Ketosis v. Plant-Based - Diet Wars with Cardiologist Joel Kahn, MD

[Music] all right joel khan i think this is your third appearance on the podcast but it's been a while yeah it's been i don't know the numbers probably two years right you came to a hotel in l.a and then once i came to your right that first time that had to be four years ago yeah he was like maybe number 38 don't quote me on that but it was pretty early and congrats on the thank you book number five comes out tomorrow right last week oh it did oh cool awesome man january one you've written like four books fifth book five books wow that's amazing well we're going to get into it yeah that's no problem all right i have no time cool go long set a record i'll do tim ferriss whatever yeah joe rogan will you cry for me yeah it was powerful i'll cry um good well i'm excited to uh to reprise uh our ongoing conversation and i think a good way to kind of get into this is to kind of canvas what's going on right now in the conversation around nutrition at large because i feel like and i know you agree there is a war afoot for hearts and minds and the battle lines seem to have been drawn and on the one side we have the ascending popularity of the low carb high fat slash ketogenic slash intermittent fasting camp and amongst the proponents of that uh philosophy or approach to nutrition we have people like uh dr rasim malhortza cardiologist yes we have professor tim knox we have gary taubs we have robert lustig people like mark sisson dr mercola on the other side we have the plant-based camp we have yourself leading the charge and at the tip of that spear also we have garth davis we have dr michael greger we have dr dean ornish dr esselstyn dr michael clapper milton mills a whole bunch of other people i'm sure i'm forgetting but this seems to be kind of where things are at in the current dialogue or debate around what is the optimal way to eat right and you have been pretty vociferous and active in terms of your blogging and television appearances and books and you know your stuff i don't know where you find the time to write all these blog posts mind body green and on thrive global and medium everywhere i look every other day i get a text or an email from you new post up so you're very active in trying to uh you know communicate and participate in this dialogue so how do you see things now uh you know what's going on yeah i agree with you and um you know that's the list you read and the two sides of which there's many you know great luminaries robert osfield cardiologists right many others so many others if i start naming them then i'm going to forget that i definitely would add neenah titles on the dark side for sure a big fat surprise um it's very confusing i think forget the most important topic which is where's the truth in the discussion for human health and human well-being and longevity and joy and freedom for medication and need for medical procedures which is really the real issue as close as we can get to knowing the answer that that is the best service we're going to be doing to ourselves our family and the public um it is a ugly ugly um situation that's very polarized yet there is middle ground and i mean i don't want to you know begin at the ending but the the thing i'll acknowledge if you go back to lauren cordain and the paleo diet book which frankly if most plant-based people read it they'd say i agree 90 of this book and is the shunning of piper processed fast food the thing that's decimating the health of the western world both camps will agree um are exited although i'll say of course our junk food vegans that have confused both the mission and the argument we have that this is a very healthy lifestyle and the other side has confused it by reintroducing dairy and bringing butter back and now you know even cheese when originally that was never a part of the low carb high fat and certainly paleo today yeah paleo shoot dairy ultimately they shoot dairy but now you know depending on you know what version of that um all of a sudden goat cheese is back and goat milk back and certainly butter is back in various versions so i mean the common ground i had the opportunity about uh a few months ago to go over to googleplex in mountain view and it was arranged via kip anderson and there was a conversation in front of a a hundred of the google uh young people but beamed all over google worldwide and the the conversation they set up for us was these are real people real health issues real health concerns real goals don't just have a fight and leave them confused because what does the public do when they're confused they do whatever the heck they want and that's the point i wanted to make um we are we are left with this polarized discussion that leads most people and very intelligent people and people even in this sector of the health world and the food world and the medical world to say you guys are so disparate i moderation everything i'll do whatever i want and that's unfortunately not serving us well so i'd rather highlight you know the common ground which is none of us are into excess sugar we can define none or low but none of us are index is sugar none of us are into fast food i don't know that anybody on their side or outside is talking about eating fried food with any regularity i mean they're not big into bacon and i don't think they did they'd advocate hot dogs and salami and bologna and obviously that's not even on our menu uh which is all in advance i mean so that and then you know a lot of leafy greens i would not stop at leafy greens i'd go into lots of fruits and lots of root vegetables and starchy vegetables but i mean maybe the first step is for all united parties to say you know school kids hospital patients airports vending people in the workplace whether they're of low socioeconomic high socioeconomic we need to get this junk out which is a you know a a an impossible job when you got wendy's and uh kfc and mcdonald's and you know these gigantic multi-billion dollar conglomerates that i think you know it'll take 10 years and they'll be doing a better job not a perfect job anyways there is a lot of commonality yet you're absolutely right i wake up every morning after a few minutes of gratitude and spend a few minutes perusing the internet what's new overnight and i kind of have my sequence to go through and it's either a hot new article on ketogenic or it's a hot new article usually about another vegan restaurant opening in london or somewhere but they're very they're very separate and there isn't much uh discussion this google talk with dave asprey of the bulletproof nutrition group and kip anderson myself was one you know one of the rare times you're not going to see you talking at paleo fx or me being invited to uh going to the lines then so i look forward to that happening i think without doubt we have science on our side and we can you know that's always my touchstone uh recognizing it's very hard to parse out there's deficiencies we don't have large randomized studies in many of these topics do we know enough to talk about what is the optimal diet for the human species and we do and it's much more weighted towards our choice of diet even if you just talk nutrition take away the environment take away animal rights just talk nutrition we are on the right path and i mean i'm emboldened by that by some recent scientists who've come out kind of independently with no axe to grind that the diet you feed your family rich the diet i feed my family and in my restaurant in detroit um the public will be able to identify that this is where they need to move towards uh even though all this confusion exists well i think it's happening i mean the ascendancy of just plant-based awareness in the last couple years alone has been pretty dramatic and and i think it's showing indications that it's not a fad that it is here to stay and it's building and that's really cool um you know but there is this debate the debate gets very emotional it gets heated and that's the spirit in which i pulled up youtube and decided to watch your your event at google with you and kip and dave and i had i guess i had a preconceived idea that it was going to devolve into not mudslinging but kind of get a little bit heated in that regard and i was quite pleasantly surprised to find that that was not the case um you were kind of the peacemaker i felt like but i found dave to be pretty amenable to almost everything that you were saying i mean kipp and him you know kind of butted heads a little bit over some of the environmental stuff but overall i find you i found you guys coming to uh you know a common sense ability on most of the top shelf big ticket items yeah i agree and um that was set up as please try and give us practical and important tips again this wasn't hollywood and a tv show where you know ugliness can be quite successful in terms of a marketing strategy this was you know real people needing real advice and you know i don't agree with a lot of what dave asprey does and talks about um and there's you know no science that he's produced that can support butter in your coffee and and his experience in tibet with yak uh tea and all the i think nonsense that uh all that story is and you know how the public loves a great story but um but when you talk about a diet very high in cruciferous vegetables and whole foods and uh absent excess sugar and absent you know junk food i mean there is that uh i would eat at his house he would in my house in fact the untold story there is when we went to the google cafeteria after that hour-long talk and we were catching in the last 10 minutes he had the toughest time of all of us i mean kip and i had no problem eating there but we're trying to find something yeah fine fine you know everything that met his list was tougher to me than ours and in fact he found a big plate um i think it was just greens and he always carries mct oil of his own derivation um and it was like he was the most uh orthodox uh kosher of the group kind of impression because he puts as i said these we are all teaching rather unfortunately now i would i call it elitist diets i mean we i don't know how many people we speak to do we speak to 10 of america sorry and i just knocked saying over on your desk and my little uh yeah you have a yoga a soldier as a yoga yeah it is of course you know how many are we talking to but um you know i hope we can expand the conversation and uh and reach out to you know close to 100 percent when the right thing to do is easy thing to do when mcdonald's has healthy options when you know schools and hospitals have healthy options i think the food industry is like a bright light of what's going on they're ignoring this debate and just putting more and more you know healthier options plant-based options out there but yeah it was a it was a good experience there was the other backstory just to make your audience laugh is i still use my aol email so i know i'm the only speaker ever to be invited to an at google talks who set it all up via my aol i have gmail accounts i just like uh i like the appearance of aol and and then that's reviews and i of course i asked him do you still use yeah well yeah a surprising number of closet people like me i think they should just rename it aold because if you're old enough to have one just be proud of your seniority card aold and um and the the the final retribution was that they were supposed to post that talk uh the day it happened it took them six weeks they had a youtube flaw and they were you know they kept apologizing and i kept responding in my aol email well i'm pretty high tech care i'll just be patient and wait they ultimately got it up to youtube but um you know but but it is the uh you know in silicon valley where we have this discussion i mean business insider magazine and such the ketogenic diet is very popular right now the idea that uh really strictly eliminating carbs of and we always have to be careful in the definition carbs are you know plants have food has usually carbs protein and fat in almost every food until you refine it the coconut has all those and and olive has all those once you refine it you may end up with only fat so all foods have the three macronutrients i don't think there's any exception to that maybe different percentages so a low-carb diet of course many of them continue to eat a decent amount of greens in their diet but they're eliminating all the whites and they're hyper vigilant about it the big difference in the ketogenic diet are you doing high fat low carb low protein which you can talk about and with a plant-based approach may actually have some benefit in science or are you doing a low carb high fat and high protein diet which probably ages you quicker than any other diet on the planet and that isn't always parsed out in their conversation so the scary skeleton in the ketogenic diet closet is you'll lose weight you may have some boost in energy for a period of time you may be increasing your mortality risk um and they just don't talk about that with great regularity so it's a it's a difficult diet and i think dave ashby trying to eat in the google i i don't know that he'd want to be cornered as a ketogenic diet proponent he has his brand bulletproof diet but you know the difficulty he had my patients telling me this is you know on the road it's easier to be plant-based than it is to eat a strict ketogenic diet right now of you know high-fat options you're going to have to carry around your own food but the gravest concern is is it a healthy pattern is there any natural population and even slightly approaches it and has done well long term kind of a bullet shot at the plant-based movement show me a society that's been plant-based for centuries and has thrived that's one of nina's big points big points but show me a community that's you can talk about eskimos in the messiah who lived to age 30 or 40 well that's not kind of the example we're talking about show a okinawa type population that was 90 plus plant-based and thrive great we have our our example that approximates the way we eat uh they have great difficulty with that in fact the scientific data is it's the converse that they are at risk shortening their lifespan if it's an animal-based low-carb diet particularly if they're emphasizing foods that they feel are high in protein which are typically going to be meats of a variety of kinds no matter whether it's grass-fed or not it's the basic constitution of animal muscle that can age you excessively and the science is well known so a couple observations on that uh first with respect to the the degree of difficulty of maintaining a ketogenic diet it's an interesting um thing to talk about because you're right like to actually do a ketogenic diet properly requires an incredible amount of like a forethought and planning and displacement it's not easy to really dial that in and make it work compared to a plant-based diet and yet i feel like the plant-based diet gets unduly criticized for being restrictive and too difficult and something that people are just never going to be able to maintain long-term despite the fact that both of us have done that but people are very quick to jump on the ketogenic bandwagon and try it with enthusiasm without that same concern being applied yeah i agree completely you know just a couple examples there's uh joe rogan had a surgeon on um shawn baker and i don't know sean baker very well we go at each other a little bit on twitter and he said very you know casually even he's an md i've done and the ultimate example of these diets is there's a whole group of people eating nothing but meat three meals a day and literally nothing but meat and for reasons i don't completely understand carnivore guy yeah and he's one of many i mean he's not the only one that shows up there they can claim short term some pretty impressive pictures of their abs and weight and some of them have some heart ct data of course there's nothing published in the literature i want to come back to that but you know dr baker said i didn't even bother to check my labs joe hogan said you've been doing this for a year he goes no i didn't check my labs well i have patients that do that and they get their labs checked not under my advice and i have one that i'm going to write up maybe on the airplane flight back to detroit later uh this evening um his cholesterol went from two i've never seen this 250 to 750. during the two months he did a meat only diet trying to approximate what he was hearing on these you know rogue not rogan kind of podcasts um and it's insanity and it's it's like religious fervor and uh follow the leader without thoughtfulness um the only medical condition that has any data everybody can verify this pubmed.com put in ketogenic diet refractory epilepsy in children and some degree adults have a number i mean several dozen published studies on a impact if standard drugs like dilating don't work and in fact before dylan ketogenic diet was a reasonable choice for kids with epilepsy as soon as drugs came out it kind of faded off and has come back for that use daniel aymond very famous local psychiatrist and a friend has a grandson that had refractory seizures rather sadly and ironically ketogenic diet was very beneficial you go beyond that you're just you're you're absent data so another startup that's hot and it's worth talking about because your listeners will hear this is verta health backed by stephen finney md i don't know much about him he appeared in dr malhotra's documentary about visiting the home of ansel keys one of the most distorted and misleading documentaries ever done called the the peop diet pio ppi don't read it don't watch it it's a waste time money and honesty but virta health claims with a ketogenic diet that you can reverse your type 2 diabetes with a high frequency and they've got a lot of backing and they've got an app and they've got you know a coaching system so they have published a study in a journal that is so obscure and so non-reputable but it is a journal which is a proliferation of scientific journals that are open and you can either pay to publish an article or get access but it's a small study of six months duration actually originally 10 weeks duration non-randomized no control group in the scientific world this is about as low as it goes and yes with the dietary plan they advocated very high dropout rate in the group studied they showed some drop in measures of diabetic control towards the better with their ketogenic diet coaching system and on that i speak to like brilliant people and they say well the debate's over virta health has shown that ketogenic diet can solve multiple health problems it's so overblown and in fact what's missing is the six seven studies that suggest to get to the point big studies hundreds of thousands of people these are association studies group of people ate a certain way questionnaires food questionnaires once food questionnaires several times during a number of years follow these people up harvard school public health tough school nutrition very prominent places a dramatic rise in long-term mortality by people's whose food pattern it can be called a low carb high fat diet a rise in death rate if you've had a heart attack and you fill out questionnaires at the harvard school public health and they follow you long term and your diet can be described as a low carb high fat diet you're much more likely to die and follow up than people that describe diets that are closer to high carb hopefully complex plant choices though these aren't vegans you know more like a mediterranean style diet so that's the untold story for anybody listening and it's falling for this optimization of performance and metabolism and control of cardiovascular risk the data needs to be addressed about death rate and until there's a study that resolves that issue and and says that's wrong six seven different studies in different parts of the world i could not in any good conscience advise somebody do a animal-based low-carb ketogenic pattern particularly if it's high in protein protein activates aging pathways protein activates biochemical pathways that right here in the city of the angels have been found from yeast to mice to humans to cause accelerated aging and aging in every aspect of our body and it is animal protein rich in an amino acid called leucine is the main trigger and you can't get around it grass-fed beef free-range chicken and lime caught fish all have tremendously more leucine than the amino acid acid structure of plants they have it but they don't have near the same amount so when you raise those concerns and those issues and make those points what is the resource um association is not causation you know so what i've done a few times is take the argument that particularly nina teichels the author of the big fat surprise number one nonfiction book in the health arena in 2014 and to this day still celebrated as some kind of heavenly light that the nutrition world has accepted as despite absence of phds or nutritional science backgrounds and she'd argue you don't need those things you just need to study lots of people talk nutrition that don't necessarily have mds phds rd's and all the rest has been accepted to the point in late 2017 the british medical journal lancet one of the most respected and wrote a review of her 2014 book three years later as if it had just come out as if it was novel praised it as if she had bought an ad in the leading medical journal in the uk it's it's just insanity so she will argue and dissected the movie what the health and first what things she did and i'll get back to you this is the answer question i don't remember it was 39 major health claims made in the movie what the hell she threw 37 of them away because either dr bernard dr greger myself dr uh mills uh and all vegan doctors can't be trusted to give credible medical research summaries because we're biased so she that was one of her rules she has a second rule a statistical role if the risk described in a if if you drop your risk of diabetes by less than 50 it's not strong statistical data and and so she only was willing to give us one or two of the claims in the movie what the health is possibly scientifically valid of course anything that is association not causation you have to do like a randomized study and understand the basic mechanism so i've gone to some of the um ketogenic data and a study called the pure study that really confused the world in late 2017. said let's apply nina's rules okay dr saleem yusuf the lead author eats meat so we have to throw him out anything he's you know it becomes farcical i mean i i and i've said this public and i'd say it again the day that dean ornish does a randomized study that says heart artery blockage reverses with beef chicken and you know and pork my obligation as a cardiologist is probably to advise a patient there's new data that's credible and you should consider even though it kills me and it kills the animals and it's bad for the environment it's it's not the case and um and we didn't we don't need to go down that path so what did they say association not causation vegan doctors uh weak data um or they don't respond um because they have their events and as you've pointed out with other people who've interviewed they seem a little more organized and a little more manly and a little more vibrant but i think we're coming on strong in the medical health plant-based world with hunky people like you and scott stoll former olympic athlete and such the uh the contention the argument that no uh no medical authority no doctor who is a long time vegan or plant-based person can be trusted or is inherently conflicted because of that point of view and and as such you know their perspective or their opinion on all of these issues should be invalidated is uh disingenuous because that the level of of investment that the other side has in their own movement is equal if not you know if if not more entrenched so if you're going to apply that rule um you know equally it would just eradicate everybody but human beings were you know we we flock to our tribes right we inherently want to be a member of a team and that doesn't necessarily serve anybody and once we become entrenched whether you're plant-based ketogenic whatever it becomes more and more difficult to be objective like i'd like to think like yourself if evidence came out that what i was the way i was eating and living was harmful to myself or to the planet or anything else that i would have the objectivity to then really look at that take ownership of that and and make changes in my life yeah so um would i i don't know yeah like people would say well i'm so you know this is my brand now there's no way that i could ever you know there is that i mean that's you know watching when what the health came out and there was a lot of praise for the movie for about two weeks and then those that have a following have to respond i mean they have to and and what the health we should get into that because i think that documentary really has crystallized this argument because a lot of these media opportunities whether it's you at google you know garth davis on the doctors these things that are happening are a result of that documentary which is creating this this debate and so in the wake like you were i can just finish your sentence like in the wake of of the acclaim or the attention that that documentary garnered there was a backlash that that sort of hit with quite a bit of severity yeah there absolutely was and you know maybe some were offended by statements in the movie but i think a lot of it was the obligation you're in a corner that says animal products are healthy grass-fed is good uh it's better for the environment because animals pooping restores the f the soil all kinds of crazy statements and yeah there was one after another whether it's dave asprey whether it's nina taiko's whether it's the diet doctor whether it's um on and on david perlmutter they all had a voice in and you know the movie took some hits um although they were largely inauthentic and easily answered as i did in a blog i wrote um to some degree um i actually was pleased to see just yesterday morning there was a review of the movie i mean it's seven months later why people are reviewing it like it's a new movie very positive um yeah but that that has done a lot to raise the conversation and we can come back to what the hell i just want to say one of the i think breakthroughs that your audience i would imagine doesn't know and a person that i would put as one of the highlights in 2017 i call the new friend is right here in los angeles you have at usc something called the institute of biogerontology a research institute about aging in fact there's a word juvenology the study of remaining youthful juvenile youthful we should all be juvenologists uh vegan juveniles we probably are and that's all led by a italian-born scientist walter longo phd who came to the united states at age 16 to be a blues jazz guitarist from genoa spoke no english but could blow some riffs on his guitar in the chicago bars but by age 19 was fascinated that he never saw disease in his family in italy and he was living in chicago and his relatives were getting sick and bloated and he had the foresight he's 50 years old now uh so whatever it was 31 years ago to say this nutrition stuff this aging stuff this is more meaningful than becoming a jazz guitarist and he totally shifted his career went to texas and then went to l.a and got a phd with some very famous calorie restriction longevity experts at ucla and then he set up his lab at usc and anybody can go read about him he's one of the most fascinating incredible authentic nobel prize nominated scientist last year at age 49 came in second it's called the jubilee award because the same field he concentrates on was also being studied by some 90 year old scientists in japan and they gave it to the uh to the scientists that you know had been in the field a little longer he will win a nobel prize but he has kind of risen to the light um as a unbiased i think a spokesman for clarity saying you can't judge nutri he go number one don't outsource your nutrition to amateurs is the example he gives if your neighbor's an engineer an automobile engineer in detroit you're not going to go flying an airplane they need design between detroit and new york i mean get a professional to build that plane don't outsource your nutrition to amateurs and base any evaluation nutrition on what he calls five pillars one pillar's basic basic science which he is the leading world scientist on many of these aspects what does sugar in the diet do to basic pathways and the answer is it's not very healthy for us what does animal protein do to basic pathways the answer is it activates aging and cancer promoting pathways called mtor called pka ras sertuan pathways he's he's a superb scientist so you've got your basic science you've got your association studies epidemiology flawed but you can't ignore them you've got centenarian studies i mean if you've got a diet ketogenic diet let's find a population in the world that's living to their 90s and 100 and climbing mountaintops and eats anything that could be called approximating that the way it's being described by these meat-eating uh you know bloggers nutritious it doesn't exist it does exist in okinawa and other places loma linda where we have many examples that approximate the diet weed i mean let's talk about randomized studies which are pretty uncommon but let's include those and there's a fifth pillar i don't really remember right now his book came out a week ago and he concludes you know that in about one paragraph you can just slash away what is commonly done in the paleo and the low carb high fat ketogenic diet as an extremely dangerous age-accelerating high mortality eating pattern if done with animal products and if done chronically and he concludes we should all be eating and he's not a member of our you know traditional vegan community he concludes we should be eating whole food plant-based enjoy life have a little wine if you want have a little sugar if you want um he likes fish one or two times a week he says in a very broken english or not so broken vegan fish i'm a vegan fish eater um and he grew up on the coast of genoa and maybe it's a little bit of that a little bit of science uh a lot of us have concern about fish and it's toxicity and fish and it's the population of the oceans and there's arguments there but you know knowing that this shining light future nobel laureate has parsed through this and challenges this other side who don't even know that his argument is this profound five pillar assessment nutrition and really there's maybe five people in the world can really say i've done all these studies and this is my conclusion dr longo is one of them is i think just a tremendous uh way that people so conflicted and confused in the public can say i need somebody to listen to so go read the longevity diet by dr longo after you read your new edition and my book and uh you won't be confused anymore yeah you just showed me that book i gotta get that guy on the podcast i can help you with that he's um he's a high energy he still plays a mean mean jazz guitar maybe you can get him to uh to bring it here and have a little fun i mean he lives by lax and uh i i can work hard to set that up in fact if you'll interview him about his book i can guarantee you it'll happen oh yeah absolutely so let me ask you this then and i don't want to go two down can somebody who eats fish two times a week be a guest on your back yes yeah okay of course coco i have an opening um what is it about eating meat or animal protein specifically that causes the aging like what is his thesis on that or what is this yeah and you know i'll go short so you can go longo with longo um it's kind of funny the world's leading expert in longevity is named longo of course you know dr toothacher yeah right right right dr smelzy the foot doctor uh we have a urologist in detroit whose name is rod stiff and that could not be true it would not be a better name for your eyes it's really his name i trained with him pity that guy growing up i think it's your best calling card um but there he didn't have a choice in what he was going to become yeah absolutely um so the basic tenet is he he's used besides the word juvenology the study of uh anti-aging or staying youthful in life staying useful in your brain and activity um in other words nutratech nutratechnology that um you can use food to activate pathways that either lead to healing regeneration rejuvenation stem cell production or you can use food that activates pathways so there's a pathway called mtor mammalian target of rapamycin pretty sciency term um rapamycin was from i think easter island rapua island and they found this fungus that makes this molecule that um has actually therapeutic benefit it's used in transplant patients mtor but you need um when you um when you're growing you need your growth hormone when you're a child you need growth hormone there's a receptor in cells for growth hormone and when you eat animal-based protein products growth hormone is activated leads down the path to maybe something you've heard about igf-1 insulin like growth factor one great thing when you're growing great thing to maybe you're 18 or 20. but eating animal products particularly with this amino acid leucine continue to trigger the growth hormone down through the igf-1 pathway and you know we don't want too much cell growth when you're 45 50 55 because we got these little cells that are uh waiting to transform into a line of cancer um and uh and and leucine is in meat it doesn't matter grass-fed doesn't matter if it's uh free range it's in meat much more you're going to find it in beans and greens sugar will activate other pathways uh it's called the pka pathway so diets and you know nobody in the health field i think is a fan of sugar and nobody espouses it that became a debate about the what the health movie uh certainly dr barnard and dr davis were not advocating high sugar diets but uh it's a different kind of topic about sugar and the development of type 2 diabetes um and then there are some other so this so you can create a diet low in sugar low in um uh animal-based amino acids like leucine uh low in protein and what they've shown in humans so what dr longo did that's fascinating is when he started his career about 25 years ago or so they were studying a lot of mouse models still pretty complex even though it's a lot less of a of a mammal than the human he went backwards to yeast single simple cell yeast and said this will allow me a model to study and nobody knew the word mtor or this these terms i used and he's the one that identified these pathways that are now known to be fundamental in aging healing generation this field of juvenology and it turns out the reason that his science has been so uh mind-blowing is these pathways in a yeast are completely preserved in the human species so what he found in the single cell organism is the same biochemistry that's occurring in your my cell right now and it has profound dietary implications so he went on like i said these five pillars that was some of the basic biochemistry and i think it's october 1 2016 a study was published in a major journal jama internal medicine take six 000 free range adults do very careful assessments high animal protein eating free range adults have a high mortality rate low animal protein eating adults have a low mortality rate that's a very profound statement those that eat a lot of vegetable based protein didn't have that relationship whether they were low or high they had a survival advantage over the meat eating group but high protein diets accelerate aging through these biochemical pathways cell death our inability to clear damaged cells out that's called autophagy that won the nobel prize that dr longo came in second on um vegetable protein doesn't seem to activate it there is in just to finish that conversation as adults get over age 65 or 70 protein becomes a more important nutrient to sustain their health long term so dr longo and some other experts because you lose muscle mass you don't want to be a frail a muscle depleted elderly person you'll be very prone to ammonia infection and other things falling breaking bones so you want to emphasize and i would say just emphasize vegetable protein your whole life eat beans eat greens he nuts eat seeds eat whole grains because you're going to be in the sector where this accelerated aging phenomenon doesn't exist so fancy stuff but it's led to and that that nutrient technology that nutrient sensing pathways high animal protein activates his aging through biochemistry it's well described i don't know how many rabbit pests i can go down there's there are these people in ecuador call um called the laurent israeli scientist v leron described these people 40 years ago they had their cells lack the receptor for growth hormone so their body their their brain produces growth hormone their cells can't respond to it so they're very short people because their cells are deficient in growth hormone they have unbelievably low igf-1 levels their whole life and there's nearly and now a scientist in ecuador amy guevaras and dr longo goes down to ecuador now all the time has described these people do not get type 2 diabetes these people do not get cancer at a rate unbelievably less than the general population of ecuador so all these pathways is just another piece of those five pillars we can do that with food when we we can eat a diet that is naturally low in producing levels of igf-1 when we eliminate dairy when animal protein and emphasize the diet you and i eat we're eating a longevity diet which is exciting to know and that the body of science is profound on that and it's totally totally missed by our carn carne eating carnivorous friends with loud voices yeah and just on an anecdotal level or a population studies type sociological survey of the situation it's pretty self-evident when you look at the work that that dan buettner has done with the black zones like you just look at these cultures look at how they're living look what they're eating right look at their their social you know structure their social their community-based you know way of life and these are the people that are living the longest they tend to be the people that are the most content and fulfilled in their lives and it's almost to me like i don't i don't need the inquiry to go much further than that but it's good to know that there are studies out there that i've never heard about the this ecuadorian population that's fascinating it really is and it's it's the layers of support for what you've chosen to do with your life and your career and what i've chosen to do with my cardiology practice and career is profoundly more established than the general public believes and i really do believe dr longo if that voice is heard is going to do a lot to clarify i was with some business people in los angeles this morning extremely intelligent people in the organic uh not food world but organic world of uh consumer products and they threw up their hands and they said we're totally confused guide us and you know and these are you know so what the rank and file doing with this issue either not paying attention which i can understand there's other issues in life when your paycheck is is an issue and or they're just uh throwing their hands up like everybody says moderation everything i'll do what i want which is a very dangerous statement to make for health it seems to me that this current divide in philosophies around diet nutrition etc can be tracked back to uh the debate that that occurred in the 70s between sugar and fat and the kind of high carb uh or not high carb uh high fat low carb community will point to the sugar industry as the culprit who sort of conspired for lack of a better term to point the finger at fat as being you know the evil you know the the evil contributor to to poor health at the time which led to our 1970s you know low-fat craze and this camp will say that that that actually contributed to our obesity epidemic when in fact sugar was what we should have been looking at all along so can you say i have i have my own opinions on this but can you share your perspective on that yeah and i'll reference first of all was that an accurate um yeah i i i think we covered a little bit of this and then we did i think talk about dr ansel keys on the last time we chatted with you so we've sort of been to i don't want to come out early down there he was taken down his amazing work was taken down and you were trying to explain like right so what we've learned since then rather shockingly and i think it's it appears to be real as three researchers at harvard in 1965 wrote an article a two-part article in new england journal medicine i've actually tried to read the article it's such dense science maybe a thousand people in the world ever read it this wasn't an article that you know got headlines it was an article that influenced um a lot of rank and file people at all but nonetheless uh some researchers found some records that those three researchers took about five thousand dollars a piece from the sugar industry which might translate to fifty thousand dollars nowadays in terms of uh equivalent uh economic value to perhaps bias the conclusion of this extremely dense scientific article um towards favoring anything other than sugar being a health issue for biochemistry of the human condition one of them a guy named david hegested was a peer of ansel keys not a co-researcher and was the head of the nutrition department at harvard and you know shines poorly but has been exploded to say all research all researchers dr ansel keys everybody involved with the american heart association everybody's in the same situation as if everybody was a hashtag me too you know across the board every guy is in the same boat i mean that's unfair everybody gets to live their life and judge and have authentic uh hopefully uh careers and all so it's been overblown i think it's a very small drop in the bucket of a larger issue um again bringing it back to what we're just talking about i mean uh sugar as a when this uh there is a statement as anybody who's seen the documentary what the health knows by dr neil barnard sugar doesn't cause type 2 diabetes um it's it's the fat and garth davis gets in the topic so i had to dig into that a bit and it's relevant to what you just asked because i'm just a humble cardiologist advising patients putting in stents i'm not an endocrinologist and you know frankly i traveled to the website of the american diabetes association a little button there says myths about type 2 diabetes we used to call it adult diabetes but kids are getting it now and the first myth they expose sugar causes type 2 diabetes myth that's american diabetes association that's what neil barnard just said went to the joslin diabetes center website which is out of boston same exact statement myth it's not the case the a the diabetic association of the uk same exact response so i actually you know felt that i didn't have too much doubt that neil answered appropriate based on the science but i called up a guy named gerald shulman he's the head of endocrinology at yale he's from detroit he speaks at wayne state university the medical school that i'm a faculty member of quite often and i discussed this with him and he said just to put it all together he goes calorie excess causes type 2 diabetes americans eat 800 calories a day more than they used to on average you don't i don't i mean some people are eating 1500 calories a day more than they did in 1970. most of that is processed food rich in processed oils sugars refined grains it's a whole gamut if you actually designed a diet that you ate so much excess sugar that you packed on 25 30 pounds you'd be very likely to develop insulin resistance but it could happen with other diets that were just uh you know uh processed oil and fat heavy it's not specific there's nothing unique about sugar that leads to type 2 diabetes it's it's it's it's deterioration of the american diet and moving away from home-cooked meals garden meals uh the whole you know response we see so um the sugar issue is overblown because it's an easy target now i mean it's not a nutrient that you need to eat it's not to say that sugar is when we're talking about sugar we're talking about refined sugar we're not talking about the sugar in an orange right or an apple but to be clear nobody's saying sugar is a health food you shouldn't be eating refined sugar i mean glucose in your bloodstream is an essential nutrient you don't have glucose you will die and we that sometimes gets confused we're telling sugar and food um you know a study came out in 2017 from china the first author dao or do do you i think it is 600 000 chinese the more whole fruit they ate the lower was a risk of developing type 2 diabetes those that had two type diabetes those that ate the most fruit at the lowest risk of complications of type 2 diabetes dr longo seems a little bit shy on fruit more vegetables less fruit couple three servings a day might be all that you choose to put in your diet i was interested in seeing that but yeah um nutrition is complex but sugar has gotten backlash that is excessive um and what's the message for you know can you enjoy an occasional sweet and an occasional um you know uh deviant from the best that's probably the only error i'd say moderation occasionally is not going to be very harmful with sugar i'd rather you be i'd rather be more meticulous about added fats of animal origin processed oils not whole foods we all agree we all love avocados we all love nuts we love olives uh really without exception i think on top of that uh the idea that the low-fat craze contributed to the obesity epidemic is reductionist and patently false in the sense that it presumes that people actually ended up eating low-fat diets as a result of that kind of edict coming down from on high which is actually not what people were doing there was a proliferation of low-fat and fat-free foods but that doesn't mean that overall if you broke down somebody's daily caloric intake that it ended up being low-fat because this meets the ascension of the processed food landing on the shelves at the grocery stores and a lot of those foods were you know the foods that we ended up binging on yeah absolutely i mean um i agree with you 100 uh dr dean ornish presents data that if you go to the usda and look what happened since about 1970 and on even those advised eat a low-fat diet to protect your heart americans didn't listen the amount of fat in the diet went up as did calories as did refined foods as did sugar we simply ate more of everything the abundance of restaurants and no longer cooking at home and convenience of grocery stores where the middle are packed with grab-and-go kind of items we we shifted our diet in an adverse way there are people that are sugar addicted and just like every other food addiction it's real and are probably best to have extreme care and avoiding added sugars and they're hidden in everything barbecue sauce and dressings and 57 names for sugar that the food industry is allowed to use fructose and corn syrup and maltodextrin and for those that find that eating foods and sugar are just not resonating with their diet i own two restaurants i've had dessert in my restaurants maybe three times in two and a quarter years i just don't go there i'm not addicted but i know it's not you know on my food plate is a very com you know it's not the health group that i'm gonna do very often and i'm there every night or many nights um i i want to point out one of the maybe you can get uh penn gillette on your uh on your podcast of penn teller but he i just finished his book well i'll tell you the connection you you your your neighbor in calabasas juliana hoever can get him to you just had her and rayon recently i mean i didn't uh i haven't put that episode up okay yeah because i think ray ray cronize is one of the most fascinating food thinkers out there now and so yeah so penn gillette in the book presto so i don't know that that book hasn't really hit a lot of people's uh nightstand i hid mine recently and one it's one of the funniest books you'll ever read he's outrageous in these his languages his his laying his chapter on ask me about protein which has more f-bombs did you read the book yeah i read that chapter yeah oh my god is that funny but the whole book's like that and he has a chapter on joel fuhrman and i just was with joel fuhrman in detroit last couple days he didn't know there was a whole chapter on him in even though in some ways it's very very respectful and praiseworthy of the book he to live in joel fuhrman it's penn's nature to make fun of people and change names so uh i tell you he's ordering the book to read it but that experience of a sugar addicted human who had to follow an extreme but also extremely um effective you know ultimate high complex carb sugar-free diet also oil-free diet i mean that's necessary for some people that are battling you know the 130 extra pounds that he was carrying around that was going to kill him and others so yeah the sugar story has been overblown except i wanted to be sensitive to people that really do feel that their physiology is affected and their psyche is affected so just stay away eat fruit and nothing more or don't eat fruit you can survive without fruit let's talk about heart disease you are a cardiologist thank you we should talk about your expertise well we're preventing our discussion we just had is about preventing heart disease we didn't call it the global sense in global sense of course so are we still in a situation where the statistics dictate that one out of every three people will die of heart disease yeah you know there's there's good and bad news the last few weeks the survival of the average u.s citizen went down for the second year in a row now a very small amount opioid addiction opioid deaths got a lot of the headline for it but it's rather distressing with all the progress and what i've seen in my 30-year medical career um and and devices and procedures and all that overall lifespan is going down and you know we live in a very very tough time but that's a bad news cardiovascular disease actually seemed to be a little bit better than the year before it's still number one canada's switched canada cancer's number one cardiovascular disease number two we're we're close but i don't see it uh shying away and yes the cardiologists in me and i was hoping we'd get there i always want to talk about how you can identify silent heart disease so you don't become the statistic i'm trying to think of the last celebrity i keep talking about blake krikorian a very famous investor in l.a he was walking from the beach to his car with a surfboard under his arm about a year ago and age 48 worth 500 million dollars dropped out of an acute heart attack i mean you know i i i feel less bad about the business aspect he had a bunch of little kids uh you know tragedies where there's young children left without usually a father it could be a mother it's just the way the disease goes in your 40s i want everybody to listen to this quote paul dudley white was the cardiologist to md taking care of president eisenhower in the 50s and he said emphatically a heart attack after age 80 is a act of god a heart attack before age 80 is a failure of the medical system he said that in 1955 that we already know the majority of the science what causes heart attacks he had no idea about the technology we have nowadays to identify heart disease early but man a heart attack before age 80 is a failure medical system we've had a completely unsuccessful medical system i can in the next three minutes tell everybody who's listening how to change that outlook for their own health which is critical yeah and we're going to get into that and just as a as a way of launching into that i had our mutual friend kim williams on the podcast a little while back wonderful and yeah what an amazing human being that guy is right and you know one of the things he said that i'm sure you will agree with is that there have been these amazing dramatic um leaps and bounds in the science and technology of how we treat heart disease in the form of stents and medications and surgical procedures and the like that have reduced the mortality rate of people who suffer from this disease but at the same time a blind eye being turned to the actual root cause and how to prevent people from actually getting to the situation where they need all of this absolutely true which is why our initial conversation is what dr dean ornish and even before him uh dr burkett dennis burkett a british physician who uh did amazing nutrition work in africa talked about the faucet that you know if you walked into your bathroom and the sink was overflowing you wouldn't run out and go get mops and towels and address the problem that way you go turn the sink off and deal with the root issue that the sink's overflowing because somebody left the faucet on the medical system is a mop and towel kind of system you've had your heart attack what amazing technology well what about the wendy's in the lobby of the hospital like the hospital i practice at harper university hospital that's a faucet what about wendy's still there it's still there and i've been so successful with my social media campaign they put a chick-fil-a this year next to it and and and i'll give a shout out tonight i'm laughing beaumont hospital in royal oak michigan just contracted with mark wahlberg to put in a wahlburgers at our medical complex which is no better than wendy's although it's got mark's q's face and a lot of the posters um you know when you get government-issued cheese which is basically velveeta and you're serving that to the nurses walking over from the hospital to the strip mall it's it's outrageous so um off the beaten path so that's how you turn off the faucet is everything we talked about but the technology the faucet isn't the same faucet we've got better technology upstream it's always upstream we can um let's talk for a minute maybe you know you've got your notes but i want to talk about like bob harper and what he went through real quick and you know how do you prevent bob harper if he doesn't mind me using him as an example biggest loser fitness trainer age 51 ripped guy in the past always with a green juice in his hand and all and working out at the gym february 2017 drops dead he has a cardiac arrest on the treadmill by the grace of heaven above next to him on the treadmill was a cardiologist and on the wall in front of him was an external defibrillator and within about the shortest time any human could have he's got a trained professional on top of him with the pads that say shock and he came back to life rushed to the hospital i believe he had a stint i haven't actually read that and he was on the ventilator but he's just one lucky dude brain kidneys everything kind of came back and he went on the oz show march or april 2017 and said the obvious question how could you have had a heart attack with all your workouts and muscles and all those years on the biggest lose or so with jd roth and your buddy and all that um and he said i found out i have a genetic kind of cholesterol nobody ever checked called lipoprotein a it's a if you whatever doctor you're seeing the routine cholesterol panel doesn't include that lpa sticky cholesterol lipoprotein a there are three terms for the same molecule costs about 25 dollars to run the blood test normal levels in most labs less than 30. i have dozens of patients whose blood levels are 300 400 500 and it just erodes their arteries and ages their vascular system and it will never show up in a routine physical unless you read you know the new york times recently talking about bob harper blogs i've written thank you bob harper for bringing up the issue there is a lipoprotein a foundation how common is it 63 million americans have elevated lipoprotein a levels 20 of adults it's genetic so you can eat well that's the kicker you you're bob harper you're rich role you're joel khan you got plants you work out you do yoga you got love and happiness in your heart and you got a lipoprotein a level of 400 you still can suffer stroke and heart attack um so that's one way i don't even know like i don't even have myself you haven't had it yeah and you know and i'm 51. yeah and i can you know write you out a blood slip but so can any doctor you know do it you can go to cedar you can go anywhere it's a simple test you don't have to go to any exotic lab um that's upstream that's turning off the faucet because if you're elevated the typical response right now is make sure the rest of your lifestyle is perfect because you've got a genetic risk that can't be dealt with be sure you eat well be sure you meditate be sure your blood pressure cholesterol blood sugar inflammation markers like c-reactive protein make sure everything else is spot-on and that's all valid and important and i think that's the path that bob harper talks about on social media since then um there is a drug investigation statins don't lower lipoprotein a so take them off the uh list for that things like lipitor there is pretty strong data that niacin a b vitamin used at high doses lowers lipoprotein a that's one approach i use in my own clinic my own patients and i can see their levels come down dramatically the science hasn't yet designed a proper study to say that's going to mean somebody's going to be less likely to have a heart attack stroke and live longer because nobody funds a study with a drug like niacin that over the counter in a drugstore costs pennies yeah you can't make any money you can't make any money so just to be clear though if you if you have this lipoprotein a lifestyle diet i'm sure it has some you know has a benefit on your overall health but that is not going to be a uh it won't protect you from that single uh there's there's a supplement company i like that has this dramatic uh poster of the heart and 19 daggers pointing at the heart of which blood pressure cholesterol blood sugar ldl h tail but lipoprotein a is one of those daggers so it won't protect you from that one dagger may you know ameliorate and turn the faucet or slow the faucet from you know 7 or 10 or 12 of the 19 but homocysteine is a blood test an amino acid genetically kind of monitored that you should know and you should check these things cost pennies or a few dollars and many of them like lipoprotein a you do it once you're 400 you got a problem you're four you have no problem and you won't have a problem because it's genetic so that's why i mean that's so how we doing i don't in my 30 years we have cooler stents we can put in heart valves without cracking the chest more and more some places do robotic bypass but we're still filling coronary care in its emergency rooms and operating rooms with procedures that you know from 1990 we know could be prevented 50 60 70 80 percent of the time using dean ornish data and dr esselstyn data but it's frustrating that um we're seeing that being grabbed on to by medical students i'm very encouraged by medical students they are the future so if we wait a generation we may actually get a lot of plant friendly or plant-only doctors in the communities but it's pretty rare right now so just to follow this theme another way to turn that faucet off of people dropping and requiring acute cardiac care is the specialty that kim williams is an expert at there are these cat scans of the heart i'm passionate about this topic you're 51 you should have one uh you don't look 51. i mean that's actually yeah no i've been thinking you know just even then so thinking of you coming over i was like you know i should really get one yeah so there's a great documentary called the widowmaker and everybody can watch it on netflix after they watch what the health at ucsf they designed a cat scan 20 years ago and perfected it it doesn't exist anymore because every standard cat scanner does this now you lie down on a gurney you go in the machine you hold your breath for 10 seconds you go home there's no iv there's no iodine there's a very small amount of radiation from the cat scan equivalent to like a mammogram that a woman has and you get a number are my heart arteries calcified zero is the winning number i wrote a blog called the biggest celebration of the heart calcium score zero because it is that your chance in the next 10 years having a heart attack and in fact the data goes you're it's a sign of aging of the body not just heart arteries your chance having kidney problems cancer brain diseases are extremely low because you have a youthful biochemistry things are working out for you and it's a very complex process to really judge what's your real age i mean you're 51 i'm 58 but internally are we are we 10 years younger than that are we 10 years older calcium score is a measure of true aging of our system and certainly our arteries and if your calcium score is as i have patients 1400 1600 1100 these are very very very degraded arteries with a process that needs to be investigated rarely leads to need for bypass need for stent but is the ability to wrap around all kinds of lifestyle and even more than lifestyle if needed measures so this calcium score in my city cost 70 who doesn't need it you've had a bypass you've had a stent you've had a heart attack you know the answer to the question do you have heart disease you're off the table i don't even think in my practice the ultra healthy um should avoid it because uh it's such a count those 19 daggers have you had all of them measured and assessed not you personally but the public in general no so i don't care where people are listening with chitau kansas and gainesville florida you can get a c-a-c-s corona artery calcium scan no iodine in indiana south bend is 45 you don't need a prescription my state you need a prescription from a doctor and i literally hand these prescriptions out when i give a talk people hear it i'll write them a script because i mean it's it's a service for them to either be reassured that they're doing great and i have patients with a cholesterol 300 calcium score is zero and the stress you take off of them doc so i can get off the prescription drug and really really focus on lifestyle for three months or six months and try and whip this thing but i don't how could you have a a an elevated there's 19 daggers and uh cholesterol has never been the only one and it's always they're more complicated than we want them to be no it's really pretty simple nobody's ever said cholesterol is the only risk factor for heart disease i mean the american heart association picked five back in the 60s smoking diabetes family history blood pressure cholesterol in age kind of factors it's always been you know a complex predictive calculation but this cat scan cuts through all that and says let's get real let's you know take 70 take you know literally a minute and don't risk it if you're the 10 of americans that have extremely high silent heart disease you know how i mean is this somebody that's people is this something that people who are like in their twenties should do like should everybody get quite a certain age where this becomes more relevant i've rarely personally i've ordered thousands and thousands and thousands and thousands of these studies over the years because it's been available in detroit in every major city for 15 years and now even medium-sized cities usually at a hospital doctors don't own cat scanners hospitals have cat scanners so i make no money you know this is not an economic thing this is a plea to turn the faucet off upstream um rarely i mean if i had a 28 year old and his cluster was 600 there are a few you know i might find a reason to do this if they're ekg or something usually it's a test for somebody 40 and up 50 if you're you know great lifestyle 40 45 a whole lot of people have heart attacks in their early 40s that almost always the presence of disease could have been identified the reason you don't hear about it much is not availability it's not cost it's not science 2 000 scientific studies and again dr kim williams is an expert in the field of cat scanning of the heart it's that the ultimate study let's take 5 000 people everybody get a cat scan half will get the results and get a program to try and work on it half will not get the results and let's see if it makes a difference in terms of death or heart attack that kind of study hasn't been done but every study that says let's look at cholesterol or blood pressure or any other measure other than this cat scan the cat scan wins the day as being by far the most accurate which is intuitive because you're actually looking at the heart directly not indirectly so yeah there is some data you've got a lot of uh high level athletes and i'm sure listening um that actually multiple endurance athletic events may actually accelerate calcification and heart arteries it's very confusing i know you've written a little bit about this yeah it's like i'm all i'm almost afraid to read those articles because you know i'm looking we need you around news we know that you know exercise please exercise we know that people that runners live longer than the average american runners-up machine remember jim fix well jim fix ate like a pig he was 52. yeah he was very famous for saying i can eat whatever i want because i exercise so much i don't know if he had lipoprotein a or just a bad diet or a high cholesterol or homocysteine but he had severe advanced three vessel coronary disease at death tragic tragic tragic and then i use that example and now you the other one is winston churchill fats smoked cigars and he doesn't die of heart attack and lives till 92. so if you rely on sensible calculators we screw up terribly the cat scan cuts through all that nonsense the good news about athletes is they are lean they have better blood pressure they tend to have better cholesterol they tend to have better blood sugar but whether ultra endurance exercise is inflammatory whether sometimes the diet isn't as green and clean as yours and how many athletic events end with donuts and pizza and uh and things that uh celebrate the uh the survival of the event but don't really uh uh heal the body um so it's just it's it's it opens a can of worm to be tested and one has to just like any almost genetic testing you have to be resilient and say i'll deal with the data and find the best uh course to take with it but um better to know than not no in the context of in the athlete example is so there's the there's calcification and that's a result of constantly uh submitting your body to so much exercise induced stress that it creates kind of a chronic inflammation problem where you're you're always dealing with trying to recover from these workouts or what is it specifically that is leading to this conclusion well i don't know that the answer is known why are there now probably three dozen studies easily of analysis of heart arteries in ultra athletes and calcification being the easiest thing to measure and it being uh elevated beyond expectation even sometimes elevated beyond people exercising less or not exercising which is rather distressing data don't stop exercising no he's like i'm am i going to stop running now like maybe go back to eating burgers and fries i mean yeah because exercise is another topic is there a sweet spot is is exercise of moderation and everything for the public not for you know the really trained athlete not for the professional athlete not for the one who's passionate but is the message to the public moderation and exercise that um you know i tell people do 10 minutes as opposed to zero because the feeling is if i don't get 60 minutes and it's not worthwhile 10 minutes is worthwhile but back to the issue you're probably not chronically inflamed you're probably acutely inflamed multiple studies say at the end of a marathon if you draw blood on a person presumably healthy a lot of them will show the enzyme that comes from the heart that leaks during heart attacks will be present in the bloodstream of healthy people after a marathon called troponin and in indeed it's stressful um uh is it they were nutritionally depleted as they didn't train adequately and there's some data that those that train more that's less common if you do an mri or an echo of the heart right after a marathon and a lot of these have been done that way actually the right side of the heart's actually a bit dilated and not looking so healthy 24 hours later it looks like it recovered real well but the question is if you do it repeatedly and repeatedly and repeatedly are you uh laying on layers of scar i mean it's so it's not crowning you probably uh are not chronically inflamed uh you're intermittently inflamed from um you know a high level of sustain and we're talking you know the kind of stuff frankly that you do and your friends do not an hour at the gym um it's not but the date is very murky that that still you know let's go to blue zones i mean of course there's not too many ultra athletes in blue zones and there is some sense they're just like perpetual motion but in terms of longevity um and i'd love you to ask dr longo that question when you get them on but um there's no reason to worry people that you're shortening your lifespan you may be calcifying your heart arteries but and it may be a bit of an aging process i mean i think you'd probably agree some of what you do is putting your body under stress and the ultimate of course of it all but uh you know i'm going on record it's great to exercise but don't just because you're a high level athlete not know your label protein and not know your homocysteine not know your c-reactive protein inflammation and don't not spend 70 and get a heart ct scan recognizing you're going to need to dig in and get a little research about what do you do with it if it's abnormal it's it's what i do every day but it's not clear-cut i try and basic on science but just like nutrition maybe we got three pillars not five pillars but do the best we can let's talk about saturated fat okay i feel like i have this conversation every time i have a doctor on this show uh and i'm still trying to get clear on this i know your perspective right and then i look at um you know asim mel hortas how do you say his last name who i've met and seems like a nice guy he's bright guy and he'll say saturn we now know saturated fat has no impact on dietary cholesterol in essence he's saying all this worry about saturated fat is misplaced this is not something you need to concern yourself with respect to cardiovascular disease right true or false false false dangerous um distorted um and instantly gets an international media attention which uh he's very good at um and that in and of itself may be no accident it may be part of the food industry and and such that you know get a cardiologist to write in a journal or do a talk about animal based foods and saturated fat in animal and based foods you know being maligned and actually being healthy will you know support a whole lot of industries that are suffering right now which is great i hope they're suffering and and wither up but um it's a popular thing so again not going there but ansel keys and many other researchers because he oh he himself always had 17 18 other co-researchers of tremendous fame that never took money from the sugar field so his co-workers that are still many of them alive in italy and henry blackburn who's dan buettner's neighbor at age 93 in minneapolis one of the most amazing scientists and such many of them are alive parsed out very clearly in all kinds of again like five pillars basic science and epidemiology and all animal-based saturated fat promotes a high blood cholesterol which is associated with and would be reasonable to say causes atherosclerosis hardening the arteries limit your animal saturated fat ansel key's diet was very rich in olive oils it wasn't a what it's build a low-fat diet his cookbooks are clearly not low-fat diets they're not vegan diets um but they were low in they never included coconut oil it's not a mediterranean diet food and ancel keys described to america the mediterranean diet that most of us agree is a reasonable place to sit in the middle if you got to sit somewhere but then came along 2008 if you talked to um a scientist on blanket on his name for a minute but exposed by michael greger and one of his nutrition facts dot org youtube's there was a meeting in mexico city in 2008 the dairy industry saying you know we're losing the battle people are drinking less dairy we need to find sympathetic scientists we need to find sympathetic bloggers we need to presumably support them invite them to meetings fund their travel and we need to put dairy for sure back on the map within a few months a scientist in oakland california ronald krauss md runs a big pediatric lipid lab in oakland is talking to the national dairy council and giving keynote talks that he's being paid for on the other the health aspects of saturated fat if specifically dairy which is typically rich in saturated fat and then 2010 comes a meta-analysis review by a patty siri torino and who's the last author ronald krauss who john mcdougall calls dr lard he doesn't respect dr krauss much as a scientist and feels since almost every paper he writes is funded by the dairy association and all comes his 2010 article and then that questions we can't verify that saturated fat is associated with increased risk heart disease it's a meta-analysis it's not new science it's just a way to play with existing studies um i'd a study that was so bad that the journal it was published in published right with it a complete and utter uh disembowelment and critique which is very rare people write letter to the editors to the journal afterwards but here's the science here's jeremiah stamler a very esteemed uh epidemiologist scientist who just dissected the study they accepted it but then they really allowed a extreme criticism but that all gets lost so we've got this paper there's this you know that's and then 2014 another paper of a similar bent uh by an author named chowdhury that's really the bedrock of this idea that we have it all wrong and saturated fat is okay they're both meta-analyses kind of a weaker style of science it's not original data the meta-analysis by chowdhury was so bad that the chief of the department of public health at harvard walter willett md one of the most respected scientists called for it to be retracted but it doesn't matter it's you know the feathers and how long ago was this 2010-2014 so there's butter on the cover right so this is what precipitated the butter on the cover and between 2010 2014 all kinds of hullabaloo um and malhotra that's all he's got i mean he doesn't have any new data that says when dean ornish took a w actually you can go way back when nathan pritikin even before nathan pritikin a internist in los angeles lester morrison at cedars took away saturated fat from his heart patients found they lived 50 percent longer in 1949-5051 nathan pritikin 70s 60s 80s showed that his heart patients did dramatically well there's no new data that says that's wrong and we can now feed heart patients coconut oil and butter and lamb and turkey and even fish which it can be high in saturated fat there's no new data that says that there's these two confusing studies and you know some ancillary ones if you really go back to what's been since 2014 this definitive series of association studies from the harvard school of public health that have confirmed without doubt when you are eating butter lard and ghee your risk of cardiovascular disease is high when you replace it with olive oil it goes down about nine percent when you replace it with vegetable oils it goes down about 23 now they didn't go to the next step what about if you have a diet that is absent added vegetable oils because that was uncommon in these and these were a data set of over 100 000 people followed for more than 30 years yes it has flaws and there's occasionally a harvard researcher that takes some money from unilever that makes one of the vegetable oils i mean it's hard to find scientists that are lily white in terms of some funding of research but nonetheless you know why that message still remains so confusing truly the biochemistry of fats confuses me the biology of fats you know gotta sit down we gotta we gotta separate set trans fat everybody hates then we gotta understand what are saturated fats well some plants have saturated fats like avocados olives olive oils 15 16 saturated fat and certainly coconut oil is 82 saturated fat and so that's difficult then we got to get to the polyunsaturated fats and separate the you know the the mufa the monounsaturated fat like olive oil and the pufas that are omega-6 and omega-3 which this stuff is just even it's so confusing that literally i got to sit down and write it all out and keep repeating it over and over what does the public do and then there are still room to discuss is olive oil on the health menu or not dr david cat said yale absolutely walter longo of italian origin absolutely we've got the cardiovascular data we've got you know other um authentic and uh caring scientists that would say in an obese society you don't need you know 120 calories per tablespoon of olive oil when you can do it with water vegetable stock or just steam foods and save yourself some of this calorie excess so i'm still on board clearly my message my patients is avoid or completely eliminate saturated fat uh containing foods which are animal foods largely and coconut and palm from your diet on the this issue of the complexity of all of these oils and how they all work polyunsaturated monounsaturated even in the the saturated fat world we have loric we have myristic we have palmitic we have steric like are there differences between those four different types of saturated fats it's the length of the chain 16s and 18. the longer chains are much more pro-ethanogenic so palmitic always loses palmitic acid is the most pro-atherogenic it's i'm not sure if it's 16 or 18 of the long-chain fatty acids where stearic which is one that does exist in chocolate and is in some beef and used by pro-beef people to say beef which has a combination of fatty acids uh it may not be as bad but you know and lauric is the one in in coconut oil because you know coconut oil that's what the mct medium chain they're not long chains the ideal chain length is 12 carbon um in coconut oil in terms of maybe being neutral to atherosclerosis and that we don't know for sure but the problem is you go buy coconut oil at the store i guarantee you it's not going to tell you it's a 100 12 carbon length or 14 or 16. these are mixtures you're taking a risk when you're buying it an organic label isn't the issue it's it's the mixture in there there's no doubt people eating a large amount of coconut oil raise their blood cholesterol and raised blood cholesterol is going to favor the development of atherosclerosis if your calcium scores zero and your homocysteine lipoprotein a and cholesterol is ideal you want to put a little uh coconut oil in your diet go for it but the problem is people are doing it with either known heart disease known diabetes known obesity or more commonly unknown risk and they're they're taking a risk so what is the history or the story behind how coconut oil became considered to be this health elixir this panacea yeah it's um there actually is a book in the 90s the miracle of coconut oil and it's written by a naturopathic doc although he doesn't put his degree there indeed the book he wrote before that is how to take balloons and fold them into animal shapes so he's written a whole bunch of interesting books it's really a true story if you were to go to amazon and go to like the earliest coconut oil short book and go just one before it by the same author so uh i don't know the man and if he's still around and i'm not making fun of him because i don't know his history but it wasn't the chief of public health at harvard school of public health and there really is and we don't have a definitive study that says for most people who are trying to avoid heart disease and aging it's a healthful unhealthful food we know that it raises cholesterol we know it's not part of blue zones we know that it's not part of the mediterranean diet even though dr malhotra introduces coconut oil to his version which is uh nothing other than another atkins version it's not a mediterranean diet um and that all crystallized june 25th 2017 when the president and the american heart association well that's another story ended up having a heart attack in december at age 52 as the chairman of the ameri president american heart association john warner from dallas but when he called a group of 11 scientists to say we need an updated conversation on saturated fat in the diet that's called the presidential advisory it was published in june 2017 they talked at length about this spectrum of eating butter lard ghee is your mainstay of fats in the diet what's the impact of converting and i went through that data and 25 page document 250 references all of that was discussing and concluding reducing saturated fat in the diet is still the proper conversation by a cardiologist with their patients one paragraph out of 25 pages said we have to conclude that the absence of data that coconut oil in a diet is helpful for heart patients leads us to recommend don't include it in the diet and that's what the blogosphere the ketosphere the you know the paleosphere when bananas about to the point dr mahatra agreed with the statement that american heart was a terrorist organization worse than isis giving bad advice to the american public and then our friend mark hyman chimed in on that and agree with that and it offended me chris chris people were sharing this meme that the american heart association was a terrorist organization over the coconut it's a scientifically valid statement to say we don't have a definitive answer you can argue does that mean that you should avoid a food that's very high in saturated fat till science fills the void that's what the american heart i think authentically was arguing um it was a pretty august group of scientists from harvard from northwestern from tufts some of the best nutrition schools in america and they didn't seem very conflicted in the uh long and detailed conflict of interest uh page that was at the end of the article i think it's a reasonable conclusion but god did ignite um a very conflicted very inauthentic response to the larger issue in the paper which never got really discussed which is go back to eating less meat go back to eating less animal products and find those amazing substitutes that are showing up everywhere in grocery stores which are naturally going to lower your saturated fat intake which remains as valid as a statement today as it did in 1970 when ansel keyes published a seven country study um with his co-authors is there any evidence to support that somehow the american heart association was conflicted or corrupted somehow like the the vietnam of the response was so what you saw and what the health is real they're not i mean two dr kim williams credit and the american college of cardiology they weren't in that movie because they've avoided some of the funding and the conflicts and the recipes the american heart association has a little different mission public education and nursing education cpr but those recipes are on their website and i've been to american heart association meetings in the coca-cola health tent and you know you need to fund these organizations and you know there weren't companies around like memphis meat and beyond meat and uh um the mayo company and the impossible burger and such you know they need funding but they've compromised their integrity and they've lost a little sticker on fruit loops that says it's a whole grain cereal with america i mean they've lost a lot of credibility doing that um doesn't mean the scientists have lost their credibility uh and that's hard sometimes for the public to distinguish or it's easy let me say it's easy for the bloggers to attack and just throw everybody under the bus it's pretty hard to throw walter willett under the bus university of michigan grad emphasize well the the blogosphere has been loud and unequivocal in its in its criticism of and its takedowns of ansel keys we went into that in length yeah in the uh this first i think it was the second time we did the podcast so i don't want to rehash that and also dean ornish you've also written about that extensively and i believe we talked about that uh but maybe we could talk and and the china study but maybe we could talk about what the health because that's sort of top of mind for a lot of people a lot of people have just seen it they're in the new year maybe a lot of people are seeing it for the first time uh and you know i think the hot button issues that that that people found to be alarmist were some of the more some of the more controversial aspects of the movie were the kind of visual imagery that surrounded the processed meats by putting like you know cigarette or cigar in a hot in a hot dog bun and this link between processed meats and uh and cancer equivocating to what was it uh i can't remember exactly five cigarettes a day to eating one hot dog or something or a pizza yeah it was one one egg a day equals five cigarettes for cardiovascular risk and then the process meet cancer risk so um yo people got pretty excited about pretty excited and i don't know kip anderson well we've become acquainted in 2017. it's not the first round he's made of a movie his website has lots of references it's a documentary but i think it was a very accurate and highly done documentary so whether you like it or not dr david jenkins md a very prominent research scientist in toronto published a study in 2012 of over a thousand people tracking how much plaque they had within their carotid and how many eggs they ate and he created kind of an index how many eggs per week per year and there was a relationship an association egg years and carotid thickening an artery that's to your brain that you'd like to keep youthful and all and when he equated it in the same data set to those that responded they smoked and how did those two risks associate one egg equaled five cigarettes a day and there was a statistical published peer-reviewed not plant-based not non-plant-based it was scientific data like all association studies it raises questions it's hypothesis generating but it doesn't mean for kip to put it in the movie was inappropriate or scientifically fraudulent it's indeed the data and with the huge number of nutrition studies funded by the egg board it's pretty darn hard to find a credible egg study in the last 10 or 15 years there were a lot of them 20 years ago but the egg board really started funding these studies since then a lot of conflicted studies the processed meat goes back maybe your listeners remember october 2015 world health organization after years of studies suggesting processed meat was linked to a rise in the risk of cancer and other syndromes heart disease congestive heart failure very strong risk maybe number one in the diet if you don't want to develop type 2 diabetes cut out processed meats with a hot dog bologna salami pepperoni bacon but that was crystallized when the world health organization put out a paper we reviewed 800 studies we have 22 world experts we're not a vegan we're not this isn't you know the plant-based movement this i can't cast probably nobody knew really the scientists they're just authentic nutrition scientists conclusion you know uh processed red meats are class one carcinogens not suspected but proven to cause cancer particularly colorectal cancer extended the prostate extended the pancreatic extended to breast cancer but statistics were highest because that processed meat is sitting in the colon so presumably it's the organ most exposed to risk since then the world health organization has published follow-up studies that confirm without a doubt this was a valid conclusion there are more people die every year worldwide of smoking and cancer-related diseases and there are the diet processed meats maybe 50 000 people a year worldwide die of processed meats and cancer do we ignore that do we say that that's not as many as you know a million so we don't address the issue right there was a the issue was that it was hyperbolic in the sense that the increase in susceptibility was relatively statistically minor but two yeah two strips less than two strips of bacon a day it's 50 grams raises in a relative value your risk of developing colorectal cancer by 18 now that may be from five percent to six percent in the general public that in itself may not sound impressive i like my bacon so much i'll take a six percent risk not a five percent risk but it is statistically valid and uh the the wealth of data but nobody will extend the conversation let's talk about heart disease erectile dysfunction type 2 diabetes obesity dementia and congestive heart failure another cardiac syndrome i care a lot about so what's the immediate step i mean hospitals this this has to be out of hospitals has any hospitals since the world health organization banned processed meats none that i know of the cleveland clinic was going to but i think they've capitulated what do you do in your own life you know eat less eat none that's for each individual to decide and any time you eat a food like that if you do couple it with an antioxidant fiber rich choice like green leafies fruits and veggies brightly colored foods there there's this fascinating study five years ago that if you walk down to a hospital lobby and pick a hamburger and eat it within an hour you can document that your arteries are dysfunctional something called endothelial dysfunction a rather shocking statement that the food is served on a patient tray directly can be shown to harm arteries if you eat that same burger with a big slice of lettuce or a big slice avocado you actually don't see that same drop so it's kind of a rule if you're not following a perfection diet and you slip up you know take the antidote and the antidote is garden foods and produce foods and i'm certainly not encouraging people to eat those foods but eat them infrequently if you are and even balanced with nature's own antidote right it's it it's uh it's worth saying that all of the claims that are made in what the health are validated and backed up with citations on the what the health website if you go to i think is it what the health dot com or what the health movie dot com or something you know i'll find i'll put it in a link in the show notes but they'll they have a section where you can go and they basically parse out every claim that they make throughout the movie and then support it with a variety of citations yeah and i agree and the worst example i saw and this got garth davis involved was a z-dog z-dog md this md in las vegas hospitalist who's developed an enormous youtube following because he can be pretty darn funny singing and acting like a buffoon but he took on what the health and uh eviscerated not just the concept as a clearly non-trained nutritionist non-trained uh epidemiologist but he made fun of the people in the movie particularly michael clapper he was just michael clapper one of the most high integrity physicians at you know practicing santa rosa a man of such integrity and it just so offended me that garth uh davis responded vigorously into youtube and a blog i responded vigorously in a blog and he seems i actually think the pushback's working i've been told that nina taikals and gary tobbs actually read when we get angry and they're a little more careful about what they say and i clearly send z-dog has backed off which is why we need to be vocal aggressive and sometimes obnoxious right i think but he achieved his goal which was to get a bunch of attention and views right you know by being controversial and then garth who's a bulldog and you know god love him that guy speaks his truth and doesn't hold back and and you know that's why he's he's the best and you know you if anybody who saw him on on the doctor saw you know like that that kind of went sideways for everybody and crazy it was like actually plant-based nutrition news which is a youtube channel did a video uh about that experience of garth on that show that's pretty interesting i'll link that up in the shout outs as well everyone just check that out because i think garth did better than even garth you know sort of i know garth didn't have a good experience on the show it was kind of a hatchet job they were gonna come after him but he stood his ground quite strongly and with respect to z-dog you know garth kind of went right back at him and then z-dog sort of backed down because now he had all this attention and realized like oh like garth actually watched you know just watch my video and garth was the one who said let's debate i'll debate any time bring anybody else or he he wanted to debate this is how i understand it i hope i'm not butchering this but gar suggested that he could come on z dog show and debate him and then z-dog sort of backed down and said well you know i'm not the best person to defend these claims you know sort of admitting like maybe he was a little bit out of his element or his area of specialty and then gar said well bring on anyone you want and i think there was a conversation about maybe having rob wolf or somebody exactly like that and then it never came together for whatever reason i don't know why it's probably better just be another more attention everybody wants to have these debates right there's a lot of energy like let's get all these people in a room uh but in my experience i don't know that that's really it's it's interesting because we all have these silos and in certain respects these silos are not serving us like we do kind of need to get together in the way that you did at google with dave asprey and have a mature conversation but a lot of times these these these conversations devolve into shouting matches and and everyone's so dug in that nobody it's like it's like watching political television on medical conversations should try not to devolve to the viewer you know they may not be the best example i will give on a similar path i got invited on the doctors about a month before garth to take on steve gundry and the plant paradox which we haven't talked about is worth maybe two minutes yeah i've been sure i shared quite a bit of my roll call email everything okay right yeah just you know the idea that legumes are dangerous because they've got hidden anti-nutrients called lectins and if you eat five kidney beans you can die if they're not properly cooked and this coming from a man who was chief of one of the more prominent cardiovascular departments in the united states in loma linda kind of ironic the center of plant-based science in the evantas health study now an anti-aging kind of guru out in hot springs california but his book got all the accolades and i went on the show to debate him and i was prepped and primed and he was relaxed and not on his game and it was um not the shouting match but it cleared there that this is another confusionist approach to nutrition when every blue zone eats legumes the very center of dan buettner's chart is legumes and every you know pocket of centenarian length uh let's clarify that for the public real quick so uh that was a fun experience not in handling the man because i actually have esteem for him and some of the work he's done but for just you know trying to turn the you know trying to stifle that as quickly and efficiently as media and tv lets you do right the basic message from that book is stay away from beans and legumes or cook them with such care that you might not choose to cook them at all because there's the the fear has been put message everybody listening don't eat raw beans it's really really bad to buy a bag of red kidney beans and eat them but i don't know any society in the world or any human that would uh try and do that yeah well i'd be in big trouble if i had to stay away from those foods because i got those right eat cooked ones or pressure cooked ones or soak your beans and cook them but there's not really much health risk with the typical human experience or you might get some diarrhea and nausea if you rush the process of it i wanted to touch on another issue that you've been it seems to me that you've been getting more and more interested in which is intermittent fasting cool great which is not like uh that's not a that's a subject matter that's been embraced by the the low carb low carbers and ketosis people like they're all about that there's a lot of science going on the plant-based community hasn't really spoken to this but i think what's going on in that world is super interesting super interesting and it circles back to the conversation we had about dr longo um you know the very brief bullet points the observation that our experience in humankind often were periods of relative starvation just on the nature of not being grocery stores a couple thousand years ago or ten 000 years ago and uh apparently we have an apparatus designed to put us into a different antibiotic state to handle you know calorie deprivation many studies that suggest there's no species in a research model that if you restrict their calories they don't live longer a yeast you restrict their calories they actually live 10 times longer if you take a mouse and restrict your calories they live 40 to 50 percent longer you know profound differences the question is is there a human experience that's possible and doable and compatible with life and that isn't the biosphere where you come out you know grumpy and uh depressed and uh and you every day of the month you have to watch how many calories you take and there are people that do that so what ultimately and the only point really to talk about because it's another really interesting part of the plant-based movement right now is dr longo seeing the biosphere experience but also enjoying life as a typical italian might want to be played over the years in in these yeast models and these mice models and recently humans and could we mimic fasting but still eat provocative crazy idea could we create a diet that doesn't have the components that food causes that accelerates the mtor pathway the pka pathway these pathways that accelerate aging and destruction of cells can we create a diet that lets you eat some um and can we actually still benefit from what fasting seems to do which is uh accelerate a process a fancy word autophagy the clearing of damaged cells to allow them to function better that process real quickly that won the nobel prize last year autophagy is like the hot button right now of anti-aging that if you eliminated every case of heart disease cancer and diabetes would extend human life by 13 years if we could end damage to cells and improve the efficiency of autophagy to take your cells that are aging and restore them to a youthful state would extend human life by 30 years so the research is going now in this anti-aging world and he created bottom line a diet that five days in a row of in the human experience 800 calories a day of a plant-based diet low in sugar and low in protein but containing whole food fats like olives and nuts and containing moderate complex carbohydrates so that the carbohydrate calorie loads about 35 percent that he found in animal models and in a study published february 2017 and 100 humans that you could see the responses you get with a complete fast but you don't have the pain of a complete fast you don't have the risk of a complete fast he called that and patent that fmd fasting mimicking diets and he has shown that not only do they favor losing visceral fat around your belly which is what so many people are doing 10 day belly bloats five days in a row in a month and you can do it as many months in a row as you can tolerate and all and we're talking about eating a nut bar for breakfast we're talking about eating soup and kale crackers for lunch we're talking about eating soup and occasionally a little cacao bar for dinner these actually come pre-packaged in a start-up that he engaged in with the university of southern california that doing that five days in a row activates these primal pathways that actually not only favor improved metabolism losing visceral fat you don't lose muscle mass which is fantastic but you actually lower igf-1 levels which is one of the goals and lastly you actually create a flood of stem cells from your bone marrow into your bloodstream stem cells that people are going to tijuana and paying a ton of money for that will go to injured and damaged parts of your body and clear out damaged cells so there's data now in animals and some human data that multiple sclerosis may be responsive to a five-day fasting mimicking diet of plants low in sugar low in fat that actually brain growth occurs in animal models and right now cognition is being studied in italy using dr longo's five-day fasting diet in addition to just weight loss that um cancer patients it's called chemo leave it's a product they've developed and not released it's being studied at the mayo clinic in other places that if you're getting chemotherapy and you do this fasting mimicking diet and use plants and use low sugar low fat you actually get a better kill rate for the chemotherapy and you get less side effects profound data athletes are being studied in verona italy right now to see if this enhances performance if it will enhance recovery and allow you to go back and do the next athletic event with more success so several hundred worldwide studies using this exact model i would describe it it's a plant-based cyclical ketogenic diet cyclical because it's five days a month and it's plants so it's not the extreme of what you're seeing on the in the blogosphere uh it's the plants and the plant proteins that don't seem to activate aging like animal-based protein and it's 800 calories a day it's not water fasting so there are people shouldn't do it underweight people pregnant people brittle diabetics brittle heart patients 800 calories a day i've done it seven of the last 11 months i'm down 25 pounds i bound this energy my labs show improvement my blood pressure shows improvement i have dozens of patients who have had the same experience and you know what do you do with a heavy vegan who's really doing it right you got to change your metabolism and this is one of the hacks that might uh you know allow our movement one to have the scientific basis to say we're in the right sector of the food plate and two to actually help people get more out of it than they're getting because not everybody eating a whole food plant-based diet with oil without oil is going to achieve their optimal blood pressure blood sugar and weight and we need more tools and this is one of the tools that's fascinating it's fascinating and it's powerful and it's you know as i said nobel prize nominated science that will one day be rewarded with the award and is there any indication that these uh benefits can be enhanced by not e eating at all or doing a multi-day fast or is are we still just too early in the process to understand or like this protocol which involves eating a little bit of food throughout the day works just as well as completely cutting yourself off um it was designed to give the benefits of a complete fast without the risk of a complete fast because those that are doing prolonged water fasting certainly in the chronic illness model are doing it in an inpatient clinic like true north or places in florida um and not everybody can access that and not everybody's gonna do that this a person does at home i do it while i'm working i'm seeing patients i'm at my restaurant you feel phenomenal at least a lot of people feel phenomenal you can get a little hangry you're allowed to cheat a little with some celery and slice cucumber pretty uh calorie and nutrient sensing pathway neutral food but it's a breakthrough and i don't think the public even has a clue how profound a breakthrough this is because the joy is 25 days a month you have no rules i mean you have your healthy diet rules but these people that are trying you know and dr longo would say the optimal time restricted period is 12 hours a day you know the days you're not doing uh this fasting mimicking diet um you know whether you're totally plant-based whether you're following a mediterranean diet the dash diet you know 8 a.m to 8 p.m is your feeding period he likes breakfast and dinner skipping lunch we're not talking about somebody burning 6 000 calories a day training or performance uh we're talking about you know the typical person out there but you couple five days a month for optimizing your regenerative innate ability with 25 days a month and you add you know a 12 hour feeding period you may indeed have that longevity diet particularly if you mimic it after you know the native cultures the blue zone cultures the italian culture the stem cell aspect of that it's fascinating i just say personally and i know you've got to be very careful about anecdotes i had a really refractory plantar fasciitis and after two months of this it went away now it didn't go away for the previous year and i've had patients tell me shoulder back and other parts there is clearly data that damaged nerve cells in animal models of multiple sclerosis regrow that damaged brain tissue and mice models called the hippocampus regrow so this is not totally conjectural that you may actually heal damaged parts of your body there's there's actually animal data that a animal model of type 1 diabetes where there's no insulin produced responds with the production of insulin for the first time and there's no human equivalent so no type 1 diabetic should do this but those research studies are underway so fascinating yeah i'd be really keen to see what the studies are going to say about the impact of this in an athletic performance context too because the conventional wisdom is replenish your glycogen stores and your electrolytes and your protein within 30 minutes of of training right and this is the way that you bounce back as rapidly as possible but if you can stimulate that stem cell you know production and and there is this what what is it uh what's the term you used uh of the cells sloughing off yeah autophagy right um what would that mean right are you are you literally turning the clock back and making you a better athlete so there is a study underway i don't know the protocol but yeah i argue for what i've termed and it's nothing special vegan plus or whole food plant-based plus you know don't be dumb take your supplements don't be don't get in a situation where you're deficient in b12 because you've heard you may not need to i think that's one play that we need to emphasize vegan plus fasting i think is a not completely untouched there are there's a facebook user's page now with 20 000 people doing ketogenic plant-based diets sometimes cyclical which i think is safer go back to food and a normal schedule um i don't know that they're all doing that but that's a growing uh group um vegan plus organic you know vegan plus no oil that you know the kind of enhancing this core data i think are really fertile areas but the the fasting is by far the most scientifically solid i mean huge data amazing data i'm going to look into that a little bit more i mean i've experimented with it a little bit just in a very informal way of of like not eating until dinner you know right like eating one meal a day right and doing that while training and seeing how that impacts my ability to recover and part of that is is trying to anecdotally with an n of one study right trying to see if that has any positive impact on on you know the efficiency with which i can tap into my anaerobic zone to like enhance my endurance by not so in addition to the training that i'm doing but through nutrition getting trying to trick my body into more efficiently using fat for fuel right and if you're not eating right that's what you're going to be tapping into in order to propel you through your workout well i i can't speak for him but dr longo is a long-distance runner so you to my and i've never heard him talk about uh uh his view on that for you know performance athletics but you'll have an interesting conversation um no i i think it's uh if this were a drug that you could show did all that's been documented uh it would be a 20 000 a month drug and we're talking about there is a commercially available food kit that he has designed because he believes you know it's exquisitely important what those 800 calories are and how they're delivered and he won't do it in powders these are foods um people have tried to mimic it there is a he has a great facebook page professor walter longo he posts a lot of stuff a prolon is the name of his research project they have a website it's very easy to find he's a very hot commodity right now he's been written up in the new york times and forbes and other places and uh what you're going to see coming out is good stuff a lot of youtubes there's actually a documentary that another reason i'm sure he'll want to talk to you call fasting that he's featured in that's just about to be launched yeah and there's a lot of different plays there's a another ucla has a researcher dr sachin nanda who's la is the center of uh the serious fasting science data but um it's a good thing to add on you know you're unique most of us are dealing with calorie excess and exercise deprivation and we're getting fat and it's far better to skip a meal than compromise it's far better to learn you can go with two meals a day maybe breakfast dinner as a routine which i've adopted there's a mindset doing this that i was not told about but darn five days 800 calories i just worked i though this program is three meals a day but you know they're not big by any stretch imagination that i mean i have the power to eat less and feel good and achieve the goals weight or otherwise and i hear that from patients all the time i've completely changed my mindset this was breakthrough for me psychologically as well as physiologically because i finally got away from you know if food's there i won't eat it because it's better to skip than to eat in the culture we live in where there's food everywhere all the time well we've just been taught that we're supposed to eat three meals a day like i don't know who came up with that but you look at ray krona he's this guy yeah it's like yeah 30 days or whatever on water and you know i'm not advocating that people go out and do that but i think it's important to like look at that and say and and he loves it to say look our bodies are capable of so much more than we you know sort of understand and to just explore the idea of what happens when you skip one meal or maybe two meals and go hey i'm still breathing air you know the single most powerful activity you can do to prolong your life is eat less every day and that's a message that is so needed right now and then we can talk about what that is but start out with that in your mind shut your mouth your kitchen your refrigerator and watch your health bloom let's talk about the book cool books just out the plant-based solution i just got it the other day so i i i wasn't able to read it yet but i have like page through it and it's good i think people are going to be um really uh helped by all of it's page restricted book just like we were talking about calorie restricted i don't have much patience to read thousand page books nor do i have the time i don't have time to write these books so it's about 150 pages of science of plant-based diets and hard plants based diets and diabetes plant-based diets and brain and sex and and uh autoimmune diseases like lupus and then my wife chipped in god bless her karen and put together a three plus week eating plan of recipes it's not elegant like your amazing meal planner uh that is an incredible resource we all appreciate but nonetheless people people have asked me non-stop you know you have a recipe book so this is as close as i've gotten so far some recipes from my restaurant and uh it's been fun it's actually gotten a lot of attention um and uh good feedback yeah it's great and what i like about it is that you've you know you've branched out beyond just cardiology and heart health you're talking about uh you know diabetes cancer autoimmune diseases gut health ms alzheimer's parkinson's aging sex drive like you're hitting all the buttons the impact of food on these conditions in terms of prevention and reversal yeah and the data's there we always need more we are a intertwined network that's kind of the philosophy of functional medicine that people ask me all the time what's the side effect of eating a whole food plant-based diet for heart disease a side effect is you're probably going to be thinner more attractive have more focus have a better sexual performance you know have a lower blood sugar and less likely develop diabetes and uh a whole series of litany so that's the beauty of the human body is you know uh has an amazing ability to heal itself it will just uh rethink you know you can't heal plant uh and nutrition-based diseases with pharmacology you have to heal nutrition-based diseases with nutrition and we're starting to wake up that the last 50 years have been rather ugly yeah you got a great forward by john mackey in there you know the guy's a gem and i don't know him real well i met him in santa rosa and then he actually has been through detroit and he comes to my restaurant and eats so he was eating in my restaurant gave me the forward next day he announced the amazon deal how he he he you know his wonderful book the the whole foods diet he was planning as you know this gigantic national tour and it all got interrupted by his need to go back to the business and uh and work on the deal and announce the deal but i mean he was just sitting there like like a poker player not mentioning anything and he left and yeah i'm very delighted that he is willing to do that because he is a very special human being is he's an amazing guy and i you know i had him on the podcast to talk about his book right in the middle of that proxy war going on and i couldn't believe that he didn't cancel the podcast because i can't imagine the amount of stress he was shouldering at the time because he was really under fire and he didn't want to he didn't you know he did these these you know investors were really just trying to do it a pump and dump and he was doing everything he he could in his power to prevent that from happening um and so yeah his it coincided with his book coming out which meant he couldn't do press except for like my podcast or maybe one or two other things uh because he had to keep his focus on that but then i attended uh his conscious capitalism conference in austin a couple months ago and what was fascinating about that is that he got on stage and did a panel with the guy from the motley fool and and talked about like his you know how he felt about this deal it was the first time he'd spoken semi-publicly about it and what was fascinating was some of the behind the scenes stuff where him you know he felt very aligned with amazon and now he's thrilled he's like this is the best thing for the company and now he gets to do what he likes doing which is like grow the business and not have to worry about all this kind of stuff so i think it all ended up for the best it is amazing that amazon now owns whole foods and it's going to be fascinating to see how that plays out yeah i i agree i mean when campbell's buy specific organic foods it's amazing i mean it's just more shells more you know uh more stress off the uh entrepreneurs to let them focus on you know creativity and production and uh who do one of the uh burger companies just sold to canadian uh firm i mean you know it's controversial that sometimes these are companies that aren't plant-based and have a bit of a conflict but they've got to grow you know access the future is right to get it in every grocery store and every red robin and every tgifs i mean it's it's groundbreaking that we're seeing this happen and they're not my favorite foods but they still deal with the environmental and the animal rights issue and and some of the health issue yeah you don't have leucine in a impossible burger to the level you have it in a beef burger so you're not going to activate mtor and all this kind of highbrow science we talked about at the beginning i think it's cool that campbell's has made this really strong push into getting into the plant-based food world i think there's some what is it plant-based food producers some some like organizations that dropped out of the general one and entered the exclusively plant-based uh growers group yeah which is a phenomenal commitment and they're serious they have a big presence in detroit about a mile from my uh cafe and it's growing and they've got hundreds and hundreds of employees in detroit in ferndale michigan um which is great how's the restaurant going uh one about to become two we're pregnant so uh our 4 000 square foot green space cafe now two and a quarter years old what i call my 401k cafe uh um i've had this because you you emptied your 401k yeah i don't have anybody else with me other than my son and he's too young to have a 401k so i've uh i've i've let passion dictate some of my financial decisions i produced a broadway play in the back past we'll talk about that uh some future i didn't know that yeah that's a whole story but i did have uh director seats on broadway for 10 years or producer seats um it's going very well the public has really embraced it what the hell drove a tremendous number of first-timers in because my wife and i we wander through every night and when you've been here before how do you like it um we just hired a matthew kenney trained chef which i'm very excited about thank you matthew of course a guest that you've interviewed and a great force i'm very excited and we're opening a small fast casual place march 1 called green space and go so we're committed we're producing food and see this tipping point which clearly has happened i mean this is although malcolm gladwell speaks horribly about plant-based diets i will embrace the term tipping point of his out of his lexicon and um i didn't know that he had spoken at all about this yeah he has a podcast and he i love malcolm he went really deep into the nina tyco's world and praised her beyond any expectation on a podcast about four months ago and i beat him up on twitter but he didn't respond you know that's how it goes i've been baiting joe rogan to just put one of us on and let us go at it i don't mind being bloodied come on joe bring it on stop talking to these orthopedic surgeons that eat meat and don't check their labs it's a bad public message i will say he had chris cresser on um a second time yeah fairly yeah recently right and you know we both know chris i like chris and i found his i found what he had to say i i i i agreed with like 99 of what he was talking about chris is a real good sensitive and you know complete you know uh medical practitioner without a doubt um i think he distorts the science a bit but we are all subject to that uh criticism hello all right fast casual where's the fast casual it's only five miles away up woodward avenue which you remember with your gross point roots uh on the yeah i haven't heard that in life 40 years one of the coolest things in detroit is coming up is the international auto show which is as cool as can be but um in the third weekend in august they've reproduced like american graffiti so they have this thing called the dream cruise and 1.5 million people bring their hot rod cars from around the world and drive them up and down woodward avenue like uh in the 50s and richard dreyfus and we're right in that strip and so it'll be it's about a 1600 square foot 20-seat grab-and-go drive-through window it's not it's not fast food it's fast casual it's whole food i'm pretty insistent that this is healthy food you know we have super foods in the salads in the bowls and the wraps we'll see we'll see if we can make that okay march 1. it's coming up cool well i love your restaurant uh i only had the opportunity to eat there that one time when i came out for the plant-based group yeah yeah plant-based nutrition support support group which was an amazing experience and you put together this incredible dinner and the restaurant is like super top-notch high-end the food was like extraordinary yeah where l.a was very little very true yeah like it was like i was like whoa like you're doing it right you know like really right and i'll just say the coolest thing lately is professional athletes red wings lions uh not a kyrie pistons we don't have kyrie irving in but we got tobias harris impact of kyrie yeah it's huge and but with tobias harris piston wonderful human in all the time some of the red wings are coming in we've had the coach of the pistons in who's you know some of these are now plant-based athletes theoritic a detroit lion is now plant-based and so we're seeing that and you know it's i i don't know that there's fasting and professional athletes i think are the two coolest things going on in the plastic plant-based world to shift the public mind well i think it's it's the what the health effect like the impact on the nba and the nfl from that movie has been unbelievable and and i think a lot of it has to do with david carter like david carter being in that movie and what he said i think really resonated with a lot of those guys and it's so fascinating to see so many of them jumping on board i mean kyrie it's huge did you see the nike ad yeah it's crazy plant-based i mean it's like the words plant-based diet are being uttered in a nike ad right and it's being done in kind of a they're sort of poking fun you know like it is flatter thing and all of that like but i'll take it like that's that's kind of an amazing cultural moment i agree i celebrate uh all these little a little hopeful and again it it isn't the war that we started with but there is a war for the health of the planet there is a war for the destruction and you know the cruelty to animals and there is a war going on with health in america and it matters everything we've talked about and from the calcium score to the saturated fat to um industry like campbell's and others buying up companies i mean uh i'm i'm very optimistic as i know when kim williams talks i mean we're just we're seeing this change the last bastion is the health industry and we're starting i see medical students which is so ironic it's so distorted that it's the food industry taking the charge and the professional athletes in the health industry limping along like we're talking about cigarettes and give us 25 years to change because you know no we went through a 25-year period before they banned smoking in hospitals it could have been done much earlier let's learn from that no they argue let's reproduce it so um that's the last bastion when medical students at least get a fair shake at learning about this stuff and i'm seeing that happen i'm seeing uh i lectured to a group of medical students about three weeks ago and expected a very negative answer the question have any of you tried eating vegetarian or vegan 50 raised their hands and laughed are you kidding we're full-time plant-based like whoa i think that was an unusual group yeah that's that gets me fired wayne state has a program now right wayne state is a gigantic medical school but they will uh they have not incorporated paul chatlin's plant-based curriculum yet but they're much more open i'm going down there in a few weeks to do lunch and learns and some of their curriculum and some medical schools are even doing better than that some of the osteopathic schools doing way better than that but that's when the when you go to your doctor and even if it's three minutes of nutrition conversation and maybe you are directed to nutritionfacts.org or forks over knives or what the health or told to read a book like the plant-based solution or you know how not to die or something um you know that's the army of soldiers we need to really the critical issue of living the best life as a general community that we can offer and greatest country in amer in the world ought to have the greatest health outcomes in the world and we're number 37 so we got some work to do but interesting times uh hopeful times yeah all right we gotta lock this down but i am going to shut this bad boy uh down with one final question that's a question i've asked you before it's the same question i ask every doctor that comes on the podcast i can't remember what you said last time but the question is this you probably already anticipated if it was a parallel universe and you woke up to be surgeon general in this crazy administration uh what would you do what would be the first thing that you would try to change or put in place yeah i i would tackle and uh i didn't see it coming the question but i would tackle the fast food industry and legislate i would i guess it's all the one answer i would take away food subsidies that create 19 mcdonald family meals that should be 75 and i would uh let no buddy left standing that fought in the way to take the dairy industry and the meat industry and all and take away those subsidies that allow that absurd situation to occur so i think that's the single first thing i do bring some equity of pricing and a free market back into the production of food which would mean some farmers in the animal world would shut down and uh they could be converted to yeah politically it's what has to happen or we're just going to keep limping along with the same system same system same system number two would be to change health care to reward prevention you know to the degree that it should be that you know fifteen dollars to talk to a patient and fifteen hundred dollars to put in the stent and not talk nutrition uh a world that i lived in and i was on the stent side while i was doing both but um is not a tenable model for the next you know generation all right your good man dr joel khan i appreciate you too sir thank you for coming here the book is the plant-based solution everybody pick it up wherever you buy your books and get your calcium scab thank you good plea to the public all right man come back and uh come back anytime we'll talk more i have a list here of all these things i still want to talk to you about we didn't even get to them we're two hours here all right my friend peace and plants you

Channel: Rich Roll

Views: 887,167

Rating: 4.5804634 out of 5

Keywords: rich roll, vegan, health, fitness, diet, nutrition, athlete, podcast, inspiration, motivation, plantpower, plant-based, wellness, self-help, LCHF, ketosis, ketogenic, low carb, high fat, joel kahn, cardiology, medicine, science, rrp, research, assem malhotra, gary taubes, dave asprey, bulletproof coffee, nina teicholz, michael greger, garth davis, what the health, cowspiracy, forks over knives, big fat surprise, heart diease, weight loss, obesity, diabetes, fasting, intermittent fasting, valter longo

Id: yrCaG2gT2Vg

Length: 131min 17sec (7877 seconds)

Published: Thu Feb 22 2018

Reddit Comments

[u/IBGrinnin]

View from only the plant-based side of the debate. I still enjoyed listening.

[u/Kerouwhack]

Can anyone summarize? I don’t have 2hrs

[u/turbineseaplane]

I'm very interested in the FMD, but I have to say, the website for the product as provided by Dr Longo is SO SO spammy and just feels like a Con.

If it really is a legit thing, he really should revaluate how he's allowing it to be marketed.

It feels like they are selling snake oil or an MLM website or something. I was so disappointed when I saw it after listening to the Podcast.

[u/-LT-]

A couple highly fascinating topics that Dr. Kahn talked about were Valter Longo and the Fasting Mimicking Diet, and Lipoprotein(a). Very educational interview.

[u/Ms_Merry_Mac]

Weird that VL disapproves of fasts longer than 12 hours. I doubt that he has anything but correlative data to back up his recommendation to never skip breakfast. And while I eat a mostly plant-based diet myself, I agree that the title of this podcast is misleading. No one is arguing the side of the ketogenic diet here.

[u/Amiflash]

Regarding, a ketogenic diet can be plant-based, a little hard to maintain though.

[u/Tacomaster9000]

I’m not sure why I can’t watch this now, but I can’t so I’ll leave this sentence here to remind me. Thanks for posting! I saw this guy on Jo Rogan a while back, interesting stuff!

[u/CrazyComi]

Just finished watching this, amazing interview. Highly recommend listing/watching this one. He had some very interesting things to say about fasting.

[u/[deleted]]

Can someone do a TLDR for the video please. I can't watch it... Drinking from jars... Ughh JK I just don't have time today.