The Rich Roll Podcast - How a Plant-Based Diet Can Prevent & Reverse Heart Disease

Episode Date: August 18, 2013

Today I delve deep with the magnificent and one and only Joel Kahn, M.D. to discuss the power of diet and lifestyle on heart health and long-term wellness. Joel calls himself an Interpreventional Cardiolgist. What is that? It means that he treats his patients with a blend of traditional interventional cardiology (stents) as well as preventive cardiology. It's this rare combination that makes Dr. Kahn unique in his field. But let there be no mistake – Dr. Kahn is no new age hippie. In additional to several post-doctorate certifications, he graduated Summa Cum Laude from the University of Michigan's prestigious Inteflex program (a 6-year undergraduate / graduate program that developed doctors fresh out of high school) and has served as a Clinical Assistant Professor of Medicine (Cardiology) at Wayne State University School of Medicine since 1993. In addition, Dr. Kahn has authored over 130 articles on heart disease, over 10 book chapters (as well as a new book due out in February 2014), and several monographs and video national presentations. He is a frequent lecturer on heart disease and its prevention. He has performed thousands of cardiac catheterizations and stent procedures and has been advising patients on heart healthy programs for over 20 years. In other words, Dr. Kahn knows what he is talking about. And his message is powerful — if you want to experience true long-term wellness, then you must focus on implementing sustainable long-term preventive protocols into your lifestyle. And this starts and ends with diet and active lifestyle. It was an honor to spend 90 minutes with Dr. Kahn, and his message is invaluable. Simply put, the world would be a better place if we had more doctors like him. So listen up people. Take his message to heart. Literally. And enjoy! Rich

Welcome to Episode 44 of the Rich Roll Podcast with Dr. Joel Kahn. The Rich Roll Podcast. Hey everybody, Rich Roll here. Welcome back to the Rich Roll Podcast. Episode 44. Today, a couple show notes before we get into the interview. I'm scheduling. On September 7th, I'm going to be at the Toronto VegFest. I went last year. It was a really good time, and they were kind enough to ask me back this year.

So I'm going to be doing a keynote presentation that Saturday, the 7th. I think it's at like 5.30 at night or something like that. And I believe I'm also doing an athlete panel with a couple other guys like John Pierre, who's a plant-based trainer, and James Wilkes, who's a former guest on this show. He's the MMA UFC fighter. We're going to talk about plant-based nutrition for the athlete. And we're also going to talk about a documentary project that James is working on called Game Changers, which is pretty exciting. It's all about kind of eating plant-based and being athletic. And it gets into all sorts of issues that come up and surround that, like issues of masculinity, what it means to be a man,

and how we approach diet as men. So that should be pretty fascinating. I'm hoping I can record that panel and put it up on the podcast. I'm going to have to see if they'll let me do that. But fingers crossed, hopefully they'll let me do something like that. If you're in the Toronto area or you want to learn more, go to festival.veg.ca and it's all the information you need. On the 21st of September, I'm going to be doing another keynote in Tucson. If you want to find out more about that, you're in the Tucson area, go to healthyunetwork.org.

Plant-based nutrition. You want to learn more about plant-based nutrition? Julie and I are pretty excited. We just launched our complete, or I guess it's called the ultimate guide to plant-based nutrition. Julie and I are pretty excited. We just launched our complete, or I guess it's called the ultimate guide to plant-based nutrition in partnership with MindBodyGreen. It's a really comprehensive video online course, three and a half hours of online video broken down into small bite-sized little videos that are five to ten minutes each, all sort of divvied up according to theme and section to address different subject matters.

Basically, every single thing that you need to make that transition to getting more plants into your diet. So whether you're just plant-curious, you're eating the standard American diet, you want to learn more about how to eat this way and do it the right way, it's great. If you've been eating plant-based or vegan for a long time, still tons of great information that you can glean from it. There's also an online network forum where you can ask questions and Julie and I interact with you. We've got recipes, we've got all sorts of downloadable tools. It's pretty cool. I'm really proud of the program. It's doing great. We're getting great feedback on it. So go to mindbodygreen.com and you can check it out. It's

right there on the homepage if you just scroll down. The other cool little product offering that I wanted to mention is my buddy, Matt Frazier at nomeatathlete.com. He's a great guy, fellow runner, fellow plant-based runner. He just did his first 100-mile ultra. Congrats, Matt. He just came out. He's got a series of these downloadable PDF e-book courses called the Roadmap Series. He did one for the marathon. He did one for the half marathon. And he just came out with one for triathlon. It's called Triathlon Roadmap Plant-Based Guide to Conquering Your First Triathlon. So if you're interested in checking out triathlon, you've never done one, maybe you're intimidated, you're not sure where to start, how to train, how to eat, what to eat before your workout, after your workout, during your workout, and stay plant-based, then this guide is great. I've written a lot on this subject, obviously, and I just released my online course, but I've never done a specific training plan for your first triathlon or a meal plan that will

take you every day through how you prepare. It's been something on my list of things that I thought would be great for me to do, but Matt beat me to it. His product's great. So I strongly urge you to go and check that out. You can go to mattnomeatathlete.com. But if you want to support this show, then go to richroll.com. My most recent blog post up is all about this program and his other programs.

And if you click through the hyperlinks to his program and end up purchasing it, we have an affiliate relationship. And so Matt will kick a few dollars our way, and that's a great way to support the podcast. It won't cost you anything extra on those products. It's the same price if you go to nomateathlete.com. But if you click through from my site, from my blog post, to his site through those hyperlinks, then it helps support what we're doing here.

And we love you for all the support that you're giving. Other ways to support the show, the Amazon banner ad at richroll.com. We're all buying stuff on Amazon. So if and when you're going to buy something on Amazon, go to richroll.com. On the blog page, podcast page. You see a little banner ad for Amazon. Click that. It takes you to Amazon.

Get whatever you're going to get, like Finding Ultra, perhaps, in case you haven't read it. And it won't cost you anything extra. Again, it's just an affiliate relationship. And Amazon will kick us a few pennies, helps keep the bandwidth flowing and you're supporting the plant power movement because this is a movement, right? This is a movement that's picking up speed, picking up steam and we want to keep it going. So thank you everybody who's been doing that. We've gotten a lot of support from all you guys out there.

This audience is blowing up and we love it. I'm so happy, proud of the show and just really feels great to have an audience out there that's interested in what we're doing and is responding positively to the message. What else? Well, you can also donate to the Rich Roll podcast. There's a donate button on my site. You can throw us a few bucks on a one-time basis, on a weekly basis, on a monthly basis. And that has been fantastic also. We've picked up some new equipment. We're building up a new studio that we're going to be broadcasting out of soon. And all your support is allowing us to do all of that.

And we're going to start videoing podcasts. to do all of that. And we're going to start videoing podcasts and we're going to start eventually live streaming them and picking up the episode frequency up to twice a week. So thank you. Thank you. Thank you. On to today's guest, the wonderful and magnificent Dr. Joel Kahn. Who is Dr. Kahn? Well, he's an inter-preventional cardiologist. In fact, I believe he's the first in the world to be certified as an inter-preventional cardiologist. In fact, I believe he's the first in the world to be certified as an inter-preventional cardiologist. Well, what does that mean? Well, it means that he is a typical Western medicine practitioner in cardiology, hence the term interventional. He puts stents in.

He performs everything that you would expect a Western practicing cardiologist to do. But what distinguishes him is his strong bent and opinions when it comes to preventive medicine. He's a vegan himself and a strong proponent of a plant-based diet with respect to treating his patients and as a means to optimizing your health. And this guy's no hippy-dippy. He's got 25 years of experience, and he's a really smart guy. He graduated summa cum laude from the University of Michigan's Intiflex program, which no longer exists. But what it was was essentially a way to immediately enter medical school

right after high school. You go to University of Michigan right out of high school. You begin medical school right away. I think it was a six-year program. And when you graduate, you're a doctor. So it's sort of like fast-tracking doctors. And we get into talking a little bit about what that program was like and what motivated him to participate in it and all aspects of his practice,

everything from how he treats patients typically to his opinions on everything from GMOs to supplements to exercise to yoga to meditation and how he interacts with his patients with respect to trying to get them to improve their diet. He's written like 130 articles. He's a very frequent collaborator. I guess, what would you call that? He submits many articles. He's a very frequent collaborator, collaborator. Uh, I guess, what would you call that? He submits many articles. He's a contributor. That's the word I was looking for to mindbodygreen.com. Um, which is how I kind of, he kind of came across my radar. He's friends with Jason Walker, the CEO of mind body green. And, uh, Jason, uh, threw up an

Instagram picture of having brunch with him a couple of weeks ago back in New York and said, I'm here with the wonderful Dr. Joel Kahn, plant-based cardiologist. And I messaged Jason. I said, that sounds like a guy I got to have on the podcast. And Jason got back to me and said, yeah, well, as a matter of fact, he's going to be in LA. So we hooked it up. The doctor was in downtown la giving a talk at a conference and he was kind enough to take time out of his day and his conference for us to sit down and have a conversation in his hotel room with the mobile podcast studio and it's a great conversation very illuminating very interesting uh his opinions are are fascinating, actually.

And what I love about him is he's very grounded. And everything that he says, all of his opinions are based on the science and the research. And that's how he practices medicine. And we need more guys like this. We need more doctors, more cardiologists that are coming from his perspective when it comes to treating patients from a preventive, I always want to say preventative, it's preventive, from a preventive perspective. So enjoy the interview. He's a great guy.

This podcast has allowed me to meet a lot of fascinating people, and this guy is right up there at the top of the list. So I'm really glad that I got a chance to meet him and to share his message with you guys so that you have some takeaways to take home and incorporate into your own life to not only maximize your health and your long-term wellness, but to unlock and unleash the best, most authentic version of yourself. We're brought to you today by recovery.com. I've been in recovery for a long time. It's not

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option for you or a loved one, again, go to recovery.com. treatment option for you or a loved one, again, go to recovery.com. Without further ado, ladies and gentlemen, Dr. Joel Kahn. Believe me, exciting to be amongst you. Oh, don't say that. It's exciting to be amongst you. Don't say that. It's exciting to be with you. It's funny because I think Jason Walkup from Mind by the Green posted an Instagram picture of, I guess you had brunch with him or dinner with him in New York. Yeah, about two weeks ago.

Yeah, the plant-based cardiologist. And I emailed him. I was like, that's a guy I need to talk to. And he said, oh, he's going to be in L. You got to sit down with him. So here we are. Yeah. Well, thank you for driving a distance and meeting me here. Oh, my pleasure. So what were you doing here in town? I came in yesterday. There's a conference in this hotel of anti-aging physicians, a small group of cardiologists amongst a larger crowd. And fortunately, I was invited to be faculty so I gave a lecture

today about what gluten can do to the heart and kind of meshes with athletic performance. Oh, that's interesting. I feel like the gluten conversation doesn't get enough air time amongst the kind of plant-based movement. I don't think it gets sort of the attention it deserves. So what's your perspective on that? Well, I mean, I call it the glugan movement, the gluten-free vegan movement, the glugans. The glugans. The glugans, yeah. Meet the glugans.

The road just keeps getting narrower and narrower, doesn't it? I just wrote a little mind-body piece about kosher, yes, no. Vegetarian, yes, no. Vegan, yes, no. Gluten, yes, no. Now I got to do GMO, yes, no. Leaves me about, no. Vegan? Yes, no. Gluten? Yes, no. Now I've got to do GMO? Yes, no. It leaves me about air.

But I agree with you. So do I think gluten is real? Yeah, I do. It's not genetically modified, but it changes in wheat structure and amino acid content, and I think people are reacting to it. And, of course, we talk about the gut and immune diseases related to it, but it looks like the heart has taken a hit in some people too. That's what I talked about today.

Right. So, in other words, there's – I mean my understanding, and correct me if I'm wrong, I'm certainly no doctor, is that there's a kind of spectrum of sensitivity to it. Some people react very negatively to it. Some people don't seem to have a problem. I mean is it something that everybody should avoid or just if you seem to have kind of a negative, adverse reaction to it? We actually had at this conference probably two of the world's experts right now. One is Bill Davis, wheat belly cardiologist.

Yeah, for sure. Pretty successful book. And he'd like to see woot. Woot. Woot. He'd like to see woot booted. Wheat booted from the American scene probably the world scene he's that passionate about uh its effects but um the famous harvard professor dr fasano thinks that's way too radical and he is the biochemical expert on gluten and

when it does it is too radical i mean there are people that it isn't affecting or they're going to live a good life but um for people that are not thriving or trying to achieve amazing athletic performance or do something to enhance their vitality, talking about gluten is a topic. Right. And so do you think, is it inherently wheat, like all kinds of wheat? Or is it because nowadays wheat is so processed and the GMO wheat and the way wheat has changed and the way we use wheat. A couple of things. I mean, without question, the refining and processing has left us with a nutrient-poor, calorie-rich, boost in blood sugar, high glycemic index food that's everywhere.

I mean, it's sticky. It's pasty. It's the reason pizza dough could be thrown in the air and caught. And it's not just in food sources. It's in cosmetics. It's everywhere. And second is, and people may not know this that are listening, but the wheat that was – there's two statements about our genetic breakup.

Until about 10,000 years ago, people weren't eating wheat. And for most of us, that seems like a long time. But in the history of our genes, our genes change very slowly, and our genes haven't necessarily been raised and adapted to process wheat. And specifically in the last 100 years, farmers trying to create a bigger crop and better output. The changes in the wheat have involved shorter wheat that grows faster. It's actually not genetically modified, but the genetic structure has changed naturally. It's a much more complex molecule, and people are making antibodies to it much more easily. So

it's on the radar screen for a lot of undiagnosed weakness, rash, gastrointestinal, joint, brain fog, a whole variety of not feeling your best. Right. And so essentially gluten is a protein yes and it like you said it's the it's used in so many things because it's actually the glue that makes everything stick together and baked goods and in condiments ketchup soy sauce all these things have gluten in it and and my understanding again correct me if i'm wrong is uh it it uh for a lot of people it produces inflammation, right? It produces an immune system response.

Yeah, you can measure antibodies. If you have celiac disease, your antibodies will clearly be abnormal. But what you mentioned, there's the tip of the iceberg. There are a group of people that maybe have some clinical problem, bloating, irritable bowel. They have no clue. They might have positive antibodies. And then there's some people that are entirely negative.

There's other substances in wheat. And I'm not an anti-wheatite, but the science is evolving, and then you have to stay open-minded as it evolves. There's actually a fascinating substance called amylopectin A, which lights up parts of your brain similar to morphine, similar to addictive opiates. And there may be the reason wheat has become so popular is that we get a high off of wheat in the same manner that a drug addict gets a high. And you go back to it and have the next cracker.

You can't eat just one, and it may be more than just your lust for obesity. We may be preying upon our population, and we're just sitting ducks for a lot of this stuff because we barely understand the science. I'd be willing to bet everything I have that I have that. I would probably agree with you, too, after reading your book. And gluten, I mean, is gluten found in its highest concentration in wheat? Because it's not just wheat.

It's all different kinds of grains. There's only a few specific grains that are gluten-free, but it's across many different types of— Barley, it's rye, it's in spelt and some others. And like you say, quinoa is awesome and buckwheat is awesome and amaranth is awesome. But so far, Dunkin duncan donuts hasn't come out with the quinoa right quinoa cruller somebody told me recently uh when i wrote my book i said listen if you think you might have a gluten sensitivity or you want to find out the best thing to do is to clean your diet up first because if you're already eating terribly just removing

gluten from your diet you're probably going to feel better anyway because you're going to have to remove all this processed stuff but clean your diet, you're probably going to feel better anyway because you're going to have to remove all this processed stuff. But clean your diet up, make it clean first, and then start removing the gluten and pay attention because although there's a blood test for celiac disease, there's really no blood test for gluten sensitivity. But somebody told me recently that now there is a test for that. There's actually, in fact, some of the companies that were at the meeting that I lectured at today have blood tests.

You have to go to a special kind of functional medicine physician. You're going to pay probably not insurance coverage. You might pay $500 to $800. But if you want to know, there's panels of multiple antibodies of all the components of wheat, and you could sort it out. And some people, that's real important. But like you say, you just eliminate it. I tell my patients, take a glucation.

Just get a glucation. Just take a glucation for three, four weeks. If your arthritis and psoriasis feels better, you're sensitive and it's very easy to avoid it for three, four weeks. Yeah, I mean, I'd encourage everybody to try it. I certainly know that I feel better and function better and sleep better and perform better athletically and recover more quickly in between workouts when I remove gluten. There's no question about it. So like I said, that may not be everybody's experience, but I think everybody should take it upon themselves to figure that out.

Athletes don't need more inflammation, ultra-athletes. They're getting enough inflammation from lack of sleep and excessive exercise. And if gluten is just a small component, get rid of it. You're going to probably improve your performance. Although, it's a great theory. I tried to look for some science to it because I've talked about enhancing athletic performance as a topic at this lecture series a few months ago. And there's still science to be done in that area. In which aspect of it?

Which aspect of it? Demonstrating in high fitness athletes that removing gluten in some measurement of, you know, maximal oxygen consumption, mitochondrial function, that has proven science. It's a very strong theory. And all you need is one athlete to tell you I feel that much better. And there's many, as you know. Right, for sure. But not yet that you can find a study that convinces you. Well, who's going to pay for that study?

Somebody who's... The buckwheat people. Yeah, exactly. The buckwheat people have to get together. If you're listening right now, the aisle right away, log in to richroll.com, and let's fund a study.

We can do a Kickstarter on that, maybe. That would be exciting. That would be good. But you're not just the gluten doctor. You're a plant-based cardiologist. So I want to get into your background a little bit. We have so much to talk about. Let's talk about Michigan first.

Okay. Born and raised in Michigan? Born and raised in suburbia about, what, 40 minutes from where you are, Southfield. You're in Grosse Pointe. Love Grosse Pointe. And only applied to one school. I mean, I didn't come from a family that bled maize and blue. So it just was the right school.

I love that. You just quoted my book. I like that. Hey, there's a few hundred thousand of us. Yeah, I know. That's an oft-quoted theory. Right, right, right. But yeah, one school.

And it wasn't like nowadays where kids apply to 20 schools. Ann Arbor was the choice. And I was very lucky. They had back then a program where you got into medical school at age 17 that combined undergraduate medical school. Right. Into Flex. Is that what it's called? Yeah, into Flex.

You got into Flex. And integrated flexible program. You literally go from high school into medical school. You do. And that's a very difficult to get into prestigious program. It's so difficult because it doesn't exist anymore. They don't have it anymore? They were trying to create these organic family practice yoga kind of doctor gurus,

and it turned out we all became neurosurgeons and cardiologists and highly specialized physicians, and they said, you know, what's the point of it? Right. I talked to Sanjay Gupta, who did that program. Were you guys there around the same time? No, he's significantly younger than me, about 10 years younger than me. And another friend of mine, Compton Rambada, who's been kind of a nutritional guru to me,

he ended up not seeing it all the way through. I can't remember what his story is, but he was telling me some great stories about what it was like to be part of that program. It sounds pretty intense. You know, it was like the NASA program at the beginning. We got so much attention. There were 50 of us. The regular class was 225, and they just surrounded us with love and support,

and I loved it. It was a perfect program for me. A lot of people took a year off to go find themselves or take more liberal arts programming, and that was encouraged. But I knew what I wanted to do, and it just was a perfect program. Right. That's great. Yeah, I mean, like you said, my family does bleed maize and blue. My mom went to University of Michigan. My dad went to law school there.

My cousin Bill, who now lives in the Middle East, he was editor of the Michigan Daily. Then he was an editor at the Wall Street Journal. Now he works for a publication and lives in Abu Dhabi. Then all sorts of cousins. I have lots of cousins that are from Grand Rapids. And then all sorts of cousins. I have lots of cousins that are from Grand Rapids. And my parents, they just sold it last year,

but they had a little house on Lake Michigan up by Glen Arbor near Sleeping Bear Dune, if you know that area. So I love it up there. It's always fun to bring people from California up there because it's so beautiful. And it wouldn't occur to you living out here that that would be a great place to spend your vacation in the summertime. But it's beautiful and amazing up there. love it we got wineries up there we got beautiful fishing you're right great great for training too great for training for ultraman i spent many hours on the road and up there training so i love it and then so you stayed and then did

you immediately go into private practice or what happened happened when you graduated? No, I, very brief biography, finished Ann Arbor State in Ann Arbor for internal medicine residency. It was during that period that I became a full, I came out of the closet as a vegetarian. Basically, I grew up keeping kosher, so there were foods that I ate and foods that I didn't eat, and when I went to Ann Arbor, I just found that hanging around Rajarani, and foods that I didn't eat. And when I went to Ann Arbor, I just found that hanging around Rajarani, the Indian restaurant in Ann Arbor and some of the other places back in those early and mid-'80s. It was just easier being vegetarian. It made my religious restrictions easy to live with.

But it wasn't an ethical vegan or vegetarian. It wasn't an environmental one. It just was simply the quickest meal and the quickest grab-and-go. It wasn't even health-oriented. It was convenience-oriented. Yeah, it wasn't an environmental one. It just was simply the quickest meal and the quickest grab-and-go. It wasn't even health-oriented. It was convenience-oriented. Yeah, it wasn't then. So I finished in Ann Arbor, and in 1986, I moved to Dallas, Texas. I was married at the time, and still am, gratefully, to the same wonderful woman who's a nurse,

and spent three years in the barbecue kingdom of the world of Dallas, Texas. But another small but transformative thing, I trained to be a cardiologist there, is I took a vacation to Aspen. And it was 1987, and that's the year that John Robbins' book, Diet for a New America, came out. And I have some person to thank that I don't know their name, that as I was leaving town to fly to Colorado, gave me a copy of that book, knew that I had been eating vegetarian style in Dallas, and sitting out there in the maroon bells looking at the sky, having a few days

off of what was a pretty rigorous few years in cardiology training, read for the first time any kind of logical argument why the world and animal rights and health would all be enhanced by vegetarianism. And really, I was 90% of the way there. I'd go home and have chicken at my mother's on a Friday night. But that all stopped. And whoever you are out there, if you're listening, thank you very much for lending me that book.

It was very transformative in my life. But John did a great job. It's a classic book. But there still was a dearth of medical evidence. And I don't make it. Right, like what year was this? That was 87. So I finished in Dallas, wonderful period of training,

went to Kansas City for a year, did more training in angioplasty. I'm a stent guy. I put in balloons and stents. I'd rather not have plaque. I actually own the trademark and a little term, prevent not stent. I saw that on your website. I'm a stenter. And anyways, 1990, I to michigan and began private practice in ann arbor actually for a few

years but that was a year a very very important study by dr dean ornish in california the lifestyle heart trial came out which really was the first scientific blow you out of the water i was i was like fertile ground i mean give me science that says the way I'm eating and my family's being raised is not only a logical and environmentally correct decision, but make a jive with my practice. And here was some of the most exciting data that you could reverse heart blockage by using broccoli and beans and rice and plant-based eating along with the rest of Dean's program, which was stress reduction and stretching and socialization and all. And it just did it for me.

I mean, I just became excited that we need to incorporate this into practice. But that was the one guy in the state of Michigan probably that really said, you know, this isn't just another random study. This thing spoke to me. So I got excited about it all. And you made those changes in your personal life at that time too about the way that you were eating? Yeah. I mean, by then, my experience had gotten us. We were a vegetarian family, never really pushed it on the kids because I had three growing kids at the time and still do. They're very grown. But it was around that period that we started dabbling with a little raw and some vegan meals and kind of going towards that route. It took a few more years until, you know, I don't love labels,

but until we would say we were totally a plant-based family and found the work of Caldwell Esselstyn and some others that, again, it was interesting to jive what we were doing personally, what we were doing in our family, and see the medical support for it all. And I've never stopped. Right. And so at the time, were you also sort of – you said you had a private practice. Were you also working at a hospital at the time?

Yeah. I settled back from 1993 to now. I've settled back in suburban Detroit. And despite all my siblings moving away, everybody now lives a mile apart. My mother lives a mile away. And we're not exactly the Kennedy enclave, but geographically we're all close. And I have stayed since and we all know that some of Detroit is great and some of Detroit is in the news and a bit struggling, but have stayed

and it's been a wonderful community for every reason. And it's increasingly a wonderful health oriented community. We have really good stuff going on. Right. Well, I would imagine that, um, over the next 10 to 15 years, it's going to see, I mean, you know,

it's sort of like when Soho in New York was just factories and warehouses and then the artists come in because it's cheap. And then there's a sort of cultural Renaissance that takes place. And then, you know, that begins to gentrify the neighborhood. I mean, right now in Detroit, I mean, it's the very early stages of that. But I would predict,

you know, 10, 15 years from now that it's going to be kind of amazing there if they can get some certain things straightened out. Yeah. I mean, they get the city economics and they will. But like one of our best and most amazing resources, and you may remember this, is the Detroit Eastern Market. It's the oldest family farmer's market in the country. It goes back 1800s. And it's this gigantic Saturday explosion of our farmers bringing produce. And we draw 40,000, 50,000 people. And just I love the mix from all the neighborhoods, from the city, young, old.

People drive up in Cadillacs. People drive up in broken cars. But it's where the city gets together, and there's people playing saxophone in raw juice places and smoothie places. It's not a vegan haven. There's plenty of meats to buy, but that's Produce City. That's where you walk out with your kale stacked at the top of your car. Right. I love it.

Yeah, I was just in Pennsylvania. I spoke at the Vegetarian Summer Fest out there, and I met a family that lives in Grosse Pointe, and they were telling me the exact same thing. So that's pretty cool. The reason that I was asking was just sort of reflecting on Dr. Esselstyn's experience of kind of trying to impose this preventative protocol on his patients and meeting that kind of resistance early on when you were proposing the idea of treating people in a different way other than just let's immediately cut them open? Well, it actually, yes, and it still exists. I had actually went through a job change recently that was in part due to you talk about cabbage too much, meaning the kind that comes out of the ground and not cabbage, which is the acronym for bypass surgery and opening your chest. You need to make your conversation in the public more about heart surgery than about

coleslaw and juicing. And that's actually just in the last 12 months. So we still got an uphill battle. Well, it's still a business and that's how the business makes money and profits. But yeah, there was. Really, people left me to myself. It was so odd. And I'm not praising myself, but it's just what everybody's heard. And it was so odd for a physician to be speaking about nutrition at every public forum that I could grab.

And I wasn't blasted too much for it because they didn't have the, in general, the fund of knowledge to really counter anything that I was saying. And I've always tried to stay grounded in science when it's available. So I'm also working on a book that will be published in February. Oh, wow. That's great. A kind of organic holistic cardiology approach. And there's so much out there that's grounded in science. Nutrition is certainly the strongest component of it.

Right. But you can't take too many pot shots when you're still basing it on science. So I don't have a chapter on colonics. Right. You're trying to keep it sort of accessible. No sham colonics that I can talk about have been done to talk about that approach to heart disease. But so much else is.

So the food is medicine. Food is poison, conversation has been very helpful to my patients and it's really well received, I'd say, in the community. But it's still shocking. And it's the first time I gave a talk five days ago to a group of cardiac rehabilitation

patients, patients who have been through recent bypass, heart attacks and such, about 100 of them. I gave just a standard talk that for me is just day in and day out what I think is common knowledge. And, I mean, it just blows people out of the water when you show them, eat a Big Mac and let's talk about your arteries being sick for five hours and ways it can be tested.

And they're just blown away that, boy, I really got to reevaluate, which is why I keep going because I love giving that message. Well, the power of marketing is palpable, and I talk about this all the time. But when we've been told essentially since birth that milk does a body good or eat a steak for your protein, And those messages are reinforced on a daily basis, you know, funded by deep pockets and lobbying groups that have a vested interest in having you continue to believe that a certain way of eating is in your best interest. It's incredibly difficult to overcome that and to combat that. I was in Death Valley a couple weeks ago where I crewed Dean Karnazes in this race called Badwater. It was a crazy ultra-running race across Death Valley. And the award ceremony the following day was in a high school gymnasium.

And hanging on the wall in the gym were these huge posters of really fit-looking high school students or maybe guys in their early 20s with the milk mustache, you know, sitting at the bench press saying, you know, and so, you know, saying got milk or, you know, milk, you know, drink milk to make. I don't know exactly what it said. I have some slogan on it. Chocolate milk. Yeah. And the chocolate milk as the ultimate recovery drink, which don't even get me started on that. But, you know, there's, so there's, there are high school students that are filtering in and out of that gymnasium on a

daily basis over the period of four years. And even if they're just seeing that out of the corner of their eye every single day, that gets reinforced. And so when you come to somebody and say, actually, maybe we should rethink this, you are combating like, you know, years and years and years of indoctrination into a different way of thinking. So it's a huge uphill battle. I agree. And, you know, from my perspective, the biggest disappointment has been the hospitals because they could stand up and say, we've got to fund a knowledge.

We have the database of real science and what food does to the body is still incomplete, but it's still pretty strong. So, for example, if you don't mind, 1997, one of the most famous studies out there is a cardiologist, Robert Vogel, did a study, eat a Big Mac. Actually, take that back. Eat an Egg McMuffin for breakfast or eat a bowl of oatmeal made with nonfat milk. So it was completely low-fat breakfast.

And he did a test of artery function, just kind of a blood pressure cuff test, but a very valid test. And for five hours after Egg McMuffin, your artery function can be measured and becomes worse and worse and worse. And by about five hours, it starts to recover. So you can go have lunch somewhere and repeat these things. And repeat it, yeah. And likely people are walking around 12 to 15 hours of the 24-hour day

with outside insults on their arteries, and that's sort of the beginnings of atherosclerosis, heart disease, my field. But, you know, Egg McMuffin, that study has been repeated all over the world in various labs in humans. If you add hash browns, it's just worse. Just a week ago, this is the sad part of the story. I'm not talking about 1987. I walked into a cardiology conference at one of the major hospitals in Detroit. I'm on staff at. And what is the breakfast du jour for the trainees that should be learning about nutrition? It was first time I've ever seen it, egg McMuffins everywhere. And honestly, I blew my gasket. I just couldn't believe it because I pick other foods, but don't pick a food that's

been studied that you can back with science and should be on the banned list just like cigarettes and sitting on your butt so long in the hospital. And here we are. The message is so wrong. I actually got chastised because I put a picture of it on Facebook and I won't say who, but sort of the top dog in the hospital called me in and said, you know, that's not good for press. You're speaking out of school, Joel. Come on. Come on, line up, be a Gosling. And you know, that's not good for press. You're speaking out of school, Joel. Come on. Come on. Line up. Be a Gosling.

And, you know, I'm 54 years old. I can't stand in line anymore with the other ducklings. It's time to scream and say, this is just wrong. It's insane. It is just, you know, it's an opportunity. Hospitals don't have to be the prime example, but they should be an amazing example where people learn about, you know, single ingredients, foods, whole foods. Of course.

Plant-based options and the whole thing. Yeah. I mean, I get emails all the time from people telling me stories. And a consistent theme is me or my friend or my loved one just had open heart surgery or some kind of surgical procedure, and then they're in the hospital overnight. And the next day, they bring them this meal that's just completely at odds with – it's why they were there in the first place. So why can't we start with the hospitals? I mean what is the – is it just because these food contracts are so huge and there's

so much money at stake? Why can't we reform what's being fed to patients in the hospital? I think there is an economic issue. A lot of places have to feed a patient three times a day for about $8 a day. But we all know you could make better choices than the sausage, egg, cheese breakfast at a hospital. And I think it's still a lack of knowledge. That's protein.

That's from good animals. And that's strengthening our patients in their post-surgical recovery. I actually think, based on this data, Dr. Vogel and others, you probably are transiently making people have lower immune responses, which isn't good for infection, probably are affecting their arteries. I can't prove it because nobody's ever looked at what's affecting these kind of meals on hospital patients, but they're already somewhat depressed to begin with. So such simple steps, I think, would make a big inroad. The real pressure is, I think, would actually save hospitalizations and cut down time and get people out, which is all that hospitals want to see done if done in a quality way.

But you'll go through millions of dollars of various efficiency pathways and purchasing pathways, but change the breakfast seems just so ludicrous nobody even approaches it, and nobody's pitching it. I've actually went around and shopped all the hospitals in my area and made proposals. Let's put this program in and gain notoriety, and let's be the first dairy-free hospital system in the world or something. And it's just the time's not right, or we're not speaking loud enough. The amount of goodwill and press that they would get from that, though,

seems to supersede whatever fallout they would have. I understand marketing. At least I think I do. And I think they would grab national and international attention. And you've got a wonderful guy in Oakland, a physician who runs a farmer's market in the hospital, which has now become not that uncommon. But the press that he got for bringing fresh fruits and vegetables on a Thursday morning to the hospital staff and patient base was amazing.

Yeah, everyone's going to want to go to that hospital. Right. It's a great statement. We're about health, and something more radical would be even more meaningful and probably economically viable for the hospital. But there's so many moving parts. But there's so many moving parts. I mean, I interviewed the administrators at PS244 Public School in Queens. They were the first public school to institute a vegetarian school lunch, and they explained kind of stuff, and they've just steamrolled it into quite a movement that has a lot of momentum right now and hopefully will be spilling over and into many other schools. It would be great to see the same in the hospital system. I think that's great.

I mean, especially when certain, I mean, there are certain hospitals that still have McDonald's in them, right? Yeah. Sort of like the Cleveland Clinic, the number one rated cardiac program in the world has a McDonald's in the list. Do they really? I didn't know that. There's 27 McDonald's and hospitals in the United States

but there's twice as many Wendy's and you can go down the list. It still remains appalling. What can you say? 24 ounce sugar sweetened soda, french fries and a burger with bacon and cheese, and that goes up to a patient's room.

If anybody listening to this doesn't realize how dramatically insane that is. Yeah, it really is remarkable. Remarkable. Getting back to Dean Ornish and Dr. Esselstyn and kind of the earlier pioneers in this movement and kind of the work that you're doing and trying to get out there and spread this message, one of the consistent sort of themes that you hear, I don't know if it's fair to say from the medical community, but there's this idea that, well, you can tell people to eat that way, but they're not going to do it, so why bother? Why don't you just tell them to do something that's a little bit more accessible to them?

There's still this idea that it's just so radical or so difficult to change your eating habits or your lifestyle to get on par with what's going to be in your best long-term health interest. Is that something that you encounter? I think there's that challenge. You know, I always admire people who've been in a crisis and come out of it transforming themselves one way or another, and, of course, you're one of those. I haven't had a giant health challenge in my health and life,

or my wife's or my children, thank God. And it's that thing about, I think, a frog in warm water, boiling water. They'll stay in the water until they die if you turn the temperature up slowly. I mean, people just aren't ready to make change, and they're waiting for the big call, whether it's the heart attack, the stroke, the cancer of the colon or something, and then maybe they'll get the light. So I think part of it is people aren't willing to make the change. And I think the other part is, and we all know the society that we've got, the fast

food society, it's difficult to search out the healthy options and it's, you're just, you know, what Kelly Burnell calls our toxic environment, Dr. Burnell from Yale. I mean, we all know it. You drive up and down any major street in America. So, I mean, we're all seeing the slow signs of change and the better health options and the better health markets and the farmer's markets. And I think it's not going to happen overnight unless it's legislated, and it's not going to be legislated.

But I really, again, I think I call upon anybody here who works in the hospital to take the banner and run with it and uh let's uh we should as a hospital-based community make the changes because we have more knowledge than anybody and we have a captured in kind of population and they're not going to leave if they're sick just because we start putting black beans in their brownies or something. Some do. I'm not without hope. I do see things like that occurring in some of the hospital menus. I'm optimistic, actually.

I mean, I think that there really is, you know, we are having a moment right now, you know, and I think that there is a lot of energy and a lot of support for, you know, the kind of work that you're doing and of support for, um, you know, the kind of work that you're doing and the kind of message that, you know, us and many others are putting out there and people are paying attention and listening and taking greater responsibility for their health. And my approach is always like, you know, this is your life, like take responsibility for it. Don't abdicate that to somebody else.

And you have more control over how you feel and how your body is going to perform and function than you think or maybe you've been led to believe. So coming at it from an empowerment perspective, you know, I think gets people excited. And I think there's, you know, like you just wrote this piece for MindBodyGreen. It was about mindfulness in your eating. And I want to talk about that in a little bit but you relate you relayed an anecdote of having been in um la guardia airport and uh being surprised to find so many vegan options and and i had that exact same experience a couple weeks ago julie and i were flying back from new york and a funny thing happened like we were getting ready to leave we were in manhattan we're getting ready to leave for the airport. And we're thinking we got to get some food for

this flight. Like, what are we going to do? We're going to go to the airport. There's not going to be anything. So I walked like eight blocks up to Chelsea market and I went to beyond sushi and I dropped like 40 bucks on like this amazing vegan sushi is a great vegan sushi restaurant. They make really awesome stuff. And I just loaded up on all this stuff that we could bring on a plane and came back to the apartment where we were staying. We were packing up. And we were cleaning out the garbage of our friend's place where we were staying. And I accidentally threw all the sushi away. I thought it was like garbage in my haste to get out of there.

And it wasn't until we were in the cab on the way over. And realized that I'd thrown out our whole lunch and we were going to the airport. We're going to be on a flight all the way to LA without any food. Julie's like, how could you do that? How could you do that? And then we're in the Delta terminal and we happen upon, I can't remember the name of the vendor. But they had more than you could imagine an airport having in terms of options. Everything from an incredible salad bar to all these pre-prepared

meals and nuts and they had smoothies. I was shocked. They even have vegan sushi. Yeah, that's right. They did. Yeah, so we did. We restocked. I did double that again. But when I see something like that, I'm thinking, well, things are really changing. I mean, I don't know how many people are coming in and loading up like we are, but the simple fact that these options are available in a place that's historically the most difficult to find healthy options is, you know, that kind of thing makes me feel optimistic.

I'm joining in on that one. Can't stop pushing because there's so much to do. Right. So tell me a little bit about what your experience was when you were in medical school in terms of education about nutrition and maybe if you're familiar with what it's like now or how it could be different. Well, I actually do not and I'm not slamming it. I don't remember a nutrition lecture and I don't think there was one.

I've read recently, I think it's true, that about the time I was in med school, 30 years ago, there were 24% of med schools in America had a six-week nutrition program. Here we are 30 years later, we're all enlightened. It's 29% of medical schools in America. It's actually 1% less than 30 years ago or some number similar to that. It was down a bit, 24%, 23%. So I don't remember any conversation on the topic.

And to this day, largely, I mean, I've been to so many hospital grand rounds and hospital presentations, some of which are required, some of which I just, you know, drop in to learn something new. The number that have been on nutrition, let alone, God forbid, something in the green world are pretty close to zero. So, I mean, I'm entirely self-trained because there really is no particularly good option other than that. And it's also relatable, though, because I can tell my patients.

I mean, I take out my prescription pad and I give them homework. You know, you have to read this book and watch this. Oh, you actually write that on a prescription pad? Oh, that's great. I usually write my body green or something. I mean, in addition, you know, you this book and watch this. Oh, you actually write that on a prescription pad? Oh, that's great. I actually usually write Mind, Body, Green or something. In addition, you need to start doing this. That's empowerment. You put in some effort because I'm not going to see you for three months.

We'll talk about your homework when you come back. And I found that pretty responsive. People actually, I can't believe it when they come back and they actually read a book. Right. Well, that goes back to the empowerment thing, I think, too. I do. Yeah. But it's still pretty abysmal out there in the medical school training world, which is there are options where a medical student or a young doctor can go outside of formal training and get excellent exposure now, whether a video series, live courses,

kind of like the course I'm at today. But you have to elect for that, right? Yes. You have to really search it out and you have to be motivated. Right. And, you know, again, I'm not cynical, but a lot of it revolves around payment and such. There isn't any special payment at this point for spending any time on

nutritional counseling with patients or becoming more educated yourself to offer it. So either you get the bug and have the passion or all the mind, body, nutrition field will wait to the day that we finally become a little more enlightened. And Dean Ornish waited 20 years to get his program certified by Medicare, although there's still very few of them. So I like puns. So I call it the day that we have re-home-burstment, where we pay for home kind of activities. I like that. That's right. When we can pay to teach somebody to juice or get paid to teach somebody to

shop a grocery store and such other than cash, which is still a valid way to try and approach patients and all that. But until we have that, even, you know, there are good scientific-based studies on meditation and yoga and cardiac patients, but there's no ohm in the reimbursement. No, no ohm in reimbursement. Well, the irony is so palpable.

I mean, Hippocrates said it in 640 B.C., let food be thy medicine and medicine be thy food. It should be a foundation of medical education, and yet here we are, and it's still such a struggle to produce doctors who are – I'm not maligning doctors by any stretch of the imagination. They want to do right. People go to medical school so they can help people. I mean, their hearts are in the right place, of course.

But it just seems like there could be so many improvements made that would be not that difficult to implement. But then again, maybe I'm naive. I don't think you are. You know, my scope on it is that a lot of this came out of the introduction 80 years ago, 70 years ago of antibiotics and some of the early surgeries where you had one problem, you had one quick fix. and some of the early surgeries where you had one problem, you had one quick fix, and you could create a cure of pneumonia with penicillin and take out an appendix for appendicitis. But we're so overwhelmed now by these chronic diseases of obesity slash diabetes slash high blood pressure slash joints falling apart slash heart disease slash heart failure.

They're very complex. There's no single solution to them, and it's not a pill and it's not a surgery. And it is largely lifestyle. That reorientation, that lifestyle medicine is a specialty. Actually, it should be the basis of all our approach. But for these chronic diseases, if we're not at least addressing what is your lifestyle and have resources about trying to educate and motivate and empower them to recognize the power of lifestyle change. We are just drowning in these chronic diseases.

How does it work? Can you paint a picture of kind of how it works on a day-to-day basis in terms of the pharmaceutical companies and the reps that pay the visits to the doctors and say, hey, we have this new thing. And you sort of hear anecdotally about, I don't know if it's pressure, but just how doctors are incentivized to prescribe and how they can sort of benefit financially or professionally from kind of getting in bed with these companies. I mean, is that conspiracy theory or is there some truth to that? I mean, what is that really like as being a practicing doctor? A couple of comments. I'm unprepared.

It has changed compared to 20 years ago. 20 years ago, you could get baseball tickets. You could get theater tickets. You could occasionally get a trip, including your spouse, to a resort where there might be a half-day conference. And it was some educational content and a whole lot of pleasure. You could go out for an expensive meal. A lot of that is regulated now.

Some hospitals and some universities don't allow any of that, even under the new restricted guidelines. They just don't permit a medical student or a staff doctor to go out for any kind of those programs. Most still permit it. So it is much more regulated. But the system does exist. A generic drug that might be as good as a name brand drug will never have that kind of educational pitch. So bottom line, every week I interact with pharmaceutical reps that are in my office

in the hospital. Pressure, you know, it's pretty clear to me that they're trying to do a good job, but their job includes reporting to their manager their sales. Some are very persistent. Some are a little meeker and milder and all. But it does drive the system to use the newest and the latest and the most expensive without necessarily a fair presentation of the whole big picture. I give pharmaceutical talks for agents that I feel are very good and

very useful. I was saying today I'm an integrative cardiologist, but I don't know when I do the old style, am I extroverted or segregated? I don't know a term for the, I still practice a lot of traditional cardiology and traditional medicine, and they're much more regulated. I mean I cannot say a word anymore that isn't in line with what the FDA has in the package insert. I mean I am not there to sell a drug. I am there to give a medical lecture in tune with what the FDA approved. But it is a system that has no balance. There isn't a nutritional rep that we don't yet have, a turmeric rep who's coming and talking about the anti-inflammatory powers this week.

Come on, turmeric people. You need to get your stuff together. I know. I think the turmeric growers should get some reps out there. And there was an article this week that turmeric was as effective as Prozac for depression. Well, I also suspect there's a whole lot less side effects to adding some turmeric in your life than Prozac. Well, I also suspect there's a whole lot less side effects to adding some turmeric in your life than Prozac. But we're not going to see anybody knocking on the door in any of the lifestyle modalities.

And until it's a grand rounds topic for physicians, until it's in the journals, which there's little shreds, just like you find good food at the airport. I will on occasion find some medical literature. But it's difficult to fund the science. So you're not going to change all systems. A few pioneers like Ornish and all persist 20 years to get a scientifically proven program finally reimbursed by the government, which his program, as I said, is one of the two that are lifestyle change programs. Right, right, right. Yeah.

Do you know Dr. Michael Greger? Oh, yeah. I love Michael. He's the best. He's awesome, right? He's the best. change program right right right yeah uh do you know dr michael gregor oh yeah i love michael he's the best i mean if anybody's listening that's nutrition facts.org and he has taught me so much i've had the pleasure of lecturing a couple times now when we email um but that combination of his wry humor dry humor and his profound knowledge. And, you know. He's able to root out those studies. He finds, you know, he'll find the needle in the haystack and he makes those videos

and presents them in a way that anybody can watch and understand and kind of get where he's coming from. It's nowhere near the quality of your How to Become a Vegan video series that you've done with your wife. That's right. Because of course not. Nothing has. We can't get Dr. Greger in front of the camera yet to do cooking classes

and blending classes and juicing classes, but the nutritional value of anybody that signs on for those free daily emails. Yeah, everybody needs to do that. Crack me up. Yeah, the survival of the firmest was his most recent addition to my lexicon, which was a report that's well-known that men with erectile dysfunction have both a much higher risk of heart disease even if they don't know it because an artery is an artery.

Right. An erectile artery just happens to be smaller than a heart artery. It just starts to fail quicker. And men with erectile dysfunction also have a shortened lifespan as increasing the data. So the point is if you have that problem, don't hide it. Get in and see a doctor. Know your cholesterol. Know your blood pressure.

Change your lifestyle. Whatever it is. So yeah, he coined that term. That's survival of the firmest. Yeah, I like that. He's great. I had him on the show and then I interviewed him again and I had a hard drive crash. I'm trying to retrieve the interview.

I lost it. So hopefully I'll get that up and out soon for people. Cause I said, I'm interviewing him again. And then people are like, why haven't, why haven't you put that up yet? So anyway, I'm working on it. Um, but, uh, to kind of, um, root it back to your, to your practice. So you start, uh, you know, you start treating your patients in a more integrative way, what are some of the results that you begin to see? Just for somebody who's listening to this, who's kind of new to this idea of plant-based nutrition or the nexus between food and health, and particularly heart health, can you attest

to that a little bit? Yeah, so my life in cardiology still is in what we call an insurance-based model. My patients have Blue Cross and Medicare and Aetna and whatever it is. And although I'm not timed by Big Brother, my appointments are 15 minutes apart and my office schedule is pretty full. You have a couple offices, right? Yeah, locations scatter across the city. But the style of practice is very similar to what most cardiologists are.

There are a few physicians and very few cardiologists that have declined insurance and are going completely on a cash basis. I think we're going to see that more and more in the next five years, but it hasn't happened yet. So what I strive to do is quality time in 15 minutes, and that includes a few extra questions. My notes actually have what you have for breakfast, lunch, and dinner in the last 24 hours, and it's always instructive to get a little bite of that.

A little bit about sleep. We could talk about that in a minute, but the seven hours or more a night of sleep is increasingly coming out as a really important marker of health. And you do rob yourself. And, you know, people that are training hard and working hard trying to get seven hours a night of sleep can be pretty challenging. You know, a little bit about stress. Where are you in life? What's got you upset and what's going on in your family, your job, your kids?

And there's always something. But, you know, some people have good coping skills and not. So get through some of that. I mean, what's going on in your family, your job, your kids, and there's always something. But some people have good coping skills and not. So get through some of that. I mean, what's your social connection? Are you going to a church, a synagogue, a bowling club? Do you have buddies? Are you a loner? Do you have family to rely on?

Because that's very important overall. Get the little feel of a patient. And in 15 minutes, plus a lot of other kind of related questions and examination, it's focused. And you can do some very fancy integrative cardiology or you can do maybe five, six basics in the model I'm in and still make a big difference. You're probably getting 80% of it done. So I mean, I have a conversation with every single patient and they know when they're coming in now who they're going to see that a little bit about the power of vegetables and fruits and nuts and seeds and spices.

And they're going to, G-Bombs is our good friend Joel Fuhrman's, greens and beans and onions and mushrooms and berries. They're going to get that. They're going to get their homework list of watching Forks Over Knives or reading a little Mind, Body, Green or reading a couple books that I like to promote. And I do use, you know, whether you want to call them supplements, vitamins, nutraceuticals, and, you know, I find that audience is very receptive.

I can't even think of a patient that didn't welcome the option of not getting a new prescription drug. And I use prescription drugs, I mean, but if they're already on two blood pressure medicines and the option is the third one or talk to them about magnesium or coenzyme Q10 or theanine, which is a great kind of anxiety reducer and lowers blood pressure, or green tea, drinking your green tea capsules and such, I found that patients really, really like that option. That I've not thrown the baby out with the bathwater, but the toolbox is bigger in terms of choices. And I find them very adherent to it. I mean, when I see them back, a lot have done their homework and a lot have gone out and actually purchased.

I don't sell vitamins to patients. I just let them go find them and give them some ideas. But, boy, it's made practice much more fun. It's given me many more. I mean, I was given the same drugs over and over and over to about five years ago and they're wonderful little devices at times, but now it's just a real panoply. Any young trainee in medicine would find practice much more stimulating to go

explore mind, body and nutrition and nutraceuticals and, uh, infrared sauna and the whole host of things out there, recce and, you know, the whole host of, uh, the menuce, and the whole host of the menu that really has a lot of evidence for it. Right. So have you had that experience with a patient

where you kind of have that dramatic before and after angiogram that you see in Dr. Esselstyn's book or you've seen these kind of turnarounds? Well, I haven't had that because he rec't, he, he recatheterized people as part of a research study. If my patients are doing well, they don't go through a catheterization. And, uh, I don't, but I would make two observations. One, I know that taking a holistic approach and combining some Western and some Eastern and some mind body, um, people definitely feel better. And in the world of congestive heart failure, if your grandma or your spouse or anybody listening has that very serious cardiac condition where the heart may not be strong, there is some powerful vitamin support that really is very similar to what an athlete might do to support mitochondrial function. I heard you talk about mitochondrial biogenesis. You make those little powerhouses.

Unbelievable responses of people where their heart is stronger, they're feeling better, they've got life back. I got this cute little, this is actually a cute little now, 86-year-old woman who lives in Great Neck, New York. I have never met her, but she was a friend's mother and two years ago started a conversation. She was very sick, very near death. This woman is independent and

running around her heart strength they were talking about doing heart surgery and it's really probably one of my most amazing saves although it was all digital advice just uh via emails and conversations and tell them what to buy um i see that a lot um and um and as i say the other is just uh so those are dramatic responses and um other probably – I'm honest about the fact I've talked to thousands of patients about their nutrition. I mean I probably have 150 vegan patients that have decided to follow an Ornish and an Esselstyn. And I'm talking complete kind of submission to it but most of them are eating much better um even if it's three salads a week instead of one or a slice of tomato on their sandwich instead of none and i mean i've either guilted them or educated them or something to lifestyle change and that's exciting now and

that's with really rudimentary tools i don't have i mean with a dietician to sit down with them or a real lifestyle change program of which there's maybe 10 or 20 around the country and only a few that are kind of vegan-oriented, you could really do some good stuff. This stuff works. It does. I mean I get emails all the time from people that say, you know, I got off my meds. I never thought that that would happen. And by making these simple changes and sticking to them and And, you know, over time, like, I've gotten off it.

You know, I've avoided the OR. I've avoided all these things that I thought were just I was destined for. So, you know, my secret tool if I can't reach out, because we all know there's that field of behavior change theory, and if somebody's in that first stage where they just don't want help, there's nothing. No, you have to be willing. You have to be at least a little open-minded. But if I find people are open-minded, you you know it's giving them some educational tools and giving

them some encouragement but my real like uh secret weapon is i talk to the guys about uh the secret direction yeah that tends to penetrate but uh the tension is mounting in the room but yeah, the power of greens and blood vessels in general. But forget about your heart. They really don't care so much about that. Let's talk about the sac. Right. I draw this little picture on my prescription pad.

I can send them home with all this stuff. I blow through prescription pads. But the average heart artery is about the size of a number two pencil in diameter. And the average groin artery is about the size of a little stirrer you might find in a gin and tonic. It's much smaller. And it doesn't take much plaque to clog that baby up. It doesn't take one more French fry or one more bite out of your triple cheese whopper

or one more KFC bucket to close that up. And they get that pretty quick. Yeah, it's the canary in the coal mine, really. It's nature's first alarm bell. That's right. If that's not working, then there's more going on. Weeding out the weak ones. They can't reproduce or something but it's easy after childbearing age.

And the great news is lifestyle change affects that dramatically and quickly. I mean Esselstyn's program within two, three weeks, many people experienced increased ability and interest in sex. Ornish reported it right away that you don't have to cause, and you asked if I've seen plaques regress and reverse. The data out of all those studies and just clinical observation is arteries can get healthier with still having plaque in them. They can get some, blood doesn't clot as easily with eating greens and beans and such. Arteries don't spasm and constrict. And that can take two, three weeks to see those results.

And actually, the ability of arteries to relax, it's all nitric oxide, which I'm sure you've read a little bit about in terms of athletic performance. And you change your diet and put some, you start chewing some greens in your mouth, you make nitric oxide right away. If you choose meat with nitrates, it doesn't happen, but it happens with greens. And if you bolster your diet, I mean, watermelon is a nitric oxide powerhouse and pine nuts is a nitric oxide powerhouse. Rhubarb is a nitric oxide powerhouse.

And you can really enhance sexual performance with a plant-strong or plant-complete diet very quickly. And you'll get their attention. Yeah. Well, it never ceases to amaze me how resilient the human body is. I mean, two to three weeks, that's like nothing. You just make these simple changes and almost immediately you can see results. Yeah. It's crazy.

It's really true. And that's why it's like the glucation or take a meekcationation that doesn't take years to get the sense that you're feeling better people get it pretty quick yeah i think it's about just getting people used to being more in touch with how they feel and monitoring that like paying attention you know i think at least for me and my personal experience when i was eating horribly and not treating myself, I just got used to feeling lousy all the time. And that was normal. And it was just, well, this is the way that it is. And to actually realize like, oh, it doesn't have to be this way and to take stock of that. If you have the willingness to do that, you can change a lot. Not just your health. I mean, it affects everything. You change that and then suddenly

the way you see the world is different and your mood is different, and then you're functioning differently in your relationship, in your profession, and suddenly doors are open. It's like it affects everything. So it's powerful stuff. It is. You were talking about nutraceuticals and supplements. What are some of the – I mean, you touched on a few, but what are some of the ones, you know, CoQ10 you talked about? Yeah, probably if I had, you know, I take a lot. I've studied the field.

I take many more than I did five years ago, but probably close to 30 to 40 individual supplements every day. Oh, wow. Yeah, I'm pretty good. I feel great. I don't know why I feel great, and I haven't done a scientific trial. But in my patients, I try not to overwhelm them, and we might creep up to 5 to 10, but I like to start with 3 or 4 or 5. And in the cardiac patients, CoQ10 is just the foundation.

Coenzyme Q10 is a powerful antioxidant, important in every cell in your body and the mitochondria to make energy, to make ATP. So if you're an athlete, it's important, although it's not 100% certain how much CoQ10 enhances athletic performance. The studies are a little bit all over the map. But in cardiac patients and patients on cholesterol medicine, I mean, it's another travesty. Hospital diet is a travesty. And the fact that we don't automatically tell patients if they're taking Lipitor or Zocor

to take CoQ10. In other countries, it is automatic. So that's always my base. Vitamin D has come on. Easy test to do. If you're a strict vegan, do it with mushrooms and other vegan sources. If you don't really care, most of the vitamin D3 is not vegan, but it's a healthful thing, so it's for you to struggle if it's okay or not.

I don't have any problem with it in my own body to take D3. Blood pressure, bone strength, probably mental function, diabetic control. I like a potent multivitamin in my patients. Very controversial topic. I can't go to Harvard and debate the chief of medicine and absolutely get them down in a full Nelson for a count of 10 on the topic. But a good natural-based – actually, there's a scientific theory that taking a couple multivitamins before every meal for the average American, because meals are inflammatory and meals are oxidative stress and meals are artery-unfriendly times. If you can flood your blood, either by eating a lot of greens with every meal, so that's a strategy that I teach my patients. You're not going to

eat like me, have a salad with your burger, have an avocado with your fried chicken, have a smoothie with your ribs or something. To buffer it. Acidic. Yeah, the acidic burden and inflammatory burden, oxidative stress burden. really cool science.

But a multivitamin probably can do the same thing if somebody isn't real good about all that. And the controversy with multivitamins has to do with bioavailability and the impact of these nutrients when they're extracted from the whole food and whether that really has an impact. Is that what the controversy pivots around? Yeah, it pivots around that and some science, some actual research studies that haven't been positive with even a few that have said it may be harmful. Generally low-quality, kind of artificially produced multivitamins. You know, if you're familiar with the vitamin E, there's eight kinds of vitamin E.

Every drugstore $1 bottle of multivitamins has one of the eight forms of vitamin E in it. Nature gives us eight forms of vitamin E. So better brand multivitamins will cover the spectrum and probably are much better antioxidant. Right, and when you eat foods that are fortified, like breakfast cereals and things like that, they generally have the lowest, sort of cheapest version of any of those things, right? Yeah, there's folic acid, as long as we're talking about vitamins, was a breakthrough in terms of spina bifida prevention in pregnant moms. But it is a great example of the cheapest, probably least effective form of that particular B vitamin.

And folate comes from greens. When you eat greens, you get the whole spectrum of folate. When you take it in your breakfast cereal, you're getting an artificial form of folic acid that has to go through about five chemical reactions to finally get into the body and do its work. There's actually some concern that that portion of the folic acid in your breakfast cereal that doesn't make it down to folate

may actually promote cancer, and it may be great during the pregnant phase. So all cheap multivitamins have folic acid, and all good multivitamins, if you notice, will say folate. There's a subtle difference, and the public doesn't know it. So anyways, I'm big on my cardiac patients having a good antacid and a base and a good multivitamin. And for somebody who's interested in maybe exploring supplements,

where would you go to buy these things to make sure that you're getting the quality versions? Yeah. You know, I'd encourage people, and these are all things I'm saying with no financial ties that I have. There's an organization out of Florida called Life Extension, and they have a website, lef.org, lifeextensionfoundation.org. And they have a magazine. You can sign up as a member. I think it's $40 a year, and you get a magazine once a month that is just so instructive. It's kind of like Dr. Grieg or NutritionFacts.org of the vitamin world. Is there a bias? Yeah, they sell 300 kinds of vitamins, so most of their articles indirectly reflect something they sell.

Or about how good their products are. But the science is so interesting, and that's a good source. And I think their vitamins are good um you know a lot of the the bigger chains whole food does a real good job and i think the people are real you know intelligent and other chains like that again i don't have any particular one to promote over the others but i don't think gas stations and the national chain drug stores are the better places to be buying i I mean, it's like so much. And maybe in our environment, more than ever, quality. I mean, spend more, eat less is a Michael Pollan statement.

And similarly, it probably applies to if you're spending money on vitamins, you probably ought to ask a few questions. But probably 10% of the people I see taking vitamins get that or have been advised about that. Right. All right. So quickly, what other supplements do you think kind of top that list? If we talked about briefly a syndrome, congestive heart failure, that's its own unique little

mix. Magnesium would be on my list. Magnesium for all. I mean, I'm a United States of magnesium, right? You know, if we eat tons of greens, we're getting a lot of magnesium and nuts and seeds and Brazil nuts and such, But most of us don't. So magnesium is important in about 300 really critical chemical reactions in the body that are helpful. And I see people all the time, whether it's blood pressure, skip beats, palpitations and such,

I put them on magnesium and they come back and they say five things are better, not the thing you put me on. I'm pooping and I'm sleeping because it's very good. Sleep is a big one. It really helps with sleep. And migraines get better and really pretty amazing. And it's something you can take other than maybe a dialysis patient has to be careful. I mean, anybody could take magnesium and take it for really the rest of their life. Or just bump up your green intake and you'll get down the road there too.

But it's an easy one. The heart failure patients take carnitine and taurine. I really like some of these adaptogens, and maybe your audience is familiar with that or not. Sure. The stress level in life, stress level of the extreme athlete, stress level of a person working hard and raising kids, just basically most everybody, stress in our cortisol system.

So I step out and put a lot of people on ashwagandha, a lot of people on L-theanine. Ashwagandha is an Ayurvedic herb that's widely available. Explain what an adaptogen is for those who might not be familiar with that term. It sounds magical, but when I finished lunch with Jason two weeks ago, I went to actually a lecture by David Wolf, who you're probably familiar with, and at the center he was talking, and I bought a book on adaptogens,

so I just finished it. It's the concept that there's certain herbs and plants in this world that somehow just smooth out the rollercoaster ride of our cortisol, our adrenaline, our stress, our anxiety, and without being addictive and without being valium kind of drugs, they do make you just a little calmer during the day without any sedating effect.

And they're all from the botanical world. And that's really cool. And there's just thousands of years of experience in some of the cultures and a fair amount of research. So I mentioned ashwagandha, an Ayvedic indian drug uh slasher that's been used forever but you just buy it in a health food store i use a lot of that l-theanine is from green tea lowers blood pressure reduces anxiety and stress uh people come back i use it in 89 year olds they come back i'm sleeping i just feel just a little calmer i mean it's a wonderful little

thing um cordyceps is a mushroom that's an adaptogen. I love cordyceps. Cordyceps is good stuff for adrenal fatigue and athlete preparation. For athletes, it's fantastic. And then just to finish up the conversation, probably probiotics, which I'm sure you've studied. But our guts are just being bombarded with processed foods and trans fats and sugars and antibiotics and all kinds of toxic events with lactose intolerant, the gluten thing,

which is killing our guts and causing leaky gut and probiotics, whether you get them through fermented foods, which is a wonderful way to get them, and that I've increasingly put in my diet, or whether you're taking a good quality probiotic in addition, or kefir, or kombucha, or whatever you like to do for it. But probiotics, it's a little hard to assess if somebody's feeling better with them, but it's just the science of what's going on in their gut is so strong. That's the whole conference I'm here about this weekend is gut health.

Oh, really? Interesting. It seems to really have taken off just in the last year. I started seeing articles about microbial were done you could document in patients some advantage. The hospital patients, put them on a probiotic and the CCU they'd bounce back quicker. There's a lot of reason to believe that but it's not really been studied in almost any syndrome in my field

but in so many others. Like you say, what we're learning in diabetics and obesity and depression and anxiety and ADHD and the effect of your gut flora. So go out there and get yourself a and anxiety and ADHD and the effect of your gut flora. So go out there and get yourself a good quality probiotic and eat some sauerkraut and eat some pickles and kimchi, and you'll be helping your body. I think there's this idea that probiotics automatically mean kefir or yogurt or something like that, but there's plenty of non-dairy versions.

So if you're plant-based or want to maintain your plant-based diet, that doesn't mean that you can't take probiotics. There's plenty that are available that are non-dairy. Absolutely. Just get some pickled beets and anything fermented will have billions and billions of colonies, to quote Carl Sagan. Billions and billions. Where do you come down on the sort of juicing and smoothie blending kind of concept of eating you know there's i don't know if i'd call it a controversy but there's different points of view on whether this is advisable or or healthy and i certainly

have strong opinions on it but would love to hear your thoughts well you know i really haven't hung my academic career on it uh it's so unusual for cardiologists to talk about juicing and smoothie making i'm a little notorious in detroit because I go on TV shows and I bring my blender and I bring my bullet and I bring my Breville and I kind of demonstrate sometimes. But you don't have dreadlocks. I know. What am I doing? I don't have a vegetable as my middle name.

But it's been fun and really fat, sick and nearly dead kind of gave me the push about three years ago when I watched that. And I met Joe Cross, who is just so dynamic and awesome, the focus of that cult video, a wonderful video. Yeah, for the listener who's not familiar, it was a very popular documentary and just amazing. Everybody needs to watch that. I think you can get it on Netflix or any video rental place. to me. So in terms of your question, I adapted this to some degree from Dean Ornish, but I mean, in the spectrum of Taco Bell, KFC, and Burger King to eating raw, plant-based, living food kind of diet of Brian Clements of Bacardi's Health Institute, a very broad spectrum. I think smoothies and juicies fit wonderfully towards the right end of the spectrum

as facilitators. I don't do them and I don't recommend to my patients to go do a two-month juice fast. I think it's fine for anybody to go do a three-day one, but I'd much rather see them three, four, five days a week learn to juice as a way to get more phytonutrients in their body in a simple way. I think the bullet smoothie kind of breakfast out the door, and I actually will do that too on my prescription pad. I tell them what to buy. I mean, go to vega.com. I've got to go check out your plant-based powder.

Now that I've learned about that, I need to do that on my checklist. But whatever it is, tell them to get the ingredients to make a smoothie in the morning. And I think they're all wonderful tools. You know, I'm sure some of your listeners who are deeply into plant-based living, as you do, I mean, my wife and I, we know when we're ready to juice because we just both feel it. You feel it, yeah. You know, I just, I've had enough of, even though everything we eat is on the healthy end of the spectrum, I've had enough of, even though everything we eat is on the healthy end of the spectrum,

there's just something about freshly juiced nutrition into the body that we just both feel better in 30 minutes. I mean, quite honestly, there's nothing that I do that makes me feel instantly great other than blending or juicing fresh greens. Like I can feel it immediately. And I just, for me, it's it's you know my research is done you know i know the impact that it has on how my energy levels of my mood and all that kind of thing so i guess there i mean the the argument against it it seems to me is that if you tell somebody you know go for it, then these juices or these blends will quickly devolve into coconut ice cream and peanut butter. And, you know, they become very calorie dense. And people don't realize how many calories they're taking in when they're drinking this stuff. If they're not doing it, kind of, you know, making sure that it's, you know,

kale-based as opposed to dairy-based or something like that. I mean I think that's part of it. And then there's this other argument that is kind of part of the Esselstyn perspective, which is that you're not masticating your food and so you're not giving your body the chance to properly digest these nutrients. I mean is that fair to say? Yeah, there is a couple comments on chewing. And one is that there are people that advise you chew your smoothie and you chew your juice just like you see some wine connoisseurs

chew their wine as they sample it. But there is a very powerful process of chewing and activating salivary fluids that certainly when you're eating whole foods and plant foods, digestion begins in the mouth and chewing and taking time really does aid grabbing all the nutrition out of plant-based eating and starts that pathway to nitric oxide and better artery health. Very interesting pathway beginning in the mouth. our artery health, very interesting pathway beginning in the mouth.

And I can't tell you that I know that I chew my juice in my smoothie, but my smoothies can be pretty crunchy with all the cacao nibs and everything. So I've not heard Dr. Esselstyn, you know, speak specifically on that, but you can fall into a trap of very high-calorie, dense smoothies, and you've just got to educate people to stay away from 1,200-calorie smoothies for breakfast. They're not going to achieve their maximum potential. And that argument itself is smoothie better, there's juice better. I mean, I can't resolve that. I think they're both great tools in a sort of difficult society to try and grab good nutrition.

So I'd love to be able to do both. Right, right, right. Yeah, I think that people grab onto this argument. Meanwhile, they're eating a terrible diet. It's sort of like, well, watch Fat, Sick, and Nearly Dead and see these incredibly dramatic health turnaround, and there's something going on there. So anyway, watch that movie. Experiment on yourself, I guess i guess i agree it's the best thing you can do um a couple other things you know one of the other questions that i get all the time is you know why why are you you know

why 100 plant-based like what's wrong with moderation like why can't you know why don't you just go and have a steak every once in a while? Or what's wrong with that? You know, and I feel like what's really behind that question is tell me that what I'm doing is okay or give me a compelling reason why it's not. Like, why do I have to be 100%? Or, you know, I guess my question really is, you know, how do you deal with the moderation issue? A couple thoughts come to mind. One is, I mean, if you're coming at it from the ethics, there's never going to be an acceptable time to torture an animal

and confine it to the kind of terrible existence that it's going to have in the majority of animal farming that occurs in this country around the world. It just can never tolerate it. And if you're coming at it from the environmental standpoint, you'd probably come to the same conclusion with 10 billion people on our planet. Pretty soon we're not going to have any room for using all the lands for grains for animals. We're going to need them for human beings and grains and grasses and such. From a health standpoint, I'm pretty soft on my patients.

I'm looking for change. I'm looking for progress. I'm looking for progress. I'm looking for advancing down that spectrum. And some of them will jump right to the end point and be a disciple of Dr. Ornish pretty quick. And if they've got serious heart disease, I'm pushing them to make that decision pretty quick. But for the average person, there's that phenomenon now, a book called Vegan Before 6, VB6. Yeah, Mark Bittman's book. Mark Bittman.

I mean, would the world be a better place if there was a widely adopted strategy? We'd be two-thirds of the way there in terms of both health and environment and animal rights and the whole thing. I don't know for sure that two or three meals a week that fall off what you're doing and i'm doing are necessary i mean it's so much better than the average right you know three meals a day with cheese and three meals a day with meat and uh certainly every meal with dairy uh as a main liquid i mean it's so much better that i give people some permission on your birthday and on your special days if you need to now as you know and i know when you make that transition from the unhealthy vegetarian and vegan with soy hot dogs and chick nuggets and

soy ribs and when you really get into whole food single ingredient plant-based eating i don't want those things anymore and i don't see my patients making that transition yeah i think you have to um you know what i always say listen, just – if you started your morning every day with a kale smoothie or a kale Vitamix blend or like a green – something green as opposed to bacon and eggs, if you just made that one shift, you'll start to feel different. And then you're on your own path. You'll start to connect with your body more and then you're going to start to want to, you know, incorporate better things in your life and you have your own journey, you know. And for a lot of people, that's the best way to do it. But I think also if somebody says, well, what's wrong with moderation? I think a lot of times people's idea of, you know, moderation isn't reality. Like I'm like, all right, well, let's talk about like, let's map out exactly what you're eating on a daily basis.

And let's see if that actually is moderate or isn't it. And more often than not, it's actually not that moderate. A food diary can be. And I sympathize. I'm not like being holier than thou about it. Like I'm, you know, I have, you know, harbor great denial for many years about lots of my habits so yeah oh i agree and no i don't know that every listener on your show is already on

the vegan end of the spectrum but i already mentioned a strategy that i find appealing which is you know if you're not ready yet to make the transition just be sure just like the american food plate from the government says half the plate is fruits and vegetables and half the plate is other things, protein and grains. Strive for that. If you're going to have a burger, be sure there's a tomato and a lettuce or a slice of avocado. This really cool study came out in March that a hospital-prepared hamburger

caused arterial damage within two, three hours like the Egg McMuffin study of 15, 16 years ago. And a thick slice of avocado in the burger repeated study did not cause the same degree of arterial damage. And other studies have shown antioxidant vitamins. Other studies have shown a glass of green juice with a meat-based meal. So there are some strategies as you're making your journey. And they're all going to result in the same equation, more vegetable, more vegetable, more vegetable, even if you haven't reduced your animal load yet.

Yeah, or you can just skip the burger and then you don't have to worry about it. And then they're going to feel as good as you feel like. That's right. We don't want that though. We can't have everyone signing up for Ultraman. A revolution of wellness breaking out. That's right, man.

What are some of the other kind of common things that your patients come to you and they struggle with in terms of changing their habits or the kind of common pitfalls and how you address them? Well, probably in the lifestyle arena, time for exercise, commitment to exercise is a big one and uh a lot of them aren't going to find 45 to 60 minutes four or five times a week to make kind of the magic 150 to 250 minutes a week the american heart association talks about so i mean this uh i don't know if your readers know but they're kind of the tabata protocols these high intensity shorter exercise protocols that have got some science behind them um telling them that you know a couple times a week if you just got 15, 20 minutes and kind of instruct them what the protocol is. Dr. Tabata, a Japanese cardiologist, I mean, 20 seconds, kill yourself.

10 seconds slower, 20 seconds, kill yourself. That's proven to be a good recommendation that a lot of them adapt. recommendation that a lot of them adapt. I'm recommending yoga as a therapy that just is scientifically proven to lower blood pressure, lower heart rhythm abnormalities, help with cholesterol control, and just seeing people blossom as they get into some of these Tai Chi, if they're a little less physically able. Tai Chi has been studied in cardiac patients as absolutely a wonderful way to lower stress and lower blood pressure. So those kind of things have been very helpful. I mentioned earlier infrared sauna. It's kind of like a hidden jewel out there. The Japanese

have studied these special dry heat saunas that have ceramide kind of heating elements. They're not the typical little box in the corner that some of us grew up with in dry saunas. But spending 15, 20 minutes at high heat, even if you're a very sick cardiac patient, and then wrapping yourself in a towel and cooling off for half an hour actually has some of the same beneficial effects on arteries as a big glass of green juice. Very beneficial.

Interesting. I've never heard that before. Yeah. There's probably 25 scientific studies out of Japan that are well regarded. And it's something that for under $1,000 or a couple thousand dollars, you can actually buy a nice infrared sauna for your home. Many places, I'm sure, around L.A., for $20, half an hour, you can go in and see one.

Now, if you're a cardiac patient, you probably want to – I can't tell you to check with your doctor because i doubt your doctor will have any clue about it i wrote an article about it on mind body green earlier this year i'll put a link in the chat on infrared sauna but um it's not a new age it's uh it's right in the mainstream of medicine it's just a hidden pearl so that's one fun one yeah so what is it what's what is it that makes it different from a typical sauna? Infrared sauna is dry, but the wavelength penetrates the skin much deeper with the heating element. So you actually heat up internally pretty quickly. And the protocol for cardiac patients, the sauna is already at high heat.

You go in for 15 minutes and you're done. So it's a quick entry. And, you know, unlike the signs on many saunas that cardiac patients shouldn't participate, particularly the kind of whirlpool, this has been studied. There's actually a fascinating study from Japan that actually suggests lifespan is enhanced by people that one, two, three times a week spend 15 minutes in this high-heat infrared sauna. So what is it biologically that's occurring?

Yeah, there's some data that it reduces inflammation and then endothelial function, the actual health of your arteries. Like I say, you don't have to necessarily clean every bit of plaque out of your arteries, but you do want your arteries to have healthy response to stress by relaxing and not clotting. Elasticity. Elasticity. And actually infrared sauna, they've studied that and it improves endothelial function along with the rest of the healthy lifestyle spectrum.

I mean you hear, as an athlete you hear, well if you want to reduce inflammation get in the ice bath. So what is it? So ice bath helps you recover more quickly, helps the muscles repair. So how does that mesh with the heat? It might be that difference between acute injury and acute inflammation and most of these chronic diseases.

Oh, like chronic low-grade. Chronic low-grade inflammation, which characterizes most heart conditions. So maybe we're not looking to immediately suppress a sore knee from a 100-mile ride. Right. Just trying to get those arteries a little bit more flexible. Gotcha. Interesting. And talk to me, let's talk a little bit about mindfulness and mindful eating.

Explain what that is. Yeah, you know, so we haven't talked about it during this interview. You know, the one experience that's often pointed to, there are these things called blue zones. Dan Buechner, a writer for the National Geographic, published that book about five years ago and looked at societies where people live on average longer than anywhere else in the world. Just fascinating research. Okinawa, an island in Japan, of course, is the longest-lived society in the world.

On average, more people over 100 than anywhere else. And they live by this principle that haribachi-bu, that you should leave the table 80% full, not 100% full, or not like most of us, 150% full. And, of course, you can't ever possibly get to a habit of leaving the table 80% full unless you're mindful about it and thinking about it and evaluating both your hunger level when you last ate habit of leaving the table 80% full unless you're mindful about it and thinking about it and evaluating both your hunger level when you last ate and what's on your plate and the size of your

plate and the size of your fork and the size of your spoon and all the rest. So mindfulness has been now something that's been studied by some very interesting food psychologists, Brian Wonsek and David Kessler, a former head of the FDA, in a book called The End of Overeating. And it's strategies to sit down at a table with a sense of gratitude, perhaps with a moment reflecting on how the food got on your table and be thankful for those that did that. There's times in our lives we're going to be able to achieve that kind of highest level and times that we're probably not going to be so focused.

to achieve that kind of highest level in times that we're probably not going to be so focused. And, you know, not rushing through every meal with standing up while doing other work and with abandon, just being aware that food is such a fundamental healing element in our life and being aware of that start to finish. Part of that is chewing, and chewing is a strategy. Some people refer to it as chewtism, the kind of religious approach that's slowly and gradually digesting food and chewing forever, and everything can be taken to an extreme. But being just in my tradition of religious background,

there's a prayer said before every meal. And of course, there's many other religions that do that too. And that's just introducing a bit of mindfulness that this is a little different than brushing your teeth and clipping your nails. A meal is a medical event, a healing event, a life celebration. And if you can think about that once in a while, it may transform your life to better choices and maybe less calorie ingestion. And some of it are tricks. And I mentioned in the article, they're not research I've done, but eating on a smaller plate, eating on a salad plate, not a dinner plate, eating with a salad fork or a soup spoon, a teaspoon rather than a soup spoon,

has been studied. And you will eat a little bit less and a little bit slower and it's an easy thing anybody can grab onto right now yeah I mean the thing with me is if it's on my plate or in my bowl like I'm finishing it you know what I mean like doesn't matter how much is in there like and I don't think about it you know I just it's not done yet I have to keep eating until

it's all gone so for me it is you know I have to check myself to say, do I need to put this much on my plate or, you know, what am I actually doing? And, you know, I would say most of the time I'm on autopilot with that. Like you have to really marshal your consciousness to pay attention to that because, you know, I'm not wired that way and our society is not wired that way. It's all about fast and cheap and quick and get it done so you can move on to the next thing. No question.

Another just super easy strategy because so many of us eat meals out in restaurants all the time, and the size of meals have just gone bananas, is to just ask right from the front, give me half the meal and pack half up when you see it's one of those platter meals. We just had our first cheesecake factory open in Detroit, and it's one of those platter meals. We just had our first Cheesecake Factory open in Detroit, and it's being celebrated like we have just. Why did it take so long? They couldn't find the right real estate because there were people lined up. Plenty of real estate now.

People lined up around the store for days to be the first people in the Cheesecake Factory, and they have a 2,100-calorie meal or something. So if you're going to go do that, you're going to have enough food for a week. Ask them to box up half of it, and then you have two meals, but not in one setting. So that's a simple strategy. Half the meal at Cheesecake Factory is still twice the meal you need, probably. I don't mean to pick on them specifically,

but that's from my hometown been the talk of the town lately. That's interesting. They pretty much win the calorie lately. That's interesting. Yeah. And they pretty much win the calorie per meal award pretty closely. Except for, what's that restaurant, the Heart Attack Grill? Yeah, yeah. They've had a little controversy lately. They've peaked, and I think Darwin is having his time with that.

It was too gross to really exist. Yeah, I think two people have died now. There was a guy sort of recently who had a heart attack. After eating, what is it they challenge you to eat this preposterous cheeseburger? The triple bypass, the double bypass,

the single bypass, and if you're over 350 pounds, you eat for free. Just this pridefulness over doing something that's so horrible for you. Where does that come from and what does that say about where we're at and what we think is okay and fun.

Another addiction. Your work is that you'll be employed for a long time. I'm not too worried. Just like healthy airports, there are glimmers of hope all over the place. Not time to rest yet. How is your interaction with other cardiologists in your field that are maybe a little bit more traditional? Do you get resistance?

Are they interested or curious about what you're doing, or how does that dynamic function for you? Well, you know, I see an impact. dynamic function for you well you know i see an impact um medical partners in practice that i've had 20 years ago saw me eating in the doctor's dining room from the salad bar or garden burger or something um which wasn't the norm we was french uh french fried macaroni and cheese was the norm in the doctor's dining room and still shows up once a while but most of them i've seen them you know look at, the revolution has started, and you can't help but know that this is important and much more obvious than it was. So I see a lot of them.

I never got real derision, but I was an odd bird, and now I'm not so alone in my activities. We actually have probably three or four vegan cardiologists in the city of Detroit, which is refreshing. But, frankly, if you ask me do I know any other vegan physicians, I don't think I can name a fifth one. They just happen to be all cardiologists. But in my physicians that send me patients is I add in vitamins and all

because it's an area that's controversial. They haven't called me to task, but I'm pretty mindful, using that word again, that I'm trying to balance my medical knowledge and what's right for patients and not get the reputation as the herbalist who has lost. I mean, I live by a statement, be open-minded, but not so open-minded that your brains fall out. And so, I mean, I'm careful both because I still believe there are attributes of Western medicine that we don't want to throw away.

But it's a tight walk. But honestly, for anybody who might be listening now in the health care fields, the growth industry is in the wellness sector and the excitement is in the wellness sector and the right answer is in the wellness sector. So, I mean, don't shy back. It's not 1980 anymore. It's not your grandpa's Buick.

It's our Cadillac. It's the time to get educated in functional medicine, root causes, lifestyle medicine, and know the tools that are available. And I think we're going to see really great results coming out of all this. Prevent, not stent.

Prevent, not stent. That's right, baby. Good, man. Well, that was great. Thank you. I think that was a good place to wrap it up i think it's fine call to action i mean i really do believe the revolution is beginning i mean in the medical world i'll just say as we and i do want to thank you for this but i have um being very self-honest ridden kind of a tight rope about how crazy to be in this and yet maintaining what I think

is a very excellent reputation in my town and still invited to speak at standard academic events and wacko juicing events and all the rest. I mean, I've had the pleasure of speaking with Dr. Asselstyn and Dr. Campbell and John Sally, NBA vegan extraordinaire and such, and I've had the whole spectrum. But maintaining that balance. But it's time for us to take all this knowledge and start demanding change in the medical world for sure. Absolutely. And I've got enough gray hairs on my head that I just can't tolerate it anymore. Can't wait any longer.

I've got to grab my colleagues around the country and say, you know, this needs to change for the right message, for the honest message, for the ethical message, and most importantly, for the best outcome of patients. So I think we'll see in the next 10 years juicing bars in hospital lobbies and smoothie bars in hospital lobbies. And, you know, and hopefully the sweet bar is gone. And we had Ben and Jerry's in the hospital for five years. I won that battle. Ben and Jerry's shouldn't be in the hospital lobby just like McDonald's. So I think we're going to see some good changes.

But anybody out there, let's start it up. Yeah, it's all about we got to do it together. Yeah. You know what I mean? And, you know, you are changing lives and you are an inspiration in your field and with the people that you work with. I applaud what you're doing, and I think it's really important for people like yourself who have an MD or have stature in their community to look at the science and also look at what's working and what's not and translate all of that and communicate that in a way that's accessible to people, you know, in a trusted source like yourself. So it's powerful. And, you know, that creates a responsibility for you, too.

And you're acquitting yourself quite well on that. So thank you for what you do. Thank you. It's been a pleasure. Yeah, absolutely. So if people want to find out more about you, your website is drjoelkahn, right? Is that right? drjkahn, K-A-H-N dot com.

Yeah, right. And where else can people find you if they want to? Well, MindBodyGreen, they can search your name. You've written like 25 articles on mindbodygreen.com. You got it.

I've got another one coming out this week. It'll be, I think, a popular one. But yes, MindBodyGreen would be great. I will in february actually starting in october i'm very grateful readers digest has named me america's holistic heart doc and i'll be nice congrats very excited we'll be having a monthly column i just swing that well i have a book coming out by readers digest in february okay cool so what's i wanted to i wasn't going to leave without talking about the book so tell me what it's called and what what's going to be in it as of this moment i would say it's going to be called

heart doctor secrets that's kind of the orientation uh peeling the onion about starting with nutrition and fitness and mind body and supplements and sleep and on and on um but it's it's within the medical tradition it's just little pearls that haven't really been emphasized but are part of the equation. And, you know, people can pick and choose whether they're patients or just healthy people, some new habits. I think it's going to be a fun book. I just didn't see another book out there. There's not going to be recipes. I'm not doing Dr. Ornish's work or Dr. Esselstyn's work.

But it's got a strong vegan voice to it and a lot of mind-body. So I'm very excited that it'll come out. That's great. It's coming out in February? February 2014. It's coming up? Yeah, it's coming up. It's been until my wife last year.

She's been beating on me, writes something. So I've got to set a deadline, and I've got it done. Hopefully you'll come back on the show when the book comes out. Okay. We could talk a little bit more in depth about the book if you're open to that. I'd love to. That'd be good. That'd be great.

Cool. And if you're in Michigan, people should just make an appointment with you and come in and see you, right? I think they should. I have offices everywhere. Yeah, you do. You're monopolizing the greater Detroit area, aren't you? Do you have offices outside of the Detroit area too? No, suburbs.

Yeah, they're in the suburbs around Detroit. But nobody's too far away from me. I've kind of franchised my practice around that. Yeah, that's great, man. Well, thanks for taking the time. Okay. Anything else you want to say? Feel good?

Hi, Mom. Love you. All right, good. We'll end it there. All right, everybody. Thanks. Peace. Plants. Thank you.