Mind Pump: Raw Fitness Truth - 1567: How Not to Die From Heart Disease With Dr. Alo

Episode Date: June 3, 2021

In this episode Sal, Adam & Justin speak with cardiologist and trainer Dr. Mohammed Alo. Why there is a lot you can get away with when you are lean and fit. (1:57) Why you may be consuming less saturated fat than you think. (5:49) The top 10 things you can do to improve your heart health. (8:17) Are we genetically inclined to be overweight? (10:27) How does plaque form in the arteries? (14:19) The truth and value of statins. (16:44) Why being in a calorie surplus leads to obesity. (23:25) The importance of building muscle to reduce cardiovascular mortality. (30:43) Why you can’t argue with studies when it comes to the benefits of resistance training. (37:48) The value of having a balanced approach with it comes to your training modalities. (39:23) Why the more muscle you have the more your body becomes insulin resistant. (41:38) Are there any supplements that help improve heart health? (47:38) Dr. Alo’s take on SARMS. (50:00) Does he recommend taking aspirin to his patients/clients? (51:30) Myth or fact: Do men suffer from more cases of heart disease than women? (53:09) How the volume of smoke you consume may be affecting you. (55:48) The obesity paradox explained. (1:00:36) Is he pro gastric bypass surgery? (1:04:45) What attracted him to Mind Pump? (1:09:00) Has he seen carry over from his personal training business to his medical profession? (1:13:50) The biggest problem he has with doctors. (1:18:40) Why exercise is NOT as important as diet. (1:22:20) Featured Guest/People Mentioned  Dr.Alo (@dr.alo) on Instagram Dr. Alo YouTube Dr. Alo Website Gary Taubes (@garytaubes)  Instagram Related Links/Products Mentioned Dr. Alo's Weight Loss Masterclass **Promo code “MINDPUMP” at checkout** Visit Vuori Clothing for an exclusive offer for Mind Pump listeners! The Seven Countries Study - Countries: Finland In Depth Diet Research Review 2021 - Dr. Alo TV In Depth Exercise Research Review 2021 - Dr. Alo TV Twinkie diet helps nutrition professor lose 27 pounds The Resistance Training Revolution – Book by Sal Di Stefano Arsenic, Lead Found in Popular Protein Supplements Framingham Risk Score for Hard Coronary Heart Disease - MDCalc Mind Pump TV - YouTube Mind Pump Podcast – YouTube Mind Pump Free Resources

If you want to pump your body and expand your mind, there's only one place to go. MIND, MIND, MIND, MIND, MIND, MIND, MIND, with your hosts. Salda Stefano, Adam Schaefer, and Justin Andrews. You just found the world's number one fitness health and entertainment podcast. This is Mind Pup, right? In today's episode, we actually talked to a real cardiologist who also is a personal trainer, Dr. Allo knows his stuff. And in today's episode, he talks about the latest

and newest research on how to prevent heart failure and heart disease. The reason why he got our attention is because the number one form of exercise that he recommends to all of his patients is resistance training now. So it's pretty cool. So this guy talks about all the latest stuff.

It's a really great episode. I know you're going to enjoy it. Now you can actually find Dr. Allo on his YouTube channel. That's Dr. Allo, d-r-a-l-o.tv. His website is Dr. Allo.net. This episode is brought to you by our sponsor, Vuri. Now they make some of the best at leisureware clothing you'll find anywhere.

This stuff feels amazing on your skin. Their style is incredible. We love wearing it to work out and to go do anything during the day. It looks really nice too. It's great stuff. Go check them out. And of course, we have a discount, right?

So go to Vuriclothing.com. That's v-u-o-r-i clothing.com forward slash mine pump. You will get an automatic 20% off your first order. Also, all month long, we're running a promotion right now. Maps Prime, Maps Prime Pro, and the Prime Bundle are all 50% off. You can head over to mapsfitinistproducts.com to check them out or to sign up. Just make sure you use the code June Prime with no space for the discount. All right, enjoy this podcast.

So Dr. Allo, I met you recently. I was on your podcast. You interviewed me about the book that I wrote and you've been listening to the show for a little while. You're a cardiologist and when we started talking, it was great because we had a lot of similar, I guess, opinions and understandings about health and longevity. And, you know, I have a lot of friends that are doctors and oftentimes sometimes we're at odds, but a lot of stuff that you were, we were talking about, we're very similar. I'd like to talk about the changes in our understandings of heart health.

There have been a few. I remember when dietary cholesterol, for example, was a big topic. We were told to avoid it for a while. What does the current research say? What do you tell your patients about things like that? What does that look like? Dietary cholesterol, it used to be a thing. We used to have it donate more than 300 milligrams a day

and try to avoid it, you know, don't eat that many egg yolks. But as it turns out, dietary cholesterol in and of itself is not a problem. They've done studies where they feed people tons of dietary cholesterol, whether it's shrimp or egg yolks or, you know, whatever it is. Your total cholesterol is not going to go up that much, nor your LDL. LDL is obviously the bad cholesterol. But saturated fat, we found actually does raise your cholesterol.

Saturate fats are fats are solid at room temperature, butter bacon, cheese, chicken skin, steak, fat, and all the good stuff. That actually does raise your cholesterol, but don't worry about it. If you're, the studies that they've done where people are leaner and fitter and healthier, the effect of satirate fat is not as much on them, where somebody's like really overweight, obesity causes inflammation. There's a number on cause of heart disease, strokes,

peripheral heart disease, all that stuff. When you're obese, your inflammation level is higher. You have your IL 6 is higher, your inflammation level is higher. You have your IL-6 is higher, you know, CRP, all the stuff we measure to measure inflammation as much as we can. I mean, it's not the best, you know, it's not perfect, but all the ways we have of measuring inflammation and blood tests are all higher when you're obese. The more obese you are, the higher it is. So we found that people who are more overweight, things like LDL, or I mean

saturated fat, things like saturated fat affect them more. They're more like it have heart attacks, more like it have strokes. I mean, it's common sense too. But the more overweight you are, the less fit you are, the more likely that is to affect you. When they've done studies, large, large population studies on people eating saturated fat and then checking their cholesterol levels. They found when they corrected for BMI, like where we looked at the lean, super lean people, people kind of a little bit overweight, more overweight obese, morbidly obese, whatever, they found that people within the same BMI, if your BMI was lower, the less likely they are for that to make a difference.

So if you're lean and fit like probably most of your audience or maybe not, but like you guys and people are pretty lean and fit, if you ate more saturated fat, up to a certain degree, it doesn't raise your LDL or cause cardiovascular mortality. You can get away with it more. There's a lot you can get away with when you're actually leaner and more fit. They've done studies where they looked at fitness versus fatness. They looked at, they would think that, like one study they did where they looked at normal weight people who were fit. People who were either normal weight or overweight and unfit, like they didn't exercise, they didn't

do anything, had two times higher cardiovascular mortality. Whereas if you took overweight people and made them fit, like they would run a few miles a day or whatever, whatever fitness is defined as they're active, they're doing things, their cardiovascular risk and mortality went back down to what a normal weight fit person would be. So you can be fat and fit. It's not as good as being normal way to fit, but it's not that far off.

Well, how much of an individual variance is there with a lot of the stuff? Cause for example, for me, obviously I work out and do all this stuff. My diet typically is very high in saturated fat. Whenever I get high, It's coming out as high as you think. Like you know, you said,

I mean, we've talked about this. You talked about it on the podcast a long time. You read me, you're eating whole foods, you're eating whole said, I mean, we've talked about this, you talked about it on the podcast a long time, you read me. Yeah, whole foods. Yeah, you're eating whole foods, right? You're eating McDonald's. Yeah, you're not eating like hamburger, you know, or whatever it is, but even if you did, if you're fit and lean, it's not going to affect you as much.

And you're probably not eating as much saturated fat as before. In Finland, there was this area, they did a study on saturated fat. There was this area called North Carrelia. In the northern part of Finland, it was a rural town, farm town. All they ate was eggs and milk and cheese and lots of dairy, lots of saturated fat. Their cardiovascular mortality was the highest in the world.

They had about 700 people die for every 100,000, which at that time in 1972, it was the highest mortality on earth for people. So the country said, hey, we gotta reduce this, it's crazy. it was the highest mortality on earth for people. So the country said, hey, we gotta reduce this, it's crazy. So they put in a lot of public health measures. They wanted to reduce smoking,

about 60% of men used to smoke at the time, 12% of women smoked at the time. There was some obesity, they got people to lose weight. And they followed that out about up to 2007, and then again, up to 2014 and 18. They found that at the time when it started, people would 23% of their calories were coming from saturated fat. I'm sure not your, you know, you're not eating

23% of your calories from saturated fat, although I don't follow you around, so I don't know. But they reduced it down to about 10%. And they did lose weight, not a whole lot. And in some people did lose weight, not a whole lot. And in some people actually gained weight, but they did reduce smoking in men from 60% down to about 16. Women's smoking rates stayed about the same.

They bumped up a little in the 90s because it was cool to smoke. Women started feeling like they want to smoke. And then it dipped back down again. But they found that they reduced cardiovascular mortality to only 100 out of 100,000. It was 84% reduction in cardiovascular mortality. And they attribute the majority of that to the reduction in saturated fat intake. They went from 23% down to about 10, slightly more. And when they did a subgroup analysis where they looked at just the women,

because they didn't change a whole lot. And their smoking didn't change. And their smoking went up at one point. And then then back down they found that even they reduce their cardiovascular mortality That much so there is a huge difference now the number one thing. I was telling my patients or when I'm giving talks The top 10 things you can do to reduce cardiovascular mortality or like the top 10 things you can do to improve your heart health Number one would be to quit smoking Can you guess number two? Exercise.

Number two would be to quit smoking. Okay. Three equals. All the first time. It's like five club. Wow. The first 10 things you can do to improve your cardiovascular mortality or your heart health would be to quit smoking.

Wow. After that, the next biggest one is to get to as close as your ideal body weight as possible. Not that many people smoke in the US anymore. It's about 18 and 19 percent. The biggest problem now is obesity. We have, according to CDC's latest, about 80 percent of our country is overweight. 42 percent is considered obese. And even in children now, the obesity rates are approaching 20 percent in some ages, you know, five to seven years old. It's about 12 percent up to about 17, 18s. We have even like rates of 20% or even more. They're almost adults at that point.

But obesity would be the next thing. So smoking gives you a 20 times risk of, if we took your exact twin and he smoked and you didn't, his rates of heart attack and stroke would be 20 times higher than yours. If we took your exact twin and he was overweight and you weren't, his rates of heart attack and stroke will be 20 times higher than yours. If we took your exact twin and he was overweight and you weren't, his rates of heart attack stroke will be 10 times higher. So those are the two main things we want to reduce. And there's no doubt about it. Saturay Fat raises your LDL.

There's like millions of studies on this. And there's no doubt that high LDL may not be what's causing the heart attacks or strokes in and of itself, but it highly correlates with it. Because we know an LDL below 57, there's zero cardiovascular mortality. If we got your LDL down to 57, there's zero cardiovascular mortality. You will not die. We have something in cardiology we call the 60-60-60 guarantee. If your LDL is below 60, and your HDL is above 60, which is a good cholesterol, and your triglycerides are below 60. Triglycerides kind of measure your metabolic overall health, you know, how insulin resistant

you are, the kinds of things you eat, you know, how overweight you are, those kind of things. If you're triglycerides below 60, you know, those 360's line up, you will not die of a heart attack or stroke. There's zero cardiovascular mortality. Oh, interesting. That is very interesting. When we talk about obesity being one of the next to smoking, is it more that the client

is obese and carrying X amount of body fat on them, or is it that they're probably taking an assault of being a calorie surplus, 90% of the time, that's why they're that way. Can we tease that out in the studies to know which one is? What do you mean? So when you say that, they're a higher risk because they're obese versus somebody who is leaner,

is it because the body- Just because they have access to automation? Yeah, or is it more of the constant assault of calorie surplus that is the stress? Well, the constant assault of calorie surplus leads to the obesity? Well, it's not the constant assault of calorie surplus leads to the obesity. It's not like they got obese because they're born that way. That's the other thing, a lot of my patients say,

oh, my family's all overweight. It's genetic. No, it's not. You inherited bad eating habits from your family. You grew up with your family, and they eat more food than they should. Montels, you got to finish your play. Whatever your habits are that you grew up with,

you're overweight because of what you eat. Now, there are some people who genetically have to be obese. They're very small percentage. There are people with short stature syndrome. They're like three, maybe four feet tall, or they come to orf's. But short stature syndrome, they have to be obese. There's almost no way they can't be.

Their genetics are such. Now, if you're not one of those, you're mostly obese because you're eating too many calories. So yeah, the calories lead to the obesity, which leads to the inflammation. Men who are obese, the adipose tissue stores and gives off estrogen, which causes more clots and can lead to strokes and heart attacks. But you notice that men who are more overweight are feminized almost. They have man boobs and acne, facial hair, redness, all that kind of stuff. Lines in their belly, like almost like stretch marks, not from actually being overweight,

but the kind of stretch marks people get when they have like diabetes or metabolic disorders. So definitely, it's a, no, there's, I'm not trying to explain that doc a little bit. I've actually never heard of you once say that, the difference in the stretch marks, what do you mean by that? So people who are diabetic, whether they're uncontrolled or going into diabetes, a lot of times you see this in kids, they have like really dark skin on their neck,

and you know, mom's like, I've been trying to wash it off for years, and it won't go away. It's like, you know, this dark skin in the creases. It's in their armpits too. That's a sign, it's called a canthosis nigricants. It's a sign of being diabetic, or uncontrolled diabetes, and they also get these white lines in their belly. You see these in kids, or you know or other people were pretty diabetic. Even though they never gave birth, they never gained a ton of weight and lost it. You see these white striations, they go up and down their belly, they get these dark marks under their armpits or

in their neck creases. You'll see a kid, like, no, this kid is diabetic, there's no way he's not. And then you ask the mom, like, yeah, you know, the doctor did say his blood sugar is a little bit elevated last time, and we need to keep an eye on it. But being overweight in and of itself, you know, obviously to do that excess calories is definitely more atherogenic. The inflammation causes all this. Now, people say, well, my cholesterol is 300. I'm not having a stroke or heart attack. Well, I mean, it's a matter of time. It might not be what causes it. It's the inflammation, high blood pressure. That's the other thing they found with the Finland study.

The majority of the reduction in mortality was due to the lowering of the satirifat. The second most was lowering blood pressure. Men in that study had blood pressures well over 180, some of them over 200. They got those down into 130s and and then that made a huge difference, because the blood pressure and the diabetes assaults the inside of your organs and arteries from the inside out. You're pounding, damaging the arteries.

A cholesterol just comes in like plaster and patches it up. Now, can you explain to me basically how plaque forms in the arteries, like, you know, their genetic factors to that. Like, how does that all come about? So the genetic factor, there are some people who have genetically high cholesterol. They're called, it's called familial, which is like family, hypercholestrol email,

super high cholesterol. These people have cholesterol, like four, five, six, hundred, the highest I've ever seen was like almost a thousand. One of my patients had a cholesterol of 998, like literally two points away from a thousand. That's really genetic. But the damage in the arteries happens

from all the other stuff. The cholesterol doesn't damage your arteries. It actually patches it up. The blood pressure, the high blood sugars, those kind of things cause shearing stress, especially the hypertension. It shears the arteries. You get little traumas and little

damage in there, and then the cholesterol comes in the LDL, especially to patch it up. So it's like scar tissueing in a sense. Imagine like I poke a hole in your plaster, your walls, and you patch it up with plaster, and then you paint it. That's kind of what happens. Somebody damages your artery or the blood pressure, and then the cholesterol like patches. So the cholesterol plaques are essentially your body's attempt at repair. A repair and trying to make best with what's going on. So then in that case, would lowering cholesterol or lower, maybe through statins or whatnot or lowering the body's ability to repair itself, could that also potentially cause more problems?

Or is it like a risk versus reward thing? No, so when you lower LDL or increase HDL, what happens is the HDL, the good cholesterol goes in and scavenges back out the LDL. The problem when we patch it up is it's soft. It's not hard, it doesn't kind of heal properly. So you've got these little patches of like balloons or like bubbles of cholesterol

hiding in there. And if I put one of those plaques ruptures, which eventually it does, all that LDL comes out, goes down with the artery, plugs it up with platelets and all kinds of stuff. And then you have a heart attack or if it happens in your brain, it's a stroke. So the LDL builds up in there. And then the HDL, if you have good HDL, the only way you can raise that release with exercise or a B vitamin club nice and It goes in and takes out the LDL so that then it heals up and it's like natural, you know, artery tissue But if you don't do that or there's more damage being done and you're still inflammatory and you're still you know overweight and all that

Eventually those do rupture. That's how you end up with these massive heart attack Yeah, so look here. let's talk more about statins because it's a bit of a controversial drug in the, I guess in the health and fitness space, I would say. Now, I used to train a lot of doctors and surgeons, and I remember one of my clients was a vascular surgeon. Now, this was about 10 years ago,

and I remember him saying, boy, if they could put statins in the water, it would be amazing. It would solve, it would help so many things. I remember thinking like, is it really that great or is it more nuanced than that? Like, what is their value? Is it something that you have just high cholesterol? You should just take or is it, you know,

much more complicated? So it depends. Stattons are definitely one of the greatest inventions ever. Like I always tell my patients to say, I don't want to take stattons, I want to take something natural. Stattons came from red yeast rice. I mean, it's lova stent, that's what's in it.

That's why those work. You can buy it over the counter. And I tell my patients all the time, if fil, if the for supplements, for example, I want to take something natural. Like all the drugs we have came from something natural. Like aspirin is willotry bark or oil of winter green, salicylic acid, cumumadin is sweet clover,

digoxin is comes from the digitales flower, from the leaves of it. Lycinopril is a blood pressure medicine, it's the one of the most common blood pressure medications, guess where that came from? Where? Just guess.

Lycinopril. I'm trying to put the name together. It has nothing to do with the name. It's super fascinating. It's V to do with the name. It's Viper Venom. Oh, yeah. Yeah, we would have never guessed. He's like, all wait. I feel like the snake venom.

I feel like the snake venom. Yeah, I feel like the snake venom. No, I've actually heard about that. That was my third guess. When a viper bites, yeah, that's right. When a viper bites a human. Like, things are blood, right? It injects a ton of this medicine called anacinibular,

like lycinopryl and alapryl, all the prills. It injects a ton of this into your blood pressure drops so low that you're not getting blood anymore. It's just the organs and then you die. So obviously we don't give it such a high dose. It's microscopic doses. But we've taken all this stuff from nature and turned it into therapeutic medicaid.

Like people come up and you say, well, shouldn't I be taking fissio oil? We have that. It's called lovaza. If it works, we turn it into a medication. Turns out lovaza, which is EPA and DHA, raised your bad cholesterol too much. So then they split it. And now it's only the EPA portion. And now it's a drug called vasipa.

So there's actually a prescription drug called Vesipa, which lowers your cardiovascular mortality and all cause mortality. So the fish oil that's unsuperated is not as good as the one that's just EPA. So I don't know. I mean, we tell that to patients all day. And I'm back to Stanton's. Yeah. And the worries.

So Stanton's of all the medications we've ever invented, other than aspirin, statins have the best number needed to treat. In statistics and medicine, we talk about this number needed to treat. It's the number of patients you need to treat to prevent one death. So most of these medications, the number needed to treat is like 20,000, 3,000, you know, really high numbers in the thousands. The number needed to treat for statins is 40. For every 40 people on a statin, you save one life.

So they're very very good. Now there are some people that have familiar with really high genetic cholesterol that statins aren't gonna be enough and you need to put them on, you know, a bunch of other stuff too. But for the average patient, like 99% of my patients, a statin by itself will reduce cardiovascular mortality, prevent them from dying almost, you know, at least not from a heart attack, and they worked very, very well. There was a concern at one point in the time, maybe like 10 years ago, probably when your patient talked to you, that they caused some neurocognitive alterations, like memory issues, but then they went back

and looked at an over 200,000 patients in all these databases, and they found that Staten's did not have anything to do with that. People, the people on Staten's are older, and they're more likely, they're not more likely than the general population to develop that if they were on a Staten or not. They just, that's what, you know.

So why wouldn't we all supplement with Staten's then like a fish oil? Why wouldn't it be a more regular? population to develop that if they were on a stand or not, they just, that's what, you know. So why wouldn't we all supplement with statins then like official oil? Why wouldn't it be a more regular? It may not be a bad idea. Really? No, it depends on your cholesterol. Like, you know, like I have patients that are, that are like, you know, 30, 40 years old, they're like, my cholesterol is 210, 220, I have a bad family of history.

Now if you're not a smoker and you're fit and you eat healthy, it's not an issue. But if you're like a smoker and hypertensive and diabetic, look, I don't want to be that guy that my cholesterol is 198 and right on the border, why can't it be 110 or 120 or 98? Why not get it down? How often do you have this conversation with people like that where they come to you, they're like, I smoke,

I eat like shit, I don't exercise. I think they, they do. And so, do you have this conversation with them where you're like, I smoke, I eat like shit, I don't exercise. Everyday. And so, do you have this conversation with them where you're like, what pill do I eat? Yeah, we can give you this drug or, you know? So here's the thing, I have seen thousands of patients. As you can imagine, I tell them every day, they have to lose weight, they have to quit smoking,

they have to do all this. How many people listen? And I give them resources. I'm like, listen, I'm here. I will help you. I've sat down with patients and set up my fitness pal for them, literally set it up, put their calories in, increase their protein, because the ratio

that gives you is not good enough. Did that with them and educate them for an hour on it. They come back three months later. Yeah, a doc I tracked for two days, and I stopped. And now, okay, don't track. Here's a way to do it without tracking. Clearly, that's not working for you. I give them ways to reduce their color. I can take without tracking.

I put them on stuff to help them quit smoking. I mean, there's a few patients that say, you know what, I don't wanna quit smoking. I actually enjoy it. Okay, fine, we don't have to quit smoking. But the vast majority do wanna get better and healthier. I always tell people, the two most addicting substances known to man are nicotine, and it is.

It's harder to quit nicotine than crack, cocaine, pain pills, alcohol, anything else they've ever tested. Nicotine is the hardest, and you talked about this in recent times, I guess. It is the hardest. But especially in cigarette, you know, because with the cigarette hits you for it, and you're doing it so often,

you're like conditioning yourself on top of it And I know you tried the Laws and Juss and gums and whatnot But that is these because it offers your mind you nicotinic receptors are in your brain. That's why I took it Feeling there's nicotinic receptors in your brain. They're sort of in the same class as caffeine almost like it's really hard to quit caffeine. I tried I had acid reflux and I had to quit for six weeks. I almost died But it's super hard to quit nic. I tried, I had acid reflux and I had to quit for six weeks, I almost died. But it's super hard to quit nicotine. The second one is food, like calories. The second hardest thing to make people give up,

not give up entirely, just cut a little bit is food and calories. But those two things would make the biggest difference in your health. I forgot what the original question was. Well, I actually want to talk about, because you mentioned my fitness pal, and I wasn't asked this earlier, so it's a good transition to this.

If you, let's pretend we actually have people that will track their food, because there's a lot of people in our audience that will, are there some generic parameters, like as far as what you would tell them to, you know, stay your saturated fat under this, or it should be only this much? It really doesn't even matter. If you're total, so here's the other thing. If you're in a calorie deficit and you're losing weight, everything else makes no difference. Like all your cardiovascular risk factors that we can measure go down. Like they've done studies where people are in a calorie deficit regardless of the portions of macronutrients.

Like they've tested where like 10% of your calories are fat, 10% are carbs, 10% are protein, and then they play with all the other stuff, and then they switch it around. If you're in a calorie deficit and weight is coming off, your cholesterol goes down, your inflammatory markers go down, your insulin resistance improves, your blood sugar goes down, hypertension goes down, diabetes goes down, regardless of what on earth you're eating, if it's in a calorie deficit and weight is coming off, not like I'm in a calorie deficit, but you're still gaining weight. If weight is coming off, not like I'm in a calorie deficit, but you're still gaining weight. If weight is coming off, all that stuff gets bad.

That's why I was asking that question earlier is it sounds like, I mean, I know you alluded to that. Obviously, the calorie surplus is what relates to obesity, but it sounds like the thing that is the most detrimental is the surplus of calories consistent. Right. Because even if you were an obese person, if you immediately get into a calorie deficit, all those factors become... Start improving right away.

Right away. Even the studies were done only six weeks. Like, all right, it was put you into calorie deficit. And it's not even like a huge deficit. They're not like 20% deficit, 25%. They're like in 10, maybe 15% deficit. They're just slightly losing weight. Even in six weeks, we notice a huge, huge difference

in their inflammatory markers and cardiovascular markers. This is why every single diet has been shown to improve health. Let's say, oh, you know, vegan, no, keto, no. Carpone, they haven't common yet. They're all locality. Now, here's the part though that I think is rarely discussed because that, I mean, that's 100% right.

We know that. I say that all the time rarely discussed because that's 100% right, we know that. I say that all the time. Like high sugar, high fat, whatever. Boy, the context makes a big difference. If you're in a deficit, it doesn't make nearly as big of a difference as if you're in a surplus. But here's what it does make a difference.

How those foods affect your energy, your appetite, your cravings. And how you look in the end. Yes, yes, yes. Like, you know, there's a, this is, I'm sure you guys have read about this There's something called the Twinkie diet the Kansas State University professor. I saw the head of nutrition Literally the head of nutrition was eating lunch with his colleagues and they're like laughing at him

They're like, dude, what are you eating? And he's like I can eat whatever I want. What do you mean? Like you're eating junk food. He's like I can lose weight on junk food. They're like, you know, you can't he said sure And these are all his nutrition colleagues. He said sure, I can lose weight on junk food. They're like, you know, you can't. He said, sure, these are all his nutrition colleagues. He said, sure, I can, I'll show you. He for the next three months, a only twinkies. He made sure he got a hundred grams of protein a day because, you know, you have to, it's insane not to you end up being, you know, looking horrible. He made sure he got, he got, you know, protein shakes and that was all he got a hundred grams of protein a day. And the rest of his food was basically twink 20s and he lost 28 pounds in three months And he's like here look at my food logs follow me around all day if you want 28 pounds in three months eating

100 grams of protein a day and basically just Trunkies right, but I of course I would argue unsustainable probably well Yeah, probably want to eat more or less. That's a problem with all these diets. Like I always tell, like I have this fictitious patient called Leslie, all right. Yeah, he asked me. My mind is Mrs. Johnson. He asked me one day, he's like, he's like, Doc, what's the best diet for you? I said, it's called the Leslie diet.

He's like, what, you know, what do you mean? What's the Leslie diet? I was like, it's your food that you like to eat. It just has to be less than what you're currently eating. He's like, what do you mean? How do I do that? I was like, well, how do you eat now? Just eat whatever you eat now. It just has to be less than what you're currently eating. He's like, what do you mean? How do I do that? I was like, well, how do you eat now? Just eat whatever you eat now.

It just has to be a lot less. Now he's like 65 and he doesn't care to be a bodybuilder and I'll protein and all that. I told him, if I give you a diet and I call it something else, you're gonna do it for two or three months and then get bored from diet fatigue. Like all these diets, keto, whatever it is, I've done most of them.

Atkins back in the day, I'm sure you guys remember that, or South Beach, slightly after that. It works, it works for a while, and you do it. But then like what do you do afterwards? You're might gonna keep eating rib eyes for the rest of my life, or not, or eating grains, paleo diet stuff that was available, 100 years ago, or the hallelujah diet, the god diet,

if god didn't make it, then don't eat it. Look at it, it has to come out of the ground. I've heard that was available 100 years ago, or the hallelujah diet, the God diet, if God didn't make it and then don't eat it, it has to come out of the ground. I've heard that one. Yeah, oh my God, there's new. It's just the mana. It's great. You eat like stuff that comes out of the ground. It's like a breathtaking universe.

If God didn't create it, then you don't eat it. But anyways, eat whatever you like to eat, because that's the only way you're gonna be able to do it long-term. Like Justin's not gonna eat what Adam likes to eat. What I like to eat, it's just doesn't work. He's not like cheese as much as me. Yeah.

So, it's like nobody does. He eats what you like to eat. I told Lesley, this is bro, you just not bro. Listen, Mr. Lesley. You eat bro. You got to eat what you like to eat. Just it has to be less than what you're currently eating. And I give them all kinds of resources to help them with that.

But the patients that actually do it, and has to be less than what you're currently eating. And I give them all kinds of resources to help them with that. But the patients that actually do it, and you'll be shocked, I guess, how many patients actually lose weight? Or I'm sure you guys know, because you worked with clients forever. Maybe of the 5,000 people I've seen, like, maybe... 10% of us, yeah.

Under 20. Under 20. Yeah. It's disheartening sometimes. But they really wanted it. Like, you have to want it. Like, I'll give the patients the same spiel every time, like, listen, here's what you gotta do, but they really wanted it. Like you have to want it. Like I, like I'll, I'll give the patients the same spiel every time, like listen, here's what you got to do, but you got to want it. I don't live with you. I can't force you to do this stuff. Same thing

with smoking cessation. But here's what you can do. Do this at home. If you want to do it, I guarantee you if you do this, you will lose weight. But you have to want it. Yeah, you're dealing, you're dealing with, I mean, just behaviors. Oh, it's all behavior. It's so hard to change that in fundamental ways and presenting people with all the information and statistics, it just doesn't matter. Even people's own mortality. It doesn't matter. It's the behavior.

They're seeing me because they have had cardiac problems. Like they almost died usually. And even that didn't give them any. Right. Oh, I can't tell you. Like I've had people have three heart attacks. They're still smoking. I And even that didn't give them any. Right. Oh, I can't tell you. I've had people have three heart attacks. They're still smoking. I mean, that's why it's so addicting. I mean, they're like, yeah, I quit for a couple weeks after

my first heart attack and then I was back at it. I mean, it's super addicting. Same thing with people who lose weight. Like all the gastric bypass patients. I mean, you rearrange their anatomy. They don't have an anatomy problem. They have a psychological behavioral hand-to-mouth problem that you bypass their stomach. Temporarily, they lose weight for a

year. You guys see them afterwards. What happens after that first year or two? They stretch that little tiny stomach back out of the way. They're all back to overweight, some back to their beginning weight. It's good because you save their life. Like it's called morbid obesity because it's, you're gonna die. That's what morbid means. But you save their life temporarily. You gave it, bought them a few years, but they have to want it. Like all my patients that eventually flip that switch, like doc, just one day I decided that was it.

And the same thing with smoking cessation. It cold turkey works the best. 48% of people quit forever, quit cold turkey. The rest of this stuff is like, you know, random meds, acupuncture, like one or two percent here and there. But if you flip that switch and you want to lose weight and you want to get healthy, it works. And you can do it, but you have to want it. Yeah, you obviously work out, you obviously lift weights. I know you listen to the show for a while, and when I talk to you, I see you, which is impressive.

And talk to you. That's insane. Yeah, smart and fast. I mean, geez, save some girls for the rest of us. But anyway, when we were talking, we were talking a lot about the benefits of resistance training, strength training. And it's not typically, or at least not traditionally,

thought of as a form of exercise to improve cardiovascular health or heart health, how important is muscle in this or building muscle in this whole, you know, everything that we're talking about. Does it make a difference to have more strength? Yeah, so they found that having more muscle improves cardiovascular mortality. It improves, like if somebody sick, like chronically ill or you know, really sick in the ICU, you're more likely to make it out of the ICU if you have more muscle, more lean body mass. It also, they found that resistance training improves bone mineral density, like they do scans, the vexascans on hips.

If you resistance train, it actually goes up. If you do aerobic exercise, it actually goes down. I mean, you talk about that one client of yours who her doctor was like, oh my goodness, you know, your bone mineral density osteoporosis is improving, which we almost never see. We have medications for it. It helps slow it down and sometimes reverses it. They're all like, you know, infusions usually. Yeah, she was on, I think it was phosomax, was the name of it.

Yeah. Yeah, and you got to take that and sit upright and drink a little more. And she felt terrible for a couple days after. It's horrible. It affects the immune system. I thought I'm mistaken. Well, I don't know the exact mechanism, but because I don't, it's not my specialty.

But either way, resistance training showed that bone mineral density actually goes up, whereas with the robot it actually goes down. And you guys know all this stuff with a robot. So first of all, I'm a cardioologist. My patients, when I give these lectures, like I teach doctors how to teach their patients to lose weight. Like my number one requested talk is, hey, Doc, you know, we want to fly you out there, we want your weight loss for

a lecture. And these are CMEs. These are continuing medical education conferences where doctors want to learn about weight loss. So they call me in. So that's the main talk I give is usually about weight loss. Two doctors so that they can teach their patients how to lose weight. So I forget where I was going. Oh, about resistance training. Oh, yeah. So resistance, so yeah, so I'm giving this talk and I'm tall. I've been doing this for like 20 years almost telling, telling doctors, listen, cardio is good for you. You know, there is no doubt cardio is good for your heart.

Endurance, cardiovascular mortality goes down. There's a study published in the journal for American College of Cardiology in 2014 that showed if you run twice a week for just five minutes and not even fast, just like two and a half, to maybe three and a half miles an hour, like a light jog or it's even just walking if you're taller. For five minutes, you reduce your cardiovascular mortality by 45%.

If you did it every day of the week, it would be 50%. And all cause mortality went down 29%. So it's good for you. Cardiovascularly cardio is good for you. It's just not efficient for weight loss. And they have found that there's this thing called the constrained model For for activity they found that people that they found that you there's a cap to how many calories you can actually burn

With activity yeah, if you run a mile. Let's say you burn 200 calories depending on how how much you wait Running an additional mile you might burn another to, you know, make it two 20, then another mile, two 40, then it kind of caps out. Your body starts taking energy from your knee and other places so that it is not, it's not linear. Like you can't just keep running all day and burn 18,000 calories. It just doesn't work that way. Your body just doesn't do it.

It adapts and says, listen, this is insane. We're not going to burn any more calories. So there's a constrained model to activity now. We know this for sure. Tons of studies on it. I think I sent you a link to all the studies. The constrained model says that the more activity you do, there is a cap to the amount of calories you can burn.

So you can only burn so many calories. Like I give my patient, like when I'm given this talk, I give the doctors or a patient an example, a patient an example. A 200-pound person, if they ran for three miles, they would burn maybe 300 calories. If they lifted weights, squats, deadlifts, big compound movements, they lifted weights for an hour, hour and a half, they might burn 150, 200 calories, too. Or how long would it take you to run three miles, like a 5K an hour?

For most of my patients, like 40 minutes to an hour, you could not eat the plain bagel with cheese. That's 320 calories. That's way more efficient. That causes zero seconds. Like literally, I just don't put it in my mouth. Like, it's at zero seconds. Whereas I run for an hour or lift weights for an hour and a half

to try to even come close to the calories and the playing bagel with cheese. So I think the point of all this is like, I'm a cardiologist. I'm not telling you guys, don't do cardio. Like this, you know, my patients need to do cardio and that try to transition them over into lifting weights once they're like, you know, their endurance has come up. endurance has come up. But my biggest issue is like if you actually lifted way, it's kind of like, you know, in your book, I read the whole thing in your book, if you you you outline this clearly, if you lift weights and put on just a little middle muscle, like even just five pounds in a year, your metabolism goes up by a lot. Like, you know, the studies show anywhere from like six to eight calories, maybe 60 calories of per pound of muscle gain.

We don't know. There's not really like a really good way to measure that. So your metabolism goes up. You're burning more energy doing everyday stuff, even while you sleep. Your body needs more calories if you were maintaining on 1800 calories a day. And now you put on five pounds of muscle. Now maybe you can eat 21 hundred or 22 hundred. And still maintain your weight. They also have found that with that same constrained model of exercise, people who are less active or sedentary, they actually burn more calories if they start an exercise program. Like if somebody just sits around all day, suddenly they start moving.

At lower levels of activity, you do burn calories. People who are already quite active, if they increase their activity, they're not gonna burn that many more calories. That's like that whole constraint model. Like it's not linear, where the more activity you do, the more calories you burn. If you don't do very much activity,

you start doing more, it goes up, and then it kind of like plateaus. Well, this is why Adam, when he was competing, he would coach competitors. These people going on stage, there's experts getting shredded, he would save the cardio for the amp. To get that boost, because eventually,

it kind of tops out and you start to adapt. Right, yeah, and that's, I did that too. I didn't compete, but I got done like, seven percent body fat, something, but that's why I did that, zero cardio. Two like the very end, add a little bit, and it's not like insane cardio, because you don't even lose muscle like they found

With excessive intense cardio and you guys already know this you talk about it every day, but excessive cardio Eats up muscle like you know you always say it pairs down muscle Absolutely true your muscle master lean body mass goes down and then if you still have fat on you your your body fat percentage goes up down and then if you still have fat on your body fat percentage goes up, that's not something most people want. Now when you're lecturing and doing this in front of all these physicians, is it well received? Because there's not a lot of doctors I hear really emphasizing the need for resistance training. Well, you can't argue with studies. They're all scientists, like me. If the research doesn't prove it, they would be like, okay, dude, you're insane. If the research doesn't prove it, they would be like, okay, dude, you're insane.

But I present it like, study by study, like listen, here's everything we know. I have like a two hour lecture on YouTube on everything we know about exercise. Goes to every single study, it's boring as hell, but doctors like this stuff. Sound like it's insane. Yeah, yeah, yeah.

People like us enjoy it. You guys would probably like it, but I go through like every single study on exercise and what it does and what we know about and how it works and how you can use it to benefit yourself. And then there's another one like that that's two hours on every study we've ever done on diet. Obviously not the stupid studies that make no difference. There's like a billion studies on diet and exercise. But the ones that kind of shape what we know about exercise and diet today are very important. So yeah, so it is well received because you can't really argue

with, you know, we made people exercise for two whole years and they lost three kilograms. Two years of exercise and they lost three kilograms. That's not efficient weight loss. They could have lost three kilograms in two weeks if you just cut your calories. Three kilograms is six, maybe eight pounds at the most. In two years, that's bad. My patients who weigh 300 pounds, if they lost three kilograms, good, but that's horrible. You need to weigh 100 something. Now, what about the studies that have shown that excessive exercise actually increases risk of... So there are. You mentioned some of them.

There's one study that showed your calcium score. There's a scan we did, the Dr. Agastin, who's a cardiologist in Miami. He's actually the doctor that wrote the South Beach diet. That's a good one. Dr. Agastin's a cardiologist who invented the heart scan. There's the CT scan in your chest. So it looks like your calcium score.

The more calcium you have in your heart, the more likely you are to have cardiovascular disease. There's the CT scan in your chest, so it looks like your calcium score. The more calcium you have in your heart, the more likely you are to have cardiovascular disease. There's a correlation there. So people who ran at an excessive amount, like they did an excessive cardio, and I think it was seven miles an hour, more than four times a week, something like that really excessive.

Fast pace, lots of running, lots of mileage. Like I got training for a marathon, or a gal training training from marathon, their calcium scores went up. There was also another study, Mayo Clinic Proceedings published this one that, if people ran a little bit, their longevity increases,

but once they hit a certain threshold, and I don't remember the exact number, but once they hit a certain threshold, your chance of dying went up, your mortality goes up after a certain point. I don't remember the exact cutoff in that one, but you, that's why I want people to have a balanced approach. Yeah, you need some endurance,

and it actually help you lift better. I mean, I'm sure you guys have noticed when a patient's just, or clients are just lifting weights, they do really well, throwing like one day a cardio here and there, just get there and turns up suddenly, they can do more reps. That's right. I mean, that's, I've seen that all the time. So there is some of that. There is some crossover, but you definitely, if you're trying to build muscle and lose fat, you definitely don't want to be

like running marathons. I mean, you guys see the pictures of people that win marathons. They're like, they don't look anything like that. It sounds like based off what you said, a good strategy might be run a mile twice a week. Cause you're saying five minutes, you said five minutes of cardio. Five minutes, not even running. It was literally like two and a half miles per hour, two, three. That's like a power walk. That's like you walk.

A walk if you're tall or like a light jog. Yeah, I walk it a three, I walk on the treadmill of three, five to a four. Yeah. So you would be a walk if you're tall or like a light jog. Yeah, I walk it at three. I walk on the treadmill at a three, five to a four. Yeah, so you would be a walk for you, but for people in my height, it would probably be, well, 3.5 is not, but it would be basically a faster walk. Wow, interesting. Now, what about insulin resistance?

I know, and I talk about some of this in the book, and there was a study, I didn't quote in the book that showed that just building muscle, regardless of body weight, improves your sensitivity to insulin. I like how important is your body's ability to utilize insulin effectively in terms of cardiovascular health? Yeah, it's definitely huge.

The more muscle you have, the more the insulin resistance gets better. In fact, diabetic doctors and technologists will tell their patients, if you ate a little bit more carbs than you should, and you don't want to increase your insulin shots after it's just due like a minute of squats. Because just getting the blood flowing till muscles releases factors that make it so you can handle that extra sugar load better. But yeah, definitely having more muscle is very protective against diabetes. And when it comes to testosterone,

they've done studies where they've given people exogenous, injectable testosterone that didn't have bad low testosterone. I know you talk about testosterone all the time. It actually has protective kind of, we'll get into that, I suppose. Yeah, I love that. But definitely when they inject the testosterone

and the people, when their body fat would go down, their muscle mass would go up, their insulin resistance improved significantly. Testosterone, I'm sure your audience wants to hear about it. But I talked about this on another podcast, but testosterone has like a U-shaped curve. We found that people with testosterone is under 200, their cardiovascular mortality goes up. And some of the worst cardiovascular patients have the lowest testosterone. People with CHF, or congestive heart failure, their

testosterone levels are usually low, really bad diabetics. Testosterone levels are really low. People with coronary artery disease, testosterone are really low. They've actually found that testosterone dilates your arteries. Your coronnea arteries, they put people on a treadmill, make them run or walk, you know, whatever it is, for as long as they could. And they they time them to see when they start getting the the chest pain or the you know, ischemia where your blood flow, you're oxygen demand and supply don't match. You get and you start getting squeezing chest pain. And then they would give them testosterone, put them on it for a few weeks,

and bring them back and have them do it again. Their arteries are more dilated, and they actually can go farther. In one of the studies, it was only like 26 seconds more, but on this Bruce protocol on an incline, 26 seconds is huge. In another study,

it was like an additional two minutes, where they could actually go further before they got the... Just from the testosterone. Yeah. wow. But they've also found that people, so at really low testosterone, the cardiovascular mortality is higher. And then as it normalizes, you're in the 4, 5, 600, maybe 800, 900 range,

it's like your cardiovascular mortality is normal, and compared to normal populations. But then as testosterone goes up again, like, you know, we got these bodybuilders injecting, whopping doses, a gram of day, two grams, whatever, or per week, I mean, their cardiovascular mortality went up. But there are studies that showed,

there was no, if people were on therapeutic level, TRT, like not these one gram a week, but like 200, maybe 300 at the most a week or every other week, whichever, there was no additional cardiovascular risk. The problem with testosterone when you get too much of it is it aromatizes into estradiol, which is a female hormone. And those have been shown to increase clotting and, you know,

those kind of things that cause some of the strokes and heart attacks that we see with testosterone. But at normal levels or at therapeutic, like they, they have hundreds of thousands of people in testosterone. Most of my patients that are older are on it. There was no additional, they've looked at populations of hundreds of thousands. There was people on TRT and people not on it. We're talking like normal doses, obviously. There was no worsening cardiovascular risk. And in some cases,

there was improvement. Like, they were less likely to have their CHF classification got better. They had less symptoms, less hospitalizations, the ischemic conditioning where they can actually do more before the chest pain starts, got better. So there are, there is, there were some trends towards improvement. Their body fat went down, obviously. Their there are, there is, there were some trends towards improvement. Their body fat went down, obviously. Their muscle size lean body mass went up. I mean, we're not, these patients are not bodybuilders, but still even with just small therapeutic doses,

they improved in a lot of categories. Was there any studies to like with growth hormone? I know that's sort of like the fountain of youth for people that they, I've seen a trend there in terms of that and how that affects the heart. Growth hormone got popular a while, you know, like maybe 10, 15 years ago, maybe more than that, but it hasn't really shown anything in terms of heart disease. And even bodybuilders don't really use it anymore because it has so many, you know, you get that weird gut, you know, thing and... Yeah, you get all kinds of weird stuff with it. So I didn't see anything about it. Yeah, I know it can affect insulin.

You can actually develop insulin resistance from, because you get all that abdominal. Or just too much growth hormone. I know what uphoses, right? If you, Well, there's also a massive difference between what bodybuilders take. And like if you go see like a specialist

that puts you on it, like taking a lot of things. Yeah, I know. They had my mother-in-law and like the dose was like so tiny compared to like what you know bodybuilders take ten eggs Yeah, but back to the testosterone because that's very fascinating because it's and it's extremely I tell people It's it's a very safe hormone like if you had to inject yourself with a very high dose of a hormone It's one of any or a man testosterone is probably one of the safer ones probably not gonna kill you Whereas you did that with the insulin or other hormones. You'd have some big problems high dose of a hormone. It's one of any of your men. testosterone is probably one of the safer ones. Probably not going to kill you. Whereas you did that with the insulin or other hormones.

You'd have some big problems. Well, insulin, you can crash your blood sugar. You could technically die. Right, right. Yeah, taking a whopping dose of testosterone, I mean, bodybuilders do it all the time. Nothing bad. I mean, there have been some who've had heart attacks

and strokes and died even. But we can't say with absolute certainty that that was why. They're probably engaging in other high risk behavior too. Yeah. Yeah, and I know you talked about the widening of the blood vessel, so it's got some of those. Yeah, the vasodilation is.

Dilating effects. Now, along those lines, are there any, because I mean, we read about supplements that supposedly help with vasodilation and supplements you take before you work out and you get a pump. And I even read some studies on citrulline and how it might lower blood pressure a little bit because of some of that. Are there any supplements that you know of that help with some of that stuff? So nitroglycerin works, we give that to patients in the prescription form. When somebody, we know that they've had a heart attack and have stents or whatever it is,

we know they have blocked arteries. They say, I walk halfway around the block. I start getting that. I pop a nitro opens up. I can keep going. We know that works. So the nitrous type stuff definitely works. I know it's supposedly in some supplements.

The problem with supplements, you don't know what's actually in it. You're buying a bottle of something. And it says it has all the stuff in it. It's really not FDA-regulated. There are third parties that test it, and you can always look for that to make sure. But I remember there was a study done at Target, Walgreens, CVS,

Vitamin Shop, all the supplements, 95% of them did not contain one lick of what they said they contain. Just heavy metals. Yeah. Maybe, but they contain almost nothing. Like you're buying a vitamin B12 and even something benign like B12 or B6 or whatever. It doesn't even have that.

Yeah. I saw these get this study on gas station like libido pills. Yeah. And like a majority of them contain normal gummy bears. No, no, no, more Jordania can be like Viagra or you know the active brains that are in yeah and They're like sneaking in some of these drugs in there and you're like man these you know gas they Should be working. Yeah, I used to do that with like the hydro testosterone or like the DHEA and all that They had like you know the stuff Mark McGuire was taking Oh, yeah, I'll believe me. I did my cheer that. I mean, back in the day,

but it wasn't illegal. Like, you know, at that time, you could buy these stacks, animal stack and whatever. Oh, I remember. I used to take, uh, there was one that was, uh, methyl master draw. I think was the name of a super drawl was another one. And I remember I, it was over the counter. You take them and they work. You're like, well, later on, I did some research and I found that they were actually antibiotics steroids that pharmaceutical companies dumped in the 60s. No, they weren't even SARS, they were actually steroids. But these pharmaceutical companies dumped them because of the side effects, but because of the way the laws were written, they kind of were a gray market.

Let's talk a little bit about the storms. What do you think about what your thoughts on and what you're seeing? That's exploding right now. The problem is they were, the problem is, we don't know a lot. Like if you're gonna do something shady and not really legal, why not just take the stuff from me? Or like something like anavar or any of the stuff that we actually know works and is safe

and is not going to kill you. Some of these things, the reason they abandon them, now people go up and look up these old patents on this stuff and they're like, oh, you know, a receptor modulator, let me, you know, steroid energy receptor modulators for people who don't know what that is. But let's look, let's try to make this

and see what happens. Like there's a reason why it was dumped. Like there's a reason why they're like, hey, this is a really bad idea. Like let's not pursue this patent and make billions. If it worked and it was safe, they'd be making billions, right? I mean, that's kind of how it works. They dumped it for a reason because they want to take the risk of you getting cancer in

your stomach or whatever it might be. And then people recreate this stuff because they find the formula. If we took a pseudophadrine and we flipped it one way, it's kind of like how they make certain other drugs. But like, you know, why would you take this when it could be insanely dangerous, when you could actually take something that we already know works really well. And it works better. Yeah, it's better. It's actually what they're trying to emulate. They're trying to create something that works like testosterone, but it's not testosterone. Just take testosterone. Right.

It would be better and safer. Now, along the lines of things that work, let's talk about aspirin for a second. It's been around forever. Lots of studies show that in some people it's taking a little bit. It's very beneficial for preventing heart attack and stroke. Is this something that you will recommend to your patients? Yeah. So the ISIS-2 trial, they looked at aspirin, and it gave you an 80% reduction.

Now, there's almost no drug. That's crazy. We've ever, like, discovered, that gives you an 80% reduction. It's like 10%, 12%, maybe 20% and some of the, you know, better stuff. But an 80% reduction in preventing heart attacks and strokes. So most of my patients they've already had a heart attack or stroke and they have to be on it regardless because if you've had a stent put in or a stroke whatever you have to be on aspirin,

I mean it's insane not to you're just asking to die. So those people have to be on it, but like a normal person like, you know, young and healthy, there's no evidence that shows you should be on these things. Now, if you're like above 50 diabetic, hypertensive, cholesterol, through the roof, smoke, or you have every risk factor, you really should be on it. There's a score where we plug in your age, height, wage, sex, all the conditions you have. And it spits out. It's called the Framing Ham risk. It spits out your cardiovascular disease risk. Anybody over seven and a half percent, and it's like the risk of you getting a heart attack or stroke over the next 10 years or heart attack is seven and a half percent or more. You should be on a stand and you should

already be on aspirin. So definitely make sure that you are, but like a normal young person that's pretty healthy and fit, doesn't smoke. Not really, right. There's no risk factors. There's really no. Yeah. Why do we see more cases of heart disease and heart attack in men than women? I mean, it's the number one killer of both men and women.

It's almost even. It is. There's about 630,000 people every year that die of heart attacks and heart attacks. Let's just put heart disease. Half or a man, half or a woman. It's like 52 to 48, 52% man, 48% woman. So then it's a myth that that men suffer from a more. They used to. But then women caught up. They started to do that. You think that as a smoking has probably, I was probably that right?

Yeah, it was smoking. Women have a protective effect because of their hormones, the estrogen. Once they pass menopause though, they're equal, once they're creating hormones anymore, but they have a 10-year delay. Men at 55 is about when they start having all these issues. Women are 65, but once they're passed menopause by about 10, 15 years or so, they kind of catch up. But because women started smoking, that caught them up. But right now, it's almost even, it's 52 to 48. Wow, do you ever get a patient that just boggles you

or for whatever reason their numbers look like they should be this way, but they're totally fine? Or maybe the opposite, where somebody gets a heart attack and you're doing the traditional test and you can't figure out why or what's going on. Is that ever happened? No.

Oh, well. So the issue is, here's, I know what you're asking. Yeah, yeah. And the, I tell medical students that's all the time, I like, listen, all the patients that we've seen, they're all smokers. 95% of my patients had a heart attack and have stints now or have heart failure

or whatever it is because they smoked. Wow. Like, no doubt about it. That's why it's the top 10, right? I think one, two, yeah. Yeah. There was this lady who was 39 years old and she had a heart attack, you know, big one. Like, you know, put a stent in her LAD.

Like, that's usually it's called the widow maker of that, that artery because people usually die. They don't anymore, you know, but back in the old days, we didn't have good treatments. They did 39 years old, you know, beautiful, healthy, fit, cross fits, whatever. And my students were like, oh, how did she have a heart that I was like, I bet you she's smoking, she said she doesn't smoke. I was like, okay, let me go ask.

So I'm like, hey, you know, I start talking to her, ask her all the way. I was like, hey, do you smoke her? Did you ever smoke? She's like, no, you never smoked before. She's like, well, when I was a kid and then like she starts telling the story, she smoked for like 10, 15 years.

Wow. When she was like in college. So it always comes out. Of course they're not a smoker now or they don't think they smoke well, they smoke for a few years on and off, but that stuff adds up. But there are people,

the other percentage of people that I see because they've had a heart attack or stroke is usually one of those like a really high genetic cholesterol. If they're also smokers, that's obviously even worse. But those are the people with the cholesterol is like 400 500. Now when we talk about smoking where it where does okay cigarettes vaping marijuana. How do that how do those all want to be? What's Adam's what's Adam's risk right? Where can we wiggle? So let's start with tobacco smoke. So the problem with smoking is the volume of smoke

and all the other chemicals. The other 4,000 chemicals lead to cancer and other stuff. But when you smoke, it like if you were just taking nicotine, it does constrict your arteries a little sort of like caffeine does, but it's not like going to kill you. If you're sucking on laws and just gum or patches or whatever. But it's the smoke. Once the, you know, if you're sucking on laws and just a gum or patches or whatever But it's the smoke once the smoke gets into your lungs. It causes reactions and inflammation stuff that starts to destroy your arteries So it's actually the smoke that causes so people who smoke hookah are like well, you know I don't smoke cigarettes, you know cigarettes are bad for you. No, well the volume of smoking like one puff of hookah Can be equivalent like 50 puffs of smoke on a cigarette. Wow. Or a hundred. You

know, the studies are a little, they vary depending on how big your breath is, I suppose, or how long you draw it in for. Marijuana, I'm very similar. You're inhaling a ton of smoke into your lungs. I bet if we took your lungs out, hopefully never. But if we did, you would have a lot of the same changes that people who smoke cigarettes. Now, obviously not as bad, because cigarettes for whatever reason is containing chemicals upon chemicals upon chemicals. And that's why we've, you know, we've tried so hard to, to ban advertising and, you know, they stood the companies and all that stuff. But definitely, it's the smoke that actually

causes all the problem. And then how, you know, does the body naturally start to repair that? Like say somebody is a, you know, day, you know, they smoke every day and then they reduce that or eliminate that, like how quick does the body heal or the lungs heal? So they say after five years your risk goes back to like 80% of normal. I've not found that to be the case. I mean, I've had patients that smoked 20 years ago, haven't smoked since then. They're like 15 hour, 65, whatever. They

have a heart attack now. So it's not perfect, but also don't forget my population of patients' bias. They're seeing me because they had that. So there is a bias there. It may be that that's true, but if you're seeing me, it's because you've had this problem. There's like a selection bias. So I've seen patients who quit smoking many, many years ago who are now having heart attacks and strokes, but they say after quitting, after about five years, your risk kind of goes back to close to normal. I would imagine too. I mean, you're seeing the volume of smoke is really what matters the most. And so let's, you know, take somebody who has a cigarette or two or three cigarettes in a day, and then you take someone like me who's like,

every other day I puff on a joint that I take about three to four hits before I go to bed, right? So the volume of smoke that I've been taking in comparison of that is not only am I taking in some of this. But also you're not taking the chemicals. Right. Then the nicotine, and the nicotine itself does constrict your arteries, and that's a part

of it. It's not just, I mean, it is mostly the smoke and all the stuff that's in it, because there's a lot of stuff in it. But I'd join it, have to look at it, but if it's just pure marijuana, it's obviously not as dangerous as cigarettes. I'll have to look at those. From what I've seen with cannabis, because the CBD has somewhat of a protective effect. For cancer, all the cannabinoids, so the big ones were, the big issue was, does it

cost cancer, and then they couldn't prove that it costs cancer. In some cases, there might even be a small protective effect. That's because the cannabinoids were anti-cancer, so that's the chemicals that are in the marijuana smoke. As far as heart stuff is concerned, studies do show that it does increase heart attack risk, but it's interesting because cannabinoids are vasodilating, that's why your blood pressure drops a little bit, and then your heart beats faster to make up the difference versus what you would get from cigarette smoke, but it's not like a zero risk.

But cigarettes have to be the worst, right? Cigarettes by far are the worst. And a lot of you have smoked cigars, but they don't get it, you know, keep it in their mouth and that helps lower the risk. And then what about this, I mean, the vape pens that are going crazy. So the vape kind of depends if it has the formaldehyde and all that crazy stuff. And it's obviously not good for you. The word formaldehyde is bad. I mean, that's like saying sulfuric acid. I mean, it's horrible. But if it's water vapor and whatnot, it's like chewing nicotine. But,

you know, they have something called vape lung, where or popcorn. I read about this. It's called popcorn lung or vape lung. Your lungs change in a way based on whatever chemicals are in the vape and you use. It destroys your lungs in a different way, may not cause heart disease, like heart attacks and strokes, but it definitely has a lot of bad effects. I just remembered a study that I wanted to bring up with you. I just remembered it. There was a study that I read,

or maybe a couple that showed that older people, older populations with higher cholesterol actually lived longer. Are you from me with this perspective? So that's the obesity paradox. We talk about that in a lot in medicine. The obesity paradox says that older people, especially men over 65, they're a little bit overweight,

they seem to live longer. So that's where they started doing these fitness versus fattenness studies to see like, can it this be true? Like an overweight person just because they're old, they live longer. And they found that it still has nothing to do with the actual weight. If they're fitter, even if they're obese, their mortality is similar. I know that doesn't directly answer your question. Colestral, they used to think that, you know, if we've been controlling your cholesterol for the last 50 or 60 years, and now you're 70 or 60, and we take you off some of your meds that you'll do better. And

that is true. Like, there are a lot of patients in the year. They're like, I have some 80 and 90 year olds now. They're like, Doc, I just don't want to be on 30 pills. Imagine if you were putting 30 chemicals into your body every day, and suddenly we eliminate some of them. You're gonna feel better, unless like some of them are like for high blood pressure and stuff that's like really gonna kill you. But if you cholesterol bumps up a little at this point,

you're not gonna, at this point, your mortality is probably pretty well defined. You know, if you're 92, are you really gonna live 280? No, but you know, when we start removing some of these things, especially beta blockers, like, you know, it makes you feel fatigued and tired. If we start removing some of these, you know, a lot of patients are like,

demented, but then you look at, it's because their blood pressure is so low. Take off, you know, they're acting off. Take off some of their blood pressure meds, they're suddenly getting profusion to their brain and they're no longer low, and they are like, oh, we cured his dementia. Wow.

So with the elderly population, that's why this geriatric medicine. You gotta be careful if you start removing some of these medications and you worked with the elderly alive. If you start removing some of these medications, not to where their pressure is like dangerously high again, but, or there are other numbers like diabetes and whatnot. But when you start eliminating some things,

they feel better, they're more energetic, they might have been fatigue, tired, depressed because of beta blockers, and now they have energy, all those kind of things. So they actually feel a lot better. That also contributes to your longevity and health. I would also imagine that there might be a little bit, like under being underweight when you're older,

that can mean a lot of bad things. Being underweight at any age is not good for you. That's right. We have the BMI, the body mass index, below 18.5 and above 30, they use 30 as a cutoff because that's when mortality or morbidity starts to affect you. Like 30 is not an arbitrary number. Like if your BMI is over 30 and I get it,

bodybuilders don't harass me. I know how it works. But if your BMI is over 30 and you're a normal person, you're not like muscular and a football player, you know, whatever. If your BMI is over 30, which is 95% of the population, but if your BMI is over 30, mortality stuff starts to happen, cholesterol, diabetes, heart disease, all that stuff, strokes, whatever all starts to go up. And the more over 30 to worse.

So that's where... And then also under 18. And then under 18, but those people are like the bulimax and the anerexics. Those people have serious, serious health issues. I mean like, it's literally deadly. I mean, that's why those eating disorders, I'm sure we've all seen tons of those. Those type of eating disorders, anorexia and bulimia,

and part of huge, huge risk because, you know, it's psychological and they go vomit or they're like, binge eating sometimes and then go throw up or they don't want to eat in front of people, they eat like a piece of lettuce and then go eat a whole cake. That kind of behavior is not conducive to living along healthy. And also the nutrient deficiencies that they tend to, you know, come in. Just like people with gastric bypass when they first get gastric bypass, they're not absorbing anything. They have this short gut syndrome.

They have to take all these extra vitamins and minerals too, like at least keep the stuff that they have because they're not. Let's talk about that. Where do you stand on that? all these extra vitamins and minerals too, like at least keep the stuff that they have, because they're not. Let's talk about that. Where do you stand on that? You get a client that comes and sees you, and they're morbidly obese. Are you pro that surgery,

or are you trying to get them to do it through their lifestyle first? Like what are your thoughts? So the way they do it, the gastric surgeons don't just throw them into surgery. They have them go through psychological counseling. They have them try a diet. They want to make them lose five to 10% of their weight

on their own first. They usually send an immediate clear them for surgery. Like you got to see cardiologists to say that you're not going to die during surgery. So they come to see me. We run a few cardiac tests on them. Now if they're like 30 years old and pretty healthy, there's not a whole lot you need to do.

Like, okay, can you walk upstairs without being short of breath or whatever? Okay. Sure, you're going to be a little short of breath because you're 400 pounds, but like you're not like coughing and puffing like you're going to die. But anyways, I clear them for surgery, but it's not like a surgeon just, okay, let's just slice you open and take out half your stomach or 90% of your stomach. But so they send them to me usually to get them cleared. But the, they make them try me usually to get them cleared, but the They they make them try to lose weight by calorie restriction for like six months. It's like a process You got to go see the psychologist then you got to go see this person then that person and then this were in in the meantime Those six months they're registering cows and trying to lose weight on their own

So it's not like they just Throw them to me and say hey, you know, here's a patient. Yeah, they do that now. They put a lot of rules and still though, the fail rate still is, because again, you're dealing with something really hard to do. I guess my question though is that, are you a fan of it? I mean, are you pro?

I mean, if it's gonna save your life, and you are morbidly obese, and you've tried everything else, you have to do it. Like this is literally life saving. If you've tried everything else, you have to do it. Like this is literally life-saving. If you've not really tried, and you just want to, like this is like a cosmetic and you think it's fun, which I don't know too many people that do,

but if you're just doing it just to do it, or everyone's telling you to do it, and you've not really tried anything else, you really should try the other stuff. But there's almost no gastric surgeon now that would, you show up in his office at 400 pounds. They're like surgery tomorrow. That just doesn't, it's not even legal.

How have you thought about, or I don't know if you do this, because in the past, at one point, like I said before, I trained a lot of doctors and then they started to send me their patients. A few of the doctors I trained were vascular surgeons and their patients, very similar to yours doctors I trained were vascular surgeons and their patients very similar to yours. They all smoked, they all had issues with their cardiovascular health.

And then they started to send me some other patients. And we actually had good success because of the daily and weekly coaching. It was like I was with them doing stuff. Have you ever worked with people that you could say, okay, look, here's a deal. You need to lose weight. It's really hard to do on your own. I can tell you what to do, but then you're gone on your own. Here's some people that you might want to work with. Yeah, so I usually have them work with a registered dietitian

and I'll send, I'll give them references of personal trainers, like listen, you, if you're serious, here's two people you need to talk to. And at the end of my talks, if I'm like in Chicago, because I used to live there, I know some personal trainers there and like some registered dietitian, I'll give them like my last slide would be, here's the name of this person and

here's the name of this person, go talk to these people, send your patients to them, as they're all doctors. And listen to MindPump. Yeah. Well, I've done that a million times. I run all these fitness groups, I don't know, I was telling Sally the other day. I run a lot of fitness groups on WhatsApp and the combat stretch. I'm like, okay, you gotta watch this video, go to minute four, four minutes, 10 seconds,

do this combat stretch before you squat, or the 1990, whichever one it is. And I'll tell them where to go. But yeah, no, I reference for you guys stuff all the time. I'm so glad we have people like you guys. Awesome, thank you. But I send them your links and your videos, especially the videos,

because it's like a visual Demonstration. Here's exactly like the active plank thing. Yeah, I could plank for 50 minutes That's not actually what you're supposed to be doing Sure, I could do it for eight hours probably, but that's not the like you're not really working out your calves or core You need to be doing it this way where it's actually like Constructural hard or like the, the, the, uh, physiological crunch. Crunch.

And nobody does those right. Like, you know, or like, you know, I want to do something for my abs. Oh, here's something, you know, like that looks easy. Like, just try it. Trust me. You're not going to be able to do more than like eight or nine without, you know, feeling like you want to vomit. Do you remember Doc, what, uh, what attracted you to the show?

Like, do you remember the first seven? I was on some fitness group on Facebook and Somebody's like any good fitness podcast and then people listed a bunch and I and what's on one of them was my But I'm pumped I added all the other ones on They're not that good and then then I'd listen to you as oh like this is different. This is really really good Like you guys talk for like 40 minutes and but recently 50 55 57, but it was like okay Sometimes I would fast forward. I'll tell the truth. In the beginning, I did at least,

because I was like, You want the fitness. I was getting into fitness and I wanted the fitness. Like, yeah, the stories are awesome. And now I know you guys, person, like I know he has a dog and, you know, Jessica Katrina and, you know, he has older children. You have some older ones, a new one,

and you got both have new younger ones. Like I know you guys' life stories. I feel like I know you, Like my patients tell me that. They're like, Doc, I watch you on YouTube. You're like my friend. I'm like, well, great. Which is good. Like people feel like they can relate to you.

So I wouldn't stop doing that. It's great. But in the beginning, I would fast forward to the fitness. I'm like, oh my God, this is exactly what I've been doing. Like I had my own fitness journey. And I've always been fit because I played sports and I worked out as a kid,

but never like properly. In 2018, I was around 43, maybe or 42. And I was like, you know what, I'm like, 193 pounds, this is just not right. I need to lose some weight. It's like, you know what, I'll do squats and pushups every day. I'll do 100 a day.

The squats are easy. I could do 100 body weight pushups a day. That was no problem. Start doing the pushups. I could do like 10, 15 in the beginning. You know, eventually got up to like 40, 15 in a row. But I still look the same. So, a friend of mine and some of her friends and my wife even, they hired a fitness trainer. And he would come to our barn. I got a really nice home gym. And he would train us there. His name is Matt Longley. Good friend of mine. He's a linebacker at Charlotte University now, but he lived in Toledo, but then he moved away so then I got another fitness trainer.

Worked out with them. No nothing about nutrition whatsoever. And I got more fit. I would, my lips were getting stronger, everything got better. No problem. He moved away too. I don't know why they do this to me. He moved away too and I'm like, why they do this to me. He moved away too.

And I'm like, oh, I got to train myself. I train myself. I was like, it's working, but I'm fat still. I'm fit, but I'm fat. I'm 193 pounds, maybe 188. And I was like, you know, I got to lose weight. This is insane. So I started really researching stuff. And I started reading all the stuff online, found you guys was reading. I was like, you know, I need a calorie deficit. It's the only way. So I, you know, re-did my fitness battle. I'd always been using it, but not religiously. Just to track my weight, put it at 1,400 calories.

Oh, that's a big, that's a big deficit. 1,400 to 1,500, I lost a ton of weight. I got down to 145, and it's in like six or seven months. By August, I was 145, but I was like, I'm shredding and I'm small. I'm tiny though. Like this can't be good.

I was not eating like enough protein. I just ate 1,400, 1,500 calories a day. And I was like, okay, this is good. I weighed less than I did in high school, but this is also not good. Like this is, I look like I walked out of a concentration camp or a jail. Like I've been malnourished.

It was horrible. And I was like, you know what, I need like I walked out of a concentration camp or a jail. Like I've been malnourished. It was horrible. And I was like, you know what? I need to be a fitness trainer. So I signed up with the NASM, took the classes and did the course. I became a fitness trainer. But then I hired a person who gets people ready for bodybuilding shows. And he was like, dude, what on earth did you do? Like seven months straight of dieting, no diet breaks, no, you know, are you tracking protein?

Like, nah, nah, you know, I just eat whatever adds up to 1,500 or 1,400. He's like, okay, that's not gonna work. So he gave me some tips. So I bucked up a little after August, got up to like 178. Then I stayed around there, still working out by myself. In the next year January, I was like,

I need, this is, I need help. I hired another guy who gets people ready for shows. His name was Jake. He was like, dude, you need to eat protein, you need to do this whatever. I got down to 163 again, but I was like, was like really shredded in. I had like muscles that sounds like,

this is good. This is what you got to do. So I was doing, I was doing all, and then I had, I had bought my anabolic at the time. That was like the first one I got. That was, I don't know, somewhere in there, like in 2019, maybe towards the end. That was like the first one I got. That was somewhere in there, like in 2019, maybe towards the end. I was doing that. I mean, that was my work on mainly compound lifts with

a squat rack and a barbell. Nothing fancy. Obviously, made huge gains. And I think that's what most people should probably do. It's start with something that's like three days a week, big huge compound lifts and just let it be. And I used to train kids because I coached like a lot of sports, a lot of youth sports, soccer, flag football, tackle football, golf, baseball, stuff, whatever. So I was having the kids come to my home gym and we trained them and I wasn't doing anything dangerous

with them, it was all regular stuff. But then when I became a fitness trainer, I knew I kind of what to focus on, what to have them do, but it was fun. I just want to make sure I was doing the right stuff, so that's why I wanted to become a personal trainer. Did you see that? Did you see any carry over to your medical profession?

Oh my God, yes. Now when I give my lecture, this is the other thing, thanks to you guys in the fitness room, I've changed my weight loss lecture a lot. I used to do all the dumb stuff. When I'd give these talks. The stuff you guys tell, don't eat after 7 p.m. and try not to eat simple carbs and carbohydrate insulin model of obesity

and weight loss like Dr. Talb's, I'm sure you've got a lot of them. His books, I'm like, don't eat bite and read. So I did keto for a while, I lost a few pounds. But then I know, when people do these weird restrictive diets, like keto for example, you lose weight because you've reduced your calories, but then once your calories match your maintenance, you no longer lose weight, increase fat,

okay, then just try getting weight again, or like, you know, all the stuff they tell you, you don't do it. Or they go off in the rebound, which is usually what happens. Right, and that's kind of what happened. I was like, okay, this is not working anymore. I need to stop. But either way, like I used to give some of that stuff in my talks, you know, and you

can find the research articles to prove that it works. There was tons of research articles in the 90s, late 90s that showed that the Atkins style or keto style diets worked. You can find it, roger cholesterol, it lowered, you know, all that stuff, but it's because of the weight loss. We found out later that it's not because of the Atkins diet where eating lots of protein and almost no carbs. It's actually because of the weight loss in and of itself. There was a more recent study done in 2007 when they wanted to kind of dispel all these myths. They took patients and they had them eat an isocaloric diet, which was

a deficit. And they had the all the same amount of protein or like enough protein for them. And then they looked at varying the other stuff carbs and fats and they found no difference. Like they all lost the same exact amount of weight whether they were on a high carb or high fat diet and all the cardiovascular risk factors went down insulin resistance, cholesterol, all that stuff, all improved, regardless. And then they did another study where they took, they were looking at diet only versus diet plus resistance training, and then diet plus aerobic training or diet plus combination training. You talked about this one all the time. Yeah. Well, this might be one of the ones I talked about. Yeah. They found diet alone, like energy intake alone Was what predicted weight loss whether they did aerobic or weights or both

None of that stuff affected weight loss as much as the calorie deficit did so the calorie deficit alone was responsible for all the weight loss I'm sure there's other studies. I mean really thousands of them But that that was huge now. I've changed my talk to my patients like my patients Like I never would sit with them and set up my fitness balance. I'd be like, yeah, try not to eat after 6 p.m. or, you know, avoid simple carbs, which does work. You know, if they are in a deficit or that creates a deficit for them. That's why it works.

Right. That's why it works. But now it's like, hey, you need to eat X amount of calories. And some of my patients are like, look, doc, I just can't track. I mean, my patients are older. Not that older people are bad with apps. A lot of them can do it. But some of my patients are like, you know Doc, I just can't track. I mean, my patients are older. Not that older people are bad with apps. A lot of them can do it, but some of my patients are like, you know, I don't wanna track the sounds crazy.

Like, find, take your food, like your breakfast plate. If you have two eggs, two pieces of toast, two piece of bacon, just cut in half. One egg, one toast, one bacon, put the rest aside. Wait 20 minutes, because it takes 20 minutes for your stomach, through your vagal nerve, and hormone signaling to tell your brain that it's full. If you're still hungry, go back and eat a little bit more. Don't eat the whole thing. Like a whole idea is to eat less. So go eat a little more and then wait

again. And just do it that way, do it visually. And that actually works too. Because I was like, if you're eating half the calories used to eat, you technically should weigh half your body weight that you weigh now. Yeah, I would tell clients that it was exercises for fitness and the nutrition is the weight loss, right? And then the other side of the exercise aspect is, yes, the fitness, but also do it in a way where it'll help with the metabolic adaptations that are going to help with the weight loss, right?

So you don't want to do something that takes away from that. I thought he was going to reference the study that you always reference about, the muscle loss. Yes, the ones that did a calorie research to diet cardio only without resistance training. Oh, yeah, that's one of the ones I have in my talk too. If you do a diet only or diet plus aerobic, you actually lost a lot of muscle, like nine, nine percent of your lean body mass went down,

whereas the resistance training group only lost like 2%, and then the combined training lost somewhere in between like 5.0 something percent. It was the group that did a diet only with aerobic loss, the most lean body mass resistance lost a little, not as much, and then the combined group lost somewhere in between the two. Yeah, that's the one that I'll talk about that one,

and then in my experience, in some cases, you'll build muscle as well But remember lean body mass also counts water So 2% 1% you know, no that's not big No, it's significant and then when you start like maintaining or walking back up You'll obviously have a better baseline foundation to go with right, right? So that makes a huge difference What's the biggest I guess piece of pushback you get from colleagues when you talk about weight loss nutrition and health, or is there any pushback because you're always referencing

studies? The way I do it, you can't really argue. I mean, it's like, the biggest and funniest things when they tell me, like, dude, you're a cardiologist. And you're telling people not to do cardio. Like cardio, it's your name, like, you know, shouldn't people, I'm like, I'm not saying don't do cardio. It's very good for you.

You can do it. I would love for my patients. If my patients did that, I probably wouldn't have that many patients, but they don't, and it's not how you lose weight. Like if you're doing cardio to lose weight, I got a 10 different ways you could do it that are much better.

Like there are literally millions of ways you can lose weight that includes zero cardio. Like you don't even have to lift the finger. Like my patients are like, Doc, I can't even get out of my chair. Like how do you expect me to do any activity? Like like a 400 pound patient who has heart failure who has swollen legs and all the stuff. How do they get out of a chair? They don't. So like, Doc, what can I do? Like, okay, I got an idea. Exercise your hand, not putting food into your mouth. That's a really easy way that costs you zero time, and you'll actually lose weight if you actually do it.

So that is, that costs you zero. They're like, well, Doc, isn't it expensive to eat healthy? I'm like, don't eat healthy. Just eat less. That's like a lot of patients in some areas are like, well, eating healthy is expensive. Like, don't eat healthy. eat whatever you're eating now. It just has to be less.

Like, don't give me any excuses. Like, well, or like patients that smoke or whatever, like, well, my mom died last year and I just went back to smoke. And I'm like, okay, lots of my patients' moms dies and they don't smoke. Like, you have to find something else. Don't always make an excuse or have some built in

Like the biggest problem I have with doctors and I tell them this in my talks stop saying diet and exercise Like we're creating a problem when you say the only way to lose weight is diet and exercise like The exercise part nobody does. It's like raise your hand if you exercise like two people raise their hand I'm like how did you lose weight? Do you exercise or do you just not eat much or are you just overweight? Like, you know, a lot of doctors are overweight. But the point is, don't give patients a built-in excuse because when you want to say diet and exercise, patients automatically think, I can't lose weight. I can't exercise. No, but they can't exercise. That's what I mean. Well, they don't. Yeah. Oh, I can't do that.

So I'm not doing any of it. Right. And they have a built-in excuse Like he the doctor told me that if I don't do diet and exercise I'm not gonna lose weight so cut out the exercise part and tell them just Diet well, here's somewhere to God you lose weight Here's something here's something interesting you might want to might want to and this depends of course on the on the patient but studies will show that when people exercise they do tend to eat better Studies will show that when people exercise, they do tend to eat better, but they don't show the opposite. If people die, they tend to not go out and exercise.

So I wonder if that strategy might even work as well. I'll say, hey, look, I tell you what, just try moving more and exercising. Oh, I tell them to do that. Like, you know, they, like a lot of people, I'm sure you guys notice when, once they start exercising or sign up with a personal trainer, like, why would I eat like crap?

If I'm paying all this money, you can get healthier. It's like, you know what, I'm not gonna eat a whole pizza, you know, whatever it is. But like when doctors say to patients the only way to lose weight is diet and the end part. And exercise, like no,

you're giving them an excuse, a built-in excuse to think they can never lose weight because they can't or won't or don't have the time or Drive the kids around or go to soccer practice. They don't have time for the exercise So tell them listen don't lift the finger do what you normally do Just don't put more food into your mouth. I swear to God you will lose weight Yeah, you know We because the success rate is so low and you've been doing this for a while and your approach is better than most

because the success rate is so low and you've been doing this for a while and your approach is better than most cardiologists in terms of talking to people about how to do things. Do you have stories for it? I was gonna say, do you ever get, do you have a positive outlook? Moving forward or is it? I do, I mean, I think, I literally have 10 copies

of the book with me. I have a bunch more at home than I'm giving to people. I brought four that you guys can sign for me. Oh, perfect. But either way, like this book literally is exactly what I've been trying to tell people. And now I can say, listen, there's a book on Amazon called The Resistance Training Revolution.

Just read it. I don't care if you do anything. Just go read it. And naturally when somebody actually reads something and does it, I'm not just gonna hand it to them because then they don't want it. Give something out for free. People won't do it.

Like your programs, if you hand it them out for free, I know you have free stuff, but if you give away maps on a blog for free, what's the likelihood of someone doing it? Not as valuable. If they pay a hundred bucks for it or whatever it is, they're more likely to actually look at it and at least read it or watch the videos

and actually do it. So, I'm not gonna just hand it out, but if my patients ask me, well, how many books are there? Any resource, I'm like, here's a bunch of resources, and there's this book you really got to read. But I think people are starting to realize that look, the exercise part is not as important as the diaper.

Like, you know, there was a abs in the kitchen, well, everything turns away losses made in the kitchen. Like you don't actually have to exercise. It's great for you. Don't go home, people watching this and say the cardiologist said you don't actually have to exercise. It's great for you. Don't go home people watching this and say, the cardiologist said, don't exercise. I'm not saying I exercise every day. It's very good for you.

You will improve all of your cardiovascular risk on it, but it's not an efficient way to lose weight. It can help. The one thing we have found about exercise, I'll tell you this, it attenuates your propensity to gain weight back. Like it prevents you from gaining weight that you've already lost back. Interesting.

So like if somebody lost 30 pounds and they're on an exercise program, being an active and exercises, you're less likely to gain that weight back. So that's something we definitely know that exercise does in terms of weight loss. All the other stuff, it helps a little, like literally they've done hundreds of studies on people. The amount of weight they lose from exercise only. It does not much. You have to do both.

You have to do both and the diet part is the most. It makes the big, I mean, there's those studies done that were done on modern hunter-gatherers and they thought they would be burning so many calories from all their activity and they weren't. Their body just learns to adapt. So it's like exercise for fitness, mobility, gatherers and they thought they would be burning so many calories from all their activity. And they weren't. Your body just learns to adapt. So it's like exercise for fitness, mobility, for quality of life, and then eat for maintaining

a lean body. That's that that was always the way I communicate it. Completely agree with you. Excellent. Well, I tell you what, Dr. Aloe, this has been great. Yeah. Yeah, I appreciate you coming on and thank you for handing out the book to your patients. Yeah, no, I definitely maybe we'll give you a maybe we should hook them up with

some kind of a code or something for as patients for some of our workout programs. Oh, that would work. Yeah, so they could have access. I do have a weight loss program that I sell to people. I mean, I give it away to my patients, but like the lectures I give to doctors, I put on YouTube. And they, they, you know, it's very scientific. Lots of research-based stuff. But the general population, like, like, you know, I, they're like, oh, all this research, like, what does this mean to me? So I have a, I have a program that people can, can get. If you go to Dr. Aloe, DRALO, no period, DRALO.net, there's a weight loss one-on-one course. And it goes through all the basics from like, what is a calorie, what is a macronutrient, how to actually lose weight. There's a workbook

that you can put in to calculate your calorie deficit and your protein intake, all that stuff. And then going through a fitness program that if you want to do some weight lifting, you don't have to lose weight. But if you want to, here's a basic compound lift type program that you can follow with like a schedule and everything. It's very simple. And I do some basic exercise demonstrations to kind of show people how to do it or how to regress them even because my patients are usually older. But that is something I usually give to my patients is one.

I would love to be like, hey, go to theresistanttrainingrevolution.com, type in this code and boom, you can get it for whatever. Excellent. That would be awesome. All right. Well, thank you, man. Thank you.

Thanks for what you're doing. Sure. No, thanks for having me. Appreciate it, Tom. And thanks for coming on and actually talking to my audience. Yeah. Because they're all doctors usually. And when they hear like from someone who actually believes in the same stuff and has the research to back it, that makes a huge difference.

So I really appreciate that. Awesome. Thank you. Thank you for listening to Mind Pump. If your goal is to build and shape your body, dramatically improve your health and energy, and maximize your overall performance, check out our discounted RGB Superbundle at Mind Pump Media.com. The RGB Superbundle includes maps and a ballac,

maps for performance, and maps aesthetic. Nine months of phased, expert exercise programming designed by Sal Adam and Justin to systematically transform the way your body looks, feels and performs. With detailed workout blueprints in over 200 videos, the RGB Superbumble is like having Sal Adam and Justin as your own personal trainers trainers but at a fraction of the price. The RGB Superbundle has a full 30-day money bag guarantee and you can get it now plus other valuable free resources at MindPumpMedia.com. If you enjoy this show, please share the love by leaving us a five-star rating and review on iTunes and and by introducing Mind Pump to your friends and family.

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