The Rich Roll Podcast - Is Butter Really Back? Heart to Heart with Cardiologist Joel Kahn

Episode Date: February 2, 2015

America's #1 killer, heart disease currently kills 1 out of every 3 Americans; 70% of Americans are obese and getting fatter; and Studies forecast that by 2030, 50% of Americans will be diabetic or pre-diabetic. The great irony in all of this is that, as Dr. Kahn so astutely points out, 80-90% of all chronic health problems can be resolved via pretty simple diet and lifestyle alternations. The tricky part is translating these lifestyle alterations from theory to practice. I understand that it can be difficult for many, particularly when there is so much confusing information out there concerning about heath, nutrition and diet. So confusing in fact, that it becomes incredibly challenging for even the most savvy consumer to separate fact from fiction and truth from hyperbole. Just because good news about bad habits makes for tempting clickbait doesn't mean the information is reliable — its usually not. To help sift through all of this, I once again sit down for a heart to heart (pun intended) with cardiologist Joel Kahn, MD — you can listen to our first conversation (RRP #44) here. A Summa Cum Laude graduate of the University of Michigan's prestigious Inteflex program (a 6-year undergraduate / graduate program that developed doctors fresh out of high school), Joel has served as Clinical Professor of Medicine (Cardiology) at Wayne State University School of Medicine since 1993. He's authored over 130 articles on heart disease, is a frequent lecturer on heart disease and its prevention, has performed thousands of cardiac procedures, and has been advising patients on heart healthy programs for over 20 years. Not only does Dr. Kahn know what he is talking about, his basic message is elementary: if you want to experience true long-term wellness, then you must focus on implementing sustainable long-term preventive protocols into your lifestyle. This starts and ends with diet and active lifestyle. The specific thrust of this conversation focuses on separating truth from marketing with respect to certain zeitgeist trends in nutrition science. To wit: Is butter really back? What are the health impacts of a low carb / high fat diet? What are the risks (and benefits, if any) of trendy practices like putting butter and oil in your morning coffee? Is everything we thought we knew about saturated fat truly wrong? Who was Ancel Keys and what is the import of his nutritional studies? What is the true impact of dietary cholesterol on arterial and heart health? Finally, and most importantly, what specific dietary and lifestyle protocols does this veteran cardiologist recommend to maintain optimal heart health in a culture in which heart disease has become a wildly out of control pandemic? You'll want to tune in to find out. Amazingly informative, this is straight talk from a solid guy. An awesome and trusted and educated and experienced and entertaining guy I am proud to call my friend. I sincerely hope you heed the call and enjoy the conversation. Peace + Plants, Rich

80% of chronic diseases that are causing our country a fortune, causing people to lose relatives and lose limbs and lose loved ones and work interruptions and all kinds of tragic situations are entirely preventable by simple, inexpensive lifestyle steps. That was Dr. Joel Kahn. And this week, it's all about heart health on episode 128 of the Rich Roll Podcast. The Rich Roll Podcast. Hey, everybody. I'm Rich Roll, your friendly neighborhood ultra endurance athlete, bestselling author,

wellness evangelist, husband, father of four, dog owner, plant eater. Thanks for tuning in. What do I do here? Well, each week, I sit down with somebody really amazing. Sometimes it's somebody you've heard of, sometimes not. But collectively, in my opinion, together, these people constitute some of the brightest, most forward-thinking minds in health, wellness, fitness, sports, nutrition, and sometimes even the arts and entrepreneurship. All people looking at the world differently, all challenging the status quo, breaking paradigms. Why do I do this? To help you discover, uncover, unlock, and unleash your best, most authentic self. Thanks for listening. Thank you for spreading the word to your friends, to your colleagues,

to your coworkers, to your family members on all your social media networks. And thank you for clicking through the Amazon banner ad at richroll.com. Come on, you guys, what's up? If you're not doing that, get with the program. It's totally free. It takes no extra time. It does not cost you a cent extra on your Amazon purchases, but Amazon kicks us a little loose commission change, and that really helps us out, helps keep the lights on over here. So thank you so much to everybody who's been doing that. everybody who's been doing that. We're brought to you today by recovery.com. I've been in recovery for a long time. It's not hyperbolic to say that I owe everything good in my life to sobriety. And it all began with treatment and experience that I had that quite literally saved my life. And in the many years since, I've in turn helped many suffering addicts and their loved ones find treatment.

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and recovery.com is your partner in starting that journey. When you or a loved one need help, go to recovery.com and take the first step towards recovery. To find the best treatment option for you or a loved one, again, go to recovery.com. All right, you guys. You've heard me say it a million times. Despite all this interest, all this intrigue out there that's revolving around wellness and health and diet and nutrition and fitness, the simple fact remains that in the United States, at least, we are in the midst of an almost unspeakable health care crisis. Let's look at heart disease, America's number one killer.

Well, heart disease kills millions of people annually, millions. In fact, one out of every two Americans will suffer from some form of heart disease in their life. And one out of every three deaths in the United States is attributable to heart disease. 70% of Americans are obese and indications are we're getting fatter. And studies forecast that by 2030, 50% of Americans will be diabetic or pre-diabetic.

So right now, what does this mean? Well, 75% of all healthcare costs are attributable to just four chronic conditions, heart disease, obesity, diabetes, and two forms of cancer, prostate and breast. And the great irony in all of this is that 90% of all chronic health problems can be resolved by a pretty simple diet and lifestyle alterations. But here's the tricky part. Amidst all of this is a ton of confusing information about health and nutrition and diet. And it's really difficult, if not altogether impossible, for even a very, very savvy consumer to separate fact from fiction, to separate truth from hyperbole, to divine the difference between good information on the one hand and good news about bad habits on the other hand, because those are two different things. So today to help me sift through all of this, I sit down with my good buddy, Dr. Joel Kahn. If you're a long-time listener of the podcast, you might remember that I had him on the show. It must have been

a year and a half ago. It was episode 44. So if you want his whole origin story, go back and listen to that episode. But real quick, who is Joel? Well, Joel is a guy who calls himself an inter-preventional cardiologist. What does that mean? Well, it is a guy who calls himself an inter-preventional cardiologist. What does that mean? Well, it means basically that he treats his patients with a blend of traditional interventional cardiology, in other words, things like stents, and also preventive cardiology. And it's this rare combination that makes him pretty unique in his field. This is a really smart guy. He graduated summa cum laude from the University of Michigan's prestigious InnoFlex program, which is this crazy six-year undergraduate slash graduate program that

basically develops doctors fresh out of high school. It's like you graduate from high school and you're immediately in medical school. And Joel has served as clinical assistant professor of medicine and cardiology at Wayne State University School of Medicine since 1993. He has authored over 130 articles on heart disease. He is a frequent lecturer on heart disease and its prevention, and he has performed thousands of cardiac procedures and has been advising patients on heart healthy programs for over 20 years. So what am I saying? Well, basically, I'm saying, Joel is a guy that knows what he's talking about. And his basic message is, look, if you want to experience true long term wellness, then you're going to have to focus on implementing sustainable long term preventive protocols into your lifestyle. And this starts

and ends with diet and active lifestyle. This is not brain surgery, you guys. But today, the main and really the specific thrust of our conversation is focused on what is really going on in nutritional science. What is truth and what is marketing? In other words, or for example, is butter really back? And what are the health impacts of a low carb high fat diet versus a plant based diet? What are the risks? And what are the benefits, if any, of hyped up trends like butter and oil in your morning coffee? What is going on with this idea that suddenly everything we thought we knew about saturated fat is wrong, and now suddenly it's our best friend? And this related idea that dietary cholesterol intake has no bearing on heart health. This is like the new

idea that's out there right now. I really wanted to get his opinion on this subject, as well as his opinion on the optimal protocol to maintain heart health in this culture in which heart disease is literally an epidemic that has already spiraled far, far out of control. So this is a good talk. It's straight talk. Joel is awesome. This one's not only educational, it's completely fun and as well as informative, and I hope you enjoy it. So let's tap into Joel and see what he's all about. So this is a unique situation. I checked my Instagram this morning. I noticed my good friend Joel Kahn happens to be in Los Angeles for unknown reasons. You're greeting the sunrise in L.A., so what do I do?

I immediately email you and go, what are you doing here? Are we doing a podcast or what? I'm in the witness protection program. I'm not actually privy to explain why I'm in L.A., and I'm using a pseudonym. Well, I mean, Detroit this time of year, you've got to escape. And look at this terrible weather that you brought with you. I know.

Shame on you. I sadly rented a Mustang convertible thinking I was going to be the big stud going up and down 405. But big stud had the top up, unfortunately. Yeah, yeah, yeah. So this is cool. This is our second time on this little merry-go-round. And thank you for making the time. Usually I sit down.

I do a lot of deep thinking, pondering what the podcast is going to be, plenty of research, but this is all very spontaneous. I want to talk about what you were doing earlier today, but you drove up here. We're kind of having a little bit of a, not a party, but we have some friends over, some of which you know, actually, and we're just all hanging out. We're like, hey, let's do the podcast. So this is a Saturday night at the Roll Household. So welcome. I'm doing lines of cacao. I've never quite seen that done before, but I'm feeling good.

Yeah, good. All right. Well, if you start to see stars or slur, we'll adjust. No problem. Yeah, but you did sign the release, right? It's all good. Cool. So you came in town to you were speaking this

morning at saddleback church right you got it tell me about that yeah it um there's a great story that about three and a half years ago pastor rick warren who uh is famous for a lot of good things and a book he wrote that sold 35 million copies did he sell that many 35 yeah i think it's the best-selling book other than the Bible. Really? Something like that. Wow. Even bigger than Grain Brain and Weed Valley. But

the story goes that he was baptizing 850 people one Sunday about three and a half years ago and dunking them and bringing them out of the tub and he realized that not only had he become quite corpulent, as they say, but his church was oversized and his shoulder was killing him. And he had this vision that he had to clean up this 30,000 mega church and introduce good health.

So long before I knew of that, he brought in Dr. Oz, Dr. Mark Hyman, Dr. Daniel Amen, and some others. Got a director by the name of Dee Eastman, who's just a doll of a human being. And really, they created a vision that they were going to use this church as an experiment in lifestyle change and behavior change. What they had, which was awesome, they had about 10,000 small Bible study groups all over Southern California. small Bible study groups all over Southern California. And they institute a program that some portion of every Bible study group had to be dedicated to cleaning up your diet, your exercise, stress management, better sleep, with a formal curriculum called the Daniel Plan, which a lot of people have heard about. And in that first year, some excess of 250,000 pounds were lost by about 16,000 of the congregants signed up in the first week.

So just as mass action. How long that was? How many years ago was that? About two and a half years ago. And then they had such a remarkable success with this kind of lifestyle change plan, kind of, you know, food being the focus but not the only component. In fact, they talk about food, fitness, focus, friendship such the five f's the five pillars um that they've developed a yearly health rally just to kind of keep people on track and focused and all so i came out as a guest last

year and participated a little but i got to be on the stage the dais uh for any of my Jewish friends, the Bema. And as someone of the Jewish persuasion being in this, I mean, it's like a mega church, right? I mean, I've never been inside it, but give me an idea of how many people are there. This dais is enormous. Yeah, well, I understand there's multiple sites for Saddleback Church. This is the main site in Lake Forest, California.

And it's in itself a huge complex. I mean, kids centers and ministry centers and all. But we were in a room that probably holds about 3,000 or 4,000, and it was packed to the roof. Incredible stage. And it was about a three-hour event celebrating health. And we had four chefs on stage. That's the part I did.

I was the John Madden of color kind of conversation. It was kind of fun. Mark Hyman spoke for a while about clean diets, and Daniel Amen spoke about good brain health. But I was working with the chefs, and they would basically show a before and after, what's in your pantry now, what's in your refrigerator, what can you substitute. And I got the job of being the person to destroy the bad food so i was jumping on bags of lucky charms in front of the church congregants you know that's what i trained for in medical school the funniest thing was i was handed a box of lunchables and a chance to talk about how wonderful that highly processed food

that most kids eat for lunch nowadays in school. And it inspired me that I should just throw it on the ground and just destroy it. So I jumped on it with my full force, not knowing it would just explode all over the front row, kind of like Nickelodeon and the goop. This is your Broadway moment. Now I know why you're really here, right? The former entertainment lawyer in me is coming out, and I'm going to squire you into town tomorrow

and find you an agent. And your career is about to take a whole new turn, Joel. We're going to be destroying processed food, kind of like Led Zeppelin crashing guitars. So it was a great event. I mean, they do great stuff down there. Cool. And so who else?

So Mark Hyman was there. Who else was speaking? Daniel Lehman. Dr. Oz was involved in originating it, but he doesn't come out very much. And then a tremendous fitness team. There was, you know, dancing and Zumba going on. And a couple of behavioral psychologists were speaking. John Townsend wrote a book called Barriers. wrote a book called um barriers uh really good advice about how to kind of control yourself and control your kids with reasonable reasonable approaches to them so just you know it's a it's fantastic this is occurring in a church and i give these people amazing credit my connection was i did the daniel plan in my synagogue in detroit we were the first jewish faith-based institution to

kind of use their system and what i mean what is the what is the daniel plan like how do you synopsize that um eliminating bad putting in good in terms of both food and fitness and positive mental focus for change so i mean the core elements would be eliminating dairy eliminating processed food upping your fruits and vegetables i mean mean, most of it is completely, you know, wonderful stuff. But it's fascinating that it's coming out of, you know, faith-based community as opposed to why isn't the hospital doing this? Why isn't a medical center as involved in the community as this? So I think it's tremendous and I'd support as they are trying to spread the word and have this reproduced all over.

Yeah, it's super interesting when you can see that kind of impact happening on a community level coming through an organization like that. I think it's really cool. First the Pope, you can see what the Pope's doing, and now see what Rick Warren's doing. What's going on? Yeah. Unfortunately, Rick was there last year. He actually, all that baptizing, he had to have his shoulder operated on last week. Oh, really?

And even though his community has gotten a bit thinner and it's a bit easier to pull him and put him out of the baptismal, he had to actually have some kind of surgery. So we wish him well and a quick recovery. Interesting. Well, I haven't seen you since the MindBodyGreen Revitalize Conference,

but you're looking well. You're looking fit. It's a lot of chlorella. Yeah. It is a lot of chlorella. Well, that prompts a spontaneous question out of me. Like I Instagrammed like, oh, smoothie of the day. And I said, oh, this one happens to have spinach in it, hemp seeds, chia seeds, blueberries, strawberries, and spirulina. And I got a bunch

of comments about like, I got to watch out with the spirulina. So tell me what's going on. Yeah, there's been some contamination. Even our good friend, Dr. Joe McCullough has written about it. I mean, it's been out there in the web that some sources in Asia of spirulina have been contaminated, I think, with a fungus. There's some toxicity issue or something like that. Yeah, exactly. Yeah, I think Dr. Greger did a video on it as well, which I should go and check out. But people were saying, yeah, you might want to opt for chlorella, not spirulina.

Yeah, there's been that word. I actually can't give you the latest world's update on if our spirulina sources are now clean. I actually do take spirulina pretty regularly also. Yeah, I have been for some time, but now I'm worried. You're looking pretty good. You saw what I wrote. I don't feel toxic. You saw my comment.

What was my comment on your Instagram? I don't know. What was it? You're looking kind of 18 for a guy that's 48. Oh, yeah. Now I remember. How could I forget that? Yeah.

Thank you. Yeah. And now here you are doing a podcast. How does that work? Who would have known? Mysteriously, right? That's right. And how's the relationship with Dr. Hyman?

Because I know the last time I saw you, like I said, at Revitalize, you were kind of doing this program with him where it was sort of vegan versus paleo, and it was you and Dr. Hyman and our friend Frank Lippman, who has also been on this podcast. You guys had a jovial kind of banter, and now you're doing events with him. Yeah. No, Mark's been a mentor, Dr. Mark Hyman, to me. And he's a force.

He's tremendous. I mean, if you take the view that highly processed food is creating the obesity crisis in America and job number one is getting rid of, you know, the team of PhDs that are making addictive and hyper processed foods that dominate what kids are eating and adults are eating. We're all one team because, you know, the Daniel plan's a clean diet in terms of that. And so is everything that Mark writes about. What he's doing now and is really fascinating is you may or may not know he's been appointed the head of functional medicine for the Cleveland Clinic. I did know that. I had a chance to talk to him about it.

And there are amazing things that they're supporting it financially, just incredible. So again, we're talking about getting into kind of the grassroots uh causes of disease which is going to go to nutrition and fitness and stress and sleep as opposed to just giving a pill for everything or getting a laser and operation for everything and um i think you're going to see a great model coming out of there the medical system has to change it's just unbelievably unbelievably locked into the idea that we got 10 minutes with a patient and the easiest thing to do is prescribe something as opposed to kind of address the root cause. So I hope he's wildly successful there. Yeah, I do too. And I think that brings up a really important point, which is,

you know, let's focus on the big things. You know, we can get into the debate and split hairs over, you know, high carb, low carb, high the debate and split hairs over, you know, high carb, low carb, high fat, low fat, all these sorts of things that we love to kind of obsess about. But let's, let's bear in mind that, you know, I don't know what's going on now, but I think there was a McDonald's in the Cleveland clinic. And, you know, most people are eating fast food on a, on a regular basis and, and really don't even have, you know, the first aspects of education when it comes to the kind of things that we're talking about. So I think it's much more productive to focus on how we're going to all get together and, you know, in the sense of community, which

is how we kick this podcast off, start to talk about and address these problems and solve them together hand in hand, as opposed to bickering amongst ourselves over, you know, this aspect versus that aspect. Well, I agree. I mean, from, you know, you and I are of one mind when you talk about the environment, you talk about animal rights and animal cruelty. There's only one approach you can really take if you want to be consistent and authentic there. you want to be consistent and authentic there. But when you get to health and what's happening and you put on blinders about those two critically important issues, you know, there are multiple pathways to health that appear to work. And the unifying statement is we've been just, you know, led down a path of unbelievably

horrible food for 60 years and it is epidemic and it has to turn around. And if the Cleveland Clinic and the CEO, there's a cardiac surgeon and he's just like supporting this to the max, which is such a rare example, but I hope other hospital CEOs take note and play catch up because we need it everywhere. Right. Right. Interesting. Right. For sure. For sure. And then, you know, so, so there is that kind of on the, you know, the mass level. But, you know, I'm also trying to parse through like all this stuff that's going on with nutrition right now. And I've been known to email you from time to time like, hey, I'm hearing this. What do you think? And one of the interesting kind of email chains that I've been lucky enough to be on with you recently has to do with something

that's going on right now that's really popular, which is this idea that, you know, per the cover of Time Magazine, that butter is back and everybody's drinking bulletproof coffee with MCT oil or grass-fed butter in it. And that this idea that saturated fat is bad is not true. Saturated fat is your friend. And that cholesterol does not contribute to heart disease is, in a most general sense, is it fair to say that those are ideas that are popular at the moment? And they fly in the face of what I was led to believe was the truth. And so I would reach out to you, Hey, what do you think is going on here? What, you know, what's the truth. And if you go online and research it, you're, you can find support for whatever perspective, you know,

you're coming from. So it's very difficult. Uh, you know, I'm not a doctor, I'm not a nutritionist, um, but I'm relatively savvy when it comes to these things. And even for me, it's difficult to parse truth from fiction. I can't imagine just the average consumer. You know, they're really at the prey of whoever is the most effective at marketing. So I'm interested in your perspective on this and kind of, you know, how we should approach this. Yeah, and that's a very well-said introduction and very diplomatic, and it is very difficult. I'm not even sure if you just stop people on the street

and say, how many of you give a hoot about this or do you even know that there's this controversy? Because I agree, you and I obsess about it. Right, we're in it. But to be fair to you, you're on the front lines. You're a cardiologist. You're the person who is looking inside these people's chests and seeing these clogged arteries and trying to address the problem. You're right there front and center. So I would imagine that you're more connected to this issue than most people. I agree with you.

And I don't know if it's fair to say I care more, but you're right. I do want to give the right advice to my patients. I do want to help them. And actually, I want a wider audience than just my patients. I want to be an influence leader for the country because it's a critically important question. And again, I think in the bigger area, do we need to, if we had to sort out the low fat, high fat, low carb, high carb, or just get donuts and Lucky Charms and Skittles out of the schools? I mean, let's, we got to do both. I mean, there's, there's a different issue there, just getting rid of all this crap that's surrounding. And again, I keep coming back to kids. It's just making kids develop diabetes and early heart disease.

But if you get down to the question you asked, I mean, I'm just going to take a couple of minutes and go through it. I mean, my understanding, and I've been a pretty good student of it, and probably this has come up in the podcast before, but there was this kind of concept until the 50s that heart disease was an age-related disease, that you lived old enough, you got it, and it wasn't something under your control. And that was at a time that maybe people were living 50, 55 years, 60 years is the average lifespan. A couple of forces challenged at the Framingham study in Massachusetts, started studying 6,000

people that lived outside of Boston and determined who got heart disease and follow-up and what were their habits and what did they eat and what was their lifestyle. And out of that, in about 1960, came the first publication, the Framingham Heart Study, that actually clearly connected smoking to heart disease, diabetes to heart disease, blood pressure to heart disease, high cholesterol to heart disease, a close family relative that had heart disease to your own risk. And we realized about 1960 on that heart disease wasn't just an age-related thing, that there were factors that influenced your chances,

and that suggested there were factors that you could take control of. You could work to avoid diabetes, high blood pressure, smoking, obesity, and the rest. That was kind of a whole new concept in 1960. And part of that was the nutrition issue, which was kind of going on simultaneous. And we get back to the famous figure of Dr. Ansel Keys, who was far from the only person, but probably the most prominent. And again, I'm not sure when I was on your podcast before we talked about that, but I've read a lot about the man.

And I mean, the man's incredible. He lived 100 years, died in 2004. He didn't just have one PhD. He had two PhDs, one from actually right here, Southern California. Actually, oceanography, his first PhD. And then he went to Oxford and got a PhD in nutrition. And he came back to Minneapolis, his hometown. That's some bizarre oceanography.

How does that work? He was out here studying health of animals and then changed it to health of humans. Went back to Minneapolis in the early 40s and started studying. He did one of the first studies of executives in Minneapolis and their risk of developing heart attacks and relationships with food and all. And this was really kind of novel work. And as some of the listeners know or not, another thing he did, because he was at that point a pretty well-recognized expert in starvation, a well-recognized expert in nutrition, he developed for the Army the K rations,

and the K is for keys. Right. It was a 3,500 calorie kit that a soldier could carry with them and survive for three, four days with enough nutrition to make it in the service and undoubtedly saved lots of lives in that. But he started studying executives in Minneapolis. And I believe he had a trip to Naples in the very early 1950s and discussed with some professors in Naples that they just basically never saw heart disease. And he was so intrigued by that concept after having studied executives in Minneapolis who had heart attacks and heart disease.

And really the very first seeds of what the Mediterranean diet might do for heart disease came in that early part. He published this very famous study in 1953 where he analyzed the rates of fat intake in the diet, the rates of heart disease in six countries. It was not a prospective study. It was governmental data, something called the FAO organization, which had a database of data on the topic. And he presented that he seemed to see a correlation between increased fat intake. I'm purposely not saying saturated fat because that wasn't even on his map. Increased fat intake in the diet, increased heart disease risk, and he presented it. And he got this incredible pushback that wasn't correct. That was 1953. That is not the seven-country study.

As it turned out, as many people have heard this story, there were actually 22 countries in the database. And he later wrote why he didn't use 16 of the 22. A lot of it was unreliable data. For example, Mexico was one of the 22 countries. Mexico didn't have death certificates at that time. It's pretty hard to judge who died of heart disease when you're dealing with a country that didn't have death certificates. Did it still correlate, though?

So in 1957, two other researchers by the name of Yeroshalmi and Hillebrew published a paper that criticized Keyes' data. a paper that criticized Keyes' data. They added those 16 countries, and they showed that there was a correlation between fat in the diet and heart disease. They showed it a little bit weaker, but it was still statistically very valid. They actually didn't disprove anything. What isn't discussed much is when you looked at all 22 countries, which were not cherry-picked by keys, but were picked based on scientific and valid reasons, that actually animal protein was even more strongly related to heart disease than fat, and animal fat was more strongly related to heart disease than plant-based fats. In fact, plant-based fats were not.

So indeed, in some way, Hillebrew and Yershaumi, these critics that the paleo and Western price people rally around, actually moved the field ahead also by pointing out it maybe was a point you could get more specific about, animal protein, animal fiber related to heart disease in all the data. All of that led Ancel Keys to try and scrap together a few dollars at a time that there was very little research going on. The NIH was funding almost nothing. And in 1958, he kicked off the seven country study. And, you know, at the time, nobody appreciates how unusual it was to do this kind of research. And there was very little of it ever done.

little of it ever done, went to, I want to say, 16 communities, 12,000 men, and they sent these forces into the field. They would go to a city in Italy, and they would go to every male in the city, and they would draw blood. They would do an EKG. They would do urinalysis, like just mass epidemiologic associations of data points way before computers. Everything's on paper. Everything's on cards. And over the years, in fact, from 1958, it took 12 years, they published a paper in 1970 with just phenomenal amount of data that supported in a prospective, on-the-field way that there indeed was a relationship between animal saturated fat intake and coronary heart disease. The seven country study, which is not what everybody points to in 1953, that was a

different paper, that was six countries, that was just a retrospective analysis, is actually still ongoing. There's still data points being accumulated on these people from 1958 even to the current day, there's updated publications. It's been a phenomenal basis of research. And by about 1970s, 1971, the American Heart Association, seeing this gigantic database come out, adopted over the time the philosophy that Americans should try and decrease the amount of saturated fat in their diet to decrease the amount of coronary heart disease. I don't see any problem with any of that that's gone along. The other interesting thing that started to happen, is that, has anybody ever talked about North Karelia on your podcast?

No, I don't think so. At that time, Finland had the highest rate of heart disease in the world. I mean, absolutely blew away every point that was out there. And a province in Finland called North Karelia, which is in South Finland, and I can't tell you why that occurs. The entire province, and I believe there's about 100,000 people that live there, they got together as a community because, you know, it's easy to say they had the highest risk of heart disease in the world. What that actually means is people your age and my age

were dropping dead of heart attacks like flies. These strapping farmers working in the fields, thin and fit, were dying of heart attacks. It didn't take much effort to realize why. They were adding butter in their diet, typically 10 teaspoons of butter a day on bread. They had a reasonably high smoking rate. They drank whole milk like banshees. It was the culture of Finland. Not a high carbohydrate culture, right? Not much spirulina in there. Fish-based. I would imagine a lot of fish in that diet, right? Probably, being close to the water, there probably was.

I can't really tell you that for sure. But animal saturated fat was sky high. And as a community effort, first in this province of North Corelia, ultimately in the entire country, they got together as a community health project to say perhaps you should use polyunsaturated margarine instead of whole butter. Perhaps you should try skim milk instead of whole milk. Perhaps you should quit smoking and some other hygienic measures. They dropped around the same time the risk of heart attack very quickly by 85%. 85%.

This is all published in peer-reviewed literature. The data still is coming from North Corelia. It's by far one of the most compelling databases to say that reducing animal saturated fat in the diet reduces coronary heart disease. You know, there's so many other points to talk about. But when you take Keys data, the North Corelia data, the American Heart Association got on board with this concept that it should be a principle to limit animal saturated fat. on board with this concept that it should be a principle to limit animal saturated fat. All right. So in the most general sense, Keyes was like this gigantic figure in terms of sort of moving the ball forward with respect to research and heart disease. And I think it's fair to say probably a lionized figure who at some point in our history, very recent history, there's been a revisionist kind of approach to this. And that lionization has gone to demonization. And there's

a lot of finger pointing saying all this research that led to the American Heart Association, et cetera, saying that we should be eating a low-fat diet is the cause of why we're having all of these problems. Because it led to, I guess you could link it to the amount of sugar that we're now eating as a result of packaged foods, trying to be low-fat and compensating with sugar and other processed ingredients, et cetera. And suddenly we find ourself in a position where the pendulum is swinging absolutely in the other direction. So what is it that happened? Why is this happening now? And what is the argument that is being used to say that Keyes' research was wrong?

So as I see the take, I mean, the American heart got on board and started telling Americans decrease the amount of fat in your diet. Well, Entenmann's cookies popped up and Pop-Tarts popped up and all these other things. Of course, nobody included that as what you should. I mean, somebody should have stood up and said, eliminate or decrease animal saturated fat and eat more fruits and vegetables, eat more nuts and seeds, eat more hemp. But that wasn't the message. Right. These packaged food companies would basically say they want to be able to label their food as low fat. So how do you do that and make it taste good? Well, you got to put a lot of salt in it or you got to put a lot of sugar in it. You got to make it taste good somehow, right? So suddenly these foods for the sake of being low fat become unhealthy in a different respect. Absolutely. And what actually happened is the amount of saturated fat in the diet

during this time that the American Heart Association was saying limit it, it didn't go down. So that's the first point that nobody recognizes. The current health crisis of obesity and diabetes was not the result of the success of this message. It did not decrease. Standard American diet is about 35% fat, which is similar to 30 years ago. But the amount of sugar went up because people, and the amount of calories per day went up. But it was just adding in more and more, all the choices in the grocery store of prepackaged and highly processed food.

And we're suffering from that. So that's one aspect is that we actually never followed these recommendations. No surprise there. A recent story has come about that really the pendulum has shifted. I think it's been about the last two years that it's just really seems to be swinging that this whole story was wrong. And it was all the keys keys was forceful personality of keys slamming this down the throat of the american heart association therefore the public heard about it and if we had only just left everything alone like finland just leave it like finland and let everybody have their heart disease so um there is allegedly i'm going to share this and i'm sure this hasn't been discussed in this podcast a meeting meeting in Mexico City in November 2008 of the World Dairy Producers,

where they were very concerned that the American Heart Association was saying, and other bodies, the European Society of Cardiology, that we should limit our saturated fat in our diet to less than 7% of our total calories. That is the recommendation until just recently. less than 7% of our total calories. That is the recommendation until just recently. And apparently they devised a plan to increase funding of researchers that were milk-friendly researchers, not so much necessarily to influence what they were going to publish.

Nobody's claiming that they actually were in there manipulating the data. But, you know, you can pick people that are friendly and not friendly and give them funding or not give them funding. The milk-friendly scientists. Milk lobby, the big milk, the big milk. And out of that, there's a feeling that a couple key publications really in the last 12 to 18 months have come out of that influence and highly criticized studies, one in 2010, so that's actually a little bit longer, and then this Chowdhury study that came out early last year. These are what are called meta-analyses,

re-evaluating the link between saturated fat and heart disease. Both of these studies, one by an author named Siri, S-I-R-I, and one by Chowdhury, both of these allegedly identifying that when you take all the world data, that really when you look at it in a big perspective in a statistical model called a meta-analysis, not new data and not going back on the field and measuring all these health parameters in 12,000 people, that they could not substantiate. Now, clearly, number one, the authors did not identify that eating more saturated fat was good for your health. They were questioning whether the link was true or not.

Both of these very highly quoted studies have had a lot of critics. A cardiologist named Stamfer in 2010 immediately jumped on that meta-analysis and pointed out all the flaws. And then the one that was published, I think it was March of 2014. Again, it's called the Chowdhury Study. Harvard School of Public Health very quickly just sliced and diced it. And it continued to be sliced and diced. But the word was out. And if you want to say the damage was done um in terms of making new york

times wall street journal media all over that um you know media loves controversy so all of a sudden we got new data that saturated fat isn't so bad for you which wasn't the message it's good for you but uh you know it was one more um break in the armor that we had a consistent story since keys and all of a sudden it wasn't consistent. It's really interesting. It's fascinating. I almost feel like I want Malcolm Gladwell to study what happened. How do these trends, how do these ideas get lodged in people's minds and what accounts for the idea that takes root and becomes the one that starts to spread like wildfire? So basically,

what you've just said is there were some studies out there that people who do what you do or who are in the know go, oh, yeah, I know. Oh, that was a pro-milk dude that did that. And oh, yeah, well, that was discounted. And quickly, we dismiss that. And yet, despite, you know, maybe you and what your peers may know, these ideas get spread and suddenly everyone is adopting this belief that you must be sitting there saying like, well, how did that happen? Didn't we all agree that that study should have been, you know, kind of dismissed? So, I mean, if you're like a forensic scientist and you're analyzing this, what do you make of this? Well, you know, there's an old Yiddish tale about being careful about gossiping about people, that is, about a gossiper that the rabbi, and I hate to share a rabbinic story with you,

but the rabbi took him up to a tower, took a feather pillow, slid it open, let all the feathers out, and then said to him, I want you to go and get every one of the feathers and bring it back. And the man said, it's not possible. The point being, same thing with gossip. Same thing. Once it's out, it's out. And the analogy is pretty clear. These studies got headlines.

These studies got Time magazine. These studies got blasted all over the place. Time magazine, these studies got blasted all over the place. Even as Harvard School of Public Health pointed out dry, boring statistical statements of weakness in the studies, the feathers were everywhere and they continue to be blown all over the place. You know, there's a few bright points out there. God bless John McDougall and Santa Rosa and the McDougall Clinic. But he's had a colleague of his named Travis, a statistician, just recently go through all the data. And there's no question in that data set that there continues to be a valid and strong connection between increased animal saturated fat, increased blood cholesterol, increased heart disease. The message being clear, be wise and limit it. I think it's also fascinating, the American Heart Association for about 10 years has said

eat less than 7% of calories of saturated fat. They came out with new guidelines last year. Didn't get a lot of attention. Do you think they loosened the guidelines? This is a panel of 15 august scientists looking at the world's literature, including these meta-analyses and everything else. They actually tightened the guidelines. They actually recommended we decrease further our saturated fat intake down to 5% to 6% of calories.

You know, that message isn't heard anywhere. That label, warning label, American Heart Association recommends less than 5% to 6% of your calories coming from saturated fat because the data is so strong. I mean, put a person in a metabolic unit, give them a high saturated fat diet, their cholesterol will go up, and you watch them long enough, they'll have heart disease. Those studies were done 20, 30 years ago. They're unquestionably accurate. All right, so a couple things. First, if this is so clearly the truth, why is it so difficult to get people to understand this?

Is it just because people like hearing good news about their bad habits or this is just the trend of the moment? Second is, you know, what is it exactly that Ansel Keys did that is being pointed at to vilify him? Ancel Keys did that is being pointed at to vilify him? And thirdly, what's with this idea that cholesterol is not linked to heart disease? Because that's sort of the meme of the moment right now. Like, hey, you know, guess what? Cholesterol is not linked to heart disease. Everything you thought you knew about that is wrong. And I see that spreading around the Twittersphere and, youphere and the Internet like crazy. So educate me. Jay asked three questions.

I'm going to test my memory to see if I remember. I didn't want to forget them, so that's why I spit them all out at once. Thank you. We'll go back. We're here a little late at night in the Roll Garage. You've been eating rock cow beans. Yeah, so I think they're going to help me through this. So why is this happening?

It's a big dollar business and any way you paint it, there's a lot of influence from big beef, big dairy, big cheese, big pork and turkey. I mean, there's a lot of money involved here in the struggle for the public consciousness on limiting or not. And I think there's a story that hasn't been told, and maybe it will be Malcolm Gladwell, or maybe it'll be Food Babe, or some investigative reporter that's going to someday find some documents, like smoking

documents, about the food industry planning, a public relations kind of attempt that's looking very good for them right now and confusing the public. And I think also once you have research out and published, like we said, it's very exciting when it comes out. It's very hard to get the public to pay attention for another five minutes when reviews and critiques come around that aren't quite as exciting. So that's one aspect. Number two, well, let me go to the third one because I remember it, which is there is no doubt that cholesterol is linked to heart disease. There's databases all over. What I have to go back to and what most people probably aren't real familiar with, there are rare genetic disorders that raise your cholesterol. There are children that have cholesterols of 400, 500, 600, 700, 800. What happens to those children when they're 9 or 10?

They have heart attacks, they get bypasses, and they usually don't live past their teens. When I was a cardiology fellow in Dallas in the late 80s, I took care of a very famous girl named Stormy Jones, who had her first heart attack at age nine, had a heart bypass at age 11, didn't make it past about age 14 or 15. Very sad story. Wonderful kid, was famous all over the world. She didn't smoke, she didn't have diabetes, she wasn't overweight, she wasn't stressed out. She had a cholesterol of 700, 800. I mean, that's the most extreme example you need, but elevated blood cholesterol will cause

coronary artery plaque. So why are people saying that it doesn't? What is the basis for that argument? These meta-analyses mainly, it's just you can cut the argument down one by one. If saturated fat isn't as bad as we thought, and if saturated fat raises cholesterol, then a high cholesterol isn't as bad as we thought. I mean, there is no controversy in the cardiology world that lower cholesterol by healthy living, exercise, weight control, or medication when appropriately used without side effects, reduces heart disease outcomes. Now, it's true, you may have to treat 50 people to have one person that doesn't have a heart attack and die, this kind of number to treat concept. But it's, I mean, I live between the integrative world and the standard world, but it is not

controversial. It is just being, what's happened is, and I hate to cast stones, certain people out there are writing books, the cholesterol myth, and they're selling like hotcakes. And there are functional medicine doctors out there who are saying, who are echoing this. You know, if we want to go off down that road a bit, and there are, and I know some functional medicine doctors actually treat their patients with cholesterol pills. It's the craziest thing I've ever heard.

Mrs. Jones, here, take this cholesterol. Not cholesterol-controlling pills, but actually giving them. This is pure cholesterol pills that raise their cholesterol to give their brain more. These are complex and deep topics, but it looks like you need a blood cholesterol of maybe 80 or 90 to provide all the cholesterol you need to make your vitamin Ds and your steroid hormones and your cortisols. Because there are healthy populations that have blood cholesterols of 100, Okinawa 110. These people are not testosterone deficient, brain deficient, and vitamin D deficient. You don't need a cholesterol 300 to provide the precursor to those hormones. Right.

I mean, is there an argument that elevated cholesterol does enhance brain function or brain health? Or, you know, isn't that part of sort of the idea behind that? That is what's being said. I mean, it's not a scientifically strong foundation. Yes, the brain has a lot of fat in cell membranes. All cells have fat in them. But do you need, at what cholesterol level do you provide adequate substrate

and what cholesterol level puts you at risk? And as I said, most of the studies that I've read have been somewhere around 100, 110 is all you need in anything. Because there's plenty of both natural societies and some people with genetic abnormalities that run these low cholesterols. And they actually live longer than average. So I think it's been very distorted. And again, the public likes, we know that our willpower to avoid foods that are so tasty and fat-filled and fat tastes wonderful in the mouth and mouthfeel and all these comments,

we've really made the message very murky. And those that are making the message tend to be authors that are selling lots of books, and maybe they're well-intentioned, maybe not. But you and I both know we could start writing the Bacon Biking book, and you'd probably sell as many as Finding Ultra, uh, perhaps. And if I wrote the bacon heart book, I'd sell tons of copies. It's just, it's not an authentic message. Right. Certainly it's, it's easier to, you know, sell a message that is making people feel better about things that they like, that they like doing. But, you know, I, I don't, and I don't want to be

dismissive out of hand to, you know, very intelligent, accomplished people like Dr. Peter, Peter Atiyah and others out there who are saying, listen, you know, ketosis is not, you know, there's, this is something that you can do and, and could be beneficial to your health. Like I'm not, I'm just not, you know, I don't have the degrees. I haven't spent the years reading the research to know the truth from, you know, whether that's true or not. I mean, we had in the cardiology world, we just had in November a study called Improve It published. 18,000 people with heart disease. They were either going to get one cholesterol medicine or two. And the combination, the two two really lowered their cholesterol more.

What did they find? Well, when you drop the LDL to about 50, which is the cholesterol we believe is most harmful, there was a clear-cut improvement in outcome versus the LDL cholesterol 70 to 80. It was a gigantic study that once more said that if you want to avoid heart disease or if you have a heart disease and you want to prevent the bad outcomes, get your cholesterol down, which you're not going to get down if you're eating tons of butter, tons of beef, tons of turkey. And turkey is actually, excuse me, chicken is probably the largest source of cholesterol on the American diet right now. That's interesting.

That's another marketing thing that people don't really realize. They think they're actually doing themselves better by eating chicken versus. Yeah, you know, gram for gram. It's very close to beef. So the second point you made, and I remember because of the Panama cacao beans that we shared. You asked about keys. And just to wrap that up, because you can go on and on. Again, there's tremendous misinformation. The statement always is, Dr. Keyes, the seven

countries study, this really phenomenal prospective epidemiologic study that's still ongoing, that provided tons of data points that really nobody questions. But he cherry-picked the seven countries. He had many more countries to pick from. That's actually totally wrong. That was the 1953 paper that he presented that was just a hypothesis-generating paper where he used this database. There was only seven countries, and there were only 16 communities, and there were only 12,000 men, and it never varied from its original design, which was absolutely phenomenal. And why upon his death have they picked him to be the whipping boy of the we can eat whatever we want and don't worry about it, feel good movement,

is really unclear. I mean, he was a real pioneer and a real contributor to medical science. It's interesting. I mean, it was a real pioneer and a real contributor to medical science. It's interesting. It's almost analogous to the manner in which Denise Menger and the Weston Price Foundation people have tried to pick apart the China study. It's a similar kind of approach to dismantling. You're absolutely right. They actually haven't done that with the seven-country study because it is scientifically so solid.

And it was actually a prospective study. The China study was more of a zillions of associations. And yes, 23-year-old Denise has decided to take on probably the most esteemed biochemical nutritional scientists in the country. And it's laughable. chemical nutritional scientists in the country and you know it's laughable but um you know again that was another something that really you know got traction yeah and and what i'm seeing here to bring it back to malcolm gladwell is like a marketing and communication problem as much as anything else because i believe what you're saying uh but somehow it's not connecting. That message is not getting communicated effectively. It's almost like you need to hire a Hollywood publicity firm to make sure that people

are understanding what's actually happening here. Yeah. And I couldn't agree more that the result of all this for those that care, and I'm still not sure if it's 10% of the public that even cares about these issues or even knows that they're controversial because, again, we spend so much time, and your listeners do too, you know, as hackers of improving our health and shooting for 120 years with good health. For the rest of the world, I mean, I'm not sure they know it, but they have not gotten a consistent message. For the rest of the world, I mean, I'm not sure they know it, but they have not gotten a consistent message. I mean, the American Heart Association is not exactly, like you say, a kind of a sexy group that's got Bruno Mars doing their video on education or something that people can relate to.

But they need that because they've lost the battle of the headlines. And the headlines are always going consistently to the idea that we screwed up and go for it, enjoy your steak and your cheese fries and your milkshake. All right, so a couple things. Is there any logic or rationale whatsoever that somebody should add MCT oil or grass-fed butter or coconut oil to their morning drink, whether it's coffee or otherwise. So is there any logic?

It appears, without personal experience, that many people say that they aren't hungry for what I'd call a real meal. Because, I mean, where's the... Well, it's an 800-calorie, depending on how much... How much butter you put in. But, you know, that it sustains them until mid-afternoon when you can then have a meal that may be rich in fruits and vegetables. I can understand that.

You know, there's a strategy there that it may help you maintain or lose weight, usually lose weight because you are developing ketotic you're, you're, you're, you are developing ketotic state every morning with that as your breakfast. It probably puts the caffeine on a slower drip, right? Does it, does it, does it slow down the, the, the metabolizing of the caffeine in the coffee? I'm not sure about that. I think, you know, the idea is you're just feeding your brain, some brain friendly, you know, sustaining ingredients in a no-carb way that allows you to use an alternative fuel for your brain, ketones. Is there a rationale?

So number one, I mean, I wrote this in Mind, Body, Green a couple weeks ago. Low-carb diets, scientifically, I hate to keep bringing up science, but low-carb diets are associated with a higher rate of dying in the literature. You can go to multiple large studies that involve hundreds of thousands of people looking at all the data, and it's out there. There's no- Yeah, but Joel, it'll make you skinny. Yeah, that's right. Who cares about dying? We're caring about performing at work and the rest. I mean, it's hate to be Debbie Downer, but there are no data that say long-term low-carb diets prolong life.

To be fair, is that because that study has not been done or there isn't a study that hasn't been around long enough to be able to evaluate that? No, there's a multitude of studies. When you add them all together in these meta-analyses, they actually show an increased risk of death. So that's an important message that's not out there. So that's an important message that's not out there. So that's one. Two is, you know, that kind of approach is an extremely high saturated fat breakfast. From what I've read, it's about 50 grams of saturated fat if you're just using two tablespoons of butter. You know, blows away your daily load that the American Heart Association would talk about or

anybody else reasonable. And what I have seen that's posted in the blogosphere is cholesterol goes up pretty rapidly, pretty predictably, and often pretty dramatically. I mean, if you want to raise your cholesterol 100 points very quickly, that's a great approach. Now, no medical scientist that I'd consider holding their weight would suggest that you drive your cholesterol up 100 points in a month as any kind of therapeutic strategy for long-term health benefit, cancer prevention. I mean, high cholesterol levels in women with breast cancer is associated with greater metastatic potential and all, let alone what it's doing to your arteries. Of course, the big unknown is

cancer takes 5, 10, 15 years. is cancer takes 5, 10, 15 years. Heart disease takes 5, 10, 15 years. This has all been a trend in the last 2, 3 years. Am I concerned? Yeah, I'm very concerned that people are going to consistently follow this diet, are putting themselves at tremendous risk for developing premature coronary disease. We just can't see it yet. We haven't studied it, followed it long enough,

and I think it's a rather dangerous thing to do. My reading of medium chain triglycerides, the whole coconut oil issue is a difficult issue, and part of it is you go to the store and you buy coconut oil, you're not actually sure what's in there. It's very biochemical and scientific, The optimal, it's very biochemical and scientific, but the optimal length of your fatty acid chains should be six or eight carbon fragments long, maybe 10. But you don't know what you're getting in the bottle. And if they start to get 10 and 12 and longer, then they're getting into the kind of long fatty acids that are in animal saturated fat, even though it's a plant-based product. So you're not sure. There is a product out there that's in the butter coffee that is an eight-chain fatty acid, high-quality group, and it's been used in some medical situations,

like liver disease and others, but nobody's studied it in people. This is an experiment that has no outcome data to know what's going to happen. And there are people clearly reporting they feel more energized and their weight's under better control and a whole lot of other testimonial stuff. But as a physician, as a scientist, as a cardiologist, as somebody who cares about people's arteries, it can be tested. As you know know there's been studies done for example eat a big mac and you can measure arterial function 30 minutes later and demonstrate damage um that hasn't been done with anybody doing these kind of very high plant-based saturated fat well this is a mixture of plant and animal because of the butter being right it's super interesting. I mean, the whole coconut oil kind of dialogue is really amazing to watch, too, because on the one hand, you have the thought that this is a very high caloric food with very little nutritional value other than its calories and its fat content, right? There's no micronutrients in this.

And my understanding is that the saturated fat component of coconut oil is comprised of lauric acid, which is a more easily metabolized version of saturated fat than some other versions. So it's less likely to be stored as body fat and more likely to be used as energy, right? Do I have that right? Yeah, you do. Versus the other side of the coin, which kind of says this is a superfood elixir and this is going to cure all sorts of ailments. And, you know, where do you, where do you, you know, like, where do you find the truth, you know, in that?

And it goes around the merry-go-round, right? Like we can, we can have this whole debate around that as well right now there's a nice study nice if you like to have heart disease with palm oil uh which is a plant-based tropical oil again i'll point out the american heart association last year specifically um recommended avoiding tropical oils that's coconut and palm. Okay, so maybe they've got it all wrong, and they've had it all wrong for 70 years since Dr. Keyes designed this nefarious project. But I'm telling you, the largest and most respected cardiology body in the country says limiter tropical oils. But at least with palm oil, there's been clear data that it accelerates heart disease. And that's a tropical oil, plant-based, highly saturated fat product now.

And what is the chemical difference between palm oil and coconut oil? I can't give you about chemistry. I think for the listeners, keep it simple. Eat your berries. Eat your chia seeds. Eat your flax in the morning. Make a smoothie. Put it on a steel-cut oatmeal.

I think it's a very dangerous path to go down this last couple years of pendulum swinging to you have no rules anymore, go enjoy all. You know, and it merges into this entire bacon philia out there, which is not part of any healthy paleo diet. And it's not part of any, um, heart healthy diet, but you know, where do you draw the line? If, if grass fed butter's okay and coconut oil is okay, then bacon's okay. We've really just circled around to having no rules. I think it's just right, right, right. So, so just to be crystal clear, when a patient walks into your office and says, hey, doc, I'm loving my, you know, my grass-fed butter and my coffee, and I hear it's doing great things, and this is the way to be healthy, your response to that is what? Do you have life insurance?

No. Yeah. You know, in my field, and, you know, it's crystal clear, there's only one group of data that demonstrates you can prevent and reverse established coronary disease, and it's crystal clear, there's only one group of data that demonstrates you can prevent and reverse established coronary disease, and it is the Dr. Ornish and Dr. Esselstyn plant-based low-fat diets that aren't how to, you know, it's very easy to say, and I hear many of my friends in the functional medicine world, oh, crazy old Dr. Esselstyn, crazy old Dr. Ornish, they did those studies years ago, They're just not valid anymore. Excuse me. I mean, Dr. Esselstyn just published a paper updating his data in July 2014. Dr. Ornish is doing the most amazing research on epigenetics with his original

plan. And it's totally changing the course of prostate cancer when you eat a low-fat, plant-based diet. It's the most cutting-edge science out there that everybody's quoting. Everybody in the world quotes Ornish. Nobody mentions that it's a plant-based, low-fat diet that's demonstrating the ability of our environment to influence our genetic makeup. And that's what I educate every one of my patients to do and to learn about and to read. Watch Forks Over Knives, read Ornish's book, read Esselstyn's book, get educated. We can talk about it. I've got this really amazing event

that's occurred in the last 12 months where a patient asked me to develop a support group for Ornish and Esselstyn heart patients with serious heart disease and just challenged by the fact that it was more than ever kind of socially unacceptable to say in a restaurant, I don't want oil on my food and I don't want butter in this. And we started up this plant-based support group in Detroit in February 2014.

I got a little room in the hospital, thought about 20 people were going to show up. We had no PR, very snowy, cold night, and 135 people showed up. And I don't know where they came from, and i don't know how they heard about it and we realized this gentleman who was just a member of the public but a heart patient and myself i said we're we got something here and turns out we basically formalized the groups that we're going to meet once a month we're going to volunteer a time to lecture so we now have 700 members in this group. It's probably the largest dynamic support group for heart patients to fight the culture and eat the way that science says. Rip Esselstyn came in September, and we filled an auditorium with 500 people. And then Dr. Esselstyn's coming in two weeks.

We've got 1,000 people already registered. No charge. It's like people are coming out of the woodwork. So there is actually that. I mean, I'm very hopeful that there are people that are discerning. All they've got to do is go to the bookstore or go to PubMed or talk to a competent physician, and they're actually getting that there is a real path

to improve your heart health through nutrition, and it isn't all the things we were talking about. So it's been a very hopeful and very exciting thing to see this dynamic mass of excited people. My role as kind of the medical advisor and kind of one of the people that founded it is every time we meet, I tell them, you know, there's a bad world out there that's going to hold a butter stick and going to hold a piece of bacon and going to, you going to tempt you with this or that based on the Wall Street Journal or Time magazine.

And let me review for you the data and how you need to be strong so you can respond to this kind of counterpush. Right, strong like emotionally to be able to kind of weather that and stand your ground and make the right decision. If nothing else, Dr. Kahn says it's okay, I'm going'm gonna do it but i want them to understand a little bit more than that so you know they know the data they've seen these amazing pictures of angiograms i mean i'd like to see again these crazy diets and some angiograms a year apart yeah let's see that let's see the before and angiograms that you see when you crack dr esselston's book yeah absolutely i mean it's it's amazing and i'm not seeing that anywhere else. Well, that question I have them ask, I said, if any of your relatives, friends,

co-workers question what you're doing, just politely ask, I like what you're doing. Can you just show me the angiograms before and after so I know it's okay for my heart to eat the way you're telling me to do? That's a pretty good response. Shuts them down pretty quick because there's no science to these crazy things going on. All right. So answer me this. If you were the Surgeon General, what would you change? What would you do?

I would use the power of legislation, Surgeon General. I know we're not supposed to interfere in people's lives and tell them what to do or not. I would dramatically change if there's any way legally to shut down or alter food. I mean, I would get fast food out, change, mandate, tax it, do something that it is no longer possible to walk out with a buck and a fried chicken and feed a family. Like just downright socialist approach to the whole thing? feed a family like just downright socialist approach to the whole thing i mean the the reason i think you need draconian measures that will upset people and raise these questions of freedom and liberty and all the rest is we've got a real problem in this country you know you can just look at one issue which is diabetes and there's about 30 million diabetics in the united

states of america the original prediction was that within about 25 years, we're going to have 100 million diabetics in the United States, about a third of all people by 2050. By 2030 or something like that, a third of Americans, like one of every three people. Exactly. Now the latest prediction is it's 40%. Sorry, we underestimated 40% of Americans in the African American and some of the Latino communities, it's 50%. We're talking about medication, shortened lifespan, work difficulties, hospitalizations, amputations, heart surgeries, and all the rest. You forget about Obama and any other alterations in the health care. This is an actual national issue that has to be addressed, that we are not going to be able to sustain 18%, 20%, 25% of the gross

national product on healthcare. So, I mean, it may take draconian measures to get into schools, hospitals, workplaces, vending machines, and all the rest, and put frigging fruits and vegetables. We need a national task force. I mean, forget the drug war for a while. Let's work on the food war and really get honest and get authentic. I mean, that's what I do. It's not going to happen. And not going to happen. What about, what about the FDA? What about the USDA? What would you do with these regulatory bodies that are sort of quasi government, quasi private? I don't see it happening, but we just got to split up the fact that the, you know, the same institution that's doling our dollars to dairy and beef and pork producers is also the one that's making food policy and regulating food rules and

it's just you know the level of conflict is not conscionable um and uh you know we've got again there has to be a national discussion at the highest level i'm glad we've got you know the first lady involved in this, but this is something that, you know, I think from president on down to, you know, recognize that this is threatening the very health and liberty of the country over the next 20 to 30 years. We don't get control over this problem. Yeah. It's insane. I mean, 40, you're talking, we're, we're basically talking about half the people, right? Almost half the people are having, you know, chronic disease, overweight,

you know, diabetic, whatever it is. Like we're basically half of our population essentially either incapacitated or severely limited in their ability to not just enjoy life, but to properly even function. Yeah. And, you know, the hopeful side is we don't need high tech to solve this problem. We need to limit and alter the food source, the food education, the food habits of America. But the solutions are very simple. And, you know, in the past, it started with a publication in 1993, but there's been a talk about other medical literature that's very important. There's been just paper after paper after paper lately. It's very easy to say that heart disease, 80% is preventable and related to lifestyle and cancer, 60% and diabetes, 90%. Those are things a lot of speakers like myself say, but actually there've been a, a treasure

trove of papers of 20,000, 30,000, 50,000 kind of large studies have consistently shown this magical number that about 80% of chronic diseases that are costing our country a fortune, causing people to lose relatives and lose limbs and lose loved ones and work interruptions and all kinds of tragic situations are entirely preventable by simple, inexpensive lifestyle steps. So one of my passions is speaking about heart attack prevention. I mean, it's a shame if you have a heart attack at age 55 and drop dead. It's a shame if you survive but are limited and all the rest. And there have been a series of studies that say it's about six or seven lifestyle habits that will make you nearly heart attack proof. And nothing's high tech, and nothing's a laser, and nothing's a bypass suite, and nothing's the kind of things, unfortunately, the hospitals invest in.

Well, that's not sexy. It's not sexy. Who's going to make money off that? It's just not sexy, which is, again, why I'm kind of hopeful about the Cleveland Clinic that this message will come out. But now just list them, and you won't be surprised by them. And just don't fall asleep out there, because these are boring. Don't smoke. Wow. But that's one that's got to be on everybody's list. Eat more than five servings of fruits and vegetables a day. That's on

every scientific list. Keep your weight trim and your waist under 40 inches for a man, under 35 inches for a woman. That's on every list. Move 30 minutes a day as part of a fitness program. And we can actually add a little asterisk there. You probably ought to stay on 5, 10 minutes a day if you've got a job that keeps you at a desk or in a chair or driving a truck. Move as much as you can. Sleep seven hours a night. That's number five.

And I hate to bring up number six, but almost all these studies in the last 15 years say that an occasional alcoholic drink is on the side of preventing heart attack risk if you can manage it and avoid the obvious downsides that exist. Now I feel bad for not giving you a glass of wine this evening. No, no, no. Totally fine. The cacao's got me buzzed. I'm glad I didn't have to stop and bring you a bottle of wine as I drove up here. I thought about it for a minute.

I said, not in a rich role. No, I was at the wrong house. That's right. Leave it at the neighbor's. But I just listed five or six simple things. And study after study, you can be in England, you can be in Sweden, you can be in United States centers will show that that will, if you want to live a heart attack free life, that does about 80 to 90% of it. Then we can add anti-aging. Then we can add chlorella and spirulina, anything else we want to talk about.

Yeah, but I want to see this super secret VIP thing that no one else knows, the sexy thing. What's the thing I can buy? Yeah, the one thing of the day that then you have to have a show next day and tell you the one thing. I mean, these are the six or seven things that work consistently

and need to be shouted from the rooftop. And that's what I'm, I've got a new book coming out in three weeks. I didn't know it was coming out that soon. Well, I'm self-publishing this one. So you are. First one called Whole Heart Solution, that Reader's Digest published. And it only came out in September. So it's not like it's an oldie moldie, but this one's called Dead Execs Don't Get Bonuses, How to Survive the C-Suite with a Healthy Heart. Wow. It's really a short manual on what I just discussed and other ways to identify and avoid heart disease during your career.

So what date is that coming out? I'm shooting for February 1. February 1? Yeah. All right. Maybe I'll release this podcast on that day. Wow. That's kind of you.

But getting back to the important point. All right, we'll finish that, but then I want to hear a little bit more about the best. What would the Surgeon General, what should the USDA do? We should rally around and popularize and educate the world that that is the goal. Because the sad statistics, even though everything I just said has been known now for about 30 years, those six or seven lifestyle habits, When you look at these studies, typically 1% of the population studies does all six or seven. Or if you look at five or six, maybe five to 10%. It's an amazing small portion of the population does. I mean, nothing I mentioned was tough. It wasn't run

a triathlon five out of seven days or anything crazy. It was walk 30 to 40 minutes a day. And usually the biggest one people fail at is nutrition. That what's called by the government a healthy nutrition pattern of five, six, seven servings of fruits and vegetables a day, it's under a percent. So get the basics done and then everything else is fluff. Why do you think the nutrition part is so hard for people? I think it's skills. I mean, I think people know they should do it,

but there's a skill to getting five, six, seven servings of fruits and vegetables a day. You know, it's something you now do with out thought and i do too but breakfast you and you got lucky charms and fruit loops and toasted mini wheats and everything where's you know you've got to make changes you got to think about slicing up fruits and vegetables and getting a blender or nutribullet or um yeah i mean it's not you know hummus carrots and celery for breakfast you know you travel in europe and you see the typical breakfast buffet is 60, 70% fruits and vegetables. It's a slightly different cultural approach to what breakfast is. I mean, when you listed out your items to be essentially heart attack proof, this is not like,

the joke is it's not rocket science. We all know this stuff. So it's not really an education issue. It's an implementation issue. It's an action issue. And, you know, maybe it's a willpower issue. I don't, you know, when there's lucky charms everywhere, how do you make the right choice? But, but it's not about not, it's not about not knowing what the right thing to do is, or, you know, maybe it is with to a certain extent, but I think that that, you know, that's, that's really not the main issue. I think the only knowledge deficit might be of how scientifically strong the database is, that it really does do this 90% diabetes, 80% heart disease. That it makes a difference. That it really is not fluff.

It is strong and repeated and up-to-date science. Publications in the last four weeks from Sweden that echo this over and over and over. But you're right. How do you implement it? And, you know, do you implement it through workforce wellness programs that will benefit by better health of their employees and lower their insurance costs? So healthier cafeterias, healthier vending machines, walking programs, no smoking programs. That's what's going on, but, you know, not completely effective. Obviously, my view always is hospitals ought to be the center point of all this education

because they should get it better than anybody, but fried chicken and bacon and milkshakes are just as common, including the lobby of the Cleveland Clinic, and we've got a long way to go. Schools clearly should be, but then you're always fighting these darn lobbies and food programs and dairy dollars and school programs. So much of it tracks back to money and government. I think everybody just ought to download your Mind, Body, Green teaching video on how to eat plant-based, and we'd be a long way down the road. Shameless plug for you for having me in your garage in a cold, rainy California night.

The whole heart solution and this new book. So walk me through the new book a little bit. It's really a simple, I'll tell you what it came from. We were talking about that before you started. It's certainly always been a passion of mine to teach this topic and lecture on this topic. But we had a very prominent executive and car designer in Detroit drop dead suddenly two years ago.

Very fit, healthy appearing 60-year-old executive, led a big design center, and was out from Michigan, but was in California riding his bike and just dropped dead of a heart attack. And his widow is now a very close friend of mine, and she was passionate about teaching the message that this was tragic and shouldn't have happened. He was seeing doctors. Nobody detected it. And out of that came the focus to do this. So it's partly in memory of Imre Molnar. His widow wrote the first chapter of his story in a plea to make that the last heart attack

in America, which is possible. And then I go through the science of how to detect heart disease early using imaging, early CAT scans, early ultrasound, advanced blood work, the data on that you can prevent heart disease through lifestyle, data that you can reverse heart disease through lifestyle and advanced technologies, and kind of wrap it all together. And it's a pretty quick read. And it's a really important message that I just didn't see anybody talking about. And it doesn't have a nutritional philosophy that should divide people.

But it's a little bit more aggressive than the way cardiology is practiced. We're dealing with a pretty big problem. Yeah, I like it. Cool, man. Well, a couple things that I want to kind of close this down with. And the first thing is something that's increasingly more and more on my mind, which is I'm 48. I'm rounding the corner towards 50. What are the things that I need to start being more careful about? Or what should I be thinking about? Or what should I be asking my doctor about? And what tests should I

be getting? I want to talk about this one CAT scan test that I think everybody should get with respect to their heart. That's really important. I think that's great. This is not Joel Kahn. This is the American College of Cardiology. This is a scientific body of data for about 20 years, but there's a type of CAT scan of the heart.

I've got to give a little background. Heart's a tricky organ. It's small. The arteries are very small. The heart's moving. What you want to know is are your arteries clean or are your arteries starting to develop blockage? And anybody that has a heart attack, a bypass, or a stent has had the problem going on for years. The problem is you go to your doctor. If you go, stethoscope doesn't show any of that. Electric cardiogram may show nothing of that. Even a stress test may come back showing total normal, although a stress test isn't part of a routine physical if your doctor decides to do it. You can miss extensive heart

disease on a stress test. Unfortunately, we're just not very advanced in that approach to heart disease. You want to find out if you have a colon polyp or a colon tumor, you do a colonoscopy, you look directly at the organ. Everything I mention in heart disease is indirect evaluation. So fast forward 20 years ago, a CAT scan method was developed. You lie down, you hold your breath for 10 seconds, and a CAT scan machine is turned on and off. No IV, no injection.

It's called a coronary artery a CAT scan machine is turned on and off. No IV, no injection. It's called a coronary artery calcium CAT scan. 99 plus percent of the time, if you have plaque in your artery, calcium has been combined with the cholesterol and other elements of plaque. Calcium shows up on CAT scans black and white. The heart looks very different than calcium. And in that very brief exam, you can find out if your heart arteries are calcified, which is early heart disease, silent heart disease. I call it the truth serum. And if you come back and your score is zero, we have more than 1,000 published medical studies, some of which follow people for 15 years. If your calcium score is zero, you have very youthful heart arteries. Your risk of heart

attack or developing angina, needing a stent are extremely low over the next five to 10 years. Of course, follow a healthy lifestyle, but a lot of things can be relaxed a little bit. You may not need medication and other things. If your calcium score lights up 100 or 500 or 800 or 1,000, you've got a problem and you need to see a person that really cares about silent heart disease and nutrition and stress management and exercise. And there's roles for supplements. There's this crazy therapy called chelation, which actually can be effective in certain settings and is now science proven.

So it's just a very aggressive approach to use, particularly this CAT scan. It's not covered by insurance in like 48 or 50 states. Used to be pretty expensive, $700, $800. My community, you can get it at one hospital for $75, another hospital for $100. So it's well worth about age 50, maybe age 45. If you're a smoker, blood pressure diabetic, probably towards that younger age. It's not right for somebody that knows they have heart disease. So I was talking to somebody in your kitchen. Their father already knows he has blocked arteries in other parts of his body.

Well, he needs the whole package of treatment. He's got hardening of the arteries. May not be necessary for somebody like that. But all the other people just saying, you know, I walked out of my doctor's office with a good physical exam report, not very meaningful in terms of identifying silent heart disease. And I'll tell you straight up, this test saves lives. It does. Like crazy people who do it. And not enough people know about it. And I will just say that for a fact, straight up, it saved my friend Jonathan Schwartz's life, who was an early guest on this podcast, really successful business manager, local guy, friend of mine here, marathon runner,

triathlete, super fit, healthy guy, was recommended to get this test, was shown to his shock and amazement that he had a pretty significant blockage and was really lucky to have caught it. It really saved his life. And it was such a profound moment for him that he has started a foundation. And now I'm kicking myself because I can't, I think it's called the Heartstone Foundation. I'll make sure, I'll research that and make sure it's in the show notes. But for anybody that can't afford this test, he feels so strongly about it that his foundation will support people to get it because it's not covered by insurance. Wow, that's awesome.

I had not heard of that, but that is really a great thing to do. You know, it's, again, everything boils down to follow the money. It's a test that doesn't really generate a lot of profit. It really hasn't caught the attention. It takes big machines at hospital zone because no offices have CAT scans. It hasn't really caught the attention of most cardiologists, and it's absolutely a shame. But you can get it. But I mean, it's available, right?

Like if you're near a metropolitan major hospital. Any medium or large-sized hospital will offer coronary artery calcium scoring. The other thing is that there's a lot of good advanced blood work, and we've gotten better and better at doing cholesterol analysis and other factors. So I love to see people around age 45 and 15 do kind of a two-stage evaluation, talk to them, examine them. You've got to kind of still be a doctor, but schedule them for the CAT scan, advanced blood work, sit down with them, and design a program for them. That's kind of what's called personalized lifestyle medicine. And it's very motivational both ways.

If they come back zero, they're just like so freaking happy. And they realize that they did everything wrong for 50 years, but they still have a second chance. And a lot of these people really grab onto better health for that reason, that it, wow, I might make it to 80 or 90. I better really start taking care of my life. And the other side is obvious. It's the scary message. You've got a problem and you need to wake up to it. And I asked them to put the report on their refrigerator and look at it every morning and kind of have a reality test. That's effective.

It works. Are you still writing prescriptions for people to go get spinach and stuff? Yeah, there's a number of us around the country. I got a shout-out to Dr. Garth Davis. Garth is doing it. Garth is doing a great program in Herman Hospital in Houston of actually prescribing fruits and vegetables that are provided by an organic producer in town.

Yeah, I use my prescription pad because people just pay more attention to that. I might write on it, you know, go see your video program or go watch Forks Over Knives, whatever. It's much more effective than any other thing I've ever had because it looks official. It's on my prescription pad. Yeah.

Cool, man. All right, man. So 50, what else do I need to be thinking about? Well, you got to do the bit. You got to get your colonoscopy, whether you like it or not. Yeah, I haven't done that. Yeah, well, you know, you got a couple of years, but it's kind of a fun little break. You get to sleep for a few minutes.

It was no big deal. couple of years, but it's kind of a fun little break. You get to sleep for a few minutes. It was no big deal. I mean, I absolutely would join Katie Couric in advising everybody to do it because it's no big deal. You know, in my field, it would be those two things, advanced blood work and that coronary artery calcium scan. What else is cutting edge? It's kind of the, you know, I believe we're at the verge of a real breakthrough and real true kind of anti-aging. I mean, we're not just going to have, again, the hysteria of the moment that comes and goes. We're really getting people like Craig Ventner from the Genome Project and Peter Diamandis from XPRIZE and all these guys are like really focusing on understanding. Diamandis is really on it, right?

Yeah, well, he's working with Ventner. They've got $100 million to start with, and they really believe we're going to understand in more detail the process of aging and ways to interrupt aging and cellular

decay and extend life in a healthy manner. I mean, it's a pretty big notion about how to do that. And implications. How are we going to have 20 million people on this planet with deforestation and animal raising and all the rest? But nonetheless, I think that's really something to watch. And the best anti-aging plan is to follow the six or seven heart attack prevention steps, which is a lifestyle anti-aging plan. We can't sit around and wait for those guys to solve the problem

and slack off in the meantime, hoping they're going to fix it for us, right? That's not going to work. You know the crazy guy Aubrey de Grey? You know who he is? He's one of the world's leading anti-aging experts with his beard down to his knees with an English or Scottish accent, and I apologize to him. I'm not sure.

I think he's English. But he says all the time, your goal ought to be to live about another 10 years with a really good body and brain, because there's going to be so many breakthroughs in this field that you'll have another technique or tool to make it another 10 or 20 years. And it's going to be bites like that, that are going to make it more routine to reach a hundred and 120 or just read the blue zones book and start doing it now. Cause that is the way right right cool cool yeah i'm getting uh i'm gonna have dan on the podcast dan butener soon pretty soon yeah

i'm having dinner with him next week i love that guy so great cool great stuff that he's doing hey man i think we did it uh we covered a lot of stuff we did i hope we weren't too heavy no it's good man we need you know we need we need the science. We need the hard facts. We need a little reality check. Look, heart disease, America's number one killer. It's killing people by the millions. It's crazy. It's ridiculous. And it's also preventable.

And so I appreciate your message. And it's not like you stand to gain. It's like this is just what it is. I really care about people not dying. It may not comport with your preference for what you want to have for breakfast or what have you. But I believe that what you're saying is the truth. I live it. And I'm glad that we had a chance to talk about it.

I just would put a plug. If anybody wants to follow up reading Dr. John McDougall's newsletter in November. You sent me the link to that too, right? I'll put a link in the show notes to that. It's online though, right? Like you printed it out there. It's actually December 2014. It has an amazing statistical evaluation of this saturated fat heart disease topic.

It's heavy and most people may not enjoy going through it. And I'll leave you this too. This Nutrition Action Newsletter in April really did a nice job of parsing the issue of saturated fat heart disease. This dairy-based meeting that I mentioned in November 2008. And I think if people started, we can raise consciousness about some of this science that supports what I believe is the real basis for nutrition and health. We'll be doing a lot of good with this podcast, as you always do. Yeah, very good. Is this Nutrition Action article online? Do we know? Yes. Okay. We'll get the link for that. So check the show notes for this episode. Everything that

basically Joel's been talking about that can be hyperlinked will be hyperlinked. So there'll be places for you guys to take this conversation further for those that are interested in doing so. Perfect. Right? Thank you. Right on, man. All right. So if you're digging on Joel and you want to connect with him, you want to learn more about his deal, the best way to do that is to go to drjoelkahn.com, right?

You got it. Pick up his first book, The Whole Heart Solution, and the second book, which will be dropping probably around the time this podcast goes live. And the title of that book, again, is? Dead Execs Don't Get Bonuses. There you go. And the third thing you can do, and we'll have to talk about that another time, you can come to Detroit and eat at my vegan restaurant that's opening March 1st. We didn't even talk about that. Well, we got a lot of green space.

We talked about it. This is what happens when, see, look, here's the deal, right? I have this fantasy that I want my podcast guests to just, I'll be sitting here ready to go, and they just roll right into the chair. We just hit record from the get-go. But we end up chitchat. That never happens, right? I always have like, you know, half an hour conversation ahead of time. And then I'm like, you know, we're going to have to repeat all this stuff. So we talked all about

the restaurant, which I'm really excited about for you. When is it opening? About March 1st. I have the pleasure of having developed a really world-class, uh, vegan restaurant that'll open about March 1st in Detroit called Green Space Cafe. And it's, you know, it's a dream of mine because it's going to combine all my philosophy and teaching and a business enterprise with my son and really got a buzz in the Detroit community. We're going to have just some, you know, you got the pleasure of living in LA where you got lots of choices all over the place and they're wonderful, but we're going to add a lot to the Detroit community. So great stuff. It's great, man. You know, know it's it's fantastic to see that happening out there and uh i love

what's happening in detroit right now with this renaissance yeah so we're both restaurateurs now i know can you believe that it's crazy in some respect yeah um also you can go to holisticheart.com that's more like on your that's sort of like the website for your book. Yes. Yeah. And on Twitter, of course, it's Dr. J. Is it Dr. J-Con? I never remember. D-R-J-K-H-N. Right. And you're pretty active on Facebook.

My wife says I live on Facebook, not at home. No. All right. We'll talk about that. Yeah. Maybe we have to work on an iDetox for you. I need to take a little break. I agree., honey. Yeah, maybe we have to work on an eye detox for you. I need to take a little break. I agree.

All right, well, we'll talk about that offline. All right, man. Cool. Feel good? Peace out. It was wonderful. All right. Thanks.

Bye-bye. Peace. Plants. All right, y'all. That's it for this week. I hope you dug it. Joel is great. No BS with that guy.

Just good, solid information. And I appreciate that. Quick reminder, check out his book, The Whole Heart Solution. Link in the show notes to the Amazon page for that book. Click through the Amazon banner ad at richroll.com. And we all win that way, right? And also, make sure you check out his new book when that comes out, Dead Execs Don't Get Bonuses. Joel also is a frequent blogger for mindbodygreen.com, for forksoverknives.com,

and the Huffington Post. Guy's constantly putting up new articles. So you can read up on all his good stuff there. I'll put links up in the show notes to some of the stuff that he's doing so you can easily access it. Also, if you happen to be in Detroit this spring, check out his restaurant, Green Space Cafe. And if you happen to be in the West Valley area of Los Angeles, the West Lake Valley, the West Lake Village, I should say area, come by our place, Joy Cafe, feeling awesome. It's right off the 101, the Westlake Village, I should say, area. Come by our place, Joy Cafe, feeling awesome. It's right off the 101, the Westlake Village Boulevard exit. And more likely than not, if you come over at lunchtime, you're probably going to run into me or Julie. We eat there all the time. If not, say hi

to Nick, Joy, have a great meal, engage them in conversation, expand your horizons, leave feeling great. It's all good for all your plant power provisions. Go to richworld.com. We got new t-shirts. We have these plant power California license plate motif shirts that are pretty cool. We got the tech tees and short sleeve and long sleeve. We got nutritional products, of course. We got the digital products, the meditation program, all that stuff. You guys know what's there. Go there, check it out. Also, go to mindbodygreen.com for my online courses. I got two of those, The Art of Living with Purpose. That's about setting goals. That's about connecting with your inner self. It's about

unleashing that authentic version of yourself. It's about how to properly set and achieve goals. And then, of course, my Ultimate Guide to Plant-Based Nutrition course, which is like over three hours of streaming video content, everything you need to know to get more plant-powered into your life. Hit us up with a review on iTunes. Send me your questions for future Q&A podcasts, production, audio engineering, music, sound design. Who did all that stuff? Tyler Pyatt did it. That's who. He's my son. He's rocking the production on this show. Thanks so much, Tyler. Additional production and editorial support, like the show notes, like figuring out the quote that goes at the top of the show, all that good stuff. That's Chris Swan. And of course, graphic art, as always, done by Sean Patterson. Thanks, you guys. See you next week. Read your food labels i'm out peace plants later