#48 - Dr James Muecke, 2020 Australian of the Year on Creating a World where Everyone can See

Dr James Muecke AM is an Adelaide-based ophthalmologist with over 35 years of experience, having practised all over the world in countries Kenya, Jerusalem, and London. 

Through his profound experience, James has taught the diagnosis and management of eye cancer in ten countries in Asia. He founded the not-for-profit organization Sight For All in 2008, turning his boundless energy into a fight against blindness in the Aboriginal and mainstream communities of Australia and some of the poorest countries of the world. Sight For All’s comprehensive and sustainable projects are now impacting the lives of over one million people each year. 

His commitment to social impact and humanitarian endeavours has earned him several awards, including:

• Order of Australia in 2012,  
• Australian Medical Association’s President’s Leadership Award in 2013,  
• Ernst & Young’s Social Entrepreneur for Australia in 2015. 
• and in 2020, James was awarded Australian of the Year 2020 for his 32 years of humanitarian work. He is using this powerful platform to raise awareness of our poor diet, laden with sugar, which is devastating the health of Australians. 

 In this episode, Dr James shared the incredible journey that led him to become a world-renowned ophthalmologist and 2020 Australian of the Year. We deep-dived into the amazing impact his not for profit, Sight for all, is having globally, which has the ultimate mission to create a world where everyone can see.  

Using his platform as Australian of the year, James is passionate about educating the world on the root cause of diabetes and prevent looming health catastrophes. In addition, he wants to challenge our perception and our relationship with sugar,  as he states that "Sugar is as toxic and addictive as nicotine".  

He walked us through the growing cases of type 2 diabetes and ways to avoid this. We also spoke about one of his patients, Neil, who, as a result of his extreme sugar intake, led to Neil waking up one morning completely blind and lead to 9 separate amputation operations. The negative effects that sugar has on our health and the correlation between sugar and blindness is confronting.

James also shared his thoughts on what the future looks like for the human race if we keep going down the path of fast food, sugars, alcohol etc.

Where to find Dr James Muecke

• LinkedIn
• Sight For All

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Say hello to our host Daniel on LinkedIn.

Transcript

Synergy IQ: 0:01

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Daniel Franco: 0:20

is synergises and welcome back to another episode of The creating synergy podcast. My name is Daniel Franco and today we have the 2020 Australian of the Dr. James Muecke here on the show. I just wanted to say up front that this is such an important podcast the knowledge shared by James, if utilized correctly can have an extremely impact not only on our lives, but on our kids lives on our family, on our friends and our colleagues. So I'd love for you to share it as to as many people as possible because it is a message that really needs to get out there. So a bit about James Dr. James Muecke is in Adelaide based ophthalmologist with over 35 years of experience having practiced all over the world in countries such as Kenya, Jerusalem and London. Through his profound experience, James is taught the diagnosis and management of eye cancer in 10 countries in Asia. He's founded the non for profit organization site for all in 2008 and turned his boundless energy into a fight against blindness in the Aboriginal and mainstream communities of Australia and some of the poorest countries in the world. Seifer rose company comprehensive and sustainable projects and are impacting the lives of over 1 million people each year. His commitment to social impact and humanitarian endeavors has earned him a number of awards, including the Order of Australia in 2012, the Australian Medical Association President's Leadership Award in 2013, Ernst Young social entrepreneur for Australia in 2015. And in 2020, he was awarded Australian of the Year for his 32 years of humanitarian work. He's now using this powerful platform to raise awareness of our port on laden with sugar which has devastating effects on Australians. In this episode, Dr. James and I talked about his incredible journey that led him to become the world renowned ophthalmologist and the Australian of the Year in 2020. We deep dive into the amazing impact is not for profit sight for all is having globally, which is the ultimate mission to create a world where everyone can see using his platform as Australian of the Year James is passionate about educating the world on the root cause of diabetes and preventing a looming health catastrophe. He wants to challenge our perception and our relationship with sugar and he states that sugar is toxic and addictive as nicotine. He walked us through the growing cases of type two diabetes, and a way in which we can avoid it. We also spoke about one of his patients, Neal, who as a result of his extremely sugar intake, led to new waking up one morning completely blind, which then led to a further nine separate amputation operations. The negative effects that sugar has on our health and the correlation between sugar and blindness is very confronting. James also shared his thoughts on what the future looks like for the human race if we keep going down the path of fast foods, sugars, alcohol, and all the above. If you love the episode, which I'm sure you will, please hit subscribe button and check us out at Synergyiq.com.au and synergy IQ on all the social media outlets. And remember, if something hits a chord with you in this podcast, please share it with your family and friends. It's a message that really needs to get out. Thanks again. So welcome back to the creating synergy podcast. My name is Daniel Franco, your host and today we have the very, very intelligent Dr. James Muecke on the show. Welcome. Thanks, Daniel. Great to be here this morning. First and foremost, I just want to kick off with a big thank you for the work you are doing the research and the work that you're doing around the world globally on blindness and on the type two diabetes and the war against type two diabetes is is amazing, which earned you honors as Australian of the Year in 2020. So just want to kick off the show by saying thank you very much.

James Muecke: 4:29

It's an absolute pleasure. In fact, I won the award on the work I was doing with my not for profit site for all so I decided to use the platform to raise awareness of type two diabetes. Excellent.

Daniel Franco: 4:40

Excellent. So I just before we kick off and get into the nitty gritties of all the work you're doing it's site for all and the and the blindness and type two diabetes. My knowing a little bit about your story. You're an ophthalmologist by trade and we'd love to hear about your your journey to where we find ourselves today.

James Muecke: 5:00

long journey. We got this thought. So yeah, I'm an ophthalmologist and I'm an eye surgeon. So I've been an ophthalmologist and now since about 31 years actually, but it's a medical specialty. So I had to do medicine and I actually I was born here in Adelaide. Dad got a job with the CSIRO in Canberra. So I left at the age of five, and went to school in Canberra. I wanted to go to Sydney University because it were all my mates were going my girlfriend was going back in, when would that have been 1982. Unfortunately, I missed out on Sydney Uni by one mark. So I decided to come back to Adelaide because family was from here, had friends here and I was comfortable with Adelaide. So that's where I headed and medical school here at Adelaide University and very much enjoyed that and love setting up a life here in Adelaide. Having said that I've traveled a bit overseas and lived overseas. In between that time after my internship which was at the world of Rhode Island Hospital. I went and worked as a volunteer doctor in Kenya, in 1989. I traveled extensively through Africa backpacked in those days, and then came back here I did my ophthalmology training. And then following that, my final year of Ophthalmology I spent in Jerusalem at St. John's Eye Hospital, as a general ophthalmologist, which was another fascinating year really did cement a passion for fighting blindness in poor communities. Following that experience, my wife and I spent some time in the UK, and I did some subspecialty training in primarily eye cancer. So I'm an eye cancer specialist, which sounds pretty obscure, which it is eye cancer. Is it a is it a common thing? No, it's rare, and it doesn't form the majority of my practice, but it forms a significant part. And at the time when I returned to Adelaide, in 19, was that 1998 I was the only I cancer specialist. Really, in the western half of Australia, there was only three of us in Australia at the time when in Sydney, Melbourne. And so talk about niche. Yeah. So we were sending patients that needed treatment into state, so there was a need for it. And over the 20 odd years I've been back was announced that there will be 20 Yeah, 23 years that I've been back, I've been building that practice and providing an important service for the people of South Australia. Although it is rare. I have one of the largest series of eye cancer on the surface of the eye in the world, and because of our exposure to sunlight, particularly in rural and farming communities. So I'm also seeing patients with melanoma in the eyes, and which is most people would never heard of it. And related to sun exposure

Daniel Franco: 7:50

is kind of like the eye spots. And is that what you see? Is it a visible thing? Or is it behind the eye? Or what does what does? What does it look like? Yes,

James Muecke: 7:57

you can you can get develop melanoma on the surface of the eye, or inside the eye or inside the eye is more common. And generally, you wouldn't be able to see that happening at all. If it does impact on your vision, which is usually the way it presents sometimes it's just picked up by an optometrist at a at an optometry visit. But if if it's starting to impact on the vision, that's maybe how it's picked up. But the other the other one that I've dealt with over the years as a is a childhood cancer called retinoblastoma, which is actually the most curable I cancers. And that's what I've been involved in teaching throughout Asia as well and developing expertise in that in that specialty

Daniel Franco: 8:38

printing. And kudos to all the work that you're doing. And thank you again. What was it about the eyes that drew you in? Right? It's a good play on words there. But what, why? When you're younger, and you're going through and you're saying you want to go to Sydney University, you come home to Adelaide to study because ophthalmology why? What was that that was inside you are saying this is something that I need to do?

James Muecke: 9:04

Sure, I knew from very early years that I wanted to be a doctor. Firstly, yeah. And then I wanted to be a surgeon, I loved working with my hands. In fact, back when I was eight 910 11 Those sort of age I was I used to build model airplanes in World War Two or tank things like that and very intricate models and paint them you may have the same

Daniel Franco: 9:27

those are the days before the skill level

James Muecke: 9:29

that was really the days before computer games and smartphones and things like that. So I used to love working with my hands. So I wanted to be a surgeon and work towards that through through my work towards getting the medicine at high school and then through medical school to become a surgeon and particularly because I love this fine work with my hands. I love the idea of micro surgery. So there are a number of areas where you can practice micro surgery One of them's plastics Every one of them is neurosurgery. And the other is ophthalmology. And during my internship, I ended up placements in neurosurgery and general surgery. There was no opportunity to do ophthalmology, but it was the it was the one thing that really, really appealed to me. I went to, to Kenya, in at the end of my fifth year of medical school. And whilst I was there, I spent three months in Kenya, I came across this little hospital in the mountains in central Kenya to the hospital called tumor tumor about two hours north of Nairobi. And I just fell in love with this place and thought one day, I'd want to come back here and live and work. And so during my internship, I wrote to the director of the hospital, and I said, I'd like to come and work here for a year. And so he welcomed me to come back. And so once I finished my internship, I headed off to Africa travel for a bit and came back and worked at this, what

Daniel Franco: 10:54

was it about the African world that you decided you loved? And you know, Australia is such a beautiful place to live? Yeah, what drew you to Africa?

James Muecke: 11:04

Well, this really, again, dates back to my childhood. So around those times I was wanting to do to be doctrine, and to also perform surgery. I had this love affair with Africa, not that I've been there. But I just knew the the appeal of the wildlife. And also the scenery in the deep dark jungles had this mysterious appeal that endless Savannah. So I, when I was a young boy, I used to love watching shows about Africa and TV Kimba, the White Lion, which was a cartoon, Tarzan of the Apes, and also deck Terry, which was a TV series from the 60s actually, but it was about a doctor in East Africa. And that held huge appeal. So you imagine that the age of whatever it was six or seven, wanting to be a doctor and wanting to work as a doctor in Africa, and then finally realizing that dream and actually becoming a deck Tyree. So deck, Terry beans, doctor in Swahili. So when I landed in Kenya, and after my internship, I was my own real life. Deck. Terry, start your own TV show. Yeah. And that's actually during my internship, I was becoming a little disillusioned with medicine. This is my first year of earning earning money. And it was my first year of practicing real medicine.

Daniel Franco: 12:16

Why I was like, why are we becoming? Yeah, because

James Muecke: 12:21

really, through that year, I was mainly encountering people, patients who had diseases that were chronic and self inflicted. Yeah. So the opportunity to provide a cure often wasn't there, these people had self inflicted diseases, mainly related to smoking back then, but also a poor diet was starting to come into play. So a cure wasn't always possible, really just alleviating symptoms prolonging life. And at first it frustrated me my personality is one that I like to have a project and I like to be able to complete that project. So you can imagine that frustrated me the the opportunity or not having the opportunity to provide that cure. So I was actually starting to rethink whether I wanted to truly do medicine, but I thought, well, let's let's head off to Africa, see how that year inspires me and really did so during that year. Now, I was encountering patients that didn't have self inflicted chronic diseases, mainly diseases that were infectious, malaria, tuberculosis, so they were imminently curable, and that really suited my personality. And so it reinvigorated from your love of medicine, but more importantly, it instilled a passion to want to pursue a career in public health. And then the idea of combining public health with surgery, but particularly micro surgery, and in particular ophthalmology. So to fight blindness in poor communities, was the thing that really drove me down the pathway of ophthalmology and the leading cause of blindness in the world is cataract. It's a 15 minute operation. It's a very beautiful and sophisticated operation, but it is the opportunity to provide a cure quite literally within 15 minutes. And is that

Daniel Franco: 14:10

the is that when people say I'll get laser eye surgery, is that what the cataracts are? No, that's

James Muecke: 14:14

a different thing. So that's, that's really to people who have to wear glasses, okay, what we call a refractive error, and the opportunity to shape their cornea so that they can they can take away their glasses. So a cataract is a clouding of the lens inside the eye that slowly develops as we age. It's a it's something happens to all of us if we live long enough. But it is the leading cause of blindness in the world makes up about 50% of cases worldwide, but in poorer countries, it is by far the leading cause of blindness. And that's why

Daniel Franco: 14:45

we in the aging population or across the board.

James Muecke: 14:50

Both excellent. Yeah, so here in Australia, it was the leading cause of blindness across the board. Yeah, okay. And Over the years, the number of ophthalmologists have increased, the capacity to do sophisticated, but also timely surgery in patients very, very used to be when you had a cataract operation used to have to sit in bed or lie in bed for two weeks with the head in sandbag, so you will move but now these days it's day surgery. It's a 15 minute local anesthesia. So it's a it's a it's a wonderful operation walk out and you can see as you will literally take the pet off the next day and wow Tensley back driving level vision at least and so yeah, so cataract cataract is eminently treatable, and it is. But it does make up the bulk of blindness in poor communities. And that's why in poorer communities, about 90% of the blindness is is what we call avoidable blindness. So it's either preventable or treatable, but in the case of cataract surgery, it's avoidable. So but you know, if it will Why'd it makes up about 50% of cases, the other 50% of blindness are due to a number of other entities. And so there were quite literally hundreds, perhaps even 1000s of different diseases, many, many blinding and some, such as I mentioned before, retinoblastoma, some eye cancers are potentially deadly, even disfiguring. And so in poor communities, many of these diseases beyond cataract had really been poorly managed, even neglected in some countries. And that's where, really cyfle has come to the fore to address comprehensively all blinding diseases, not just Kettering. Yeah,

Daniel Franco: 16:36

well, I think look site for all the mission for site for all is to create a world where everyone can see, you know, that's a, that's a out there vision, right, that that you've embarked on, which is an amazing and so the other 80% of the world's blindness is avoidable that that's an alarming statistic in its own right. How do we what is the low hanging fruit to avoid blindness?

James Muecke: 17:05

Yeah, so it is, it is a very well called big, hairy, audacious goal to create a world where everyone can see but it's important to have such a goal because it's something to strive for spot on. And so cyfrol has this this this B hag big, hairy, audacious goal, creating a world where everyone can see. And so if you realize it's actually 90%, now used to be 80%. But it's up to 90% avoidable blindness. And they're about 43 million people in the world who have blind, that many, many more than that, that also have an outline, but have a low level of vision, you know, in the hundreds of millions. And so if we say that cataract is that leading cause of blindness, and yet it is a very treatable operation, then we should be able to really now significant proportion of that avoidable blindness at least. So the other 10%, worldwide, is unavoidable. And many of those would be genetic or inherited diseases, which at this point in time, we can't address but we also have a research arm which is looking at being able to potentially manage some of these, at this point in time and avoidable causes of blindness. So, in in Australia, I mentioned that cataract was the leading cause of blindness some years ago, but now we have enough ophthalmologists and enough expertise and the infrastructure and the affordability to be able to do that here. And so it is now no longer the leading cause of blindness, but in poor communities. And often, in many situations. So in many countries, particularly in regional areas, there may not be eye centers, or ophthalmologist, or even when there are ophthalmologists, there may not be the equipment that they can use to be able to perform the surgery and so that's why it is still a big big problem in these poorer communities. And even if there is the equipment patients may not be able to afford them. Most of these countries is not free like it is here in Australia with our Medicare system

Daniel Franco: 19:00

it's amazing look at and again the Australian of the time off the back of this site for all mission which is you know, like you said the be hag goal. We talk us through that and how the whole how the whole string of the came about? No, firstly and foremost, I'm an emotional empathy empathic person, I like the emotion in all of it. How did you feel when you were announced? Australian and the like, just, you know, you set these goals and I know you're not. It seems to me as if you're not about the personal accolades is about the you know, the greater good, but there must have been something inside that felt good when you when you were awarded that surely.

James Muecke: 19:41

Oh, naturally. Yeah, amazing experience. And fortunately, it was just before COVID Struggling early last year and I had all of my family there. So I had nine family members in the audience when it happened. I was not expecting to win it. I wasn't expecting to win the South Australian award either because you have to have that before you can go on to the national ceremony. So I was not expecting it. And particularly because the year before Richard Harris won it. So here's another doctor from LA, where they're going to give it to a doctor from Adelaide two years in a row. I didn't think so. And the other against the odds were definitely gets me and I knew that myself and I kept on hearing that from people. So when my name was called out, it was like, Well, you know, this is this is, this is a huge shock. But we had to be prepared. So all of us who were finalists had to have a speech ready. So speech ready, I knew I wanted to raise awareness about type two diabetes and the dangers of sugar and our poor diet. So I was prepared for that, but not expecting it. But I think for me, the most important, and it was a lovely accolade for me, and it kind of, you know, all of the decades really, and quite literally 1000s of hours that have volunteered Blood, Sweat Tears. Yeah, really, it's, it is quite extraordinary. And sort of justifies that, which is nice. But more importantly, I felt this was now the opportunity for cyfrol to get the recognition that it really deserves, you know, we are doing wonderful work. And I can share some stories about that in a moment. But we're really still struggling with, with fundraising and money coming into the organization to really continue to do not just to continue to do the work, but also to grow, because I know what we were doing was really powerful, high impact sustainable. However, you know, so many charitable organizations in Australia, that that money gets diluted, and you know, unless you have a passion for, for blindness, let's say it's affected yourself or your family. Or if you have a passion for development in poorer parts of the world, particularly Asia, you know, it's not always easy to find that money. And so I thought, here's an opportunity cipher was gonna get recognized, and the money will start flowing in and we'll be able to grow the organization, and all sorts of wonderful things. And lo and behold, what happens next is COVID pandemic COVID comes out on the back of the bushfires, of course, and that really directed a lot of the charitable dollar as well. But certainly, when, when COVID hit, they're just scaffold, everything. In fact, fundraising, while it's literally flatline, perhaps even dropped off a little, which was, which was and still to this day, it's terribly frustrating that on the back of this amazing opportunity, we've not been able to leverage off it to flourish.

Daniel Franco: 22:33

So tell us some of them about some of the work, you are doing it site for all and you know, some of the good stories that are coming out of it? Sure,

James Muecke: 22:39

sure. So site for all is a social impact organisation, quite clearly dedicated towards Fighting Blindness. We really have founded in 2007, on the back of work that a number of us were doing from the Royal Adelaide Hospital here in Adelaide, in those early years after I returned from my training overseas. And so we, we launched in 2018. We registered it in 2008, with a vision of creating a world that everyone can see and with four key strategies to try and achieve it. So the strategies are research, education, supporting infrastructure, and raising awareness. So I can tell you a story that really captured that the best the best way. I love that story. So one of the things one of the really powerful, if not the single most powerful moment in my clinical career was being involved in a charter bonus study in Myanmar, back in 2007. And there's a bit of a story leading up to that, but and I've been involved in teaching in Myanmar, and growing their ability to treat all blinding diseases. Up to that point. I was even involved in adult blind study in Myanmar with my colleagues here in 2005, and that that was an interesting experience, actually, you mentioned before about cataract affecting people, elderly people or people of all ages. Certainly there is something called congenital cataracts. So you can actually be born with cataracts. And there are a number of causes for that, but senile cataract aging cataract as the most common. Now I was in my early 40s At the time, and when I was involved in that adult bonus study in central Myanmar. And so there were patients that were younger than me, who had seen our type of cataract and you know, we were only seeing patients or people in that study from the age of 40 up but there were people at the age of 40, who are visually impaired, even blind you to their cataract, that's something you just do not see here. And so that was like, quite staggering to me. Anyway, that was a really powerful study that led to all sorts of interesting outcomes, which we can talk about later. But coming, then on the back of that study, I thought it would be a great opportunity to see what's happening in children in this country when we determined that cataract was the leading cause of blindness and even patients in that study in 2005, who'd had cataract surgery, many of them are still blind, which was quite an extraordinary encounter as well. So I thought, let's go back and take a charter blind study. This involves visiting all of the schools for the blind throughout the country, and at the time, there are about seven. And the results were like, wow, it was quite disturbing, quite confronting. Firstly, we found that nearly half of the kids has at schools the blind had blindness or could have been prevented or treated. Nearly half are needlessly blind shouldn't even be at those schools. But the finding that really impacted on myself was the leading cause of blindness that we discovered, which was measles. Okay. And and this was quite simply in children who had not been vaccinated, so they were susceptible to the complications of measles, one of which is damage to the cornea, window to eyesight, and then damage is quite devastating. It's generally irreversibly blinding. It's also horribly disfiguring. So for myself, to be surrounded by children who had irreversibly needlessly blind at schools for the blind across the country was so incredibly powerful,

Daniel Franco: 26:39

especially considering we have a cure for for measles, right?

James Muecke: 26:43

Well, no, we don't have a cure we have we have a prevention. Sorry. So Correct. You talked about avoidable blindness. So measles, I would say would be absolutely a preventable cause of blindness. It costs less than $1 to prevent measles, measles in a chart through the vaccination program. But if you develop measles, keratitis or inflammation of the cornea, yes, it's treatable. Generally in a poorer country in a regional area where services are not there. It's going to be devastating and blinding. Whereas cataract is at this point. The senior type of cataract is not preventable, but it is highly treatable. So it's interesting to see the the comparison between those two. So this was a highly preventable cause of blindness, quite simply because there was huge paranoia amongst the government at the time about measles vaccination. So the program hadn't worked was firstly not not providing the reach that it needed. You know, we're going through an interesting experience with vaccination here in Australia, in the world, and then the world absolute, you can imagine in some of these poorer countries where how on earth in countries of a billion people are they going to reach where we're struggling even to reach 20 25 million, but how in a country of a billion people? So So you can imagine then, so here's a country back. This was 2007 measles vaccination program was not reaching regional areas, children were becoming blind, because of lack of herd immunity. So it shows you how herd immunity works. You know that if you develop measles, particularly if you're in a poorer part of the world, often there's an element of malnourishment, which can make measles a deadly disease. And so kids were dying from it. And if they weren't dying, they were had devastating long term complications, such as blindness. So it was just such a powerful moment for me. And the kids. I don't really want to try and describe how it looks, because it is it is quite a disturbing thing. And quite literally, you have a sea of children who are just disfigured. And blind from this was, you know, each each evening, we'd get back after the study, and we'd be chatting around dinner having a having a beer or a gin and tonic and just hit, you know, hidden hands. And you know, he is really, how did this happen? So? So once

Daniel Franco: 29:10

what was the case that what was the case group study, how many children were you working with?

James Muecke: 29:14

Not a huge amount. It was, it was, for me, it was over 200. But again, seven schools of the blind across the country, in a poor country of over 50 million people. Yeah, they're only just over 200 Kids in maybe it was over 300, something like that, anyway, not that many. Yeah. So the vast majority of children weren't even making it to a school for the blind. That was another disturbing revelation that kids won't even get into the schools, probably hidden away in their villages, perhaps a source of shame for their families and certainly a burden on their families. So, you know, very, very disturbing to me as a doctor to see such a preventable situation just completely out of hand. So go home. I wrote the paper we published the paper Paper. And I felt very much that that something needed to be done here. So once we had the paper published in a major international journal, I went back, I met with the Health Minister, I lay the paper on his lap, and I said, we have a problem here. And he, he read the abstract, looked at the conclusion looked up at me and said, I thought we were doing better. So the good thing about that, so this is where powerful research can actually have an impact. He then allowed us to to bring an eye surgeon to Australia to train as a children's eye surgeon monocle, a pediatric ophthalmologist. So on the back of that very powerful study in my advocacy and meeting with a health minister, we were able to bring an eye surgeon to Australia and a young man named Dr. Tan tune on. He was a young ophthalmologist at the main teaching center, the Yangon Eye Hospital in the capital city. And so he spent a year with myself and my colleagues at the Women's and Children's Hospital in 2010 training to be a pediatric ophthalmologist. So he went home at the end of that hands on year of training as the very first pediatric ophthalmologist in this country. We set him up in the country's first children's eye unit at Yangon Eye Hospital. And I remember taking the kid of equipment over and we set it up and and then he literally was on his way. So wind the clock forward 10 years, I actually went back early last year again, just before the panic, a pandemic struck. I'm creating a documentary about his work, because it's so inspiring. So I'm back to do the second stage of filming early last year. And he is now providing close to 30,000 treatments to kids every single year. Wow. absolutely staggering. So from that, when you have training, cinema, the equipment, he is now having huge, huge impact alone. But more importantly, in 2015, he finished training the second children's and he now trains at least two every year. So this is where sustainability comes in. So if you look at that story, compounding. Exactly, exactly. And that story demonstrates the research the power of research, the power of education, and in supporting that education with the appropriate equipment. Yeah, time and effort and purpose. Right. Exactly. So the equipment involves diagnostic equipment, which was not there and surgical instruments specifically for childhood blinding problems, which was also not there. And then quite simply doing that. and off you go. And you can see that him able to train his own colleagues pass. Even if he's not training other pediatric ophthalmologist, he's there and his main teaching center training ophthalmologists who coming through the system so that they know and understand blinding problems of childhood,

Daniel Franco: 32:45

they vaccinating them with as well. Right. So yeah, good point.

James Muecke: 32:49

So that's the other part of the story again, that same visit, when I met the Health Minister, I went and met with UNICEF who are running the measles vaccination program. Great. And that prompted them to upscale the measles vaccination program, which they've done. And I don't have the data on that. But actually, we went back in 2018, to do a follow up charter blindness study, so just just over 10 years later, and we found that the level of avoidable blindness had dropped from something like 47.3% to 37.8%. So it had dropped. It's not a huge drop, but it's a significant drop, and it's in the right direction. And so, as Dr. Tanto, long trains more of his colleagues and collectively they treat more children than we expect this to ripple effect will be very, very, very powerful. Now, if you realize pediatric ophthalmology is only one of 10 subspecialty areas of my profession. So we've trained pediatric ophthalmologist through now I think something like nine countries in Asia, but we've also trained in all of the sub specialty areas of the profession. And not just ophthalmology, also in optometry as well. And so if we calculate the impact of the work we're doing, it's certainly over a million people every year. So then that's why I received the awards are amazing through my facilitation and of that process, and it's really powerful, really exciting. And so that, to me, is the joy I mean to to go back into here the story of Dr. tenten on what drove him, and then to watch him in action. We filmed him in a number of scenarios and I've never been prouder of course, I'm very proud of my family, my kids achievements. But beyond that this is one of the most single powerful moments that I've ever had in my life to watch this young man and the mastery of of my profession of his profession are well served so so proud to see an experience out and that's one very powerful story of the work that we do but we've now trained subspace Atlas in probably close to 100. Now, across Asia, so you can imagine they're all doing amazing work. And it's just a special thing to, to watch someone with a mastery that that you'd been involved in the training of and to see the impact of that is that is to me, you know, people often ask me what's the line to take the pan off and someone can see again, well, that's a special thing. But there's nothing more special than to watch someone that you trained, having an impact, right?

Daniel Franco: 35:28

It's really, it really hits the mark that you're trying to achieve, which is create a world where everyone can say, you must, you must go to bed every night, you know, feeling very grateful and unsatisfied with some of the work you've done. And you're only, not even really commenced what you really want to achieve. But it must be a great feeling, knowing that you are having an impact on the world and in the lives of many, many people, including especially the young children who can grow up and have a live and potentially, you know, create or become ophthalmologists themselves to where they can then go and have more of an impact or even cure cancer or whatever it might be like these, these young children who never would have stood a chance. Now. Now do so it must be a great feeling. You're so

James Muecke: 36:19

right. And then you're in even when you that minority of children that do get to a school for the blind, even when they do education, sadly, in poorer countries is substandard. And there's limited prospects of them for certainly for a well paying career or a fruit for life. So to be able to have an impact on that. And if we actually add up the number of years a person has to live with their blindness, charter blindness, and second after cataract as the leading cause of blindness in the world. So if you're able to turn that around, that is that it's special, because then a child has a lifetime to fulfill their lives and to contribute to their family, to their community, to their society, their country, really. So it's, it also has actually an impact on the economy of a country. So it's been calculated that for every dollar spent on fighting violence, about $4 is returned to the community. So we're fighting poverty as well. So

Daniel Franco: 37:09

it's returning. Yeah, exactly. You mentioned earlier that you are using will you use the platform of the Australian of the Year to talk about type two diabetes? Yeah, and blindness? Are you able to elaborate on that now there is the this video on YouTube that you have called blinded by sugar. It's discussing a client of yours new hands. So it's pretty confronting, really diving into what he's gone through. He said something in that video, which says, I went to, I went to bed one night, with my wife's face, for the last time I woke up the next morning, and I couldn't see went back to sleep thinking something wrong here, I'll go back to slave I'll wake up again later. And then my vision is gone. He also said, my not being able to see my grandchildren smiles, all these things that you just take for granted. It's a really powerful story, then he went on to have having, you know, amputation and everything like that as a result of obvious type two diabetes. And can you just deep dive into this story for us? And, and the and the message that you're trying to convey in that world?

James Muecke: 38:33

Of course, yeah. So Asia is home to half the world's blind adults and two thirds of the world's blind kids. And so that's where our focus is. But we also feel we have a responsibility to fight blindness here in Australia, both in mainstream and Aboriginal communities, because there are significant planning issues here in this country, despite the fact that we have access and affordability of eye care. So for me as an ophthalmologist of 31 years, for that entire duration I've been fighting, or trying to treat the blinding impact of diabetes. And what I've noticed over that period of time over three decades, is every year seeing more and more patients who are losing vision, even going blind due to their diabetes, but particularly type two, which makes up about 90% of cases, and it is a largely avoidable, manmade dietary disease.

Daniel Franco: 39:22

So just elaborating on that, is it too much sugar, too much bad poor diet? What is the cause of

James Muecke: 39:27

yes, so our interestingly, our poor diet is responsible for more disease and death than alcohol, smoking or inactivity combined, and it's particularly a diet that's laden with sugary drinks and ultra processed foods. So that's the real pandemic. That is, yeah, and if we look at 2020 last year, during my year, we lost 15 times more lions to type two then to COVID-19. So it is it is a big, big problem. So So type two is is a blinding disease. and blindness is the most feared complication of type two. amputation of a leg due to gangrene is the second most severe complication. But there are a myriad of other complications 80% of patients with type two will ultimately die of thrombotic complications such as stroke or heart attack 70% of all developed dementia. So it's a it's a devastating disease that impacts on not just the individual, but the family as well. And we now have about 1.7 million people in this country with type two diabetes. And is it reversible? We are that's it's largely preventable and potentially reversible. Or we can put type two diabetes into remission, some people prefer to use remission rather than 30. But yes, there is certainly plenty of evidence to suggest that that's the case. But if you look at some poorer parts of Australia, so Greater Western Sydney, as an example, 50% of the adult population over the age of 24, have pre diabetes or type two diabetes. And we have many other poor socio economic areas in this country where type two diabetes is, is getting out of control. So it's a big, big problem. I mentioned that yes, it's a blinding problem. Why is it such a blinding problem? Well, there are reasons why it is a blinding problem, one of which is the growth of type two diabetes. But also the fence 98% of the blindness due to diabetes is preventable or treatable. So nearly all preventable or treatable. But to avoid the blinding complications, patients need to have their eyes checked on a regular basis. So in Australia, that 1.7 million with diabetes, more than half probably well over half and not having these regular all important sites, API checks. And that's why it's now become such a serious problem. It's actually the leading cause of blindness amongst working age adults in this country. So the leading cause of blindness amongst the demographic Yeah, I mentioned cataract was before. But now diabetes. Yeah. Well, so it's, it's a big problem. And myself as an ophthalmologist, yes, I've been dealing with the blinding complications of this disease for over 30 years, but never really until recently considered that it was my role or responsibility to raise awareness of the root cause, which is, which is apt for diet for type two. So type one's a different disease that's unavoidable. It's due to normal autoimmune damage to the pancreas. And it usually happens in early in life. Interestingly, type two used to be called maturity onset diabetes, that we now seeing this disease developing in our children. So children in Australia as young as seven, developing Type Two due to their poor diet. In the UK, there's a child of the age of three that develop Type Two Diabetes, so it's also straying off the track of it. Aboriginal people, it's devastating Aboriginal populations has been at fault eight, zero fold increase in type two diabetes in the past 4050 years. And absolutely what's what's,

Daniel Franco: 42:57

what's the reason for affecting the Aboriginal community?

James Muecke: 43:00

Again, more so again, the poor diet exposed to it's not the traditional diet didn't not their ancestral diet, it's a diet, they've actually been encouraged. So

Daniel Franco: 43:09

is it as simple as plant based diet and meat? Is that as simple as if you change your diet to a much more leaner meal, then you'll prevent like it? What what, how do we prevent Type Two Diabetes? Okay, so that's a big question.

James Muecke: 43:26

I actually come back to come back to that. So okay, just just on the original question, which was, why did I start to why did I take this on? Yes. So in late 2018, I thought it would be interesting to do a documentary about the experience of blindness and what it means to be blind. So I selected 10 people, for children who are born blind, for elderly people who are slowly going blind, at the end of their life due to a condition called age related macular degeneration, which in Australia, is the leading cause of blindness in elderly Australians, but actually now is the leading cause of blindness overall. And then I chose two patients that had suddenly gone blind in both eyes due to their diabetes. And, you know, HANSOL, you mentioned was was one of those 10. And the story was unbelievable. And you recounted some elements of that story. That hour and a half of the interview I did with him, the end of it. I was in tears. The filmmaker was in tears. The sound engineer was in tears. Him and his wife were in tears. We were it was just the most heart wrenching story and the crux of it, yes, he woke up one morning bind in both eyes and remains blind to this day. And you know, the loss to him have the ability to, you know, pursue his hobby. And to see the beautiful smiles on the faces of his wife and grandkids. You know, those loss of independence, the ability to drive all of those things have been absolutely devastating for him, but you know, it's extraordinary. His his spirit is quite amazing. In fact, yesterday I was involved in a ABC documentary series and Neil Hansel was also being interviewed and the the interviewer, the film producer was blown away by the story is just so powerful. So Neil, he first added any money at the age of 16. He was on the go, he was he had a busy job, I think it was a courier, something like that. And he consumed four liters of soft drink every day. And 10 years later, lo and behold, he developed type two diabetes. He didn't know how addictive it was, he didn't know he was doing himself damage, didn't drink water, he drank software, he just just was on the go. And he was he was thin. And he didn't realize that he was he was doing himself a damage. So why on the clock forward, blind in both eyes, he's had nine amputations. In fact, he had a nine amputations over 14 month period, ending in loss of his left leg in March last year. And he's also had two heart attacks. So Neil has been devastated by this disease. And he's become quite an advocate to raise awareness about the dangers of this disease. When he was diagnosed, he wasn't aware what lay awake for him. And I think this is the problem for many patients with type two. So that recounting of that story, that powerful moment, made me sit back and think, gosh, don't I have a responsibility to raise awareness, particularly about the black blind complications, and so I created a TV commercial, which played nationally and late 2018. I started talking about it more. We also created a number of short films, documentaries, to raise awareness, particularly amongst Aboriginal people, we created a music video, which is on the site for a website, I created a cartoon to encourage people to have regular checks. And we also created a wonderful, award winning documentary about cataract blindness and Aboriginal people. So interestingly, the leading cause of blindness in Aboriginal people is still cataract, as it is in poorer parts of the world. But diabetes is the most rapidly growing cause of vision loss. So on the back of that, I really wanted to start raising awareness of this blinding impact that was just growing in our society. And when I received the South Australian award of my speech, I talked about the desire to encourage people to have the regular eye checks, received the award, once again, not expecting to but going forward to the national ceremony, I thought, if I if I am to receive this award as Australian of the Year, what's our biggest health problem at the moment? It is quite simply type two diabetes, it's about poor metabolic health. Two thirds of Australian adults over two thirds actually are overweight or obese. And about a quarter of our kids, the majority of us are not metabolically healthy. The United States 88% of Americans are metabolically unhealthy. And this is driven by our poor diet. So I thought, Do I not have a responsibility of Australian of the Year to raise awareness of that and to advocate for this. And so that's, that's the journey I went on once I received the award. And it started off talking about sugar. And I came up with this, this concept of five days of sugar toxicity, but it's really evolved and grown since then, because there's, there's so many layers to it. It's quite a fascinating journey that I've had. But you asked me before about, you know, is it simply sugar? It is, sugar is a large part of it. There are over 8000 studies now linking sugar to a range of chronic diseases, particular type two diabetes, obesity, tooth decay, and complications of type two, which I mentioned some of them. But if you realize that there is another very abundant form of sugar in the form of refined carbohydrates, so white rice, white flour, white potatoes, and the foods prepared from these, they're all starch. And starch is simply a long chain of glucose, which breaks down into glucose when it reaches the gas. So when you're consuming refined carbohydrates, you are consuming sugar. And if you realize then that sugar and refined carbohydrates make up a significant proportion of ultra processed foods, or what I call Ultra processed food, like substances, you can't really call them foods. And then you realize that this is a big driver for health. And the the other elements are the seed oils, what we're euphemistically called the vegetable oils, you know, canola, safflower, sunflower, vegetable oil, and they have been linked to chronic diseases as well. And they're another significant component of ultra processed foods. So this is a perfect storm. And there's a gun pointed

Daniel Franco: 49:22

our livers I'm my background is Italian right. So we're the pastor's the pizzas. The jalopies, the cannolis Oh, the kala you think about the Mediterranean diet almost. There is I can almost guarantee there is in some families. In the Italian community there's pasta or with or bread with every single meal. And you're suggesting that is completely wrong or is it everything in moderation and then what does moderation look like?

James Muecke: 49:57

Yeah, it's interesting. It's an interesting question that Unfortunately, there is a significant proportion of Italian and Mediterranean communities that do have type two diabetes that are not metabolically healthy. But if you realize that we have this grow growth of exposure to sugary drinks and ultra processed foods on top of the refined cap, let's say if it was just a diet of refined carbohydrates and which does form as you say, a significant proportion of the Mediterranean lifestyle. But if you throw in the mix, or the sugary drinks, the orange juice as a glass of orange juice has almost as much sugar as a glass of cola, for example, you throw in the mix, packaged foods, ultra processed foods, cereals, you know, we just bombarding our bodies. And so the key to the as I mentioned that those three things, sugar, refined carbs, which are sugar in disguise, and the seed oils are like a loaded gun pointed at the liver. The ultimate, the outcome here is what's called a fatty liver. And fatty liver is central to this whole process, which builds on the back of a medical term called insulin resistance. And so when you develop a fatty liver, then it gets to a point when you are diagnosed with type two diabetes, where the liver can take no more fat on and so the the fat gets exported away from the liver as a triglyceride and the triglyceride in the blood, combined with the high insulin level in the blood is really the damaging thing, in addition to the high sugar level, which damages the blood vessels throughout the body, and that's what gives rise to the life changing and life threatening complications of this disease. Now, if you if a person is insulin resistant, then even and one of the so the let's look at let's look at just sugary drinks. For example. The most common additive in our food and drinks is sucrose. What we know is tail sugar is what we're doing it in coffee. And that sucrose molecule is made up of 50% glucose and 50% fructose. And it's particularly the fructose element that is so dangerous. So damaging. Fructose is what gives sweet products is their sugary flavor. So sugary products a sweet flavor, it's actually not recognized as a food by the body, it does not trigger the release of insulin. The majority of it when it's taken into the body is actually metabolized by the liver, and about 30% is converted immediately to fat. So that fat is stored within the liver. As I mentioned, some of it's actually exported away as triglyceride. And it's it's it's this, the fructose component, which is independent of obesity, independent of the number of calories we consume, which is the damaging thing. So if you have a traditional diet, which does have pastor and breads and you throw in the mix, lots of sugar in the form of modern food and drinks that we're consuming at ridiculous amounts, on average, we're consuming 14 to 16 teaspoons of sugar every day, who recommend six teaspoons of sugar a day, young, young teens, 14 to 18 year olds are consuming 22 teaspoons of sugar a day. And if you look at a 600 mil bottle of soft drink, that in itself has about 16 teaspoons of sugar. And if you had a bottle of that every day, which many people do 23 kilograms of sugar a year. So you throw that in the mix of a traditional diet. And then bang you know, you're in strife and you throw in junk food, you throw in fast food you throw in foods cooked in those ads, just it's a disaster, what we

Daniel Franco: 53:41

human rights, right, we're, we're strange bunch, we keep doing things that are not good for us. You know, that's the reason why the helmets invented. But you know, we do silly things and, and we find ways to keep on doing him. And we know everyone, I reckon you'd be hard pressed to find a human being in the western society at very least that wouldn't know that. Oh, you know, the ice creams, the the over overloading in carbs and all that sort of stuff is not healthy, right? But yet we continuously do it. What is the draw for like, why do we keep getting drawn to these foods for you know, for me the idea of an ice cream after dinner, I know you've mentioned this in a previous conversation that we've had as well. It's almost like a reward after that or you know, it's a treat at the end of the day. Um, first question is why do we keep keep going back to the to the sugary treats? And and secondly, what is an option or another option or other options for that reward that we can give ourselves to, you know, hit those dopamine levels,

James Muecke: 54:47

where we're really worthy of an entire new podcast. It was a whole nother thing. It really is. It's such a big conversation. And there's it just brings to mind An expression breakfast is the most important meal of the day. You've heard that Gabriela shores heard that the whole world is heard that. In fact, I gave a presentation community presentation a couple of weeks ago and I asked the audience to raise their hand and every single one of them raise their hand. Now that you realize was a slogan that was popularized by John Harvey Kellogg in 1906. to market his newly invented breakfast cereal cornflakes in yet to this day, there's no evidence to say that we need to have cereal for breakfast. In fact, we're probably doing our bodies harm because more often than not cereal is a sugary issue.

Daniel Franco: 55:33

So so that was a marketing ploy. So amazed, amazing. I think I did see your LinkedIn posts that mentioned that and that that blew me away. So because because the there's the studies now that the fasting diet is one of the most prevalent I guess, in well, it's one of those ones that's catching on the 16 Eight, where people are finished eating at eight o'clock at night, and they're not eating to 12 o'clock the next day, they're skipping the breakfast. And the amount of people that I've heard no, no, you need breakfast. It's the most important meal of the day.

James Muecke: 56:03

It's rubbish. Yeah, it's absolute rubbish. I mean, breakfast is quite literally the breaking the fast of overnight where you can break your fast whenever. Yeah, I do that I break my fast at lunchtime. Yeah, and certainly don't need to break fast with with carbohydrates. So when you realize that most of us are metabolically unhealthy, we actually are intolerant of carbohydrates. So ramming more carbohydrates into our body is not great. Now, you mentioned that most of us aware of it. I'm a doctor, I'm a medical doctor trained, understand, but actually didn't fully realize how dangerous our diet was. I didn't realize how addictive sugar was I didn't realize how dangerous Ultra processed foods was. Yeah, you kind of sense it, but I don't think we fully appreciate. And that's why it's such a problem, I think in our society. But more to the point. So when I leading up to the receiving the award, I came up with this concept called the five A's.

Daniel Franco: 56:53

Yeah, I was gonna ask you about the five A's because they can answer a lot of these questions. Yeah, exactly. So that does answer

James Muecke: 56:57

a lot of the question of the question. So just going through those. First eight is addiction. So sugar is highly addictive, it's been shown to be as addictive as nicotine. When we consume sugary products, it activates the reward center in our brains leading to release of neurotransmitters such as dopamine, and they won't make us feel good, makes us want to do it again and gives us those cravings. So secondary alleviation, we often usually to alleviate stress and to make us feel better when we're down. So when we're stressed the body's flooded with cortisol. And so we need to balance it by releasing feel good chemicals such as dopamine and sugar is a great trigger for 30. Accessibility. Sugar is quite literally everywhere in our lives. We can't walk into my service stations without being confronted by a wall of confectionery certainly can check out for most supermarkets and stores without being enticed by half price. Yeah, sugary drink. Chocolate. To me,

Daniel Franco: 57:47

it's disabilities that one of the biggest problems I have in the US there's always something in the pantry, right? Even just a cook plate of pasta is the easiest milk because it's quick. So accessibility. Yeah, I find that I'd have the most trouble with that one. Well, that's right. And now with UberEATS and stuff like that, which is with Ober eats here, when we're making everything easier.

James Muecke: 58:09

We certainly are. And also, you know, when you when you quite literally can't go to a to a supermarket, even the post office, even the chemists these days, and the checkout counters are surrounded with sugary products. It's just unbelievable. I think you

Daniel Franco: 58:23

put up a sign or sorry, LinkedIn post about a sign at a bus stop. Or was it it was similar with the KFC sign or something like that where you know, this marketing is constantly in

James Muecke: 58:35

your face? That's right. And on one side of the bus, the sign was was a fast food on the other side was a public health message. Yeah, government. Yeah. Yeah. Unbelievable. So just going go finishing off that, yeah, those are the two A's because that'll explain some of the things as well. So the fifth eighth edition, so an astronomical amount of sugar is added to our food and drinks. So certainly, that was the fourth, a fourth, so forth. Ultra processed foods. So something like 75% of our food and drinks have added sugar. And there are 56 common names, I think there's something like 260 odd names for sugar, so that actually confuses the consumer even more, but our nutritional labels don't actually tell us how much added sugar is contained within. There's even something called the hill star rating system which is flawed, because it's actually voluntary. Only 30% of manufacturers use it. But it's also flawed because many healthy products get a five star rating. This is actually a device been designed by industry for industry and an orange juice is a great example of a five star product which has recently earlier this year being downgraded to two stars. So the fifth a is advertising. Our world is absolutely flooded with TV commercials and ads for sugary products. You can't walk out the door and once you actually open your eyes to it you see how much is out there it is quite staggering. You know the bus stop on the side of the bus or mortar buildings, you know I mean it's everywhere. To on TV on social media. Our kids are exposed to three commercials unhealthy products every hour on TV during those hours that they're watching. Teens are exposed to 100 promotions for unhealthy products every month on social media. So bang, they have the recipe for why it is so prevalent in our society, those five days. Explain it. And those five days also explain how we can get out of it.

Daniel Franco: 1:00:19

Absolutely. You know, I talked before about you, you must, you know, sleep well at night, knowing that you're changing the world in a positive way. You wonder about the these big businesses in whether they're, it's they're going to sleep at night, knowing that they're potentially killing people or blinding people. It there's got to be some sort of,

James Muecke: 1:00:39

I think they go to sleep at night thinking they're making lots of money for shareholders, because it's all about profit and profit. Yeah, certainly over health, there's no doubt, as I said, 8000 plus studies showing that there is a link between sugar and chronic diseases and ultra processed foods, there are plenty of studies showing there. These are not healthy for us to do studies showing that cedars are not healthy for us. And yet, the literature is polluted with industry funded studies. And we know when industry funds are steady, nearly eight times more likely to show result favorable to that industry. And there's a really interesting study that looked at sugary drinks and obesity. 43 of the 44 studies that were not funded by industry showed a link compared with none out of 26 that were funded by industry, so you can see how they they skew the data. And then they can say, well, the data is inconclusive, they pollute the literature. So you know, there's agendas, they're in there. Predation is unbelievable. And really that brings me to to three overarching strategies. I mean, the top a is action. Yeah, we need action, and we need action from our government. But the the the three overarching strategies are awareness, accountability, and assistance. And if you're happy for me, just Yeah, please, please do. So we do need awareness, we need awareness of the dangers of sugar of ultra processed foods of fast foods. We need awareness of the previous inability and reversibility of type two, and the complications of type two for patients who develop it, we need awareness of those five days of sugar toxicity that that sugar is and sugary products are addictive, and that we are using them to alleviate stress. And once you realize that you can actually put in place methods to either detox or to use other things to actually make you feel better. So awareness is really critical here and also awareness that our current high carb diet, this low fat promotion, this is the other thing that we've kind of known for the last 50 years that saturated fat and Bamford's. You ask anyone saturated fats bad for us than actually, actually the natural saturated fatty acids in our diet in products such as and processed red meat, full fat, dairy, eggs, even dark chocolate not linked to cardiovascular disease. So people still think they're putting themselves in danger by having those products actually did the best foods that we can. Not all this carbohydrate, normally cereals and grain products, not all these processed foods. So awareness is really important. And accountability. Accountability is the second a accountability of businesses in industry to do the right thing by as you know, this, having sweet products at checkout counters is preying on our addictions is preying on the vulnerable. And in particular, it's preying on our children, particularly when you realize that a lot of these products with kids eyeline. So, the predation also seen on social media and on TV, someone needs to hold these businesses to account they're certainly not going to do it. You know, I'm not one for sort of banning this and banning that. But certainly, I think there's some predatory tactics, which are actually praying, you know, which are preying on on people in our society, where the government needs to step in and do something about it. So accountability is really important. Finally, assistance, and there are a number of levels of assistance. And just one example my son, medical school, third year, last year in secondary medicine, he had the option of doing an elective in nutrition science. So this is the biggest health problem that we have as medical practitioners and it's not even compulsory medical school. So that's just a few examples.

Daniel Franco: 1:04:21

There's a whole bunch of questions that are coming in and that is, first and foremost, what is an acceptable amount of sugar in our diet and carbohydrates and if we if we combine that with running and exercise and all the above the you know, the Does that, does that work by combining if I carbohydrate for every single meal and have ever have a sugary sweet, two or three times a day, but yet I'm running 10 to 20 kilometers every single day? Does it sort of balance itself out? And secondly, what can we do with our children in getting them and educating them? Because you know, with this advertising and one mom and you're saying it Reality I see so many so many ads. Not only that, when that when I send my kids to my mother in law was like we could shoot it up again, what can we do in that space as well? So the two questions.

James Muecke: 1:05:10

Firstly, you can't outrun a bad diet. And there are examples of marathon runners who are metabolically unhealthy. Yeah, look at me, I'm talking in March last year, I found out that I had a fatty liver. So I was on the pathway to type two diabetes potentially, and I look at what the diet I was consuming was was pretty bad, and particularly their sugary products. So it's, it's really, it's really critical for us to be aware, you know that being overweight. Being obese is not the central it's the biggest risk factor for type two diabetes, but it's only a marker of poor metabolic health and you realize there are more thin metabolically unhealthy people than there are overweight or obese metabolically unhealthy people, then you realize that obesity is not the full picture here. And it's really down to these, these calories. And, and I mentioned before, the poor diet is responsible for more disease and death and smoking, alcohol and inactivity, so you cannot outrun a bad diet. Exercise is critical. I love exercise. It's important for mental health because it does trigger dopamine release, you know, you go for a run, go for a walk, go for a cycle, particularly nature somewhere beautiful, and you feel good. So that's a really good way when you're feeling down rather than going to the fridge and consuming a liter bottle of soft drink, grabbing a block of chocolate and consuming the whole lot. Go for go for a walk somewhere lovely. You know, that's that's a great way of countering that cortisol reactions flooding our bodies during anxious times. So exercise is great for mental health. Exercise is great, because it makes you sleep better. And having a good night's sleep is also critical in helping to prevent chronic diseases as well. And yes, exercises is important, but you can't type two diabetes is not due to a lack of exercise. So exercise. I'm a big advocate for but not to try and continue to consume a poor diet. So really, it's all about diet. And you know, what can you do? I had a big bowl of ice cream after dinner every night. Probably chocolate after TV every night. I'd have cereal for breakfast, orange juice for breakfast, I'd have white bread for lunch, rice, or pasta, white potatoes for dinner. And I'd have a pack of cream biscuits every day during work. So yes, just clearly not good. And what I did was I gave up actually, only early last year, I thought a bit of walk the talk if I'm talking about this. So before receiving the award, I went into a detox I did a 16 eight fast. I stopped having a bowl of ice cream every night. I still have one every now and then. Because I love it. Yeah. I've cut back on sugar. Sorry, cut back on chocolate, you know have dark chocolate every now and then rather than the really sweet milk chocolate. And I've really cut back on confectionery. I've stopped having fruit juice. Haven't had fruit juice for probably a couple of years now. Haven't had soft drinks for a couple of years. Stop eating that pack of biscuits stopped having cake morning tea when someone's got a birthday at work, and then cut out.

Daniel Franco: 1:08:05

What about the old wine or or scotch? Yes, I

James Muecke: 1:08:08

thought from having gin and tonics before to having a whiskey. Yeah, I've gone from white wine to red wine. I have a love of beer but cut back on because it's quite delicious. And so I've just and with the refined carbs. So I have whole grain bread rather than my bread. But not every day. I'll have brown rice rather than right rice but not every day and homeopaths rather than white pasta. Again, not every day, and just adopting a lower carb dietary approach. Certainly if I had pre diabetes, I'd go strict low carb. And if I type two diabetes, I'd even be looking at a ketogenic diet. We're really reducing your carbs or less than 50 grams a day. So yeah, there are a lot of strategies that you can do. But detoxing from sugar is quite unpleasant. The symptoms are nasty, headache, fatigue, clouded thoughts, irritability, cravings, last for several days, sometimes a week or two. But if you realize also things like condiments, sauces have so much added sugar, cereals. You know, if you clear all of those products out, you'll go through this detox process. A couple of panels judiciously help relieve the symptoms. But then once you actually get through that barrier, you can then it's quite liberating. Actually. You don't have to go racing to the pantry and grim yes gets

Daniel Franco: 1:09:28

so I think that answers the kid's question in regards to just educating them really on and changing their habits. Not for not feeding him saying no, when they're asking for

James Muecke: 1:09:39

and our grandparents. Yeah, my grandparents, the grandparents treat the kids spoil the kids. Yeah, one for you, one for me, and it's often a bit of battle with the grandparents because they see it as their role but actually their role should be to to promote healthy kids not to poor health.

Daniel Franco: 1:09:53

Absolutely. Now I'm really conscious of your time but I got one last question before we wish we round up site for all everything that you're doing in the world of debate, debate is top to blindness, the impact that we're having across the world, and in the mission of everyone being able to see paint done for us, like what, what does? What does it look like when you've achieved your mission? What does the world look like when you've achieved your mission?

James Muecke: 1:10:21

Having a world where everyone can see, I suppose, but I don't think I'm gonna see that in my lifetime. It's such an enormous, it's a, it's a worthy goal. It's such an enormous goal, and it's so far off. But also with with, you know, I think, I think a, an environment so our food environment is diabolical, in, in poor communities, and in Aboriginal communities, it's bordering on criminal what's going on. So to have an environment where we're not bombarded with sugary and ultra processed products, having a TV where we're not exposed to the things so, so looking at those, those five days of toxicity, just relieving our environment and, and having access to fresh, healthy real foods. So that and also affordable for many people in poorer communities. So basically, having having a food environment, which is, which is leaning towards healthier real food, whole food, rather than leaning toward Ultra processed food in the United States. 62% of the American diet is ultra processed foods 50% of the British diet, probably close to that here. So our diet is not healthy. So to see people re embracing meat and three veg re embracing real food, and also supporting local communities and farmers. You know, I think that would be a wonderful thing to say,

Daniel Franco: 1:11:39

absolutely. Well, like I said, I am conscious of your time, we normally round off with a bunch of quickfire questions which are normally quick fire, they normally dive into it, but I know you, you do have to shoot off. So I just want to say thank you again, for everything that you're doing in this world. And for the for the people of this world, essentially, the children, the people who are suffering from Type Two Diabetes, the awareness that you're giving to the likes of the people asked me Gabriela, myself, and everyone that's listening about, about what we can do to change your habits and change, you know, change our everyday processes and, and reaching for the chocolate bar, as opposed to reaching for an apple or something like that. So yeah, I really appreciate and I know everyone who's listening really appreciate the work that you're doing. So thank you very much for

James Muecke: 1:12:27

for that. And thank you, Daniel, thank you for all you're doing to to raise awareness as well, it's important to have these conversations and get these conversations out there. So people start to realize it's education, it's awareness raising, and, and what you're doing is absolutely,

Daniel Franco: 1:12:40

and I think for, for the message that I'd love to sort of get out of this, everyone's probably thinking this is a business podcast we're talking about. But health is really important, especially in the world, we're talking about mental health, where we're working in industries, which, you know, our habits and mere stresses of what we're doing every day, can can produce bad habits. So the message I'm really trying to get out of this this podcast is this awareness of how do we look after ourselves first, and then hold our businesses to account? Yeah. As well, if where and what the messages that we're putting out there? Yes, I think it starts with starts with self and we work on

James Muecke: 1:13:16

from there. Yeah. Oh, good on you for getting behind it all.

Daniel Franco: 1:13:19

Perfect. Thank you. Dr. James Muecke, it's been a pleasure having you on where can we find you? LinkedIn is the best place.

James Muecke: 1:13:25

I have Dr. James speaking on Facebook, Instagram, and LinkedIn and site for all on Facebook, Instagram, LinkedIn, YouTube. So there's, we've got the we'd love for you to follow us. Yeah, yeah,

Daniel Franco: 1:13:35

absolutely. There's some amazing videos. And when's that documentary do out,

James Muecke: 1:13:39

just go into post production now editing. So I'm hoping early next year, something like that.

Daniel Franco: 1:13:44

Excellent. Keep your eyes peeled. And we'll share it on our page when it all comes out. So thanks again for your time. Thank you to Daniel.

Synergy IQ: 1:13:51

Thank you once again for joining us here at creating synergy. It's been great spending this time with you. Please jump onto the synergy IQ Facebook and LinkedIn page where the discussion continues after the show. Join our mailing list so you'll know what's happening next at Synergy iq.com.au. And of course, don't forget to subscribe to this podcast. And if you really enjoyed it, please share it with your friends.