Two cardiologists debate fat, sugar & coconut oil

got booked so before we so you brought props and and books and and not a gift for a scene before we and so what what is your how we're going right for the t-shirt okay t-shirt told everyone to wear solids yes we did but so the t-shirt says feel lucky little Dirty Harry reference but you won't see that there's two dots and my plea is a professor at a university in Detroit I talked to the guys about male health and erectile function I've asked 10,000 guys how's it going bedroom or if they're lucky other than bedroom fun places like airplanes that's the size of the human coronary artery three millimeters he's put many stents in corn arteries I've put many stents and coronaries that's all it is that's the size the human's penis penis artery right there it's one millimeter big and when I talk to my guys very you know seriously about it I mean you I'm there to protect that artery from clogging because your lifestyle goes down dramatically when that gets clogged up so we're talking about such small or two I am fascinated by the human body as I seem as I mean I'm fascinated by cardiac physiology but that's the kind of small small circulatory differences that we are going to discuss what's AI my field in our field the optimal way to protect and keep them clean so buddy that's what you got got your big guy you're a big guy I mean I will give it an answer ah that's all right hi children before before we jump into this work for mommy what's a penile artery let's uh the seam has a fabulous new film outlet let's let's roll the clip of the the film real quick before we get started the big fat fix the scientific evidence is very clear I think one of the key things of the Mediterranean diet is the rise food that adopting a lifestyle that involves a high-fat Mediterranean diet we use extra virgin olive oil what nuts contain a fatty acids and another interesting is being oily fish leaving the dessert has been cooked in olive oil mobility is hugely important Thank You work is that going to work movement really does heal movement stress reduction and stopping smoking is more powerful than any drug in preventing heart disease treating heart disease and improving one's physical state emotional state mental state and longevity awesome look very uh very impressive with the log there seem so so talk to me why the film you know Jason I think one of the reasons we're all here is that you know on a serious note we actually have now a complete health care system failure rooted in a number of factors and that includes biased funding of research so that's research that's funded because it's likely to be profitable not beneficial for patients bias reporting in medical journals bias reporting in the media and commercial conflicts of interest and it's now quite clear looking at the bigger picture that you know the third most common cause of death after heart disease and cancer is prescribed medications in the United States a third of healthcare activity brings no benefit to the patient and we're talking about health care spending in this country which is close to three trillion dollars and the reality is the future of healthcare is going to be through lifestyle now why have we got such a increasing burden of chronic disease that's affecting healthcare systems in the UK where I'm from in the US and a lot of that is driven by diet in fact The Lancet global burden of disease reports now tells us that poor diet contributes to more disease and death than physical inactivity smoking and alcohol combined I've been on a campaign in a mission for the last few years like Joel I trained as an interventional cardiologist and I saw over you know my 15 year career that you know more and more people more and more sick people coming in more misery more unhappiness more chronic disease our hospitals have become branding opportunities for the junk food in three you know I'm operating on someone the middle night with a heart attack and the next morning when I'm trying to tell him about a good life healthy lifestyle he's being served burger and fries completes its scandal and when I started on that mission to try and you know improve our understanding around nutrition and health etc one of the things I looked at was a research around the low-fat movement and the coming back to your question so I'm simple specifically I made a documentary film with a my co-producer Donal O'Neil as a former Northern Irish international athlete and we wanted to go to the roots of the Mediterranean diet so one of the most powerful and influential men in the history of nutrition is a chap called Ancel keys an American scientist and he did most of his research from a tiny Italian village called PRP and Simon Italy now this village has a population of around 200 people and their average life expectancy still is around 90 a lot of people live over the age of 100 so we went back to this village to see how these people living what were the secrets there how do we apply that to modern scientific literature and you know what we found actually was very interesting is the you know there are many commonalities which I'm sure Joel will agree with but you know the amount of sugar they were consuming was very low um sense of community was really important and you know how do we look at the modern scientific literature in terms of other dietary components that are going to reduce the risk of heart disease David's already very eloquently talked about the role of inflammation in the body and coronary artery disease is an inflammatory disease it's not a disease caused by dietary fat and certainly there is a lot of you know debate going on at the moment and I'm sure we'll talk about that with Joel shortly or unsaturated fat whether that causes heart disease so that's kind of where things have started for me and the film is really to look at the root causes of you know the increasing burden of chronic disease is really being driven by excess sugar in the population and you know potentially vegetable oils as well industrial vegetables so we'll start let's go back to so what's at the stage you guys have a lot in common you're both interventional cardiologists you both believe that heart disease is it you know preventable through lifestyle 80% of it at least you there you go you both don't you know don't believe in sugar you both believe in exercise but where you start to depart is you know talking about Ancel keys you've both been to the villa but you have different opinions on what the takeaway is and you shared your takeaway Joel what is your takeaway yeah very quince identity I was in popin actually where I see it totally clean I didn't over the movie so we were there I don't know how many months apart it's a beautiful place to visit although I chose I choose to eat a vegan diet that's personal reasons you can embrace it or not I teach my patients the data of Nathan Pritikin Dean Ornish Neal Barnard Caldwell Esselstyn I can go back to Walter Kempton or what's called the rice diet at Duke peer-reviewed published data that coronary disease melts away with a low-fat plant-based diet that's for the very sick and the very few but it is uncontested in fact there's only two diets that our government reimburses a patient for to reverse heart disease the Pritikin diet which is a no added oil vegetable based diet they do allow three meals a week that have animal products and the Ornish diet which is the same but allows none our government has evaluated all other programs and has found those are the only diets I'm obligated as a cardiologist to teach patients with Koerner disease this is science this is an option and I've chosen myself to live that way I have a restaurant that cooks that way but I don't choose to you know put that in anybody's lap unless you have severe corners you need to know Forks Over knives exists the other option in my mind is the original Mediterranean diet which is P o P which is Nicotero which is Crete which can be a very high oil diet it's just not a high saturated fat animal driven oil diet Crete is 40 percent calories from fat almost all olive oil very low saturated fat content and they have almost no coronary disease Ancel keys recognized that he chose Crete as one of his test subjects his diet books I don't know if people know Ancel Keys Row 3 diet books that became bestsellers they are unbelievably rich in olive oil diets 1959 1972 and 1975 he in fact I have him right here he banished sugar from his recipes in 1959 now a lot gets confused and plant-based diets are naturally low sugar and depending on your orientation can be naturally low in fat Mediterranean diet if done as prescribed as naturally low in sugar I mean we agree on that but in your documentary you push the bread away cereal pasta and bread is the foundation of Mediterranean diet as every dietary trial that studied the Mediterranean diet include Preta med included you have to bring the bread bowl back because that is the foundation I know that's unpopular but that is you have to do a new study if you're going to make the Mediterranean diet a low-carb high-fat diet when those studies have so let's start so you both I both heard the phrase plant-based so you both agree on that where you start land strong plant and plant strong but starting with lots of great healthy fresh green vegetables we agree on that where you start to diverse fat I accept a pretty darn high-fat diet for the general public as a reasonable they I love the Mediterranean diet forty percent calories 30 percent killers so that's olive oil that's gonna be olive oil and I know you're gonna love me for saying this organic canola oil and the Leone Heart Study reduced reef current myocardial infarction by seventy heart attacks by seventy five percent I know it's the least popular position to take but another study showed that endothelial ready function improve with canola oil it's crazy data just I wouldn't buy it except oils you got coconut oils right um avocados well so just be time efficient since as seen published a very widely read editorial in the British Medical Journal in 2013 Harvard School of Public Health has been slamming this topic of you have to look at if you're going to give up saturated fat what are you replacing with and we all agree if you replace it with simple carbs white sugar snack well cookies graham crackers you're doomed it's a horrible thing to do it actually doesn't make you worse than eating saturated fat it's just no advantage if you place saturated fat with whole grains according to Lee last year Harvard school public health under 30,000 people you drop your risk of dying now if you're smarter than that he replaced saturated fat with vegetable oils not coconut oil because there's no coconut oil in the Mediterranean Basin there is no extra virgin coconut oil in the Mediterranean diet you are now creating a new model but if you do replace saturated fat like butter lard and such with vegetable oils your risk of having that goes down 25% that's my job to reduce heart attack rates I embrace that data about Ned's job that's published in the last six weeks by Harvard School of Public Health Walter well let's talk about Harvard School of Public Health only a few years ago the New York Times published a piece I remember the begin I talk to a biased funding of research Harvard scientists were paid by the sugar industry to shift blame to fat so the question is how do you cut through 9:6 a lot a lot of the ball that'll be honest 19 um yeah so agree with Joel you know when we talk about the base of the food pyramid the problem with the refined carbohydrates and the breads and the pastures in excess and you know actually in PRP a lot of Italians you know I've got a lot of Italian friends I've been to Italy a lot of times actually we have taken what was small amounts of pasta as an antipasti you know like as a starter and turn it into main course it's all about you know the amount but you know this brings us on to something else and this is irrefutable type 2 diabetes is a disease of carbohydrate intolerance now when you look at the three macronutrients fat protein and carbohydrates refined carbohydrate in particular that is what has the biggest response on glucose and insulin and these are the types of foods that are going to be make you more likely to develop type 2 diabetes not only that I want to come back to insulin resistance in a second ago that's really important there's actually been quite a lot of data and is there's a general practitioner in the UK who has actually started advising his type-2 diabetes patients to cut out the refined carbs in the sugar and that means the bread the white bread it means pasta and it's cutting out the rice it reducing potatoes and it's quite extraordinary that within months patients are coming off their medications the type 2 diabetes I saw a patient only a few weeks ago who was a lady in her early 60s she'd been type 2 diabetic for 25 years for the last 17 years she had been on insulin up to 80 units a day she came to see me to get an assessment about her heart etc and she had actually managed to come off within three months all her insulin and I said how did you manage that and she says smiling she says I could out the the the rice the bread and the sugar and now I'm eating butter and cheese again a cholesterol profile was perfect and you know this has been an quite scandalous because we actually can reverse type 2 diabetes and certainly the very least reduce the need for medication so coming back to what joel has said yes it did feature of course bread etc pasta is in there but it's much smaller amounts the modern wheat that we have now is very different to the kind of wheat they were consuming in the times of Ancel keys and what should be at the base of the food pyramid should be lots of vegetables ideally non starchy ok so two thumbs up on that absolutely you know olive oil definitely go mm nuts like you know there are lots of good studies on nuts and the anti-inflammatory properties of nuts and I want to come onto that as well in a minute but inflammation and oily fish and Joel talks about all these data studies and Dahl talked about different studies but you know it's about the quality of the research now Cambridge Medical Research Council did a very big study published in Annals of internal medicine looking up all of the data from observational studies randomized control trials over 600,000 participants and what they concluded was what was very interesting is that saturated fat and listen I'm not here to say people should be gorging on butter or having a bath and bathing themselves in butter this can be part of a healthy diet okay this can be part of a healthy diet as long as you're getting the base the rest of it right you could have the refined carbs of the sugar you have the vegetables all of all the nuts the oily fish if you like you can have some some meat as well and actually to be honest you know David already talked about fat as medicine you know it's actually very satiating and it has a least impact on insulin responses now let's talk about into resistance very quickly what's the most number so number one risk factor for heart attacks in men it's not cholesterol its insulin resistance it's more important than high blood pressure more important than high body mass index more important than low HDL cholesterol LDL cholesterol which is where all of this has come from the saturated fat causing increase in LDL driving heart disease actually has a much smaller effect not only that I published some research only a few months ago and BMJ open and what we found was if you're over 60 LDL cholesterol was not associated with cardiovascular disease so this is so-called bad cholesterol and was inversely associated with all cause mortality partly because cholesterol is one of the most vital molecules in the body in fact it's simple involved in immune system and probably protects against infection so we've got everything kind of upside down now why is it most people don't know this because we've got a huge industry around low-fat foods to lower cholesterol even though other than statins there's not be in any single trial that shows that low in cholesterol from reducing saturated fat has actually improved cardiovascular outcomes in terms of randomized data and the whole insulin resistance issue the reason most people don't know that is because the solutions are relatively simple there through lifestyle mechanisms they through diet movement and exercise stress reduction sleep you know and this is where the solutions lie so the future of healthcare is going to come through lifestyle and you know I hate to say it but good health and I'm sure a lot of you will agree with this rarely comes out of a medicine ball so is insulin resistance in your opinion the biggest marker for heart disease absolutely and you know it's also linked to many other you know it's a precursor to types of diabetes forty percent of the American population are pre-diabetic we know that it's linked out Symes disease David's talked about that already so you know this is where the focus should be and you know there's never been any one of the other issues around into resistance we've never really produced any effective drug that's being able to target into resister so that's why one of the reasons we don't know about it so much but you know that the good news is lifestyle change and you know I've got no issue with people being vegetarian or vegan if you're getting your nutrition requirements and you're otherwise leading a healthier lifestyle that's not you know I don't think there's any major issue of my mum's are vegetarian I mean I probably get about three mess what's that messages her from a week talking about plant-based diets and how good it is for you and I grew up actually on a vegetarian diet and I'm actually slightly biased towards the fact that I think Indian food has the most variety for vegetarian food and I love it but you know let's look at the science properly in totality let's look for the commonalities and of course more research needs to be done but in terms of the data that exists at the moment certainly a higher fat diet than one it exists and Jolla agrees with that now where the saturated fat come in well actually there are many different types of saturated fatty acids and there is some data suggesting certainly that we've looked at butter specifically dairy smells of fairness and from Tufts has done a very good you know research looking at butter and I would say that eating butter from a cardiovascular point of view on-site is good for you I'd say it's neutral a sort of at worst could be related to redo reduction in risk of type 2 diabetes but again it's about getting all looking at the whole overall diet and not demonizing one particular food no hero and demon foods well though hero hero I think you'd all agree plant-based vegetables yeah absolutely yeah we do disagree there has been a randomized study of a plant-based no added oil diet that got to the level of size and in mortality reduction that the government is now reimburse the sport it's called the work of dr. Dean Ornish then he proceeded to look at prostate cancer and he showed that a low-fat plant-based diet shrinks prostate cancer lowers PSA and actually lengthens telomeres which we talked about last year as a marker a longevity in the Preta med Mediterranean study with 40 percent fat calories telomeres did not lengthen with a low-fat no added oil Ornish diet telomeres lengthen whether that means people on that diet are going to live longer is unknown but it's an area of current follow-up I'm concerned will differ cheese in the Preta med study increased insulin resistance and increased metabolic syndrome occurrence you recommend cheese in the diet I will not recommend cheese because the Parata med Mediterranean diet says that's a food type that increases your risk a metabolic syndrome which I you know I don't favor in my patients so I agree parsing the data is difficult but a low-carb high-fat diet increases coronary artery risk and death I mean that's that's incontrovertible data well actually I disagree on that so critical review and nutrition critical review nutrition actually showed that apart from fasting or starvation if you like falling for type 2 diabetes low carbohydrate diet had the most beneficial effects not just in reducing the need for medications or improving glucose markers in the blood for people type 2 diabetes but also reversing all markers of the metabolic syndrome now let's talk about dean ornish and i have a lot of respect for Dean Ornish's done I think he's done some great work the study that Joe's referring to you know small numbers but certainly looked at very good outcomes in people you know who at risk of heart disease who had heart disease and it was multiple factors now yeah of course low fat was part of it but it was all so about reduction in stress it was exercise it was all these are the aspects to its smoking reduction I mean smoking the biggest decline in cardiovascular death in the last several decades has happened because of a decline in smoking you know there was a place in Helena Montana in 2002 they broke they brought in a public smoking ban within six months just to give you an idea because it's links to died within six months of the smoking ban there was a 40% decrease in hospital admissions for heart attacks 40% when the tobacco lobby weighed in the law was rescinded the admission levels went back to preceding levels and how do you explain that biologically well just 30 minutes of secondhand smoke increases what we call platelet reactivity so basically makes the blood more credible and you know that the comparisons between tobacco and big sugar are quite chilling it took 50 years between the first links between smoking and lung cancer were published in the British Medical Journal before any effective regulation happened and that's because big tobacco tobacco played dirty you know they had a corporate playbook which basically included denying the you know cigarettes cause cancer planting doubt confusing the public and even buying the loyalty of scientists and we've seen we're now learning the same thing has been happening with sugar so you know I think Dean Ornish did some very great work can you tease out specifically it was low fat I don't think you can add on things and if you want to look at you know look at this data or critique of that work in the best possible way and it's not good to criticize the in Ornish then I suggest you look at Nina ty Coles has done a very good analysis and critique of Dean Ornish's interpretation certainly of Dean Ornish's work so for all the people out there you know who are listening you know what we don't want as people become more confused absolutely so you know if we're going to take the best of both worlds right and also the knock on diet is sometimes it's not accessible so if we're going to take the best of both worlds what does that look like so you all great plant-based diet fats you agree to some degree unable to be an ally little fats olive oil you're great diet can be plant-based fats butter you disagree on we both agree we're not going to bathe in it the unsaid and it's always has to be mentioned it's 1500 gals the water to make a pound to meet it's a thousand gallons water make a pound of cheese we're in Arizona many of you from California the environmental impact of your food choices is a single biggest decision you can make for a green earth or a barren earth and only plant-strong diet and plant-based diets are going to make that impact and let's stop raping and killing animals for our lust I mean I live in a life that is enriched by knowing I don't harm animals my boots are bigger so I want to bring that up as the always unset in the Paleo low-carb movement it is huge I think everyone everyone understands out here we need to live that if we understand that in at least in my life I can't talk to other people yeah and I'm not gonna stand here and say you have to have meat to reduce your heart of cardiovascular risk and you don't need to the question is how is that data and interpretation of the evidence on the science around me consumption how is it being used by people who have you know fundamental beliefs and I respect those beliefs about you know harm to animals and not eating meat there's no issue with that you know as I said my mum's a vegetarian and feels might very much the same way but let's just get the science right the commonalities coming back to what you said Jason I think you had the olive oil the vegetables you can War Andrew mentioned that and cut out the refined carbs and sugar so your risk of type 2 diabetes stabbing doughnuts start eating apples will change the health in England of America right away I mean there we go thank you guys thank you very much there you go I brought you gifts though huh Oh

Channel: the mindbodygreen podcast

Views: 210,913

Keywords: cardiologist, heart, heart health, Dr. Joel Kahn, Dr. Aseem Malhotra, cardiology, vegetarian, vegan, plant-based, nutrition, sugar, fat, cholesterol, paleo, veganism, vegetarianism, specialty diets, wellness, health, body, heart attack, weight loss, cardiac health, overweight, obesity, fat loss, arteries, oil, coconut oil, healthy fats, omega-3

Id: OKXouN4PMFY

Length: 23min 41sec (1421 seconds)

Published: Thu Sep 29 2016