The Rich Roll Podcast - Plant-Based vs. Ketosis: Diet Wars With Cardiologist Joel Kahn, MD

Episode Date: February 22, 2018

Recent years have seen the ascendency of low-carb, high fat diets. Indeed, the ketogenic lifestyle has been heralded as a veritable health panacea. In parallel, we bear witness to mainstream acceptance of the plant-based approach to vitality, lifestyle disease prevention and reversal. The debate pitting these distinct approaches to nutrition is as emotional as it is divisive — an impassioned war for hearts and minds waged across the scientific literature, mainstream publications and the internet that can leave even the most intelligent and well-intentioned consumer utterly baffled. So who's right? To help divine the line between truth and fiction, Joel Kahn, MD joins the podcast for his third appearance. Dr. Kahn is an Interpreventional Cardiologist, Clinical Professor of Medicine at Wayne State University School of Medicine, Founder of the Kahn Center for Cardiac Longevity in Michigan, and 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). He’s authored hundreds of articles on heart disease, is a frequent lecturer on heart disease and its prevention, has performed thousands of cardiac procedures, and is the owner of GreenSpace Café in Ferndale and Royal Oak Michigan. In addition, Dr. Kahn is the author of five books, including The Whole Heart Solution* and his newest offering, The Plant-Based Solution*. This a comprehensive and highly instructive conversation that endeavors to provide needed clarity when it comes to the aforementioned debate — a deep dive into the veracity of nutritional research findings to provide the information you need to promote maximum health, hinder lifestyle disease, and abet longevity. In addition, we explore emerging research on the benefits of intermittent fasting and why everyone should get a coronary calcium scan. Amazingly informative, this is straight talk from a trusted and experienced man I'm proud to call friend. As a final note, this podcast episode is also available in video format on YouTube. If you are enjoying the video version of the show, please subscribe to my channel at youtube.com/richroll to be alerted when new videos post. Finally, if you missed our previous conversations, check out episodes #44 & #128. For the visually inclined, you can watch watch (& subscribe!) to the podcast on YouTube here. I sincerely hope you find our conversation instructive — because health is wealth. Peace + Plants, Rich

Quick announcement before we get into it. I am very excited to announce that Julie and I have a brand new cookbook coming out April 24th. It's called The Plant Power Way Italia. We're very proud of it. If you enjoyed our first book, The Plant Power Way, I think you're going to freak for this one. It's inspired by our retreats in Tuscany and the cuisine of the Italian countryside. It's super next level, incredible photography, 125 entirely new, and of course, delicious plant-based Italian countryside. It's super next level, incredible photography, 125 entirely new, and of course, delicious plant-based Italian recipes. And it's available for pre-order now

from all your favorite online booksellers. You can learn more at richroll.com. Pre-orders are very important to the book's viability. And so it would mean a great deal to us if you reserved your copy today. Thank you so much. I greatly appreciate it. And now on to the show. The single most powerful activity you can do to prolong your life is eat less every day. And that's a message that is so needed right now.

And then we can talk about what that is. But start out with that in your mind. Shut your mouth, your kitchen, your refrigerator, and watch your health bloom. That's Dr. Joel Kahn, this week on The Rich Roll Podcast. The Rich Roll Podcast. The conversation that tends to swirl around nutrition is as emotional as it is confusing,

capable of confounding even the most intelligent and well-intentioned among us. So in an effort to gain some much-ne needed clarity in this battle over hearts and minds in which we find ourselves embroiled, today we focus on the impact of our dietary choices on a number of things, maximizing health, promoting longevity, and preventing disease. My name is Rich Roll, and today's co-pilot is my friend, Dr. Joel Kahn, making his third appearance on the show, his first being back in August of 2013, episode 44, and then again in February of 2015, episode 128. Dr. Kahn is an interpreventional cardiologist and clinical professor of medicine at Wayne State University School of Medicine, as well as the director of cardiac wellness for Michigan healthcare professionals. School of Medicine, as well as the Director of Cardiac Wellness for Michigan Healthcare Professionals. He is a graduate summa cum laude of the University of Michigan School of Medicine

and lectures widely on the cardiac benefits of vegan nutrition, mind-body practices, and heart attack prevention. He is the author of The Whole Heart Solution, and his newest book is entitled The Plant-Based Solution. We cover a lot of interesting ground in this one. I'm excited for you guys to hear it, but first... 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

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from fact when it comes to evaluating the veracity of nutritional research findings and successfully seeing yourself through the muddled, confusing, and often incredibly emotional debate that swirls around what to eat, what not to eat so that you can live your healthiest, longest, most vibrant life. As a final note, we did video this conversation. So if you'd like a more immersive experience, you can enjoy it on my YouTube channel at youtube.com forward slash rich roll. And that's it. I love Joel. I love this conversation and I hope you do too so let's talk to him ready to go i'm so happy

yeah me too i'm good all right joel kahn i think this is your third appearance on the podcast but it's been a while yeah it's been i don't know the numbers probably two years right you came to a hotel in la and then once I came to your garage. Right. That first time, that had to be four years ago at least. Yeah, I was like, maybe number 38. Don't quote me on that, but it was pretty early. And congrats on the new book.

Thank you. Book number five. Comes out tomorrow, right? The Plant-Based Solution. It came out last week. Oh, it did? Oh, cool. Awesome, man.

January 1. You've written like four books or something? It's my fifth one. Fifth book? Five books. Wow, that's amazing. Well, we're going to get into it. Yeah, that's no problem.

Good. I have no time. Cool. You can go long, set a record. I'll do Tim Ferriss, whatever. Yeah, Joe Rogan. Will you cry for me? Yeah, it was powerful stuff. I'll cry. Good. Well, I'm excited to reprise our ongoing conversation. And I think a good way to kind of get into this is to kind of canvas what's going on right now in the conversation around nutrition at large. Because I feel like, and I know you agree, there is a war afoot for hearts and minds. And the battle lines seem to have been drawn. And on the one side, we have the ascending popularity of the low-carb, high-fat slash ketogenic slash intermittent fasting camp. And amongst the proponents of that philosophy or approach to nutrition, we have people like Dr. Rasim Malhorta cardiologist yes we have professor Tim Noakes we have Gary Taubes we have Robert Lustig people like Mark

Sisson dr. Mercola on the other side we have the plant-based camp we have yourself leading the charge and at the tip of that spear also we have Garth Davis we have dr. Michael Greger we have dr. Dean Ornish, Dr. Esselstyn, Dr. Michael Clapper, Milton Mills, a whole bunch of other people I'm sure I'm forgetting. But this seems to be kind of where things are at in the current dialogue or debate around what is the optimal way to eat, right? And you have been pretty vociferous and active in terms of your blogging and television appearances and books and, you know, your stuff. I don't know where you find the time to write all these blog posts, MindBodyGreen and on Thrive Global and Medium. Everywhere I look, every other day I get a text or an email from you, new post up. So you're very active in trying to, you know, communicate

and participate in this dialogue. So, how do you see things now? You know, what's going on? Yeah, I agree with you and, you know, that's the list you read on the two sides of which there's many, you know, great luminaries, Robert Osfeld, cardiologist, plant-based, and many others. There's so many others. If I start naming them, then I'm going to forget people. And I definitely would add Nina Teicholz on the dark side, for sure, a big fat surprise. It's very confusing.

I think forget the most important topic, which is where's the truth in the discussion for human health and human well-being and longevity and joy and freedom from medication and need for medical procedures, which is really the real issue. As close as we can get to knowing the answer to that is the best service we're going to be doing to ourselves, our family and the public. It is a ugly, ugly situation that's very polarized yet there is middle ground and i mean i don't want to you know begin at the ending but um the the thing i'll acknowledge if you go back to uh lauren cordain in the paleo diet book which frankly if most plant based people read it they'd say i grew 90 of book. And is the shunning of hyper-processed fast food the thing that's decimating the health of the Western world? Both camps will agree are exited. Although I'll say, of course, there are junk food vegans that have confused both the mission and the argument we have

that this is a very healthy lifestyle. And the other side has confused it by reintroducing dairy and bringing butter back. And now even cheese, when originally that was never a part of the low-carb, high-fat, and certainly paleo are today. Paleo eschewed dairy altogether. Eschewed dairy. But now, depending on what version of that, all of a sudden goat cheese is back and goat milk is back,

and certainly butter is back in various versions. So, I mean, the common ground, I had the opportunity about a few months ago to go over to Googleplex in Mountain View, and it was arranged via Kip Anderson, and there was a conversation in front of a hundred of the Google young people, but beamed all over Google worldwide. And the conversation they set up for us was, these are real people, real health issues, real health concerns, real goals. Don't just have a fight and leave them confused. Because what does the public do when they're confused? They do whatever the heck they want.

And that's the point I wanted to make. the public do when they're confused they do whatever the heck they want and that's the point i wanted to make um we are we are left with this polarized discussion that leads most people and very intelligent people and people even in this sector of the health world and the food world and the medical world to say you guys are so disparate i moderation everything i'll do whatever i want and that's unfortunately not serving us well so i'd rather highlight you know the common ground which is none of us are into excess sugar we can define none or low but none of us are into excess sugar none of us are into fast food i don't know that anybody on their side or our side is talking about eating fried food with any regularity

i mean they're not big into bacon and i don don't think they'd advocate hot dogs and salami and bologna, and obviously that's not even on our menu, which is all in advance. I mean, and then a lot of leafy greens. I would not stop at leafy greens. I'd go on to lots of fruits and lots of root vegetables and starchy vegetables. But, I mean, maybe the first step is for all United parties to say, you know, school kids, hospital patients, airports, vending, people in the workplace, whether they're of low socioeconomic, high socioeconomic, we need to get this junk out,

which is, you know, an impossible job when you got Wendy's and KFC and McDonald's and, you know, these gigantic multi-billion dollar conglomerates that I think, you know, it'll take 10 years and they'll be doing a better job, not a perfect job. Anyways, there is a lot of commonality, yet you're absolutely right. I wake up every morning after a few minutes of gratitude and spend a few minutes perusing the internet, what's new overnight. And I kind of have my sequence to go through. And it's either a hot new article on ketogenic or it's a hot new article, usually about another vegan restaurant opening in London or somewhere. But they're very separate, and there isn't much discussion.

This Google talk with Dave Asprey of the Bulletproof Nutrition Group and Kip Anderson and myself was one of the rare times. You're not going to see you talking at Paleo FX or me being invited to go into the lion's den. So I look forward to that happening. I think, without doubt, we have science on our side, and that's always my touchstone. Recognizing it's very hard to parse out. There's deficiencies. We don't have large randomized studies in many of these topics.

Do we know enough to talk about what is the optimal diet for the human species and we do and it's much more weighted towards our choice of diet even if you just talk nutrition take away the environment take away animal rights just talk nutrition we are on the right path and i mean i'm emboldened by that by some recent scientists who've come out kind of independently with no axe to grind that the diet you feed your family rich a diet. I feed my family and in my restaurant in Detroit. The public will be able to identify that this is where they need to move towards, even though all this confusion exists. Well, I think it's happening. towards, even though all this confusion exists? Well, I think it's happening.

I mean, the ascendancy of just plant-based awareness in the last couple of years alone has been pretty dramatic. And I think it's showing indications that it's not a fad, that it is here to stay and it's building. And that's really cool. You know, but there is this debate. The debate gets very emotional. It gets heated. And that's the spirit in which I pulled up YouTube and decided to watch your, your event

at Google with you and Kip and Dave. And I had, I guess I had a preconceived idea that it was going to devolve into not mudslinging, but kind of get a little bit heated in that regard. And I was quite pleasantly surprised to find that that was not the case. You were kind of the peacemaker, I felt like, but I found Dave to be pretty amenable to almost everything that you were saying. I mean, Kip and him, you know, kind of butted heads a little bit over some of the environmental stuff, but overall, I found you guys coming to, you know, a common sensibility on most of the top shelf big ticket items.

Yeah, I agree. And that was set up as please try and give us practical and important tips. Again, this wasn't Hollywood and a TV show where, you know, ugliness can be quite successful in terms of a marketing strategy. This was real people needing real advice. And I don't agree with a lot of what Dave Asprey does and talks about. And there's no science that he's produced that can support butter in your coffee and his experience in Tibet with yak tea and all the, i think nonsense that uh all that story is and i know how the public loves a great story but um but when you talk about a diet very high in cruciferous

vegetables and whole foods and uh absent excess sugar and absent you know junk food i mean there is that i would eat at his house he would eat at. In fact, the untold story there is when we went to the Google cafeteria after that hour-long talk and we were catching him in the last 10 minutes, he had the toughest time of all of us. I mean, Kip and I had no problem eating there, but... I was trying to find something that way. Yeah, trying to find, you know, everything that met his list was tougher to meet than ours. And in fact, he found a big plate, I think it was of just greens, and he always carries MCT oil of his own derivation. And it was like he was the most orthodox kosher of the group kind of impression. Because he puts it, as I said, we are all teaching rather, unfortunately now, I call it elitist diets.

I mean, I don't know how many people we speak to. Do we speak to 10% of America? Sorry, I just knocked something over on your desk. You have my little yoga army man. Yeah, you have a soldier as a yoga. Yeah, it is, of course. How many are we talking to? But I hope we can expand the conversation and reach out to close to 100% when the right thing to do is the easy thing to do,

when McDonald's has healthy options, when, you know, schools and hospitals have healthy options. I think the food industry is like a bright light of what's going on. They're ignoring this debate and just putting more and more, you know, healthier options, plant-based options out there. But yeah, it was a good experience. There's the other backstory, just to make your audience laugh, is I still use my AOL email. the other back story just to make your audience laugh is I still use my AOL email so I know I'm the only speaker ever to be invited to an at Google Talks who set it all up via my AOL I have

Gmail accounts I just like uh I like the appearance of AOL and and the retribution of course I asked him do you still use the AOL? He's like, yeah, of course I do. A surprising number of closet people like me. I think they should just rename it A-O-L-D, because if you're old enough to have one, just be proud of your seniority. Call it A-O-L-D. And the final retribution was that they were supposed to post that talk the day it happened. It took them six weeks. They had a YouTube flaw.

And they kept apologizing, and I kept responding in my AOL email.ol email well i'm pretty high tech here i'll just be patient and wait they ultimately got it up to youtube but um you know but it is the uh you know in silicon valley where we had this discussion i mean business insider magazine and such the ketogenic diet is very popular right now the idea that that really strictly eliminating carbs. And we always have to be careful in the definition. Carbs are, you know, plants have, food has usually carbs, protein, and fat in almost every food until you refine it. Coconut has all those and olive has all those. Once you refine it, you may end up with only fat.

So all foods have the three macronutrients. I don't think there's any exception to that, maybe different percentages. So a low carb diet, of course, many of them continue to eat a decent amount of greens in their diet, but they're eliminating all the whites and they're hypervigilant about it. The big difference in the ketogenic diet, are you doing high fat, low carb, low protein, which we can talk about and with a plant-based approach may actually have some benefit in science or are you doing a low carb high fat and high protein diet which probably ages you quicker than any other diet on the planet and that isn't always parsed out in their conversation so the scary skeleton in the ketogenic diet closet is you'll lose weight you may have some boost in energy for

a period of time you may be increasing your mortality risk and they just don't talk about that with great regularity so it's a it's a difficult diet and i think dave asprey trying to eat in the google i don't know that he'd want to be cornered as a ketogenic diet proponent he has his brand bullet Bulletproof Diet. But the difficulty he had, and my patients telling me, this is on the road. It's easier to be plant-based than it is to eat a strict ketogenic diet right now of high-fat options you're going to have to carry around your own food.

But the gravest concern is, is it a healthy pattern? Is there any natural population that even slightly approaches it and has done well long term? Kind of a bullet shot at the plant-based movement. Show me a society that's been plant-based for centuries and has thrived. That's one of Nina's big points. Big points. But show me a community that's, you can talk about Eskimos and the Maasai who lived to

age 30 or 40. Well, that's not kind of the example we're talking about. Show a Okinawa-type population that was 90% plus plant-based and thrived. Great. We have our example that approximates the way we eat. They have great difficulty with that. In fact, the scientific data is it's the converse, that they are at risk shortening their lifespan. If it's an animal-based, low-carb diet, particularly if

they're emphasizing foods that they feel are high in protein, which are typically going to be meats of a variety of kinds, no matter whether it's grass-fed or not, it's the basic constitution of animal muscle that can age you excessively and the science is well known. So, a couple observations on that. First, with respect to the degree of difficulty of maintaining a ketogenic diet, it's an interesting thing to talk about because you're right. Like, to actually do a ketogenic diet properly requires an incredible amount of, like, a forethought and planning and discipline. It's not easy to really dial that in and make it work compared to a plant-based diet. And yet I feel like the plant-based diet gets

unduly criticized for being restrictive and too difficult and something that people are just never going to be able to maintain long-term, despite the fact that both of us have done that. But people are very quick to jump on the ketogenic bandwagon and try it with enthusiasm without that same concern being applied yeah i agree completely um you know just a couple examples there's uh joe rogan had a surgeon on um sean baker and i don't know sean baker very well we go at each other a little bit on twitter um and he said very you know casually even he's an md i've done and the ultimate example of these diets is there's a whole group of people eating nothing but meat three meals a day literally nothing but meat and for reasons i don't completely understand carnivore guy yeah and he's one of many

i mean he's not the only one that shows up there they can claim short term some pretty impressive pictures of their abs and weight and some of them have some heart ct data of course there's nothing published in the literature i want to come back to that but you know dr baker said i didn't even bother to check my labs joe rogan said you've been doing this for a year he goes no i didn't check my labs well i have patients that do that and they get their labs checked, not under my advice. And I have one that I'm going to write up maybe on the airplane flight back to Detroit later this evening. His cholesterol went from 250 to 750 during the two months he did a meat-only diet, trying to approximate what he was hearing on these rogue, not Rogan kind of podcasts.

what he was hearing on these, you know, rogue, not Rogan kind of podcasts. And it's insanity. And it's like religious fervor and follow the leader without thoughtfulness. The only medical condition that has any data, everybody can verify this, PubMed.com, putting ketogenic diet, refractory epilepsy in children and to some degree adults have have a number I mean several dozen published studies on a impact if standard drugs like Dilantin don't work in effect before Dilantin ketogenic diet was a reasonable choice for kids with epilepsy as soon as drugs came out it kind of faded off and it's come back for that use Daniel Amen very famous local psychiatrist and a friend has a grandson that had

refractory seizures. Rather sadly and ironically, ketogenic diet was very beneficial. You go beyond that, you're just, you're absent data. So another startup that's hot and it's worth talking about because your listeners will hear this is Virta Health, V-I-R-T-A, backed by Stephen Finney, MD. I don't know much about him. He appeared in Dr. Malhotra's documentary about visiting the home of Ancel Keys, one of the most distorted and misleading documentaries ever done called the POP Diet, P-I-O-P-P-I. Don't read it, don't watch it. It's a waste of time, money, and honesty. But Virta Health claims with a ketogenic diet that you can reverse your type 2 diabetes with a high frequency. And they've got a lot of backing. And they've got an app.

And they've got a coaching system. So they have published a study in a journal that is so obscure and so non-reputable. But it is a journal, which's a proliferation of scientific journals that are open and you can either pay to publish an article or get access but it's a small study of six months duration actually the originally 10 weeks duration non-randomized no control group in the scientific world this is about as low as it goes and yes with the dietary plan they advocated very high dropout rate in the group studied. They showed some drop in measures of diabetic control towards the better with their ketogenic diet coaching system.

And on that, I speak to like brilliant people and they say, well, the debate's over. Virta Health has shown that ketogenic diet can solve multiple health problems. It's so overblown. And in fact, what's missing is the six, seven studies that suggest to get to the point. Big studies, hundreds of thousands of people. These are association studies. Group of people ate a certain way, questionnaires, food questionnaires, once food questionnaires, several times during a number of years.

Follow these people up. Harvard School of Public Health, Tufts School of Nutrition, very prominent places. tough school nutrition, very prominent places, dramatic rise in long-term mortality by people whose food pattern, it can be called the low-carb, high-fat diet, a rise in death rate. If you've had a heart attack and you fill out questionnaires at the Harvard School of Public Health and they follow you long-term and your diet can be described as a low-carb, high-fat diet, you're much more likely to die in follow-up than people that describe diets that are closer to high-carb, hopefully complex plant choices, though these aren't vegans, more like a Mediterranean-style diet. So that's the untold story.

For anybody listening and that's falling for this optimization of performance and metabolism and control of cardiovascular risk, the data needs to be addressed about death rate, and until there's a study that resolves that issue and says that's wrong, six, seven different studies in different parts of the world, I could not in any good conscience advise somebody do an animal-based low-carb ketogenic pattern, particularly if it's high in protein. Protein activates aging pathways. Protein activates biochemical pathways that right here in the City of the Angels

have been found from yeast to mice to humans to cause accelerated aging and aging in every aspect of our body. And it is animal protein rich in an amino acid called leucine as the main trigger. And you can't get around it. rich in an amino acid called leucine is the main trigger and you can't get around it grass-fed beef free-range chicken and uh line caught fish all have tremendously more leucine than the amino acid structure of plants they have it but they don't have near the same amount so when you raise those concerns and those issues and make those points what is the retort um association is not causation you know so what i've done a few times is take the argument that particularly nina tycoles the author of the big fat surprise

number one non-fiction book in the health arena in 2014 and to this day still celebrated as some kind of uh heavenly light that the nutrition world has accepted as, despite absence of PhDs or nutritional science backgrounds, and she'd argue you don't need those things, you just need to study. Lots of people talk nutrition that don't necessarily have MDs, PhDs, RDs, and all the rest, has been accepted to the point that in late 2017, the British medical journal Lancet, one of the most respected and all wrote a review of her 2014 book three years later as if it had just come out as if it was novel

praised it as if she had bought an ad in the leading medical journal in the uk it's it's just insanity so she will argue and dissected the movie what the health and first what thing she did and i'll get back to you this is the answer your question i don't remember if it was 39 major health claims made in the movie what the health she threw 37 of them away because either dr bernard dr gregor myself dr uh mills and all vegan doctors can't be trusted to give credible medical research summaries because we're biased. So that was one of her rules. She has a second rule, a statistical rule.

If the risk described in a, if you drop your risk of diabetes by less than 50%, it's not strong statistical data. And so she only was willing to give us one or two of the claims in the movie what the health is possibly scientifically valid. Of course, anything that is association, not causation, you have to do like a randomized study and understand the basic mechanism. So I've gone to some of the ketogenic data and a study called the PURE study that really confused the world in late 2017.

It said let's apply nina's rules okay dr salim yusuf the lead author eats meat so we have to throw him out anything he's you know it becomes farcical i mean i and i've said this publicly i'd say it again the day that dean ornish does a randomized study that says heart artery blockage reverses with beef chicken and you know and pork my obligation as a cardiologist is probably to advise a patient there's new data that's credible and you should consider even though it kills me and it kills the animals and it's bad for the environment it's it's not the case and um and we didn't we don't need to go down that path um so what do they say? Association, not causation, vegan doctors, weak data, or they

don't respond because they have their events. And as you've pointed out with other people we've interviewed, they seem a little more organized and a little more manly and a little more vibrant. But I think we're coming on strong in the medical health plant-based world with hunky people like you and Scott Stoll former Olympic athlete and such. The contention, the argument that no medical authority, no doctor who is a long time vegan or plant-based person can be trusted or is inherently conflicted because of that point of view. And as such, you know, their perspective or their opinion on all of these issues should be invalidated is disingenuous because the level of investment that the other side has in their own

movement is equal, if not more entrenched. So if you're going to apply that rule equally, it would just eradicate everybody. But human beings, we flock to our tribes. We inherently want to be a member of a team. And that doesn't necessarily serve anybody. And once we become entrenched, whether you're plant-based, ketogenic, whatever, it becomes more and more difficult to be objective. I'd like to think, like yourself, if evidence came out that the way I was eating and living was harmful to myself or to the planet or anything else that I would have the objectivity to then really look at that, take ownership of that and make changes in

my life. Yeah. So, um, I don't know. Yeah. Like people would say, well, I'm so, you know, this is my brand now. There's no way that I could ever, you know, there is that, I mean, that's, you know, watching when what the health came out and there was a lot of praise for the movie for about two weeks and then those that have a following have to respond I mean they have to and and what the health we should get into that because I think that documentary really has crystallized this argument because a lot of these media opportunities whether it's you at Google you know Garth Davis on the doctors these things that are happening are a result of that documentary which which is creating this, this debate.

And so in the wake, like you were, I can just finish your sentence, like in the wake of, of the acclaim or the attention that that documentary garnered, there was a backlash that, that sort of hit with quite a bit of severity. Yeah, there absolutely was. And, and, you know, maybe some were offended by statements in the movie but i think a lot of it was the obligation you're in a corner that says animal products are healthy grass feds good uh it's better for the environment because animals pooping restores the uh the soil all kinds of crazy statements um and yeah there was one after another whether it's dave asprey

whether it's nina tycals whether it's the diet doctor, whether it's on and on David Perlmutter, they all had a voice in and the movie took some hits, although they were largely inauthentic and easily answered as I did in a blog I wrote to some degree. I actually was pleased to see just yesterday morning there was a review of the movie. I mean, it's seven months later. Why people are reviewing it like it's a new movie. Very positive. Yeah, but that has done a lot to raise the conversation. And we can come back to what the hell. I just want to say one of the, I think, breakthroughs that your audience, I would imagine, doesn't know, and a person that I would put as one of the highlights in 2017 i called a new friend

is right here in los angeles you have at usc something called the institute of bio gerontology a research institute about aging in fact there's a word juvenology the study of remaining youthful juvenile youthful we should all be juvenologists vegan vegan juvenologists. We probably are. And that's all led by an Italian-born scientist, Walter Longo, Ph.D., who came to the United States at age 16 to be a blues jazz guitarist from Genoa. Spoke no English but could blow some riffs on his guitar in the Chicago bars. But by age 19 was fascinated that he never saw disease in his family in Italy and he was living in Chicago and his relatives were getting sick and bloated. And he had the foresight, he's 50 years old now, so whatever it was 31 years ago to say, this nutrition stuff, this aging stuff, this is more meaningful than becoming a jazz guitarist. And he totally shifted

his career, went to Texas and then went to LA and got a PhD with some very famous calorie restriction longevity experts at UCLA. And then he set up his lab at USC. And anybody can go read about him. He's one of the most fascinating, credible, authentic Nobel Prize nominated scientists last year at age 49, came in second. It's called the Jubilee Award because the same field he concentrates on was also being studied by some 90-year-old scientists in Japan,

and they gave it to the scientists that had been in the field a little longer. He will win a Nobel Prize. But he has kind of risen to the light as an unbiased, I think, spokesman for clarity, saying you can't judge nutrition. He goes, number one, don't outsource your nutrition to amateurs is the example he gives if your neighbor's an engineer an automobile engineer in detroit you're not going to go fly in an airplane that he designed between detroit and new york i mean get a professional to build that plane don't outsource your nutrition to amateurs

and base any evaluation nutrition on what he calls five pillars. One pillar is basic, basic science, which he is the leading world scientist on many of these aspects. What does sugar in the diet do to basic pathways? And the answer is it's not very healthy for us. What does animal protein do to basic pathways? The answer is it activates aging and cancer-promoting pathways called mTOR, called PKA-RAS. Sirtuin pathways, he's a a superb scientist so you've got your basic science you've got your association studies epidemiology flawed but you can't ignore them you've got centenarian studies i mean show if you've got a diet ketogenic diet let's find a

population in the world that's living to their 90s and 100 and climbing mountaintops and eats anything that could be called approximating that the way it's being described by these meat eating, you know, bloggers, nutritious. It doesn't exist. It does exist in Okinawa and other places, Loma Linda, where we have many examples that approximate the diet we eat. I mean, let's talk about randomized studies, which are pretty uncommon, but let's include those. And there's a fifth pillar. I don't really remember right now. His book came out a week ago.

And he concludes that in about one paragraph, you can just slash away what is commonly done in the paleo and the low-carb, high-fat ketogenic diet as an extremely dangerous, age-accelerating, high-mortality eating pattern, if done with animal products and if done chronically. And he concludes we should all be eating. And he's not a member of our traditional vegan community. He concludes we should be eating whole food, plant-based, enjoy life, have a little wine if you want, have a little sugar if you want. He likes fish one or two times a week.

He says in a very broken English, or not so broken, vegan fish. I'm a vegan fish eater. And he grew up on the coast of Genoa, and maybe it's a little bit of that, a little bit of science. A lot of us have concern about fish and its toxicity in fish and its depopulation of the oceans, and there's arguments there. there. But, you know, knowing that this shining light future Nobel laureate has parsed through this and challenges this other side who don't even know that his argument is this profound five pillar assessment of nutrition. And really, there's maybe five people in the world can really say I've done all these studies and this is my conclusion. Dr. Longo is one of them, is I think just a tremendous way that people so conflicted and confused in the public can say, I need somebody to listen to.

So go read The Longevity Diet by Dr. Longo after you read your new edition in my book and you won't be confused anymore. Yeah, you just showed me that book. I got to get that guy on the podcast. I'm definitely going to read that book. I can help you with that. He's a high energy. He still plays a mean, mean jazz guitar.

Maybe you can get him to bring it here and have a little fun. I mean, he lives by LAX and I can work hard to set that up. In fact, if you'll interview him about his book, I can guarantee you it'll happen. Oh, yeah, absolutely. So let me ask you this then, and I don't want to go too down the road. Can somebody who eats fish two times a week be a guest on your podcast? Yeah. Okay, cool.

Cool, cool, cool. I have an open mind. Open mind. What is it about eating meat or animal protein specifically that causes the aging? Like, what is his thesis on that? Or what is the science? Yeah, and you know, I'll go short, so you can go Longo with Longo.

It's kind of funny, the world's leading expert in longevity is named Longo. Yeah, of course. It's like, you know, Dr. Toothache or the dentist. Yeah, right, right, right. Dr. Smelzy, the foot doctor. We have a urologist in Detroit whose name is Rod Stiff. And that can't be-

That cannot be true. Cannot be a better name for urologist. Are you, it's really his name? I trained with him. I pity that guy a better name for your it's really his name i train with him i pity that guy growing up i think it's your best calling card um but there you didn't have a choice on what he was going to become yeah absolutely um so the basic tenet is he he's used besides the word juvenology the study of uh anti-aging or staying youthful in life, staying youthful in your brain and activity. In other words, nutritechnology, that you can use food to activate pathways that either lead to healing, regeneration, rejuvenation, stem cell production, or you can use food that activates pathways. So there's a pathway called mTOR, mammalian target of rapamycin pretty sciencey term

rapamycin was from i think easter island rapua island and they found this fungus that makes this molecule that has actually therapeutic benefit it's used in transplant patients mtor but you need when you when you're growing you need your growth hormone when you're growing, you need your growth hormone. When you're a child, you need growth hormone. There's a receptor in cells for growth hormone. And when you eat animal-based protein products, growth hormone is activated, leads down the path to maybe something you've heard about, IGF-1 insulin, like growth factor 1. Great thing when you're growing.

Great thing to maybe you're 18 or 20. But eating animal products, particularly with this amino acid leucine, continue to trigger the growth hormone down through the IGF-1 pathway. And, you know, we don't want too much cell growth when you're 45, 50, 55, because we've got these little cells that are waiting to transform into a line of cancer. And leucine is in meat. It doesn't matter if it's grass-fed. It doesn't matter if it's free-range.

It's in meat much more than you're going to find in beans and greens. Sugar will activate other pathways. It's called the PK pathway. So diets, and nobody in the health field, I think, is a fan of sugar, and nobody spouses it that became a debate about the what the health movie certainly dr barnard and dr davis were not advocating high sugar diets but it's a different kind of topic about sugar and the development of type 2 diabetes um and then there are some so this so you can create a diet low in sugar low in um

animal-based amino acids like leucine, low in protein. And what they've shown in humans. So what Dr. Longo did that's fascinating is when he started his career about 25 years ago or so, they were studying a lot of mouse models. Still pretty complex, even though it's a lot less of a mammal than the human. He went backwards to yeast, single simple cell yeast, and said, this will allow me a model to study. Nobody knew the word mTOR or these terms they used. And he's the one that identified these pathways

that are now known to be fundamental in aging, healing, generation, this field of juvenology. And it turns out the reason that his science has been so mind-blowing is these pathways of the yeast are completely preserved in the human species so what he found in the single cell organism is the same biochemistry that's occurring in your mice cell right now and it has profound dietary implications so he went on like I said these five pillars that was some of the basic biochemistry and I think

it's October 1 2016 a study was published in a major journal, JAMA Internal Medicine. Take 6,000 free-range adults, do very careful assessments. High animal protein eating free-range adults have a high mortality rate. Low animal protein eating adults have a low mortality rate. That's a very profound statement. Those that eat a lot of vegetable-based protein didn't have that relationship.

Whether they were low or high, they had a survival advantage over the meat-eating group. But high-protein diets accelerate aging through these biochemical pathways. Cell death, our inability to clear damaged cells out, that's called autophagy, that won the Nobel Prize that Dr. Longo came in second on. Vegetable protein doesn't seem to activate it. There is, and just to finish that

conversation, as adults get over age 65 or 70, protein becomes a more important nutrient to sustain their health long term. So Dr. Longo and some other experts, because you lose muscle mass, you don't want to be a frail, muscle-depleted elderly person. You'll be very prone to pneumonia, infection, and other things, falling, breaking bones. So you want to emphasize, and I would say just emphasize vegetable protein your whole life. Eat beans, eat greens, eat nuts, eat seeds, eat whole grains,

because you're going to be in the sector where this accelerated aging phenomenon doesn't exist. So fancy stuff, but it's lead too. Because you're going to be in the sector where this accelerated aging phenomenon doesn't exist. So fancy stuff, but it's led to. And that nutritechnology, that nutrient sensing pathways, high animal protein activates is aging through biochemistry. It's well described. I don't know how many rabbit paths I can go down. There are these people in Ecuador called the Liran. Israeli scientists, V. Liranan described these people 40 years ago they had their cells lack the receptor for

growth hormone so their body their brain produces growth hormone their cells can't respond to it so they're very short people because their cells are deficient in growth hormone. They have unbelievably low IGF-1 levels their whole life. And there's nearly, and now a scientist in Ecuador, Amy Gaviria, and Dr. Longo goes down to Ecuador now all the time, has described these people do not get type 2 diabetes. These people do not get cancer at a rate unbelievably less than the general population of Ecuador. So all these pathways are just another piece of those five pillars.

We can do that with food. We can eat a diet that is naturally low in producing levels of IGF-1. When we eliminate dairy, when we eliminate animal protein and emphasize the diet you and I eat, we're eating a longevity diet, which is exciting to know, and the body of science is profound on that and it's totally totally missed by our carn carne eating carnivorous friends with loud voices yeah just on an anecdotal level or a population studies type sociological survey of the situation it's pretty self-evident when you look at the work that Dan Buettner has done

with the Blue Zones. Like, you just look at these cultures, look at how they're living, look what they're eating, look at their social, you know, structure, their social, their community based, you know, way of life. And these are the people that are living the longest. They tend to be the people that are the most content and fulfilled in their lives. And it's almost to me, like, I don't need the inquiry to go much further than that. But it's good to know that there are studies out there that I had never heard about this Ecuadorian population. That's fascinating.

It really is. And it's the layers of support for what you've chosen to do with your life and your career and what I've chosen to do with my cardiology practice and career is profoundly more established than the general public believes. And I really do believe Dr. Longo, if that voice is heard, is going to do a lot to clarify. I was with some business people in Los Angeles this morning, extremely intelligent people in the organic, not food world, but organic world of consumer products. And they threw up their hands and they said, we're totally confused, guide us.

And, you know, so what's Rank and File doing with this issue? Either not paying attention, which I can understand, there's other issues in life when your paycheck is an issue, or they're just throwing their hands up like everybody says, moderation, everything, I'll do what I want, which is a very dangerous statement to make for health. It seems to me that this current divide in the 70s between sugar and fat and the kind of high carb or not high carb high fat low carb community will point to the

sugar industry is the culprit who sort of conspired for lack of a better term to point the finger at fat as being, you know, the evil, you know, the evil contributor to poor health at the time, which led to our 1970s, you know, low-fat craze. And this camp will say that that actually contributed to our obesity epidemic when, in fact, sugar was what we should have been looking at all along. So, can you... I have my own opinions on this, but can you share your perspective on that? Yeah.

And I'll reference... First of all, was that an accurate... Yeah. I think we covered a little of this and we did, I think, talk about Dr. Ansel Keys on the last time we chatted with you. So, I don't want to go too far down there. He was taken down. His amazing work was taken down and you were trying to explain like how that was.

So what we've learned since then, rather shockingly, and I think it appears to be real, is three researchers at Harvard in 1965 wrote an article, a two-part article in the New England Journal of Medicine. I've actually tried to read the article. It's such dense science. Maybe 1,000 people in the world ever read it. This wasn't an article that got headlines. It wasn't an article that influenced a lot of rank-and-file people at all.

But nonetheless, some researchers found some records that those three researchers took about $5,000 apiece from the sugar industry, which might translate to $50,000 nowadays in terms of equivalent economic value, to perhaps bias the conclusion of this extremely dense scientific article towards favoring anything other than sugar being a health issue for biochemistry of the human condition. favoring anything other than sugar being a health issue for biochemistry of the human condition. One of them, a guy named David Hegestead, was a peer of Ancel Keys, not a co-researcher, and was the head of the Nutrition Department at Harvard and, you know, shines poorly but has been exploded to say all research, all researchers, Dr. Ansel Keys, everybody involved with the American Heart Association, everybody's in the same situation as if everybody was a hashtag me too, you know, across the board.

Every guy is in the same boat. I mean, that's unfair. Everybody gets to live their life and judge and have authentic, hopefully, careers and all. So it's been overblown. I think it's a very small drop in the bucket of a larger issue. Again, bringing it back to what we were just talking about, I mean, sugar, there is a statement, as anybody who's seen the documentary What the Health Knows by Dr. Neil Barnard,

sugar doesn't cause type 2 diabetes. It's the fat fat and Garth Davis gets on the topic. So I had to dig into that a bit and it's relevant to what you just asked because I'm just a humble cardiologist advising patients, putting in stents. I'm not an endocrinologist. And frankly, I traveled to the website of the American Diabetes Association. A little button there says myths about type 2 diabetes. We used to call it adult diabetes, but kids are getting it now. And the first myth they exposed, sugar causes type 2 diabetes. Myth. That's American Diabetes Association. Well, that's what Neil Barnard just said. Went to the Jaws and Diabetes Center website, which is out of Boston. Same exact statement. Myth.

It's not the case. The Diabetic Association of the UK, same exact response so I actually you know felt that I didn't have too much doubt that Neil answered appropriate based on the science but I called up a guy named Gerald Schulman he's the head of endocrinology at Yale he's from Detroit he speaks at Wayne State University the medical school that I'm a faculty member of quite often and I discussed this with him and he said just to put it all together, he goes, calorie excess causes type 2 diabetes. Americans eat 800 calories a day more than they used to on average. You don't. I don't.

I mean, some people are eating 1,500 calories a day more than they did in 1970. Most of that is processed food rich in processed oils, sugars, refined grains. It's a whole gamut. If you actually designed a diet that you ate so much excess sugar that you packed on 25, 30 pounds, you'd be very likely to develop insulin resistance. But it could happen with other diets that were just processed oil and fat heavy. There's nothing unique about sugar that leads to type 2 diabetes. It's not specific. There's nothing unique about sugar that leads to type 2 diabetes.

It's deterioration of the American diet and moving away from home-cooked meals, garden meals, the whole response we see. So the sugar issue is overblown because it's an easy target. I mean, it's not a nutrient that you need to eat. It's not to say that sugar is, when we're talking about sugar, we're talking about refined sugar. We're not talking about the sugar in an orange or an apple. But to be clear, nobody's saying sugar is a health food. You shouldn't be eating refined sugar. I mean, glucose in your bloodstream is an essential nutrient. You don't have glucose, you will die.

And that sometimes gets confused. We're talking sugar and food. You know, a study came out in 2017 from China, the first author, Dow or Dow, I think it is, 600,000 Chinese. The more whole fruit they ate, the lower was the risk of developing type 2 diabetes. Those that had two type diabetes, those that ate the most fruit had the lowest risk of complications of type 2 diabetes. Dr. Longo seems a little bit shy on fruit. More vegetables, less fruit.

A couple, three servings a day might be all that you choose to put in your diet. I was interested in seeing that. But, yeah, nutrition is complex, but sugar has gotten backlash that is excessive. And what's the message for, you know, can you enjoy an occasional sweet and an occasional, you know, deviant from the best? That's probably the only area I'd say moderation occasionally is not going to be very harmful with sugar. I'd rather you be more meticulous about added fats of animal origin, processed oils, not

whole foods. We all agree. We all love avocados. We all love nuts. We all love olives, really without exception. I think on top of that, the idea that the low-fat craze contributed to the obesity epidemic is reductionist and patently false in the sense that it presumes that people actually ended up eating low-fat diets as a result of that kind of edict coming down

from on high, which is actually not what people were doing. There was a proliferation of low-fat and fat-free foods, but that doesn't mean that overall if you broke down somebody's daily caloric intake that it ended up being low-fat and fat-free foods, but that doesn't mean that overall, if you broke down somebody's daily caloric intake, that it ended up being low-fat, because this meets the ascension of the processed food landing on the shelves at the grocery stores, and a lot of those foods were, you know, the foods that we ended up binging on. Yeah, absolutely. I mean, I agree with you 100%. Dr. Dean Ornish presents data that if you go to the USDA and look what happened since about 1970 and on,

even though it was advised to eat a low-fat diet to protect your heart, Americans didn't listen. The amount of fat in the diet went up, as did calories, as did refined foods, as did sugar. We simply ate more of everything. The abundance of restaurants and no longer cooking at home and convenience of grocery stores where the middle are packed with grab-and-go kind of items, we shifted our diet in an adverse way. There are people that are sugar addicted, and just like every other food addiction, it's real and are

probably best to have extreme care and avoiding added sugars. And they're hidden in everything, barbecue sauce and dressings and 57 names for sugar that the food industry is allowed to use, fructose and corn syrup and maltodextrin. And for those that find that eating foods and sugar are just not resonating with their diet, I own two restaurants. I've had dessert in my restaurants maybe three times in two and a quarter years. I just don't go there. I'm not addicted. But I know it's not, you know, on my food plate is a very, you know,

it's not the health group that I'm going to do very often, and I'm there every night or many nights. I want to point out one of the, maybe you can get Penn Jillette on your podcast of Penn and Teller. But I just finished his book. Well, I'll tell you the connection. Your neighbor in Calabasas, Juliana Hever, can get him to you. I just had her and Ray out recently. You did?

I haven't put that episode up yet. Okay, yeah, because I think Ray Cronise is one of the most fascinating food thinkers out there now. And so, yeah, so Penn Jillette and the book Presto. So I don't know that that book hasn't really hit a lot of people's nightstand. It hit mine recently. And one, it's one of the funniest books you'll ever read. He's outrageous. And he's his language is his his ling, his chapter on Ask Me About Protein, which has more F-bombs.

Did you read the book? Yeah, I read that chapter. Yeah. Oh, my God. Is that funny? But the whole book's like that. And he has a chapter on Joel Fuhrman. And I just was with Joel Fuhrman in Detroit last couple of days.

He didn't know there was a whole chapter on him. And even though in some ways it's very, very respectful and praiseworthy of the bookie to live in Joel Fuhrman, it's pen's nature to make fun of people and change names so uh i tell you he's ordering the book to read it but that experience of a sugar addicted human who had to follow an extreme but also extremely um effective you know ultimate high complex carb sugar-free diet, also oil-free diet. I mean, that's necessary for some people that are battling the 130 extra pounds that he was carrying around that was going to kill him and others.

So, yeah, the sugar story has been overblown, except I wanted to be sensitive to people that really do feel that their physiology is affected and their psyche is affected. So just stay away, eat fruit and nothing more, or don't eat fruit. You can survive without fruit. Let's talk about heart disease. You are a cardiologist. Thank you.

I was hoping we'd get there. Your expertise. Well, our discussion we just had is about preventing heart disease. We didn't call it that. In the global sense, of course. So are we still in a situation where the statistics dictate that one out of every three people will die of heart disease? Yeah, you know, there's good and bad news.

Last few weeks, the survival of the average U.S. citizen went down for the second year in a row. Now, a very small amount. Opioid addiction, opioid deaths got a lot of the headline for it, but it's rather distressing with all the progress and what I've seen in my 30-year medical career and devices and procedures and all that overall lifespan is going down. We live in a very, very tough time, but that's the bad news. Cardiovascular disease actually seemed to be a little bit better than the year before. It's still number one.

Canada switched. Canada cancer is number one. Cardiovascular disease number two. We're close, but I don't see it shying away. And yes, the cardiologists in me, and I was hoping we'd get there. I always want to talk about how you can identify silent heart disease so you don't become the statistic. I'm trying to think of the last celebrity. I keep talking about Blake Krikorian, a very famous investor in LA who was walking from

the beach to his car with a surfboard under his arm about a year ago at age 48 worth $500 million dropped out of an acute heart attack. I mean, you know, I feel less bad about the business aspect. He had a bunch of little kids, you know, I feel less bad about the business aspect. He had a bunch of little kids. You know, tragedies where there's young children left without usually a father, it could be a mother, it's just the way the disease goes in your 40s. I want everybody to listen to this quote. Paul Dudley White was the cardiologist MD taking care of President Eisenhower in the 50s. And he said emphatically, a heart attack after

age 80 is a act of God. A heart attack before age 80 is a failure of the medical system. He said that in 1955, that we already know the majority of the science, what causes heart attacks. He had no idea about the technology we have nowadays to identify heart disease early. But man, a heart attack before age 80 is a failure of the medical system. We've had a completely unsuccessful medical system. I can, in the next three minutes, tell everybody who's listening how to change that outlook for their own health, which is critical. Yeah. And we're going to get into that. And just as a way of launching into that, I had our mutual friend, Kim Williams, on the podcast a little while back.

Wonderful. And yeah, what an amazing human being that guy is. Right. And, you know, one of the things he said that I'm sure you will agree with is that there have been these amazing dramatic leaps and bounds in the science and technology of how we treat heart disease in the form of stents and medications and surgical procedures and the like that have reduced the mortality rate of people who suffer from this disease. But at the same time, a blind eye being turned to the actual root cause and how to prevent people from actually getting to the situation where they need

all of this. Absolutely true, which is why our initial conversation is what Dr. Dean Ornish and even before him, Dr. Burkett, Dennis Burkett, a British physician who did amazing nutrition work in Africa, talked about the faucet. That, you know, if you walked into your bathroom and the sink was overflowing, you wouldn't run out and go get mops and towels and address the problem. That way you go turn the sink off and deal with the root issue that the sink's overflowing because somebody left the faucet on. The medical system is a mop and towel kind of system. You've had your heart attack. What amazing technology. Well, what about the Wendy's in the lobby of the hospital,

like the hospital I practice at at Harper University Hospital? That's a faucet. So Wendy's still there? It's still there, and I've been so successful with my social media campaign, they put a Chick-fil-A this year next to it. And I'll give a shout out to my friends, Beaumont Hospital in

Royal Oak, Michigan, just contracted with Mark Wahlberg to put in a Wahlbergers at our medical complex, which is no better than Wendy's, although it's got Mark's cute face and a lot of the posters. You know, when you get government-issued cheese, which is basically Velveeta, and you're serving that to the nurses walking over from the hospital to the strip mall. It's outrageous.

So off the beaten path. So that's how you turn off the faucet is everything we talked about. But the technology, the faucet isn't the same faucet. We've got better technology upstream. It's always upstream. Let's talk for a minute. Maybe you've got your notes, but I want to talk about Bob Harper and what he went through real quick. And how do you prevent Bob Harper, if he doesn't mind me using him as an example?

Biggest loser, fitness trainer, age 51, ripped guy in the past, always with a green juice in his hand and all and working out at a gym february 2017 dropped steady as a cardiac arrest on the treadmill by the grace of heaven above next to him on the treadmill was a cardiologist and on the wall in front of him was an external defibrillator and within about the shortest time any human could have he's got a trained professional on top of him with the pads that say shock. And he came back to life, rushed to the hospital. I believe he had a stent. I haven't actually read that.

And he was on the ventilator. But he's just one lucky dude. Brain, kidneys, everything kind of came back. And he went on the Oz show March or April 2017 and said the obvious question. How could you have had a heart attack with all your workouts and muscles and all those years on The Biggest Loser Show with J.D. Roth and your buddy and all that? And he said, I found out I have a genetic kind of cholesterol nobody ever checked called

lipoprotein A. It's a, if you, whatever doctor you're seeing, the routine cholesterol panel doesn't include that. LPApa sticky cholesterol lipoprotein a there are three terms for the same molecule costs about 25 to run the blood test he normal levels in most labs less than 30 i have dozens of patients whose blood levels are 300 400 500 and it just erodes their arteries and ages their vascular system and it will never show up in a routine physical unless you read, you know,

the New York Times recently talking about Bob Harper, blogs I've written. Thank you, Bob Harper, for bringing up the issue. There is a lipoprotein A foundation. How common is it? 63 million Americans have elevated lipoprotein A levels, 20% of adults. It's genetic, so you can eat well. That's the kicker. You're Bob Harper.

You're Rich Roll. You're Joel Kahn. Youel khan you got plants you work out you do yoga you got love and happiness in your heart and you got a lipoprotein a level of 400 you still can suffer stroke and heart attack um so that's one way i don't even know like i don't even know myself you haven't had it yeah and you know and i can and i'm 51 yeah and i can I can write you out a blood slip. But so can any doctor you know do it. You can go to Cedar. You can go anywhere. It's a simple test.

You don't have to go to any exotic lab. That's upstream. That's turning off the faucet. Because if you're elevated, the typical response right now is make sure the rest of your lifestyle is perfect because you've got a genetic risk that can't be dealt with. Be sure you eat well. Be sure you meditate. Be sure your blood pressure, cholesterol, blood sugar, inflammation markers like C-reactive protein, make sure everything else is spot on. And that's all valid and important. And I think that's the path that Bob Harper talks about on social media since then. There is a drug in investigation. Statins don't lower lipoprotein A,

so take them off the list for that, things like Lipitor. There is pretty strong data that niacin, a B vitamin, used at high doses lowers lipoprotein A. That's one approach I use in my own clinic, my own patients. And I can see their levels come down dramatically. The science hasn't yet designed a proper study to say that's going to mean somebody's going to be less likely to have a heart attack, stroke, and live longer because nobody funds a study with a drug like niacin that over-the-counter in a drugstore costs pennies. Yeah, you can't make any money off that.

Can't make any money. So just to be clear though, if you have this lipoprotein A lifestyle diet, clear though if you if you have this lipoprotein a lifestyle diet i'm sure it has some you know has a benefit on your overall health but that is not going to be a uh it won't protect you from that single uh there's there's a supplement company i like that has this dramatic uh poster with the heart and 19 daggers pointing at the heart of which blood pressure cholesterol blood sugar ldl hdl but lipoprotein a is one of those daggers so it won't protect you from that one dagger may you know ameliorate and turn the faucet or slow the faucet from you know seven or ten or twelve of the 19 but homocysteine is a blood test and amino acid genetically kind of monitored that you should know and you should check.

These things cost pennies or a few dollars in many of them. Like lipoprotein A, you do it once. You're 400, you got a problem. You're four, you have no problem. And you won't have a problem because it's genetic. So that's, I mean, that's how we're doing. I don't, in my 30 years, we have cooler stents. We can put in heart valves without cracking the chest more and more.

Some places do robotic bypass, but we're still filling coronary care units, emergency rooms, and operating rooms with procedures that, you know, from 1990, we know could be prevented 50, 60, 70, 80% of the time using Dean Ornish data and Dr. Esselstyn data. 80% of the time using Dean Ornish data and Dr. Esselstyn data. But it's frustrating that we're seeing that being grabbed onto by medical students. I'm very encouraged by medical students. They are the future. So if we wait a generation, we may actually get a lot of plant-friendly or plant-only doctors in the communities.

But it's pretty rare right now. So just to follow this theme, another way to turn that faucet off of people dropping and requiring acute cardiac care is the specialty that Kim Williams is an expert at. There are these CAT scans of the heart. I'm passionate about this topic. You're 51. You should have one. You don't look 51. That's actually... No, I've been thinking, you know, just even thinking of you coming over, I was like, you know, I should really get one of those. So there's a great documentary called The Widowmaker, and everybody can watch it on Netflix after they watch What the Health. At UCSF, they designed a CAT scan 20 years ago and perfected it.

It doesn't exist anymore because every standard CAT scanner does this now. You lie down on a gurney, you go in a machine, you hold your breath for 10 seconds, you go home. There's no IV. There's no iodine. There's a very small amount of radiation from the CAT scan equivalent to like a mammogram that a woman has. And you get a number. Are my heart arteries calcified? Zero is the winning number. I wrote a blog called The Biggest Celebration of the Heart. Calcium score is zero because it is. Your chance in the next 10 years of having a heart attack, and in fact the data goes,

it's a sign of aging of the body, not just heart arteries. Your chance of having kidney problems, cancer, brain diseases are extremely low because you have a youthful biochemistry. Things are working out for you. And it's a very complex process to really judge what's your real age. I mean, you're 51, I'm 58. But internally, are we 10 years younger than that are we 10 years older calcium score is a measure of true aging of our system and certainly arteries and if

your calcium score is as i have patients 1400 1600 1100 these are very very very degraded arteries with a process that needs to be investigated rarely leads to need for bypass need for stent but um is the the ability to wrap around all kinds of lifestyle and even more than lifestyle if needed measures so this calcium score in my city costs 70 dollars um who doesn't need it you've had a bypass you've had a stent you've had a heart attack you know the answer to the question do you have heart disease you're off the table i don't even think in my practice, the ultra healthy should avoid it because it's such a count, those 19 daggers, have you had all of them measured and assessed? Not you personally, but the public in general, no. So I don't care where people are listening with Chautau, Kansas and Gainesville, Florida, you can get a CACS, coronary artery calcium scan, no iodine.

In Indiana, South Bend, it's $45. You don't need a prescription. My state, you need a prescription from a doctor. And I literally hand these prescriptions out when I give a talk. People hear it. I'll write them a script because, I mean, it's a service for them to either be reassured that they're doing great. And I have patients with a cholesterol 300 calcium score is zero and the stress you take off of them doc so I can get off the prescription drug and really really

focus on lifestyle for three months or six months and try and whip this thing but I don't know did you have a elevated cause there's 19 daggers and the cholesterol has never been the only one. And these things are more complicated than we want them to be. It's really pretty simple. Nobody's ever said cholesterol is the only risk factor for heart disease. I mean, the American Heart Association picked five back in the 60s. Smoking, diabetes, family history, blood pressure, cholesterol and age kind of factors.

It's always been a complex predictive calculation. But this CAT scan cuts through all that and says, let's get real. Let's, you know, take $70, take, you know, literally a minute. And don't risk it if you're the 10% of Americans that have extremely high silent heart disease, you know. How, I mean, is this somebody that people is this something that people who are like in their 20s should do like should everybody great question certain age where this becomes more relevant i've rarely personally i've ordered thousands and thousands and thousands and thousands of these studies over the years because it's been available

in detroit in every major city for 15 years and now even medium-sized cities, usually at a hospital. Doctors don't own CAT scanners. Hospitals have CAT scanners. So I make no money. This is not an economic thing. This is a plea to turn the faucet off upstream. Rarely. I mean, if I had a 28-year-old and his cholesterol was 600,

there are a few. I might find a reason to do this if they're EKG or something. Usually it's a test for somebody 40 and up. 50 if you're, you know, great lifestyle, 40, 45. A whole lot of people have heart attacks in their early 40s that almost always the presence of disease could have been identified. The reason you don't hear about it much is not availability, it's not cost, It's not science. 2,000 scientific studies. And again, Dr. Kim Williams is an expert in the field of CAT scanning of the heart.

It's that the ultimate study. Let's take 5,000 people. Everybody get a CAT scan. Half will get the results and get a program to try and work on it. Half will not get the results. And let's see if it makes a difference in terms of death or heart attack. That kind of study hasn't been done. But every study that says, let's look at cholesterol or blood pressure or any other measure other than this CAT scan, the CAT scan wins the day as being by far the most

accurate, which is intuitive because you're actually looking at the heart directly, not indirectly. So yeah, there is some data. You've got a lot of high levellevel athletes, and I'm sure are listening, that actually multiple endurance athletic events may actually accelerate calcification of heart arteries. It's very confusing data. I know you've written a little bit about this.

It's like I'm almost afraid to read those articles because, you know, look we need you around so there is good news we know that you don't exercise please exercise we know that people that runners live longer than the average american runners are meaner remember jim fix well jim fix ate like a pig he was 52 yeah he was very famous for saying i can eat whatever i want because I exercise so much. I don't know if he had lipoprotein A or just a bad diet or a high cholesterol or homocysteine, but he had severe advanced three-vessel coronary artery disease at death. Tragic, tragic, tragic. And I use that example, and the other one is Winston Churchill.

Fat, smokes cigars, and he doesn't die of heart attack and lives till 92. So if you rely on sensible calculators, we screw up terribly. The CAT scan cuts through all that nonsense. The good news about athletes is they are lean. They have better blood pressure. They tend to have better cholesterol. They tend to have better blood sugar. But whether ultra-endurance exercise is inflammatory,

whether sometimes the diet isn't as green and clean as yours, and how many athletic events end with donuts and pizza and things that celebrate the survival of the event but don't really heal the body. So it opens a can of worm to be tested and one has to just like any almost genetic testing, you have to be resilient and say, I'll deal with the data and find the best course to take with it. But better to know than not know. In the context of,

in the athlete example, is it, so there's the, there's calcification and that's a result of constantly submitting your body to so much exercised induced stress that it creates kind of a chronic inflammation problem where you're always dealing with trying to recover from these workouts? Or what is it specifically that is leading to this conclusion? Well, I don't know that the answer is known.

Well, I don't know that the answer is known. Why are there now probably three dozen studies easily of analysis of heart arteries in ultra-athletes and calcification being the easiest thing to measure and it being elevated beyond expectation, even sometimes elevated beyond people exercising less or not exercising, which is rather distressing data. Don't stop exercising. I know. He's like, am I going to have to stop running now? Right, and maybe go back to eating burgers and fries.

I mean, we're back to throwing our arms up because exercise is another topic. Is there a sweet spot? Is exercise a moderation in everything for the public? Not for the really trained athlete, not for the professional athlete, not for the one who's passionate, but is the message to the public moderation and exercise that, you know, I tell people do 10

minutes as opposed to zero because the feeling is if I don't get 60 minutes in, it's not worthwhile. 10 minutes is worthwhile. But back to the issue, you're probably not chronically inflamed, you're probably acutely inflamed. Multiple studies say at the end of a marathon, if you draw blood on a person, presumably healthy, a lot of them will show the enzyme that comes from the heart that leaks during heart attacks will be present in the bloodstream of healthy people after a marathon called troponin. And indeed, it's stressful. They were nutritionally depleted as they didn't train adequately,

and there is some data that those that train more, that's less common. If you do an MRI or an echo of the heart right after a marathon, and a lot of these have been done that way, actually the right side of the heart is actually a bit dilated and not looking so healthy. 24 hours later, it looks like it recovered real well. But the question is, if you do it repeatedly and repeatedly and repeatedly, are you laying on layers of scar? I mean, so it's not chronic.

You probably are not chronically inflamed. You're intermittently inflamed from, you know, a high level of sustain. And we're talking, you know, the kind of stuff, frankly, that you do and your friends do, not an hour at the gym. But the data is very murky that that's still. You know, let's go to blue zones. I mean, of course course there's not too many ultra athletes in blue zones and there is some sense they're naturally perpetual motion but in terms of longevity um and i'd love you to ask dr longo that question well you get them on but um there's no reason to worry people that you're shortening your lifespan. You may be calcifying your heart arteries,

and it may be a bit of an aging process. I mean, I think you'd probably agree some of what you do is putting your body under stress and the ultimate course of it all, but I'm going on record. It's great to exercise, but don't just because you're a high level athlete not know your lipoprotein a not know your homocysteine not know your c-reactive protein inflammation and don't not spend 70 and get a heart ct scan recognizing you're going to need to dig in and get a little research about what do you do with it if it's abnormal it's it's what i do every day but

it's not clear-cut i try and base it on science, but just like nutrition, maybe we got three pillars, not five pillars, but do the best we can. Let's talk about saturated fat. Whoa. Okay. I feel like I have this conversation every time I have a doctor on this show. And I'm still trying to get clear on this.

I know your perspective. Right. And then I look at, you know, Asim Malhotra's Twitter feed. Malhotra. Malhotra. Is that how you say his last name? Who I've met and seems like a nice guy. He's a bright guy. And he'll say, we now know saturated fat has no impact on dietary cholesterol. In essence, he's saying all this worry about saturated fat is misplaced. This is not something you need to concern yourself with respect to cardiovascular disease. Right.

True or false? False. False, dangerous, distorted, and instantly gets you international media attention, which he's very good at. And that in and of itself may be no accident. It may be part of the food industry and such that, you know, get a cardiologist to write in a journal or do a talk about animal-based foods and saturated fat in animal-based foods.

You know, being maligned and actually being healthy will, you know, support a whole lot of industries that are suffering right now, which is great. I hope they're suffering and wither up, but it's a popular thing. So again, not going there, but Ancel Keys and many other researchers, because he himself always had 17, 18 other co-researchers of tremendous fame that never took money from the sugar field. So his co-workers that are still many of them alive in Italy and Henry Blackburn, who's Dan Butiner's neighbor at age 93 in Minneapolis, one of the most amazing scientists

and such, many of them are alive, parsed out very clearly in all kinds of, again, like five pillars, basic science and epidemiology and all. Animal-based saturated fat promotes a high blood cholesterol, which is associated with and would be reasonable to say causes atherosclerosis, hardening the arteries. Limit your animal saturated fat. Ancel Keys' diet was very rich in olive oils. It's billed a low-fat diet. His cookbooks are clearly not low-fat diets they're not vegan diets but they were low in they never concluded coconut oil it's not a mediterranean

diet food and ansel keys described to america the mediterranean diet that most of us agree is a reasonable place to sit in the middle if you got to sit somewhere but then came along 2008 if you talk to um uh scientist i'm blanking on his name for a minute uh but exposed by michael gregor and one of his nutrition facts.org youtubes there was a meeting in mexico city in 2008 the dairy industry saying you know we're losing the battle people are are drinking less dairy. We need to find sympathetic scientists. We need to find sympathetic bloggers. We need to presumably support them, invite them to meetings, fund their travel. And we need to put dairy for sure back on the map. Within a few months, a scientist in Oakland, California, Ronald Krauss, MD, runs a big pediatric lipid lab in Oakland,

MD, runs a big pediatric lipid lab in Oakland, is talking to the National Dairy Council and giving keynote talks that he's being paid for on the health aspects of saturated fat, and specifically dairy, which is typically rich in saturated fat. And then 2010 comes a meta-analysis review by Patty Siri Torino, and who's the last author? Ronald Krauss, who John McDougall calls Dr. Lardy. Doesn't respect Dr. Krauss much as a scientist and feels since almost every paper he writes is funded by the Dairy Association and all. Comes this 2010 article, and that questions, we can't verify that saturated fat is associated with increased risk for heart disease. It's a meta-analysis.

It's not new science. It's just a way to play with existing studies. A study that was so bad that the journal it was published in published right with it a complete and utter disembowelment and critique, which is very rare. People write letters to the editors, to the journal afterwards. But here's the science. Here's Jeremiah Stamler, a very esteemed epidemiologist scientist who just dissected the study. They accepted it, but then they really allowed a extreme criticism. But that all gets lost.

So we've got this paper. There's this, you know, that's, and then 2014, another paper of a similar bent by an author named Chowdhury. That's really the bedrock of this idea that we have it all wrong and saturated fat is okay. They're both meta-analyses, kind of a weaker style of science. It's not original data. The meta-analysis by Chowdhury was so bad that the chief of the Department of Public Health at Harvard, Walter Willett, M.D., one of the most respected scientists, called for it to be retracted. But it doesn't matter. It's, you know, the feathers in the pillow.

How long ago was this? 2010, 2014. So there's butter on the cover of time. Right, so this is what precipitated. The butter on the cover. And between 2010, 2014, all kinds of hullabaloo. And Malhotra, that's all he's got. I mean, he doesn't have any new data that says when Dean Ornish took away.

Actually, you can go way back when Nathan Pritikin, even before Nathan Pritikin, an internist in Los Angeles, Lester Morrison at Cedars, took away saturated fat from his heart patients, finally lived 50% longer. In 1949, 50, 51, Nathan Pritikin, 70s, 60s, 80s, showed that his heart patients did dramatically well. There's no new data that says that's wrong and we can now feed heart patients coconut oil and butter and lamb and turkey and even fish, which can be high in saturated fat. There's no new data that says that.

There's these two confusing studies and, you know, some ancillary ones. If you really go back to what's been since 2014, this definitive series of association studies from the Harvard School of Public Health that have confirmed without doubt, when you are eating butter, lard, and ghee, your risk of cardiovascular disease is high. When you replace it with olive oil, it goes down about 9%. When you replace it with vegetable oils, it goes down about 23%. Now, they didn't go to the next step.

What about if you have a diet that is absent added vegetable oils? Because that was uncommon in these. And these were a data set of over 100,000 people followed for more than 30 years. Yes, it has flaws. And there's occasionally a Harvard researcher that takes some money from Unilever that makes one of the vegetable oils. I mean, it's hard to find scientists that are lily white in terms of some funding of research. But nonetheless, you know, why that message still remains so confusing.

Truly, the biochemistry of fats confuses me. The biochemistry of fats, you know, got to sit down. We got to separate trans fat. Everybody hates. Then we got to understand what are saturated fats. Well, some plants have saturated fats like avocados, olives. Olive oil is 15%, 16% saturated fat. And certainly, coconut oil is 82% saturated fat.

And so that's difficult. Then we've got to get to the polyunsaturated fats and separate the MUFA, the monounsaturated fat like olive oil, and the PUFAs that are omega-6 and omega-3. It's just so confusing that literally I've got to sit down and write it all out and keep repeating it over and over. What does the public do? And then there are still room to discuss, is olive oil on the health menu or not? Dr. David Katz at Yale, absolutely. Walter Longo of Italian origin, absolutely.

We've got the cardiovascular data. We've got other authentic and caring scientists that would say in an obese society, you don't need, you know, 120 calories per tablespoon of olive oil when you can do it with water, vegetable stock or just steam foods and save yourself some of this calorie excess. So I'm still on board. I'm still on board clearly. My message to my patients is avoid or completely eliminate saturated fat containing foods, which are animal foods largely, and coconut and palm from your diet. On this issue of the complexity of all of these oils and how they all work, polyunsaturated, monounsaturated, even in the saturated fat world, we have lauric we have myristic we have palmitic we have steric like are there differences between those four different types of saturated

fats yeah it's no it's the length of the chain 16s and 18 the longer chains are much more pro-atherogenic so palmitic always loses palmitic acid is the most pro-atherogenic it's i'm not sure if it's 16 or 18 of the long chain fatty acids where stearic which is the one that does exist in chocolate and is in some beef and used by pro-beef people to say beef uh which has a combination of fatty acids uh it may not be as bad but i you know and lauric is the one in in coconut oil because you know coconut oil that's what the mct medium chain they're not long chains the ideal chain length is 12 carbon um in coconut oil in terms of maybe being neutral to atherosclerosis. And that we don't know for sure.

But the problem is you go buy coconut oil at the store, I guarantee you it's not going to tell you it's a 100% 12 carbon length or 14 or 16. These are mixtures. You're taking a risk when you're buying it. An organic label isn't the issue. It's the mixture in there. There's no doubt people eating a large amount of coconut oil raise

their blood cholesterol, and raised blood cholesterol is going to favor the development of atherosclerosis. If your calcium score is zero and your homocysteine, lipoprotein A, and cholesterol is ideal, you want to put a little coconut oil in your diet, go for it. But the problem is people are doing it with either known heart disease known diabetes known obesity or uh more commonly unknown risk and they're they're taking a risk so what is the history or the story behind how coconut oil became considered to be this health elixir this panacea yeah it's um there actually is a book in the 90s the miracle of coconut oil and it's written by a naturopathic doc although he doesn't put his degree there indeed the book he wrote before that is how to take balloons and fold them into animal shapes so he's written a

whole bunch of interesting books and there's really a true story if you were to go to amazon and go to like the earliest coconut oil short book and go just one before it by the same author. So I don't know the man and if he's still around and I'm not making fun of him because I don't know his history, but it wasn't the chief of public health at Harvard School of Public Health. And there really is. And we don't have a definitive study that says for most people who are trying to avoid

heart disease and aging, it's a unhealthful food. We know that it raises cholesterol. We know it's not part of blue zones. We know that it's not part of the Mediterranean diet, even though Dr. Malhotra introduces coconut oil to his version, which is nothing other than another Atkins version. It's not a Mediterranean diet. other than another Atkins version.

It's not a Mediterranean diet. And that all crystallized June 25, 2017, when the president of the American Heart Association, who that's another story, ended up having a heart attack in December at age 52 as the chairman of the President of the American Heart Association, John Warner from Dallas. But when he called a group of 11 scientists to say, we need an updated conversation

on saturated fat in the diet, that's called the Presidential Advisory. It was published in June 2017. They talked at length about this spectrum of eating butter, lard, ghee as your mainstay of fats in the diet. What's the impact of converting? And I went through that data and 25-page document, 250 references, all of that was discussing and concluding reducing saturated fat in the diet is still the proper conversation by a cardiologist with their patients. One paragraph out of 25 pages said, we have to conclude that the absence of data, that coconut oil in the diet is helpful for heart patients, leads us to recommend don't include it in the diet. And that's what the blogosphere, the ketosphere, the paleosphere,

when bananas about to the point, Dr. Mahatra agreed with a statement that the American heart was a terrorist organization worse than ISIS, giving bad advice to the American public. What is the basis of that? And our friend Mark Hyman chimed in on that and agreed with that. And it offended me. Chris Kress, people were sharing this meme that the American Heart Association was a terrorist organization over the coconut oil. It's a scientifically valid statement to say we don't have a definitive answer.

You can argue, does that mean that you should avoid a food that's very high in saturated fat until science fills the void? That's what the American Heart, I think, authentically was arguing. It was a pretty august group of scientists from Harvard, from Northwestern, from Tufts, some of the best nutrition schools in America. And they didn't seem very conflicted in the long and detailed conflict of interest page that was at the end of the article. I think it's a reasonable conclusion. page that was at the end of the article. I think it's a reasonable conclusion, but God,

did it ignite a very conflicted, very inauthentic response to the larger issue in the paper, which never got really discussed, which is go back to eating less meat, go back to eating less animal products and find those amazing substitutes that are showing up everywhere in grocery stores, which are naturally going to lower your saturated fat intake, which remains as valid as a statement today as it did in 1970 when Ancel Keys published a seven country study with his co-authors. Is there any evidence to support that somehow the American Heart Association was conflicted or corrupted somehow. Like the vehemency of the response was so. What you saw and what the health is real, they're not. I mean, to Dr. Kim Williams' credit and the American College of Cardiology, they weren't in that movie because they've avoided some of the funding

and the conflicts and the recipes. The American Heart Association has a little different mission, public education and nursing education, CPR. But those recipes are on their website, and I've been to American Heart Association meetings in the Coca-Cola health tent. And, you know, you need to fund these organizations. And, you know, there weren't companies around like Memphis Meat and Beyond Meat and the Mayo Company and the Impossible Burger and such.

You know, they need funding, but they've compromised their integrity and they've lost a little sticker on Froot Loops that says it's a whole grain cereal with Americano. I mean, they've lost a lot of credibility doing that. It doesn't mean the scientists have lost their credibility. And that's hard sometimes for the public to distinguish. lost their credibility. And that's hard sometimes for the public to distinguish, or it's easy, let me say, it's easy for the bloggers to attack and just throw everybody under the bus. It's pretty hard to throw Walter Willett under the bus, University of Michigan grad, I'll emphasize. Well, the blogosphere has been loud and unequivocal in its criticism of and its takedowns of Ansel Keys. I mean, we went into that in length in the first, I think it was the second time we did the podcast. So I

don't want to rehash that. And also Dean Ornish, you've also written about that extensively. And I believe we've talked about that. But maybe we could talk and the China study, I would say. But maybe we could talk about what the health, because that's sort of top of mind for a lot of people a lot of people have just seen it they're in the new year maybe a lot of people are seeing it for the first time and you know I think the hot-button issues that that that people found to be alarmist were some of the more some of the more controversial aspects of the movie were the kind of visual imagery that surrounded the processed meats by putting like, you know, cigarette or cigar in a hot dog bun. And this link between processed meats and cancer equivocating to what was it?

I can't remember exactly. Five cigarettes a day to eating one hot dog or something or a piece of bacon or something like that. Yeah, it was one egg a day equals five cigarettes for cardiovascular risk. And then the process meet cancer risk. So, you know. People got pretty excited about that. Pretty excited. I don't know Kip Anderson well.

We've become acquainted in 2017. It's not the first round. He's made of a movie. His website has lots of references. It's a documentary, but I think it was a very accurate and highly done documentary. So whether you like it or not, Dr. David Jenkins, MD, a very prominent research scientist in Toronto, published a study in 2012 of over 1,000 people tracking how much plaque they had within their carotid and how many eggs they ate.

And he created kind of an index, how many eggs per week, per year. And there was a relationship, an association, egg years and carotid thickening, an artery that's to your brain that you'd like to keep youthful and all. And when he equated it in the same data set to those that responded, they smoked. And how did those two risks associate? One egg equaled five cigarettes a day. And there was a statistical published, peer-reviewed, not plant-based, not non-plant-based. It was scientific data. Like all association studies, it raises questions, it's hypothesis generating, but it doesn't mean for Kip to put it in the movie was inappropriate or scientifically fraudulent.

It's indeed the data. And with the huge number of nutrition studies funded by the Ag Board, it's pretty darn hard to find a credible egg study in the last 10 or 15 years. There were a lot of them 20 years ago, but the egg board really started funding these studies since then. A lot of conflicted studies. The processed meat goes back, maybe your listeners remember, October 2015, World Health Organization. After years of studies suggesting processed meat was linked to a rise in the risk of cancer and other syndromes, heart disease, congestive heart failure, very strong risk, maybe number one in the diet.

If you don't want to develop type 2 diabetes, cut out processed meats with a hot dog, bologna, salami, pepperoni, bacon. But that was crystallized when the World Health Organization put out a paper. We reviewed 800 studies. We have 22 world experts. We're not a vegan. We're not, this isn't, you know, the plant-based movement. This, I can't, probably nobody knew really the scientists. They're just authentic nutrition scientists. Conclusion, you know, processed

shred meats are class one carcinogens, not suspected, but proven to cause cancer, particularly colorectal cancer, extended to prostate, extended to pancreatic, extended to breast cancer, but statistics were highest because that processed meat is sitting in the colon, so presumably it's the organ most exposed to risk. Since then, the World Health Organization has published follow-up studies that confirm without a doubt this was a valid conclusion. There are more people die every year worldwide of smoking and cancer-related diseases than there are that die of processed meats. Maybe 50,000 people a year

worldwide die of processed meats and cancer. Do we ignore that? Do we say that that's not as many as, you know, a million, so we don't address the issue? Right. The issue was that it was hyperbolic in the sense that the increase in susceptibility was relatively statistically minor. Well, but two strips, less than two strips of bacon a day, it's 50 grams, raises in a relative value, a risk of developing colorectal cancer by 18%. Now that may be from 5% to 6% in the general public. That in and of itself may not sound impressive. I like my bacon so much, I'll take a 6% risk, not a 5% risk. But it is statistically valid and the wealth of data.

But nobody will extend the conversation. Let's talk about heart disease, erectile dysfunction, type 2 diabetes, obesity, dementia, and congestive heart failure, another cardiac syndrome I care a lot about. So what's the immediate step? I mean, hospitals, this has to be out of hospitals. Has any hospital since the World Health Organization banned processed meats? None that I know of. The Cleveland Clinic was going to, but I think they've capitulated.

What do you do in your own life? You know, eat less, eat none. That's for each individual to decide. And anytime you eat a food like that, if you do, couple it with an antioxidant fiber-rich choice like green leafies, fruits and veggies, brightly colored foods. There's this fascinating study five years ago that if you walk down to a hospital lobby and pick a hamburger and eat it, within an hour you can document that your arteries are dysfunctional, something called endothelial dysfunction, a rather shocking statement that the food served on a patient tray directly can be shown to harm arteries. If you eat that same burger with a big slice of lettuce or a big slice of avocado,

you actually don't see that same drop. So it's kind of a rule, if you're not following a perfection diet and you slip up, take the antidote. And the antidote is garden foods and produce foods. And I'm certainly not encouraging people to eat those foods, but eat them infrequently if you are, and eat them balanced with nature's own antidote. Right.

It's worth saying that all of the claims that are made in what the health are validated and backed up with citations on the what the health website if you go to i think is it what the health.com or what the health movie.com or something you know i'll find i'll put it in the link in the show notes but they'll they have a section where you can go and they basically parse out every claim that they make throughout the movie and then support it with a variety of citations yeah and i agree and the worst example i saw and this got garth davis involved was a z-dog z-dog md this md in las vegas hospitalist who's developed an enormous youtube following because he can be pretty darn funny singing and acting like a buffoon, but he took on what the health and eviscerated not just the

concept as a clearly non-trained nutritionist, non-trained epidemiologist, but he made fun of the people in the movie, particularly Michael Clapper. He was just Michael Clapper, one of the most high integrity physicians at, you practicing Santa Rosa a man of such integrity and it just so offended me that Garth Davis responded vigorously in the YouTube and a blog I responded vigorously in a blog and he seems I actually think the push backs working I've been told that Nina Teicholz and Gary Taubes actually read when we get angry and they're a little more careful about what they say and i clearly sense z-dog has

backed off which is why we need to be vocal aggressive and sometimes obnoxious right i think but he achieved his goal which was to get a bunch of attention and views right you know by being controversial and then garth who's a bulldog and you know god love him that guy speaks his truth and doesn't hold back and and you know that's why he's he's the best and you know you if anybody who saw him on on the doctor saw you know like that that kind of went sideways for everybody and crazy it's like well actually plant-based nutrition news which is a youtube channel did a video uh about that experience of garth on that show that's pretty interesting i'll link that up in the show notes as well everyone should check

that out because i think garth did better than even garth you know sort of i know garth didn't have a good experience on that show it was kind of a hatchet job they were going to come after him but he stood his ground quite strongly and with respect to to ZDogg, you know, Garth kind of went right back at him. And then ZDogg sort of backed down because now he had all this attention and realized like, oh, well, like Garth actually watched my video. And Garth was the one who said, let's debate. I'll debate anytime. Bring anybody else. He wanted to debate.

This is how I understand it. I hope I'm not butchering this. But Garth suggested that he could come on z dog show and debate him and then z dog sort of backed down and said well you know i'm not the best person to defend these claims you know sort of admitting like maybe he was a little bit out of his element or his area of specialty uh and then garce said well bring on anyone you want and i think there was a conversation about maybe having rob wolf or somebody like that join it and then it never came together for whatever reason. I don't know why.

It's probably better. It's just be another more attention seeking. Everybody wants to have these debates, right? There's a lot of energy. I'm like, let's get all these people in a room. But in my experience, I don't know that that's really, it's interesting because we all have these silos. And in certain respects, these silos are not serving us like we do kind of need to get together in the way that you did at google with dave asprey and have a mature conversation

but a lot of times these these these conversations devolve into shouting matches and and everyone's so dug in that nobody it's like it's like watching political television on any network. The view. The view. Medical conversations should try not to devolve to the viewer. You know, that may not be the best example. I will give, on a similar path, I got invited on The Doctors about a month before Garth to take on Steve Gundry and the plant paradox, which we haven't talked about. It was worth maybe two minutes. Yeah, I shared quite a bit of my roll call email every time okay right yeah just you know the idea that legumes are dangerous because they've got hidden anti-nutrients called lectins and if you eat five kidney beans you can die if they're not

properly cooked and this coming from a man who was chief of one of the more prominent cardiovascular departments in the united states in loma linda kind of ironic, the Center of Plant-Based Science and the Adventist Health Study, now an anti-aging kind of guru out in Hot Springs, California. But his book got all the accolades, and I went on the show to debate him, and I was prepped and primed, and he was relaxed and not on his game. And it was not the shouting match, but it cleared the air that this is another confusionist approach to nutrition. When every blue zone eats legumes, the very center of Dan Buettner's chart is legumes

in every pocket of centenarian length. Let's clarify that for the public real quick. So that was a fun experience, not in handling the man, because I actually have esteem for him and some of the work he's done, but for just trying to stifle that as quickly and efficiently as media and TV lets you do. Right. The basic message from that book is stay away from beans and legumes. Or cook them with such care that you might not choose to cook them at all because there's the fear has been put. Message, everybody listening, don't eat raw beans.

It's really, really bad to buy a bag of red kidney beans and eat them. But I don't know any society in the world or any human that would try and do that. Well, I'd be in big trouble if I had to stay away from those foods because I eat those every single day. Right. No, eat cooked ones or pressure cooked ones or soak your beans and do that. Well, I'd be in big trouble if I had to stay away from those foods because I eat those. Right. No, eat cooked ones or pressure cooked ones or soak your beans and cook them. But there's not really much health risk with the typical human experience. Or you might get some diarrhea and nausea if you rush the process of it. I wanted to touch on another issue that you've

been, it seems to me that you've been getting more and more interested in, which is intermittent fasting. Great. Which is not like a, that's not a, that's a subject matter that's been embraced by the, the low carb, low carbers and ketosis people. Like they're all about that. There's a lot of science going on. The plant-based community hasn't really spoken to this, but I think what's going on in that world is super interesting. Super interesting. And it circles back to the conversation we had about Dr. Longo. You know, the very brief bullet points, the observation that our experience in humankind

often were periods of relative starvation, just on the nature of not being grocery stores a couple thousand years ago or 10,000 years ago. And apparently we have an apparatus designed to put us into a different metabolic state to handle calorie deprivation. Many studies that suggest there's no species in a research model that if you restrict their calories, they don't live longer. A yeast, you restrict their calories. They actually live 10 times longer if you take a mouse and restrict your calories they live 40 to 50 percent

longer you know profound differences the question is is there a human experience that's possible and doable and compatible with life and that isn't the biosphere where you come out you know grumpy and depressed and uh and you every day of the month you have to, you know, grumpy and depressed and every day of the month you have to watch how many calories you take. And there are people that do that. So what ultimately, and the only point really to talk about, because it's another really interesting part of the plant-based movement right now, is Dr. Longo seeing the biosphere experience, but also enjoying life as a typical Italian might want to be, played over the

years in these yeast models and these mice models and recently humans. And could we mimic fasting but still eat? Provocative, crazy idea. Could we create a diet that doesn't have the components that food causes, that accelerates the mTOR pathway, the PK pathway, these pathways that accelerate aging and destruction of cells. Can we create a diet that lets you eat some? And can we actually still benefit from what fasting seems to do, which is accelerate a

process, a fancy word, autophagy, the clearing of damaged cells to allow them to function better. That process, real quickly, that won the Nobel Prize last year, autophagy, is like the hot button right now of anti-aging. That if you eliminated every case of heart disease, cancer, and diabetes, we'd extend human life by 13 years. If we could end damage to cells and improve the efficiency of autophagy to take your cells that are aging and restore them to a youthful state would extend human life by 30 years.

So the research is going now in this anti-aging world. And he created, bottom line, a diet that five days in a row of, in the human experience, 800 calories a day of a plant-based diet, low in sugar and low in protein, but containing whole food fats like olives and nuts and containing moderate complex carbohydrates so that the carbohydrate calorie load's about 35% that he found in animal models and in a study published February 2017 in 100 Humans that you could see the responses you get with a complete fast, but you don't have the pain of a complete fast.

You don't have the risk of a complete fast. He called that and patented that fmd fasting mimicking diets um and he has shown that not only do they favor losing visceral fat around your belly which is what so many people are doing 10 day belly bloats five days in a row in a month and you can do it as many months in a row as you can tolerate and all and we're talking about eating a nut bar for breakfast. We're talking about eating soup and kale crackers for lunch. We're talking about eating soup and occasionally a little cacao bar for dinner. These actually come prepackaged in a startup that he engaged in with the University of Southern California. That doing that five days in a row activates these primal pathways

that actually not only favor improved metabolism, losing visceral fat, you don't lose muscle mass, which is fantastic, but you actually lower IGF-1 levels, which is one of the goals. And lastly, you actually create a flood of stem cells from your bone marrow into your bloodstream. Stem cells that people are going to Tijuana and paying a ton of money for that will go to injured and damaged parts of your body and clear out damaged cells. So there's data now in animals and some human data that multiple sclerosis may be responsive to a five-day fasting mimicking diet of plants, low in sugar, low in fat. That actually brain growth occurs in animal models.

And right now, cognition is being studied in Italy using Dr. Longo's five-day fasting diet. In addition to just weight loss, that cancer patients, it's called chemoleave, it's a product they've developed and not released yet, it's being studied at the Mayo Clinic and other places, that if you're getting chemotherapy and you do this fasting mimicking diet and use plants and use low sugar, low fat, you actually get a better kill rate from the chemotherapy and you get less side effects. Profound data. Athletes are being studied in Verona, Italy right now to see if this enhances performance, if it'll enhance recovery and allow you to go back and do the next athletic

event with more success. So several hundred worldwide studies using this exact model. I would describe it, it's a plant-based cyclical ketogenic diet. Cyclical because it's five days a month and it's plants. So it's not the extreme of what you're seeing on the blogosphere. It's the plants and the plant proteins that don't seem to activate aging like animal-based protein. And it's 800 calories a day. It's not water fasting. So there are people shouldn't do it. Underweight people, pregnant people, brittle diabetics, brittle heart patients, 800 calories a day. I've done it seven of the last 11 months. I'm down 25 pounds. I have boundless energy. My labs show improvement. My

blood pressure shows improvement. I have dozens of patients who have had the same experience. And what do you do with a heavy vegan who's really doing it right? You got to change your metabolism. And this is one of the hacks that might, you know, allow our movement, one, to have the scientific basis to say we're in the right sector of the food plate, and two, to actually help people get more out of it than they're getting. Because not everybody eating a whole food plant-based diet with oil, without oil is going to achieve their optimal blood pressure, blood sugar, and weight. And we need more tools. And this is one of the tools. That's fascinating. It's fascinating and it's powerful. And it's, you know, as I said, Nobel prize nominated science that will one day be

rewarded with the award. And is there any indication that these benefits can be enhanced by not eating at all or doing a multi-day fast? Are we still just too early in the process to understand? Or like this protocol, which involves eating a little bit of food throughout the day, works just as well as completely cutting yourself off? works just as well as completely cutting yourself off. It was designed to give the benefits of a complete fast without the risk of a complete fast. Because those that are doing prolonged water fasting,

certainly in the chronic illness model, are doing it in an inpatient clinic like True North or places in Florida. And not everybody can access that, and not everybody's going to do that. This, a person does at home. I do it while I'm working. I'm seeing patients. I'm at my restaurant. You feel phenomenal, at least a lot of people feel phenomenal.

You can get a little hangry. You're allowed to cheat a little with some celery and sliced cucumber, pretty calorie and nutrient-sensing pathway neutral food. But it's a breakthrough, and I don't think the public even has a clue how profound a breakthrough this is. Because the joy is 25 days a month you have no rules. I mean, you have your healthy diet rules. But these people that are trying, you know, and Dr. Longo would say the optimal time restricted period is 12 hours a day.

You know, the days you're not doing this fasting mimicking diet, you know, whether you're totally plant-based, whether you're following a Mediterranean diet, the DASH diet, you know, 8 a.m. to 8 p.m. is your feeding period. He likes breakfast and dinner, skipping lunch. We're not talking about somebody burning 6,000 calories a day training or performance. We're talking about, you know, the typical person out there, but you couple five days a month for optimizing your regenerative innate ability with 25 days a month and you add a 12-hour feeding period, you may indeed have that longevity diet, particularly if you mimic it after the native cultures,

the blue zone cultures, the Italian culture. The stem cell aspect of that is unbelievable. It's fascinating. I just say personally, and I know you got to be very careful about anecdotes. I had a really refractory plantar fasciitis. And after two months of this, it went away. Now it didn't go away for the previous year. And I've had patients tell me shoulder, back and other parts. There is clearly data that damaged nerve cells in animal models of multiple sclerosis regrow. That damaged brain tissue in mice models called the hippocampus regrows.

So this is not totally conjectural that you may actually heal damaged parts of your body. There's actually animal data that an animal model of type 1 diabetes where there's no insulin produced responds with the production of insulin for the first time. And there's no human equivalent, so no type 1 diabetic should do this, but those research studies are underway. So fascinating. Yeah, I'd be really keen to see what the studies are going to say about the impact of this in an athletic performance context too because the conventional wisdom is replenish your glycogen stores

and your electrolytes and your protein within 30 minutes of training, right? And this is the way that you bounce back as rapidly as possible. But if you can stimulate that stem cell, you know, production and there is this, what is it? What's the term you used? The cells sloughing off? Yeah, autophagy. Autophagy. Right. What would that mean? Right. Are you literally turning the clock back and making you a better athlete? So there is a study underway. I don't know the protocol. But, yeah, I argue for what I've termed, and it's nothing special, vegan plus or whole food plant-based plus.

You know, don't be dumb. Take your supplements. Don't get in a situation where you're deficient in B12 because you've heard you may not need to. I think that's one play that we need to emphasize vegan plus fasting i think is a not completely untouched there are there's a facebook users page now with 20 000 people doing ketogenic plant-based diets sometimes cyclical which i think is safer go back to food and a normal schedule um I don't know that they're all doing that, but that's a growing group. Vegan plus organic, you know, vegan plus no oil, you know, the kind of enhancing this core data, I think are really fertile areas. But the fasting is by far the most scientifically solid. I mean,

huge data, amazing data. I'm going to look into that a little bit more. I mean, I've experimented with it a little bit, just in a very informal way of, of like not eating until dinner, you know, or just do like eating one meal a day, uh, and doing that while training and seeing how that impacts my ability to recover. And part of that is, is trying to anecdotally with an N of one study, trying to see if that has any positive impact on the efficiency with which I can tap into my anaerobic zone to like enhance my endurance by not so, in addition to the training that I'm doing,

but through nutrition, getting, trying to trick my body into more efficiently using fat for fuel, right? And if you're not eating, right, that's what you're going to be tapping into in order to propel you through your workout. I can't speak for him, but Dr. Nalongo is a long-distance runner, and I've never heard him talk about his view on that for performance athletics, but you'll have an interesting conversation. No, I think it's, if this were a drug that you could show did all that's been documented,

it would be a $20,000 a month drug. And we're talking about there is a commercially available food kit that he has designed because he believes you know it's exquisitely important what those 800 calories are and how they're delivered and he won't do it in powders these are foods um people have tried to mimic it yeah they um there is a he has a great facebook page professor volta longo he posts a lot of stuff. Prolon is the name of his research project. They have a website. It's very easy to find. He's a very hot commodity right now.

He's been written up in the New York Times and Forbes and other places. And what you're going to see coming out is good stuff, a lot of YouTubes. There's actually a documentary, another reason I'm sure he'll want to talk to you, called Fasting that he's featured in That's just about to be launched. Yeah, and there's a lot of different plays. There's another UCLA has a researcher, Dr. Sachin Nanda, who's LA is the center of the serious fasting science data. But it's a good thing to add on.

You know, you're unique. Most of us are dealing with calorie excess and exercise deprivation, and we're getting fat. And it's far better to skip a meal than compromise. It's far better to learn you can go with two meals a day, maybe breakfast, dinner, as a routine, which I've adopted. There's a mindset doing this that I was not told about. But darn, five days, 800 calories. I just worked. I ate, though this program is three meals a day, but they're not big by any stretch

of imagination. I mean, I have the power to eat less and feel good and achieve the goals, weight or otherwise. And I hear that from patients all the time. I've completely changed my mindset. This was breakthrough for me psychologically as well as physiologically because I finally got away from, you know, if food's there, I won't eat it because it's better to skip than to eat in the culture we live in where there's food everywhere all the time.

Well, we've just been taught that we're supposed to eat three meals a day. Like, I don't know who came up with that, but you look at Ray Cronise, this guy goes, like, I don't know, 30 days or whatever on water. And, you know, I'm not advocating that people go out and do that, but I think it's important to like look at that and say, and he loves it, to say, look, our bodies are capable of so much more than we, you know, sort of understand. And to just explore the idea of what happens when you skip one meal or maybe two meals and go, hey, I'm still breathing air. The single most powerful activity you can do to prolong your life

is eat less every day. And that's a message that is so needed right now. And then we can talk about what that is, but start out with that in your mind. Shut your mouth, your kitchen, your your refrigerator and watch your health bloom let's talk about the book cool books just out the plant-based solution i just got it the other day so i i wasn't able to read it yet but i have like page through it and uh it's good i think people are going to be um really uh helped by all of the page restricted book just like we were talking about calorie restricted i don't have much patience to read thousand page books nor do i have the time so

i don't have time to write these books so it's about 150 pages of science of plant-based diets and heart plant-based diets and diabetes plant-based diets and brain and sex and and uh autoimmune diseases like lupus and then my wife chipped in, God bless her, Karen, and put together a three-plus-week eating plan of recipes. It's not elegant like your amazing meal planner. That is an incredible resource we all appreciate. But nonetheless, people have asked me nonstop, do you have a recipe book?

So this is as close as i've gotten so far some recipes from my restaurant and uh it's been fun it's actually gotten a lot of attention um and uh good feedback yeah it's great and what i like about it is that you've you know you've branched out beyond just cardiology and heart health you're talking about, you know, diabetes, cancer, autoimmune diseases, gut health, MS, Alzheimer's, Parkinson's, aging, sex drive, like you're hitting all the buttons and the impact of food on these conditions in terms of prevention and reversal. Yeah. And the data is there.

We always need more. We are a intertwined network. That's kind of the philosophy of functional medicine that people ask me all the time what's the side effect of eating a whole food plant-based diet for heart disease the side effect is you're probably going to be thinner more attractive you have more focus have a better sexual performance you know have a lower blood sugar and less likely to develop diabetes and a whole series of litanies so that's the beauty of the human body is you know it has an amazing ability to heal itself it will just rethink you know you can't heal plant and nutrition-based

diseases with pharmacology you have to heal nutrition-based diseases with nutrition and we're starting to wake up that the last 50 years have been rather ugly. Yeah. You got a great forward by John Mackey in there. You know, the guy's a gem. And I don't know him real well. I met him in Santa Rosa. And then he actually has been through Detroit. And he comes to my restaurant and eats. So he was eating at my restaurant, gave me the forward.

Next day, he announced the Amazon deal. How he, you know, his wonderful book, The Whole Foods Diet, he was planning, as you know, this gigantic national tour. And it all got interrupted by his need to go back to the business and work on the deal and announce the deal. But, I mean, he was just sitting there like a poker player, not mentioning anything. And he left. And, yeah, I'm very delighted that he's willing to do that because he is a very special human being. He's an amazing guy and i you know i had him on the podcast to talk about his book right in the middle of that proxy war going on

and i couldn't believe that he didn't cancel the podcast because i can't imagine the amount of stress he was shouldering at the time because he was really under fire and he didn't want to he didn't you know he did these these you, investors were really just trying to do a pump and dump. And he was doing everything he could in his power to prevent that from happening. And so, yeah, his, it coincided with his book coming out, which meant he couldn't do press except for like my podcast or maybe one or two other things because he had to keep his focus on that. podcast or maybe one or two other things, uh, cause he had to keep his focus on that. But then I attended, uh, his conscious capitalism conference in Austin a couple of months ago. And what was fascinating about that is that he got on stage and did a panel with the guy from the Motley Fool and, and talked about like his, you know, how he felt about this deal. And it

was the first time he'd spoken semi-publicly about it. And what was fascinating was some of the behind-the-scenes stuff where he felt very aligned with Amazon, and now he's thrilled. He's like, this is the best thing for the company. And now he gets to do what he likes doing, which is grow the business and not have to worry about all this kind of stuff. So I think it all ended up for the best. It is amazing that Amazon now owns Whole Foods and it's going to be fascinating to see how

that plays out. Yeah, I agree. I mean, when Campbell's buys Pacific organic foods, it's amazing. I mean, it's just more shells, more, you know, more stress off the entrepreneurs to let them focus on, you know, creativity and production. And one of the burger companies just sold to a Canadian firm. I mean, you know, it's controversial that sometimes these are companies that aren't plant-based and have a bit of a conflict. And they've got to grow. And access. This is what the future is.

Right. To get it in every grocery store and every Red Robin and every TGIF. I mean, it's groundbreaking that we're seeing this happen. And they're not my favorite foods, but they still deal with the environmental and the animal rights issue and some of the health issue. You don't have leucine in an Impossible Burger to the level you have it in a beef burger, so you're not going to activate mTOR and all this kind of highbrow science we talked about at the beginning. You're not going to activate mTOR and all this kind of highbrow science we talked about at the beginning.

I think it's cool that Campbell's has made this really strong push into getting into the plant-based food world. I think there's some, what is it, plant-based food producers, some like organization. They dropped out of the general one and entered the exclusively plant-based growers group, which is a phenomenal commitment. And they're serious. They have a big presence in Detroit, about a mile from my cafe, and it's growing. And they've got hundreds and hundreds of employees in Detroit, in Ferndale, Michigan, which is great. How's the restaurant going? One about to become two. We're pregnant. So our 4,000 square foot green space cafe,

So our 4,000 square foot green space cafe, now two and a quarter years old, what I call my 401k cafe. I've had- Because you emptied your 401k into it? Yeah, I don't have anybody else with me other than my son. He's too young to have a 401k. So I've let passion dictate some of my financial decisions. I produced a Broadway play in the past. We'll talk about that some future time. I didn't know that.

Yeah, that's a whole other side story. It's not worth going. There's no plant-based connection there. But I did have director seats on Broadway for 10 years, or producer seats. It's going very well. The public has really embraced it. What the Health drove a tremendous number of first-timers in, because my wife and I, we wander through every night.

You've been here before. How do you like it? We just hired a Matthew Kenney-trained chef, which I'm very excited about. Thank you, Matthew. Of course, a guest that you've interviewed and a great force. I love Matthew. I'm very excited. And we're opening a small, fast, casual place March 1 called Green Space and Go.

So we're committed. We're producing food and see this tipping point, which clearly has happened. I mean, this is, although Malcolm Gladwell speaks horribly about plant-based diets, I will embrace the term tipping point out of his lexicon. And I didn't know that he had spoken at all about plant-based diets. He has a podcast. That hurts me. I love Malcolm Brown.

He went really deep into the Nina Teicholz world and praised her beyond any expectation on a podcast about four months ago. And I beat him up on Twitter, but he didn't respond. You know, it's how it goes. I've been baiting Joe Rogan to just put one of us on and let us go at it. I don't mind being bloodied. Come on, Joe. Bring it on. Stop talking to these orthopedic surgeons that eat meat and let us go at it. I don't mind being bloodied. Come on, Joe, bring it on. Stop talking to these orthopedic surgeons that eat meat and don't check their labs. It's a bad public message. I will say he had Chris Kresser on a second time fairly recently.

Right. And, you know, we both know Chris. I like Chris. And and i found his i found what he had to say i i i i agreed with like 99 of what he was talking about chris is a real good sensitive and you know complete you know medical practitioner without a doubt um i think he distorts the science a bit but we're all subject to that uh criticism although. All right. Fast casual. Where's the fast casual? It's only five miles away up Woodward Avenue, which you remember with your Grosse Pointe routes.

Oh, my God. Yeah. I haven't heard that in like 40 years. One of the coolest things in Detroit is coming up as the International Auto Show, which is as cool as can be. It's coming up as the International Auto Show, which is as cool as can be. But in the third weekend in August, they've reproduced like American graffiti. So they have this thing called the Dream Cruise.

And 1.5 million people bring their hot rod cars from around the world and drive them up and down Woodward Avenue like in the 50s and Richard Dreyfuss. And we're right in that strip. And so it's about a 1,600-square-foot, 20-seat, grab-and-go, drive-through window. It's not fast food. It's fast casual. It's whole food. I'm pretty insistent that this is healthy food. You know, we have superfoods in the salads, in the bowls, in the wraps. We'll see.

We'll see if we can make it. When is that open? March 1. March 1. Oh, it's coming up. Cool. Well, I love your restaurant. I only had the opportunity to eat there that one time when I came out for the-

Plant-based group. Yeah. Plant-based nutrition support group, which was an amazing experience. And you put together this incredible dinner. And the restaurant is like super top-notch, high-end. The food was like extraordinary. Yeah, we're LA. We brought a little LA to Detroit. Yeah, like food was like extraordinary yeah we're la it was very

yeah like it was like yeah i was like whoa like you're doing it right you know like really right and i'll just say the coolest thing lately is professional athletes red wings lions uh and not a kairi pistons we don't have kairi irving in but we got tobias harris who's on the impact of kairi yeah it's huge and but with tobias Harris, a piston, wonderful human in all the time. Some of the Red Wings are coming in. We've had the coach of the Pistons in who's, you know, some of these are now plant-based athletes. Theoretic, a Detroit Lion, is now plant-based.

And so we're seeing that. And, you know, I don't know that there's fasting and professional athletes, I think, are the two coolest things going on in the plant-based world to shift the public mind. Well, I think it's the what the health effect. Like the impact on the NBA and the NFL from that movie has been unbelievable. And I think a lot of it has to do with David Carter. Like David Carter being in that movie and what he said I think really Resonated with a lot of those guys and it's so fascinating to see so many of them jumping on board I mean Kyrie it's huge. Did you see the Nike ad? Yeah, it's crazy plant-based diet I mean, it's like the words plant-based diet are being uttered in a Nike ad right and it's being done in kind of a

They're sort of poking fun, you know, like it is flat earth thing and all of that. But I'll take it. Like that's kind of an amazing cultural moment. I agree. I celebrate all these little hopeful. And again, it isn't the war that we started with. But there is a war for the health of the planet.

There is a war for the destruction and, you know, the cruelty to animals. And there is a war going on with health in America. And it matters. Everything we've talked about, from the calcium score to the saturated fat to industry like Campbell's and others buying up companies. I mean, I'm very optimistic, as I know, when Kim Williams talks. I mean, we're just seeing this change. The last bastion is the health industry. And I see medical students very well. Which is so ironic.

It's so distorted that it's the food industry taking the charge and the professional athletes and the health industry limping along like we're talking about cigarettes and give us 25 years to change. Because, you know, no, we went through a 25-year period before they banned smoking in hospitals. It could have been done much earlier. Let's learn from that. No, they argue let's reproduce it. So that's the last bastion, when medical students at least get a fair shake at learning about this stuff.

And I'm seeing that happen. I'm seeing a lecture to a group of medical students about three weeks ago and expected a very negative answer to the question, have any of you tried eating vegetarian or vegan? 50% raised their hands and laughed. Are you kidding? We're full-time plant-based. Like, whoa.

I think that was an unusual group. Yeah, that gets me fired up. Wayne State has a program now, right? Wayne State is a gigantic medical school, but they have not incorporated Paul Chatelain's plant-based curriculum yet, but they're much more open. I'm going down there in a few weeks to do Lunch and Learns and some of their curriculum. And some medical schools are even doing better than that.

Some of the osteopathic schools are doing way better than that. But that's when you go to your doctor, and even if it's three minutes of nutrition conversation, and maybe you are directed to nutritionfacts.org or forks over knives or what the health or told to read a book like the plant-based solution or you know how not to die or something um you know that's the army of soldiers we need to really the critical issue of living the best life as a general community that we can offer and greatest country in america and the world ought to have the greatest health outcomes in the world and we're number 37 so we got some work to do but interesting times hopeful times yeah

all right we got to lock this down but i am going to shut this bad boy uh down with one final question it's a question i've asked you before it's the same question i ask every doctor that comes on the podcast i can't remember what you said last time, but the question is this, you probably already anticipate it. If it was a parallel universe and you woke up to be surgeon general in this crazy administration, what would you do? What would be the first thing that you would try to change or put in place? Yeah, I would tackle, and I didn't see it coming, the question, but I would tackle the fast food industry and legislate, I guess it's all the one answer.

I would take away food subsidies that create $19 McDonald family meals that should be $75. And I would let nobody left standing that fought in the way to take the dairy industry and the meat industry and all and take away those subsidies that allow that absurd situation to occur. So I think that's the single first thing I do. Bring some equity of pricing and a free market back into the production of food, which would mean some farmers in the animal world would shut down. And they can be converted to. Yeah, politically, it's what has to happen or we're just going to keep limping along with the same system, same system, same system. Number two would be to change health care to reward prevention, you know, to the degree that it should be that, you know,

$15 to talk to a patient and $1,500 to put in a stent and not talk nutrition, a world that I lived in and I was on the stent side while I was doing both, but is not a tenable model for the next generation. All right. You're a good man, Dr. Joel Kahn. I appreciate it. You too, sir. Thank you for coming here.

The book is The Plant-Based Solution. Everybody pick it up wherever you buy your books and get your calcium scab. Thank you. Good plea to the public. All right, man. Come back and come back anytime. We'll talk more. I have a list here of all these things I still want to talk to you about. We didn't even get to them. We're two hours here. All right, my friend. Peace and plants. two hours here. All right, my friend, peace and plants. All right, we did it. We got it done. It's complete. I think we went there. I think it was pretty good. We covered a lot of stuff today. Hope you guys enjoyed that. Be sure to drop Joel a line on Twitter at Dr. J Khan on Twitter and let him know how this one landed for you. Pick up Joel's new book,

the plant-based solution. And also as always check out the show notes at richroll.com for plenty of additional links and resources on all the subject matters discussed today to expand your experience of this conversation beyond the earbuds. Once again, plant power way Italia is now available for pre-order. Reserve your copy today. It would mean a lot to us. Thank you so much.

You will not be disappointed. And if you would like to support my work in general, please make a point of subscribing to this program on Apple Podcasts or on whatever platform you enjoy this content, this program. It really helps us out a lot with visibility, expanding reach, all kinds of stuff. And it only takes a second. And I would appreciate it. You can also support the show on Patreon at richroll.com forward slash donate. If you need help with your diet and nutrition, please check out our meal planner.

It offers thousands of custom-tailored plant-based recipes, grocery lists, even grocery delivery in almost every U.S. metropolitan area. even grocery delivery in almost every us metropolitan area this incredibly powerful robust toolbox with everything you need to eat the way that you deserve to live well to be healthy for just a dollar ninety a week when you sign up for a year to learn more go to meals.richroll.com or simply click on meal planner on the top menu at richroll.com i want to thank everybody who helped put on the show today jason Camiolo, as always, for audio engineering, production, interstitial music, show notes, WordPress page configuration, all kinds of miscellaneous tasks that Jason performs. Sean Patterson for help on the graphics. He creates all the beautiful assets that accompany each episode that I use on Instagram and Facebook and Twitter and the like Michael Gibson for videography. He's the one who filmed today's episode and edited it and created the shorter clips that I'm sharing on social media. So thank you,

Michael and the music as always by Anna Lemma. Thanks a lot. I love you guys. See you back here soon. Eat well, treat yourself, right? Be kind to yourself,

be kind to others, walk gently on this planet earth and be happy. And until then, I'll see you guys back here soon in a couple of days with another great episode. Peace plants. Thank you.