I recently recorded a conversation with Michael Easter from the TWO/PERCENT, a Substack and podcast. Michael offers “practical, accurate, and useful health, performance, and mindset information,” and in a space where there is a lot of drive, I find him remarkably thoughtful.
Our conversation is on the podcast feed. Below are my notes for our conversation with links to many of the things we discussed.
Adam Cifu, MD
I am skeptical of wellness celebrities and influencers. They annoy me because they tend to pick, choose and extrapolate data to fit their agenda. Because good medical advice is mostly personal and boring, many influencers cross over to data-free sensationalism to hold an audience.
Michael Easter is a rare exception. On the TWO/PERCENT he somehow manages to be a sane, thoughtful – I might even say Sensible – health personality. I got to know Michael when he invited me to be on his podcast to talk about my article on the cult of the healthy lifestyle. Before talking to him, I dove into a bunch of Michael’s work and was impressed by its quality. I should have known that a person who would invite someone who had come out against the healthy lifestyle on his show dedicated to the healthy lifestyle was someone I’d like.
My Questions:
For people who don’t already follow you, tell me about the 2%. Where does that come from and how to you extrapolate its meaning?
Tell me a bit about yourself, how did you end up here?
In my intro, I mentioned that I think you are a rational “health influencer.” How have you managed this?
Is it a challenge to keep things fresh while telling people to stay active, eat less, and don’t do stupid things?
How do you see the balance of educating and inspiring?
I wanted to talk to you about a couple of recent posts that I thought epitomized your approach.
The benefits of silence was a post about introducing silence into your life. This is something that really doesn’t need data, but you went deep into the data, and then acknowledged how aware you are of the possible confounding. (People’s whose houses are on loud streets die earlier. That might be the noise but they are also poorer and are exposed to more particulate air pollution…).
What got you interested in that topic?
The downsides of blood tests and full-body MRIs
This was a discussion with Dr. Bobby Dubois about the potential benefits and harms of screening tests. I’ve written a ton about this, but I was so impressed with the clarity of the conversation and, although you guys came out pretty negative on the topic, you were honest about the potential benefits and the reasons people find these attractive.
You seem to have a lot of respect for the audience.
Nice conversation with a nice and thoughtful man. The fundamental problem in the "healthy lifestyle" debate is that most people don't differentiate between their health and the way they feel. Being physically fit and following a basic common-sense diet will often help people to feel better but, in no way, will prevent actual disease; and, in fact, there is no biologically plausible mechanism by which diet or exercise would do so. We doctors are not in the health business but rather are in the disease business. Our job is to diagnose and, where possible, treat disease. We can neither provide nor maintain health. Most all of the "healthy lifestyle" advice closely resembles that which we received from our parents and grandparents and doesn't require anything more than experience and common sense.
As seductive as the theory about ultraprocessedfood is, there is not much evidence to support it (read Gary Taubes). I feel like the devil's advocate here because I avoid UPF myself but the nutrition research field is such a mess....
There is actually no evidence to support the junk food narrative which is loaded with a lot of junk science. Taubes' book "Good Calories, Bad Calories" is actually two books in one. The first half of the book is an excellent summary of the evidence showing that cholesterol and fats have nothing to do with cardiovascular disease. The second half of the book cites sugar as the culprit and , for evidence, uses the same types of flawed studies he so brilliantly critiqued in the first half of the book.
I find GT's (and others) case against sugar quite convincing. Also, he is asking for more serious and challenging studies. That is why I like that nonetheless he remains prudent about the ills of ultraprocessed food.
I like Vinay and find that Adam offers little value for me but I applaud that this is a site that allows differing views and lets readers do their own thinking.
What about John? Do I rank second or third? ;-)
Dr. Cifu, Thank you for this enlightening conversation. I had seen Michael Easter a few months ago and meant to follow his podcast but somehow forgot him. I will add him today. As an aside, I often read Science Backed Medicine website and I was surprised to see they have a little problem with you. I think it is mostly because of your association with Vinay Prasad and his dispute with masking and covid vaccines. Like you, I think Vinay has many important insights to share but is a little wrong on these items. I wonder if I ever came across Vinay when I was a teaching attending at Northwestern. Probably not because I taught only a tiny fraction of students there! Anyway, as always I really appreciate your insights and I just had these thoughts I wanted to share with you. Bob Perlmuter, MD, FACP