Biggest Health Breakthroughs of 2023 with Dr. Andrew Freeman | The Exam Room Podcast

[Music] it is time to sit under the Learning Tree and my goodness gracious is it ever bearing fruit today we are going to be looking at some of the most fascinating health research of 2023 and a man who has his finger on the pulse of everything that's happening right now is Dr Andrew Freeman from National Jewish Health Endeavor he also will be speaking at the International Conference on nutrition and Medicine in Washington DC August 10th through 12th Dr Freeman thanks for being here my friend always a pleasure thanks for having me back man how much do you get giddy for all of this research because when I said that we're sitting under the Learning Tree and it's bearing fruit I actually think that's a big time understatement well I I would tell you that first the vast majority of us docs know very little about nutrition and the the headlines they don't reach us and so I'm always extremely excited when I get to see studies that check out some of the things that I've always been curious about and so every year there's a gigantic amount of nutrition public Publications and my goal is to try to pull out the good ones and share them with everybody in a concise high-yield way so that's my goal this year as well oh we got some gems to talk about here today just a little preview of what it is you're going to be speaking about at the conference the headline for your presentation by the way the urine plants 2023 latest science reinforces the plant-based lifestyle and I guarantee that a lot of the studies that we're going to be talking about here today are the very ones that have been splashed all across headlines worldwide so let's start with a big one there's been a lot made about sweeteners of late in your presentation you're really going to zero in on sucralose and so it's funny how people turn to these artificial sweeteners zero calorie sweeteners and they think that it's really a solution to lose weight because there's no calories but some of the research that you've pulled that you're going to be talking about show well hey wait a minute here these zero calorie sweeteners really aren't that sweet ticket to weight loss that we think well I mean it doesn't take much you know we just got back from a family trip to Disney and uh you know you see everybody there with the sort of gallon-sized soda and some of which is diet soda uh and they're not small people and so the end of the day the perfect beverage for human consumption remains water and maybe with a close second with unsweetened tea or unsweetened coffee and that's it really um and so this study was on sucralose commonly known as Splenda uh which shows that people actually are hungrier after they consume things that contain it and there's been a whole slew of other research that's not even in this deck that came out since on other artificial sweeteners so I always tell people do your best to really limit or avoid artificial sweeteners besides some of the weight issues some of them can be linked to cancer and so forth you may have seen even headlines yesterday that the who is calling some of the artificial sweeteners likely carcinogens um but then says you could probably consume them and you're probably going to be okay I don't like that probably okay okay uh you know as my my good colleague Dr Kim Williams who's probably been on your show a handful of times at this point says you know we're all going to die most of us from heart disease I just don't want it to be my fault that's such an interesting thing it's like you're probably going to be okay to me I kind of interpret something like that and and I guess this is just a philosophy on life but it's like you could probably smoke a cigarette or two and be okay but nobody's gonna argue with you that the cigarette is healthy you certainly wouldn't consider it to be a healthy practice why should we be looking at this or anything else any differently well you know you get I get such a kick out of this so um you know I'll say to some of our leadership here at the hospital sort of tongue-in-cheek you know hey we still have uh some thankfully not very much uh processed red meat being served in our cafeteria maybe we should add back the cigarette machines uh you know and everybody just sort of kind of growls at me and looks at me but you know I always tell my patients I'm like look at the end of the day a pinch of cyanide or a pound of cyanide is still going to kill you so why bother and the truth is we know now that the additive effects of bad lifestyle is really what gets people so yes you probably could get away with smoking a cigarette here or there in very very infrequent uh times and it may not have a major effect on you in fact if we visit some parts of our planet that are high in air pollution we may be having the equivalent of smoking a cigarette if that makes sense um but that said uh I would do your best to avoid it as much as you can I think it's our cumulative risk and exposure to bad things that gets people ill I would I would think so I would think so it's never one particular thing but for the sake of this interview let's let's stay focused on that one particular thing being those little yellow packets of Splenda or sucralose here interesting study the one that you're going to be talking about where they took about 75 people or so and they they had them drink basically just sweetened uh Splenda water I mean that's kind of the best way to do it and then they put them under uh the MRI and and they checked their brain and they were uh seeing how everything reacted and it correct me if I'm wrong but didn't the sucralose actually kind of like suppress uh some hormone levels that really the hormones that would say Hey you know you're full now you're you're satiated you should stop eating it actually suppressed those and like that's what causes those hunger cravings yeah there's a you know it's interesting I would say that this is probably an effect for the lot of different foods we eat but I think when we eat sweet things in general our body gets tricked and has a whole insulin ghrelin response which is what that study was looking at and it you know it does it interferes with our satiation meaning we don't feel full and so then we grab more you know I don't know about you but if I'm ever traveling and I I'm forced to find a plant-based option because I didn't pack a lunch or didn't have time and I eat something that is a processed or refined carb I'm hungry shortly thereafter and I think the same thing is true for lots of sweetened things whether they're sweetened with Splenda or others so it's pretty eye-opening uh to see that this study shows that the brain actually has a biochemical response uh that makes us want to eat more so and uh true or false in this study didn't they also find that um women had a little bit even stronger response than men here yeah you know it's interesting some of the stats that are coming out about obesity are suggesting that uh women actually will have a bigger or harder time with it in the years to come and it's predicted that they will have greater weight gains and body mass index increases so this study shows that and I wonder if some of the chemicals in our diet are contributing to that um and I would just tell you a recent trip to Disney as I mentioned you know something like one in ten for my rough estimation were very large people on scooters electric scooters because they couldn't ambulate very well because of their weight and comorbid conditions so we are in some serious trouble if we don't make changes quickly no doubt about it you know as we're talking about this too you're talking about sweet you're talking about sugar and a lot of us in the coffee right now I've got a black cup of coffee right here but I think the majority of people are very quick to reach for the splendid to put that in there or regular sugar Agave or goodness gracious God knows we are like very quick to drop five six seven dollars on a caramel macchiato at Starbucks but coffee as you said at the top can be a very healthy beverage I know this year in particular there has also been a ton of research pointing to the health benefits of coffee yeah you know the more we look at Coffee the better it is and remember the quickest way to transform a two calorie per cup beverage into a 2 000 calorie per cup uh beverage is to put all the sweeteners creamers uh dairy products Etc in it even some of the non-dairy uh sweeteners and non-dairy creams and sugars and whatnot are also very caloric so I tell people to drink it sort of the way it comes if you can which is just a uh black cup if you can do it maybe add a little bit of unsweetened soy or almond milk or something like that but by and large it approve it continues to prove itself as a beneficial substance um it's antioxidant Rich it's filled with all sorts of flavonols and other active compounds and it seems to improve outcomes from a cardiovascular perspective and you can actually get away with quite a few cups there's been studies showing you know somewhere between three and seven cups a day now seven cups a day for most people will make them really uh jittery so you don't need to drink that much but you know feel free to indulge just don't ruin it with the additional sort of coffee shop favorites is it uh could you get those same type of benefits if you were drinking a decaffeinated cup of coffee or is there something to the caffeine itself as well here yeah you know it's interesting in years past I've put some slides in about decaffeinated you know something about the decaffeination process seems to make the coffee a little less helpful and the reason for that is not entirely clear there are some chemical additives and residues that remain um you know the antioxidants are still there so if you truly you know want to have a decaf cup I certainly won't interfere um but I would say that in general if you're if you're not bothered by caffeine feel free and I should point out for the listeners that caffeinated beverages actually don't raise blood pressure if you drink coffee habitually meaning if you drink coffee never and then once in a while you have a giant you know three or four cup serving you might feel jittery your heart might raise your blood pressure might Spike but if you drink a little bit every day it actually does not have that effect there was even a study showing that it doesn't necessarily increase arrhythmia risk which is really important because many of us have been told over years that if you drink caffeine or coffee you're going to get arrhythmias and it turns out that may not be true so what I would tell people is you know test the waters and then if you do decide to drink it drink it regularly or skip it all together yeah let's look at some of these studies that you are going to be talking about at the conference here this one jumped off the screen at me uh you're going to be talking about one where close to 400 000 people without a known risk for any sort of cardiovascular disease uh tracked their coffee consumption habits those who had two to three cups a day so certainly not the seven uh but two to three cups had a 10 to 15 percent lower risk of developing uh coronary heart disease heart failure arrhythmia which you were just talking about and as well as that all-cause mortality that's two to three cups of coffee a day again not talking caramel macchiatos here yeah just plain coffee and you know there's something special about this because again this has been shown probably in dozens of studies at this point across the world I might add um so there's something special about coffee that seems good and there may be some Associated Health behaviors you know you could argue that if you're drinking a couple cups of coffee your social network might be pretty good if you're having it with other people uh maybe you're getting up early and you're exercising and need that coffee to get through today to work and you know so there's so many other things but in general coffee consumption it seems seems to be positive you know and another one that I found was pretty interesting was uh among people who already had some sort of arrhythmia or atrial fibrillation here um big study of uh I think over 30 000 people about 24 000 or so had afib but what they found was those who again consumed the coffee actually had a lower risk of dying despite the fact that they already had afib of dying of an afib related event I mean that goes back to what it was you were saying earlier is like as long as it's not that Mega Ultra huge dose of coffee that if you're not a regular coffee drinker it's not really gonna like have that same kind of effect on you that's fascinating to me and kind of very counter to what it is that we have been taught for so many years yeah and I would say that just even in clinical practice I think that um you know you're always going to come across somebody who's quite sensitive to Coffee doesn't feel good when they drink it I don't recommend those people drink it but by and large um if you're not very sensitive to it um you know again feel free to indulge the the positives are pretty powerful so you know just stay away from the artificial chemically processed versions of whatever it is you're going after We Know by the way about the risk of coffee and cancer because I know that there was some interesting research that came out this year about that as well yeah I think in general that there's um a lot less bad outcome when people drink coffee so you know I usually tell people that if they can get away with it the benefits are probably more than cardiovascular um and so you know that if you look at overall death rates as an example from whatever cause that are less and people that drink coffee and there's been studies in the years past about reductions in things like colon cancer and other types of cancer so in general like I said feel free to indulge but try to be careful of the artificial stuff that gets added all right so we've got sweeteners we've got coffee let's switch over and talk about dairy dairy too has also been making a lot of headlines recently there was a study that came out that showed that uh or purported to say that a whole fat dairy diet is actually protected for a person's health that was just out as we record this within the last couple of weeks but by and large the literature also that's come out earlier this year is really counter to that message what have we learned that's new regarding Dairy and the risk of heart disease and cancer and all of these leading causes of death yeah so I should point out for the listeners who haven't heard me talk I mean think about this we are the only species on the planet that drinks another animal's mother's milk so think about how strange that is now yes if you live in a very remote part of the planet that can't grow fruit or vegetables and that's all you got yes that's what you have to do but lots of studies um in general the totality of evidence would suggest that Dairy is probably much more harmful than we think and it's one of the more inflammatory foods that has all sorts of associations with cancer autoimmune disease and heart disease remember that the full fat Dairy that was purported to be healthy in this study is actually the number one source of saturated fat which clogs arteries in the United States so in general I usually tell people to avoid it and really avoid it if they can you know anywhere you go these days there's dairy in the foods we eat they're in the breads that come out in restaurants they're you know they use cheese to be added to virtually every dish um you know you start looking in the grocery store and they've added milk fat or away or butter or butter oil or whatever it may be into the foods and so it's been woven into our our sort of food in some very hidden ways and it seems to be quite harmful and studies that were done in the last couple of years again continue to show that there's linkages between Dairy and breast cancer and prostate cancer so in general I usually tell people to really avoid it and I think that it is a total sort of error in our ways to say that that full fat Dairy is healthful because it really isn't yeah and and one of the studies in particular that you're going to be talking about too is a pretty big one out of Japan 26 000 participants in this one uh the Japan collaborative cohort study 37 higher risk of developing prostate cancer for those who were really heavy Dairy consumers versus those who really didn't have a lot of milk or cheese in their diet I mean 36 seven percent risk that's big man yeah it's huge and it's scary I mean remember that most of Asia was not a dairy consuming part of the world for a long period of time and you know the truth is the prostate cancer breast cancer risk from dairy has been known for a really long time I mean what does milk do well milk is designed to turn a baby calf into a giant cow in six months I.E growth and what is cancer cancer is uncontrolled growth so there must be something in the dairy products that is triggering this uncontrolled growth in parts of our bodies that are susceptible so I tell people to do their best to absolutely avoid um Dairy whenever possible I Can't Tell You Chuck how many people I take care of who have breast cancer or are prostate cancer survivors and they are consuming Dairy every day I mean that's like Superman eating Kryptonite it just doesn't make sense I mean look let's quantify this a little bit more here we have another study that just was released more than a half a million particip a half a million here participants in China track them for 11 years and we're not talking about Mega doses of dairy for this at all we're talking about 50 grams which as you point out in your presentation that's just a quarter of a cup of milk that's it one quarter of one cup overall cancer seven percent greater risk liver cancer in particular 12 percent greater risk breast cancer among women 17 higher risk and again all we're talking about is a quarter cup of milk if you go to any coffee shop and you order any sort of uh drink that would have cream or even just you want to leave a little room for milk at the top yeah that's that's going to be that quarter cup so every single time you go to Starbucks essentially you get that with the with the with the milk here would I be wrong in saying well there's your seven percent risk of cancer there's your 12 liver cancer risk there's your 17 breast cancer risk am I wrong in seeing it that way no I mean you know you could you could get confounded in that the coffee may be enough of an antioxidant load to cancel out some of the dairy but that hasn't been shown but I guess what I would tell you is you're spot on that if you were to tell you people oh I don't drink milk or I don't eat dairy if you were to carefully analyze their diets the patients every time are just blown Way by how much Dairy they actually consume it is truly in everything and you have to be on the lookout for it because it can easily get into your diet without you even realizing it but yes it is a scary risk you know if you look at this very large study right it's a huge amount of patients and it's a very small amount of dairy and patients are like well I only want to splash of this or I only want to splash of that and the truth is some of the dairy products that get added to coffee as an example also contain trans fats which are very associated with heart disease so I would just tell you that in general staying away from dairy and creamers and all these kind of things is really important and also correct me if I'm wrong here but with cheese being as concentrated of a dairy food as it gets I don't think it would be a whole lot to get those 50 grams or a quarter cup of milk and cheese at all I mean are we talking like about a slice of cheddar would that be the equivalent here yeah I mean it depends on how thick you make it but yeah I mean you know I always tell people a gram is roughly the weight of a paper clip so if you can put 50 paper clips together which when you bind them together it looks like a little stack of coins it's like a little cheese cube it's really not very much so you know just beware it is mind-blowing how much cheese is in our diet all right so we've got Dairy being on the negative side but then let's get some good news out there let's switch over to nuts which unlike Dairy have actually shown to have some really protective cancer-fighting benefits here what do we know about the latest research on nuts and cancer risk yeah so it should be you know um mentioned that nuts as you probably are aware in the plant-based world are a little controversial and some nuts are called nuts but are actually legumes um so but what I would say is that in general nuts in smaller quantities have always been shown to be largely helpful and even if you push my good friend and colleague Dr esselstyn and others you know he'd let you have a few Walnut halves in a day Believe It or Not uh but that said um yes nuts appear to be helpful there's been data shown over the years um you know even with like one Brazil nut a week that it can lower cholesterol and there seems to be something helpful about nuts and seeds in cancer so I guess what I would say is in general um consume them but be wary they're highly highly highly caloric I always tell people that the worst thing that ever got invented was shelled pistachio nuts right the pistachio is a delicious and tasty and healthful nut and the shell is designed to slow you down and so if you get a big bag of shelled pistachio nuts it's easy to eat too much and get a big caloric load it's funny I was just taking the train down from New York back to the home studio outside of Washington DC yesterday and uh went to order just a cup of Fruit on the train and they did not have any of that that particular day but they did have the bag of nuts and it's it wasn't like one of those small bags either like it was a pretty good like size of my my hand here a bag of pistachios and you look at that it's like two to three servings of nuts per bag and there's a lot of fat and calories in there it is hard for us though doc the way that I think that we're just wired as human beings to control how many of those nuts that we eat at a particular time especially as you said if they've already been shelled for us it just makes it so much easier and as the great Will Ferrell said in the movie Old School once it hits your lips it's so good it's so good well it's true and of course you know most of these nuts come salted and some of them are oiled and salted so you really get something that's decadently delicious so use nuts as a treat I mean if you go back in time and maybe you remember this truck when you were a kid you know when you had a dessert that had some sort of nut on it it was a dessert it was decadent and now I feel like many people you know are consuming jars of nuts every week it's just it's probably too much that said they are healthful just don't overdo it and with this particular study and and we'll move on to something else I really want to get into just some extraordinary uh research that's been published also on Healthcare spending in this country I mean it is just it's hard to even comprehend those numbers but let's put a bow on on the nuts here really quickly before we move on uh this study looking at breast cancer survivors in particular about 3 500 of them the Shanghai breast cancer survival study followed these women for about eight years uh found that those who ate more nuts improved their overall Survival by five percent or more and disease-free survival rates by eight percent or more so definitely some benefits there but again word of caution we're not talking about eating that entire jar of peanuts I think the way that it's really been said a few times on the show is about you know fitted into the palm of your hand and call it good use it as a Salad Topping as opposed to the entree itself yes yeah uh Healthcare spending man this is always a big one and it seems like every year the numbers keep going up and up and up and up but now some research has come out that's really been able to Peg it and as a matter of fact the term that was thrown out there was we have reached for a lot of people catastrophic spending in terms of the amount that's being spent on health care every single month what do we know as far as the cost of Health Care and can you elaborate a little bit on this catastrophic spending for us yeah so for clarity I'm sure um any of you who have health insurance or even Medicare or whatever and you go to the hospital I mean it's just insane what health care costs what we Bill and then even what we pay and so for many people you know they get quite ill they have a heart attack they have a stroke um and they're in the hospital for a while they've sometimes even in the ICU for the to the tune of a couple hundred grand and for the people that don't have good coverage or Insurance you know their co-pays could be uh you know many dozens of thousands of dollars and so it's easy for people to go bankrupt I mean medical bankruptcy is a real thing catastrophic spending levels people are trying to decide if they can afford their insulin or their food over um you know you know they're trying to decide between the two if that makes sense so it gets really tricky for many people who are on a very fixed income and and not bringing in large dollars in their everyday work or they're not working anymore what do they buy do they buy meds or do they buy food and I think you know wouldn't it be nice if food is medicine right yeah I what what a concept here what a concept um by the way the number of Americans that fall under the catastrophic spending for health care right now 1.2 million according to this research um and then we're talking about spending get this more than 40 of their family income on insulin if they're battling diabetes 40 most people don't spend 40 on their rent or their mortgage and this is going strictly to insulin every single month on top of that you have the rent on top of that you have the mortgage on top of that you have utilities and oh by the way we haven't even gotten to the food bill yet I mean holy cow that is a large nut to go back to what it was we were just talking about it is and actually I would argue in many of the cities that we all live in people are spending 40 and 50 of their income on housing which isn't incredible so we're in an interesting you know part of our time if you will where costs have risen for virtually everything including Healthcare and medicines for fortunately many states as you may know Chuck have passed the legislation to cap the costs on insulin in particular but it's interesting because if you follow these people who are on larger amounts of insulin have bad raging diabetes they're also spending large amounts of their food dollars on highly processed Ultra processed foods which may make diabetes worse right so it's a win for the food companies it's a win for the medical providers and it's a loss for the patients absolutely um and let's uh grab a couple of more here before we wrap things up um another slide that will be in your presentation also stood out to me here it's called eat plants take less meds you kind of alluded to this a little bit earlier I thought that this was absolutely just mind-blowing 328 participants 60 years or older uh really showed that if a person is eating a vegan diet here they reduced the number of pills they were taking by close to 60 percent that's big it is I mean think about this the pill burden these days is insane you know I talked to my colleagues about this a lot but gone are the days when we see people who have just high blood pressure or just high cholesterol or just a heart attack right people have diabetes and sleep apnea high blood pressure high cholesterol some form of cancer and so you know their med list is humongous and very expensive and so reducing pill burden is one of the best things I get to do every day and clinic right when somebody comes in and says doc my blood pressure is 100 can I get off of these blood pressure pills of course they can and that's what we're after and with a good lifestyle exercise diet uh low-fat Whole Food plant-based diets the results are extraordinary and we're just starting to see this uh in a mass scale so my hope is those scales keep tipping and more and more docs get more and more enlightened uh over time so and let's end with the biggest number that will be in this presentation this to me is almost uncomprehendable medically tailored meals could save the us nearly 13.6 billion dollars every single year 13.6 billion and what Doc is the definition of a medically tailored meal in this case well think about this right we are very willing to prescribe pills to people no matter what the cost is Right some of these fancy new diabetes and weight loss pills you know it can cost ten to forty thousand dollars a year but imagine what I could do if I could provide someone with a low-fat Whole Food plant-based portion controlled meal um for 10 grand I could probably give them a whole Year's worth of meals or maybe even several people a whole Year's worth of meals you know remember that beans and rice and squash and whatever are not expensive Foods so imagine if I would prescribe them true diet and give it to them uh how much we could save on costs so I mean think about that for a second how weird that would be imagine you go to your doctor you don't leave with a pill or you don't go to the pharmacy but you go right to a you know Food Distribution Center and pick up a week's worth of meals that are completely covered with no or limited copay I mean that would be Earth shattering um and you know what it's like you're saving all that money you're probably feeling better you're going to want to stick around a little bit longer too because here's the other big thing and we will 100 and with this you eat better the studies continue to show including this year that if you eat that optimal diet you can not just add a year or two to your life but by and large in a lot of cases you can add a decade or longer what do we know what is the latest research showing in terms of longevity and healthy eating yes so there's a direct link I mean you know I think that we know already from all the Blue Zone work that's been done and you've probably had Dan Butner and others on but in general when you live well you live longer and the goal isn't so much to live longer but to be alive and well and that's what these types of Lifestyles do they enable people to hit those um golden years if you will avoiding what I call the American curse which is you work hard your whole life you save your money you retire and what do you look forward to heart attacks Strokes dementia erectile dysfunction it's a terrible way to retire and Isn't it nice to think about that if you were to eat better and change the environment you live in so that you could do more be more productive be around for those grandkids or great grandkids that's what we're after and so getting a decade or more by eating better is just an amazing thing to think about and they were able to go in there these particular researchers and and quantify this and they looked at well what would happen if you started to eat what they called an optimal diet at the age of 20. and it found here that among women uh averages about 10.7 years so really the spam was about 8.4 to 12.3 years for all of women and for men I mean you're talking like 13 years anywhere from 9.4 to 14.3 that is that's a lot of bonus time that is a lot a lot of bonus time totally it's a decade or more which is just amazing and I think you know we need to hear this type of data I mean I can't tell you how many times that I see people say well I'm not going to listen doc I'm going to eat poorly and then they end up not dead but disabled so they're alive but unwell and that's a terrible way to be oh man look there's so much more research that we could get into here but we're going to save it because we definitely want people to come see you at icnm the International Conference on nutrition and Medicine August 10th through through 12th and Washington D.C man I cannot wait for your presentation thank you for really compacting everything and and putting it together in such a concise manner for us I can't wait to see you unpack it some more I know that you're also going to go into Ultra processed foods the latest data there big time promising findings in terms of reducing the risk of dementia we're going to be looking at children and healthy eating the long-term effects that that can have there are so many different things and man like yours is one where I'm going to sneak away from the broadcast table and I'm going to come just like sit in the back and sit under your your Learning Tree a little bit more man I just can't wait to see you yeah the evidence continues to be overwhelming and I guess what I would leave everybody with is Living Well eating well does wonders for health in every category so why are we not all doing it I don't know that's a fine question to ask ponder it as you go and get your tickets pcrm.org icnm and while you're on the web head over to Twitter give my man Dr Freeman a follow there heart cure doc my friend thank you so very much for making the time we will see you soon my pleasure thank you if your health IQ was a couple of points higher than it was a few minutes ago go ahead and like this video or subscribe to the YouTube channel and to take it even higher head over to Apple podcast or wherever you get your favorite shows look for the exam room by The Physicians committee hit the 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Channel: Physicians Committee

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Length: 32min 36sec (1956 seconds)

Published: Tue Jul 25 2023