Dr. Anand Parekh
speaker
112 appearances
1 recordings
1 series
first heard Jan 2025
last heard Jan 2025
Dr. Anand Parekh’s voice in public audio — every appearance, attributed to the second.
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It'll be making money by keeping people out of the hospital. And that's a very different paradigm shift, but we're not quite there yet.
i think it's pretty important because if you don't actually provide an environment that allows people to make easy healthy choices it's hard to do the right thing and i think one of the biggest challenges in this conversation is the sort of dichotomy between the idea of personal responsibility and sort of the nanny state you know the environment we live in how do we change the toxic environment and i think most of the messaging from
most of professional associations, much of our government policy, and certainly the food industry, is that It's your fault you're overweight. It's your fault you're sick. It's a personal choice, just like smoking is a personal choice. And they talk about moderation. There's no good and bad calories. A thousand calories of broccoli is the same as a thousand calories of soda.
There's focus on exercise as the solution. There's focus about moderation. It's really interesting, and it's a culture that's really focused on personal responsibility, but it ignores the fact that actually can't be personally responsible in a toxic environment. If you can't go in your neighborhood and buy a vegetable and you have to take two hours of buses to buy a carrot, that's a problem.
And if we don't address the environment we live in, we're not going to be able to get people to make healthy choices. I remember reading a study where they looked at people who were overweight and diabetic who lived in very low socioeconomic neighborhoods. They moved to a slightly better neighborhood
and their blood sugar went down and their weight went down without any other intervention, just giving them a better zip code. So basically the zip code we have is a bigger determinant than our genetic code when it comes to our health. And we don't really seem to acknowledge that in our policies. We say it's all about choice.
Because the truth is, you know, food industry and pharma are not investing in research around this.
Is that really true? 19% of the NIH budget goes to prevention? 19%.
Well, let's just define prevention because is a mammogram prevention, is a colonoscopy prevention? No, it's early detection. True prevention is really dealing with the causes, the upstream causes that you talked about in your book.
Yeah, one of the things you mention in your book, in addition to sort of these points, is sort of targeting things that work but aren't paid for. So digital health, for example. You mentioned Omada Health, which I helped advise when they were starting out.
And I said to them, look, the diabetes prevention was a good start, but it's based on a little bit antiquated nutritional data about low-fat diets and high-carb diets for diabetics. But it worked because, and I met people who were in the program And they said, well, it worked because we came to groups, because we had to write down everything we ate, because we exercised together.
And it wasn't so much the food, although it was healthier, it wasn't the healthiest. And there's been more sort of advanced versions of that that have developed that are digital. For example, Virta Health, you probably heard about, where they literally take in poorly controlled, like pretty overweight, poorly controlled diabetics, 60%, 60% reversal. Now, in traditional medicine, it's like zero.
It's zero, right? Unless you get a gastric bypass. And they had 60% reversal. They had 90% or more off of insulin or very low insulin doses. They had 12% weight loss, which is a massive amount. In weight loss studies, you get five. Everybody's dancing around, happy and excited for 5% weight loss. And they did it through a digital platform where there were coaches and support.
There was remote monitoring for ketones, for weight, for blood sugar. And they published the data. It was a ketogenic intervention, which is the opposite of the DPP, which is basically high fat. And yet this is not reimbursed. And it's the amount of savings in these patients just astronomical.
So how do we sort of get, because this sort of goes back to the conversation we were having earlier about prevention and treatment. So prevention is important. It's a population-based intervention, and not all the people you're gonna do the intervention on are gonna get the problem. In other words, not everybody who gets a colonoscopy was gonna get colon cancer, right?
But everybody who's already sick needs the intervention of lifestyle interventions, because it's lifestyle as treatment, not only as prevention. But that's not reimbursed, and yet it's probably the biggest bang for the buck in terms of our healthcare system. And how do we get our government to start to understand that?
And maybe it's what you talked about, is funding more research that proves the model. Right, right.
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