Moving Medicine Forward with Dr Michael Klaper & Dr Zach Burns

In addition, Dr. Klaper is a renowned clinician and educator with over 50 years in healthcare focusing on diet based interventions to combat chronic diseases, and Dr. Burns is a family medicine practitioner, assistant professor, and a dedicated advocate for plant-based nutrition. I will also say Dr. Burns is here in Rochester, New York. So Mariann and I get the benefit of actually being friends with him in real time. We could say he is a wonderful guy. Dr. Klaper, we are sure you are too, and we hope that you come visit us sometime soon in Rochester. Welcome to Our Hen House to both of you.

Dr Michael Klaper: Thank you.

Dr Zach Burns: Thank you.

Jasmin Singer: It is a delight to have you, and as I mentioned, what a time. What a time to be alive, what a time to be discussing these issues. We'll get to all of that in just a moment, but before we do, just a quick reminder about the Our Hen House podcast. Rising anxieties comes out on Tuesdays, The Hen Report on Thursdays, and the long form interview, that's this, on Fridays. Bonus for flock members comes out on Monday.

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Dr. Klaper, let's start with you. We seldom are quite as on top of the breaking news as this, but wouldn't you know it shortly before we're recording this, Secretary of Health and Human Services, RFK Junior announced a new program to encourage medical schools to include nutrition advice in their programs. And here we are. That is your book and your campaign in a vegan Whole Foods nutshell. So I would like to approach this interview with the overview that all of these thoughts and ideas are absolutely needed right now, like today, like immediately, like right now.

So let's start at the beginning. You recount coming up as a young doctor and realizing how diet was being completely ignored. And I feel like now we're in a place where diet is often recognized as important to health, but most people are still eating as poorly as ever. So how would you say things have changed?

Dr Michael Klaper: Oh my. What a powerful question, important one. Uh, things have changed, as you say, at least on the awareness level. Uh, the fact that the Mr. Kennedy get up and, uh, talk about getting nutrition taught medical schools, and everybody I know says, yes, that's a good idea. You know, so, uh, the fact that we're that much closer to making that a reality that's huge and, and has a lot to do with podcasters like you folks who have been educating the public and demanding that our doctors know something about nutrition.

I think it's raised the pressure and the temperature, uh, to reach the, uh, public health folks and the legislator folks. So just the awareness, uh, changing, uh, has certainly been a major advance, uh, that I'm, uh, really, uh, positive about. And, uh. Oh, the, and the, you go through a supermarket. I, I became vegan in 1981 and back then, uh, the, the health food stores were bleak.

There was, um, powdered soy milk in the corner, uh, and uh, uh, that was about it. And, uh, now you go into most any supermarket and you see a whole panoply of plant-based, uh, food ideas and ingredients, uh, you know low glycemic pastas and, uh, minimally damaging veggie burgers and, uh, uh, plant based

Jasmin Singer: Is that how they advertise it on the packaging?

Dr Michael Klaper: Minimally damaging.

Yeah. As compared to the real beef burgers. Uh, but the yogurts and the cheeses and the ice cream. No one's saying that these are, um, that these are the bastions of healthy foods, now, but at least they are, uh, giving a thumbs up to people who are on their plant-based journey, that they don't have to feel that they're, uh, bereft of, uh, taste and textures and, uh, uh, all the social implications of that.

Every restaurant, no matter what they serve, steak houses, they have a vegetarian section on the, uh, on the menu, you can make a plant-based meal happen in most any restaurant and ask and you shall receive. So there's been significant progress. We're still in the embryonic uh, stages and this remarkable event has happened where Mr. Kennedy has, uh, gotten pledges from 53 of the nation's medical schools. And there's, there's 160 medical schools in, in, in the United States, so that's a third of them have committed to, to come up with some type of nutrition curriculum. Uh, now what's gonna be taught in that is, is another issue, which Dr. Burns and I still have a lot of work to do to make sure the plant-based message gets strongly delivered. But the fact that it's happening at all, you know, is just remarkable. And, uh, even the other a hundred medical schools who didn't make that uh, pledge, still have the option to incorporate, uh, nutrition based, uh, principles into their general curriculum.

And, uh, so, uh, I'm excited about these important couple of inches of, of progress. They, you know, they say when the dog plays the violin, don't criticize the quality of the playing. You know, the, the fact their playing at all is wonderful. In the same effect, these people are, uh, are talking about teaching medical schools, uh, uh, medical nutrition is important.

But a major mission that Dr. Burns is going to be undertaking is we are going to, we have the list of those 53 medical schools and we are going to ride herd on them. We're gonna ask to see the curriculum that they are proposing be taught, and see what kind of input we can get to make sure that the plant strong messages delivered clearly in these curricula.

But it's a, it is an exciting time, so, uh, very, uh, timely that we're, we're having this discussion. Really appreciate it.

Jasmin Singer: Importantly, I have four dogs and just like thanks a lot, Dr. Klaper, 'cause now they're gonna want to pick up string instruments and...

Mariann Sullivan: Zach, I really wanna hear about, I mean, obviously this was just announced and you're just putting together what you're gonna be doing, and I really wanna hear about how you're gonna be handling this project, which sounds just like a huge opportunity. Before we even get to that, you've been only practicing for a few years.

I mean, you've been out of school for a few years and practicing family medicine. Can you just give us the overview of your experiences in like a, a, you're not in a lifestyle medicine practice, you're seeing all sorts of different patients. What is your experience of, um, what people know about what they should be eating and what they actually are eating?

Dr Zach Burns: Well first of all, it's really nice to be here. I have three mentors here, in medicine and in activism, and it's a pleasure. Um, what has practice been like? I've been fully licensed for a year and a half. It's been a wild ride. Before that, I was three years in residency, so I was functionally practicing.

What do people know about nutrition? Um, most of us, uh, in our society don't know much at all. Uh, we never learned it. It's not part of public education. And in fact, we receive a lot of misinformation and, uh, big food advertising and junk. We're bombarded with it on the roadside billboards. It's everywhere.

So this is not news, but a lot of us are, are eating junk as the norm. We're, we're not splurging and, and having a treat. That's just the food that people are eating, is what we consider junk. Um, it's hyper processed. It's high in animal protein and fat. It's minimal in fiber, fruits, veggies, legumes, uh, whole grains.

And we just take that for granted. I think most people, that's, that's just what, that's what we eat. Um, well we've seen that it has dramatic health consequences. And so that's who Dr. Klaper and I see when our patients come in. Um, people have the predictable consequences of the modern food stream.

Um, and it's not pretty. It's, I'm very concerned about it. These chronic disease rates are only growing. Um, by 2030, 50% of Americans are projected to be obese with a BMI 30 plus. Um, BMI isn't everything right? It is not a perfect metric, but it does correlate with complications. Uh, diabetes is on the rise.

900,000 Americans die of heart related disease every year. That's twice as many people as died in from COVID in 2021. This, this is happening annually, right? So I think that it's good that, you know, MAHA is, is aware of chronic disease and trying to tackle chronic disease. I do have some concerns about the approach.

Jasmin Singer: Yeah. Dr. Klaper, did you wanna weigh in on that? You, you look like you might want to.

Dr Michael Klaper: No, it's, it's so great to have, uh, Dr. Burns on, on board, uh, with our work here, uh, for so many reasons. He's the next generation. He's gonna be the receiver of the torch here to carry on the tradition. And, but he's in communication with his generation. Makes me feel so old. I used to be young too. Uh, but, but, uh, uh, the fact that he's tuned in to many of the things that I'm not, he is such a powerful ally, and he really, uh, he is the ray of hope, uh, that, uh, makes us all feel good there.

So, uh, and, uh, he's absolutely right. We've got, we still have lots of work to do here to make sure that what's taught is not carnivore propaganda. Uh, but, uh, uh, it's a doable mission. Mission. And we'll stay on it.

Mariann Sullivan: Ray of Hope. Could you, uh, could you just chime in? 'cause you mentioned that you had some, uh, some... I'm gonna call you that from now on, uh, Ray of Hope.

Dr Zach Burns: I like it. Yeah.

Jasmin Singer: You know what's so funny though? That's what we all call you!

Dr Zach Burns: Could be my Instagram handle.

Mariann Sullivan: You mentioned that you had, that you have, you know, some hopes and fears, I guess, uh, about this new initiative. We don't know a lot about it yet. Can you, can you go into a little bit more detail about what you're worried about? You know, what it is you're trying to prevent from happening and what you're hoping you could make happen?

Dr Zach Burns: Sure. So I think it's fantastic that the government has gotten 53 medical schools to commit to 40 hours of nutrition curricula. Um, we just have to put it in perspective. 40 hours is still meager. Med students are studying, they have thousands and thousands of hours of classes. So it, it's, we gotta celebrate small victories, but put it in perspective.

There are a few, there are a few facets to this. Um, when they talk about nutrition in the curricula, it's loose. I think that's good. We want medical schools to really have the final say on, on the curriculum and not the federal government. Uh, but what they're, what they're doing is either MAHA, RFK Junior, they're encouraging these core competencies.

Some of these competencies came out of an expert review. It was a, uh, 2024 article in the Journal of the American Medical Association. So it was a legitimate review, and they came out with 36 competencies and they're all reasonable. One of them actually is we should, um, help medical students make the connection between our food system and, you know, personal and planetary health. So that's, that's pretty progressive, I'd say.

Mariann Sullivan: Seriously.

I guess thatt it's not personal, planetary, and animal health, but you know, it's a step.

Dr Zach Burns: It's a step, but what RFK Junior has, has done is he's taken a, a select number of those competencies and added a bunch of his own. And I haven't gotten to see the, the, the entire list, but there's reporting that some of those competencies are a little wacky. The med schools are not required to incorporate them, but they're a little wacky.

And importantly, several of the competencies encourage, uh, medical students to learn about the National Nutrition Guidelines. Well, uh, that's interesting because recently those guidelines were updated and they literally inverted the food pyramid, so the pointy part is on the bottom and meat and dairy are featured prominently on top.

Um, the protein requirement for Americans just in the last month, it went from 0.8 grams of protein per kilogram body weight to 1.2 to 1.6 grams of protein per kilogram body weight. So that's up to double the previous protein requirement. Well, that strikes me as problematic because we were already consuming too much protein based on vast bodies of evidence around how our bodies handle protein and what we, we actually need, which is more fiber and more nutrients.

These are just a few, a few issues that come to mind when we're thinking about what the curricula will consist of.

Dr Michael Klaper: Um, I would like to shape this to a more digestible form here, um, in that, what we don't want is for them to come up with a, uh, in the third year of medical school, uh, uh, a 20 hour course on scurvy and Beriberi and nutrition-based diseases, the things we'll never see, uh, and call it a course here.

Um, and I've often, um, uh, had professors, uh, who've come out to me arms full , Look, doc, you want us to teach nutrition, the curriculum is already so full with chock full with anatomy and physiology and pharmacology. What do you want us to drop out of that curriculum to make room for your nutrition course? Ha ha.

And, uh, and this is, uh, the absolutely opposite approach of what we're advocating here. The point is, um, medical school is classically four years. The first two years are, um, are the basic sciences, anatomy, physiology, pathology, pharmacology, microbiology. The last two years are rotations through the clinical, uh, um, sides.

Uh, you start with obstetrics, delivering babies and pediatrics and children and internal medicine and surgery, et cetera. And the point is, uh, nutrition should not crowd out anything. It should be interwoven with every one of those courses. When you're studying anatomy in first year, let's talk about the anatomy of the digestive system and how it turns food into energy. Physiology, let's talk about the physiology of hunger and elimination and how you can optimize it. Pathology. Well, these diseases are mostly caused by what the patient is eating. Let's weave the patient's diet into the pathology. Pharmacology, the action of drugs is gonna be dependent on what the person is eating, their fat stores, et cetera.

It should be woven into all the basic sciences. And certainly once the the student gets out into the clinic, obstetrics, these women are eating too much, um, protein, fat and calories that are winding up huge. They delivering big babies that can't, that require cesarean sections. They develop gestational diabetes.

Pediatrics. We're seeing childhood obesity, childhood diabetes, nutrition should be woven into, into that, uh, uh, discipline every week. Uh, an outpatient pediatric clinic, you should sit down and talk about these patients' diet. Certainly in internal medicine, all the heart disease is from what they're eating. Surgery, what are they doing up in that operation? They're taking out gallbladders, infected colons, from what their patients are eating.

It should be woven into all four years of all the medical disciplines. So when the young doctor graduates, Aha, he has a good understanding, or she, uh, has a good understanding of what they're gonna be seeing in, uh, once they get out and practice and how to help these patients, how they find a plant strong dietician and work with them to get these folks on to a, to a plant strong diet there.

So this is what we're, what we're advocating of actually comes to pass. We'll see what, what kind of resistance there is, but uh, this is

Mariann Sullivan: I, I noticed in that article, and obviously I don't know any details, but one of Harvard Medical School's pushbacks was that they are already incorporating, they don't need separate nutrition courses. Just kinda like what you said, they're incorporating it into other courses. Do you know how, how, how much they are? Or, uh, is that, do you just think that that is an idea that is starting at least in some of the best medical schools to start to take hold?

Dr Michael Klaper: Choice B there, we, we think it's going to be inculcated, in, in the, all the best medical schools, but you bet I want to get my hands on the Harvard

Mariann Sullivan: Yeah.

Dr Michael Klaper: cirricula and see what they are teaching. Absolutely. Yeah.

Dr Zach Burns: So just to paint the picture for people who aren't in this medical education space. There is a national initiative through the American College of Lifestyle Medicine, uh, for medical schools to take on a certain amount of, of lifestyle medicine, right in the, in the curriculum. So this predated MAHA and RFK Junior. And they have these levels, bronze, silver, gold, and medical schools are being encouraged to, to get one of these certifications and then they can sell it to, to, uh, prospective students.

And , you know, if they have a certain level of, uh, intensity of lifestyle medicine, those students graduate and they can sit for the boards of lifestyle medicine. So it's a whole thing and, uh, Harvard has been involved in that. Um, there, there are schools, you know, what's interesting is that when you look at those 53 schools who signed on, it doesn't necessarily include some, some of the schools that have been most active in incorporating lifestyle medicine already.

For example, University of South Carolina, Greenville, these guys are pioneers and they have culinary medicine. They're doing all this stuff. They didn't sign on. Um, not surprisingly, the universities where there's been a lot of drama and debate and threats of defunding from the federal government, they have not signed on.

So it, it, it, I don't think it's a perfect match between who's invested in nutrition and uh, in who signs the, uh, the ticket there.

Jasmin Singer: Well, I might not have gone to medical school, but I do watch The Pitt, so I feel like that

Dr Michael Klaper: There you go.

Jasmin Singer: me at, it got me at least two years.

Dr Zach Burns: Definitely.

Jasmin Singer: Dr. Klaper. It seems obvious now that we have your book, but it, I, it kind of didn't occur to me before that there would be controversy about which diet should be taught, since it is weirdly not obvious to everyone or to every doctor that a whole food, plant-based diet is the way to go.

In fact, part of your book compares a whole food plant-based diet with two diets that have been popularized and are probably embraced by many people in the medical profession. I could answer this, given the fact that I watched The Pitt, but you know, I'll, I'll give you the honors of answering it, Dr. Klaper, can you tell us a bit about your efforts to compare the Lufkin, Means, and whole food plant-based diets?

Dr Michael Klaper: I've been in the nutrition game for 50, count 'em, 50 years already, and I've seen that pendulum swing back and forth, and right now it's swung over, uh, to the meat lovers side and the, uh, uh, the carnivore diet, the paleo diet, and all of these are in ascendancy. And why? Because as, uh, as, uh, my friend, the late Dr. John McDougall used to say, People love to hear good news about bad habits. Ooh, you can eat all the steak you want. Ooh, bacon is good for you. Ooh, doctor says so.

And then whoop and the American public, and, uh, not known for great discernment when it comes to nutritional advice jumps on that wagon and we're seeing, uh, an upswing here.

Um, as the experienced physician, I know what is going to happen. Um, and I'll put a hundred dollar bill on the table. Uh, that the results of packing the human intestine... we are plant eating homage by anatomy, by physiology. You take our plant eating body and you pack it through it full of animal flesh three times a day, uh, let that percolate for a few years and I guarantee within 48 months the, uh, the medical journals are going to be erupting with studies. Carnivore diet, a higher rate of risk of colon cancer. Paleo diet, higher risk of vascular dementia. Uh, meat-based diet, and increased risk of autoimmune disease. And my right eyebrow won't go up this much.

Um, yep. That's what's gonna happen. And that's some, and it'll hit the six o'clock news that you'll see, and suddenly those veggie burgers gonna start looking much better. And that pendulum's gonna swing back here. But right now we're in this, uh, uh, this meat based phase.

And, uh, we did, uh, we talked about, um, uh, Dr. Casey Means, the nominee to be Surgeon General. I'm sure she's a lovely person. Um, and she says some really good things. She knows the importance of good nutrition. Yay. But, uh, I was so disappointed when I read her book, uh, in that, uh, basically came down her main problem, uh, uh, enemy is ultra processed foods.

So as long as it's, uh, whole foods and organically raised, it's okay. Doesn't matter if it's plant or animal. I've had people do good on a vegan diet. I've had people do good on a meat-based diet. As long as it's, uh, uh, as long as it's organic and uh, uh, pasture raised or whatever, then it's okay.

Well, for a scientist to say something... that there's no difference in the body between broccoli and, and pig's anus in a, in a hot dog, that they have the same effects in the body. Are you kidding me, doctor? Have you read the studies, uh, than higher red meat consumption, you go higher all cause mortality? Have you not seen these studies? And she blindly passes over that. The word vegan appears in her book once and it maybe twice and never mentions it again. Yeah, people can be healthy and a vegan diet, but never says another thing about it.

And Dr. Lufkin from USC, wherever he's from, he, he's, he's against sugars. Yay. And, and a lot of bad diseases are from too much fructose in the body, and he's right. It's the cause of fatty liver. It's the cause of, uh, inflammatory bowels. He's absolutely right. Uh, but, um, but again, uh, and he also made a, People can be healthy on a, on a vegan diet, but, and then he gives, uh, his recommendations, uh, you know, full of meat, but low sugar. Well, both these doctors are missing the point.

Uh, you know, uh, Dr. Colin Campbell, uh, wrote this wonderful book entitled Whole, W-H-O-L-E. And um, and he's saying, stop focusing on the vitamin B content of, of, uh, Betty Crocker's chocolate cake or whatever. It's the whole food stream that goes through your body. We don't eat nutrients. We eat whole foods. And if that whole food stream is of whole plant foods going through your system day after day, good things are gonna happen in your gut, in your bloodstream and your, in your, in your tissues.

But you start adulterating that with meat and dairy and oil and sugar, um, health is gonna take a nose dive. And, and that's the, the ultimate truth of it. And Dr Means, Dr. Lufkin, that they're, they're so fixated on their tiny little, uh, aspect of what they think nutrition's about. It is really disappointing.

Um, and so I, uh, Uh, Dr means, uh, is called Good Energy. Thank you Mariann, for putting that in. And Dr. Lufkin, a great title, I wish I had thought of it. Uh, his book is Lies I Taught in Medical School. Uh, and, uh, he was teaching that, uh, I think he was teaching that meat is bad for you, and now I don't believe that anymore.

Um, so, uh, so Lufkin, L-U-F-K-I-N, uh, his Lies I Taught in Medical School and it's sad. Uh, he, they both missed the point here. We are plant eating hominids. Honor that natural law, you'll wind up in a lean, healthy body. Start eating the diet of the mountain lion, you're gonna wind up, uh, uh, with, uh, lots of bad diseases here.

So, uh, my colleagues have a lot to learn.

Dr Zach Burns: On the MAHA movement, it's tricky for Dr. Klaper and me and our, our team, right? How do we help people navigate this stuff? Because they're saying some things that make sense and they're taking a stand, um, and they're recognizing that diet and lifestyle has contributed to chronic disease.

They wanna do something about it. Okay, good. But they're, they're champions, right, of the Maha movement. There's lots of reason to be skeptical. They lose credibility in certain areas. You know, Dr. Means has this startup, uh, I don't know how big it's become, but it's called levels. And they basically sell memberships so it can scrutinize your, your blood sugar variability using, uh, continuous glucose monitors.

So it, it's this kind of new brand of like biofeedback and personal health that I don't think is really the solution to chronic disease. I think it's for people who are really, you know, interested. Honestly, I think it'd be cool to have a CGM, I would wear it, you know, as a doctor, I think it'd be fascinating. But this is not the answer to, to create more technology and biofeedback tools, um, and get everyone a membership so they can do this.

It, it does come down to the basics, right? And it, it's, it's what we're eating three times a day. It's not about supplements. It's not about checking lab panels that are like, you know, a hundred labs long and cost the patient thousands of dollars. This isn't a, a viable option.

Then you have RFK Jr himself. Um, I just, I have trouble trusting someone's health advice when they get artificial tans. I'm sorry. And I also worry about, I mean, he's done a lot of policy, um, that is really detrimental to, uh, to public health. So he's gutted the CDC, um, vaccines have never been less popular. Uh, it's very hard to get people here in Rochester to get a vaccine. Um, so you don't have to be in rural Texas.

So it, it matters. These conversations that are coming out of the MAHA movement. And overall, I, I think even if RFK Junior has good intentions, now he's gotten himself wrapped up with the boss and the base, and he's constrained. Not to mention the food industry and the pharmaceutical industry. I think he's constrained to, to, to do a lot, even if he wanted to.

So that's my take on on that.

Mariann Sullivan: Yeah, I, I couldn't agree with you more. I mean, the Maha movement is such an interesting combination of finally breaking through, in some ways, to talk about these issues that we've been wanting to talk about for a long time, and then saying all the wrong things about them. It's, it's very frustrating, but at least we're talking about it.

And Dr. Klaper, one of the, I, I'm not sure how, how much we could go into it, but I have to say as a lawyer, I so appreciated your idea, I mean, 'cause you were facing the fact that not everybody agrees on what the right diet is, and you can't just, we're not gonna get to go into medical schools and tell them, No, this is the right one. This is the one you should teach.

And having this idea of cr creating these legal arguments and having people, having, having legal designed after appellate arguments or trials, like, and, and evidence, bring evidence worth... the law is always trying to find not the truth necessarily, but the closest thing we can come to the truth.

'Cause you can't always know the truth. So I love, I just wanna say I love that idea and I think that's a very powerful way for, you know, now that this debate has been opened for, for you to bring in, uh, you know, these arguments. Because, because you're not saying, My way or the highway. You're saying, Here's, here's a time tested method for finding out the truth.

And we all know if we're actually looking at evidence, we're gonna win. I mean, come on. Uh. So, uh, I, I'm not sure there's a question there if you wanna talk anything about your idea for bringing that legal argument. I just wanted to mention that. I loved it. I loved it.

Dr Michael Klaper: Go ahead.

Mariann Sullivan: Zach, you've actually experienced this situation fairly recently of being in medical school and, um, do you think this reluctance to add nutrition to the curriculum is, I mean, the, the argument they seem to get give, which seems ridiculous, is there's not enough time.

I mean, if it's important, it's important, like, you know, you have to make the time. I don't know. Uh, but do you think that's true or do you think it's hiding something else? What, what do you, what was your experience of, of medical school? And I know that you had a lot of trouble, uh, just bringing up the issue that you were kind, it was kind of a DIY effort on your part.

So what do you think was, was really behind that?

Dr Zach Burns: Sure. So I'll give you a, a glimpse into my medical education in terms of nutrition. You know, I, I had a great education and I appreciate my faculty and you, you have to learn some things about medicine that don't, you know, it's not all nutrition like, so it's important to have a diverse curriculum,

Mariann Sullivan: I know

Dr Zach Burns: We what we did learn of nutrition was what Dr. Klaper mentioned. It was these really obscure vitamin deficiencies that we don't see in the United States. You might see them, they're, these are important topics in global health and epidemiology. We were talking about, you know, vitamin deficiencies, protein deficiencies, like when you see those really horrible ads for, you know, like donate to children in Sub-Saharan Africa and their, their bellies are distended 'cause they're actually protein deficient.

We just don't see it. If you ask any doctor in this society, they, they only see protein deficiency in, uh, people with terminal cancer or AIDS or certain kidney diseases. So the nutrition we did learn, maybe about 10 course hours, was irrelevant to modern practice in, in this area.

Um, why? Why was it that way? I think there are a few reasons. One, our professors didn't learn about it either. And doctors, we like to be confident about what we're teaching. So they didn't know the information. They can't teach to the next generation if they don't, if they don't know it. Number two, I think the pharmaceutical industry is involved in every facet of, uh, medical research and education, and they've really captured healthcare and they don't necessarily want the next generation of doctors to be fired up about diet and lifestyle.

Uh, right now 80% of antibiotics in the country go to farmed animals. And the highest grossing drugs of all time are for chronic diseases. Things like, you know, if you've had a stent after heart attack, or if your cholesterol's high, you need a statin. Um, or some of these fancy biologics that more and more people are requiring for their autoimmune conditions, which in large part are coming from complications of metabolic syndrome, like obesity.

So, and they, they donate to medical schools, right? Drug companies. And they, they heavily influence the medical guidelines coming from our professional organizations. There are guidelines that get updated regularly and they say, All right, you have a new diagnosis of type two diabetes. What should you do? And the organizations that are so trusted to give us that info are taking generous annual donations from big pharma. So are they gonna be as outspoken as they can and should about the role of diet and lifestyle? No. They're gonna say, All right, first line, you know, pay lip service to lifestyle.

Then immediately after that, um, you could either start Metformin or GLP-1, like Ozempic and, and that's, that's the juicy stuff. That's what med students, um, are made to think is important. When they're gonna go out and practice, they really need to know how to become glorified drug dealers. But when you, when you show medical students that there's a, there's another path and you, you can actually not just manage, but reverse the vast majority of these chronic diseases, they also get excited.

And that's the fulfilling part of our work in the organization, Moving Medicine Forward, is we, we, we get to expose some of these students to, to lifestyle medicine for the first time, um, or we, it's another touch point if they've heard about it some. And we show them that it's a viable way to practice, it's a viable career path, and they don't have to just refill meds and increase the dose every visit. They could actually heal people.

Dr Michael Klaper: We have no illusions about the resistance that is gonna be forthcoming here. There's a lot of doctors, uh, who are not thrilled about this. The, uh, the heart surgeons are gonna see them doing, if people actually start eating healthier, there's gonna be less bypasses done. There's less stents placed.

The general surgeons are gonna be taking out fewer gallbladders and fewer colons. Uh, the endocrinologist is gonna be treating fewer folks with diabetes as threatens their practice model and it threatens their financial model. Uh, and, uh, it's gonna take some creative work with the administrators, with the insurance companies.

There are ways to reward doctors and patients, uh, for not getting sick, for staying out of the hospital. Um, I had a, uh, uh, an insurance executive, plant-based fellow, a vegan, uh, insurance worker, said, um, doctor, every time the we pay for a bypass, coronary artery bypass, it costs us $250,000. Um, for every bypass that is not done, we've got that 250,000, we'll, we'll pay the doctor 20,000 for keeping his patient healthy for 10 years. We'll pay the patient 20,000 for staying healthy. We're still sitting on almost $200,000 that we can do other things with. There are the, the bean counters need to change the way the beans are flowing, but there's ways to do this.

But it is gonna take some spade work down in the basement there, and then the structure of the, the administration and finances. But it's doable. It's, but we're a long way from, uh, fait accompli, but I'm optimistic, uh, the truth will prevail here.

Mariann Sullivan: I wanna hear more about the, the program and specifically the masterclass. And I just wanted to add too about, about your book, the tone of your book was, so I think is, I mean, I think it was a great tone to take and, and also it's going to be so powerful now that you do have this opening because you, you're not really blaming anybody. In a, you know, and I, you know what I was thinking, when you think of those heart surgeons, they've spent their career thinking they were saving people's lives. Well, maybe not all of 'em. Maybe some of 'em are in it for the money, but I bet a lot of 'em just think that they're doing the right thing. And it must be, you know, difficult to, uh, to make these adjustments.

But I, I think the way you approach it in this compassionate way is going to be very, very helpful. And even Dr. Casey Means, you say a lot of nice things about her, which I'm really glad you did now that, now that she, she's in the catbird seat. But anyway, my question is more, um, I wanna hear about, 'cause there are different elements of your program and I want people to hear what they are, um, as part of this interview.

And so tell us about the masterclass.

Dr Michael Klaper: We have a 12 unit masterclass on applied plant-based nutrition, um, and how to use it, how it has beneficial effects to the cardiovascular system, GI system, nervous system, et cetera. What it does in the body when you eat a plant-based food stream, uh, these are 90 minute videos, uh, that we did a while back.

Uh, and, uh, people who, uh, actually, um, joined Rochester Lifestyle Medicine, uh, Institute, uh, have access to, uh, to our, um, to our masterclass in plant-based nutrition and, uh, want to get it out in, uh, the general knowledge there. And by the way, the, uh, cardiac surgeons, I've spoke to some of them that are so discouraged because, uh, they do these eight hour operations on overweight patients and they limp outta the hospital and head right to the fast food restaurant and start eating more burgers and clog up their grafts and the, this is money wasted.

That money could be used to fix the bridges and the roads, to put kids in college. It's a waste of taxpayers money to, you know, this black hole of medical care. So, um, there's a more positive, uh, future ahead of us here, but again, we're still got, got a lot of work to do.

Mariann Sullivan: Yeah, that's great to hear it. I, I, I think I noticed that, um, the masterclass doesn't count for, um, continuing medical education is one of your goals to, to get that?

Dr Michael Klaper: Absolutely. Dr. Burns, where are we with that process? Are you, I think we're this close.

Dr Zach Burns: It's underway. Yeah. We, we will certainly have it count soon, um, maybe in the next couple months.

Mariann Sullivan: Oh, that's great. That is huge. I mean, uh, also being in a profession that requires continuing

Dr Michael Klaper: Education. You bet.

Mariann Sullivan: like, uh, that is really gold.

Dr Zach Burns: I can tell you

Mariann Sullivan: They're not getting credit for.

Dr Zach Burns: You are right. So this masterclass came out when I was in medical school and I had this amazing role of facilitating the discussion between Dr. Klaper and, and the guest panelist, um, as part of the class. And I felt like the luckiest med student in the country. Uh, and I was getting this education, which has become really integral to my practice, and, you know, so I had to go out my way to get it.

This is not part of the curriculum, but if we can show more, more students this masterclass, especially once we get our foot in the door with one of our lectures to the relevant medical student group or even sometimes their entire class, um, then we, we follow up with the masterclass. We go deeper into the physiology and it starts to make sense.

It clicks for these scientific thinkers who wanna understand, not just, Okay, yeah, um diet, eat your broccoli. That's intuitive. They wanna understand exactly why it's good for the inside of the blood vessel walls, why it discourages the deposition of plaque, uh, why people are less likely to get, uh, hyperglycemia in their brain and develop, uh, neurodegenerative diseases through the standard diet, and how to reverse that process through healthy eating. So it becomes academic and really fascinating. We wanna get this, this masterclass, um, out there.

Jasmin Singer: It needs to be. I mean, and I realize this was a long time ago, but uh, 20 something years ago, I went to school for nutrition, for holistic nutrition, and Marion Nestle was one of the instructors. And I had a friend who was, had been vegan for like seven years at the time and went to see, um, Marion.

And Marion said to her, you look like you need meat. And the friend started eating meat. I mean, it, it was, I, I'm, ahh! Like, this is probably, I don't know from my, from my position where this is all in the periphery for me. You know, I don't work within this field, but obviously as a, as a vegan activist and animal rights activist, it's very much coming into my inbox. I really am blown away when I see things like that by someone as famous and well known as a nutritional expert as Marion Nestle.

Dr. Klaper, I'm curious, you've mentioned that you've been doing this for, um, I think you said like 500 years, is that, you said five. Okay. Um, so like how has the, how have things been changing in that time?

I mean, I know, I know you had to like reconstitute your TVP that you bought at the health food store in the corner where everyone smelled like petru. I get it. But like, you still seem like a, a hopeful person and I don't understand that. I mean, maybe I'm just like a curmudgeon, but, uh, tell me about how things are changing and if you genuinely feel like we're gonna turn a corner.

Dr Michael Klaper: Uh, yes. I generally feel that, uh, we're going to turn the corner. America's gonna become plant-based one way or the other. And, um, I will let, let that sit there and percolate for a minute there. But, uh, meat's gonna become more and more expensive as the climate changes and plant foods are gonna be cheaper and, uh, more economical people, just for the economics, will swerve towards more planned foods.

But, uh, that a, that anecdote that she related regarding Marion Nestle and telling that person they need meat. I'll, I'll put a a hundred dollars bill on the table, that as that scene unfolded, uh, one of the first things, the person, somewhere along the line, uh, that she said, the V word says, I'm vegan.

And I X, Y, Z, I don't have energy or whatever. And that's gonna immediately get you the response, um, uh, you need to eat meat. Uh, there is a huge anti vegan stereotype, anti vegan, uh, mindset out there for all sorts of reasons. It's threatening to people. It's, uh, everybody knows a vegan who didn't do well, therefore, the whole thing is dangerous.

You know, we all have heard the litany there. And, and Marion, uh, disappointingly, uh, uh, unfolded, uh, her, her role in that. Um, and for that reason, depending who I'm talking to, I don't, I seldom use the V word, uh, in common company here. And, and I seldom use it, uh, in front of medical audiences. I just don't want it to, uh, uh, to evoke that response in them.

Uh, so we use, uh, pleasant, uh, a pleasant words to sub. Plant based and plant predominant, plant strong. That is true if, if someone, uh, eats a small piece of meat once a week, probably nothing terrible is gonna happen. I can't say that it's a, and with intellectual honesty that it's a evil thing to do.

It's evil from the animal's point of view. It's evil from the planet's point of view. But yes, uh, it is true. Uh, and we can't be so, uh, rigid, uh, because it drives people off there. And, uh, so be careful about opening that can of anti vegan sentiment there. 'Cause it's even for, with scientists and doctors that they're so, it's so threatening to them.

It's for so many reasons, uh, that, that, uh, it is not worth, uh, unfolding that scenario there. So, uh, if we, I think that was behind mostly what we're seeing. So knowing that the science is solid, you know, that's the issue. When I have to see, now many of these folks who adopt a pallo dietary carnivore diet initially get better.

Uh, and they lose weight, uh, because they stopped eating the white bread and the dairy and the oils. And stop eating the white, you know, flour products, dairy products, and, and oils, you'll lose weight. And the weight loss will help, will make your insulin, uh, receptors function better, will improve your lipids.

And people say, Aha. See, it's the best diet. But, uh, a six month study or a 12 month study showing some the beneficial changes in numbers does not equal longevity and human health. Now, you follow these people along in 10 years, 20 years, and see who's still alive. Now you will find, uh, that the plant eaters have a huge advantage.

So, uh, I, I have absolute confidence that we are plant eating hominids. Uh, we have fingers on our hands, not claws. We've got, uh, you if you need validation from the university, enzymes in our saliva are, is amylase for digesting starches. If that's not a clue from the universe about what we're supposed to be eating. Now, there's no question the plant eaters are, are gonna do better in the long-term medical studies, and they're the only thing to keep your eye on.

So let the winds blow, uh, keep, like the Desiderata says, state your truth clearly and quietly, uh, it will, uh, it will find its way to the surface. I have confidence in the truth of this. They say, you, you can't, you can't keep a hat pin in a cloth bag for very long. The point comes out.

Mariann Sullivan: I just wanna say that, uh, that I, I mean, I actually have some hope here, which anybody who listens to the podcast knows that it's not something I'm well known for. And, and it's because of, I mean, this whole conversation we've been having about what happened in the newspapers today and the fact that here you are having done all of this work, having written, I mean, a lifetime of work, having written the book, um, then, Zach, you're out getting the, um, the continuing medical education credits.

Like you, you, it's like the universe got you guys poised. Like if you weren't here, the only people chiming in would be, you know, the paleo people. Well, there, there are other plant-based people, obviously, it's not just you. But, uh, but specifically from the medical point of view and from the medical school point of view, it really does seem like the universe is speaking that this book is, I wish the book was coming out tomorrow and not next month.

Um, because the timing could not, just could not be. And, and it's because you did all this work based, you know, you took a chance, uh, that this was going to matter. And, and the universe is, is really making that happen. And I know that there's more that we wanna talk about. I don't know, maybe we should save it for bonus, because you don't always, you don't only talk about medical education in the book, but also about clinical work and, and what a clinic should look like.

So, um, maybe we can talk about that, uh, in, in the bonus content.

Dr Michael Klaper: Yes. One of my favorite chapters was, uh, a Day in the Disease Reversal Clinic, which should be part of every hospital you

Mariann Sullivan: It really, it, it absolutely should be.

Dr Michael Klaper: Absolutely. There should be pediatric clinic, ology, disease reversal clinic, and you know, the, and I said every doctor's office should be a disease reversal clinic.

These are eminently reversable diseases. And we talk about the physiology of how to, how to that happens and how to make it happen.

Dr Zach Burns: And ultimately the, the book is about the, the next generation and moving things forward. And it's optimistic and, and hopeful. And I think this, current trainees, whether they're students or residents, they get it. And they, they're, I think they're more likely to make that connection between human health, the environment, and animals, because the pressures on the environment are increasing.

Uh, young people today are concerned about climate change and other environmental degradation. They see that beef is the number one driver of deforestation and biodiversity loss and mass extinction. They, they get these things. And it also, unlike some of our colleagues, Dr. Klaper and I are outta the closet as vegans.

And, um, I think that's actually a, a really, like an appropriate, uh, position to take as a physician. Uh, are we just gonna do no harm in the exam room, or might we choose to do no harm outside it? Um, are we gonna make the connection between our protein economy and antibiotic resistance and the next pandemic, all these zoonotic infections?

Um, we're gonna realize that climate change has a impact on human health? So when you start to put these things together and, uh, it becomes really clear that that's the reason that you can't, you know, as you're feeling a little sleepy, um, maybe you should have more red meat in the diet. Are there are other ways to go about it?

Because we don't have the resources, um, for more people to enjoy more meat. Uh, we we're running out of resources swiftly, so, um, so that, that's my take. And I, I am optimistic that more people coming up in healthcare feel that way too.

Jasmin Singer: Good. I'm really glad to hear that. And Zach, when, when we interviewed you last time, that was one of my favorite moments of Our Hen House history ever was, and I can't remember specifically exactly, but it had something to do with me asking you if like the first do no harm ethos, if it was like somewhat awkward to bring it up with your clients and you were like, Jasmin, you're an idiot. Why would you ask me that? You didn't say that, but you thought it a little bit.

No, you were like, why don't you think you were like, don't you think there's a problem with that question? Like, don't you think that's sad? And I was like, Who is this, Dr. Burns? Like I, it was so, it was so refreshing, especially because all of us listening to this, all of us have had to walk into a doctor's office and deal with ignorance and, and it's, it's, it's mind boggling that this

Mariann Sullivan: It's, it's so true that the minute, like the first thing they, they, they, they ask you, uh, if like, if, especially as you pointed out, Dr. Klaper fatigue, if you mention anything like that, as if there weren't other causes of fatigue in the universe. They, they find out you're vegan and they assume that that's, that, that's, that's the issue.

It, it like closes down the conversation. I, that has happened so many times.

Jasmin Singer: Mm-hmm. Absolutely.

Dr Zach Burns: Quick thought experiment. Very briefly, so imagine, you know, say you have this doctor you really like, would you still trust 'em if you found out they abused their spouse? Maybe not. That'd probably be a red flag. What if they abuse their dog? What if they paid someone else to abuse pigs? In other words, they ate pork.

Right? What's the, what's the difference? So I, I think you start to erode trust if you are participating in, um, in animal cruelty, whether it's directly or not.

Jasmin Singer: Yeah, a billion percent. That's such a perfect note to end on, but Dr. Klaper, can you please reiterate the name of your book and tell people like the best way for them to follow you because you, you're, you are no stranger to the digital sphere. You're always popping up with videos and podcasts. So can you just tell our listeners a little bit about how to follow your work?

Dr Michael Klaper: Indeed. Thank you. Uh, the book is Moving Medicine Forward. It's the name of our nonprofit organization. It'll be, it's available now on Amazon for pre-sale, and the more pre-sales we get, uh, the higher the ranking and the lower the price will come down. So, uh, if you wanna support us, go to Amazon now and, and pre-order your copy and it'll be delivered to you.

It will come out in hard copy in the bookstores April 7th. And, uh, it is a great gift, uh, to give to your doctor. Buy two copies, one for yourself and one for your doctor. And, uh, if you would like to, uh, follow us, go to our website movingmedforward.org. Movingmedforward.org. Uh, and, uh, you can follow us on Instagram and I think we have a Facebook page too.

Uh, so I'm sure the, uh, the handles will be published, uh, in the show notes here.

Jasmin Singer: Absolutely. And Dr. Burns, how can people follow your work?

Dr Zach Burns: I keep all my stuff on my personal site. It's www.herbivores.Life, herbivores.Life. I have a blog and some longer form essays.

Jasmin Singer: Wonderful. Well, thank you both so much. I know you're gonna stick around for a q and a, and I know there's some questions brewing already, including I have some, uh, but we, this has been a delightful conversation, truly. And, uh, for those of you listening, those of you in person, as well as those of you tuning in right now, whether it's through your favorite pod catcher or through YouTube, we're so happy you're here.

So thank you for tuning in, and please subscribe, hit like, comment, share the word, spread the love, and we will talk to you next time.

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