33

She didn't consider it. But then 1 of her friends was like, I know this is really inappropriate But you should ask his family for consent to extract semen from him

Yeah,

They called 5 doctors in the Gold Coast region. Everyone was like, we've heard of this, but none of us have ever done it and we don't think it's going to work. The percentage chance of it working were very small and she fell pregnant with his child.

It's better now because you can extract it directly through needle aspiration from the vas deferens, which is the tube which, you know, transports the sperm, or this, you know, prostatic stimulation.

But- Do you know what? Fuck the anal sex thing. This is a much better question, because now we're raising awareness

to the fact that- That you can, yeah.

In the most horrendous situation- If It's

a tragic situation, then this is a possibility. Although, I would say that I've never heard about it done in the NHS, and I don't know, because also it'd be up to the doctors, it'd be up to the family of the deceased person. There's like a whole ethical can of worms. And there's so many consent issues and legal issues and ethical issues and moral issues that it would be very difficult to find a doctor. You know, like even those doctors in Australia saying, don't want to do it.

That's an also an ethical issue for the doctor. Like, you know, you want to go in and extract semen from someone who's dead. What was his wishes? Did he not want his body to be tampered with, etc, etc. But with regards to the anal sex, that is a common source of trauma that I would see.

I would see as a surgeon people coming in with-

And that's why I ask, because of

the- Yeah, inserting foreign objects up their bottom. But sometimes it can be, it's not only just kink, it can be abuse, rape. Someone's come in with anal trauma. And it can be to the extent where it can actually damage the external anal sphincters and cause lots of lacerations and damage over there. And that can affect the bowel function.

But in terms of 2 consensual people having anal sex, The 1 thing is that when you insert something from the bottom end, like an enema essentially, it can produce a laxative type effect. So, anecdotally, if someone were to ask me that, hypothetically, I would say, make sure you fully cleaned out from the bottom end and obviously taking it slow because the actual anus, the kind of stretch potential of that is about 6 inches. You know, anything more than that then it's irreversible damage.

Wow. I knew you knew a lot about bums. So when you were like ask ask you a question I was like, it's gotta be bum fun.

It's gotta be bum fun.

The reason I have such a bone to pick with myths and misinformation about health, wellness, diet, fat loss and all that stuff is because it directly affects the patients I see and obviously this week we're gonna be focusing on the diet industry which is full of nonsense. Alright so the first 1 avoid carbs if you want to lose weight. Now this is it's a difficult 1 to talk about because clearly if you avoid carbs it's not a guarantee that you're gonna lose weight and you can also eat carbs and still lose weight. Now if we look at carbs, carbs tend to be hyper palatable. You want to eat them more.

They're moreish foods like crisps or chips, rice, things like that. They also happen to be higher in calories. They're more energy dense. They're moreish. They're more convenient to get, gain access to.

They also have a relatively high volume you can eat a lot and still not feel full they're not very satiating it's easier to over consume these and then possibly gain weight a lot of people find that if they cut out carbs they lose weight and then correlate that with carbs being evil. But the fact is, for the reasons I mentioned, they're probably overeating carbs because they're easier to overeat. So everything in moderation. So this is not quite a total myth, but carbs are nothing magical. They're also not demonic, so include them as part of a normal diet.

So here's another 1 you probably might have heard, some foods speed up your metabolism. Now 1 variable that you need to take into account when you're talking about your metabolism and your metabolic rate is the thermic effect of food. There are certain foods which burn more calories when you eat them because your body, you know, needs more energy and more works put into digestive. So commonly something like that would be foods that are high in protein. Your body has to work harder to digest it as opposed to something like carbohydrates, simple carbohydrates like maybe a banana for example.

So a steak versus a banana your body is going to be burning through more calories and more energy to digest the steak versus the banana. So yes, technically, if you looked at it and accurately measured the calories burnt when you're eating a steak versus a banana, you'll be burning more. Does that mean you just need to eat steaks and ignore all of these foods that don't burn calories? No, you need to have a balance in everything. And as I've always said, you know, prioritizing in meals, making sure you get enough protein in your meals.

Now we're not talking about crazy excessive amounts of protein, you don't need to be eating 100 grams of protein every meal, but you do not need to pay consideration to fat burning foods. That is a myth. And you also don't need to buy any scammy fat burning pills because there is no such thing. So ever since I started medical school, and then even when I became a doctor it got even worse. I've had friends, family and even just acquaintances start messaging me about various problems and on social media as I've grown my following, I've even had some unsolicited pictures of soft fleshy parts for me to diagnose.

But this is the chance for you to ask questions to me and I will answer them. This is crowd science. So Kiana has emailed in asking, should I be taking ibuprofen and paracetamol at the same time? Now ibuprofen and paracetamol work in different ways. Ibuprofen is an NSAID, it's a non-steroidal anti-inflammatory drug and paracetamol, both of those together they have their own functions on the body and they are great painkillers and actually they are agonistic which means they work really well when you take them together.

Now, there are some caveats to that. So, you know, an average adult, assuming they are, you know, have no other significant liver conditions or anything like that, it's safe to take up to 4 grams of paracetamol on a daily basis. Anything more than that, you are overdosing on paracetamol if you're taking more than 4 grams. And another important thing to, you know, take care of is it's very easy to overdose on paracetamol. You know, a lot of these cold and flu remedies that you take, where you pour the sachet and then you pour some boiling water on, they contain paracetamol in low amounts, maybe up to 200 milligrams sometimes.

And then if you're also taking paracetamol tablets, you can see if you're combining the both, it's very easy to go over that 4 gram limit. Now, when it comes to ibuprofen, 1 of the effects of ibuprofen is it obviously gives you fantastic pain relief, but also in the way it works, it's a Cox enzyme inhibitor. So what it does is 1 of the roles is obviously pain relief because it does that by blocking the production of prostaglandins. Now prostaglandins are these pesky chemicals that are involved in the perception of pain and that's why you know you get period pains, you get heart attack pains, because there's a release of prostaglandins. Now by blocking the production of prostaglandins, there's another role for prostaglandins as well and that is mucus production and you need mucus to line your stomach cavity.

So if you've got less prostaglandin, you potentially got less mucus that's protecting your stomach lining, and you can get irritation of the stomach lining because that defense barrier has been weakened. So there have been reports of ibuprofen or these NSAIDs, nonsteroidals, if they're taken continuously, especially on an empty stomach, it can cause ulcers and very rarely even erode into the stomach, causing a perforation or hole in the stomach or the small intestine. So take it with a meal. And if you're taking it long term, so for an extended period of time, you probably need something to protect your stomach lining as well, like a proton pump inhibitor, something like a meprazole, something like that. Anyway, this is all for educational purposes and if you need any medications prescribed or any changes to your medication speak to your doctor Thank You Kiana that was a very good question And if you've got a burning question that you want me to answer get in touch at the referral pod.com Okay, so that is enough of me talking for this week, you can pick up your next dose of science chasm next Tuesday.

Thanks for listening to this episode of The Referral. Yes, I am a real doctor, but it's important to know that if you require specific medical advice, please contact your own doctor. And please remember, nothing on this show is intended to provide or replace specific medical advice that you would receive from your own health care worker. This has been a Sony Music production. Production management was Jen Mistry.

Videos were by Ryan O'Meara. Studio engineer was Ed Gill. Music was by Josh Carter. Grace Lakewood and Hannah Talbot were the producers and Gainor Marshall is the executive producer.

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