Why too much exercise may cause you a heart attack | Dr Aseem Malhotra | Fat & Furious Ep 20

welcome you are listening to the fat and furious podcast in this podcast series your host Steve Bennett father of seven best-selling author and adventurer will be joined by 23 of the world's most forward-thinking medical professionals doctors authors and top nutritionists when he'll share the truth behind living healthier and happier for longer in this episode I'm going to be talking with a very good friend of mine dr. Aseema lot truck a scene is both a practicing cardiologist and a professor of evidence-based medicine he's a founding member of action on sugar and has led work highlighting the harm caused by excess sugar consumption in our country particularly in its role in type 2 diabetes a scene is written for dozens of publications including the British Medical Journal The Guardian and Observer BBC online Huffington Post The Daily Mirror The Daily Mail the Daily Telegraph and The Washington Post in 2018 he was ranked by analytical as the number one doctor in the world influencing our thinking on obesity his first book co-authored with Donald O'Neil that pie appa diet was published in 2017 and he's already an international bestseller great having with me again last session was absolutely fascinating looking at the heart of a great diet and a lot around your Poppi diet for those that haven't listened to that show yet give us a brief brief introduction about yourself and today we're going to talk about why too much exercise might kill you okay that's so we talk about exercise more today Robin justjust diets but for everybody at home that's that's new to you yeah that's a brief introduction so I'm a consultant cardiologist I've been practicing medicine for almost 19 years specializing in cardiology for last ten years originally trained in doing keyhole heart surgery now shifted my focus more to prevention because my personal mission or aim is to save a million lives at a time just a few and and and my main focus my area of interests in research now is about preventing and potentially reversing heart disease okay so preventing I can understand reversing heart disease that once some he's already had symptoms or a heart attack or some sort of cardiovascular system so quite a broad term actually Steve so there's one of what are the various risk factors combined together to make you more likely to develop heart disease and have a heart attack and we know that those risk factors from my own experience and what I advocate with my lifestyle plan we know those risk factors can be reversed very quickly you know in even within 21 days within a few weeks which most people learn quite extraordinary so that's great news isn't it absolutely it's great because then you know they're in a much healthier position for the long term now to truly reverse heart disease we're talking about a narrowing in the artery that develops over time reducing that narrowing reducing that sort of we call as stenosis is a medical term from it and there is evidence out there that happens and that can be done the only question is we don't know exactly although I'm pretty sure my in my own mind we don't have what we call the the highest quality best studies to prove it 100% but it does happen I've seen it happen with with my patients and there are there's research out there showing a combination of things that people do relate to their diet and reducing stress and exercising and stopping smoking contribute to that potential process so my next stage over phases that I have you know designed a trial clinical trial to try and prove that and I'm working obviously on getting that under way I think one of the things that we discussed discussed before one of the issues or problems in modern research is bias funding so the funding has to come from somebody who isn't there to profit from the results so either government funding or an independent body to make that study happen but irrespective patients who follow this plan of mine will reverse their risk factors quite quickly so I what I want to do is get this widespread across the world because then we will genuinely curb reduce heart disease well let's get strength of data and let me just say that because of people like you and all the research I've done when I was late forties obese friends dying of cancer family dog cancer I was convinced I wouldn't last a 60 years old just because it was it was it was just prevalent all around me I'm now gonna for a hundred right so I'm gunning for a hundred and while I and instead quite a lot about how to avoid cancers quite a lot about how to avoid diabetes and Alzheimer's I really want to hear from you then how I do my absolute best to make sure to avoid the heart attack because one of the things the heart attack I have a friend of mine Colin died in the sixties last year an ex PE teacher he was the last person anybody would've thought would drop dead of a heart attack and one things that scares me a little bit with the heart attack is that while obesity comes on slowly and you can see the physical signs of it when Alzheimer's of course you know you can see the signs of it arthritis you can see the size heart attacks and just appear to happen overnight so I really want to hear in this hour you know again linking back to exercise and shorten that is or can we do too much of it talk us through in detail in detail then what is the heart attack what causes it what's the best way to make sure we're not yeah it still is the most prevalent cause of early death in the UK I believe yeah absolutely globally West in the Western world certainly it is in Europe it's the number one cause of death in prematurely in men specifically as well so dying under the age of 65 is heart attacks and there are still places in the world cut off remote places in the and is that the Masai in Kenya Tanzania where heart attacks just don't happen so yeah it must be it must have a preventable element to it because there are parts the world weight just doesn't happen yeah absolutely so to understand heart attacks a heart attack is basically when there is a sudden reduction in blood supply to the heart muscle so the heart is a muscle that pumps blood all around the body and provides oxygen and nutrients to all ourselves when the sudden reduction in blood supply to the heart muscle supplied what by the coronary artery so these early heart has its own separate blood supply of coronary arteries that last long enough to cause damage to the cells of the heart muscle and that can be small or it can be large as soon as this damage to the cells we call the cell death because of the reduction blood supply that's called a heart attack and that's diagnosed from a history from a patient that but ultimately from a from using an ECG a heart tracing in a blood test the blood test indicates cell death we call that troponin so that's how we diagnose heart attacks now it's interesting what you mentioned about you know very sad about your friend but 50 percent of heart attacks roughly happened with no preceding warning okay so and about 50 percent of people who have heart attacks don't make it to us for life so this can be all very sudden yes and the reason why people don't get any warning is for some people that suffer heart attacks they usually may be diagnosed with we call angina you may have heard that term angina a lot of people have heard that yes oh it's a classic feeling of a chest tightness yeah in the center of the chest that happens with exertion and is really all with stress and is relieved by rest sometimes it can go up into the jaw down the left arm if that happens with exertion relieved by rest you must see your doctor because it's there's a strong chance it could be angina and enjoy no isn't a heart attack so what's actually happening in the arteries is usually for angina to happen at least 70% of your archery needs to be blocked right so what happens is when the heart undergoes stress in the sense of it needs more oxygen with exercise that 70% narrowing suddenly becomes it's not a veil it's not out there's not enough blood to hit the heart and then you get pain in the chest that's what you don't notice it day-to-day but as soon as you put a bit of load on the system but you try to pump more blood through a narrowed artery and trying to pump it faster that's when we get enjoying absolutely now what's interesting though and coming back to why 50% of people who have heart attacks of no pre warning signs or no angina preceding it for months or years beforehand is and this is where something that has I've been involved in trying to shift that understanding is that most heart attacks happen at narrowings that are not 70% there maybe 20% they may be 30% there may be 40% so they won't call was any problems in terms of symptoms with exercise or stress but suddenly what happens that narrowing I liken it to like a pimple okay imagine a pimple or a volcano or something that if it stays as it is doesn't cause a problem the volcano but the volcano erupts you've got a problem so suddenly that pimple of a volcano that erupts or bursts or whatever and it releases the contents of the inside of that inside the blood vessel and then suddenly a clot forms and it takes minutes for a quater form and you say that volcanos on the inside lining of the archer wall yes absolutely absolutely and then that clot forms you get a complete often a complete occlusion then of that pol artery because a clot the body's reacting forms a clot and the blood doesn't go through and then you have a heart attack so that's how it happens often it's it that's why a lot of people don't get any warning signs so and the other thing to mention as well which is interesting people a lot of people have heard of heart stents so these are little metal scaffoldings that are put into people with stable heart disease or to treat a heart attack when it's happening but we know actually what's interesting from data that even if you have a 90% blockage that's stable hasn't caused a heart attack that's found from you know an angiogram if you put a metal scaffold in there to try and you know stretch the artery and open up that narrowing that doesn't prevent heart attacks or prolong life because the process behind heart attacks is an inflammatory one that causes a sudden eruption and if you have a gradual narrowing in your arteries so another side of all of this say you don't have that eruption that sudden clot forming if the narrowing which develops over over years it can start even in teenage alright small starts with a small fatty streak of inflammatory shells and cholesterol and all that if that builds up over time gradually that will rarely cause a heart attack even if it 100% blocks gradually because the letters found its alternative we call that collateral vessel so new blood vessels form so for me having so people need to understand that first once you understand that then the question is well well well what what can you do to reduce a risk of that if there's a narrowing there that's developed you've got you know how do you reduce the risk of that causing a heart attack or rupturing or erupting or whatever and can you potentially reduce that narrowing so let's talk about reducing the rupture first chances of a happening and that's a bit we're really worried about exactly so there are things you can do no symptoms just at any point your life if there's something you can do that can reduce the risk of rupture so if your smoker we know stopping smoking is you know one of the most important as a smoker the most important thing you can do to prolong your life more important than any medications we can throw at you if you're diagnosed with heart disease reducing risk farts are can prolonging your life so stopping smoking because you know the toxins that are inhaled are getting to the bloodstream or pro-inflammatory and they contribute to the likelihood of this volcano or pimple bursting or erupting okay so stopping smoking reducing stress like severe stress can suddenly cause these things so sometimes you see in films somebody's heard some bad news or some things happen and suddenly the clutching their chest and they're falling down that's acute stress really sad being the last kind of there are so many marathons where people have died in the marathon taking part in a you know big exercise of hven and I guess that says hey the muscles muscle the the archer walls must be so stressed warrior yeah so I think on that now let's talk about we'll come on to the other diet stuff in a minute but on the exercise stuff it's quite interesting this because again this is someone talking someone like yourself and we were avid obsessive exercises but and people some people still think that if you exercise really well and you do loads of exercise you'll notice a part disease that's completely false in fact one study published in 2017 showed that people that did about seven and a half hours of exercise quite moderate to intense exercise a week there are people out there that do that crazy stuff the exercise of that level they develop more heart disease than people that did moderate a lot more than people who didn't moderate activity which is basically you know two and a half hours a week in motor activity now the reason the way that was discovered over a 25-year period follow-up is that people when they did these scans called calcium scores which is a scan that can actually be a good mark of how much heart disease you've got they had Nelson is the thing that builds up in the in the artery walls that then explodes is that right no yeah it's part of that pock it's a marker of underlying narrowings and the high your calcium score the more narrowings you're likely to have it's just part of what goes on with that inflammatory process so what happens is the artery gets damaged there's inflammation it then forms a little pimple and it can build over time and then suddenly it can release its contents of rupture and cause that cough and calcium is part of that process so calcium is a mark and it B you can do a scan using x-rays to to look at the calcium they found in those people that had very high levels of exercise up to middle a so up to about fifty fifty five years old they had higher calcium scores that did more exercising the people that did less now to be fair just to you know we talking about consumers exercise kill you I think it can that may also be different to saying that not necessarily resulted in dying earlier we don't know that but logically to think there's more heart disease or more at risk of death yes interesting that you know we all think that people have been jogging forever but my view on this is that exercise should be what the body's designed for what it's evolved from so need to walk more because we were all nomadic thousands of years ago you all need to get out and walk more we need to lift heavier things because got to keep out especially as we age you should see I believe older people in the gym more than younger people because we need to keep our muscles as we as we age but this relentless jogging which I used to be part of that fraternity actually quite a modern thing in fact I call ken Cooper in America in the late 60s they reckon back in 1968 in America less than a hundred thousand people class himself as joggers within two years after ken cooper coined the phrase aerobics there was something like 30 million people starting to job so jogging actually he's quite alien to the human body you know I can't Cooper and I admire this man because he did a complete u-turn he's a guy that the educated presidents and Olympic sport stars on more exercises better is better and better and towards the last latter end of his life he said I got it completely wrong yeah I assumed that more exercise meant longer life well actually if you go over the top it actually shortens so it's just getting that balance right to exercise that's a good point so they did a very large study observational study looking at X Olympic athletes and they found that elite athletes don't live and he got longer than golfers or cricketers so what I say is a little goes a long way know why you're exercising it and listen to your body so one of the problems with jogging I mean a lot of my friends orthopedic surgeons and they said to me they're seeing more and more people in their 30s and 40s having me and hip replacements yeah because they're jogging on the road he said no one should be running on the road but there's this kind of mentality driven by whatever seeing stuff on TV or thinking it looks good and it's also not the best as you know Steve it's not the best way to get a cardio anyway sure you know you're only going to a certain level when you do you know it's much better to do things like client since the interval training for short periods you know use compound movements use your you know get your glutes involved your quads also we in the big fat fix we talked about all of this stuff so that's exactly how you get cardio yeah but without damaging your joints and think people need to think about that because some people get properly crippled yeah in older age because and they've been you know doing marathons and stuff and they they can't walk and it's not nice yeah you know I don't wanna be that person why was that person I was that 10 to 15 hours a week jogging full-on cycling I've had to have a knee replacement and it just goes on and on and all that time I was obese so it isn't the answer to losing weight for sure is it the answer for happiness and longevity I don't think so cause it's alien to the body pain yeah it's not nice yeah you know even if you're an athlete to have chronic pain you know it makes you depressed it's not a nice way Sabean I've had injuries in my life I've had to change my exercise routine completely I used to be a runner 5k slam it you know every morning wake up at 6 run 5k on the treadmill take a shower into the operating theater for the next ten hours or whatever and it started to affect my knees so I've not I've stopped in the last year's I don't run anymore I do some occasional sprints very short Sprint's but I don't do that running on a treadmill for 5k three times a week anymore yeah in fact I believe in the primal living book we call it a moms principle mo max right max at so Hinesville training where you lifting not massively heavy weights but till you just can't move them anymore because I believe son is your age you shouldn't be lifting massive big dumbbells because then you're gonna hurt yourself but light dumbbells like bars but just keep going till you can't move anymore and really max out the muscles then we say the best one of all is the middle bit of moms mm move more yeah just get out and walk yes infographic you're going to share a little bit later you say that one the best ways to prevent the heart attack you just get out and walk I think you said 22 minutes per day will help health organization quite 25 minutes a day but in that region of 20 25 minutes yeah just get out and do everything the way we came over more 22 minutes is basically it was times by 7 roughly 150 minutes a week to miss day but just get your heart rate up to get you a little bit breathless doing the all these blue you know these people are outside they were walking that's all you need what he doesn't need in terms of longevity now okay there are other things as you get older one of the things that happens is you lose muscle mass we call it sarcopenia and that is an issue especially the elderly they're more vulnerable to falling and injuring themselves breaking a hip you know something you want to try and avoid if you break a hip 25% of those people will die in hospital so it's a big issue so a bit of resistance training a bit of lifting stuff functional movements really important as well yeah I say should always see more older people bench pressing in the gym than younger people because we do you know do lose that muscle mass I think it's 5% every 10 years as we get older sure right next question then so if it's not going out and killing ourselves on the running track or cycling like crazy to avoid a heart attack what can we do to reverse any symptoms of already God or to lessen our chances of being one of those poor people that it just they just drop dead of a heart attack what do we do to lessen our chances so to reduce a risk I think you know all the data I've analyzed is basically falling a dietary pattern is a Mediterranean diet that's low in sugar and starchy carbohydrates which is higher in base fat of extra-virgin olive oil I mean I I would describe olive oil looking at the data and its effects on the body good quality olive oil like a medicine to be honest and if you think about that that kind of potential volcano that's about to erupt in the arteries and you see that fire burning you know I would say you know to explain it if you have the olive oil with your vegetables and oily fish like it's almost like dowsing the fuels the flames of that fire you know if you think about that so kind of the artery and that will this it's about stabilizing what's already there so use the risk of that causing your problems down the line say olive oil Malcolm big fan of Amiga threes as well does that fit into the same category absolutely absolutely so oily fish you know certain seeds will flaxseed for example so these Omega threes are very very good very anti-inflammatory and avoiding the other thing actually to avoid which what people probably don't know about is cooking in local industrial seed oils like sunflower soybean oil that kind of stuff when you heat those oils or they become quite toxic relatively you know not very high temperatures and they're pro-inflammatory so you want to be cooking ideally your base fats should be extra virgin olive oil but on top of that then if you're doing that then there's no issue with having some butter and coconut oil and all that kind of stuff yeah key you know I use this all the time but the main thing is get at least four tablespoons of extra virgin olive oil in per day I probably get about ten isn't that amazing that all the things you just mentioned five years ago was the enemy you know people say saturated fat that's what clogs the artery but all the ones you just mentioned coconut oil is high in MCT saturated fat but as high in saturated fat meets the high in saturated fat well even extra-virgin olive oil has a soul chain 220 percent saturated fat which is higher than what we're recommended to consume it and of total calories and the facts we should be avoiding or the manufactured man-made hydrogenated the margins that the oils they probably use in chip shops and you know yeah and I've sent you earlier on you know in my other job is around gemstones and I've frustrated for years I've been with Swarovski crystal calling their Swarovski crystals crystals when they're not crystals and it's just this big con and it's like if you want to look at you know all y'all got a bad name a fad got a bad name yeah around heart attacks and everything and yet all the things they said was bad for a saturated fat there it's the natural ones that are part of the solution yeah part of the problem is all those vegetable oils and reasonably mint since our us because isn't a crystal and vegetable oil isn't made for vegetables it's just ridiculous those types of manmade oils get back to natural fats and even even nuts you know high in fatty acids are thought to be anti-inflammatory so a tree nuts I would say a handful of either almonds walnuts hazelnuts very good Brazil nuts are also very good so I would say a handful of those every day this is what I advise my patients to do and you're you know going you're a long way to reducing your risk significantly of a heart problem but again not to do things in isolation make sure you're doing at least a bit of Mordo be sanitary and really think about reducing your stress levels now some people are great at listening and absorbing information some people are better with images so those are listening on the podcast then I'm gonna bring up an infographic from the British Journal of sports and if you maybe pause right now and just type into Google any of the search engine saturated fats does not clog arteries you'll find this infographic that you were part of putting together yeah talk us through then yeah what it is we're looking at here so so this was an editorial published in Britain of Sports Medicine I was a lead author there were two of the eminent cardiologists actually involved in this it wasn't just a C Malhotra causing trouble again no absolutely but - so they're both editors a medical journal so it gave it a lot I think you give extra credibility that this is something that people state notice off and actually the rest of that title so saturated fat does not clog the arteries coronary arteries is a chronic inflammatory condition that can be effectively managed with lifestyle interventions quite a long title but that was kind of shifting that paradigm let me just say one more time because is a miracle for me so saturated fat just not clog the arteries coronary heart disease is a chronic inflammatory condition that can be effectively combatted or managed with lifestyle interventions and that so therefore if it can be managed it can therefore be reversed absolutely I believe that that is the case and at the very least even if you're not necessarily reducing the narrowings you can stop those narrowings from causing a heart attack and just remain stable for the rest of your life potentially if you do these lifestyle changes so this infographic which is there if you google that you can have a look at it basically shows first of all the bottom it shows the root of heart disease it's a combination of insulin resistance which is in layman's terms excess body fat you know often related to too much starch and sugar in the diet and systemic inflammation and what causes that is basically you know the wrong sorts of diet too much stress smoking being sedentary so therefore to combat it you sort your diets out and we talk about you know I recommend personally a higher fat Mediterranean diet so that's you know base of it lots of vegetables extra-virgin olive oil nuts oily fish moderate intake of cheese and yogurt a lot of these you know certainly PRP and somebody and we think that interesting on dairy there's been a lot of controversy on dairy but at the moment the data suggests and again it's not the most robust you know conclusive data but it suggests that full-fat dairy may protect you protect you from heart disease and types of diabetes and plus it's nutritious and you enjoy so incomplete you turn so I say moderate intake of cheese and yogurt and something that's low in sugar and refined carbohydrates tempt a you have to completely avoid it altogether but you should try and reduce it significantly and then combined with that is regular activity we say walking 22 minutes a day 150 minutes a week moderate activity so getting your heart rate up to at least 50 percent of your target heart rate what does that mean so everybody has a target heart rate and maximum heart rate which is a simple calculation 220 minus your age okay if you're 40 year old person to 20 minus or ages under 1/8 see yeah and you want to get to at least 50% of that yeah for 30 minutes yeah ideally 50 to 70% some of that so that means gang it's a 90 beats a minute and you can use apps if you want you know check that get that for at least 30 minutes a day or 22 minutes a day if you like to get to 150 minutes a week in layman's terms is that a fast-paced walk as opposed to a run yes it's a British walk yeah brisk walk so that the exercise side of things and of course you can do other stuff as well of course that you enjoy you know I say if you like doing this or your golf or do what you enjoy whether it's dancing cycling I wrote an article in The Washington Post when we on the back of another British trust sports medicine article had written called busting mr. physical at physical activity and said dancing cycling sex even you know preferably not all three at the same time and then stress reduction big thing really important is meditation yoga there is some good studies out there showing that it does reduce a risk of having heart attacks yeah and even death rates from introducing that especially people who are at high risk of heart disease who have had a heart attacks already and I'm a very big advocate of that not just for physical but even mentally my patients feel so much better mentally when they do that within weeks of doing meditation you know half an hour a day now we talk about reducing that the facts how quickly can this us we don't know that our arteries are clogging up lots of people now it's suggesting that if you're concerned at all going up at the CAC scan to see what your calcium levels are but if you're not having a CAC scan and you're worried because maybe you know you've been overweight for a long time maybe you were an ex-smoker maybe you drank too much how quick can we start seeing benefits if we start to follow what you're suggesting here with the the high-fat miterrand diet getting out and walking is does it take years and years so it depends where you're starting from Steve to be honest but if you are already you have what we call metabolic syndrome yeah so metabolic syndrome is a synonymous another way of describing into resistance but specifically the reason I talk about metals box syndrome and I'll define it now is two thirds of people having heart attacks now have metabolic syndrome okay and most some interests and we have normal cholesterol levels but we'll come on to that in a minute because I think I'm sure people want to hear a bit more about cholesterol and why we should not worry about it so much but metabolic syndrome is basically any three of these five high blood pressure pre-diabetes or type 2 diabetes high blood triglyceride low HDL so-called good cholesterol and increase waist circumference so we think about those you matter what extender and being the big issue with heart disease how quickly can you reverse those risk factors it can happen within weeks 21 days yeah you know I've seen it happen and against waist up if you've got metabolic syndrome you can reverse get out of the definition of having metabolic syndrome and you know within a few weeks of changing your lifestyle it's that quick answer let's break down the word metabolic and syndrome because I hate every conference I go to at the moment people say metabolic syndrome all these things know the main cause of death in the UK and westernized society heart attacks cancer Alzheimer's diabetes obesity all of these can relate in a big part to metabolic syndrome yes and they don't happen in cutoff areas like the kick saying the Andes and many of the Blue Zones of modern civilization you're obviously right it's a cluster of risk factors yeah and it is a you know I think there's very good evidence say yeah it's not just about heart disease it's about cancer and dementia as well yeah so I think this is with the information we have in terms of lifestyle the impact this is the best available data we have to show how you can you know stop this happening or at least very least delay it and and live a decent healthy life for most of your life I just would come back to that again one more time because it's really encouraging I think that if we say metabolic syndrome you have two or three of those symptoms a large stomach high blood pressure they are and so on and so forth if they're all related but you can revert start start the reversing process in three weeks or so twenty-one days that's really encouraging isn't it because you know even if you were an ex-smoker even if you you know you just maybe drank too much for such a long period but I put myself in that camp and ate all the wrong foods because I wasn't used to be massive on carbohydrates because of all the running and all the sports you know the encouraging thing is don't take it seriously because these are lifestyle changes that are way more important than obsessing about cholesterol or things like this absolutely 100% and that is rapid and I see that with my patients in fact there was a the PRP diet was released in Holland the Dutch version a day after a documentary film was made where they actually took three you know Dutch cities I was there to explain the science and said dr. Malhotra we want to test out your theory about this 21-day reversal one chap had type 2 diabetes about to go on insulin either chap Hyder had blood pressure diagnosed with stable heart disease and the third the lady had struggled with weight for many years it had bariatric surgery but it was then now clinically obese as well and I explained to them the science explained a u-turn on what they should be doing in terms of what they eat and it was actually very emotional for them because they were followed by GP all the blood markers and a month later it was actually 28 days in the end it's because of where the filming was they were told their results the chap with type 2 diabetes about to go on insulin came off his medications and sent his type 2 diabetes into remission well just from falling PRP diet the gut with the high blood pressure similar he was able to reduce the doses of his blood pressure pills come off one or two of them as well and felt great because of it it also lost some weight around his belly and the lady with who had weight issues and again part of also this is there's no counting calories you eat all your fault yes well you don't snack but you need two or three meals a day Neitzel your fault you enjoy your food the lady with with the weight problems lost 10 kilograms and can't believe it and she said she felt great so it showed that this stuff works and it will then the book was released in Holland and you know I was pleasantly surprised that for the next six weeks it was number one and all the charts and all and you know it was it had a really big impact because of this this program was sort of quite famous bought your book and I don't think you knew him at the time he was the deputy leader of the Labour Party Tom Watson yeah and I met Tom a few months back and he had credit I mean he was diabetic he was massively overweight awfully stressed as a politician and yeah he puts it all down to following your diet and look at him now he's a picture of yeah I did I'm so pleased for him actually I think tom is being public about the fact that you know he's getting into his 50s and he was suddenly got very worried and scared about the fact that he was saying you know colleagues of his some labour politicians who died of heart disease prematurely and he thought I'd only be that person and then he contacted me an issue through Twitter I think about six months into the fact he was falling the die and said and I was you know he said I've been following your plan and I've lost I think about stage sixty-six pounds or something like that but I want to see how long do I think sustained and if it's and then he's been able to continue anything he's lost of a total of a hundred pounds and he's doing really well it was amazing advocate for this don't go back to your trial a moment go and also Tom cuz Tom would have been overweight for a long long time not only can you it appears reverse it it's always the easy to reversely if you've only just got so diabetes you know if you can catch it early enough try and avoid the medication possibly and try and change your lifestyle first before you commit to a lifestyle of medication but I'm sure you or somebody I was listening to recently they said you've even seen people that have been 25 years on medication that once they commit to reversing it can still happen absolutely it's it's extraordinary and so my patients come to me who some of them who've come to the NHS in the first time said by the way doc you know I've been on blood-pressure pills for fifteen years I went in your diet plan to start walking again nothing else and within three months stopped three of the four blood pressure medications had been on fifteen years yeah I never felt better so it does have that you know it does have that rapid impact there's another question about sustainability and I think that's an important question in general you know people will say why most diets fail people change stuff it helps in the short term and then they fall off the wagon for me I think you know if it's enjoyable it's more like to be sustainable if people feel better then what I sustain it but they're still battling against this food environment which is altered processed food yes and I think you know that's why for me part of my work isn't just about explaining the science for individuals to be helped which is great but to sustain it and help more people we need to make sure that this sort of food is is abundantly available and affordable for everybody mm-hm and if that's the case then we we can sort this on a population level as well and and help people sustain this for a longer period of time yeah and that's where a lot of you know on my other side which is health daddy.com she's not for profit you know where we are lobbying the eat well guidelines and how you're doing the same to say look we have to scrap them or change them or do something because while there's eat lightly well guidelines are in place then it's very easy for the big food corporations peddling their sugar load it chemically infused no sense to us just to hide behind the guideline so let's get rid of them or at least get them changed I also think you can't have one guideline for everybody you know no sure if somebody is slender and very active and and all the things you suggested like walking everyday occasional sprinting lifting some weights and younger of course you can have a few car buy my yeah that's the part of you money but if you want dad who's diabetic injecting himself every day he should be avoiding them as much as he can to try and reduce that medication and eventually hopefully hopefully come off it sure hundred percent so let's keep on lobbying against those guidelines and it's great well you've got Tom Watson as a complete advocate so who knows what's going to happen in politics maybe one day you can have a bigger influence on it let's just what we've been talking about exercise let's put these into some sort of not I don't put chart because it's different for everybody but exercise is good as in walking but not too much running and so on so forth if you had to say the number one preventative thing or if you've already concerned about maybe your arteries may be clogging up and you just got feeling that that might be you we're gonna have a CAC scan just to put your mind at rest because stress is a bad thing anyway but if you aren't going to have a CAC scan would you say start diet start to look at understanding food because that actually the diets the wrong word isn't it because diet is like a fad word diet the actual diet word is a Greek word for a waiter yeah it's a lifestyle lifestyle Chatterley so in our understanding yours and mine of what diet means yes you should be on a diet but not one of these fad diets I've always said change really happens when people understand the problem with calorie counting I know so many people on diets and I've been on all of them over the years where you were told what to do but didn't really understand it then eventually you get become fat again so you know it's about understanding the basics of macronutrients those carbs proteins and fats and understanding which keep you slender and which make you fight listen you can have something that's zero calorie but it's going to make you overweight isn't that amazing so if you for me you know these diet drinks for example they actually work as appetite stimulants quite often you end up eating more yeah and so you got to think about how is what you're consuming affecting your appetite control mechanisms or hormones your metabolism this it's not just about simple calories in calories out calories do matter but where the calories come from matter more and when you eat nutritious healthy foods in general your body corrects itself there was no obesity in our grandparents generation yeah they weren't counting calories were they yeah they weren't noticing real food just eating food without labels on it that gave a playground and if you think about the three macronutrients and people say but it is about counting calories and that's where they hide behind some of these big food companies I say that a calorie from fat is different to calories from protein which is different from a calorie from carbs and some people say that's rubbish I say okay think of it another way a hundred dollars a hundred euros and a hundred pounds are all a hundred of a currency but they all buy you different things it's exactly what the case is with food so you need to understand the basics of food understand the fats not the bad guy I'd say what I'd like to probably end up this session on we're talking about how the speed of reversal of heart disease we're talking about had too much exercise could kill you we haven't yet touch them that word that that I've been paranoid about four years and caused me untold stress because I've been threatened to go on statins by my doctor so many times tell me about cholesterol because we haven't mentioned principles yet so it's a very good question so for years what I learned in medical school is high cholesterol is a risk factor for heart disease in fact it's been at the heart of public health policy and amongst cardiologists and you know even through to GPS that the most important thing we can do to reduce risk of heart disease the number one target is cholesterol and get it as low as possible let's explain where that came from so there was a study that we carried out over several decades started in the 1950s in a town called Framingham Massachusetts in the United States and they followed up 5,000 people and from that lots of publications and you know medical journals came to try and look at various risk factors to try and determine disease so we got smoking about exercise now cholesterol emerges a so-called risk factor from that study but to find an association a strong association with high cholesterol and heart disease and that was true however the levels were actually very very high affecting a very small proportion of people so it's only they found that the association was strong if your total cholesterol is above 10 now I rarely see patients have a closer or anywhere close to that and we now know that that is linked to a genetic condition called familial hypercholesterolemia so genetic condition where people have got very high cholesterol levels interestingly on their and that affects about 150 people Steve but interestingly on there another thing that is misunderstood a lot of our cholesterol total cholesterol generally is genetically determined anyway probably bout 80% of it we kind of influence it by diet slightly so there's a genetic thing now on the other side the people with very low cholesterol levels less than 3.8 total cholesterol genetically have almost no heart disease or less heart disease but for most of the population in middle 90% plus your total cholesterol did not determine who was good at heart disease and who wasn't right okay but what's happened is there's been a mindset that we need to get everyone's cholesterol lower level as low as possible into this lesson for category or less than three point a and that's the best way to combat heart disease now what how can you do that there are two ways you can do it from diet but the studies have now confirmed that low in saturated fat does not have any impact on heart attacks strokes death whatever okay so basically a waste of time potentially harmful one study showed that people heart attack patients who lowered their cholesterol using a safflower oil containing margarine had more death rates and the patients that had butter instead so this is you know so on that what I would say I quote a colleague of mine Rita red Berg who's a cardiologist in America and she says cholesterol is just a lab number who cares about lowering cholesterol unless it translates into a benefit for patients agreed okay so I say don't think about low in cholesterol think about these other things and cholesterol further down the bottom if that in terms of should be the focus it's not so true I've read somewhere that if you have to lower cholesterol that's equally dangerous yeah so so interesting as you get older the lower cholesterol higher mortality rates which is what we found in our study when we looks at people over the age of 60 the other side is drugs so you can take drugs statins are prescribed to 8 million people this country probably about 100 million people around the world taking stand in the UK okay long prescribe that more than 1 in 10 people are status and we know that unless you've got heart disease you don't live longer taking us down and then you've got the whole issue of side effects which can affect in my view anything up to from anything from 20% maybe even 50% depending on what your individual makeup is well though that's frightening isn't it so my doctor for years was trying to push that things certainly threatened me with statins unless I got my cholesterol down and yet research I've read recently back to by blooming baggies that it takes three hundred people they call it numbers needed to treat yes around 300 to get one benefit and yet the side effects are way higher than the benefits yeah that's in the low-risk category absolutely and most people taking statins around the world are in low risk but they're not told this so it's it's a flawed approach it's it seems to have failed to curb heart disease from data that we've looked at and the reason for that is partly because there's another way of looking at the data in statistics if you take an average increase in life expectancy in people with heart disease taking statins every day religiously for five years and you take it as an average the average lis increase in life expectancy Steve based upon industry-sponsored database selected and probably weeds out people with side effects yeah for days you'll live longer over five year period so you go take the drugs but five years possibly having big side effects to get four days increase on average increase on average over that five year period oh right you can extrapolate out ten years whatever yeah but it's still a lot less than what people are led to believe and then when you look at the data on people stopping their statin and this is before any awareness of side effects about half of them who were prescribed it will stop it within a couple years of being prescribed so even if statins work which I think there probably is some small benefit I generally think there is some small benefit but one tell the patient to on a population level because of the side effects and discontinuation rates they've failed to curb heart disease it's a failed model and we should be focusing on insulin resistance inflammation and dr. bachlin chemic says there is slight evidence that the in that one in 300 he might help prevent heart disease but actually it's probably a byproduct and nothing still to do with lowering the question yeah I mean I wrote about this in Britain in British Medical Journal 2013 that my own understanding having looked at there were other drug trials that lowered cholesterol they didn't have an effect on heart attacks but statins seem to work so the question is why is there another mechanism and there is some evidence is yes it's anti-inflammatory or has some reduction in clots or whatever so I think it's probably more likely to be an independent of cholesterol-lowering mechanism so lowering cholesterol isn't its failed yeah it has failed and it shouldn't be the focus certainly for most people now if you've got this genetic condition with a very high cholesterol from it might be different for you and it may have some benefit you said one in 250 but I've seen a number of patients with that diagnosed for the first time as having high cholesterol in their fifties never been checked before lightly genetic they've had it for all their life and then we've done imaging on them and found there's no artery disease whatsoever so for those people high cholesterol is not a problem for them and they don't have to worry about statin and we've had that conversation and we've you know and they're making forms they don't so these are people request ones of 15 or 20 very high this rare genetic disorder one in 250 that still doesn't mean they're gonna have a heart and doesn't even mean that they need to go on studies they should go and have a proper scan of CICS something so we know 50% of men and 70% of women untreated who have familial hyperlipidemia will not develop premature heart disease so we're not what we need to do with the science is try and figure out is there something else going on there are some evidence suggests that some of these peers actually because they're more caught ability of the blood yeah that's actually the issue but that leads to expand I think it's been a slightly lazy approach and obviously there's a you know we're talking about an industry here without being naive Steve sales of statin drugs total revenues are estimated to reach one trillion US dollars by next year oh so there's so much money involved in this cholesterol hypothesis it's gonna take a bit more time to break that wall down yeah but I'll do my beer can I say I suggest everybody that the disputes or things that maybe this is discounted for read Malcolm Kendricks book called doctoring dates to find out who a to the nine members on the panel for suggesting that we should lower cholesterol by just a tiny point of 1% were funded by because they were all funded by the big pharmaceutical companies and every little bit they can drop down what is now the acceptable range of cholesterol means more more billions of dollars for the Indian the next approach is let's just get it lower and lower and lower yeah and then we all die for not having enough cholesterol I'm gonna ask a question and you don't have to answer first question how many physical heart operations key holes what have you done over the years so okay and that's the first question yeah and there it's a back up what we've been talking about things go through your head on must be while you're operating also you're concentrating on doing I can never tricks on my eye to hand coordination is terrible but yes you've gotta be very careful when you're in these operations but going through yet I bet it never goes you should have loaded your cholesterol it must have been lifestyle must have been off only you come in six months ago if you'd come in a year ago and I could have helped you the weight taught you about carb taught you about carbohydrates talking about the importance of avoiding packaged foods it there must be loads of emotions as you yeah sure acting absolutely absolutely so two things one in terms of my clinical experience in managing patients with heart disease tens of thousands over the years we expect all patients and and thousands of people with heart disease angiograms which is the visualization of the arteries I've done over a thousand of those and in people having extents put in either for what we call stable disease if they've got quite bad symptoms but more importantly heart attacks have done hundreds of those yeah so that's my background experience and knowledge in terms of Steve you're AB see right you're coming you're a very passionate guy you're very empathy levels were made I mean you really care about people a lot to do I think with the tragic story of your brother dying young and obviously suddenly losing your mom last year so you must really fit these are human beings we're not talking I always say that the million people dying or something is just a statistic but one person is a tragedy must be really yeah and get home for no it doesn't you know you go into medicine you're going to it's cardiology on the front line so the people are coming to have cardiac arrests have had a heart attack outside hospital they're being resuscitated they're come in and on the table and we can sometimes help them sometimes they die in front of us we've got to go in speak to the family it's one of the worst things that you know it's something you have to do you get used to and you have to be compassionate but it's something I'd rather I didn't have to do I'd rather not have to go to a family who'd lost you know their father or their their brother you know their sister their mum in their 50s or early 60s from something that was entirely avoidable you know and and for me that you know inspires me to keep going and the patient's I see in my outpatients as well who come in you know who have really suffered or they you know because of their of their lifestyle because they didn't know any better and they were given wrong information must really frustrate you I had Robert Holden in recently and he was saying that what really annoyed him with the eat Lancet report which pretty much said everybody in the world should go vegan or vegetarian or you know should definitely stop eating me he said I'm so frustrated because well there were 30 of them not one of them was a farmer that we came and asked me as an organic farmer what is the right thing to do and it must be the same for you having so many people peddling the wrong information around cholesterol and the wrong information around saturated fat when you're the guy on the front line operating on people yes seen thousands of people with fat families have been affected where they've lost loved ones knowing that actually most of what we're told is a lie and actually we can all reverse it quite quickly if we just come back to living primally eating the right food avoiding the chemical nonsense or we eat yeah I think one handicap is well Steve with a lot of these people who push these guidelines they don't have any and listen I respect academics who do their work rigorously but I think one issue is a lot of people are out of touch with they don't have patient contact yes and they're also out of touch with what patient want once you know and I think that's also crucial because you know evidence-based medicine which is what I advocate for is to improve people's health outcomes but there are three components how do you do that one is use your own clinical experience as a doctor yeah best available evidence although we know that a lot of that has been corrupted by commercial influence so after I have to cut through you know the misinformation there if you like and last but not least is taken to consideration patient values and preferences and that means having a conversation with them about what they really want you know and and and being foot and fully informing them which again doesn't fully happen and then they make a decision to whether it's about taking a statin having a stent done or following a particular lifestyle plan and it's to help them in the best possible way but if we just have you know one approach that patient comes in cholesterol according to a guideline which is not based upon any rigorous evidence suggests that the cholesterol is high give them a statin and then they're scare monger you must take the statin or you will die which is actually what happens then patients being middle all stress pate is becoming misinformed and and inadvertently harmed because you know one of the quick thing I'll touch on is one things I used to see is something called statin gluttony so people are given this drug to lower cholesterol given the illusion of protection it means they can eat what they like they think it's like the whole exercise thing yeah sighs you can eat what you like same thing with statins in some ways and the study showed that patients were the same risk factors followed up in middle-aged follow up over ten years the one that took statins end up more overweight than the people that didn't because of this they're relying on that pill for every ill cholesterol so it means you die it's funny Kenny what you like so you can go eat junk food and they end up getting diabetes and being obese but their cholesterol is fine so who cares and in fact there are some cardiologists actually believe this as well and think that way I'm not worried about the rest of it we've got your cholesterol down because you know they're making that decision or their understanding is is flawed and they haven't really looked at it in depth and they've accepted information that has been you know peddled as rigorous independent science as a gospel truth when in fact it often is the complete opposite yeah and we have a phrase in business you know stand back for the coalface take a helicopter view and see what's going on and you know I can't say I can't support doctors enough because 99.9 percent are trying to do what they got intermitted meds for just to help their patients but with such onslaught of patients coming in now a basic country overall we're dying younger yeah they're at that coal face and they can't stand back thank goodness though yourself dr. David Unwin Malkin Kendrick and a whole host of others now her stepping back saying hang on a minute okay we've come step back a little bit even though we're stressed we've got so much going on because we've gotta stop this from happening in the first place and it's great and the whole world and I can say things I'm not a doctor that probably can't say it is corrupt and we are misled by corporate greed and and it's not so much individuals that have deliberately harmed us as a nation it's they're doing what they're paid to do which is return shareholder investment yeah whether you be a food company whether you eat coca-cola mcdonald's whether you be a big pharmaceutical company you know pharmaceutical companies don't want us to get healthy because if we get healthy we stop taking pills you know food companies wants to keep eating their products and we keep putting more things in to make them addictive like more sugar more chemicals to make them addictive just like cigarettes and you're up against this whole war but thank goodness yourself Malcolm David and many others are stepping back now and saying time now to reflect on why we're a Sikh nation time down your case we're going to southern Italy and looking at how are they living longer why in in Europe are some people in some areas got a bit to do I guess we've the environment the climate but why they living so much longer than we are in the UK and just thank you for that research so I say what I'm 53 you're a lot younger give me then if it's not too too much exercise can kill me and I believe that that's why I don't do as much these days I'm definitely more healthy for it as well that's cutting back on the exercise I already buy into sort of the high fat low carbs anything else you'd recommend and make sure you getting I mean we spoke about this last night but you know make sure you getting at least seven hours sleep a night yeah for sure sleep sunshine thirty or thirty minutes of meditation a day yeah you know whether it's yoga Pilates or just deep breathing for sure and that's what I'd recommend for you but otherwise I think you're you're on your own course to live to 100 million good I'm working on it so stop being paranoid about cholesterol again get all these things checked you would have better go and see your GP that's that's what they're there for but also do your you know if you are diagnose hi clex will go and do your own research and lifestyle lifestyle lifestyle you know you know we've had cholesterol for the last two million years cholesterol has worked perfectly in our body and works perfectly in the bodies of people in remote communities it's those other influences that are happening to us in this westernized world that are causing the problem but of course then when we have problems people make drugs to sell to us and peddle to us I see you should start last night which I thought was fascinating you said that what tends to happen with drug companies cuz their business is they do find something that alleviates some problems for people they've got real severe symptoms of that problem but of course every business then needs to grow and expand and expand and expand so eventually though it gets past a point with most medication where it's really doing yeah there are my ways any good and then you've got a problem and that's you know that's a regulatory system failure you know it's driven by greed and I think that's that and then it causes it causes more harm than good and and then they deliberately try and cover up stuff too when people try and expose it this is no benefit or we should be telling people the truth so that's where things get very murky unfortunately yeah it's a way it's a way some business is done but it's certainly a lot for big business they have a lot of power yeah so we need to change the whole really change the whole system needs changing and that comes through knowledge and hopefully podcasts like this and broadcast like this help get that knowledge I mean there's a friend of mine who you probably know robert lustig who's Jean dresser of endocrinology you know sugar guru and we have we know he's very good friend of mine he said you know to me and I repeat this is I have no problem with people making money doing the right thing I have a problem with people making money doing the wrong thing mm-hm that's a great line he's book by the way is a great book it's although it's called hacking the American mind take the make a bit out it's all about what have we been promoted happiness from all these big food and yeah happiness and pleasure attitude if this whole thing is a difference between pleasure and happiness um pleasure actually it's like a short-term game yeah and you know we eat that Matt Donald's have that coke because it gives it instant pleasure but it destroys our long-term happiness somehow and yet all the companies are using the word are happy and play and so on to market to us when actually they're selling completely the opposite so read that a great book by Robert called hacking the American mind and for people to follow we've come to her and certainly it's very very quickly for people want to follow you more tell us about your book which is I think yeah P Appa diet you can get that on Amazon my website is dr. seem calm and if you know people can contact me there as well if they want a consultation or whatever I also do consultations so I mean NHS work but also off Harley Street as well so a lot of people that really want a transparent conversation to understanding how they can reduce a risk but if they're on a statin for example a lot of people come to me and need that honest conversation about stents heart disease so that's my main focus in my interest in passion and then I'm on social media dr. Seymour hot sure on Twitter Instagram lifestyle medicine doctor and Facebook as well doctor assume Archer well the please just keep doing what you're doing they are more successful you'll come the more those big giants will come after you to try and put you know suppress you and push you down but keep doing what you're doing and I I think your aspiration and helping a million people at time will come to fruition thank you for everything then fabulously I hope you all enjoyed listening and watching to it and I'm sure hopefully we'll see you again thank you Steve thank you lovely thank you if you enjoyed this podcast then why not subscribe to the full series so you can hear from all the incredible health professionals we spoke to for the full story you can also get the book fat and furious written by Steve Bennett available on Amazon and to say a huge thank you for watching us here on YouTube we are even offering you an exclusive Amazon discount code so you can get yourself a coffee for more details head to the description below

Channel: Primal Living

Views: 2,191

Keywords: Steve Bennett, primal living, dr aseem malhotra pioppi diet, dr aseem malhotra cholesterol, dr aseem malhotra 2020, dr aseem malhotra and statins, dr aseem malhotra covid, dr aseem malhotra saturated fat, fast and furious podcast, heart disease in women, heart disease, heart disease symptoms, heart disease in men, heart, exercise for the heart, too much exercise can kill you, heart disease prevention, why cholesterol may not be the cause of heart disease with dr. aseem malhotra

Id: czzetqi9rq8

Length: 60min 27sec (3627 seconds)

Published: Sun May 31 2020