Six Tips to Live Longer and Healthier with Dr. Tom Frieden

Summary

That Can't Be True with Chelsea Clinton

Episode: Hypertension, Potassium, and Anti-Cancer Vaccines with Dr. Tom Frieden

Date: February 12, 2026
Host: Chelsea Clinton
Guest: Dr. Tom Frieden (former CDC Director, President/CEO of Resolve to Save Lives, author)

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Episode Overview

Chelsea Clinton welcomes renowned public health expert Dr. Tom Frieden for a fact-driven discussion centered on his new book, The Formula for Better: How to Save Millions of Lives, Including Your Own. The episode focuses on practical steps for better health—especially hypertension—as well as top-of-mind public health topics like vaccine misinformation, healthy eating, and the promise and peril of technology in healthcare.

Key segments include Dr. Frieden’s “six things everyone should do for a longer life,” deep dives into blood pressure management, the evolving landscape of vaccine skepticism, and science-backed myth-busting in a rapid-fire Fact or Fiction round.

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Key Discussion Points & Insights

The Search for Trustworthy Health Information

• The Challenge of Reliable Health Sources:

  • The most common audience question for Dr. Frieden is “Where can I go for reliable health information?”
  • “Don't believe anything from anyone who's trying to sell you anything.” — Dr. Tom Frieden (03:55)
  • Suggests medical organizations as reliable sources for specific questions (e.g., AAP for vaccines).
  • Artificial intelligence (AI) is both a source of dangerous misinformation and a powerful tool when trained and used properly.

• AI in Healthcare:

  • Dr. Frieden recounts using a specialized medical AI to diagnose a rare side effect mid-flight.
  • “Medical science is so complicated that it's virtually impossible for anyone to have a complete and comprehensive understanding. That doesn't mean we're going to defer things to AI, but it means it's a tool and like any tool, it can be used well or it can be used poorly.” — Dr. Tom Frieden (07:33)

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The Formula for Better Health: Six Actions that Matter

• The Simple Six (08:15):

  1. Control blood pressure (ideal = 120/80 mmHg)
  2. Control cholesterol (LDL under 70)
  3. Get enough sleep (7–9 hours/night)
  4. Physical activity (30 min brisk activity, 4+ days/week)
  5. Avoid toxins (tobacco, excessive alcohol, industrial toxins)
  6. Eat healthy (more fruits/vegetables/nuts; less sugar, processed meats, and saturated fat)

• “It’s what your mother told you. Go out and play, get enough sleep, eat your vegetables. These aren’t really complicated. And they’re right.” — Dr. Tom Frieden (10:54)

• Nutrition Nuances:

  • Highlights potassium-rich foods (e.g., sweet potatoes), and the importance of balancing potassium and sodium.
  • “Who knew that something that tastes like a dessert could be so healthy? It’s high in potassium, it’s high in all sorts of vitamins.” — Dr. Tom Frieden, on sweet potatoes (10:27)

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Hypertension: The Overlooked Killer

• Blood Pressure: The #1 Priority (16:43):

  • Clinton: “If you paid attention to one thing... that could have the highest ROI... it's blood pressure.”
  • Dr. Frieden: “Absolutely, absolutely.”

• Widespread Misconceptions

  • “We need to see that most American adults have unhealthy blood pressure. We need to believe that it's not a normal part of the aging process and it is not.” — Dr. Tom Frieden (16:48)
  • Most people and even some providers think rising blood pressure with age is “normal”; it's not inevitable.

• Potassium vs. Sodium

  • Refers to pre-industrial populations with high potassium/low sodium diets who do not experience age-related blood pressure rise (17:32).
  • Suggests potassium-enriched salt (with doctor check if kidney disease).
  • For every 20-point increase above 115 mmHg systolic, risk of stroke/heart attack doubles (18:32).

• Adherence and Medication Access

  • Copays—even as low as $5/month—are a major barrier to medication adherence for asymptomatic conditions like hypertension.
  • The best health systems ensure essential medications are free and accessible.

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Diet Fads and Drug Skepticism in Public Health

• Saturated Fat & Carnivore Trends:

  • Some evidence more saturated fat creates satiety, but high consumption exceeds recommended limits (21:19).
  • “Having more saturated fat may allow you to consume fewer calories... But there’s a real disconnect between what Mr. Kennedy says and what the guidelines say.” — Dr. Tom Frieden (21:23)

• Medicine Skepticism:

  • While acknowledging over-medication (especially for symptomatic conditions), Frieden stresses the danger of rejecting medicines that prevent symptomless killer diseases.
  • Example: He personally eats well, exercises, but still needs hypertension and cholesterol meds due to genetics and aging.

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Vaccine Misinformation and Infectious Disease Threats

• Measles Resurgence & Vaccine Skepticism (29:01):

  • Concern over systematic weakening of US vaccine infrastructure and public confidence.
  • “We’ve seen a weaponization of science...basically retreat from a concept that there is a shared reality.” — Dr. Tom Frieden (29:01)
  • Downplaying illnesses like measles is dangerous: even if most cases are “mild”, the disease kills and disables in large outbreaks.

• Long-Term Effects of Infection:

  • Measles: wipes immune memory, stunts growth, raises risk of severe infections (31:51).
  • COVID: Long COVID risk is decreasing but persists for some; vaccination helps reduce it.
  • Chickenpox vaccine likely reduces dementia risk—reason to stay up-to-date on adult boosters (33:01).

• Praising Anti-Cancer Vaccines:

  • HPV and hepatitis B vaccination can prevent cancers; Australia is on track to eliminate cervical cancer due to HPV vaccination (34:54).

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Technology, Telehealth, and the Human Touch

• Promise and Limits of Telemedicine

  • Tech can increase access but can’t substitute for robust, affordable, primary care providers (38:17).
  • Warning: Utilizing robots and tech is sometimes a workaround for underinvestment in primary care and public health workforce.

• Provider Compensation Gaps

  • “A primary care doctor after 20 years...will make less than half as much money as a surgeon who graduated yesterday.” — Dr. Tom Frieden (39:32)

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Rapid-Fire: Fact or Fiction (40:27–46:16)

1. Measles only spreads after rash shows up:

   • Fiction. Highly contagious before rash; can infect dozens indirectly (40:27).

2. Americans smoking less than ever before:

   • Fact. Smoking rates at modern lows, especially among youth—but tobacco remains top preventable death cause (41:12).

3. Hypertension—a risk factor for dementia:

   • Fact. Big increase in dementia risk if uncontrolled; benefit if kept below 130 (42:15).

4. Dancing helps prevent dementia:

   • Fact. Any vigorous enjoyable activity, including dancing, works (42:27).

5. People today get sick more often than pre-COVID:

   • Fiction/toss-up. Big headlines obscure overall improvement; some setbacks in global health due to funding cuts (42:50).

6. Everyone should take some supplement:

   • Fiction. Most unneeded; exception: selected nutrients for certain people, and creatine for strength training (43:57).

7. Americans don’t eat enough potassium:

   • Fact. Most consume half or less of what’s needed for optimal health. More potassium helps increase sodium excretion (44:29; 44:37).

8. High potassium foods? If you don’t like bananas:

   • Pistachios, sweet potatoes, yogurt, avocado, tomatoes, mushrooms—“find fruit and vegetables you enjoy” (45:17).

9. Cold plunges boost immunity:

   • Fiction. No evidence for long-term health benefit (45:44).

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Notable Quotes & Memorable Moments

• “Good science doesn't give you certainty. It gives you humility because you understand how much you don't know.”
  — Dr. Tom Frieden (05:17)

• “Facts are stubborn things. Facts are on our side and facts are powerful. And even if they're ignored, twisted or suppressed, they're still facts.”
  — Dr. Tom Frieden (47:20)

• “People want to live a long, healthier life. And by seeing the invisible, believing that we can make what seems inevitable actually much better and working together to create a healthier future, we can have a more connected society, longer lives, lower healthcare costs, and feel better for longer.”
  — Dr. Tom Frieden (47:20)

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Timestamps for Key Segments

• Reliable Health Information & AI: 03:11–08:03
• Six Steps for Better Health: 08:15–11:16
• Diet, Potassium, & Sweet Potatoes: 10:27; 44:29
• TrumpRx Program & Prescription Drug Access: 12:27–15:51
• Hypertension: Discussion & Importance: 16:43–20:03
• Diet Fads, Medication Skepticism: 21:05–24:35
• Vaccine Hesitancy, Measles Outbreaks: 29:01–34:54
• Tech & Telemedicine: 38:17–39:49
• Fact or Fiction Round: 40:27–46:16
• Optimism for Public Health: 46:22–47:34

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Final Thoughts

Dr. Frieden’s message is clear: the fundamentals of good health are simple but often undervalued. Focusing on controlling blood pressure can save more lives than trendy supplements or fads. He offers hope that even in a polarized, misinformation-rich era, facts—and practical, evidence-based actions—can help build longer, healthier lives for all.

Transcript

[Julia Louis Dreyfus]

Hiya, Julia Louis Dreyfus here from the Wiser Than Me podcast. Among other things. And I've got a bit of a hot take. Our relationship to our food can feel disconnected. We don't always know how or where our food is grown. And if we throw food scraps in the garbage, we don't think about where it's going. Or at least we try not to. One way that I get back a little of that connection is by using my mill food recycler. Sure, Mill has totally changed my home life in a lot of practical ways. It works automatically. You can fill it for weeks. It never ever smells. But this is also really important. When I use mill, I'm participating in a circular system. All the food I don't eat is helping to grow the food that I do. It makes me feel like I'm part of something bigger. And that feels really, really, really good. And it's all so ridiculously easy. I just drop my scraps in my mill and it transforms them into nutrient rich grounds overnight. I have mine sent to a small farm, but if I wanted to, I could use them in my garden or for my backyard chickens if I wanted backyard chickens. And I don't know, maybe I do now, maybe I don't. Anyway, maybe mill is transforming me too, just a little. If you want to feel more connected or you just want your kitchen to feel less gross, try. Try Mill's risk free trial and just live with it for a while. Go to mill.com wiser for an exclusive offer.

[Dr. Tom Frieden]

Lemonada.

[Chelsea Clinton]

Welcome to that Can't Be True, a show that sorts fact from fiction, especially on issues impacting our health. Hi, I'm Chelsea Clinton, and today I'm talking with Dr. Tom Frieden, who is a physician with deep public health and epidemiology training. He led the CDC for almost a decade and also ran New York City's health department. He now heads up Resolve to Save Lives, an organization that focuses on epidemic preparedness, cardiovascular health, and actionable public health policy. His new book is called the Formula for Better how to save millions of Lives, including your own. And I had the pleasure of talking with him about it recently at the New York Public Library. We're going to talk about all of that, especially about hypertension and his six tips to live a longer and healthier life. Plus some of the top public health stories leading the news right now. And of course, our fact or fiction questions, which will cover measles, tobacco use, potassium, and dancing. Hi.

[Dr. Tom Frieden]

Hi.

[Chelsea Clinton]

It's so nice to see you. Thank you.

[Dr. Tom Frieden]

Great to see you. And it was great to do the event at the library.

[Chelsea Clinton]

I loved that event at the library. In fact, maybe we'll start off talking about your book and that you've been on a tour for your book, the Formula for Better Health, and just so curious what questions you're getting. Have any of the questions or where people's attention has gravitated toward. Has any of that surprised you?

[Dr. Tom Frieden]

I think there were probably two main questions that I heard over and over. The first was, where can I go for reliable health information? And that's not so easy.

[Chelsea Clinton]

And what do you say? What do you say, Tom, in these days?

[Dr. Tom Frieden]

Well, depends what you're interested in. If you're thinking about vaccines, a group like the American Academy of Pediatrics, if you're concerned about health during pregnancy, the American College of Obstetricians and Gynecologists. But this is a landscape that's changing really fast, and there is massive amounts of misinformation. I would start with saying, don't believe anything from anyone who's trying to sell you anything.

[Chelsea Clinton]

Seems like a good adage for life in general.

[Dr. Tom Frieden]

And I also think we need to go a little more deeply into the levels of certainty, and I talk about this in the book, that there are things that we're virtually certain about. You know, we're never going to find out that tobacco is good for you. And there are things that are highly likely, but they might change. They're things that we have some evidence about. It's a reasonable. There's at least one good study, but it could definitely be wrong. And then there's things for which there is no. No evidence whatsoever, which doesn't mean they're not right, just means we don't know. And so I think it's really important to kind of understand those four areas. And they apply to so many things. They apply to personal health, they apply to public health advice. And when we think about something no one wants to talk about anymore. But Covid, the fact is the virus is changing, the vaccines are changing, our immunity is changing, the. The environment is changing, our knowledge is changing. And so we need to adapt what we recommend, what we do. And that's kind of a level of nuance that's important for people to understand.

[Chelsea Clinton]

And yet has always been fundamental to science, right. To the fundamental tenets of what the scientific method is.

[Dr. Tom Frieden]

You know, good science doesn't give you certainty. It gives you humility because you understand how much you don't know. So that was the first main question. Where can I go for more information. And I'll just say before wrapping up that question that I do think artificial intelligence is changing this in a big way.

[Chelsea Clinton]

Talk more about that. What do you mean?

[Dr. Tom Frieden]

So in a negative way, you're seeing kind of the industrial scale production and dissemination of misinformation through artificial intelligence. And you're seeing even in leading models continuing hallucinations and inaccuracies where you really wouldn't want to use this for making medical decisions. On the other hand, there are some products that are medical AIs that are optimized for medical information. They don't have any stock in it or financial interest in it, but I use open evidence every single day, multiple times.

[Chelsea Clinton]

Well, and I remember at our event at the New York Public Library, you said arguably doctors who weren't doing that were now engaged in male practice because they weren't availing themselves of the best possible tools today to help them do their jobs.

[Dr. Tom Frieden]

I don't practice full time. I was on a flight a few weeks ago international and overhead. Is there a doctor on board? There was a patient having a medical problem or a passenger, I should say became my patient having a medical problem. And it was not life threatening medical problem. But the situation was a little complicated and I suddenly felt, hey, you know, I just don't feel comfortable taking care of this person without double checking with AI and paid for the wi fi for the flight, got onto the AI that I use for medical stuff, put in my careful history taking and the situation and it came back with a potential diagnosis that not only had I not thought of, it was a very rare side effect of a medication that she started about six months before, which she's now had three episodes of this symptom.

[Chelsea Clinton]

Oh wow.

[Dr. Tom Frieden]

And it is so rare that I happened to be with one of the world's experts in this condition just a week or two later. And I said, did you know about this? He said, I had no idea. So medical science is so complicated that it's virtually impossible for anyone to have a complete and comprehensive understanding. That doesn't mean we're going to defer things to AI, but it means it's a tool and like any tool, it can be used well or it can be used poorly.

[Chelsea Clinton]

How many questions did you get about you personally? Like, were people asking you, like, what do you eat? Or do you exercise or do you really sing Happy Birthday two times while you wash your hands? Did you get questions like that too?

[Dr. Tom Frieden]

In the book I outline the formula for better health. See, believe, create, see the invisible, believe that Things that may seem inevitable can be changed and create a healthier future. And after outlining all of those in great detail, I then go to how does that imply things for how we do our healthcare and public health system? And then finally, how is that relevant for your personal health? And I did get a lot of questions about personal health. Food, exercise, sleep. And what's really striking is that when you look with the eyes of an epidemiologist on personal health issues, it's not all that complicated. There are six things that everyone should do if they wanna live a long, healthy life. Control your blood pressure, ideally to 120, 80. Control your cholesterol, ideally with an LDL under 70. Get enough sleep, seven to nine hours per night. The wonder drug. Get physical activity, at least 30 minutes of a brisk walk, enough so you can't sing Happy Birthday, you're a little out of breath for at least 30 minutes, at least four days a week. Avoid toxins, tobacco, alcohol, and then some more complicated toxins that are more recent in our environment. And we can talk more about that. And then sixth, eat healthy. And although there's a lot of debate about healthy food, the essence is really pretty simple. Eat more healthy food, particularly fruit, vegetables, nuts. Eat less unhealthy food, especially sugar, processed red meat, Red meat generally, and fatty foods. And you know, for me, I really like red bell peppers and so roasted as a snack in salads. You know, it's a food I. I like, I enjoy and it's really healthy. So sweet potatoes. I wrote, I have a substack. I wrote an ode to sweet potatoes. That was it.

[Chelsea Clinton]

Also a poem? Was there a poem in there? It was not just an ode, but in prose, not poetry.

[Dr. Tom Frieden]

Yes, definitely not. This is one thing I've changed since doing the research on the book. Like, who knew that something that tastes like a dessert could be so healthy? It's high in potassium, it's high in all sorts of vitamins.

[Chelsea Clinton]

I mean, Tom, I feel like my grandmother has always knew that sweet potatoes were rather magical foods. I think both of them always were trying to maybe even sneak more sweet potatoes into parts of the kind of lunch or dinner.

[Dr. Tom Frieden]

Well, and you know, if you look at the things I just went through, it's what your mother told you. Go out and play, get enough sleep, eat your vegetables. These aren't really complicated. And they're right. I mean, and in the book, I go through what's the rigorous evidence for how many more months of healthy lifespan healthspan will doing that give you?

[Chelsea Clinton]

And it's Pretty meaningful. I wanna talk about all of this more particularly your focus on blood pressure because it's what I found so striking when we kind of did our event together recently. Before we though, move deeper into your book and to your work, I do wanna talk about some of the news of the day. You referenced some controversy around kind of whether or not we all should be eating more fat or not. And we've talked already on this show a lot about our food pyramid, although it's not really a food pyramid, it's an upside down triangle. But one thing that we haven't talked about at all is sort of the Trump RX program that has been percolating for quite a while. But late last week, Trump unveiled the new Trump RX website and gave some indication of kind of what he hopes it will facilitate and enable, but also is pretty clear about what it's not going to tackle in terms of kind of some of the challenges in our health care system, including as relates to pharmaceutical pricing. So I just want to play a tape of what he said as it was covered by ABC News and then get your take.

[Julia Louis Dreyfus]

The Trump administration last night launching its new website known as Trump rx, designed to make prescription drugs cheaper.

[Dr. Tom Frieden]

Dozens of the most commonly used prescription drugs will be available at dramatic discounts for all consumers.

[Julia Louis Dreyfus]

The website does not sell medications directly. Instead it offers pharmacy coupons like this or discounts through the manufacturer. The President saying consumers can expect big savings on medications used to treat diabetes, heart disease and obesity.

[Chelsea Clinton]

Trump RX discounts are available only to cash paying patients and do not apply.

[Julia Louis Dreyfus]

To those using insurance.

[Chelsea Clinton]

So Tom, basically what do you make of all of this and where do you hope we go from here?

[Dr. Tom Frieden]

Well, let's start with the end of that clip that it only relates to people who don't have insurance. Currently that's less than 10% of Americans. However, with the legislation that the administration signed into law last year, something like 20 million Americans are going to lose health insurance coverage. Many have already lost it. Drug prices are scandalously high in the US And a lot of that is from, you know, it's not popular say, but basically from extortionate prices by the pharmaceutical industry. And you know, one of the approaches of the Trump administration to the difference in price between in the US And Europe is to try to get companies to increase their prices in Europe so that there's less of a difference. That's a very strange approach. But look, if someone gets affordable medications through Trump rx, that's a good thing. I think there's Another aspect of medical care costs, and it's related to, you mentioned hypertension. We've looked at the issue of, hey, what about a $5 a month copay? Isn't that okay for patients to pay? And it turns out to be no, not for medications that are really important for prevention and for which there are no symptoms. We'll talk more about high blood pressure as an example. It's the world's leading killer and we find that in many countries patients are charged to copay for medications. Hypertension is called the silent killer because the first symptom is often a heart attack or stroke. If my shoulder hurts, I'm going to pay the five bucks if you tell me, hey, you might have a heart attack or stroke or have dementia in 5, 10, 15, 20, 30 years, maybe I want to spend something else. Spend that $5 somewhere else. So the evidence is quite clear. And a really good healthcare system would identify medications that are preventive and make sure those are really free and easy to get to patients where you can get three months, maybe six months at a time, if you're stable, get them in the mail, don't have to pay a penny for them. So I think access is really important. We pay as, you know, twice as much as the next highest paying country in the world for our healthcare and we have a lower life expectancy than any other high income country and lower than several middle income countries as well. So we're not doing a good job with our health system. And part of that should be that core medications and they don't have to be expensive but are available free of charge to patients.

[Chelsea Clinton]

So, you know, trump Rx, hopefully a step in the right direction, but not the end of the road. Since we've now talked about hypertension, I do want to talk about high blood pressure here because, you know, I think in this moment, you know, I see and I'm asked questions all the time about, you know, should people be like taking this new peptide or should they be taking this new supplement or should they be taking this vitamin? Should they really be monitoring their vitamin D levels? Like, should everyone have a continuous glucose monitor? But I was quite struck when we were at our event together at the public library where you said, I'm paraphrasing, but effectively, if you paid attention to one thing and you really, really spent a lot of time trying to control one thing that could have the highest roi, if you will, like for your health, it's blood pressure.

[Dr. Tom Frieden]

Absolutely, absolutely.

[Chelsea Clinton]

Why do you think that's not more in the conversation?

[Dr. Tom Frieden]

I think It, Chelsea, comes back to the formula for better health. See, believe, create. First off, see, we need to see that most American adults have unhealthy blood pressure. We need to believe that it's not a normal part of the aging process and it is not.

[Chelsea Clinton]

And do you think that that's a real challenge here? That kind of a lot of people think like, oh, I just get older, my blood pressure goes up. Do you think that's also a challenge with how like, doctors and nurses may be talking about this with their patients?

[Dr. Tom Frieden]

Absolutely. You know, we were taught medical school that it's normal for blood pressure to increase with age. And although it is the norm, it is far from normal and not inevitable.

[Chelsea Clinton]

Not inevitable, I think is what you're saying.

[Dr. Tom Frieden]

Not inevitable. That's exactly right. And there's some fascinating studies that looked at some pre industrial populations where people were consuming 10 times as much potassium as we consume and about 110 as much sodium. So their sodium potassium ratio was totally different. And they had no zero age related increase in blood pressure. 90 over 60 at age 16, 90 over 60 at age 60. Now, we're not going to replicate that dietary pattern in all likelihood, but there are things we can do. Switching to low sodium potassium enriched salt with at least 25% potassium. If you've got a kidney problem, check with your doctor first. That's one of the few ways that we can systematically reduce the risk of high blood pressure. But most of us will need medications. And just since we met, the American Heart association has reduced the target from 140 to 130. For most people, saying 120 is ideal. And that's really the case. There are these big brilliant studies from a group in Oxford that looked at people over many years and showed that for every 20 point increase in blood pressure starting at 115systolic, your risk of a heart attack or stroke doubles. Doubles.

[Chelsea Clinton]

Oh, wow.

[Dr. Tom Frieden]

And that's heart attack or stroke before age 70, between age 29 and 70. So think of high blood pressure, that the blood in your arteries is like a battering ram slamming into your heart, your brain, your kidneys, with every single heartbeat of every single day doing damage. And there are simple ways you can take your medicine every day. You know, I put mine in the way that I can't actually get to my breakfast unless I go through my medications. So I'm going to take them every morning before I have breakfast, because I like to have breakfast every morning. Whatever works for you to take them every day makes a big difference.

[Chelsea Clinton]

So, Tom, you just spoke about so many of the different factors around, you know, high blood pressure, you know, limiting sodium intake. Earlier you spoke about kind of limiting processed red meat consumption and, you know, focus on cholesterol. I know, because we spoke about it at our event and you talk about it in your book, you know, also a real focus on eliminating industrial produced trans fats. And yet in this moment, you know, a heavily carnivore diet with a lot of natural fat has become a core part of how this current administration, you know, certainly Secretary Kennedy talks about what they believe to be a healthy diet. How do you reconcile or is it possible to reconcile, like all of the evidence that you use in your book or kind of that, you know, continues to inform your future work? This conversation, you know, that we're having today kind of with what the administration is saying it believes to be a healthy diet.

[Dr. Tom Frieden]

I think there is nuance here. There is some evidence that if you consume more saturated fat, you feel full satiety, as it's called, so that you may eat somewhat less. And that's pretty consistent evidence.

[Chelsea Clinton]

And so examples of saturated fat are for people who don't know hamburger, okay.

[Dr. Tom Frieden]

A fatty piece of beef, frying things in beef tallow is not a health food. But having more saturated fat may allow you to consume fewer calories over the course of a day. And so I think it's important that again, from virtually certain to highly likely to possible to, we don't know. It's possible that for some people, having more saturated fat may help them with weight and health, but there's a real disconnect between what Mr. Kennedy says and what the guidelines say, because the amount of saturated fat that the guidelines outline, you would go way through that limit with anything like the kind of diet that he's demonstrating. So saturated fat is one of the more complicated issues. But what we know for sure, fruit and vegetables are good for you, nuts are good for you. Sugar is bad for you. Processed meats are bad for you. And I think there are unknowns. But what we often miss is there's a lot that we do know and we should focus on implementing what we do know while we try to find out more about, about the things that we don't fully understand yet.

[Chelsea Clinton]

There's also a kind of strain in the kind of Make America healthy movement that is antagonistic to any medicines. I mean, you've now referenced some people should take a statin or maybe something else. I know there's also a really live debate right now around taking a statin versus taking a PSK9 inhibitor. Would love to hear your thoughts on that and also what you would say to people who think if we really focus on our diet and we also do all the other things that you recommend, like get enough sleep, which is still my main area of need for improvement, get exercise, that you definitely don't need any medications. What do you say when kind of people, I'm sure people have said similar things to you. How do you respond?

[Dr. Tom Frieden]

I actually agree with Mr. Kennedy on some of the overmedication issues. I think especially for conditions that have symptoms, adhd, we are seeing over medic pain, we're seeing over medication rather than a more systematic approach with physical activity, physical therapy, counseling, other issues. And so I do think there is over medication of kids and others. But it's really dangerous to suggest that you don't need any medicines if you just live healthy, eat healthy. You know, personally, I basically do just about everything right and I still have hypertension, which is really annoying, and I've gotta take a couple of medicines every day and try to get it under 130, under 120. Ideally, that's just the cost of living our modern lives.

[Chelsea Clinton]

And thoughts on the PSK9 inhibitor versus statins.

[Dr. Tom Frieden]

Okay, first off, really great article. Just came out reviewing massive amounts of data on statins. Statins are really safe. There's really interesting analysis that in the placebo controlled studies, there's no increase in muscle pain with statins. But in the unblinded follow up, people who know they're on a statin say, oh yeah, my muscles hurt. And interestingly, there was a study that compared three groups. One group was on a statin, one group was on a placebo. They didn't know if it was a pill or a statin, and one group was not on either pill. Both the placebo group and the statin group said, yeah, yeah, my muscles hurt. The group not on any pill said, no, no, my muscles don't hurt. So, you know, that's a real issue. There are a couple of other great medications. We don't have long term safety information on them to the degree that we do for statins. And so, you know, I think a lot of people should be on statin, you know, too much information. But a couple of months ago I started a statin not because I'm at high risk, but because I have hypertension. And given the age group I'm in, even though my, my cholesterol lipid panel is pretty good, it's not perfect. And the evidence suggests that the lower the LDL and the lower your apoprotein, apolipoprotein B, the lower your risk of a heart attack disability, and the higher your likelihood of living a long, healthy life, which I certainly want to do. I think most people do.

[Chelsea Clinton]

Absolutely. I want to talk about infectious diseases, too. But before we do, thoughts on how frequently you would recommend someone who generally is healthy? You have all those levels checked, get your levels checked every month, be really on top of things, or once a year probably isn't enough. Maybe twice a year or once a quarter, or actually like once a year should be fine as just a continued.

[Dr. Tom Frieden]

Baseline really depends who you are.

[Chelsea Clinton]

Really depends who you are.

[Dr. Tom Frieden]

So if you're young and healthy, you get a baseline, it's fine. Annual or even less is just fine. If you're on medications and you're adjusting the medications, you may need to check them every month or even more. So it really is about you and the situation that you are in. One thing that is important to understand is that for some of these numbers, there's a normal and an abnormal level. But what's more important is your personal trend. So it may be that you're in the normal level, but over time, you're heading in the wrong direction, and we may need to intervene earlier. That doesn't mean medications. That may mean looking at your diet, physical activity, other things that could be changed. And I think that's really quite valuable. Take something like hemobility, hemoglobin, A1C glycosylated hemoglobin. That can be normal but creeping up to the abnormal level. And that's really important to catch early. Same with your blood pressure. You know, 125 is not normal, 130 is not normal. Doesn't mean you should necessarily be on medications, but you should be thinking of what you could do to get it down to below 120.

[Chelsea Clinton]

So we've talked a lot about hypertension, blood pressure, cardiovascular health, how diet, exercise, medications, maybe shifting the balance on potassium and sodium affect all of that. I do, though, want to get your thoughts on some of the kind of infectious disease news that we've seen painfully. You know, particularly thinking about not only the explosion of measles cases, you know, in South Carolina alone, but additionally the clusters that we've really seen in many states now across the country in the last year, as well as the Trump administration disclosing that there have been a couple of measles cases at a large ICE detention facility in Texas that we know recently there were reports of exposures in airports and public transportation Systems in different cities. How worried are you about this? Do you think this is just our new normal? Do you have a glimmer of hope that we'll be able to increase vaccination rates again? And hopefully this will be kind of a blip and not predictive. What do you think?

[Dr. Tom Frieden]

I'm worried. I'm worried and I've been worried since 2020 actually, because we've seen a weaponization of science. We've seen the basically retreat from a concept that there is a shared reality that we can understand and learn about. Senator Moynihan used to say, you're entitled to your own opinion, but not to your own facts. Now I think many people feel they're entitled to their own facts. I started my public health career working on measles outbreaks in New York City. And we had thousands of cases, hundreds of hospitalizations, dozens of deaths.

[Chelsea Clinton]

And this wasn't that long ago.

[Dr. Tom Frieden]

No, no. And that's what led to the Vaccines for Children program. And what we see Mr. Kennedy doing is systematically dismantling our vaccine infrastructure systematically. We've seen the ideological takeover of a key committee, the Advisory Committee for Immunization Practices. We've seen the muddying of the conversation about what should be recommended. You know, what the CDC should say is simply this vaccine is proven to reduce or not proven to reduce these outcomes and to do so safely or with these, this rate of side effects, we've gotten away from that to eh up to you if you want to get a vaccine or not. That approach, for example, applied to hepatitis B, that will condemn dozens, hundreds or even thousands of American children to getting a lifelong and often fatal infection in their infancy or childhood. So there are real implications of this measles. You know, when I see Mr. Kennedy saying, oh, you know, it's a mild childhood illness, well, that's not completely wrong. Right. There used to be 3 or 4 million million measles cases a year in the US in bad measles years. But when you have that many cases, that meant you had hundreds of deaths and thousands of kids who were disabled for life from it. So, yeah, it's not serious unless it is. Same was true of COVID Sure, most people have relatively mild illness and get over it, but some are going to have problems for life and some will die from it.

[Chelsea Clinton]

You know, Tom, I wonder too if you can reflect on what we've learned about the long term effects of COVID Certainly. But also what we've learned about the long term effects of measles and wiping out immune memory and what we know about how other viruses, even once maybe the symptoms have left us, actually can continue to haunt us for years or perhaps a lifetime.

[Dr. Tom Frieden]

Let me give you three, please. It's really interesting. Let's start with measles. We know a lot about it. Measles used to kill millions of kids per year around the world, still kills over 100,000 kids a year in lower income countries. The measles vaccine is highly effective. Dr. Bill Foege just passed away two weeks ago. And Dr. Foege led the global eradication of smallpox. And one of the things that he used to say is that measles was like the tugboat, that because families could get the measles vaccine, they were also going to get other vaccines as well because they saw the devastation that measles virus causes. And it doesn't kill people from measles, it kills kids because it knocks their immune system down and you get bacterial and other infections afterwards. And, you know, it was just shameful that Mr. Kennedy went to Texas, met with families and said, oh, they didn't really die from measles, they died from infection. No, that's how measles kills. So, yes, measles sets kids back on.

[Chelsea Clinton]

Their growth curve quite literally. Right. It has a stunting effect.

[Dr. Tom Frieden]

Yes, yes. And a really big increase in illnesses. Now for COVID 19, we're still learning more. Long Covid is changing over time. It does appear that vaccination reduces the risk of long Covid. There are people still suffering with long Covid. The rate of long Covid after infection seems to have been coming down quite a bit. And we're still learning a lot about long Covid. But the third one to mention is chickenpox. Chickenpox also routine childhood infection. It's one of the ones that it looked like the advisory committee might stop recommending because there are a couple of countries in Europe that don't recommend the chickenpox vaccine. Big mistake, right? I mean, a lot of kids really miserable with it. No harms of the vaccine. Some kids quite seriously ill from it. Rare, but quite seriously ill. But interestingly, Chelsea and I would put this in the some evidence. There is growing evidence that getting a shingles vaccine over the age of 50 doesn't only protect you from shingles, that we're sure it does. Because if you've had chickenpox, you've got a real risk of having really terrible, painful shingles late in life. We know the shingles vaccine works to prevent that very effectively, but there's increasing evidence that it also works for reasons we do not understand to reduce the risk of dementia. So you're seeing a big reduction in dementia risk in people who got the shingles vaccine. And the studies have been very elegant on this, where you might have a group that the shingles vaccine was just recommended for a certain age during a certain month, and they compared the group before to the group after and they see a 20, 30% reduction in dementia risk. So there are real benefits to vaccines.

[Chelsea Clinton]

Well, and the HPV vaccine, it's quite extraordinary that Australia believes that it will completely eradicate cervical cancer within the next decade because of effective universal HPV vaccine coverage.

[Dr. Tom Frieden]

Both HPV and hbv, hepatitis and HPV vaccinations, these are anti cancer vaccines and they're very effective.

[Chelsea Clinton]

And I wish that we used that language more because I think to your earlier framing of sort of seeing. I don't think we in the public health community have always done a good job of being, as you also mentioned earlier, humble around what we don't know or continuing to have our knowledge kind of evolve around and also bold in making the linkages between how preventing a virus today may help prevent a cancer tomorrow. In the proverbial sense, absolutely.

[Dr. Tom Frieden]

I think communication is changing in a big way. We're seeing more video, more YouTube, Instagram for people getting their news. And in public health, we're kind of behind. We're fighting the last war and we need to have our messaging that works better. There are some influencers out there who are responsible. Doesn't always mean it has to be 30 seconds or less. People are interested in information. The challenge is how can we identify for people what is reliable and what is not, what is hype and what is fact and, and that's hard. I don't think we have a good answer to that so far.

[Chelsea Clinton]

Before we go to our last section, which we call kind of fact or fiction, where I'll ask you a variety of questions or maybe more accurately kind of throw out different claims that we've been seeing circulate. I do want to, you know, just spend a little bit more time talking about technology. You know, you, you mentioned earlier in the conversation about open evidence and kind of the extraordinary ways in which responsible AI, you know, really built by experts, really now is an imperative that experts themselves kind of use. And you shared that kind of harrowing story about kind of being the doctor on the plane and I'm so thankful, having been on a few airplanes where kind of similarly the bell has rung. Grateful that there's always been a doct doctor on the plane to answer it. Just want to know what other kind of tech innovations you might be especially excited about or arguably wary about. Thinking about all of the different stories I've seen recently on robotics, including Dr. Oz praising the use of robots to help deliver ultrasounds to pregnant women in Alabama. What if any, what kind of thoughts, hopes, concerns do you have about those examples and also others in the aegis of technology?

[Dr. Tom Frieden]

So there's a lot that's inefficient and telemedicine is really important. It doesn't replace hands on medical care. If you look at our healthcare system, the biggest gap we have in the US and the biggest gap we have globally is primary healthcare. Being able to, to see a doctor, a team of health providers who understand us and will help us interpret and make a choice that's right for us. And to the extent that new technologies can help with that, great. But you know, having a robot do something because you don't have enough doctors, because you're not paying enough for primary care, you didn't expand Medicaid in your state. I don't think that's a great solution. At least it may help some people and that's a good thing.

[Chelsea Clinton]

So if it helps extend care, to paraphrase you think that's a good thing. And also in a moment where we've had such a precipitous decline in kind of trust between kind of patients and providers, we should be doing more to help train and compensate providers so that they actually have the time to build those human to human relationships with their patients.

[Dr. Tom Frieden]

Another shocking fact I learned while doing the research for the book the Formula for Better Health is a primary care doctor after 20 years of work, dedicated works, caring for people will make less than half as much money as a surgeon who graduated yesterday.

[Chelsea Clinton]

Wow, Sobering and important. I think for those of us who care about improving health care access and importantly health outcomes in our country to know. So just for our last segment, which again called fact or fiction, I'll throw out some claims and you'll tell us whether they're fact or fiction or if there's nuance. All right, so we already talked about painfully, the growing presence of measles in the United States. And I do think it's really important that every parent know the signs of measles. So Tom, fact or fiction? Measles only spreads after the rash shows up.

[Dr. Tom Frieden]

Fiction. Measles is really infectious. It is probably the most infectious of all infectious diseases. I investigated measles outbreaks where one person who didn't Have a rash. Was in an emergency department left. And many kids who came in in the following hours got measles from that one person. Wow.

[Chelsea Clinton]

You talked about starting your career here in New York City. You also returned to New York City to kind of lead public health efforts in our beloved city. And one of those was trying to lower tobacco use. Americans are smoking less today than ever before. Fact or fiction?

[Dr. Tom Frieden]

Fact. Well, not than ever before, but than at any time since the 1950s.

[Chelsea Clinton]

Yes, since we've been alive, I should say. Despite this, tobacco remains the top cause of preventable death in the US. Fact or fiction?

[Dr. Tom Frieden]

Fact. Fact.

[Chelsea Clinton]

I don't think enough people know that.

[Dr. Tom Frieden]

Yeah, it still kills about a half a million Americans a year. That's a lot of people.

[Chelsea Clinton]

That's a lot of people.

[Dr. Tom Frieden]

Still causes about a third of all of our cancers, about a third of all of our heart attacks and strokes. So there's still groups in the US that smoke at a high rate, but we are seeing encouraging decreases, but not low enough. Other countries have gotten their smoking rates even lower. One thing that is really encouraging is how low smoking rates are among kids. They're really low. They're in the low single digits. And that is the lowest that's ever been measured.

[Chelsea Clinton]

That's super encouraging. And clearly still have more work to do because no kid should be smoking. Hypertension is a risk factor for dementia. Fact or fiction?

[Dr. Tom Frieden]

Fact. Big increase in dementia risk and a reduction in that risk with control to 130 or less.

[Chelsea Clinton]

Dancing can help lower your risk of dementia. Fact or fiction?

[Dr. Tom Frieden]

That is true. That is a fact. You know, for physical activity, do whatever you love to do and do it at least four times a week for at least 30 minutes till you get out of breath. And if that's dancing, more power to you.

[Chelsea Clinton]

Studies have shown that people are getting sicker more often today than since before the COVID pandemic. Fact or fiction?

[Dr. Tom Frieden]

I would say fiction, although that one is a toss up. In general, health is getting better. We don't see that because the headlines if it bleeds, it leads. But in general, health is getting better. We've seen a recovery post. Covid. Globally, what we're seeing is for diseases like tuberculosis and hiv, we've seen a little bump in cases and infections because of the interruption in services before or during COVID And frankly, in the past year, we're seeing a bump because of the abrupt pullout of US assistance in global health, with a big increase in malaria for the first time in decades, a decrease in child survival globally. But if you're talking about the US environment, I would say it's quite cyclical. What people get sick from. With different viruses circulating. We're learning more about allergy and asthma, but that's a more complicated one. I would say that's a.

[Chelsea Clinton]

Maybe everyone should be taking some form of supplement for something.

[Dr. Tom Frieden]

Absolutely false. Most supplements are not necessary. I do outline why you might want to take vitamin B12. In my book and in my substack. Most supplements really don't have any value. Another exception is creatine. If you're doing strength training, building muscles, creatine does support gains in strength and muscle mass, especially in older adults. And it's safe, it's well studied, and it's a rare supplement that works. But it only works if you work out.

[Chelsea Clinton]

We talked about this a bit earlier, but I just want to be clear. We don't eat enough potassium as Americans. Fact or fiction?

[Dr. Tom Frieden]

Absolute fact. We probably have half or even way less than half, as much as we should be taking to have a long, healthy life. And interestingly, if you consume potassium, you often will feel more energetic. That's been studied, and I didn't even realize this until very recently. When you increase potassium, it isn't just that potassium is healthy and sodium is unhealthy, but when you increase your potassium consumption, you also increase the amount of sodium you excrete. So it has a double benefit.

[Chelsea Clinton]

I feel like that was like chemistry in high school.

[Dr. Tom Frieden]

Absolutely.

[Chelsea Clinton]

If people don't like bananas, what would you recommend that they eat?

[Dr. Tom Frieden]

Find high potassium foods that you enjoy. Pistachios, sweet potatoes, yogurt, avocado, tomatoes, mushrooms. There are lots of high potassium foods. It's not so simple because there's bioavailable potassium versus total potassium. It matters how you cook the foods, but basically fruit and vegetables.

[Chelsea Clinton]

There's no strong evidence that cold plunges boost immunity.

[Dr. Tom Frieden]

Long term fact, absolute fact. I mean, cold plunges may be exciting, but there's no evidence for a long term health benefit. Zero. That doesn't mean there isn't any. Just to be very clear, there's an old saying. The absence of evidence is not the evidence of absence. One of my favorite sayings, but no, it's fiction.

[Chelsea Clinton]

But when I ice my feet after the marathon, that's not harmful to me.

[Dr. Tom Frieden]

No evidence that that hurts and hope it makes you feel better. And congratulations for running a marathon, Tom.

[Chelsea Clinton]

Thank you so much. Is there anything that we should have talked about that we didn't?

[Dr. Tom Frieden]

Well, going back to your first question you asked me, what were the most common questions I got in traveling to a dozen plus states and giving dozens of talks, I talked about where to get more information. But the other main question I got is how can we maintain hope? How is it possible, given all of the challenge that we have, to continue to be hopeful? And I think frankly, there's plenty of reasons to be hopeful. We do have better technology than ever before before in human history. We've been in hard times before, although we are seeing unprecedented attacks on public health. But facts are stubborn things. Facts are on our side and facts are powerful. And even if they're ignored, twisted or suppressed, they're still facts. And one of the facts is that people want to live a long, healthier life. And by seeing the invisible, believing that we can make what seems inevitable actually much better and working together to create a healthier future, we can have a more connected society, longer lives, lower healthcare costs, and feel better for longer.

[Chelsea Clinton]

Tom Dr. Frieden, thank you for leaving us on an optimistic note. Thank you so much for coming on and I hope that we get to continue this conversation over the hopefully long road ahead. Thank you just so very much.

[Dr. Tom Frieden]

Thanks so much. It's been a real pleasure to speak with you. Thanks for doing this and thanks those of you who are listening for listening.

[Chelsea Clinton]

Thank you. You can follow Tom Frieden rtomfreden on Instagram and his organization is called Resolve to Save Lives. Thanks for listening. Talk to you next week. That Can't Be True is a production of Limonada Media and the Clinton Foundation. The show is produced by Katherine Barnes Mix in sound design by Ivan Koraev. Kristin Lepore is senior director of New content and Jackie Danziger is VP of Narrative and production. Maggie Kralshore is our Managing Director of Partnerships. Executive producers are Jessica Cordova Kramer, Stephanie Whittles, Wax, and me, Chelsea Clinton. Special thanks to Erica Goodmanson, Sarah Horowitz, Francesca Ernst Kahn, Caroline Lewis, Sage Falter, Barry Lurie Westerberg, Emily Young, and the entire team at the Clinton Foundation. You can help others find our show by leaving us a rating and writing a review. And if you can think of someone who might benefit from today's episode, please go ahead and share it with them. There's more of that Can't Be True with Lemonada. Premium subscribers get exclusive access to bonus content when you subscribe on Apple Podcasts. You can also listen ad free on Amazon because music with your prime membership.