Dhru Purohit Show - #251: How Fasting Can Reverse Aging & Prevent Disease with Dr. Pradip Jamnadas

Episode Date: December 9, 2021

This episode is brought to you by BiOptimizers and Cozy Earth. These days, we hear a lot about fasting. Intermittent fasting, time-restricted eating, and water fasting are just some of the many terms being thrown around in support of better health. Which one is best? What does it all mean for our longevity, brain health, and overall wellness? This week on The Dhru Purohit Podcast, Dhru sat down with Dr. Pradip Jamnadas to talk about how fasting can troubleshoot our biology, boost our energy, and decrease our risk of disease. Dr. Pradip Jamnadas is the founder and medical director of Cardiovascular Interventions and has practiced in Central Florida for over 32 years. Widely recognized for his skill in interventional cardiology, Dr. Jamnadas has been awarded Orlando Top Doctor by Orlando Magazine consecutively for over a decade. In this episode, we dive into:  -Why we get fat (10:57)  -Glucose intolerance and hyperinsulinemia (18:46)  -The #1 cause of hypertension (27:10)  -The surprising truth about salt (32:08)  -Why seed oils are not really “heart healthy” (38:05) -How fiber impacts the gut microbiome (48:11)  -The top benefits of fasting (56:26)  -How to prepare for a fast (1:13:48) -How your mental state affects your physiology (1:21:37)  -Dr. J’s #1 recommendation for his patients with leaky gut (1:41:35) For more on Dr. Pradip Jamnadas, follow him on Instagram @PradipJamnadasMD, on Facebook @PradipJamnadasMD, on YouTube @DrPradipJamnadas and @TheGalenFoundation, and through his website https://orlandocvi.com/.  This episode is brought to you by BiOptimizers and Cozy Earth. BiOptimizers Magnesium Breakthrough contains 7 different forms of magnesium, which all have different functions in the body. I haven’t found anything else like it on the market. Right now, BiOptimizers is offering my audience 10% off. Just head over to magbreathrough.com/dhru, with code DHRU10.   If you’re looking for super comfortable and stylish men’s and women’s pajamas, joggers, robes, pullovers and hoodies, basically all the stuff we’re all wearing working from home these days, Cozy Earth has got you covered! So what’s Cozy Earth’s not-so-secret fabric that powers their superior comfort? It's the miracle plant bamboo! Right now, Cozy Earth is offering my audience 40% off. Just head over to cozyearth.com and use the discount code DHRUPODCAST. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

Because we're addicted to eating in this lifestyle. We want to eat every two, three hours. So we get addicted to the food, the patterns. We change our circadian pattern of eating and our hormones in our body. So the addiction has to stop. And that's one of the biggest impediment that I find in teaching people how to fast. Hi, everyone, Drew Prod here. Today on the podcast, we have Dr. Perdip Gymnatus,

who's talking all things fasting, how to use fasting to age in reverse and reduce chronic inflammation and reverse disease. It's a fascinating episode. Stay tuned. Welcome to the Drew Perrault podcast. Each week we explore the inner workings of the brain and the body with one of the brightest minds in wellness, medicine, and mindset. This week's guest is Dr. Perdip, Gymnatus.

Dr. Gymnatus is the founder and medical director of cardiovascular interventions and has practiced in central Florida for over 32 years. He's widely recognized for his skill in interventional cardiology and his expertise on many health topics, including fasting. And that's what we're talking about in today's topic. How fasting can help reverse aging and prevent disease and reduce chronic inflammation. Dr. Jay, as many of his patients call him, is incredibly gifted at the art of storytelling and combining it with health education to truly help you walk away with a deep understanding of a new topic.

Dr. Jay was educated in England at the University of London College Medical School with internships at London and Kent. He completed his residency in internal medicine at the University of Maryland and his cardiology fellowship at Yale University. In addition, he's completed an interventional cardiology fellowship at St. Luke's Hospital in Wisconsin. I'm excited for you to watch today's interview. A little background story. I was on YouTube a few months ago and I came across this incredible lecture on fasting, which had over four million views, and it was by Dr. Jay. It was called Fasting for Survival. I'm excited that we have them on the podcast today to do a deep dive into this topic and cover a bunch of questions that I

often get from my community on fasting. I hope you enjoy. Dr. Jay, welcome to the podcast. I've been a huge fan of all your lectures that are going viral all across YouTube. It's amazing to see millions and millions of people are so fascinated by the power of fasting. And I was telling you, as we were starting off and exchanging some pleasantries, that your combination of storytelling and humor and your deep understanding of the science is truly what I would say is the heart of a teacher. I have sent your videos to so many of my friends and family who have had their own skepticism about fasting or had questions about it, and you just strike a chord with people in a way that is just so powerful. So I just want to express that to you and share that gratitude.

And also thank you for making the time to come on the podcast to talk about everything that you know. No, thank you, Drew, and it's a pleasure to be here with you. You're very complimentary. And really, the whole purpose of doing all this is to motivate people, make the change. And to do that, you've got to somehow get into their mind and change something there so that behavior can change. And once that changes, then things happen. So you've got to find that way to get into it. that patient's psyche. You know, just information on itself doesn't do it. You combine it and get their

attention. And that was the whole point. In terms of getting people's attention, I'd love to start off by diving deep into the world of fasting, which you know so much about. And I'd like to ask you, why is it that you think with all the evidence that we have, with the body of work that's been done, especially in the last five to ten years on the topic of fasting, why is it that fasting is still so underrated and often overlooked by the traditional medical industrial complex. Well, it's because fasting is not sexy. There's nothing fancy. There's no drugs. It's just fasting. So people think, oh, come on, that's nothing, just not eating and how can I get better? Because they also don't understand that when you don't eat, you're bringing in a whole new

biochemistry. They don't understand that. They don't know what fasting really does. But once they understand that fasting is not just fasting. It is a huge new biochemistry. It's a whole new metabolism that you're bringing in. And then you talk about that metabolism. And now how you can get that flexibility in your metabolism, now you got their attention. So I think it's been basically we need people like you and Mark and other people that can talk about this and educate people. No, fasting is not just fasting. It's not just a boring subject. There's so much science behind it. And also the other thing is, you know, traditionally we've been fasting and, you know, as you know, in the Hindu religion, Buddhist religion, Christianity, and also in Islam, we do fast.

And it has been linked more to the religiousness rather than the science when actually there's a lot of science behind it. Talk about some of the benefits of fasting. For those that are, you know, nobody's not really familiar with the word anymore, but still sometimes there's a little bit of a misunderstanding of the full spectrum of what people have available to them when they tap into the power of fasting. If you would say the top three benefits in your experience in reviewing the science, what would those be when it comes to the power of fasting?

You know, three, there's so many. But first of all, addiction. You get rid of addiction because we're addicted to eating in this lifestyle. We want to eat every two, three hours. So we get addicted to the foods, the patterns. We change our circadian pattern of eating and our whole. hormones in our body. So the addiction has to stop. And that's one of the biggest impediment that I find in teaching people how to fast. So I want to get rid of that addiction. So that's one big thing.

The second big advantage is what I call metabolic flexibility that you're supposed to be using another part of your metabolism. So you're getting out of the glucose and out of the sugar and now using another physiology that there are other substrates that you can use for energy in your body. And that gives you a healthier and a better metabolic pathway. You can use one or the other. It's like having a car that can run on two different fuels. And that has a whole bunch of advantages associated with. And the third thing is that once you start fasting and you start changing your hormonal status,

now you get a whole bunch of health benefits, coronary artery disease, strokes, blood pressure, obesity-related diseases such as joint disease, degenerative changes, and even dementia. So you get all these advantages. So it's amazing what fasting can actually do for you. And when you look back at the history of it, we say, why don't we do this before? Why do we really examine this before? It's so true. And I want to talk about a little bit your personal history with fasting, your family history

with fasting. But before we go into that, I was reflecting in preparation this interview, and I was thinking that there's so much misconception about fasting, even still some very mainstream doctors or people that go on the news and actually tell patients and scare them shitless in terms of you should be really afraid of doing fasting, right? You know, and there's, obviously, there's different types of fasting and everybody has to personalize it to their goals and their condition and other things, but I'm talking about the generalized sense of fear. And a lot of that fear is based on the platform of misinformation. And I can't think of any area that there's more information on than this basic idea of

why do we get fat, so to speak, right? I think there's still a little bit of a misunderstanding in terms of this calorie model and what is known as the hormonal model that's tied into. to insulin. So can you break that down for the audience that's listening? No, you're absolutely right. You're absolutely right about this. You see, the problem is calories, calories, the old calorie theory was that the more calories in, the more you're going to gain weight. And if you don't burn the calories, you're going to gain weight. And we know now from numerous studies that that's absolutely not true. What it is is the hormonal model. So you're

absolutely right about the hormonal model. Now, what we're eating and how often we're eating is changing us from a hormonal standpoint. So you're a hormonally modified human being now. You're no longer the same human being from four generations ago. And your hormones are changing because of what you're eating, the type of food you're eating, the processed foods, how often you are eating. So that's what's happened. And the reason why we've come to this is, look, every day you're bombarded by advertisements. You're bombarded by people who tell you that, you know, you've got to eat five meals a day, that you get in the car, you've got to have your drink and your food, and you've got to eat on the motion. And so every day, you know, your instinct of saying that, you know, I'm not hungry, but you still eat.

And there's so much pressure for you to eat because people are, everything is being pushed on you, the advertisements, the snacks, the everything just points towards consumption, consumption, because we need to break out of it. because otherwise we are going to suffer. See, we are addicted because we've been made addicted. And then, of course, the medical profession, but also government forces have not really helped us because they've told us dietary advice that was not entirely correct. So we were told it was all fats, fats, fats, fats, fats.

But now we know it's not all about fats. We know it's also about sugar and carbohydrates and processed foods and what that does to us and changes of physiology. And these foods are addictive. So we've moved to a calorie-rich, addictive diet. And that's why addiction is such a huge part of everything I talk about to my patients, and I've got to get them out of the addiction so that they can make changes in their life.

So it's not just about just eat this, eat this, eat this, no, I have to recognize that these people are addicted. And this addiction is a serious addiction. It's as serious as being addicted to morphine. or any other drug. And it's that serious. And people look at me and my patients look at me and say, you mean to say I'm a junkie?

I said, yes, you're a junkie now. You really are. And I see it every day. I see it every day in my clinic. This is my clinic. And I run my practice every day. I do surgery. This morning I did angioplasty.

I did a stent. So I'm a day-to-day cardiologist. And when I speak to my patients in the clinic in the afternoons, it's addiction. You know, one day and they go, oh my God, I was breaking out in a sweat and I felt my sugar was getting low. So I had to go and eat and I felt better. And I said, and did you take your sugar level?

And they said, yeah, and it was 100. Well, then it's not hypoglycemia. Pure addiction. It's pure addiction. So that's what's happening. We've moved away from eating real food to addictive substances. These are not foods, by the way. These are substances.

So should we be consuming substance or should we consuming real food? That's the issue. We move it away from real food to substances, chemicals, addiction. And the combinations of these foods is also a problem. So you see, fasting is also about what type of food you? Look at the combinations. It's high sugar and high fat. And of course, there's lots of salt in it too. That combination is not found in nature. So when that gets into our body, it causes these hormonal changes and the biggest hormonal problem I found was insulin. And I want to tell you a little bit about how I actually got into this. Please. Because ultimately, I'm just a cardiologist, right? So why is a cardiologist talking about dieting and sugar and weight and all these things? Well, you know, I've been doing

angioplasty and standing for over 35 years. So fortunately, you know, in London, I graduated as an MD at only age of 23. So I got into cardiology really early on. And I would do this amazing angioplasty. And some patients do great. Others keep coming back. Sorry to interrupt. Could you just explain angioplasty for those that are not familiar with it or maybe not be in the world of medicine?

You could just explain that. Absolutely. So they come to me with chest pain. And I do an angiogram, which is putting the dye in the coronary arteries. And I find a blockage. So this blockage is preventing the blood from flowing into the heart. muscle and supplying the muscle with the oxygen that it requires. So these blockages cause chest pain. And of course, when the blockages is 100%, you get a heart attack. And there,

the muscle is completely deprived of oxygen and dies. So what I do is I specialized in putting a fine wire into the coronary artery, the artery in the heart. And then I would slide a little, it's like a spring into the artery and open up that artery and then leave the spring behind and then deflate the balloon, pull it out, and now the stent is left behind. So the stent is an angioplasty. Angioplasty means you're just basically fixing an artery of blockage. So that's what I'll do. And Drew, the thing is that some patients did absolutely great,

and others would come back with new blockages, six months later, a year later, two years later. And I just couldn't understand it. And I looked at my traditional risk factors, smoking, high blood pressure, of course, diabetes. and then the list starts going blank. And I said, there must be more things that are causing this. And then that got me really curious. And then what happened is that I would have patients having heart attacks or in China, and then I would look at their risk factors, and they don't have any.

And I said, no, can't be, why does this patient have a hardening of the arteries? So then this was about 20 years ago, I did a study here in my office where I took 100 patients in whom I did an angioplasty, and I said, how many of these people have diabetes? And I found that roughly a third of them had diabetes. But I did a glucose torrents test on all of them in my office. It's a cheap test to run, so I did it. And I found that actually 80% of my patients had abnormal sugar metabolism. But yet only a third of them had a diagnosis of diabetes.

So what happened to the other one-third or just over one-third is that they had an abnormality in their sugar metabolism, they didn't know about it. And then I found that about 10% of them were actually diabetic, and they didn't even know they had diabetes. So there's a condition called glucose intolerance. That means your sugar level is a little high, but not high enough to make a diagnosis of diabetes. So I found that at least half of my patients in whom I didn't have a diagnosis of diabetes actually had slightly elevated sugar levels. And Then that got me thinking that why is this happening? And right around that time we were realizing that insulin levels are really high in these patients

and that type 2 diabetes is a case of hyperinsulinemia. So let me just explain that a little bit for the audience. So what happens is that in these patients, they do have high insulin levels, which keeps the sugar level down. So when you do the glucose tolerance, it doesn't look too bad. And you look at the blood test called a hemoglobin A1C, which is a test to see what your blood sugar has been doing over the last few weeks. they also stay nice and low.

But the problem is the insulin level is so high, and I found that on my patients, that the insulin levels were so high for 10 years, 12 years before they become diabetic. So it's finally when the insulin just can't keep the sugar down, the sugar starts going up. He's said, oh, now you have diabetes. But guess what? He's already had high insulin for about at least 10 to 12 years. And right then my curiosity really got there.

I said, you know what? there's something going on here. And then as the more research came out and other researchers also came in, I realized that it's insulin resistance. And now, almost routinely, almost every patient gets an insulin level. Now, the problem is we were not doing insulin levels before. No one was measuring it. If you go to your family doctor and say, I want to measure my insulin levels,

he says, no, you don't need it. It isn't a glucose tolerance test. And you do a glucose tolerance test, and it tells you nothing. It tells you that your sugars are okay, and you get a pattern on the back and say, go home. But in reality, behind the scenes, you've got this really high insulin level. So I think that this is a time when we need to be educating our medical professional so that we need to be looking at the insulin levels because I'm finding that when I find

these high insulin levels and then I chase that and I bring it down through methodologies which we'll talk about in the second, now I'm making an impact on those patients who have heart disease and all of a sudden I started noticing the patients were getting better. When I bring their insulin levels down and the way I brought it down, there's no magic pill to bring insulin levels down, as you know. There's no injection to bring your insulin level down. So that's when I got interested in fasting because I realized how am I going to bring this insulin level down? How? How am I going to? Okay, okay, we're going to change the diet. Don't eat sugary things. Don't eat carbs. Don't eat simple stuff. But then I,

As I started peeling that onion, I realized that it's not just that. It's also processed foods. It's also certain combinations of foods. And then I realized that, oh, my God, we're eating too often as well. That's when I came and I said, you know what, there has to be one thing that will help all of this. And that has to be fasting. And I looked at my insulin responses. It was fascinating that if you don't.

eat all day long and then have only one meal, you're going to make less insulin for that one meal than you had you eaten that same meal after having had two previous meals that day. So what that tells me is that your sensitivity to insulin changes on a day-to-day basis, or hour-to-hour basis. So even your own circadian cycle, as you know, makes you insulin resistant at certain times of the day. You know, like when you're waking up in the morning, you're going to be a little bit more insulin resistant at that time, things like that. So as I read more and more, I got lost in this field.

I said, oh, my God, this is so amazing stuff. And how come we do anything about this? So that's how I got into fasting. So you can see it was a little roundabout way that I got into fasting. Yeah. It was a roundabout way, but really at each intersection, you're asking yourself, okay, what's deeper? okay, what's deeper than this?

Okay, what's deeper than this? And that's what brought you to a place of, wow, this one thing, this insulin, which plays so many different roles inside of the body, you know, one of them being, you know, keeping your blood sugar, you know, down is so central to all these conditions. You know, you mentioned one, which is people having their arteries clogged. What are some other conditions, symptoms, issues, challenges that people are going through? because often sometimes people hear this and they're like, well, I don't have any history of diabetes in my family. Okay, I might be a little bit more overweight, but I'm not having a diagnosis of diabetes.

I'm not sure if this is something that I should pay attention to. But talk about all the things that this is connected to beyond just diabetes, beyond just, you know, somebody worrying about their arteries being clogged. What else is insulin and having too much of it in your body connected to? So this insulin doesn't just affect the condition of your arteries in your heart. Because ultimately, remember, when you're born, that bud comes out of your heart and then all the arteries grow out, the arteries in your heart grow out, and then the arteries, your aorta your carotid arteries, and then down to your kidney arteries, your leg arteries.

These are all blood vessels. And what we've done in medicine is we've compartmentalized everything, and then we break it up into different organs, so we don't see that there's a universal connection. So if you have kidney disease, for example, what's wrong with your kidneys? Now, there are many different types of kidney disease, but the number one thing is still macrobascular disease in your kidneys. So when you have high insulin levels, the tiny blood vessels in your kidneys are not going to work very well. They lose their ability to vasodalate. So insulin blocks nitric oxide production. Nitric oxide is a vasodilator, as you know. So when your nitric oxide is not there, you can't vasodilite. And the body is supposed to

have this vasodilitary capacity. You're supposed to be vasodilate and vaso-constraint. And you're supposed to have that flexibility. But you immobilize all your tiny blood vessels and caprives when your insulin levels high. So in your kidneys, you're not going to get adequate kidney function. In the brain, you're not going to have adequate brain function. You're going to develop major arteries will also clog up your carotid's, your peripheral vascular disease. So insulin, Influen affects every organ because every organ has blood supply and you are as old as your blood supply. I mean, William Osler said that, right? You're as old as your arteries.

So the manifestations of high insulin are widespread. So I'll give you an example. Some of my older patients coming in and say, you know, I'm getting a little demanded. I'm getting very forgetful. And the spouse will say the same thing. And I will find hyperinsuliniaia. And when I treat them and I change their diet. And I'm just the cardiologist, but I tell them, look, you've got to do the following things.

The wife will come back and say, you know what, his memory is so much better now. He's functioning better. And we now know that when you do magnetic resonance imaging studies in the brain and look at functional studies, that is the vasodilation, vaso-constriction that occurs in your brain, in different parts of your brain. And you basically immobilize all that when your insulin levels are high. And insulin is a growth factor. That's something else that people need. So how does it cause hardening of the arteries?

Well, the walls of your arteries have smooth muscles. Okay, that's why they can vaso-constriction and vasodilate. And what insulin does is that it causes that smooth muscle proliferation. So it causes it to thicken. So the walls of the arteries become thicker as well. So it's a growth factor. It also causes left ventricular hypertrophy. Big word.

Basically, the heart muscle gets a little fat. When you put the patient on insulin or you have high insulin levels. So it's a growth factor. Growth factors also affect cancer and cancerous cells in the body. So a growth factor is something you want when you need it, but when you have an inappropriately high insulin level, you don't want those growth factors to be there. So take blood pressure. Now, Drew, I'm going to tell you something about blood pressure.

I've been dealing with blood pressure since the day I graduated from school, and I was told that hypertension is essential. Well, there's no such thing as essential hypertension. There's always a cause for hypertension. And the number one cause that I have found in the last 10, 15 years, it's a hyperinsulinemia. So I'll give you a typical example. Young guy like you comes to the office, he's got no other problems. He says, my blood pressure is high.

I bet you you've got insulin resistance. And I measure his insulin levels, this guy high. Bring his insulin levels down. So now he says, my doctor told me I have to be on blood pressure medications forever. I was one of those doctors. That you have to be on blood pressure medicines forever. You can't come off because you've got hypertension. And I have realized that that's absolutely not true.

If you find a patient who has essential hypertension, I now look for hyperinsulinemia. And invariably, I do find it, bring it down through dietary changes and lifestyle changes, and the blood pressures go away. And I've done that to hundreds and hundreds of patients in my office. So insulin causes hypertension because I just told you, a vaso constriction, and it doesn't allow your blood vessels to dilate appropriately, and that causes hypertension. So when you look at metabolic syndrome, part of it is hypertension.

And this is how it works. It's all because of hyponcinoneemia. So it causes hypertension. It causes hardening of the arteries in all your organs, and then you're going to feel the symptoms of that organ, whether it's your brain, your kidney, or your heart, or even your peripheral asclature, or even endothel dysfunction causing erectile dysfunction.

So as a cardiologist, I don't see those patients, but my urology friends and I have now got this rapport going, hey, you see those patients with irritable dysfunction, they have endothel dysfunction. If they have endothel dysfunction, there's something going on. You should be looking at the insulin levels. And it's been very exciting because we've actually, actually restored endothill dysfunction in these types of patients by appropriate dietary

interventions and prejudicing the instance. So you can see that it has ramifications beyond what we imagine because it just depends which organ is being affected by the dysfunction due to the hormonal imbalance of hyperinsulinemia. Yeah. It's so true. You know, in the traditional model of medicine, well-intentioned, it was name it, tame it, and blame it, right? Or name it. blame it and tame it. So you're looking for all these different fancy ways to talk about really a few root causes that are there. So we might call it erectile dysfunction. We might talk about somebody having restriction of blood flow to their brain or inflammation of the brain that's there. And we call that Alzheimer's. You know, we have all these different names that are out there. And really, the question is,

can we look upstream and see what is the common river? What is the common? What is the common pathway that is feeding all these different components. And then again, well-intentioned, you know, you mentioned hypertension. They're, you know, thank God that we have the mechanisms of science. And again, well-intentioned, sometimes we put the focus on the wrong element of it. So patients become overly obsessed with thinking about the table salt or the salt that they're adding to their food, not realizing that the vast majority of their salt, which be playing partly a role in hypertension is coming from processed foods. And those processed foods also have high sugar, high fat, and that combination which increases insulin in the body and causes a cycle to continue,

to continue to continue. And, you know, I see the internet. It's pretty popular these days to feel, you know, kind of negative a little bit about social media, the internet. It's in the news a lot. But I'm so thankful of things like YouTube and Facebook and other stuff because they're finally giving people, including practitioners who are looking for answers, right? People that have been to school like yourself and are incredible doctors and other practitioners out there. It's finally giving them access to or questioning or providing them information that allows them to have a potentially new perspective on something that they thought they understood well but wasn't working for them or their patients. You are so right. You're very astute, especially by the fact that you mentioned that salt, because the increased salt intake is associated with the other goodies, which are the sugar and the vegetable seed oils and that combination. And that's where the deleterious effect.

So when you get rid of that food, then, of course, the blood pressure comes down, but we think it's allocated to the salt. But it's actually not salt. And I can't just tell you a little bit about salt. that as a cardiologist, you know, I was taught that salt is terrible. You've got to stay away from salt, and everyone must be in a salt restriction, and you must only be on 2 grams sodium. Well, I tell you, I don't believe in the 2 gram sodium diet. In fact, my patients feel better when they're on a minimum 4 grams to 6 grams,

and nobody measures it. But basically, I don't tell you to go measure your salt intake. No, I just say, salt your salads, salt your foods. Don't go crazy. don't need processed food because they have all the salted stuff in them. So I don't restrict salt. The only patients that I restrict salt on patients who have decompensated congestive heart failure. So obviously if you fluid overloaded, you have kidney failure and your legs are swollen and your lungs are full off of water, then I stay away from salt. But otherwise, I don't restrict my salt on my patients.

In fact, the studies do even show that if you do restrict the salt, you get more what we call neurohomonal activation because you're really getting the body is sensing that there's salt deprivation so that it causes those neurohomonal changes that causes further vasol constriction and actually can worsen blood pressure and that neuromonal activation is not very very healthy for you multiple ways not only just blood vessels but your platelets and their reactivity and you know and i mean we can talk about the um the antitensin receptors as well and how how they all get affected and it's a fascinating subject. So I don't restrict salt.

But the restriction should be on the processed foods and those combinations. That's where it's coming from in our diets anyway. We pay attention to that and get all the benefits of reducing processed foods in our life. I mean, it's so amazing. There was a study that came out a few years ago. We'll link to it in the show notes for everybody to see that processed foods, ultra processed foods. So we have processed foods and we have old.

ultra-processed foods. So all the ultra-packaged foods that are out there that are in the store aisle, which are making even, you know, that are addictive, as you've mentioned, they're extremely addictive, and it's very difficult for us to stop. And they're being engineered by scientists who are essentially addiction specialists. It's how do we get people to keep on eating these foods so that we have a greater share of the stomach. But the study was saying that ultra-processed foods are responsible for approximately 11 million debts worldwide every single year are directly connected to ultra-processed foods in our diet. And you mentioned one of them, which you and I have a shared background, ancestral. Our families are from Gujarat. We were both born in Africa.

That was a beautiful thing to find out about yourself, yourself in Zimbabwe, myself in Kenya. If you've been to India, when you drive around, one of the things that you mentioned earlier, you see billboards for it everywhere, and that is vegetable oil. You see it all over India. There's all these billboards for different types of vegetable oil, canola oil, peanut oil, this oil. And it's that this oil is heart healthy. There's always a little heart emoji, little symbol next to us.

Help us understand how this classification of highly processed. to seed oils may not actually be what the marketing is trying to say that it is. Joey, you're so observant. You're so observant. But you see, they got that sign because it's cholesterol-free. So because it's cholesterol-free, they got the green card to say that, hey, this is heart-healthy. And that all came about, again, because of us in the medical profession, we allowed this myth that vascular disease, cardiovascular disease, is called.

caused by cholesterol. Which is still pretty widely, you know, accepted by a lot of people, even though it's been disproven. Now, there is no doubt that there's a component here, but it gets a little complicated, and we can talk about LDL and oxidized LDL and why you get small, dense LDL, and that is predictive for cardiovascular disease, but not just your totals. And you can have large, let me explain a little bit about the LDL particles and then I'm going to talk about vegetable seed oils. So we vilified fats and LDL. And this was wrong.

First of all, when Eisenhower had his heart attack, as you know, we had to find a cause for this heart attack. So then everyone jumped onto fats, and then we had Ansel Keys that came along with his studies, and his studies were not very accurate, but then everyone jumped onto that bandwagon. And this caused the govern party to then come up with the recommendations that we need to get off fats and start eating more carbs instead. And we, the people who are so good, actually followed their advice. And we have a 55% reduction in meat intake and we replaced it all with carbs. And what happened? Blood pressures went up. And heart attack went up. Strokewicks went up. Dejective disease went up. We got sicker and sick and sicker metabolically.

And we blamed cholesterol, cholesterol. So anything that then came out saying this is cholesterol-free got a green card. Oh, yeah, this is great stuff. And that's how vegetable oils got onto this thing, onto the scene, that, hey, butter is no good. Saturated fats are actually no good. Now, these polyunsaturated fats, so there's two types of fats, right? There's saturated fats, actually there's three. There's saturated fats, which are found naturally in meats and chicken and in some.

plants, and then you have your polyunsaturated fats, and then you have your trans fats. Now, polyunsaturated fats are what found in vegetable seed oils, and they were touted as being heart-healthy. But as time went on, more and more studies showed that actually this, that is not true, because that's omega-6 and omega-9. those two components of your vegetable seed oils are actually very pro-inflammatory. So they cause inflammation in the body. And that makes sense because they're polyunsaturated.

So there's double bonds that can interact with things. So when you have a saturated fat, there's no bonds to interact. Unsaturated fats have bonds that can interact. So they can be oxidized as well. And they can attach themselves to other molecules in the body and the plasma lemma, you know, the lining around each cell. So the polyunsaturated fats are actually pro-inflammatory, and that's exactly what happened in India. That we moved away from consuming saturated fats in the form of ghee,

ghee, which is clarified butter, and we all moved over to vegetable seed oils. And with it, we saw an epidemic of coronary artery disease in younger and younger, younger people. So we need... for a society that traditionally didn't really have a lot of that in their, you know, in their lineage and background. Oh, absolutely true. I was flabbergasted because you're right. Our great-grandparents did not have coronary artery disease.

And people say that all about they didn't know they didn't have it. No, no, no, no, autopsies were done, diagnostic studies were done. They did not have coronary artery disease to the extent that we have today. And every time a young South Asian walks into my office, I go, oh my God, there it is again. You know, I mean, it's terrible. 38, 35, they're already coming in with heart disease. And when I look at them, I find two things wrong with them, Drew. Number one, they're consuming a lot of vegetable seed oils.

I measure the linoleic acid levels in the blood, and it's sky high. So before, the upper limit used to be 20. then we found that the population has a higher levels. We moved it up to 30 and said now 30 is normal. How crazy is that? So linoleic acid is a reflection of your omega-6 intake. And omega-6s come from all the processed foods and the vegetable seed oils. Now, why do they use vegetable seed oils?

Because it's nice and dry. It has a long shelf life. You can put in the package. It'll be like that for the next year. You don't have to worry about it. It's cheap. Yes, absolutely. So everyone started using vegetable seed oils.

So the ionoloneic acid levels are really, really high. And then these fats are pro-inflammatory, and that causes further inflammation in our body. And I found that the LDL particles, they become small and dense versus large fluffy particles. So many times patients will come to my office and they do their advanced lipid panel, which is a blood test that we do on some patients. And I'll find that they have a pattern B. That means they have small, dense L-DL particles. And they're doing everything right.

And I said, now what's the final thing I can do for you? And I tell them, you know what? Cut out all the vegetable seed oils and start consuming some saturated fats. And they look at me with the wide eyes saying, would you tell me to eat saturated fats? And I said, just start putting some butter instead of other things, other vegetable oils. And they'll come back and they'll find that the panel improved six months later. They now have a pattern A, large, fluffy LDL particles, less inflammation.

The blood markers that I do also are improved. So generally speaking, vegetable seed oils should be discouraged. And in India, particularly they advertise that as an alternative, a better form. They call it vegetable ghee, which is a pretty misleading. And so I tell all my friends, family, patients, stay away from vegetable seed oils and go back to consuming ghee when you are cooking. And it's much, much healthier for you. You get more absorption of all the vitamins, ADEK. It has a higher burning point when you're cooking with it.

It's not going to produce trans fats the way the vegetable seed oils produce trans. You know, look, look. You know how we take our foods and it's left over and put in the fridge and the next day we take it out again. and we reheat it again or we put in the microwave, you're just generating trans fats if you've cooked with vegetable seed oils. So you've produced your trans fats as well. This is a very, very bad habit. And traditionally, we never did that back home in India,

or ancestral events. We would cook each meal separately. We never reheat the meals. And reheating food that has been cooked with vegetable seed oils is extremely deleterious. And a moment my patient stopped doing all that, I see the results, I see the blood test, they also do better, they have less event rates, but I see it in the blood reports. I see benefits. Vegetable seed oils, absolutely no, no. So a lot of them worry about things like olive oil. You know, should I consume olive oil and it's supposed to be very healthy. Now, olive oil is healthier, but you've got to remember that it's not all monosaturated. See, many people just categorize oils as one or the other.

It's always a blend. It's a blend. You're absolutely right. You see, olive oil is about, depends on where you get it and how it gets into your bottle. But it's about 50% mono-unsaturated. And that still leaves another 20 to 30% depends on where it's made and how it comes into your bottle of polyunsaturated. And then it has a little bit of saturated fats. So olive oil, generally speaking, is better, should not be heated, should be added to your salads,

because it causes, when you heat olive oil, you get rid of the polyphenols, and it's got a lower burning point, so I don't heat olive oil. So I tell my patients to stay away from that, from heating olive oil as well. But you're so right about the varnespati ghee and vegetable seed oils, and I think that that And the second problem I found in all my young patients is young patients from South Asia is hyperinsulinemia, even though they're not overweight. So the term I applied to them. And of course, 20% of non-obes patients can also have this. I call them Toffees.

It's a term that's been used by a lot of people, thin on the outside, fat on the inside. So when I look at my South Asian patients, they are thin, but they've got a stomach. and that's because of insulin resistance, too much carbs. And what really got me was when I found out that if you look at Hindus in India, 80% of them are vegetarian. And yet they have the highest incidence of coronary artery disease. And nobody questioned that. You know, why would we have such a high incidence of coronary artery disease in a vegetarian population? is because they're consuming vegetable seed oils,

and it's because they're consuming far too much sugar, and it's all processed. That's the other thing, processed and processed, and processed powderized. The food is powderized. And that's another form of, it's not an ingredient, but it's a form of the food that causes a huge rise

in your insulin level when you consume it. So those are studies that have been done in rats and in human beings, that if you powderize something, unnatural. Since when does nature let you consume a powderized substance and then expect your insulin response to be normal? It just doesn't happen. But we did it. And in India, you know, we grind up everything. And ever since the invention of the steel mill, I think it was around here, 1830, 1840, I don't know, ever since then, if you look at the curve, the incidence of all these degenerative diseases went up. The milling process,

is a malignant process. And I think that, you know, your great-grandmother, my great-grandmother, had a stone, and she ground the grains if she's going to consume grains. Non-process, it was very granular. And I think that's very important. Which it meant that it had more fiber content than just the stripped out refined flowers that we have today of all. all different types, which are also becoming very pervasive in the health world. We're using a lot of tapioca, cassava. We're using a lot of those flowers.

And they're great tasting products and they're nice to have is like occasionally a little bit here and there. And it's beautiful. But anytime we strip out those flowers, which a lot of our ancestors, just because we didn't have access to the technology, anytime we took out the, sorry, the fiber, because we didn't have the technology, we now are left with essentially a sugar. It's straight up sugar, but the population doesn't see it as sugar, but it has just as much impact on your blood sugar and your insulin as having straight sugar in the body would. Absolutely right. I mean, if you look at the grain, it's got the outer husk, which is the fiber, then it's got the endosperm, and then the germ. So everything stripped out except for all the

starch. And then you expect that to be a healthy food. And then, of course, because you got rid of all the antioxidants and other ingredients, you add them back to the flour. And of course, the fiber, not the fiber, I'm going to tell you a little bit of a fiber. I mean, as I said, as I peeled this onion, I found so many layers. So the fiber. So they say, oh, yeah, fiber is good for the heart, it's good for the heart healthy. And I said, how?

How is fiber healthy? Well, fiber does only one thing. It doesn't do anything for you. Right. It's your bacteria. You already got the answer. See, the thing is that there's wisdom in the way nature packages things together. So the fiber does a number of things to you.

And from the time that you consume it, first time, the K cells which are in the duodenum, which detect the food that's coming in, and it's going to tell the pancreas how much insulin to make. So they, for some reason, when you consume food with those soluble and insoluble, fiber, they form like a layer. And it's like a lattice made of the insoluble fiber, and the in-between-between-the-lattice is the soluble fiber. And the insulin response you're going to get is a much attenuated response, much smaller response if the food is containing fiber.

If it's without the fiber, the K-cells will just say, whoa, I've got all those carbs coming in and let's make a gallon of insulin. See? That's a problem. The second part of this problem is that the fiber, which is missing, your bacteria in your gut are never going to see that fiber. So now your garden, your garden of bacteria in your gut, the 10 trillion that you have in there are starving. And you're going to grow the wrong bacteria in your gut. And because you don't have the right bacteria in your gut, you're going to get inflammation.

Definitely you're going to get inflammation. because the bacteria in your gut are now turning out to be a huge factor in health, which we totally ignored until recently. And now we're discovering that, oh, my God, these guys are our friends. The 10 trillion bacteria are our friends. And now we're changing our mind about that. That's why the fiber has to go back. And it's not just fiber in the form of metamuse or no, no, no, no, no, in its natural state.

You've got to have these fibers. So that's how it reduces blood pressure. It's said, oh, yeah, fiber increases and lowers heart attack rates. It's through inflammation, but it's not because you're doing it. It's because your bacteria are doing something. And the metabolites from the bacteria have huge health benefits to us. And now we're realizing that diet and fasting changes your bacterial flora. And if you then go back to your good, healthy bacterial flora, your immunology is going to get better, your leaky gut, your substances that are actually crossing over and causing inflammation in your body,

causing connective tissue disease and other diseases, all that gets better. So that's a whole new chapter. It's amazing, you know, what we're learning now. and it comes down to what our granny already knew. It's amazing, isn't it? It's just fascinating to me. It's so fascinating. You know, my wife was asking me, what's today's interview about?

I said, you know, if I had to say this, the gentleman, Dr. Jay, that I'm interviewing, had a mission. It would be that I think he's trying to make fasting. You said this in the beginning of the interview. You said fasting isn't sexy, but you're making it sexy. And part of the way that you're doing that is through, storytelling and the combination of patient case studies, what your experience is, but then also the integration of the science component.

So let's talk about that. Since you took us full circle, which was beautiful, by the way, this is why I always tell guests, and I don't know if you know, but originally when I reached out to your team, I was like, you know, we would really, really love like an hour and a half of his time. I know it's long. And they were like, you know, he can give you like 40 minutes. I was like, no, no, I promise. We'll do it justice.

Like, we'll make it a good interview because we're 48 minutes. it's in and we just have the basics that are there. It took that much time to set the foundation and to come back to what started off the conversation. So let's come back to that in terms of fasting. You know, you said, I believe it was one of the talks. It was like, there is no drug out there on the planet that can do the same thing that this not doing of something, not eating, can do in our body. So talk about some of the science that's out there that you came across. that really helped you connect the dots in terms, and in addition to your own experience with your patients

and seeing the improvements with their health, talk about some of the studies or some of the general research that's out there that really helped you connect the dots around fasting. Yeah, yeah. So when you're not consuming calories, right? When you're not consuming calories, the insulin levels obviously drop. Because insulin only is produced when you're ticking in calories.

So your insulin will drop. And I found through all the research that, so what happens now is the body, through all its chemicals and changes, realize that, hey, I need an alternative source of energy. Well, guess what? You do have it in the form of fat because you stored it away for a rainy day. Well, the rainy day has come because you haven't eaten. So when you don't eat and you're fasting, now the rainy day has come and your body has to start mobile. the fat stores. But the problem is that all of us are hyperinsulinymic. So so long as your insulin level is high, those fat stores are locked away. You cannot mobilize them. But when the insulin level start coming down because you're fasting, now those fat stores, because they've got hormone

sensitive lipase and other hormones, as a result, the fats start mobilizing. The fats now come in the form of triglysis to your liver. Your liver will start producing some ketones. and the ketones can be utilized by the body as an alternative energy source. So fasting unleashes a whole new metabolic pathway of energy production through ketones. And you and I do that or supposed to be doing that naturally because it's built in our system to do that because you are not supposed to be eating every two hours. And our physiology is such, we were about more than 10,000 years old. and our genetic engineering is from that time when you eat now, and you may not eat again

for another day or two. And therefore, during those times, you have an alternative source of energy. And we just didn't realize that we thought there was only one energy source, and it was all sugar, sugar, sugar, and glucose only. But no, these are the pathway available to us. So what is the advantage of having that alternative pathway? Well, when you use that alternative pathway, you're getting rid of the fat from the so you don't develop the obesity that we're getting nowadays.

But more than that, more than that, the body makes you stronger because you're going in that pathway. Why? Because the body wants you to survive. So when you're in a survival mode, you're going to come back stronger and better than before. Because, look, if you don't have calories, you think you're just going to crawl into a cave and die over there and just become weaker and weaker.

I can't think anymore and you just go, no. Nature wants you to come back, stronger, become brighter, smarter, stronger than before, go out and get your food so that you can get back. And that's what this ketogenesis is all about. This new pathway is not just providing energy to you. It's actually bringing you back better, bringing you back better. So the research that I found is that when you allow this to happen, it's a kind of a homitic stress that you're creating on yourself.

Hometic stress means that you're creating a stress on the body, which is going to bring you back better. So when you do this fasting, there's so many benefits. Number one, I'll tell you. I'll just rattle them off, basically. There's a thing called brain-derived neurotropic factor that is released. And that makes your brain brighter, smarter. You can actually grow new cells and neuroplasticity as well,

which is fascinating. We never thought that this was possible, that our brains can actually grow, grow back. So, BD, you know, brain-teref neurotropic factor. And then when you do feed yourself afterwards, there's a release of stem cells into your bodies. These things don't happen under normal circumstances when you're constantly eating. So this stem cell mobilization is fascinating information. Growth hormone.

During fasting, you get growth hormone. You get more growth hormone. production during fasting than at any other time. So your growth hormone allows you to maintain your muscles and repair. That's fascinating stuff that's going on inside your physiology when you are in the fasting mode, which you wouldn't at other times. And then there's this thing called autophagy. And I know there's a lot of people talking about autophagy, and you know about autophagy, but for your audience, I'm just going to tell that, yeah, when you running out of fuel and substance is not coming in, you're going to take all your intracellular redundant parts of your cells and say, you know what,

I'm just going to use these for energy, because I need energy, right? So under the circumstances of fasting and some ketone production, you're going to take your intracellular organelles that are redundant and you're going to basically package them into lysosomes and basically export them out of the cell so that the body can utilize them. Now what you've just done is you've cleaned up your intracellular debris, as it were. And same thing with old mitochondria. You're going to get rid of your old mitochondria because the body is now saying, you know what? I'm out of fuel here in the house. My fire is getting down. Well, you know, there's this old piece of furniture. I'm want to burn this old piece of furniture. That's what it's doing. It's getting rid of redundant

furniture. Now, when you feed yourself again, those parts are going to be replaced. So the science is now showing that when you clean up your mess in your cells and then you do feed yourself again, you're going to get new mitochondria. You're going to get better intracellular functions and energetics is going to get better in the cell. So I have found especially right now with everything that's going on with post-COVID and, you know, the patient's coming on no energy whatsoever. And I tell them to do fasting, their energy gets better. And I said, why is that?

It's because they're getting mitophagy, their mitochondria are getting better. They're getting new, better mitochondria. So the fasting process is not just about losing weight. It's about changing your entire cellular mechanisms, and we're supposed to have that. That's what keeps us young. Our telomeres also get longer when we're doing this. They don't shorten so fast, I should say. So there are so many biochemical changes.

Drew, it's crazy that we didn't take advantage of this pathway before. So everybody gets into a ketotic state at a different level of their. fasting, you know, it just depends on what your diet has been before, how much, how much sugar you've been consuming in your diet. But let's say that, like, I eat once a day. That's what I do. So for me to get into ketogenesis very easily, I start spilling some ketones very quickly. By about 16 hours, I'm already got some ketones in my urine. So I know that I'm in that pathway. Others may take them a little bit longer, but then slowly it becomes shorter and shorter and shoulder, so you start producing.

So what I'm saying is that you need this metabolic flexibility to become healthier and to heal some of the bad things that have happened from as a result of our lifestyle and diet. So fasting has, to me, as you said in the beginning, you know, as a cardiologist, I realized that when you first start your fasting, you're going to get rid of your addictions. It's going to be a tough process for a couple of weeks. then you start fasting one day a week. Skip one meal a day, maybe for three, four days,

and then skip two meals a day for the next week or two weeks so that your body is getting used to it. Look, I didn't die. Nothing happened. I missed two meals, but I'm still here. I felt okay. And it empowers the patient to say, you know, I can do better. And then the next time they say, you know, evening came about.

It was supposed to be my meal. I'm not hungry. I feel good. I'm just going to skip it. I'll go to tomorrow morning. You just did a 36-hour fast. So that's how I empower them to gradually get into it. Because if we just go straight to fasting, they fail. They fail, they fail miserably and they feel terrible, and then they won't come back to you. They'll say, oh, I can't do this fasting stuff. But you've got to do it gradually. You've got to just learn to skip meals and know what to expect. you're going to get some cravings. And these are all part of your addictions in the beginning.

Then you're going to get some, besides the cravings and the addiction symptoms, you might get electrolyte imbalance. That's why you're going to drink lots of water. Because as your insulin levels come down, you'll find that you'll have a diureasis. You'll have much more urine output. So you need to replace sodium. Because with insulin, when your insulin levels are high, you hold on to salt and water. When your insulin levels come down, you start mobilizing all that.

So you start having a diariesisic. I'm making so much urine and you're losing salt. So if you get cramps, you're getting cramping in your legs and arms, I tell them to take some little bit of salt with the water and they start getting better. So now all of a sudden they're saying, you know, I feel good. Yes, Doc told me about my cramps. I took salt. He told me about my cravings and my behavior.

I'm just going to have to work my way through that because I'm a junkie. He called me a junkie now. So I'm a junkie now. So I'm getting out of it. So it will take me two weeks to undo all that. And after two weeks, they feel empowered. I did it. And then they start feeling better. You know, the mental fog is gone.

They're sleeping better. Their memory is better. And at the end of the day, they just feel so much. energy inside them. And they say, you know, Doc, I never felt so much energy before. And they go and they work out in the gym. They're actually holding on to more muscle as well because their growth hormone pills are higher as well. So they come back and they tell me all this. I feel great, Doc. I don't know what it is, but this fasting stuff is very working with me. And if they're really obese, once they've reached this stage, then I make them do a three-day water fast. So first,

you got to do all this. You've got to graduate. You can't just go to university. You first got to go through high school and get through all this stuff. So I make them go through all this and then say, okay, now you're ready. You're going to do a three-day water fast. And then it's just water for three days. And then we get better results. Yeah. One clarifying question that I have is that for example there, because I know a lot of people are paying attention, watching this on YouTube or listening on the podcast, for those that might find themselves in that same category, would you say, you know, generally, you know, time restricted eating, you know, not having food between a certain, you know, period of time, having like an earlier

dinner and a little bit of a later breakfast, doing a basic practice that would fall under the world of fasting of time restricted eating. I think generally, you know, most people would regard that now. Even mainstream medicine would say, like, that's safe, you know, that's all good to go. Then there's like the longer fast that are there. There's the intermittent fasting. and then people working themselves up to like a 24-hour fast. And you've done some great videos on this and we'll link to those as well. Would you say in the category of a three-day water fast, that's something that people can navigate on their own

or should they really have some connection to a medical professional like yourself or somebody else that's out there? Do you have any opinions on that? That's a great question. So if you are on insulin, this is very, very, very, very important. If you're on insulin and you're fasting and you're still taking insulin, you're going to get hypoglycemic. Now, that means that your sugar levels are going to drop because you're not taking calories and you're taking your insulin. So you are going to be in

grave danger of getting hypoglycemia and you can get a seizure and you can even die or get a heart attack. So when you are fasting and you're going to do a three-day water fast, for example, even the 24-hour fast, you really need to have a medical professional that is going to oversee that if you're taking medications. So what are my general advice is as follows. If you're on insulin, you really need to talk to your provider because you should not be taking insulin when you are fasting. And even when you do the 24-hour fasts, you need to cut back on the amount of insulin. So what I tell my patients typically is that the long-acting insulin you can stay on, but the short-acting insulin that you're taking for meals, you shouldn't have. You still need your background

on insulin. But the goal here is to get you off insulin. So I'll tell you right now, I've taken about 150 patients off insulin in the last few years. So they've come to me on tons of insulin. So I think that when you're fasting, you do need medical supervision if you're a diabetic and you're taking insulin. Now, if you're taking oral agents for diabetes, for example, then what should you do with those on the days that you're fasting? You shouldn't take them. You shouldn't take them if you're fasting for 25 hours or more. So on the three-day water fast, I tell them, don't take it. But they can take all the other medications. So there may be on medications for cholesterol or gout or anything else. Fine, you can stay on those medications, but nothing that's going to lower your

blood sugar. So you've got to be a little cognizant of that. And then same thing for blood pressure medications. You will notice that your blood pressure goes down when you are fasting. So watch your blood pressure. So what I typically do is two things. I tell all my patients, get a blood pressure cuff, you need to monitor your blood pressures on the days that you're fasting or starting this whole program. Number two, if you're on insulin or if you're a diabetic, you should get continuous glucose monitoring, the device that you put on your hand. I think that's amazing because that'll empower you to know that your symptoms you're having

right now are not due to low blood sugars and you can basically be confident that you're not hurting yourself and you get more confidence. And yes, the sugar may go up because you don't take your insulin shot. So it goes up from, let's say, 150 to 200 or 250. That's not going to bother me that much because that temporary increase in your blood glucose level is not going to harm you that much because it's temporary. And then it'll come back down again. So if you look at the effects of glycation due to high sugars,

that effect, that detrimental effect on your proteins through the glycation end products is not as deleterious as having that high insulin level and inflammation in your body. So I kind of let the sugar run a little bit higher and make sure that they don't become hypoglycemic because that's the problem. So when you are starting this program and you start skipping meals, it's a little bit easier without supervision. But once you start getting a little serious and you're only eating once a day or doing a fast more than 24 hours, I think you really need to have a doctor or somebody who knows a little

but about this involved in your case. And it's kind of hard these days because a lot of people are still not on board with this fasting issue. But that's a great question. I think that generally speaking you do. Now, I tell you, I got a patient that came to see me from South Florida, and he was on his 83rd day of fasting. Only water. 83 days.

Drew, I looked at this guy, and he looked amazing. And he felt amazing. And he didn't have all that skin, you know, all over his face and under his arms and everything else. So, and that's because when you do this type of fasting, you lose weight and mostly fat, but also your skin shrinks. So it's a different type of weight loss than when you're losing weight by eating five small meals a day and doing collardic restriction.

I've definitely seen a difference in the way the patients present. But this guy was 83 days, and I was shocked. I said, this is amazing. And so I have a blood lab. Immediately did his electrolytes in the office, normal. Wow. CBC, normal. Are you on any medications now?

No, I was on diabetes medication, and I was on blood pressure medications. He's on nothing. The guy looked amazing. So he weighed 385 pounds. He was down to 230 pounds. So I said, okay, so according to the scale, I want you to come down to about 190. I think that that'll be the perfect weight for you. And he just called me, he broke his fast.

So I told him to take some bone broth and, you know, broke his fast gently. And he's doing wonderful. Now, he's not going to go back to eating five times a day or three times a day. He knows what to eat, how to eat, and he's going to start eating only once a day. And he says that I'm happy doing that. So here's a guy who came off all his medications. But I think that people are looking for help and where are you going to find these practitioners. is, it is a bit of a problem, Drew, right now. There's more and more that are coming out each day.

A lot of younger people who are into, like, working out or CrossFit, like my brother-in-law, he's a cardiologist at Kaiser in San Diego. And, you know, he practices his lifestyle. And he'll work with his patients and try to support them in fasting and other aspects. So there's more and more people, and there's places like the Institute of Functional Medicine or Integrative Centers that are out there or A-4-M. If you dig a little bit, you can try to find some doctors that are out there or some practitioners that can guide you. And I think that, you know, what you just shared, by the way, that's an astonishing story.

And I think there's a couple layers of it. Number one, for people who listen and are immediately shocked, like, whoa, can somebody even survive 83 days just on water? Here you have a medical doctor telling you that he's had firsthand experience with somebody who did. And on top of that, you know, it sounds like, did you formally accept him as a patient? So was he working with you? Yeah.

So he's also now a patient. So it's not that you're saying that this is something that everybody should be considering out there. You're really highlighting what's possible and how this fear, especially for individuals that might be classified in the obese category or extremely overweight category where there's a lot of extra storage that's there that the body can use. You're really highlighting what's possible when we allow our body to do what it needs to do best. And then within that, everybody can personalize their own approach on how to tap into the power of fasting. Yeah. And the fear factors need to be eradicated. Number one,

oh, I'm going to run out of vitamins. Well, you know, your liver and other parts of your body can store up to two months worth of vitamins. And I mean, I did the research. I was shocked. Yes, there are plenty of vitamins that are stored. And that's what it's for. It's for a rainy day. the body was designed in a very supreme fashion, to be able to do that, to store the micronutrients in your liver. So you don't need to be popping all of that. I have needed for two days. So I need to take my multivitamin. You don't have to do it. Of course, if you are nutritionally depleted from the beginning, and let's say you did a spectro cell blood test, which is a test that can look at all your micronutrients. And if you're missing, and you're really depleted, yeah,

you might need to take some supplements. But, you know, for most patients, they don't need to do that. Number two, fats. There's plenty of fat storage in your body. If I take away all calories from you today, the average person can go at least 30 to 40 days. And I'm not saying that you should, but they can. So the fear factor needs to be taken on. People think that, oh my God, they missed a couple of meals. I'm starving. You're not starving. You're not going to die. You're going to be fine. Your body is supposed to have that physiology. You're supposed to subject your body to this type of flexibility. If your body is not flexible in the metabolic way, then I think that you're setting yourself up for degenerative long-term diseases. So on that topic of metabolic flexibility, do you feel it's important as one clarifying point? And I'd love to hear your opinions on it. some people recommend that first a patient or somebody that might be navigating this on their own goes and starts switching towards a direction of a whole food diet so that before they go on

a little bit of a longer fast or they start even fasting for 24 hours they're not going into almost like a deep detox that comes from going into that what's your experience been with patients especially ones that are more like eating processed foods, Oreos, junk food, other stuff. When they jump right into fasting, do you sometimes see that they have what would be seen as either detox symptoms or negative reaction when they first jump in? Great, great, great question.

Yes, this is the danger. Two things. One is they are truly addicted to this. And there's two forms of addiction that I've discovered with these patients. not me discovered it, but through experience. Firstly, there's the psychological aspect that, you know, you've become Pavlovian. You know, you come home and the first thing you want to do is gorge on some junk food. Okay.

It's a Pavlovian. It's that house. It's that kitchen. It's that sofa. It's sometimes getting into your car that you dig for something. So we need to get rid of that Pavlovian reflex. So I tell patients, when do you eat? What stimulates your thought about food?

What makes you crave for it? Is it certain friends that make you do it or a certain environment that do? So those are all psychological cues. And then the second part of it is the true chemical addiction, which I do believe that is really true because these processed foods, especially sugar. Sugar is number one.

It goes to the dopamine center. And now all of a sudden, the next time you eat sugar, you need more and more of it. And there's cravings. But you know what? Worse than the cravings, I have to point this out, worse than the cravings are the fact that it changes your brain completely. There's actual neuronal pathway changes that occur in your brain.

So when you are eating all those Oreos all the time, you've already got those pathways built into your brain where the rostro pathways from your dopamine center and limbic system which go to your frontal cortex, they downregulated. Now, what does that mean? That means that when you're addicted to that type of food, you can't think straight about that food. That means you've become a little dumber about the intelligence of your diet and your

control over your diet because it wants to continue to be addicted. So you don't get so smart about it. Okay, because if you get smart, you're going to not be an addict anymore. So it makes your frontal lobe go down in its function. And then it goes to the hippocampus. So there's connections that go to the hippocampus that actually make you remember that wonderful feeling that you had when you ate five really bad processed food items in a matter of one hour. So you get that. You can't break all these down.

So yes, you're absolutely right. To break those neuronal pathways and the habit pathways, you can't. you've got to bring in this slowly. So, you know, I do discuss with my patients how far are they along the path of this processed food addiction and what is the consumption? I mean, today's it's really sad that almost 57% of all the calories that they're consuming these days are coming from processed to ultra-process foods. So you've got to bring that number down. So changing the content of the diet first before we even introduce fasting, I think you're very right. You've got to change what they're eating first.

Because if you just go straight into dieting, they will get a lot of withdrawal symptoms. And then, as I said, you know, they're going to be so dismayed and feel so bad, they'll fall off the bad wagon and they'll never come back again. So do make the change. You've got to give them alternative foods. You've got to show them that these foods are the ones that are non-addictive foods, non-addictive foods that you've got to get on, which is basically whole foods, real food. If it looks like that in nature, eat it. If it's going to go bad, eat it. If it's got a barcode on it, be suspicious.

Don't touch it. If it's got a food label on it, be suspicious. Try not to read it or eat it. Just get rid of it. Just get rid of it. So just go for real food. So people come to me and say, you're a cardiologist. So, you know, I became a vegetarian.

I don't eat meat anymore. And I was one of them that believed that meat, hey, hey, this is bad stuff. You know, I'm cardiology, FACC. I realized that the research doesn't support that. So why would red meat be bad for you? It can be. And my association with that or my interest in that is that if it's grain-fed cows, you're going to have too much omega-6.

That omega-6 is getting into you now. So that beef is not going to have the same concentration of fats of a cow that's eating grass, because that's a grass-fed cow. it'll have more omega-3 and it'll have more saturated fat in it, not the omega-6s. You see, you are what you eat and what that ate. So meat is actually okay, provided it's grass-finished and thereby it doesn't have all that omega-6 in it. Chicken is okay.

Organic chicken. And if you're eggs, organic eggs. I have no problem with these foods because they are whole, they're natural. And when I put my patients on these, I guess what? I get better compliance. Because you can go ahead and eat your egg. Have your egg for breakfast. You know, just get rid of the toast.

Just have your two eggs for breakfast. Cardiologist saying two eggs are fine, yes, because the cholesterol that's in the eggs is not what's going to raise your cholesterol level. Your cholesterol is what you're making mostly in your liver. So this type of education, they feel better about it and say, Doc, let me eat eggs. He lets me eat beef. He lets me eat chicken. But I tell me, it's going to be the right stuff.

And then, of course, with it, you've got to have your vegetables with it. So you've got to make these changes in their diet. So they're eating better quality food, better classes of food in the whole state with everything, just way nature made. If it's like that in nature, consume it. If it went to a factory and got changed, get rid of it. That's the bottom line. It's the bottom line. And sometimes the simplest answers still take is an uphill battle against the entire way that society is organized around food.

and pleasure and as you've mentioned addiction. So I want to say for anybody who's listening that is hearing this and is nodding their head along as they're listening or watching this, you know, especially with you, Dr. Jay, working with patients, you know that there is so much past baggage that people have to let go of. Sometimes that's even trauma. Sometimes that's all sorts of different components as to even though it's a simple answer, we know you're fighting a nut pale battle. And for everybody who's listening that feels that they should be further along than they are,

you're doing the best you can. And yes, there might still be changes that you want to make and be gentle in the process, but keep on at it because you're headed in the right direction. Again, you know, you're so far ahead of everyone because you understand that your eating behavior is also affected by what else is going on in your life. So if you have a job that's extremely stressful, you've had a lot of crises going on in your life,

then at that point, I'm going to tell you, okay, you ought to do this, this, this, this, and the other, it's going to be very difficult for you to do it. So when you look at dietary changes and behavioral changes in eating, you also got to look at the totality of the patient's life, how much stress is going on in his or her life, what kind of job, what can't, but, you know, now you're digging even more layers on that onion. You see what I'm saying? So you got to, it's so deep. It's a lifestyle. So you've got to say to yourself, okay, I'm, Dr. Jay, it's not just talking to me about when to eat, how to eat and what to eat. It's also talking to me about, am I happy? Am I peaceful? Do I have purpose? Do I have

connection? Am I depressed? You know, because all these factors are also going to affect, not only your eating habit, but also your general health. I mean, you know, let me give you an example. I mean, we look at the attributable risk of, let's say, hepatension or cholesterol to coronary artery disease. But have you looked at the attributable risk of things like depression? It's far worse. So if you're depressed, you're a sitting duck to have a heart attack.

And nobody talks about that and says, okay, let's look at the risk factors or sit on your tummy, tell me if you're depressed, you fill this form up and tell you if you're depressed. And nobody's got time to it. family doctor doesn't have time to do that. And yet we don't realize that the attributable risk of depression and other psychological illnesses that you might actually have are far more. Do you feel connected? You know, what's your understanding of your standing in society in general? Or do you feel that you're at the bottom? Do you feel that you have confidence that you can talk with? all these things affect your physiology.

So diet is one big part of it, but all these other things are so important. And I've got to tell you about this one study because this will really raise your curiosity on how I got involved with this. This was a study that was done at Johns Hopkins. They took medical students and obviously paid them for the experiment.

You put an arterial line in their radial artery and they were drawing out blood and putting it through a machine that measures your platelet reactivity. Okay? Right? So they can tell moment to moment because it's done through light as to whether the platelets are aggregating or not. So platelets, as you know, are those tiny little particles that make your blood clot, make your blood sticky, which you don't want because you want your arteries to be free-flowing.

So what happened is that they give them a test while they're doing this, and they flip through the page, they answer the questions, and the platelets are happy, and then they turn the page, and now you've got a question. that on a subject that you were never taught. These kids go crazy now. Oh my God, I don't know the answer. And gets what happened to the platelet reactivity. Changed instantaneously.

This is so fascinating that, you know, and I read the study about 30 years ago, and it stuck with me. But it showed me how your moment to moment, moment to moment, I'm not sure even moment to moment, even moment-to-moment perception of stress affects your physiology. This is just one example. I've got hundreds of examples I can show you of how your mental state affects your physiology

and how your body reacts on a moment-to-moment basis, down to even expression of angiotensin to receptors in your endothelium and your blood vessels. So whether you're going to actually clot right now or you're going to flot. right now or you're going to flow. And the number of receptors that are expressed, moment, you know, we say that we have these angiotensin to receptors in ourselves, right? So we think they're fixed. They're not.

Three quarters of them are involuted. They don't express themselves. Now, under certain circumstances, they'll all of a sudden express themselves. And that, the stimulus for the expression of those receptors could be dietary, but more so, it can also be psychological, how you feel. And it's amazing to me that 50,000 receptors, now all of a sudden they are 100,000 expressing themselves. So now when the antietensin comes along,

you're going to get a hypertensive blood pressure response. Suddenly your blood pressure goes up. So we have these biochemical pathways. We know about it. But nobody's saying that, okay, fine, let's look at your diet, but also, come on, get a handle on your life. Let's decrease the stress levels. Let's do some meditation.

Let's look at the peer group that you're spending time with. Are they supporting you with their habits? There was a study that was an offshoot from the Framingham data, the Framingham Heart Study that was done in Massachusetts, that long, longitudinal study. And the study's title was the spread of obesity through social networks. And they weren't talking about Facebook and Instagram and that. They were talking about how we don't typically think of obesity.

as a contagious condition or a contagious makeup that somebody might have, but actually they found that when they looked at somebody in their life, if their best friend or there's somebody that was close to them that was a friend, even more so than their spouse, even more so than their parents or their siblings, if their close friend became obese, they were much more likely to become obese themselves. So this just goes back to the message that you're sharing that when you step into this mindset of wanting to improve your life, feel better, and hopefully make the world a better place, too,

you start to look at every single aspect that's there and ask yourself, what is the nutrition that I need in that area of my life to feel whole, complete, and give back to the world. And in some cases, it's actual food nutrition. In some cases, it's healing your relationship. In some cases, there's so many people that are so alone today and don't have somebody that they would call a best friend, somebody that they can rely on that they can be, that can be their confid on. And every time I hear you speak, I'm just reminded of like how deeply connected all aspects of our life are. And we should feel happy about that. Because even sometimes you have a week where you don't feel like you hit your fasting goals or you didn't

make as much progress in your dietary goals that are there or you didn't get as good enough sleep. Okay, great. Don't beat yourself up. There's all these other areas. How about just calling a friend that you haven't talked to in a little while and making their day? How about doing something nice or kind for someone and feeling that joy that comes from giving back into the world, even if it's something really small? There's always something that you can do to take a step in the right direction of feeling

better. Oh, absolutely. So you see now you're really talking about a holistic approach to this whole problem of chronic degenerative diseases, of which nutrition fasting is one part of it. But you just hit on so many important points about it's our whole lifestyle. You know, the number of visitors that come see a patient after open heart surgery dictates how well that patient's going to recover. I mean, it's ridiculous. The complication rates are higher if that person has no visitors. What's that got to do with complications? versus if there's lots of visitors, I mean, these studies are all done. The number of visitors after open heart surgery dictates whether he's going to get home at day number nine

or whether he'll be discharged at day number five. What's that got to do with it? So it gets really complicated, but, you know, it gets complicated, but then when you sit down and think about it, it makes sense. That you feel connected, your platelets are now pacified, your endothelium is working better, your blood pressure is better, your physiology. Your physiology is dictated by the chemicals you put in and the medicines and the food, which is your medicine, but also how you think, your brain and your whole psyche can also affect your entire physiology. So it's not just fasting. I mean, you can't be unhappy and fast. I mean, I think that's very bad. And you mentioned something about the contagiousness of, you know,

this is definitely because behavior is contagious. That's why when you're trying to fast, you've got to stay away from those enablers that enable you to break your fast and go back and fall off the bandwagon because your best buddy says, oh, come on, man, we're going to go for a drink and we're going to have some chips and et cetera, et cetera. That's one thing. And the other thing is bacterial flora. So, you know, it's amazing that your bacterial flora can dictate a lot of your physiology, too. And I'm just digging into all this now. And I'm sure you, I'm sure, you're aware that, you know, you can do fecal transplants from an obese person to a thin person and vice versa, and you can actually change physiology. And this data is just coming out and it's

fascinating. But again, I tell my patients, you know, look, that may be true. Just take care of your own flora. Feed them the right things. Give your gut a break. Let the bacteria flourish, the good ones because the bad bugs have a short half-life. That means if you don't eat for six or eight hours, you've knocked off some of the bad bacteria in your gut. So the good ones are the ones that are going to stay behind and they're going to be a resident population. So I said, feed them the right thing. Eat it according to our program over here and you'll have the right bacteria. Then you won't have to talk about fickle transplants and crapsules and all these things that they talk about these days, absolutely fascinating stuff.

It's so true. And also, too, when you get a craving, you have to think, we don't have the ability to distinguish it now, but is that you, or is that the quote-unquote wrong bacteria that's having that craving, the yeast inside of the body, the candida, the buildup of different funguses, other things like that that are in the gut, that are craving because they feed off of these sugars. And those signaling molecules, those modulation of the gut bacteria, can drive your own craving that's there. So sometimes it's not even you that's craving it. Sometimes it's your bacteria and maybe not the type of bacteria

that we want to continue to grow further. You are so astrid. You hit on that gut brain access connection. And it's so true. And I just don't leave you with one word about that. That is that almost 50 or 60 percent of the micronutrients that are floating around in my bloodstream and your bloodstream are not what we ate.

It's what the bacteria made and liberated them as a gift to you because you harbid them and you fed them the right stuff, hopefully, and the right kinds are there. And they now float in your body. So if you look at turmeric, which our ancestry uses, and we say, oh, it's an antioxidant and all that. Well, actually, it works in different ways. And similarly, there are many others that actually the bacteria, the polyphenols are taken up by the bacteria, and they utilize those and then release the final chemicals into your body. It's not the body field that's getting into your bloodstream.

So you're eating for yourself and you've got to do the fasting, all this stuff, but you're also eating for your bacteria. And your bacteria, in turn, are producing tons and tons of chemicals that are then liberated into your bloodstream. So you just hit onto a huge thing right there. And, you know, we can talk about hours and hours about all this wonderful stuff we're learning. It's just amazing. amazing. It's so amazing. I have a couple more questions that I want you to just be able to share

about your world a little bit and just anything that you want to have. If you had to ask for our audience, you know, to check out something that you're up to, then I'd love to get to that. So a selfish question that I'd love to ask you. You know, I have, I wear a continuous glucose monitor and that's been amazing. I was one of those people that I was always more on the thin inside, but I even noticed that even in my college career, growing up vegetarian, everything, I started even as thin as I was and quite skinny at the time because I was vegan. I actually became vegan after that. After being vegetarian, I started to get a little bit of the belly.

So I was that tofu. I was that, you know, thin on the outside, you know, fat on the inside and I had that belly fat. Then I got into the world of functional medicine, other things, tried a bunch of different stuff, started incorporating back in super high quality animal foods into my diet. diet completely a game changer especially. I tested my omega-6 to omega-3 ratio using omega-quant. It's a test that's out there that's pretty popular. No affiliation. And I saw that my omega-6 was really high and my omega-3 was really low. So I started incorporating high-quality

fish into my diet, salmon, wild-caught salmon, other things. And I felt like a completely different person mentally. Like I was turned on. I wasn't clinically depressed before, but I was feeling like I didn't, I wasn't as sharp and I didn't feel like that luster for life. So that evolved into as keto became a little bit more popular. I said, you know what? Let me try this on. Now, I found through my experimentation of keto and I eating lower sugar, lower carbs in the diet that was there, that I followed into what looked like, this small class of, smaller

classification of people that has Lucy been called like lean mass hyper responders. Those are people who their lipids, a lot of people go on a higher saturated fat diet and their lipids improve, like a lot of the patients you worked with. I went on that, even though I wasn't having the sugar and other things. And my markers, my LDL, my NMR profile breakdown of my small dense, they went in the wrong, like in the not the great direction. Have you worked at all with patients like that that are in that category that might signal that, you know, generally that type of diet works well for?

for a lot of people and probably most people that are following the Western diet, but there could be either a phenotype or a genotype component where people don't do as well on that diet. Would love to hear any thoughts that you have. So I think you hit on a number of good points over there. Number one is we are very variable in the way we respond to foods as well. So wearing the glucose monitor, you'll notice that somebody else eats that same meal. There is sugar response is different and yours is different. And different foods create a different rise in your glucose.

so we are all a little bit different. So you need to find your food profile that best suits your glucose rise. So after experimenting with your diet to see which of your foods cause the greatest sugar rise in your bloodstream, you can't then take that and give it to everybody because they may react a little bit differently. So to a certain degree, what you've done is very unique because you've done a unique examination of your own sugars. So we all tend to respond a little bit differently. So I think that that's a very important point. And then the other thing is that your lipids, for example, how they responded.

Generally speaking, when I put my patients on a moderate fat, no-sugar, moderate protein diet, the LDLs to go up, exactly like yours did. But what I find a little surprising with you is you said you had small, dense particles. they usually, they go up, but they usually large, fluffy particles. So when your LDL particles become small, this is the take-home message. That means that no matter what you're doing, it may be helping you in other ways, but there may be some inflammation going on. Because when the LDL particle, how does it become small dense?

It becomes small dense because lipopolysaccharides from your gut are actually getting in, and they displace the cholesterol from the LDL particle, and now create a small dense. particle. That small dense particle also is more likely to get oxidized. So these small dense particles, you don't want them because they're more oxidated. So it tells you that you've got lipopolysaccharides, which is endotoxin getting into your bloodstream. So then you're going to ask yourself, why is that happening? And it may be that there's certain foods that may not be causing symptoms in you, but may be causing a breach in your gut barrier that may be. Because you've got to ask yourself where this inflammation give.

And that's the million-dollar question I asked every professor when I was doing my fellowship. Where does this inflammation come from? Nobody had an answer. Not a single professor had an answer. And it's plagued me all my life. Where does this inflammation? It comes from the gut. It comes from the gut.

You know, it's so interesting that you said that because we had a microbiologist on the podcast. His name is Kieran Krishnan. And he's with a company called Microbiome Labs. And he had suggested to me because I had talked about this early on that I said I had a relapse of some skin irritation and acne and he said you know what for some people that had a history of leaky gut and i used i had a lot of antibiotics usage when i was a kid for sore throat other things and i'd suffer from leaky gut in some instances higher saturated fats even though they can be a lot of beneficial like butter ghee coconut oil they actually if your leaky gut isn't fixed they cause an endotoxemia effect so i

removed coconut oil for my diet i removed the higher saturated fat foods even though i love you know grass-fed beef and I think, you know, I generally recommend it for people. And I noticed a cooling of the inflammation. My skin irritation went away and it kind of brought down. And now I'm doing a, you know, an updated gut protocol to heal all that. In the meantime, I've eased up on some of those foods personally, again, you know, just for my own life to cool that inflammation for me. But it just goes to show you that there's so many layers that are there, generally speaking, everything that we talked about in this interview is largely going to work for people that are there. But we're all on our own unique journey of figuring things out. Exactly. So we knew that you've got small dense particles,

lipopolisaccharides get. How do they get in? They get into the leaky gut. What is the mechanism? What's the carrier molecule? The carrier molecule is saturated fat. So we do know that the more saturated fat you consume, and if you have a leaky gut, now those saturated fats will take endotoxin or lipopolysaccharides into your bloodstream and now, of course, small dense particles. So you've got to work this out. So you're absolutely right. So working out this chemistry is very important. And everyone's individuals. They say, okay, you did this, you did this, you did this, but now you got this. But what else can cause this? So you've got to think this. Now, look, I'm a simple cardiologist. I'm not a gut doctor. No, I'm, but, but you know. But you know more than most gut doctors

that are out there, just saying, I just, you know, it's fascinating to me. It's very humbling that all this is going on, and we need lots more researchers. I mean, people like you, to let people know that look, it's complicated, but it can be done. Like how you worked it out. You said you still have a leaky gut? Okay, fine. And saturated fats are the mechanism by which the lipopolysaccharides get in. So you've got to look to see which foods may be causing your leaky gut. And how can you get rid of that? So again, you know, that gets really complicated and people do tests in the bloodstream to see which antibodies are there and which foods might be causing it. Because you may not have over-Gi symptoms, but you may have certain food intolerances, especially wheat products.

So what I do in my practice as a general rule, okay? As a general rule. When I'm suspecting that there's this gut issue going on, I just have to stay away from wheat because that's the number one problem I've found. And when I do that, honestly, for 80% of the patients, it helps my situation. They may not come back and say, oh, my bowel's real great, but I know that I've helped them because I see the markers in the bloodstream and other things that weigh, and everything. else I see. So wheat. Wheat is a big one, especially processed wheat, and it's all processed. It's all made into powder. Wheat is number one. And then, of course, some people don't tolerate dairy products, but I do an elimination, a simple elimination. Look, right now, just get rid of all wheat. Just get rid of

all wheat. And then if you're going to eat other substances, I do believe that you need to be careful about some lectins, because at a time to soak the lectin-containing foods, and then use a pressure cooker to kill them. So I teach them a little bit about how to eat right. And then I looked and see what's happening. So with the leaky gut, it gets a little complicated, but yeah, an elimination diet before I do blood tests. Because others use so many blood tests.

It's so true. And even just practicing, and there's been a lot of people that have talked about this, even just incorporating fasting, fasting is one of those mechanisms that supports your body in repairing that gut lining when you take a break. So even taking a full circle, fasting can play a central role in helping you to address that leaky gut in the first place. And we'll link to a few resources that are out there.

Dr. Jay, I want to be honoring of your time. I'm sure you have patience and other stuff and things to get into. Tell us a little bit about your world. You know, I came across these viral videos of you on YouTube that you gave as a lecture to, I forgot the institute's name. Can you remind me? Yeah, it was Florida Hospital, which is now known as Advent Health,

the big hospital, right, in Orlando. I saw those. Amelia, I reached out to your office, and I said, I gotta, you know, I gotta get Dr. Jay on the podcast.

You know, what, since you putting out this content and it being out there in the world and getting such a great response, you know, tell us what you're up to, you know,

you're seeing patients. I mean, after this interview, I know some people are going to ask, Like, can I work with them as a doctor? You know, what's going on in your world? Are you thinking about writing a book? Because I think a lot of people would be very interested.

Yeah, just tell us a little bit about your world. Well, I'm still a day-to-day cardiologist. I still see patients every day, and I do my procedures. I do pacemakers, I do aces, and I do all the stuff. I do antoplasti. But I have a full of fantastic staff. So I have a bunch of nurse practitioners and PAs that I have trained to address these issues with my patients. And those who are the toughest ones, then I do still see them.

So I am a regular practicing physician. I'm creating new slides. I'm going to do another video on food addiction because I really think that that's a huge problem and how to overcome food addictions. So I'm going to do that problem. And then the South Asian paradox, and I'm going to make another series on that. So again, more education. A book, you know, it's so hard to find more hours in the day to do that,

although I've been told that I should, it's hard, it's hard to do it. But hopefully in the future, I do want to do that. But on another note, I am going to open another wing of my practice, which is going to be for lifestyle and medicine, where I will see patients personally for a longer period of time. I can sit with them for one hour. And then the next visit will be with a nurse practitioner or a nutritionist and then have a nutritionist in the office, I'm looking to build that.

So I'm not ready for that yet, but I'm building that because I think this is badly needed. But in the meantime, you know, if people watch these videos and they make changes, because, you know, I get so many emails that, you know, we've never seen you. We live in some part of the country, and you've made a great difference in my life. And to me, that's very rewarding because I'm not seeing you, and yet I'm able to touch many lives, just like you. You have improved thousands of people's lives through the content of your talks. And I think that that speaks great for this new platform that you've created and this

internet that we now have with YouTube and everything. So we'll continue to do this. And we're going to cross paths. I'd love to meet with you again in the future and tell you about the new things that I'm doing, which is really the gut bacteria. Oh my God. Drew, I've read four books on the gut bacteria later. I am so excited about it.

And as you know, you know, how the TMAO and how that all links in with atroscarosis, I'm finally beginning to answer or get a glimpses of questions that I asked my professors for years and years and years. So I think the future is going to be We'll talk more about the gut microbiome And if there's one thing I'm going to leave you with It's that I think that there's a lot there I think it's all going to a lot is going to come down to the microbiome

So that is the next Big challenge for people like you Well, I can't wait And I think as our audience continues to go down the rabbit hole Of all the work that you put out there in the videos which will have a link to all of that in the show notes. They're going to be just excited. Like their favorite TV season, episode, series is like they're waiting for that new season.

You know, you talking about the gut bacteria, they're going to be super pumped. So anytime you want to come back on the podcast and talk about that, we would love to have you. Dr. Jay, thank you for your work. You know, often in medicine, you know, I have a lot of family members that are doctors. My dad was involved with health care for a long time. And often in that world, I know how much it's seen as, yes, when you are sitting one to one with patients or in surgery or doing an operation, yes, that is practice. But a new type of practice that's happening because we have so many people on the planet that are suffering is actually taking a time to dive into the latest research, connecting the dots that haven't been connected because on average it can take 12 to 17 years between the latest science ending. up in your physician's room.

And there's a lot of people that are out there. They're suffering that can't wait that long. So they need somebody to say, okay, nobody's done a full on randomized clinical, you know, double-blind trial on this. But we don't need to because these dots are there and they're basically connected. I'm going to storytell and I'm going to be charismatic and I'm going to teach you. And that is a form of practice. And I just want to say thank you for having the courage to step into that and putting your

message out there because there was. people that don't have the means, don't have the ability to travel, don't have the ability to come and see you in person, and yet their lives are better off because they're seeing your work. And for that, I applaud you and I honor you. Drew, it's been my pleasure and I look forward to our next meeting. Wonderful. Thank you. Thank you.