Ending Heart Disease: Cardiologist Kim Williams, M.D.

[Music] hey everybody I'm rich roll this is my podcast or at least the visual version of my podcast welcome to it it's the show where I go deep and long with some of the most intriguing interesting people that I can find to have conversations that I think are at least I hope matter exploring all facets of health human health emotional health spiritual health planetary health and in the case of today's show and today's guest heart health today's guest is dr. Kim Williams he is the outgoing former president of the American College of Cardiology now we're going to sit down and we're gonna talk about cardiovascular health because this is truly the epidemic of our time of our era one out of every three Americans will die of heart disease about 800,000 Plus Americans die of a heart attack or some form of cardiovascular disease every single year but the thing is this disease is easily preventable and often reversible through some pretty simple diet and lifestyle changes that's what we're going to explore and I couldn't think of a better person to walk us through this incredibly important issue than dr. Kim Williams his work is inspiring and he is definitely a change maker so sit back and enjoy my conversation with are you ready to go absolutely right let's do it okay dr. Williams it's a pleasure to finally meet you thank you for carving out the time to talk to me today certainly my pleasure is this your first time at this conference or are you presented here before I actually have presented yeah yes a couple years ago and then I think once before that uh-huh I only got in last night so I missed your talk yesterday sorry not right what was that what was the specific subject matter that you spoke about so I wouldn't normally talk about is heart heart disease and dying and in the past I've always talked about sort of vegan diet versus vegetarian versus pesco vegetarian versus eating it no real like you know beef and pork and the like and and what is the data show how is processor at need worse than red meat which is worse than chicken which is worse than fish which then it's sort of the hierarchy of cardiovascular right effects and this one is actually what's going to be a fair amount of that from other people and so what I proposed to the plan trician folks got stole would be that I'd actually talk about sugar because there's just some work you Malay ting so much more data on sugar mm-hmm probably the the linchpin even though there's data out there before the linchpin was a an article in the Journal of American Medical Association last year that showed that the sugar Research Foundation had actually paid some researchers the influential people to turn attention away from sugar for cardiac disease in towards saturated fat of course that was a good target but it left lots of us people doing plant-based nutrition eating a high amount of sugar thinking that grows in the ground it's okay doesn't have a mother doesn't have a face mm-hmm fits our criteria when it turns out that the data was actually pretty damaging well now there's actually been a fair amount of sugar research and correlation with everything all the things that you would want there's a good mechanism that is the sugar increases your insulin levels insulin increases plaque insulin resistance makes it heap up on itself and the next thing you know you've got sugar addiction mm-hmm and you've got a lot of sugar marketing and I then spoke about the sort of the politics economics the fact that our country actually does have congressional support for farm subsidies for production of high fructose corn syrup mm-hmm and so we pay them with text money to produce things that make them inexpensive so that we eat them more which increases the amount of disease which we then pay for with our Medicare system and right it's really a circle that needs to be broken now it's actually pointed out to me by one of the Oregon congressmen I had no idea until a couple years ago that this was going on oh it's a huge problem it's a huge problem and the repressed pricing of these types of products including all the processed snacks etc tend to disproportionately impact the lower socioeconomic strata of our culture further you know further further creating you know exaggerating the divide between the haves and the have-nots and and you know these people end up getting more and more sick and more and more dependent you did that well you could have given myself yeah I did talk about that I talked about SNAP program healthy foods and hospitals how we need to change a lot of things but the SNAP program has really been sort of the safety net for people and there was an article published just a couple hours before my talk that I was able to fit in there talking about the important how having a SNAP program that is having access where you could actually go to a grocery store and buy some decent food mm-hmm actually decreases healthcare costs by $1,400 per person per year that's incredible numbers and what is the current scope of how you can spend those snap dollars because I know traditionally it didn't apply to healthy produce etc although I was doing a podcast with I think it was Dan Buettner the other day and he was saying that you can now use snap dollars at your farmers market is that true we well as far as I know but the other side of it it's what we've been after that is we meaning the American College of Cardiology and the American Medical Association actually passed a resolution pushing Congress and regulators to change the SNAP program so that you cannot buy unhealthy foods mm-hmm and to try to make preferences and so we we I think people are starting to understand the impact of diet on our society and the more data we accumulated talking about health care costs and the food choices that we make the better off we're all gonna be yeah I think it's I think it's happening I mean certainly there's a tremendous amount of work to be done that remains of course but let's go back to the sugar thing for a minute you know I think we as human beings are reductionist by our very nature and the scientific method is reductionist as well by necessity I suppose but we always want to look for you know that one evil culprit like it's the sugar it's the saturated fat it's the this it's the bad and that's what we should be sort of marshalling all our attention and resources towards but obviously you know that this is a incredibly complex matrix of many factors that come into play that contribute to things like heart disease so when you're thinking about sugar and when you're thinking about saturated fat like how do you explain these ideas to the patients that come to see you well there's first of all there's certain allotted certainly a lot of data that's impugning and supporting saturated fat and this is a big fight that people are having right I want to get into this too so sorry but but the interesting thing about it is that when you're talking about saturated fat or you're talking about cholesterol or the new bad kid on the block heme iron that is iron that should be good for you except it came in a form of a red blood cell and it's very toxic to your blood vessels and making a heart attack stroke and death and this is the this is the iron that is contained in animal Aronnax what exactly and exactly right and so so it turns out that you've got all these candidate genes if you want to call them that for what is actually causing so much of the differences between plant-based nutrition and the standard American diet for example but those none of those things I just mentioned are actually taken in isolation sugar absolutely I mean you're putting it in tea you're putting it in coffee the data on tea is good they don't coffee is even better but you're putting it once you put sugar in it then you're doing it in high amounts which some people do you're actually increasing everything from blood vessel inflammation to the atherosclerosis and so that's the one distinction and that is it's really difficult to call out you know saturated versus polyunsaturated versus monounsaturated and you know if you're overweight maybe you really shouldn't and if you are you know running and healthy in you know athletic then you probably can tolerate more it because you're gonna burn it as fuel but sugar it's probably not good for us under in under any circumstances there's an idea out there that there's no distinction between refined sugar and the sugars that you find in fruit for example so can you speak to that is there a difference in how we metabolize these things and the health impact when you're talking about sugar what are you talking about specifically if I can borrow a term from new reductionism you know we have to think of these things than in the absence of like prospective trials we think of them in terms of mechanisms and so what I have in preparation for this talk said the bad guy here is insulin we know that people would get when they get central obesity they get insulin resistant they're in their insulin levels are very high and it's promoting more and more plaque and therefore that's the thing that I would like to control is the insulin level and so that's one end took the fruit sugar fructose the usual blood sugar that we have glucose sucrose of course is the table sugar that's the combination of glucose and fructose and let's see what happens when you have a dose of this and increasing doses of it what happens to your insulin level and I was able to find a manuscript that detailed all of this over time you take you know 50 or 25 50 100 grams see what happens and but they did an interesting thing they actually had a fourth thing in there and it was actually white bread and the insulin levels were with all four we're about to the same and so the idea that refined carbohydrates refined grains are pretty much as bad as sugar it's pretty much true as far as your pancreas was concerned and production of insulin right and and with respect to when you're talking about that it made me think of a conversation that I had with dr. Neal Barnard was very adamant that we should be looking more at the fat intake in our diet and the impact of that when it comes in the form of animal products in our diet and how that relates to the onset of type 2 diabetes rather than all of this focus on sugar so how do you think about that or do you have a different point of view on that then dr. Barnard well so Neil's a very smart guy he reads a lot and I try to read as much to catch up with them but the fact is that I think that they're both bad we actually that article that I mentioned if people look it up the sugar Research Foundation sugar industry in the Journal of American Medical Medical Association there was actually an accompanying editorial that had this one graph that everybody should see it's country by country cardiovascular disease mortality on the one axis and a dot for sugar and a consumption per capita and a dot for saturated fat and the two of them for every country they're in lost are in lockstep it's Japan at the lowest United States at the highest and all these countries in between so I'm not sure that we need to make a distinction I think we just need to find out all that we can about each element that's not good for us whether it's heme iron or sugar and then try to avoid them right I mean looking at that from a correlative point of view it's hard to parse the distinctions between them right that's right from a scientific perspective well I think you know the average consumer right now you know it's and we're in an interesting time there's so much information available to everybody you know with all of our devices etc but I think it's also never more important that we become more discerning about the sources of the information that we consume and there are a lot of vested interests out there that are heavily invested in making sure that you remain confused and it is confusing unless you're someone like yourself who's really mining the data and you know rolling up your sleeves and really trying to understand what's going on out here you can go online and you'll see oh it's sugar oh it's fat oh it's the saturated fat is back you know all this discussion about saturated fat and heart disease is nonsense and now we know that saturated fat has no impact on arterial cholesterol you know levels increasing all of this so can you just help me make sense of this for the listener who's just trying to like make better choices well it's not easy you know they recalled several years ago 14 years ago when the portfolio diet came out which end which was David Jenkins it's a marvelous work and again Journal of American Medical Association so not you know vegan propaganda rag yeah I mean this was a peer-reviewed high-quality manuscript and it talked just about inflammation and cholesterol your LDL cholesterol and your c-reactive protein what are the what is the response to a statin versus a plant-based diet mm-hmm wonderful article and I figured that after you saw that the LDL cholesterol the bad guy goes down dramatically within two weeks with both the statin and the diet the plant-based diet and it had almonds it had plant sterols and you know a soluble fiber etc and then you looked at the inflammation and they both went down but the plant-based diet lowered it faster then the statin did okay I figured that that would take every capture everyone's imaginations surest biochemical it's not outcomes heart attack stroke and death but it's pretty pretty important well the response was actually not as much as we would like and the reason was one of the reasons was that at the bottom you could see that it was supported by the California almond industry mm-hmm and part of the diet was to do three handfuls of almonds every day it doesn't mean it wasn't right I'm sure is right I think it's a wonderful guy you know but the it was a good lesson to me early on to try to stay away from industry influence as much as possible right and so we have had just what you're saying confusion I fight we're gonna pick one it would I'd be concerned about the egg board and saying that cholesterol is not a nutrient of concern which actually came out in the Dietary Guidelines for Americans early in 2015 we were able to show them up that is Health and Human Services and the USDA who sort of partnered together to put that document it's together and run the dietary Advisory Group we did get them to change it we showed them all the literature Neal Barnard was very helpful in there but you're realizing that you've got to have science that's that's pure that's independent so that no one's best at interest it's interesting everybody asked me well when is your book coming out and that's one of the reasons I don't want to I mean there's plenty of books out there a great books and the other is I never want somebody to say that I have a vested interest other than my own right you're just trying to show books exactly right never that it's always gonna be about my patients about my family about my country and that's that's what it's about yeah well I think you know first two things first of all that was a quite a victory for the ACC when you were president right getting that you know getting those nutritional guidelines shifted with respect to cholesterol so you know that I thought they left out the punch line yeah what the bottom line of in the document it actually says which is a quote from the Institute of Medicine not ACC it said that people should eat as little cholesterol as zero oh I'm sorry a little class of cholesterol as possible which of course I interpret in my brain tonight as I just did at zero which means you pretty much have to be a vegan because there's only you know how many animal products don't have cholesterol I think a quites jello and about it right well let's talk a little bit about I mean the second point I was gonna make was that you know we're in a capitalist society and you know it costs money to perform this research and somebody's got to pay for it right so aside from grant money or however else you know these studies get funded industry is sitting there you know willing and ready to fund these things and that comes with its whole you know bag of compromises obviously but to see our way forward I mean do we need new ways of funding these studies like how can objective studies get performed in a way that in a way such that they're not compromised by industry interests a lot has occurred over the last few years the development of data safety monitoring boards for example where people who are completely independent of the study they are paid by industry which is a funny thing because they're paid to block them well if things are going badly in the study and yet that's considered a relationship with industry with something we ought to think through I think but we also have you know Clint clinical trials.gov where people if they're gonna do a big clinical trial they should submit it everyone can review it and so there's more of a truth than there was before if I could point to one issue with the industry sponsored trials in the past and that's it's really not just industry it's all of us it's the positive publication bias we see for example heme iron suppose there were you know five investigators out there and four of them found that there was no relationship between heme iron and heart attack stroke and death and one of them did before if they submit it is a negative study it may not get published because it's not scintillating but also us as investigators when we do a negative trial and say oh well that didn't work and we move on to the next thing they might not even submit it hmm whereas the one that found the relationship they're going to publish it so it brings up the whole question of no this public this positive publication bias really brings up the question of all of the things that we're doing and why we would like to have large prospective registered randomized trials so since that's been happening we actually are getting data you know yeah and in pretty much every area everyone knows the the acronym for the trial and you will wait for the results you know you have a presentation on what the methodology is and then two or five years later you get a big result and it's positive or negative and everybody knows about it now so that's I think it's been an improvement and it's it mitigates the industry influence because they can't cherry-pick right what's gonna get published and what's not right much ado has been made in over the past a year about this idea that saturated fat is back lots of articles being written about everything you thought about saturated fat is wrong we don't need to worry about this anymore it's your new best friend knock yourself out with bacon and eggs so when you read that when you see that what what happens with you so there's so many responses but I'll try not to recap too much of what I said already but just a couple of highlights one is we just don't take the Crisco put it in a pan heat it up and then drink it okay so whenever we're getting saturated fat it's with something else that probably isn't good for you and it might be heme iron it might be cholesterol and it might be just animal protein itself and it's you know the fact that that promotes cancer growth so we have to take everything I start to say with a grain of salt but that might not be the best thing to do either but we have to try to look at the research that you know that what they're really doing typically is is doing food frequency questionnaire x' and then analyzing the components of what people said they ate and then trying to correlate that with outcomes and that is just very difficult you're making several assumptions along the way and you're not really capturing the the whole team of things that are potentially damaging and so to pick out each one and then get reliable results every time may be difficult so the best example I think is the pure trial and that's the one that everyone's talking about slim Yousef is a good friend of mine and you know we happen to be at a dinner at the European Society of Cardiology and the day that his article came out sadden talked to him for a while about this and my concerns that you really weren't capturing the vegetarian population which meant that you were actually comparing things that were not healthy necessarily from one population to the next and then 19 different countries and that it's not not the same kind of fat that we're getting United States okay so you know he had he defended it well he said there were some small vegetarian populations in the 19 countries but they don't overwhelm the data so Mike my biggest concern about the peer trial is that and I probably should have might run it by and the next time I see him is you know a actually is a pretty darn good job of categorizing the fat saturated polyunsaturated monounsaturated but the carbohydrates were not characterized that I could find it anyway I bet he has an appendix somewhere where he can explain that because I have just as you know from my interest in sugar carbohydrates are not all carbohydrates and so when you're talking about complex carbohydrates that are not gonna drive up your insulin levels you're probably doing something that you you can burn as fuel it's not going to be you know anti it's not gonna be inflammatory it's not promoting and rise in your cholesterol and increasing plaque formation that is completely different than having a sugary refined flour type of body response and so it wouldn't surprise me that saturated fat it falls second to carbohydrates if they're refined carbohydrates in terms of the damages that they can do right and so we really need to have good comparisons of healthy foods so none of that was talking about whole food plant-based diet and the last comment is I borrow for I think from Giuliana haver you probably know who's sure I know yeah yeah you tell me who said this originally but the fat you eat is the fat you wear that is such an important concept that and I know the American Heart Association did a wonderful job by the way a few months I think last May of doing a presidential advisory where they reviewed all of the available literature on saturated fat and came to the conclusion that you really should need it based on the literature they also actually made a slightly controversial statement which was that you probably shouldn't eat coconut fat either because that's has so much saturated fat and it compared to other vegetables and I know they got a lot of pushback from it I know they're there and this interesting that the presidential advisory was one guy dr. Steven Hauser who's wonderful guy and then John Warner who took over as president so I got the blame just because of writing that they switched in so but you know what what can you do about that the they have the right to review all of the literature and make an expert opinion and say that that's what it is it's an expert opinion nothing definitive and all that does is invite us to do studies and if there are people I know David Katz thinks Yale thinks that coconut oil is really good I don't have enough data that make a conclusion myself let's do some trials and right up with whether or not it's damaging or not yeah I think a lot of people would like to know the answer to that I mean what I my understanding and correct me if this is incorrect is that the the saturated fat in coconut oil is comprised in large part by lauric acid which is a more easily metabolized version of saturated fat a more readily available source of energy burning fuel versus the set so there's different kinds of there's not just one saturated there's different kinds of this right like okay this is not click baby stuff like you got a really you know dig into it and understand that this is highly nuanced and you've devoted your whole life to this well this part is I'm much more of a nuclear guy so I thought I was gonna spend my life doing cardiology and nuclear physics at the same time and now I'm in nutrition but I am a fan of all of that and and yes the the H a report actually goes into that and talks about something that I didn't know that the fetch weed is the fat you wear but more so of its animal fat that is the vegetable saturated fat for the reasons you said that shorter chains there's less calories in it so it actually is better for you but is it good for you that's right question right right right I bet that we don't know yeah interesting so you are the outgoing president of the ACCC there was a one-year tenure yep yeah 2015 to 2016 so so let's talk a little bit about that organization and what the kind of mission statement and purpose of it is and you know what your your your goals were during that period of time and and other than what we already mentioned you know what was accomplished well it's it certainly is a growing organization that is dedicated to making sure that people do better in terms of their heart health so the mission actually is to improve heart health and transform cardiovascular care and the two go hand-in-hand what we really are meaning is to try and add more members add more member of Araya teas and so we have 53,000 members or so right now it used to be cardiologists now it's then it became cardiologists and nurse practitioners and then it became pharmacist and then we started doing international and so anyone who's interested in improving heart health and is as part of the team and we work right now on a lot of issues that are facing the cardiovascular field prevention is one of them and so I would say that during my year we focused a little more than we had in the past on population health it was interesting to have meetings on population health have experts come all from all over to Washington DC to the heart house and discuss how we can make things better and it's you know everyone's sort of looking kind of you know out of the corner there are saying wire cardiologists trying to decrease their income just because we feel like this is our job isn't that the core goal here I think you said there was I saw a quote from you like my job is to hook cardiologists out of business that's exactly right and you know it would take a while and I have to say that it's it's timely it would be great if other organizations were focused on these things as much as we do because and you know inside and outside of medicine because last year was the first time in 40 years that cardiovascular disease deaths in the country went up hmm and that is just something that we just can't abide by you know they've new we're always bragging about this decreasing curve about 50% over 40 years and cardiovascular mortality and it's bypass surgery and statins and beta blockers and AIDS and they were all these medications for heart failure and decreasing sudden death because we put into fib relators that shocked people when they when they have a fatal arrhythmia and they come back to life and we were so proud of all this stuff and then the American population somehow has overcome no matter what you do exactly yeah and when the CDC put those numbers out there they said it was obesity and diabetes that's driving it and that's a nutrition and so at all the fundamental issue that we've been dealing with for the last so many years is really at the core of all we do and it will uproot and and undo any success that we can do with devices and medications yeah it's got to be a shift in priorities and focus because it is amazing to reduce by 50% the mortality rate of people who are suffering from heart disease as a result of all this amazing science and technology but if that comes at the cost of really addressing the fact that the incidence of people who are you know you know becoming patients in the first place then you're you're waging a losing war ultimately yeah everyone's gonna get older and they're gonna pass away at some point wouldn't it be nice if we were as healthy as possible until that happened and not you know I have these chronic diseases that are completely avoidable by you know by lifestyle yeah I mean we need to be talking about prevention and we need to be creating systems that promote prevention I mean we're seeing it with the rise of functional medicine clinics and doctors who really are up to speed and paying attention to these things and but you know it's tough when we have a structure that's set up that allows well-intentioned doctors only 15 minutes with a patient and they're incentivized to just diagnose and scribe and move on to the next thing like we're never gonna you know crack the code that's going till we really get to the core of how the whole you know system functions that's right so getting back to what the college does so then the population health is just one small aspect we actually are a global organization we have 40 chapters international chapters where a chapter can be formed whenever there's members who are have obtained a high level of proficiency they're called Fellows of the American College of Cardiology if you have 20 fellows in any area you can have a chapter and then it has a governor which then participates in the governance of the college no no taxation without representation right and so it turns out that we have collectively learned a lot you know we have our members and Lebanon for example are dealing with smoking and very young people you know heart failure in Brazil and it's not just the Chagas disease infection that people can google and say oh my gosh this people get an infection in their heart you know disappears yes they also have hypertension at a high rate the diabetes in Mexico and then the obesity in the United States and we can all learn from each other about how to improve outcomes so the international mission I think is is is key to success for us we also do a lot of hospital accreditation in terms of making sure that if you're gonna go in for an angiogram you're going to in a places that's that knows what they're doing and they've demonstrated it and and they're probably our biggest product nowadays is the registries of the National cardiovascular data registry and CDR it collects information on all the important diseases you have a defibrillator are your people your people putting and defibrillators when they need it if you have atrial fibrillation are you getting the right medication for it and so a lot of disease management so with that you would think that we cover the globe literally in Figure and literally and geographically and as well as figuratively but we do feel that all of these things should be reduced and we're managing things said that can be prevented and so let's continue to focus on that and we'll try to continue putting that influence out there right very good and was that was your presidency is that a like an appointed thing or an elected thing like how does that work how did that work it actually is an election election it's an election by a nomination committee that reviews all the people who are applicants who have been leaders who and it's in my case it was other people asking me to run and I'm saying I don't know if I can do this just just there's a politician well it's a the politics was fine actually you know there was a time when I was very much interested in the political side I've been an advocacy person for a while always going to Congress talking about how to improve outcomes for everything and you know like hospital food that's one of our what that's something we're on right now let's legislate that hospital food has to be healthy and we actually got that through the American Medical Association so I I know I'm tange ending here but god I'll give an example yeah and the it was such an impressive outpouring we were a little nervous s at college it was actually Neal Barnard who was - started it and when the in the Washington DC chapter of the AMA and you know we had there were people at the college who were nervous that you know we're gonna step on everyone's toes but ultimately we've went on ahead and supported it and pushed it and what's the resistance to that so the issue is that you're going to make an enemy somewhere and so you're always looking for unintended consequences it's politics in a way right right okay and suppose for example and I don't think this would happen but suppose for example the American Hospital Association said that you know the this you know this program you're doing is disenfranchising our hospitals therefore we're not gonna use anymore ACC products yeah which is then gonna hurt our patients okay so I mean so you right you're trying to balance everything and so but at the end of the day you realize that it's just the right thing to do you know and damn the torpedoes we're gonna go ahead and so so I you know along with Neil and I thought we were gonna be alone at the microphone and sure I am a delegates were lined up outside the door trying to talk about the the ravages of the hospital food now there are most of them were actually plant-based all of them were concerned cardiologists coming up to the mic saying I just put a stent I just put three stents in this person and bring them back to the CCU I come around on them and you've given them bacon and eggs and the McDonald's in the lobby right absolutely and so this is something that that we really are taking on and we'd like to improve I know it's gonna decrease our income but it's going to improve aren't the outcomes of our patients and that's wonderful that's what we're really about yeah that's great have you done similar have yet similar initiatives with school lunch so odd year you know it's the the if there's two things that happen with one about five years ago there was a pilot in our Northern California Chapter of the ACC that a pilot that they were supporting that they were very proud of where they had gone into schools and removed the junk food and put in carrots of celery and it said that it had an amazing impact and the kids actually started to like the more healthy foods they were making more healthy food choices and that it's by their assessment they were making more healthy food she was choices at home so that actually I think may have influenced FLOTUS given the First Lady of the United States and they were actually she sent a representative to our population health meeting at the American College of Cardiology to talk specifically about the F and D program I did see the Jim Jimmy Kimmel sort of they they had a good job yeah yeah joking relationship and in Kimmel would say well you tried less move and nobody did okay so so let's go FNV except you got to change the name yes it doesn't sound right and though they go back and forth but I think they got the point across their fruits and vegetables were the way that people were supposed to go and so it would have been nice to have that program that kind of program I think they were starting in Norfolk Virginia I haven't seen an outcome for Deb eschmeyer was her food czar who was very helpful in getting that and very helpful to us when we were fighting this you know dietary guideline thing I don't know where that's gonna go I know a lot of the things that in the Obama administration of being reversed it'd be good to see what what actually happens in terms of school foods mm-hmm so you famously adopt a plant-based diet in 2003 spent about 15 years right so so let's talk about that like what prompted that you know how did you make that decision so it's interesting that this in in retrospect I mean you make a decision and then you can look back on it later and try to figure out what led to that and I'm I was able to identify a few key things one that I don't talk about very much was my affiliation with the association of black cardiologists and there was one cardiologists in that organization his name was Tazewell banks and Tazewell was always talking about diet and he was always talking about Dean Ornish and he had seen the the life trials and read them pay attention to them changed his diet and he was director of the coronary care unit and EC General Hospital part of Howard University and he was claimed he made this outlandish claim that every person came in there with a heart attack he changed their diet that moment to vegetarian diet he made sure that they understood it before they left and then they'd stick to it and he had followed everyone for at least one year and no one had a recurrent heart attack this was back in the days when recurrent heart attacks was actually quite frequent so how many years ago was this so that would have been probably the mid 1980s it was not too long after some of Dean Ornish's first studies were out there so that was in the back of my mind because I had actually heard that and then being a nuclear cardiologist I had actually seen the the land schooled Dean Ornish PET scans with rubidium 82 rubidium 82 is an isotope that you do PET scanning with I didn't turns out that that actually was my research when I was a cardiology fellow was in rubidium 82 so everything with rubidium I to always take a look at him and so I'd seen those images where in three months the blood flow dramatically improves and you know is can that really happen so I put it in the back of my mind and then right before I went to that American College of Cardiology meeting where I had the cholesterol test in the context of though getting a little older and having my son who was a nationally ranked tennis player and I was his coach and he had aged out and he was going to you know play baseball at Valparaiso University and I wasn't on the tennis court twice a day every day that change in lifestyle and continuing that diet of chicken and fish which we thought were healthy back then but if I had just done the literature search I would have seen that that actually was high in cholesterol right so that's a common misunderstanding exactly and you know there are some relative benefits know if you're compared to process with me that's way better it's a little better than red meat but it's still not vegetables in terms of mortality right so you're eating this diet look I mean good I'm not eating processed meat something any red meat I'm eating my chicken and my fish and I'm treating it clean and you know I'm doing what I'm supposed to do that's right and so in that context I'm on my way to this meeting and where this is about to happen to me where I get the blood tests done and there was a lady who came to my lab my nuclear lab and I was the reader that day who actually had a scan that looked pretty good but as usual I looked through the chart and I see that there's an old skin so I pull it up and I'm comparing him and it's dramatically improved this wasn't this was the study the first one which had been about six months earlier had a tremendous amount of blood flow problems she must have had I figured three vessel disease and that those festivals were pretty tight okay so I'm looking on our little worksheet because we you know my nuclear lab that I created that University of Chicago is you know we just collected data on everything every little thing was in the report that you would ever want to know and there was something missing it was the bypass surgery what happened to the bypass surgery what happened to the stenting you would had a stent probably five vessels I figured no one to do that she probably went to bypass surgery how did it get so much better and so in the absence of any data that they could that they collected I actually called the patient I said sorry to bother you but I think my lab left out something okay did you get bite when was the bypass surgery or the stent and she says no they told me about it they told me I needed it but I refused I looked on the line and I found Dean Ornish's program and I went on this diet and started exercising and it took about six weeks for my chest pain to go away I would never do that by the way okay I would do the Dean artists and the stenting and six weeks of chest pain is probably not what we're recommending but she lost a lot of weight and she was exercising so well that she was training for like a 5k or a 10k she was just doing so well and she tripped on a curb and broke her ankle and so that's why she was back in the lab because there's she is refusing an angiogram had not gotten the standard treatment and now she's got to go to the operating room for an elective surgery and everyone's afraid there's problem patient Oh Mike well Coast's anesthesia does not want to put you to sleep with untreated heart disease and so it really was a fantastic story and the idea that the Ornish diet could be just as good as the scans that I was saying routinely after bypass surgery after stenting was very impressive and then fortunately I had my cholesterol done and then a next couple of days after that and right see your LDL was like 170 it was 170 I didn't actually believe it I thought you know this was back in the day where we had the exhibitors on the floor in the meeting okay and you going exhibit Hong you stand in line you get your cholesterol tested for free great I thought it was a plot to sell cardiologists statins so I went to their competitor and it was 169 so then I fasted all night okay came in the next morning that's so funny than know it was wrong to figure this out exactly so after fasting all night it was still 169 and so I stopped eating animals right at that day and it never went back wow that's amazing and you you wrote about this you wrote this it was on like what's that cycle like med med page today or something like that I actually couldn't read it because I'm not a member or what I couldn't log in to read it but you kind of talk about why you made this decision right the reasons that supported it you know the history leading up to it and it caused quite a stir you had as many fans as detractors right and there's a lot of think pieces written about this and given your you know your position as you know president of the American College of Cardiology kind of foisted you into the spotlight in a big way so there was there was a very bright light being shined upon you and this decision what is he actually saying he's a member of this vegan propaganda unit he's advancing some industry you know interest I don't know what's going on here alright but there was a lot of you know there's a lot of discussion about this right so you know how did you you know whether that navigate that and how do you kind of perceive that now in retrospect well you know it's an interesting story in that it was actually a staffer in the American College of Cardiology PR department the media department you noticed that I was eating different and always asking for different food and the meetings and said well why don't why are you doing that since it said heart attack stroke and death and she said well why don't we put that in our block you know and do a little nutrition prevention page so I said okay that's fine and then that got picked up by met page today I said okay then that got picked up by the New York Times and the next thing you know it's all over the place and Dean Ornish came to my rescue at that page today and rode dice they asked them if he couldn't write a because there's a like a 400 word lemma and he says you know can I write a substantial piece to talk about the data that made him do this and so that became a wonderful companion piece and a lot people looked at I didn't you're quite correct I was accused of you know the industry influence and pushing someone's you know agenda that's really just about my LDL cholesterol then I found out all the other stuff that that happens because a lot of the publication's weren't out there in 2003 but the data is out there now animal protein is bad for you heme iron is bad for you the cholesterol the igf-1 in the animal protein this is this is all science and so the difference is now I read it now the other major controversy which I probably shouldn't repeat one more time but I guess I'll commit to it was making that comment which was completely half joking but I was making a statement about cardiovascular research and the fact that nutrition research is typically in the American Journal of Clinical Nutrition it's not in the Journal of American College of Cardiology so much and so it's not in front of the cardiologists and so I made that statement again more than half joking the statement that that yeah why don't you you say it right two kinds of cardiologists Vicens and those who haven't read the data uh-huh no a little trouble yeah it did well the interesting part is that you know it's wit like like like they say if you take the text out of the context then all you're left to put this the con and so people were misunderstanding I thought I'm throwing all my colleagues under the bus when I'm really claiming or asking for more research more review articles more little more data to go into cardiology journals so that people are actually seeing it then they can influence that their lives and their patients but then two things started happening one is the you know the pushback from that was actually they've I think most people understood that I was saying that if they know me at all and they don't know me they they wouldn't say anything to me if they did know me they knew that I was you know it's saying that in a joke in a jocular manner but there were some people who took it seriously particularly at rush where you know I'm the chief of cardiology and we now have you know nine Deacon cardiologists some people people looked at the data and they saw them yeah this is probably something I shouldn't be eating and they've they've changed their own lifestyle which is wonderful because it gives us a good cadre of people who work on prevention the other thing that happened though I have to say is that I'd spent six years on the American Board of Internal Medicine doing the cardiology exam and then the ACC leadership position folks so I'm seeing a lot of cardiologists then my time at the American side and nuclear cardiology I was a president 12 years ago each one of those organizations has had some luminary person who died of heart disease and I'm kind of saying that's where we really need to start that is in order to fix the population through all the powers of our accha guidelines the the people who were actually getting that data out there and putting it in the hands of patients and the prescriptions and telling people what how they should live this cardiology so at this point I've had an enough of the sudden cardiac deaths I'm actually my new goal is to not retire until the leading cause of death and cardiologists is no longer heart disease and so it's amazing that it it precipitates at that level amongst you know amongst your peers he's on some level it's like you can't transmit something you haven't got like if you're if you're not living this life in a certain way where you're you know where you're an embodiment of the message that you're promoting that's inherently problematic right so I really has affected me in terms of the guilt when one of my friends would pass away you know they knew that I was eating different I ate with them they knew that I was getting different and did I say anything and did I say it loud enough and so now in equip that I can come up with it gets on Fridays today or Twitter I'm fine with I'll take the backlash if it's gonna save some of my colleagues lives ultimately that will help our country you know that will help reduce this this terrible epidemic of heart disease even if it makes me unpopular we should point out that your LDL went down from 170 to 90 yeah how long did that take well you know according to David Jenkins it probably took two weeks but I measured it at six weeks ah but you know a nothing yeah yeah it's interesting and and I you know statins do work that fast diet works that fast they both can precipitously drop the cholesterol in a matter of days really and so it's interesting that there's there's a lot of confusion about the amount of research on diet and cholesterol that people really need to understand and so why was I so that people will say oh you're that one of those 25 percent who are hyper responders well that may be true but more than likely it's just the fact that I was eating a certain amount of high cholesterol food and then I decrease it dramatically and you could see that fall the thing that is confused most of the diet research on this is the idea of saturation of the receptors meaning you can only absorb so much cholesterol you're making some in your liver and then you eat some and you can only absorb so much and so when someone tests a regular American diet which has a lot of cholesterol in it and then they say I'm gonna give you zero or one egg and then four and then we're gonna do a cross over and you know it's three weeks or something and you're gonna do two eggs every day the cholesterol difference of those two diets is tremendously different okay but the amount of absorption of that extra cholesterol is small because you already got all this baseline cholesterol so what I think everyone would say is that we're all pretty much human and and that that's saturation of the receptor phenomena that is you can only take up so much if you're if you're eating a lot of cholesterol you eat more it makes mutton very little different if you're not eating a lot of cholesterol and you eat and and you stop your cholesterol goes down right yes so it's not a one-to-one ratio of dietary cholesterol to blood cholesterol it's much right right right yeah that's interesting I think what you said about you the responsibility that you feel that kind of you know speak to these issues in light of you know having colleagues that have passed away is an interesting one it's like how do you like what is the best strategy to be as helpful as possible to people who are in need you know are you the person who's gonna like browbeat somebody are you just gonna be a lighthouse and stand in the light and wait for people that come to you is it some you know is somewhere in between those two things but I think being mindful or having an understanding of how you best communicate is really important right like in a yourself being somebody who you know is somebody of high stature within you know within this field that is directly relevant to this problem I would assume that that makes you feel compelled to you know speak a little bit louder then then then perhaps somebody else I think you're right at the end of being compelled now after but the CIM compels me really is the bad outcomes and that's for patients that's for family it's for colleagues well and I really am a believer that every person and that's whether I'm in the clinic dealing with patients or talking to colleagues everyone's different you have to kind of deal with people where they are and there are some people who are interested some people who are not interested our job is to try to increase their interest and their investment in changing their health outcome and so I think it takes a wide variety of strategies and some people you just hand them an article general American Medical Association on August 1st 2016 animal protein kills you doesn't matter which kind and in terms of increasing death but each one kills you in a different rate processor had meat much worse than etc etc that article is so easy to hand out to people and it can change their behavior right one person will just be like that's all I need I'm done I'm making the changes the other person's like well I might just prefer to go to my grave eating unhealthy food and I've heard that with that guy oh well you know actually I've sat next to him you know three nights ago at the owner mer can Congress of cardiology in in Panama City and it's a wonderful cardiologist I won't say his name of course I feel and he won't listen to this net this yeah yeah but he was saying that you know he saw my my talk in Panama City on diet and mortality and eating animals and he says no I will never change that I just won't do it and it's that and that's I've had patients say that to me the mortality rate of people saying that to me is pretty high but that that's talking about you know people who are who have disease in a clinic so I would say that everyone is going to require something difference and you're not going to get a hundred percent but I could say two things one is the groundswell of everyone coming together from different points of view so I know you've been in Australia right what I noticed about our car plant-based nutrition colleagues in Australia is that there's a little less cardiology a little more animal rights okay a little more environment and we have that in the United States as well and I think everyone coming from different angles to try to solve this are we're going to help each other the other observation is the power of media like what you're doing right now the number of people who have walked up to me and I saw your twenty seconds and in what the health and I saw I saw your 90 seconds and eating you alive and I really appreciate what what you did and I haven't eaten an animal since I saw that movie and that really it's really encouraging yeah it's gonna make a difference so so I should be interviewing you and congratulating you on getting out there and and getting the message to people well I appreciate that but you know you're you're doing the hard work you know you're doing the important work and and you know and you're the man behind the science that supports all of this and I think you're right we need all voices you know you need the hardcore protester who's you know storming in the streets and you need the quiet person in the corner like all of these voices are important the environmental the animal right like they all there's an interplay here and I think the more variation we have then the more opportunity you have for somebody to connect with one of those voices right because everybody is different like you said so when you have these patients come into your into your office and you do an intake or whatever and you're trying to figure out like okay what's gonna motivate this person you know I've spoken to doctors like Robert Oz felt or you know dr. McMackin and they'll actually an even joke on like though they'll actually you know write out a prescription pad like eat vegetables and they'll hand them a DVD of what the health or Forks Over knives or something like that like how do you you know what is your protocol so this interesting that we have the benefit which I know a lot of physicians my age do not like this benefit of the electronic electronic health record everything has to go in this electronic system so I'm sitting in front of the patient I'm sitting at 45 degrees but they can see the screen - uh-huh and so I actually pull up this the same eye sometimes well actually if it's of someone particularly highly educated I actually stick in my jump drive with the slides on it and I start giving them my talk I know it's no I it's the luxury of being chief of cardiology let me give you my key now and and it really resonates with people to see the data because most of my talk is just this article and then that article in the other and so it's all data and they can choose to not respond to it but you while I'm giving them this data and after I've assessed you know where they are educationally which is important to try to make sure that you're speaking and where they can understand one of the things that we have to do is we take a food intake questionnaire and find out where they are right now mm-hmm and how much change do they really need to make and then you know I have to admit I do a lot of transition diet and stuff because I've seen just you know I don't have randomized trials on it but it started off with the fact that the transition diet by that I mean like veggie burgers veggie hotdogs veggie stuff the kind of stuff you get a Tiger Stadium right right right yeah bridges just get them used to a different way well it actually what it really does is just that stops the animals and so these you know you know I get a lot of friends and even family saying you know you really shouldn't be eating veggie bacon it's like gets processed well we have a lot of data on process me and I'm still looking for the data on process vegetables every time I hear something process it seems to get absorbed a little better but you might be missing nutrients and stuff like that should that you could be I would host that somebody does that research in the meantime what's happening is there's their cholesterol is going down their weight is going down the blood pressures going down because all of these you know veggie products are full of veggie protein which lowers blood pressure so I'm reaching my goals in terms of their health care and for specifically for cardiology that seems to be the easiest switch to pull that is to find it whatever it is you tell me an animal product and I will find a vegetarian substitute and it could be you know the veggie cheese made out of chickpeas which is fairly common and you know they and you know will obviously down the road these products will be out there because they're increasing so rapidly which means the uptake must be good this is a capitalistic society that wouldn't if they weren't successful products see they wouldn't do well so I'm saying that we should be researching them and finding out if there's benefits or not or to all this process stuff it doesn't sound like the best thing to do but I can tell you it's better than animals yeah yeah yeah well it's never been easier to find these products right and it's getting better every day every store pet store has them yeah which also means it's never been easier to be an unhealthy vegan you know right well we're very particular about that I I'm glad you mentioned that there's been loads of literature coming out we had a recent high-profile article in the Journal of American cardiology talking specifically about unhealthful plant-based diet and they actually made an index of how many of these refined carbs and sugar and the like and there was a correlation with death and so let's let's try and have more fruits and vegetables and less of this the stuff I don't know how you would characterize a veggie hot dog you know I mean or a veggie burger right like what the food group does this fall under well I you know it's but but is it healthier if not healthy we'd actually have data we have data that says you know you can get a vegan doughnut that is not healthy if doesn't matter at this vegan or not it's not healthy but we don't have good data on you know we know sure you can say potato chips it's fried and so you know we there's certain amount of data that we have and then data that we don't right how are we how are we going to better address serving the people that need this information the most you know we touched on earlier this socio-economic divide and we're in a culture in which you know wellness or being vegan quote-unquote vegan seems to be the purview of the well-heeled who can do all their shopping at Whole Foods and meanwhile we have millions of people living in food deserts and these are the people who are suffering the most from these chronic ailments and we need to figure out strategies in ways for penetrating these communities and serving them better and I know this is something that you care a lot about and have to put a lot of thought into well it's not an easy issue these are the areas that I grew up in and South Side of Chicago and the west side of Chicago it's where I work now at Rush University I have to mention you know I have to shout out to rush they even before I got there there was a interest in the community that is not financially motivated they were actually spending hard-earned dollars to go and set up programs to try to take care of people do primary care and places that you probably wouldn't want to walk you know and at night the neighborhoods on the west side particularly as a South Sider but as it turns out all of this hard work is going to be improved even further if we can have programs where people will get education and so I've actually gone to the west side community centers and given talks and I've been in the churches giving informational talks about diet that have improved some of their outcomes on the one hand then we have a couple other major programs one of them in cardiology called the heart program the heart standing for a hell being everyone assess risk today uh-huh okay I got it I wonder what Jimmy Kimmel would think of that I tried hard coming up with that algorithm it's pretty good so it actually is playing off of the fact that the American College of Cardiology and the American Heart Association put out a risk calculator it's an app that anybody can get off of the app store and you put in all your numbers and it tells you what your ten-year risk of having a cardiac event is and so will go into a church and we will set up booths where we measure a finger stick cholesterol and a finger stick hemoglobin a1c that's the fancy way of telling you whether or not you have diabetes and or pre-diabetes and do the blood pressure fill out the form you know age gender black or white and once you have that data in there it comes up with a number of what your risk is and then you can have a discussion you can have a real discussion if you change these things in your lifestyle you can reduce that risk if you don't reduce that risk you probably should be on a statin or medication until you can because your that's a you know if your risk is high now the other program that's very popular at rush is called the alive program and that is run by our prevention colleagues and they actually go into churches they've gotta they've been doing it on the mostly on the west side of Chicago and they actually do six weeks of studies sort of a Bible based health food approach I'm hoping that we can partner with them I can see this you know heart a live heart sandwich where we go in see what the risk is see what the effect of their educational program is by measuring it after the fact so anyway obviously when I'm describing sort of granular details about our you know our overall strategy of trying to impact the community it's not just sitting there on the west side you know hoping that you know everybody will come in from the server's we are actually we do want people to come in from the suburbs and they do because Russia's highly ranked and it's a top clinical program there's you know great academic programs in the city of Chicago but the one with the best rankings in the University Health consortium every year for clinical programs clinical care is actually Rush University so now we're able to so far we've been able to bring in the business that allows us to take care of the community yeah that's great I mean basically what I'm hearing is you have to you have to be boots on the ground and engage these can you know these communities by meeting them where they're at like there is there are there churches there at there wherever the community centers are and like and it's a one on one thing really absence how you arrived change that's beautiful yeah well your own personal story is is super interesting as well I mean you grew up south side right through a relatively poor and have you know made quite a life for yourself but what I thought was really was really interesting is like you're a tennis superstar right you have that you know you were thinking about going becoming a professional tennis player well it was actually my coach that was thinking yeah tell me this story well you know it it is it's interesting that I was a championship chess player one of the top but in the state of the Wow and at the end of my junior year I was a kept on the chess team and and my guys who who were on the team at the end of chess C's and said they're going out for tennis and I just went with him so it turns out that yeah I learned enough in a short amount of time to actually become the number three singles player even though I had never picked up a racquet your friends were like this guy good at everything well no this is I mean it would have been nice to have been exposed to tennis in our early age because most people are starting at age four and five six and here I was 15 and so as it turns out one of the schools that we played Chicago vocational only had one player and then that one player actually told us that there was a program designed for inner-city poor kids at the University of Chicago you can see what's going to happen right and so I said well I I should just go over there so I got on a bus and went to this program and I learned to play tennis on a court with 60 kids and didn't have I didn't really have rackets or anything like that but I talked to the coach who turns out he was african-american and he was actually a sort of part-time minority recruiter for the University of Chicago and he was the varsity tennis coach and so he had a tremendous impact on me he actually got me an interview which I didn't know was an interview at the time until I applied to University Chicago and I couldn't get an interview and I called up and they said no you had it back at already July I was I was shocked I'm trying to remember everything I said anyway I ended up getting into University Chicago I learned enough tennis there to go back and play number one in my high school but I still look this wasn't real tennis so I went to the University of Chicago and talked to the coach he says no you're not gonna make this tennis team but you know you're welcome to come to practices and I was so determined you know sort of two things one was making that leap from Chicago Public Schools with the reading skills to the universe Chicago was a big difficulty and the the one thing that would make me sit in a wreath yeah sit and read Plato for hours is if I played about six hours of tennis then I could set right and so that actually worked for me and so and of course playing six hours of tennis you actually get pretty good so barely made the tennis team at the starting lineup but I just barely beat out the number six guy on the the day beef before the matches began and so I actually did play that year but I had gone to college a little early so I was still 17 and I that would within my first year of the 18 and unders if I had known that there were tournaments which I didn't okay but I found out about these tournaments and I started playing them and I lost in the first round of every tournament in the Chicago district and so after the first couple rather than just you know going back home I figured out that what I should do is figure out why I'm losing and I actually would go to the draw after after my go to the draw look at the top to seed see who they were see where they were playing and hang around until I watched them play their matches and what was the difference how are they constructing points how do they hit the tennis ball to everything and it turns out that I learned so much by the losses and the observation that I went back to university cago with nobody graduating and I won I beat everybody so probably number one so then my tennis career started taking off once you're the number one singles player then you can teach lessons on the side okay then you've actually got a stream of income and and so one thing led to another so my coach really after I got applied to medical school and there's this sort of the last free summer of your life there's between freshmen and sophomore year and I had had a tough year right between college and med school in terms of not understanding what you understand very well the the intensity of playing pro tennis was not something that was ready for and I would cramp up then you know be up you know a break in the third set after my fourth match and I just couldn't never got beyond the quarters of any of those pro tournaments so then that next year I focused on the fitness I really did and I was training every day I was in I incorporated into my teaching or teaching big junior development groups and you know I would try to win that three-mile race every single day needless to say I did not lose based on fitness anymore and I had a really good year and at the end of that year at the American Tennis Association national championships after I had beaten the number one seed they there my coach was just pressuring me don't go back to medical school go on to pro Turk Pro Circuit and you know I look back at that so what did and then say would I yeah because it was a tough decision the good fortune for me is that I got injured I'd semifinal match and and so I really couldn't play for about six weeks and so I would have missed the US Open this was a qualifier from the US Open which would have launched me into I don't know what you know no sponsorship you we eat what you kill essentially and without the price money you don't do very well so as it turns out I did go back to medical school and and when I think about it I really wouldn't give up one year okay Iraq that's not one at which for for pro tennis I love tennis it's a wonderful sport British Journal of Medicine says that it has a 47 percent decrease in cardiovascular mortality there you go to be a tennis player so I really been a benefit to me and you kept me focused and kept me exercising but it's it's it's not something that would have given up medicine he made the right choice I think so and then you got to sounds like you're your son became quite the player he did he did and my son is a as a Marine and he actually feels very strongly about we you know coming coming out of high school going into college soon after 2009 11 he wanted to actually go and you know go into the Marines and and I say that he'd used all that tennis training the idea of getting up at 5 o'clock in the morning it might have been foreign to the rest of the guys in the room but not for him because that's because he had been doing that since he was 8 9 years old as a tennis player you know being able to think strategically and do hard physical tasks that's I think it's we you know I don't know if he'll decide what but I think that's what made him listen up the Marine that he is and how he's a he's a he's a great guy very cool well uh I know I gotta let you go here soon but I can't let you go I don't a skillful last one so the first question I wanted to ask is you know I always like to give people some simple takeaway so if somebody's listening to this you know they're one of those people who's been mired and the confusing morass of conflicting information that's available out there they're just looking at me like just just tell me just just give me like the thing I should do first or what's the what's the most important thing is it exercises a diet is it is it dairy is it meat is a process you like just give me a couple marching steps that I can easily digest and implement into my I really we would like to have more comparative data but we have some and it does say that that principle that you can't exercise your way out of a bad diet there's some truth to that I mean you can mitigate a bad diet but you can't you're gonna have a bad outcome ultimately it's not gonna solve you and so I would say that nutrition is the most important decision that we can make if we could change one thing it would be to have heart-healthy information coming out and and have that be a real definition and so for the individual patient finding out where they are and seeing what are the elements that are going to create more and more diseases similar to what brought them to my office in the first place and and I understand that that's this is not primary care this is a nun family practicing you know these are people who already have heart disease when they're seeing me and so I have a little easier job because they're already motivated the fact that they're in my office means that they're motivated to try to make some kind of change they're expecting to come out of there with something different that's gonna change their outcome not every physician has that advantage but it's something that we all should take advantage of because you know yeah almost everyone is having you know a family member who suffers from heart disease or has had heart disease or has sudden cardiac death and so just trying to get them to understand that there is a relationship between your lifestyle and your outcome just make that connection if we can do that we would all be so much better off right it's a great answer and the final one if you were to wake up in some strange parallel universe to find yourself the new Surgeon General Wow what's the first thing that you put in motion I said that's a that's a good one you know previous Surgeon General was a good friend of mine Regina Benjamin and she was very concerned about she's african-american as you recall and it was very concerned about delivery of of health care and getting health equity I would I would really want to continue the momentum that that she had started terms of getting people to understand the whole impact of healthcare disparities we actually and it's interesting that you know that yeah it's racial segregation and educational depression and all sorts of things that led to these health care disparities not just genes okay all of this can actually be improved by lifestyle and if we could get that word out there there was a wonderful analysis of this published in circulation in 2015 called the regards trial if you look on their website and try to find the paper it's buried in like 200 publications that they did just so so good at getting stuff out there but the regard study was looking at racial and ethnic risk for stroke and what they found is not just stroke a stroke heart attack and death and it is related to diet in that southern diet that the African America you know southern meaning the southside of Chicago as far as I'm concerned because that's what we were eating there that diet is so damaging that if you could just fix the nutrition the gap in healthcare disparities would change almost on a dime hmm dr. Kim Williams you're an inspiration sir my pleasure I really appreciate your having me yeah thank you so much please keep doing what you're doing spreading the healthy powerful message that you do we need you and we need more people like you so thank you very much and thank you for all that you're doing it's my pleasure if people want to connect with you online where's the best place to find out information I mean you know the the rush website that would imagine the rush website has each of the faculty members and you know there's actually a one of our faculty members Jeff so we'll just put up a whole thing on plant-based nutrition it was really wonderful to see that and we are have a big presence there if they just google can they Williams MD you'll get a few million hits and a couple of them are my my son who's a neurosurgeon first out in practice oh wow I'm sure in the next few years he'll be taking over those Google hits aha yeah it's a Kim Williams senior can oh yeah right and you're on Twitter at cardio 10s that's like a tennis number 10s right so you hit him up there absolutely all right thank you so much well hopefully we can have a will you come back to talk to me some other time absolutely sure I'm sure there'll be more data I'm hoping it's alright thank you these planners [Music]

Channel: Rich Roll

Views: 83,800

Keywords: rich roll, vegan, health, fitness, diet, nutrition, athlete, podcast, inspiration, motivation, plantpower, plant-based, wellness, self-help, heart disease, artherosclerosis, CVD, cardiovascular disease, heart attack, cardiology, cardiologist, kim willliams, lifestyle, exercise, saturated fat, sugar, plantbased, rush university, american college of cardiology, medicine, preventive medicine, functional medicine, science, research

Id: X4TMsRKOe8Q

Length: 78min 23sec (4703 seconds)

Published: Sun Nov 05 2017