Heart Surgeon's Shocking Red Meat Opinion! [Phillip Ovadia, MD]

hello my friends Dr Ken Berry family physician here with you today uh you may know on this channel I'd like to talk about controversial studies topics in General Studies in general and I have a guest on today who is one of the preeminent authorities on cardiovascular health he is in fact a cardiothoracic surgeon who you can see in the show notes was trained at some fairly prestigious uh institutions and he has some concerns about low carb diets keto diets carnivore diets and heart health and so I wanted to have him on today to discuss these controversial topics many people who are follow this channel are eating uh ketogenic or ketivore or a carnivore diet and I really think you need to listen to what this heart surgeon has to say about that you may be surprised and it may actually change the way you think about human nutrition so I have Dr Philip avadia on today and let's bring him on Hey doctor welcome hey Ken good to see you again good to be back with the group here uh really excited to uh dig into some of this and you know it's uh funny you mentioned some of the institutions that I trained at and uh one of them in particular I think stands out these days because I did my cardiac surgical training at uh Tufts uh University and of course Tufts has been in the news lately around nutrition and uh the school of nutrition there and the head of the school of nutrition has uh released uh that most recent uh scoring system for food that famously put uh I believe it was Fruit Loops over uh eggs and meat uh so um that's a little little bit of a shame um that the good name of the institutions that I uh trained at are now being associated with such things um yeah I think Dr obadi is talking about the food Compass yeah uh that is recently released by The Friedman School of of public nutrition and or nutrition and public policy and it it scores all foods from healthiest to least healthy and they literally give a higher score to Lucky Charms to Reese's Puffs and to many other highly processed sugar-filled cereals saying that you should give them to your children versus an egg scrambled in butter that that is that is going to be a healthier choice for your children now some people find it a bit conspiratorial doctor of audio that uh the tough School of nutrition and public policy takes large checks and they call them donations from Kellogg's and craft Heinz and Mondelez and General Mills and post cereals uh do you think that there's any connection at all between those very large annual checks that they get from these billion dollar corporations and their decision their their learn it well thought out considered opinion that you should give your child Lucky Charms versus an egg fried in butter do you think that had anything to do with it yeah you know I think it certainly does and you know uh I view it as the uh institutional uh takeover uh that's really uh so prevalent throughout medicine today and it shows up in so many different ways uh you know when we look at our societies uh the the medical societies that are supposed to be uh representing you know the interests of doctors and patients and we see that they too uh are you know heavily funded by the pharmaceutical industries by the Food Industries uh and the influence that that has when we look at the Committees that draft guidelines on various Topics in medicine um we see the heavy influence of Pharma and the food industry again uh and quite frankly you know the majority of the research that gets done uh is funded by pharmaceutical Industries and and of course that research is going to be used to promote the interests of the pharmaceutical companies um you know are they out there uh with the goal of you know harming people harming patients I don't I wouldn't take it to that level uh but I think it's just you know they're representing their own interests and uh they you know the bias uh quite frankly you know they probably don't recognize the bias they think they're doing good uh I I do believe that most people have good intentions they just are so blinded by the system that they are trapped within uh that they can't see uh the possibility that they might be wrong about some things I totally agree and we're going to be taking questions from our private Community during this live and if you're watching this on YouTube as a replay and you'd like to have access to ask your own personal health and nutrition questions to some of the leading authorities in health and nutrition on the face of planet Earth and in my opinion Dr ovadia he is the preeminent voice among cardiothoracic surgeons when it comes to what you should eat versus what you should avoid so if you'd like to have access to these leading authorities and ask them your personal questions then please consider becoming part of our private Community there's a link down in the show notes and speaking of which I've got a question here from Pam asking for a friend thoughts on cholesterol injections and I assume she's talking about rapatha and probably went here to reverse plaque and calcium in the face of extremely high cholesterol what are your thoughts on repatha and prowluen yeah so clearly we don't have any data uh that pcsk9 Inhibitors reverse plaque um you know the data that we have around uh this pcsk9 Inhibitors these very powerful cholesterol lowering medications that are delivered by injection is that they do severely lower cholesterol levels um and uh in people with a history of heart disease that has shown some benefit in lowering uh recurrent certain recurrent events namely uh non-fatal myocardial infarctions uh but you know there is a lot of controversy around the data and again we were talking a little bit earlier how you know the influence of the companies uh might come into play when looking at data and uh the the large study that was done to get the original um approval uh for the FDA and and in Europe for pcsk9 Inhibitors uh there was a group uh that recently went back and re-analyzed that data very difficult for them to do the the companies certainly weren't open with sharing this data they had a you know do Freedom of Information Act request uh in Canada uh and in Europe to get the data but when they re-analyzed the data they found that there were a lot of deaths uh that were attributed incorrectly uh to being non-cardiovascular death and when you you know properly attribute those um those deaths uh it turns out that there was no benefit to these medications and in fact there was a suggestion of harm um that uh overall cardiovascular mortality uh was actually slightly higher in the group that got the medications versus the placebo group so absolutely and so first of all let's make everybody aware that the study that study you're talking about and all subsequent studies that got rapatha and probably went through FDA approval and that that they now show to doctors all of those studies were designed by funded by the actual company that sells the drug and then the majority of the researchers either were employees of the drug company or they owned stock in the drug company or they've received a research Grant from the drug company and many people don't know that but if you're in in the research field you're always looking for money to do studies because studies are expensive and so if you can make a good partnership with a huge billion dollar pharmaceutical company and maybe tweak the data just gently just slightly not doing anything that's just overtly immoral or unethical but maybe leave this out maybe misclassify this maybe call this death some other reason than oh they were on the drug and they died uh then that's going to establish a better relationship between you and that billion dollar Corporation with Deep Pockets and big checkbooks isn't it true that every single study that's been done about repatha and proud you went was was designed and funded by the drug company that stands to promise to profit from the results of that study yeah as far as I know there haven't been any uh independently funded studies uh that show benefit of these medications um and really you know also understand that uh the the the the measure of success of these medications has become do they lower LDL cholesterol uh the outcomes really aren't even looked at anymore you know it just doesn't effectively lower LDL cholesterol and it's just accepted as truth as gospel that if they're lowering LDL cholesterol then they must be benefiting cardiovascular outcomes and of course we know you know we've had the discussion many times that uh those two things don't necessarily correlate um and uh you know so those are some of the many reasons to question uh the science that's out there the other thing to understand about some of these studies is if the results aren't in favor of the pharmaceutical company they're simply not going to get published you know there is not a requirement uh to publish studies um we do have more stringent requirement these days about registering studies and and you have to declare that you're doing the study uh but if you do a study you know and the study is supposed to last two three five years as these studies often do and at the end the results you know aren't what you want them to be and you just don't publish them the reality is is you know most people are going to forget about that you know they're not going to like remember that you even started the study in the first place so um oftentimes that's another way that the that the re you know the published scientific literature gets influenced uh because negative studies just won't get published or if they do get published they'll be published in some Journal that no one ever reads and uh you know they're not the studies that you're and to see hitting their headlines of of CNN in the New York Times so then the question could pop up well how many studies were done uh with about repatha or graduate that didn't show a benefit or that showed a a negative outcome how many of those studies were actually done in the question of the answer would be we have no idea because that is considered by our U.S the US government anyway as proprietary information owned by the corporation even if they received Federal funding to perform the study and so maybe they got a two or three hundred thousand dollars from the NIH they still that is proprietary information owned by the corporation uh if one of the researchers were to release that study they would immediately be sued for Millions if not more dollars and so everybody knows to keep your trap shut if there's a negative result and you're you're exactly right they now have to register a new study that they're planning on doing but if that study results it doesn't turn out like they wanted to that study can disappear forever and that's that's in my opinion highly unethical highly immoral but it's not illegal that's that's their uh intellectual property that's how it's looked at now let's talk about rapatha and Prague because I predict that within five to ten years this is going to end badly okay because these things they lower LDL there's no question about that and they lower LDL much more precipitously than do the statins like Zocor Lipitor Crestor and I am in my opinion that is inherently undanger very inherently dangerous because we know that at least one thing that LDL cholesterol does is it's very intimately related to the proper function of our immune systems right that's very very important and so when you start lowering people's LDL cholesterol down to 30 or down to 40 with rapatha or Parliament that's not going to end well and it's and so people don't also don't realize that they're like well they surely done research on that no my friend they're doing the research right now when you go to your doctor and you pay your co-pay and you wait for an hour and you get your repatha prescription you go home you inject it once a week they're following you they're tracking you you are the experiment right now there is no long-term data right now everybody out there if you're taking a path or a problem there is no long-term data showing long-term safety of either one of these drugs that experiment is going on as we speak and you are the lab rats and so when something does come out of this that's terrible like like happened recently with vioxx that wasn't just an accident that's the way it's set up to function if something bad happens we'll know about it in two or three years when you are having the problem and so if any of you guys are out there taking repayment or repatha or prowluent you are the research you're the lab rat and that's you're on your on the on the back of your life and your health that's how we're going to find out that these things are ultimately very very bad for you uh do you have any have you seen any research on lowering people's LDL cholesterol down to 20 to 30 to 40 because many I've seen many cardiologists on Twitter saying I'd love to lower your LDL to zero yeah yeah it's interesting you know there there certainly isn't studies looking at that as you said with these new medications um you know if we go back through the historical literature around uh cholesterol uh we see that low cholesterol was a significant concern uh you know it was a marker of uh death uh essentially or risk for death you know if you look at older people um you know not on medications uh those that have a lower cholesterol level are at an increased risk of mortality and you know that's because of things like cancer that's because of infection as you said you know cholesterol plays men any essential roles in our bodies it is the precursor for many of our hormones and uh it is involved in our immune system and you know to think that we should just be eliminating this from our bodies uh is a very uh concerning concept to me uh and then you know uh now we are putting that into action and again you don't have to look hard to find other examples of you know medications that were thought to be very safe and they went bad you know you mentioned vioxx uh thalidomide is obviously a very uh prominent example there were a number of medications uh related to the cholesterol issue that were developed to low to raise uh HDL cholesterol level and they were demonstrated to raise HDL cholesterol uh but they had you know many side effects and were ineffective in preventing um heart disease so um it is not the same you know you can't just make the assumptions uh that you know moving these these markers uh in the direction you want them to move uh is going to have the effects that you intend them to and you also can't ignore the other effects that occur from that and you know we refer to them it's funny you know we refer to them as side effects uh but the reality is we're not talking about side effects we're talking about effects of the medication you know the effect of these medications is to lower LDL cholesterol dramatically and to just say that that's not going to have any other uh you know ill toward effects in the body is crazy and you know I I see it now in my patients I see many uh men who are coming to me uh and they're on these medications and they have extremely low um LDL cholesterol levels and their testosterone is in the tank and they are suffering bring all sorts of effects from low testosterone so that that's one obvious you know short-term effect that I'm seeing and then of course the long-term concerns around brain health and then around susceptibility to cancer and infection I think are very real questions that we don't have the answers for but I I like you I'm very concerned about it yeah and so what we're going to see within the next three to ten years just depending on how many people suffer and how quickly is that repathione probably going to be pulled off the market because the risk of of life-ending infections goes up when you take them autoimmune condition uh severe symptoms flare up and also the rate the risk of death from cancer goes way up if you're on repel repathara so anybody taking those you might want to just think twice about that I'd almost rather somebody be on a Statin versus rapatha probably one and that's saying a lot coming from me do you agree with that statement well you know at least uh we uh I think with statins the effects are less severe and uh you know some of the side effects that occur with statins can actually be dealt with with you know proper supplementation um I think the real problem with these medications again is you know the message that has been prevalent uh for the past you know 30 years now essentially you know it was the late 1980s and the early 1990s that statins became uh the most widely prescribed class of medication and the messaging is is that this problem can only be addressed with medication uh and you need to do it with medication and it ignores the fact that we can have very powerful impacts on our risk of heart disease if we change the foods that we eat and if we address insulin resistance because insulin resistance is the real root cause of of heart disease it is the real big risk factor for heart disease um and we get the perfect time for me to bring bring this up and let's look at this so this is a a study that was published in Jama Cardiology now this study was just in women but I think this is absolutely applicable to every human being on the planet and so Dr oveda avadia is saying we what we're trying what you're trying to do is prevent a heart attack you're trying to prevent heart failure you're trying to prevent early death that's what we're trying to all of us everybody in the world if you care about your life and your health then you you want to minimize the things that are going to cause you to die of a heart attack or die of anything else and so when you crunch the numbers from that drama Cardiology study then what we're looking at is Hazard ratios that means the risk of something bad happening because that the person has the following thing and I've ranked these These are the top 10 Hazard ratios that came out of that very large study and so if anybody out there is interested in not having a heart attack not having heart disease then you need to focus on the biggest pieces of the pie first and fix that and then focus on the next biggest or you could just do what Dr ovadi and I do and we we fixed our diet and so we're we're working on all of these at the same exact time because would you would what's your opinion on this doc do you think that every single piece of pie in the top ten here that causes uh coronary heart disease the what what what part does Diet play yeah exactly you know the the only two slivers uh on that piece of pie that aren't affected by the food you're eating is smoking uh and inactivity you know although inactivity also you know usually tracks with uh not eating well but you know besides that all of these other factors do get influenced by insulin resistance and by the food that we are eating and uh the reality is is that none of the factors on this graph uh are actually influenced by statins and people will say oh well I see LDL there uh but what you see there is actually small dense LDL particles and it turns out that statins really don't have much of an effect on small dent LDL they lower LDL overall but they disproportionately lower large fluffy LDL and they can actually make the small dent LDL uh more of a problem uh but insulin resist instance is what uh causes LDL particles to shift towards the smaller size and become damaged and oxidized and then you know everything else we see on this list is certainly related to insulin resistance uh so that is the discussion that I that is the way that I have tried to shift the discussion around heart disease um you know it's it's not we can forget about the Statin issue for a minute we could even if we wanted to accept Okay statins are as great as they say they are and they do everything that they say that they do and all the published studies are correct um which obviously it's not but if we accept that um we still can't ignore this graft that it is only attracted it is only addressing a very small part of the risk pot of the risk puzzle and insulin resistance is the vast majority of the risk puzzle so why aren't we addressing insulin resistance when we are talking about heart disease absolutely and when you see this this this information graphed like this it immediately becomes a huge deal that the tough School of nutrition and public policy that they're recommending for both you and your children that you eat things like Lucky Charms and Reese's Puffs cereal and even Corn Flakes because all of those spike your blood sugar spike your insulin or into at least some degree inflammatory in nature and are also void of many of the nutrients the vitamins and minerals amino acids and fatty acids that your body needs now Dr ovadi and I both are eating a diet that will minimize the risk of every single one of these top 10 risk factors and let's just talk I would love to know what a cardiothoracic surgeon eats I think that'd be good relevant information tell us about your diet Dr ovadia and and why you're eating that diet to minimize all of these risks yeah sure thing so you know my diet is a carnivore diet um you know it is uh based in animal eating in eating animal protein uh first and foremost and the vast majority of what I eat is animal protein uh typical day like yesterday um you know around noon time or so uh or even a little later than that when I got out of the operating room I had a a uh it was a flank steak yesterday but oftentimes it will be uh you know a steak of some sort and probably about five hours later or so I had a pound of ground beef with a couple of duck eggs scrambled into it and that's what I Aid in a typical day and I do that exactly because of what you said you know avoiding insulin resistance avoiding all of these things um I've been uh I've been wearing a continuous glucose monitor the last few weeks uh which I do on an occasional basis and it my glucose just stays a nice Flat Line pretty much all day long you know within about a 10 point range it will vary uh when I eat that way and so it is addressing you know all of the things on this list uh by doing so absolutely and I think when you see this list because type 2 diabetes most people know what that is that's chronically high blood sugar metabolic syndrome is chronically high triglycerides blood pressure blood sugar and then a waste to height ratio that's that's you're too fat in the middle basically yeah hypertension is high blood pressure obesity every single one of these things is going to respond to having a lower average blood sugar and and this is one of the reasons that that we all recommend you wear a CGM even if you haven't been diagnosed with pre-diabetes Type 2 Diabetes Type 1 diabetes mody or l-a-d-a you need to wear a CGM for a few weeks so that you can figure out which foods really spike your blood sugar and which foods don't really spike your blood sugar and I I think probably the official recommendation from Tufts University would be I you don't need a CGM because if you wear a CGM and you eat the foods they recommend you're going to see very quickly that those Foods spike your blood sugar off the chart now you see number three on this list is hypertension and I've got several questions from the tribe about hypertension let's let's get Maria's she was just described prescribed carving law for hfpef info says it may cause hyperglycemia absolutely should I be on a carnivore diet only or is ketovor okay while taking Carvedilol yeah so uh well let's uh first of all uh translate that into English for some people may not be familiar so uh hfpef is heart failure with preserved ejection fraction and basically what that means is that the heart is squeezing okay but it doesn't relax like it should and so therefore uh we're not getting uh the same um effect uh from the beating heart and we can develop some of the symptoms of heart failure uh Carvedilol is a beta blocker medication so it's a medication that both lowers blood pressure slows heart rate and also has unique effects on the heart muscle itself it really helps the heart muscle to relax lack some and that's why that medication is useful in this situation um hyperglycemia is one of the known uh effects or side effects of beta blocker medications and you do want to be careful about that and you know I would suggest that the best way to deal with this situation would be a you know carnivore ketovore diet uh and I say that for two reasons one is that you know ketones are the perfume the preferred energy source for your heart and being in a ketogenic state has been shown to have some benefit in heart failure uh the studies are small they're not you know large uh studies uh some of it is animal bait animal data that we're basing that on but there is at least a suggestion that a ketogenic diet can help in heart failure my clinical experience with patients is that it does help in heart failure um and so not only are you going to be avoiding the hyperglycemia from this medication but you're going to be addressing the underlying condition Carvedilol that medication is not changing whatever led to you developing this condition in the first place medications don't change the cause of the problem they just treat the symptoms of the problem in most situations when we're dealing with chronic disease uh so I think a ketovore diet or you know carnivore ketovore diet in this situation uh would be a great suggestion obviously usual caveats you know you need to talk to your doctor if your doctor can't discuss this with you find another doctor who can uh you want to have medical supervision when you're dealing with conditions like this uh but I I would have no objections uh and would be firmly in favor of those dietary approaches absolutely another question about blood pressure uh eight months on strict carnivore I'm still on uh lisinopril for my blood pressure now I'm assuming that you still have high blood pressure you're not just taking the pill because your doctor hasn't stopped it yet will my blood pressure ever come down enough I still have weight to lose now let's start doctor with what do you consider a normal healthy blood pressure what's your cut off and then let's discuss that first and then we'll get into the question yeah so I consider a normal healthy blood pressure to be less than 130 over 80. uh both of those numbers uh lower than that um the um you know the the air that when we start get can get concerned about high blood pressure is certainly you know when it gets above 140 for the top number uh and uh above uh 90 you know 85 is concerning to me but above 90 is where you can really start to show uh harm occurring uh so those are the numbers you want to be looking at um you were sort of uh alluding to it you know are you on the medication because your blood pressure is still high or are you on the medication because your doctor just hasn't tried stopping the medication um and you know this is something I run into often uh you know people will start uh low carb diets and you know some people right away you got to stop the medications because they start getting low blood pressure they start getting dizzy and lightheaded uh other people I work with their blood pressure stays about the same and then we just take them off the medication and their blood pressure stays the same uh and it just that the medication isn't isn't doing anything and you can get it off it but like you said most doctors don't think about stopping blood pressure medication yeah ultimately to improve your hypertension you need to address your insulin resistance and this can take a while you know we do see uh significant improvements quickly with you know low carbohydrate and carnivore diets uh but you know getting rid of all of the insulin resistance that for many people has been there for 20 30 you know plus years it can take a while and unfortunately there may be some you know uh damage to the blood vessels that ultimately can't be undone and you may not get off of all of your medications but uh the most the vast majority of people I can't think of one you know person that has been adherent to a low carbohydrate carnivore diet that we haven't been able to at least lower their medications yes I agree now I have to ask you a somewhat controversial question doctor why are you directly going against the American Heart association's guidelines that the gold blood pressure should be under 120 and under 80. you said 130 over 80. what's wrong with you as a health care provider why do you not adhere to the ahas obviously that was based on research and rational judgment why why don't you say 120 over 80. yeah because you know that that wasn't based on uh rational judgment oh basically what that was based on is that they came out with the original guidelines and you know medication based approach uh to uh you know uh lowering blood pressure and avoiding the complications of high blood pressure and then they saw that it was ineffective we weren't getting much of an effect and their answer was we must need more medication we must need to drive the blood pressure lower similar to the cholesterol story you know um we've been focused on lowering cholesterol for as I said 30 plus years now with medications and we're not seeing the effects uh heart disease Remains the number one killer uh in the United States and worldwide despite the fact that our cholesterol levels are lower and the answer from the pharmaceutical industry uh and their influence on our medical societies is that well we just must just need to lower it more we must just need more medications and instead I you know and many others uh you know have stepped back and said maybe it's the wrong approach maybe it's what we shouldn't be focused on yeah and when you look at the data around high blood pressure we see that under one for you know until you get above 140 you cannot demonstrate harm exactly and that's that's exactly why I tell people in our private Community as long as you're resting blood pressure that's been checked properly because very often doctors offices do not check your blood pressure properly there is a there's a list of things that must be done for the number you get on the sphignobanometer to actually be your real blood pressure and I've got a YouTube video about that um but if the all the research shows that there starts to be a little harm if your blood pressure checked properly is averaging above 140 on the top and then 90 on the bottom really is where the research shows the inflation point where you're like yep you're starting to do a little damage there uh here's let me say there was another good question where did that go uh oh here it is right here yeah yeah so this is from Susan she says would 1 30 is over 70 to 80 be okay for a 77 year old I stopped my Losartan a month ago I'm still taking 50 of metoprolol my answer would be uh for a 70 year old 77 year old 130 is over 70s is effing awesome okay you probably no longer need the metoprolol either what's that you cardiothoracic surgeon yeah so again I agree I would be working on getting you off the metoprolol um and I would be continuing your dietary changes uh and you know you you do again you know um you want to you may need to tailor this to your individual situation you know if you told me you had had a history of a stroke you know that might change my thinking uh you know if you've had uh other effects from high blood pressure if you have a thickened heart if you have uh you know something like an aortic aneurysm maybe that changes but in general I agree you know 130s over 70s is going to be just fine for a 77 year old and there's a good chance that you can get off the other medications as well absolutely absolutely here's a question from Tamara we're a halter monitor for two weeks due to left side uh pain in the arm chest and neck no abnormalities on the halter monitor cardiologists Shrugged it off any other test to determine what's going on this makes me very nervous I feel like this if if that was the extent of the cardiac work up that was a half-assed job what what else would you like to see Tamara have checked yeah so you know with pains uh especially on the left side and the chest neck and arm you know you want to make sure you are not having what we call angina which is basically think of it as a cramp of the heart uh it's a sign that your heart is not getting enough blood not getting enough oxygen uh and a Holter monitor is not going to show that at all so I hope that wasn't the first test and the only test uh just to you know again explain some of the terms a Holter monitor is a monitor uh it's basically an EKG a continuous EKG that you wear at home so it's going to look for abnormalities in the heart rhythm which doesn't really have much to do with the blood flow through your heart so I would want to see some evaluation of do you have adequate blood flow that could start with something like a coronary artery calcium scan uh in someone who's having symptoms I probably would skip right to either a CT angiogram um which is a type of cat scan that they give you dye and they can look for blockages in the heart uh I I might consider something like a stress test although I I really don't consider it as good a test as the CT angiogram uh my preference would probably be in a situation like this let's get a CT angiogram and let's see if there are any blockages in the arteries of your heart yep I totally agree uh but yeah if if the doc's not comfortable with the CT angiogram you absolutely need some kind of stress test you definitely need an echocardiogram surely the goodness those things were were scheduled and you just don't know about it yet Tamara if you're a cardiologist if all they did for your symptoms because most people know that in women they very often don't have the classic symptoms of angina if that's the full workup you got you need to fire that cardiologist's ass and find another cardiologist ASAP there's hundreds of reasons why you might have been having left-sided arm chest and neck pain but until proven otherwise you have not had a thorough cardiac work up and you need to find another cardiologist ASAP still could be nothing wrong don't worry but do set up the appointment with another cardiologist um let's talk about what's wrong with cardiologists because you and I are having this discussion we're both doctors we're both rational people uh we both want what's best for ourselves for our family for our children for our patients we want the world to be a better place right but the average cardiologist would completely agree with virtually everything both of us have said since we started this video why what's wrong with the average cardiologist why do they recommend the things that they do where are they mistrained are they nefarious what why do cardiologists get it so wrong so often yeah so I think this really goes back to our education and the system that you know we are a part of uh I believe you know you and I graduated medical school about the same time um and by the time you know we graduated medical school it was a given that cholesterol is the cause of heart disease and the way to combat heart disease is to lower cholesterol uh both with dietary changes and medications uh and that was an unquestionable fact uh despite uh you know despite there being plenty of evidence to the contrary but we we don't care about that evidence we only hear one side of the story uh and that's during our education and that's you know as we're in the Health Care System uh after our education you know talking to our colleagues and and going to the meetings you know when you go to the American Heart Association scientific meetings uh the science that that gets presented is typically all in the same direction you know and they really won't even entertain the other possibility uh and again we don't have to go back that far but the reality is is there there aren't many doctors still practicing who remember the pre-statin era uh you know again the first statins were introduced to the market in 1987. uh so you know we're talking about we're coming up on 50 years uh or or 40 years sorry that statins are there and so even the doctors who were 20 back then you know they're in their mid late 60s now and uh there aren't too many of them around and so no one remembers that prior to 1987 when you go through the literature around heart disease you actually see a very uh contentious debate about whether it was cholesterol or whether it was sugar uh that was the primary driver of of heart disease and insulin resistance related to the sugar the work of the scientists around insulin resistant the work of scientists like Gerald Riven uh like Joseph craft these have been largely forgotten and so you know I don't ever remember hearing about uh either of those scientists during my medical school I don't know in any of the books uh I think that's the environment that we're in and so the average cardiologist just hasn't even considered that there might be an alternative Theory uh and and that's the reality of it and then they're so busy that they're so busy taking care of people with heart disease uh that they don't have the time to think about it uh they don't have the time to ask these questions and it's usually you know if something happens in their life that prompts them to start looking into it deeper you know so many of us in this community Dr Barry and I share the same you know background that we had a medical problem ourselves you know for me I was obese I was pre-diabetic and I was headed down the pathway and I started asking why when I was following all the advice was this happening and that's what led me to discover that there even was an alternative Theory and then it's been a lot of work to work through that you know it wasn't like I just said oh okay the other answer is the right answer you know it's hundreds and thousands of hours of reading the studies of you know listening to podcasts reading books uh you know all of the research that has gone into it that makes me comfortable that this is the correct approach uh but that takes a lot of work and it takes a mindset of being willing to admit you were wrong um I have to admit uh and you know I know you've done the same that we were wrong we treated patients in the wrong manner we probably harmed people by doing so uh that wasn't our intent we just didn't know any better exactly to be able to admit that takes a lot and those Physicians aren't willing to do that true and now what I've been recommending people in our private Community do and what I want everybody to start doing because obviously the cardiologists they are not going to hear this message from the top down that's never going to happen and so what we've started doing and it's actually getting traction doctor is I have people print out this study from Jama and then in many of my YouTube videos I'll have the the research that I based the video on in the show notes and I tell people print out that research take it to your doctor because in many cases the doctor has either never heard of that research or they heard a summary of it but they didn't they didn't really think of it the way we're thinking about this and so everybody down at the bottom is the there you can print this study out yourself take it to your cardiologist and say Doc How come every time I come see you all you want to talk about is lowering my LDL cholesterol or my apob or some other thing but I don't even see them on this pie chart they don't even show up in the top ten why do you never talk to me about my pre-diabetes or my metabolic syndrome or my you know the cardiologists love to talk about blood pressure too but not quite as much as LDL cholesterol but you never talk to me about these other things with the same intensity that you talk to me about lowering my LDL cholesterol why is that and I think when enough patients have asked enough cardiologists that question they'll go yeah that is kind of weird that because that's all I hear talked about is LDL cholesterol and apob I never hear really about it's like oh type 2 diabetes yeah take your medicine but what if there was a dietary intervention that would that would fix the top ten that would be pretty cool now here's a question that uh this is a very controversial question from Tim Cook can a CAC score we've already you and I have already established you cannot lower your CAC score by taking repatha or prowling or Crestor or lipitor's okor that does not lower your CAC score there's no research that shows that but have you seen CAC scores come down by changing the diet yeah so I have seen coronary artery calcium scores come down by changing the diet Now by changing the diet alone is always a little bit difficult uh to answer that because you know the reality is is that we never just changed the diet you know we change our lifestyle and uh for my patients with increased coronary artery calcium I'm oftentimes you know in addition to the diet uh you know maybe recommending some supplements and and you know we're changing around their medications uh but uh uh you know to look at this a different way I would say I've never seen a coronary artery calcium score decrease without changing the diet uh so um that I think is the question we should be answering uh you know are some of these supplements uh necessary honestly I'm not quite sure but you know I think it's a safe bet you know when you look at something like vitamin K2 uh and I tell patients that you know you should adopt the low carbohydrate you know oftentimes mostly carnivore type diet um you should be getting a lot of vitamin K2 in that type of diet so do you need to supplement with K2 the honest answer is I'm not completely sure uh but you know the safe bet is take the supplement as well you know there's really no harm in taking a K2 supplement so um uh I don't know if diet alone is truly enough uh but I do know that without diet you you have zero chance of of lowering your coronary artery calcium score absolutely and I'll I'll tell you guys from personal practice experience I have seen multiple people eating a proper human diet uh Dr Adam Nalley who does cimt scanning in his office he's seen and then also orders the CAC scan and then Dr Arthur Agustin who is the cardiologist who came up with the basically the CAC scoring system we have all seen multiple people when they adopt either a ketogenic akitivore or a carnivore diet and and let's be very clear this is a slow process this is calcium in the in the arterial wall this is not going to go away in a few days or a few weeks or a few months but we all recommend that you repeat that CAC score annually every 12 months and so after what's supposed to happen according to Dr Arthur Agustin the cardiologist who came up with the CAC scoring system is the average adult their CAC score is going to go up about 20 a year that's that's normal that's what we would consider average or normal and so when somebody adopts a proper human diet so they got a score of 100. on this first one they repeat that in 12 months what should have happened is it went up to 120 give or take right but when they get that score back and it's only went up to 105. that's a that's a victory or it stayed 100 or it went down to 97. that's a humongous victory that the average cardiologist doesn't even know is on the table like that's not even an option it's going to go up we just want to try to slow it down but yes and so there is I I'm holding my breath for research that will back that up because we currently don't have any but I can tell you anecdotally there are thousands and thousands of cases of people who have lowered their CAC score or at least slowed down the progression of their CAC score by adopting a proper human diet and a proper human life I can tell you that anecdotally there's no research to support that currently all right doctor uh We've covered that oh I know what we need to talk about we need to talk about the miracle drugs ozympic mcgovi monjuro yeah the these these are all over the news right now ozympic uh how it's hard there's a shortage everybody wants it needs it but nobody can get it or not many people can get it are you excited about the health benefits of ozympic mugovi manjuro or do you have some hesitations what do you think about these drugs and and what is your not MediCal opinion but what is your recommendation for the average person who's like hey man I need to lose 30 pounds amen I've I need to lose 50 pounds should these drugs be the the predominant way they address that problem yeah I am not excited about these medications at all um I have not prescribed it for a patient um as of yet and I really fail to see the role in it because again uh as we discussed earlier I don't think medication should be the first line in you know in the battle against obesity I think the dietary changes should be first a low carbohydrate you know proper human diet keto carnivore uh and uh interestingly there was just some data uh I believe I saw the article yesterday or the day before it was a mouse study looking at the mechanism of action of uh these medications and basically what it showed is you know they are uh blocking essentially blocking the absorption of of carbohydrates or or speeding up the excretion of carbohydrates uh and so if you're on a low carbohydrate diet there's probably going to be no benefit to taking these medications uh and uh you know as with any medication I have concerns about the harms and quite frankly I just again the we know that when these medications are stopped uh weight regain occurs we know even if the medications are continued over time weight regain occurs and so you know the concept that we're going to have people on a medication for their entire lives as a way to combat obesity again it's just it makes absolutely zero sense to me so um I am not a fan of these medications uh and I you know I advocate for the people that I work with uh let's do the dietary changes and then quite frankly there's no need for these medications I agree 100 and I predict also that the ozympic story will also end badly I'm working on a YouTube video about this right now but one of the main concerns I have about ozympic and would go be in manjuro is that the their GOP one uh agonists the GOP one receptor occurs all over the human body it occurs in the brain it it occurs in the in the gut for sure no doubt but it also occurs in the in the kidneys it occurs at multiple many different places in the human body and so when you have a GOP one Agonist like ozympic it's going to work on all these receptors it's not just going to work on the receptors that the the pharmaceutical company wants it to work on that's the only receptors they want to talk about of course because that's going to make them probably hundreds of billions of dollars geez I can't even imagine what the profits are going to be on these things but again the patients who are taking ozympic right now you are literally part of the long-term safety study you are a lab rat right now if you're taking ozympic or agovi and so you have to know that up front and and then when you start to say wait a minute so there's GOP one receptors in the kidney how does ozympic affect those what's the long-term outcome going to be of that that my friends is a great question and no nobody on the planet knows the answer to that question currently you're part of the study we'll find out in three to ten years so if you're willing to take that risk because the the GOP one agonists they definitely you're going to lose fat absolutely but when you start to muck around with a a Millions year old evolutionarily conserved mechanism like hunger because that's what they do they basically just muck up your hunger signal from your brain so you're almost repulsed by food now you know people talk about oh if you fast or if you eat keto that's you that's an eating disorder or you're liable to call up cause an eating disorder by doing that you're telling me that a a pharmaceutical that has has no long-term data studies on safety that basically turns off your hunger signals or it it transmutes them into like a feeling of mild nausea if you even think about eating you don't think that sounds like an eating disorder because I do but I predict that's going to end very very very badly um okay Susan's got a great question your thoughts on getting annual annual lipid profiles on children should we do that at what age should we start and would the adult ranges of normal be the same for kids um yeah so you know this uh in some ways I do support getting lipid profiles on children because metabolic syndrome is becoming Pro so prompt predominant in children and so you know again I'm looking at that lipid profile different I'm not looking at the LDL I'm looking at the triglycerides in the HDL and if that ratio is over two and those triglycerides are over 150 uh and really over a hundred I'm going to be concerned about that and so that is the utility I think in getting uh these measurements on children uh probably you know um we know that our lipid profiles are different uh you know uh uh as infants and young children so you know you probably somewhere around 10 to 12 years old is where you settle into the adult values uh but like I said you know knowing and especially if the child is overweight or there's some other reason that you think that they might be insulin resistant I would be interested in seeing the lipid profile uh of uh because if we can make the changes directed at insulin resistance early in life those effects are going to be extremely powerful unfortunately most Physicians and certainly the pharmaceutical industry is thinking can we get these kids on cholesterol lowering medications early in life and that is going to be disastrous so we think that lowering cholesterol is problematic in a 60 and 70 year old I really don't even want to think about the effects of lowering cholesterol in a child who is still developing a child who is going through puberty and all the hormonal changes um you know that is just a disastrous situation waiting to happen here uh but the unfortunate thing that I see as a heart surgeon is you know I am operating on younger and younger people uh it is you know common for me to operate on people in their 40s these days and it is not unusual that on up I'm operating on someone in their 30s and realize that you know I started my career as a heart surgeon 20 years ago uh only 20 years ago and at that time it was rare to be operating on people in their 50s we were mostly operating on 70 80 year olds uh and there has been a dramatic shift in the last 20 years as to the age of the patients that I am operating on and that's because insulin resistance is showing up earlier and earlier you know we see type 2 diabetes not childhood type 1 diabetes but adult onset type 2 diabetes being diagnosed in teenagers routinely today yeah it's very concerning uh and you know we can just do the math because we know it's you know two to three decades between when you first get diagnosed with type 2 diabetes and you end up with Advanced heart disease and so if you're getting diagnosed when you're 12 you're going to be on my operating room table at 30. yeah and and that is a major problem I totally agree I got another question from a PhD tribe member and if you're watching this on YouTube and you're like how are these people able to ask Dr ovadia these questions I want to ask a question all these people are in our private Community there's a link down in the show notes you can sign up it's five books a month and you'll have immediate access to some of the leading authorities when it comes to human health and nutrition that's how you do it it's super simple uh Liz says I've been diagnosed with mitral valve stenosis should I still take a Statin and should I get a second opinion on my diagnosis yeah so a Statin is going to do absolutely nothing for mitral valve stenosis uh so again to unpack this a little bit the mitral valve it's one of the valves in our heart it controls the flow of blood uh basically from the top part of the heart the Atria to the bottom part of the Heart The ventricle over on the left side of the heart and stenosis means that it has become thickened it has become uh you know usually calcified and it doesn't open like it should and that's prevent the heart is working extra hard to pump the blood past that uh obstruction essentially uh Statin medications will do absolutely nothing for that um you know should you get a second opinion um I'm always in favor of getting a second opinion unless it's a life-threatening emergency and you know the usual questions around mitral stenosis become you know when is it time to intervene on that uh typically that's going to be a surgical procedure there are some catheter-based procedures that can be done for mitral valve stenosis uh but uh it you know again uh the Statin isn't going to help mitral valve stenosis here's another good one from Susan small dents versus large fluffy it's such a relatively new thing in the literature can we trust this early in science in this that small dents is truly bad and large fluffy is truly good yeah so it's actually not uh that new of a thing you know it hasn't been talked about uh but the sign you know the uh ability to differentiate particle sizes for cholesterol you know goes back uh probably 30 years now you know uh uh and maybe even before that um it you know does it hasn't been talked about uh and really you know again why don't we talk about it I think because it would reveal things that you know we don't want to see uh when you start looking at you know cholesterol particle sizes you start coming to some different conclusions uh that maybe don't support some of the interests we've been talking about um and um it's a lot you know um it's interesting uh when we look at it sort of from a marketing standpoint you know the simple message of LDL High prescribed a Statin it's a very simple message it's simple for patients it's simple for Physicians and it has been phenomenally successful in getting people on these medications uh when you start getting into the complexity of particle sizes and that starts muddying the water um you know then we have problems uh but yes I I you know I think the science on small dents versus large fluffy is is very well established and uh I do think we can trust that if you have a whole lot of large fluffy LDL uh and you don't have a lot small dense LDL even if overall you have a lot of cholesterol that is not a problematic situation and the science continues to evolve you know uh we're looking at it there are ongoing studies um you know I know you've had Dave Feldman on here and you've talked about some of the scientific studies that his uh citizen Science Foundation is leading uh we want more studies we want more information all the time uh but I am pretty confident in uh you know telling my patients that if you have a lot of large fluffy LDL that is not a problem yep I agree great question from Roxanna one of our leaders in the private group is a carotid artery scan like a cimt a good test for overall cardiovascular health and if if so why if not then what would you prefer yeah so you know a carotid artery scan first of all understand that there are two types of carotid artery ultrasounds there's the cimt so carotid intimal medial thickness which is a very specific technique done with the ultrasound and then there's the usual sort of carotid artery duplex study it's called Uh that's the Carotid artery duplex is is only going to detect Advanced plaques and advanced disease in the arteries the the cimt scan is a you know going to detect those more subtle changes in the lining of the artery uh that indicate um atherosclerosis uh so I do think the cimt is a good test but it's still an indirect test uh you know if we're worried about disease in the heart let's get the scan that looks at the disease in the heart and so I I always prefer a CAC scan and uh that doesn't mean that you know cimt can't also be used uh certainly if your cimt is abnormal you want to get a CAC score uh but I do see people with normal cimts that have abnormal coronary artery calcium scores uh and that's the disease we're concerned about let's get the test to look for it directly love it and what tell us the pros and cons and when and what clinical situation you would order a CAC scan versus a CT angiogram of the heart uh what are the strengths and weaknesses of those two tests yeah so the um you know the disadvantage of the CAC scan is it only shows calcified plaque and we know that you can have non-calcified plaque uh so you're not going to see that on the CAC scan uh you'll see that on a CT angiogram and the drawback of the CT angiogram is that it you need to get you know you need to have dye injected uh it's a more expensive test it has more radiation uh involved than the CAC scan so typically if I'm just screening if I just want to know if the patient has any evidence of heart disease I'm going to start with a CAC scan now if I have a reason to be concerned that someone already has significant heart disease and I really want to know what's going on in those blood vessels that's when I'm going to get the CT angiogram so this may be because of patients having symptoms like the earlier questioner or this may be because we got the CAC scan and it shows that the patient has you know moderate or severe calcification and now we've got to get a better picture to really see what's going on there what else in closing dock what else do you want everybody out there to know to want them to consider want them to ask their doctor at the next follow-up visit give us kind of a summation of of how we should be thinking about heart disease going into the future yeah I think you know the the questions we've been talking about uh are the ones that you should be asking your doctors more and more you know why aren't you talking to me about insulin resistance uh why are you only focused on cholesterol we just have to advocate for our health you know you can't be passive about your health uh you you need to take an active role uh you can't depend on your your doctors and it's not because your doctors are bad people it's because your doctors are overworked overwhelmed and trapped in a system that isn't focused on keeping you healthy the only one that's going to be focused on keeping you healthy is you uh so you have to advocate for yourself uh you know sometimes that's going to take some work you know your local doctor may not be the best option for you you might have to travel you might have to get online uh your insurance company might not pay for some of these things sometimes but that's a worthwhile investment in your health uh so uh be your own Advocate is really the message uh that I emphasize to people yeah I totally agree with that and I I love how you put that don't think of oh my insurance doesn't cover that test therefore I'm not even going to consider it because that's an unnecessary expense uh if you think that your insurance company is the best gauge of whether something is an expense or an investment you my friend are deluded any of this testing that we've talked about today if your insurance doesn't cover that that is not an expense that is an investment in your current health and your future health absolutely save up the money borrow the money don't steal the money that's not nice but you got it you got to have these tests checked because knowing this not only uncovers perhaps hidden disease but it also uncovers the false Paradigm that your doctor may be practicing under uh just like the CGM many people if you don't have type 2 diabetes your insurance is not going to pay for that you need a CGM for a few weeks and not only for your for your own self you go oh my God I thought oatmeal with bananas I thought that was one of the Ultimate Health Foods in the world but every time I eat that my blood sugar goes to 200. not only did Dr ovadia and I want you to know that we also want you to tell your doctor that because your doctor is probably deluded as well but when enough patients go back to them and say Doc I I spent the money for a CGM and I found out every time I eat oatmeal and bananas my blood sugar goes to 200. is that healthy how's that how's that possibly good for me the first time your doctor hears that they'll think well you're just an outlier or a kook you're just crazy I don't know but when they've heard that 10 20 30 times that's going to shake their current paradigm and make them go well I don't know why this is happening to all these people I I swear I thought that was a healthy breakfast I thought that Fruit Loops and Reese's Puffs cereal were healthy breakfast because the the one of the preeminent schools of nutrition in the world Tufts said it's okay it's a green light to eat Reese's Puffs every single damn morning but when my patients do it their blood sugar goes over 200. so there's something dead in Denmark here something's rotten something stinks I don't understand what's going on but I need to put my student hat back on because I used to be a good student back in medical school that's how I got through I need to put my studio head back on and I need to start investigating what's going on here because SAR did you guys have that when you're in residency uh the act it means ain't right at any time you didn't know it was wrong but something was wrong you're like ah SAR right there we gotta we gotta figure this out so SAR docs if if this food that's get a green light from Tufts is making people's blood sugar go over 200 SAR you got to look into that and if you haven't looked into that then are you truly doing your job as a doctor Dr ovadia man it is always a pleasure to talk with you um in case people watching this don't know Dr ovadi and I both went to Costa Rica uh we were experts at the recent reversed carnivore Edition that is coming out sometime in the future we don't know when and we don't know where so don't ask us when we find out we'll announce it but we were down there with a great panel of experts and some wonderful people in Costa Rica talking about a carnivore diet any parting words doctor no just uh great being with you here Ken uh you know great uh being a partner with you on this Mission uh some other real exciting things that we're working on that aren't quite ready for announcement yet but we'll be coming soon and uh just uh I encourage everyone out there to you know Take Back Control of their health and uh find the support of docs like like Ken and myself uh to help you in that absolutely and you can find Dr ovadia at iFix Hearts I think that's his handle on all social media and I'm gonna post a link to his book stay off my operating table uh that you can get at I'll have an Amazon link but you can get it at any bookstore there's also an audible of his book for people with ADHD like myself who have to be doing something while they read a book Dr Philip ovadia thank you it's an honor and a pleasure I'll see you next time

Channel: KenDBerryMD

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Id: FT18fL9OopQ

Length: 73min 4sec (4384 seconds)

Published: Fri Apr 14 2023