Early in the new year – January 7th to be exact – Robert F. Kennedy Jr., the head of Health and Human Services, quietly posted a new set of food guidelines on the USDA website and an upside-down (or inverted as he called it) Food Pyramid. Replacing the “My Plate” pictograph of the Biden years. The guidelines themselves are updated every 5 years - and at a quickly organized White House news conference, RFK Jr. promoted the changes. Which push lots of red meat, whole milk and butter. He said, “We are endng the war on saturated fats.” The guidelines also include beef tallow as an alternate to olive oil or butter for cooking. And feature the MAHA mantra of ignoring highly processed foods. That part medical associations applauded, even as the American Heart Association warned again about the risks of eating a lot of high fat animal products. Very healthy whole grains are at the very bottom of the upside-down Pyramid; they had been featured, along with fruit and vegetables, on the previous “My Plate” guidelines.

The Food Guidelines are important to a number of government food programs – and to dietitians. Many of us remember learning about the older Food Pyramids in grammar school. My Boston school served a hot lunch but most of us brought our own sandwiches and washed them down with the free cartons of milk delivered daily to all city schools and - yes, it was 8 ounces of whole milk.

So. I went looking for a Registered Dietitian who could explain what’s good or bad or just different about RFK Jr.’s 2026 Inverted Pyramid. And I found one of the best.

Stephanie Hodges has MS, MPH and RDN degrees. She’s a Registered Dietitian and food policy expert who has spent more than a decade improving access to healthy food through public health nutrition programs and policy. She’s the founder of “The Nourished Principles” which supports clients in strengthening public health nutrition programs and policies, writing and implementing grants, and translating complex nutrition topics for diverse audiences. Here’s a link to her website . She’s really good at this!

YouTube Episode Link: https://youtu.be/BwDozyX5ffI

YouTube Channel Link: @conversationsonhealthhowwe4827

Donald Trump has changed America in many ways since his second term began a year ago. But perhaps in none so personally important as our overall health and health care. On February 25th 2025 the Senate confirmed Robert F. Kennedy Jr. as Secretary of Health and Human Services. Nearly a year later he has managed to dismantle or re-direct much of it. Among the multitude of public health agencies administered by H-H-S, the one where we’ve seen perhaps the biggest changes is the Centers for Disease Control and Prevention – or as we usually call it – the CDC.

Many experienced scientists and other employees have resigned or been let go. Many research grants to universities or non-profits - cancelled or cut back. And many long-term health policies have been changed. RFK Jr. has tried to promote a long debunked link between childhood vaccines and autism, and between Tylenol during pregnancy and autism. This last was definitively shot down this month by a retrospective study in the prestigious women’s health journal - Lancet. A meta-analysis of 60 studies found no association between Tylenol when taken as recommended and autism - as well as with intellectual disability or ADHD.

The other big area attacked by RFK Jr. and his appointees has been vaccines. For both adults and children. Routine recommendations have been removed from the CDC website and the members of the Advisory Committee on Immunization fired and replaced with RFK Jr’s choices. Including a number of vaccine skeptics.

Perhaps the most controversial change, posted in early January, is the Childhood Vaccine Schedule – reducing the number of routine vaccines from 17 diseases to 11. After much discussion - measles remained on the list – as a measles outbreak raged in South Carolina, doubling in just a week and spreading to at least 3 other states. The outbreak mostly among unvaccinated kids.

In late August a group of CDC senior officials and scientists resigned - after CDC Director Dr. Susan Monarez was fired. She refused to implement RFK Jr’s vaccine policy changes. And among those who walked away from their long-term CDC careers is my guest on this episode – Daniel Jernigan MD, MPH. Dr. Jernigan is a nationally recognized public health leader with more than 30 years at the CDC. Most recently he directed the National Center for Emerging and Zoonotic Infectious Diseases and the Influenza Division. He has led responses to major health crises including anthrax, SARS, H1N1, Ebola, MERS, and COVID-19. He’s authored over 160 scientific publications and is a recipient of the Service to America Medal. Dr. Jernigan is a graduate of Duke University, Baylor College of Medicine, and the University of Texas School of Public Health and has completed residencies in Internal Medicine and Preventive Medicine. Our conversation clarified a lot of now “murky” health issues.

YouTube Episode Link: https://youtu.be/3RtVJOq7K7I

YouTube Channel Link: @conversationsonhealthhowwe4827

What will happen in the US if cases of a now contained virus – or a totally new one - suddenly start multiplying by the millions? The CDC has drastically cut back on vaccine research as well as childhood vaccine recommendations. What diseases may come roaring back? Episode 40 drops on Tuesday January 20th with some answers from Daniel Jernigan, MD, MPH - one of the former top officials at the CDC. Links to the major podcast platforms and show notes on https://stephanishelton.com/conversations

It’s not exactly an episode – thus the A-40 label. It’s just me talking to you for a few minutes. We had some last minute cancellations – which of course can happen as the holidays as well as the end of the business and financial year approach. The historically long US government shut down also took its toll. On virtually everything.

So -- we will resume the usual episodes on the third Tuesday of January – the 20th to be precise - with Episode 40. Please check the podcast page on my website for guest and subject info; it will be there as soon as I know it – stephanishelton.com/conversations. And while you’re there you may want to review the notes on Episode 37 and then the podcast itself - the Emergency Update on Autism. You’ll get the actual scientific facts about autism – which Trump appointee and vaccine skeptic Robert F. Kennedy Jr. Is now trying irresponsibly to link to the one drug pregnant women can take to reduce dangerously high fevers – Tylenol. There’s an earlier and more detailed podcast on autism as well – Episode 34 – both with autism expert Amy Wetherby of Florida State University.

One of the subjects I hope to discuss during the coming year is what’s happened to the CDC and the FDA under RFK Jr. And the whole, once highly respected, scientifically factual, federal public health data base. And the government grant money which would normally be going to areas like cancer research and the virtually miracle-like mRNA base for everything from individualized cancer treatments to new vaccines for potential pandemics. Remember – smallpox was eradicated globally thanks to vaccines. And in the US the routine vaccination of children had virtually wiped out measles, polio and many other diseases. Now measles is coming back big time here. It’s a dangerous disease which can and is killing babies, children and even unvaccinated adults. And don’t forget Covid. It still makes a lot of people really sick and still kills a surprising number of them – and not just the very old and ill. Lots of people live their whole life in what we might call fragile health. Vulnerable to many diseases because their immune systems are suppressed by their diseases or by the drugs they take to control those diseases. I could go on a total rant about what RFK Jr. has done to the credibility of any US government report on any disease and what he and the unscientific people he’s appointed to key positions at the CDC and FDA are doing to the overall health and potential health outcomes of the American people. But I’ll leave that for the guests I hope to have in 2026 discussing this situation and where it’s taking us.

I don’t think a lot of people actually understand science. It’s not immutable, not unchangeable. It is called science precisely because as researchers and scientists keep testing what they know, they often learn something new which modifies specifics about a disease or a treatment or a procedure. And so what health professionals use as their guidelines often get rewritten by new discoveries. Which, i think, lots of us find confusing. And when you’re confused you tend to stop believing. In anything.

Of course none of us knows what 2026 will bring. Sadly it’s a pretty sure bet that many people on Obamacare health insurance now won’t be able to afford it after January first – unless there’s a small miracle in the few days left before Congress goes home for its holiday break. On the podcast – I hope to discuss that along with subjects like how venture capital contributes to drug, device and treatment breakthroughs. The extension of the 9-11 Fund for First Responders. And likely some personal stories which a lot of us can identify with. And in small, understandable chunks – i want to discuss more about how all health systems – hybrid like ours or totally government controlled like the rest of the world – will have to change in order to pay for expensive new treatments and the social care that virtually every health system seems to put on the back burner.

I want to thank all of you who have subscribed to this podcast and especially those who have stayed with me over these 3 years. Please tell your friends and colleagues about us. And if you have suggestions for episodes – please let me know. May 2026 bring you and yours health and happiness and the courage to follow your dreams.

YouTube video link: https://youtu.be/UlTpOZzAMfw

Our neighbor and long-time friend Canada has been the subject of President Trump’s ire -and his tariffs - since he became President again in January. He’s even claimed Canadians would have “much better” health coverage if Canada were somehow to become the 51st US state. Actually, Canada - like almost all other industrialized countries - has a publicly funded, government run health care system. Which is somewhat similar to the UK’s venerable NHS. Which of course this podcast has looked at several times. Every Canadian in the country legally is covered. Although some fringe coverage can vary from province to province. Since there’s so much inaccurate information about the Canadian system floating around – I thought I’d try to set it all straight in a conversation with the extremely well-qualified Gregory P. Marchildon, CM, PhD, FCAH. He’s Professor Emeritus at the University of Toronto’s Institute of Health Policy, Management and Evaluation. And the Founding Director of the North American Observatory on Health Systems and Policies. Gregory Marchildon has worked as a lawyer, senior public servant, and consultant for numerous governments and international organizations. In recognition of his impact on both scholarship and public policy in Canada, he was made a member of the Order of Canada. He has written extensively on Canadian history and public policy. His most recent book is Tommy Douglas and the Quest for Medicare in Canada published by the University of Toronto Press in 2025. I’m embarrassed at how much I didn’t know about the Canadian system – even with research – until I talked to Greg. I think you’ll learn a lot also..

YouTube Episode https://youtu.be/_DxK-GUviPY

UPDATE -2/26 SEE END OF SHOW NOTES

As I record this – at the end of the second week in October 2025 – the US government is officially shut down. Senate and House Democrats are demanding negotiations with Republicans and President Trump to restore major health care cuts to Medicaid and the Affordable Care Act marketplace subsidies for 2026. It’s expected that if these cuts aren’t restored – and restored quickly - insurance premiums will double or even triple. And millions of Americans who now have at least some basic health insurance will be unable to afford any. Many small, rural hospitals may have to close as well.

Which brings me to the overall state of the US healthcare “system” – such as it is. And my guest. Dr. Erica Rowe Urquhart. She’s a leading orthopedic surgeon who runs a private practice in New Jersey with her husband – who’s also a highly credentialed orthopedist. Dr. Urquhart has a PhD in molecular and cellular neuroscience and served her orthopedic surgery residency at New York’s renowned Hospital for Special Services. After 15 years in private practice Dr. Urquhart also got an MBA from Oxford’s Said Business School, so she could deal with the ever more complicated insurance issues we’ll be talking about – issues which often prevent even patients with “good” insurance from getting the medical procedures they need. Her book - The Invisible Hand Wielding the Scalpel - is just out. We cover a huge amount of ground in our conversation and I think you’ll identify with many of the issues we raise. As usual on this informal podcast, we use first names.

YouTube Episode link: https://youtu.be/YFuhwDcJxKU

https://drurquhart.com/

https://www.urquhartortho.com/

Channel link: @conversationsonhealthhowwe4827

UPDATE 1/16/26: Today, January 16th, the Lancet – a prestigious women’s health medical journal – published a review and meta-analysis of 60 studies about Tylenol (acetaminophen)and its potential effect when taken as recommended by pregnant women. The research found no association with autism, intellectual disability or ADHD

UPDATE 9/22/25; There was no real study released in late September, as expected, on a potential causal relationship between autism and Tylenol. Instead we got, basically, a rambling statement from President Trump (with HHS Secretary Robert F. Kennedy Jr.at his side) warning that pregnant women should ask their doctors before taking Tylenol. (Already a protocol). The President – citing no evidence - told pregnant women just “tough it out”.

I’m calling this an emergency update on autism – as we wait for the new causal studies authorized by Robert F. Kennedy Jr. – the Secretary of Health and Human Services. So far, according to a recent Reuters report, researchers have submitted more than 100 proposals for RFK Jr’s 50 million dollar study of autism’s causes – essentially mining the CDC’s large data base. There’s a separate review in progress on vaccine safety as well as the relationship if any to autism. Secretary Kennedy originally made the unlikely promise to have definitive findings by September – that’s this month - but has now stretched that much further out.

Earlier this month Kennedy appeared before the Senate Finance Committee for what evolved into a highly contentious hearing. Mostly on vaccines, changes at the CDC – and autism. There’s an excerpt in the podcast.

So I’m bringing back Dr. Amy Wetherby - one of the top US autism experts - for this emergency update. To set you straight on the facts. The science. What we know now about autism’s causes – which is quite a lot. And how early intervention can change an autistic child’s life. Dr. Wetherby was my guest last June on Episode 34. Here’s the link to that much longer and more detailed podcast. https://youtu.be/5EMedABGCrU

Amy Wetherby is a Distinguished Research Professor in the Department of Clinical Sciences and Director of the Autism Institute in the College of Medicine at Florida State University. She’s also a Fellow of the American Speech-Language-Hearing Association with over 45 years of clinical experience and the Executive Director of the FSU Center for Autism and Related Disabilities. Amy is also co-developer of the websites Autism Navigator and Baby Navigator - which can provide a huge amount of help to the parents and teachers of autistic children. This update was recorded September 12, 2025. I’ll add to these notes if something coming out of HHS or the CDC substantially changes anything we discussed.

Autism Navigator now has a new menu of diagnostic services: https://autismnavigator.com/diagnosis-get-started-now/

The Society for Developmental and Behavioral Pediatrics (statement)

YouTube video link: https://youtu.be/0RTTN5Yh4lc

Channel link: @conversationsonhealthhowwe4827

The cornerstone of any healthcare system is the general practitioner or GP. In the US we’ve renamed the GP to the rather cold sounding “primary care doctor”. Perhaps because so few of us still have that old multi-year connection with our doctor or perhaps because of the way our huge health insurance companies function. In the last podcast – Episode 35 - we talked about the UK’s still ailing health system – the NHS – a year after the Labor Government took over. Not much change yet but a recently released 10 year plan envisions most standard health care centralized in neighborhoods at the GP level. Including the mushrooming varieties of medical imaging.

This doesn’t sound particularly revolutionary – especially if you live in the Czech Republic. Health care there still revolves around the general practitioner.

So we’re going to meet a long time GP in this episode – who also teaches and is involved in many international health care projects.

In addition to his MD, Dr. Bohumil Seifert also holds a PhD and is an Associate Professor at the Institute of General Practice, First Faculty of Medicine at Charles University. He headed that department for 14 years - until 2023. Dr. Seifert now spends half his time practicing in central Prague – the Czech Republic’s capital. The rest of his time is spent in international activities and research, much of it for the World Health Organization and WONCA - the World Organization of Family Doctors. We used first names in this interview – as is my custom on this podcast.

YouTube Episode Link:

Dr. David Marx Episode #1 https://youtu.be/io3rVfvYgj4