Full Transcript Introduction to Evidence-Based Supplements 0:00 Well. Hello everybody. 0:01 Welcome back to Reversing Heart Disease Summit 4.0. 0:04 This is your host Joel Kahn be mean to you here in 2026. 0:09 Trying to bring you some helpful information in your journey 0:13 to avoid heart disease. 0:14 Identify air disease and reverse heart disease. 0:18 And I put together a brand new talk on supplements. 0:22 There may be an adjunct to everything else you're doing to keep 0:25 your heart healthy, and that is called lifestyle, lifestyle, lifestyle. 0:28 We've talked about that in many other places in this informative summit 4.0. 0:34 Evidence base reversal of atherosclerosis supplements in 2026. 0:40 And I am talking specifically about evidence base where there's good data 0:46 that a clinician could evaluate and say 0:49 we're going to use that or a baseline 0:51 good evaluate and say we're going to use that. 0:53 And we've got this up to date 0:56 and to complement some of the 0:57 other talks that I have prepared for this summit. 1:02 4.0 so without dilly dallying 1:05 and without making this real long, let's get right to it. 1:08 So the point of the picture I'm showing you here, some of you might recognize, 1:13 I wish every clinician in the world recognize that. 1:17 And most hard patients are those that don't want to be our patients. 1:20 Is this is the results published in 1998, in the journal called Jama 1:25 Journal American Medical Association, presented by doctor Dean Ornish and other 1:31 very prominent researchers 1:32 put in the out of the University of California, San Francisco, where, 1:36 as you know, Doctor Ornish designed a study that initiated in the 1980s, 1:42 first published in 1990, and then this five year follow up in 1998, 1:47 where he demonstrated that the lifestyle hard trial focusing on a whole food 1:51 plant based diet, walking, stress reduction, yoga, meditation, group 1:56 support would actually halt or reverse heart disease.
Dean Ornish Lifestyle Trial as the Foundation 2:00 And just to remind you, if you look at the black circles, 2:03 these are people 2:04 they volunteered in this study and followed with their cardiologist care 2:09 without being actually part of an experimental group. 2:13 And over five years, the amount of narrowing in their heart 2:16 arteries got worse and worse, started at 40.7%, narrowed on average 2:21 in their heart, arteries rose of 51.9%, narrowed on average in their heart errors. 2:27 But Doctor Ornish demonstrated that our disease is reversible 2:31 to an extent over five years using just lifestyle. 2:35 And then the white squares. 2:37 The amount of narrowing at baseline was 41.3% narrowed across the heart arteries, 2:43 and that dropped it dropped to 37.3 with the lifestyle treatment. 2:48 So this is always going to be our touchstone. 2:51 I'm not offering to you 2:53 that supplements will do it and you can ignore the lifestyle. 2:56 Oh no. 2:57 And this talk is not about prescription medication. 3:00 We'll get into that at other points. Oh no. 3:02 This is about supplements and and on to 3:05 optimal scientifically proven lifestyle okay. 3:09 So supplements a may reverse cancer's 3:12 grosses can be quite a mouthful, particularly the first two. 3:16 But we're going to go through them and show you a little tidbits of data. 3:20 Pick marginal and send Tilikum. 3:22 They actually are two separate, herbal supplements 3:26 that end up in one preparation. 3:28 And they have data. How much data? 3:30 How impressive data? 3:32 Well, probably about a dozen studies. 3:34 But first of all, let me let you see the words. 3:37 This is from the National Library of Medicine. 3:40 Pick National and Centella Asiatic. 3:43 I'm really going to confuse you because Centella Asiatic 3:47 is a bush largely growing in India that's also known as Zen Telecom. 3:51 That's a registered trademark name, and it's also known by name. 3:55 You might know if you're into supplements, go to cola. 3:59 Got you. Cola. 4:01 Nothing to do with Coca Cola. 4:04 And er for example, is a very important paper from a university in Italy, 4:09 in Pescara, Italy, if you know the region, the Abruzzo region, 4:13 pig nodule in Central Asiatic and to prevent asymptomatic 4:18 after cirrhosis progression and clinical events published in 2017. 4:23 But first, just a little bit about pig nodule. 4:26 There's more known about pig nodule than about CIN Telekom, 4:29 but there's a lot known about both pig nodule is a registered 4:33 trademark name by a company in Europe for French maritime pine bark. 4:39 What do we know about pig? 4:40 Dogs are very powerful antioxidant in the tissues, in the blood, 4:45 preventing oxidation of cholesterol, DNA and other factors. 4:49 It's anti-inflammatory and some of the pathways are known. 4:53 It actually prevents 4:54 platelets from sticking and aggregating improves endothelial function. 4:58 Sounds like a dream supplement.
Pine Bark and Centella for Atherosclerosis 5:00 I actually think it is. 5:02 And then it has impact on the cellular matrix 5:06 and the extracellular matrix that's involved in atherosclerosis 5:10 and other disease processes, like scarring throughout the body. 5:14 We do know that there is data that pig nodule 5:17 through these multiple, pathways of activity, can, improve skin 5:22 insurance studies, support healthy eyes, healthy joints, suborn. 5:26 Now art and circulation, 5:27 we're going to talk about some role and women's health, cognitive health, 5:31 respiratory health, including some data that developed during the pandemic 5:35 for the use of Pig National to support healthy lungs and even in sports. 5:40 But those are all the topics we are going to stick to. 5:43 Agents and Tilikum in the heart. 5:45 Just one more quick overview of published science. 5:49 The energy is powerful. 5:51 It reduces many markers of inflammation. 5:54 I'll just point out TNF alpha, the blue one 5:57 called NF kappa, B cox two and five logs. 6:01 And these are potentially good impacts on pig marginal. 6:06 Because so much of cardiovascular disease is inflammation. 6:10 So going back to the 2017 study, what exactly did they show 6:15 with this combination that, as far as I know, is available from one 6:19 a supplement company in a single capsule 6:23 or two capsules a day if you choose. 6:26 But you can also buy Pig Natural. 6:28 You can bison Tilikum and take them separately. 6:31 So why am I impressed with this study? 6:33 Because there were nearly 400 individuals. 6:37 That's a big study for a supplement company. 6:40 A study 6:41 that started and actually completed a four year study. 6:45 That's also impressive. 6:47 This is not a four week, eight week, 12 week study. 6:51 They had carotid ultrasounds that were measured similar. 6:55 What we do in my clinic with intimate medial thickness and digital assessments. 7:00 And they found at the end of four years, the progression of plaque in the carotid 7:05 arteries was significantly lower in the two supplement groups. 7:09 The two supplement groups were picked 7:11 Nadra was and telegram, based on different dosing. 7:15 There was a control group. 7:16 So this is a study that had a control arm, which is very important 7:21 when you're assessing the quality of the study. 7:24 There also was no funding conflict. 7:26 There was a reduction in plaque progression 7:29 in the supplement group with the best effects 7:31 obtained by the combination of these two herbal agents considering measurements 7:37 of plaque thickness, length and exogenous city plaques became more dense. 7:43 That means probably more calcified and less risky. 7:47 Now, what's really interesting 7:49 was that in this fairly large group of people 7:53 studied over four years, some of them had symptomatic heart disease, 7:57 not just asymptomatic carotid black. 8:00 And the amount of angina that was identified 8:02 was less in the supplement group than in the control group. 8:06 And actually the number of myocardial infarction that's called to heart 8:10 attacks was less in the treated group than in the placebo group. 8:14 Minor transient ischemic attacks I don't know what's 8:17 minor about a stroke like syndrome, but minor ones were less frequent 8:22 with the supplements than in controls. 8:26 Look at hospitalizations in the controls 8:29 16.4% in the treated group 8:34 with just pick 8:35 Nashville 8.9%, and with those that were treated 8:39 with the combination 3.3% rate of hospitalization over four years. 8:44 The conclusion phenomenal. 8:46 And the combination, which I think is the optimal approach 8:50 I'll pick Najib Plus and Tilikum Asiatic up our go to call. 8:55 If you like that name, 8:56 reduce the progression of arterial plaques and then progression to clinical stages. 9:01 The reduction in plaques and clinical progression 9:04 was associated with a reduction in oxidative stress. 9:08 The results justify a larger study 9:11 I agree, but in the meantime this is the big one. 9:15 You will have a very hard time finding supplement studies 9:19 bigger than this with aid control group without other conflicts. 9:23 Finding both imaging advantages and clinical advantages. 9:29 This is a supplement combination I'd be using on my practice 9:33 for over a dozen years. 9:35 I take it myself every day, 9:37 even though I have pretty close to plaque free arteries. 9:41 It's a good one, in my opinion. 9:44 All right, let's turn to number two age garlic, 9:46 of all things, a cardiologist in California. 9:49 I came back from a trip to Japan about 15 years ago 9:53 and said those cardiologists in Japan are using age garlic pills 9:58 and heart patients. 9:59 So we know that garlic and aged garlic, which is stronger, more potent 10:03 than regular garlic in your food, can lower blood pressure, 10:06 homocysteine levels, cholesterol levels and inflammation. 10:11 So there have been a number of studies, about a dozen of them 10:14 looking at age garlic tablets and in this case, coronary arteries. 10:20 How unusual. 10:21 This is a randomized, double blind, placebo controlled study. 10:26 And the authors 10:27 begin by saying several previous studies have shown that age garlic extract age 10:33 inhibits the progression of coronary artery calcification 10:36 and non calcified plaque in the general population. 10:39 Its effect on black progression in patients with diabetes 10:42 has not yet been investigated, at least to the best of our knowledge. 10:46 This study investigated whether Aggy reduces corner plaque volume 10:51 measured by cardiac computed tomography angiography. 10:55 That's a wonderful test in patients with diabetes. 10:59 80 participants with diabetes mellitus median age of 57 years 11:03 to 2400mg of age, garlic extract or placebo. 11:09 Remember, it's a placebo arm. 11:11 Both groups had a baseline and a one year follow up, with 66 participants 11:17 completing both parts of the study baseline and follow up. 11:21 What did they find this right? 11:23 The top compared with the placebo group, the age garlic extract group 11:27 exhibited a statistically significant regression
Aged Garlic Extract for Coronary Plaque 11:31 in low attenuation plaque. 11:33 Low attenuation. 11:34 Because dangerous plaque, there were no differences 11:37 measured in other kinds of black like hard, calcified, lower risk plaque. 11:42 On the whole, this study indicated that the percentage low attenuation plaque 11:46 change in the age garlic extract group was significantly greater 11:52 with shrinking of the low attenuation plaque than those in the placebo. 11:57 Very provocative for a very inexpensive, safe supplement. 12:01 My patients had been using for over, 12 years. 12:05 And, really no complaints. 12:07 So, age garlic extract gets a fairly high regard. 12:11 Well, let's turn on this topic. 12:13 We're talking about supplements and may augment lifestyle 12:16 and other measures to a seaweed extract called Romulan sulfate. 12:21 And the seaweed is actually known as mana strong magnetism. 12:25 It's green seaweed not brown seaweed. 12:27 Brown seaweed has other properties. 12:29 And this was a wonderful 12:32 a series of cases published in 2023 by a physician. 12:37 I believe she's in the state of Washington. 12:39 Christine Burke, six patients. 12:41 She was caring for 12:43 that had a significant and resistant plaque in the carotid arteries. 12:47 They did the advanced, crowded ultrasound called a CMT. 12:52 And these were plaques that were not going away. 12:55 Despite other measures that were being done in this clinic. 12:58 There was no placebo, there was no control arm. 13:01 Each patient serves as your own control in the fact 13:05 that they previously had not regress or plaque. 13:08 They took their seaweed supplement, 13:11 a commercially available vitamin, daily. 13:14 I think they took two pills a day 13:16 and their plaque burden was measured after six months. 13:20 In every case 6 or 6, the total plaque burden was reduced, 13:24 with an average reduction in the six 13:26 patients of 5.55mm, which is statistically significant. 13:31 That's a big drop in the CMT. 13:34 Significant reductions in the maximum carotid 13:37 plaque thickness were also observed at the end of six months. 13:40 This study suggests a remnant sulfate from management and the tedium. 13:45 Green seaweed may provide a safe and effective intervention 13:49 for reducing atherosclerotic plaque. 13:51 So interesting report. 13:53 Commercially available vitamin used in my clinic 13:57 after we discussed pig nodule and synthetic gum. 14:01 After we consider age, garlic extract. 14:04 Not a large study, not a double blind randomized study. 14:07 The lead author is a consultant to the company. 14:11 That's just something that's known, very high integrity physician and all. 14:17 So it's a consideration to look for this particular supplement. 14:22 All right. 14:23 Here's a hot topic. 14:25 If you spend some time on Instagram or TikTok and other social media sites, 14:31 you will see post after post about natto kinase 14:34 as a substitute for aspirin as a blood thinner 14:38 that has advantages over aspirin is what is being claimed. 14:42 And you would think 14:43 that there was a brand new, large, double blind, randomized study. 14:47 Well, everybody goes to this paper about four years old, 14:51 and it is not a double blind randomized study is a large study. 14:55 1062 people with atherosclerosis, who they found
Seaweed Extract Case Series 15:00 in a retrospective study in a database, who is taking that, a kinase. 15:05 Now, the kinase is a natural blood 15:07 thinner that comes from the natto being it's an enzyme, but it's also known 15:11 to have the potential to lower blood pressure, cholesterol and plaque. 15:15 And who wasn't taking that again? 15:17 And if they weren't taken out of context, what dose were they taking? 15:21 So this says that a kinase known as a potent fibrin analytic 15:24 and antithrombotic agent, that means a blood thinner has been shown 15:28 to have anti atherosclerotic and lipid lowering effects. 15:31 All the data on human clinical studies are limited 15:34 in this clinical study involving 1062 participants, 15:39 our objective was to examine the efficacy of Neda kinase 15:42 in atherosclerosis and hyperlipidemia and safety 15:45 at the dose of 10,800 F.U. 15:49 That stands for Fiber Analytic Units per day. 15:52 After 12 months, all and various factors that influence 15:56 its action were investigated. 15:58 We found then that a kind of at a dose of 10,800 16:02 vibrant clinical 16:03 units per day effectively manage the progression of atherosclerosis 16:07 and hyperlipidemia, with a significant improvement in the 16:10 lipid panel, a significant reduction that the thickness of the carotid artery, 16:16 a median the size of the carotid plaque, was observed. 16:20 Their improvement rates ranged from 66 to 95% better. 16:25 They did fine. 16:26 It was ineffective if you took a lower dose 16:28 because people could take whatever dose they were. 16:31 So if you took one third of the dose, 3600 16:35 fiber analytic units per day, it didn't work. 16:38 And a lot of the Neda kind of supplements out there are in the lower range. 16:43 Very few are in this 10,800. 16:46 Fibrin, a lot of care today. 16:48 So if you look at table four from this paper, change 16:51 in the thickness of the intermedia of the common carotid artery, 16:55 you'll see that there were 683 people in the sample. 17:00 The CMT measurement was 1.33mm before 17:06 and 1.04mm thickness after. 17:09 Those are thick, right.
Nattokinase Evidence and Limitations 17:10 And those were quite abnormal. 17:12 So there was a 22% change improvement 17:17 shrinking under the plaque, or at least the measurement 17:20 of the intermediate thickness as what was reported. 17:23 There are some limitations associated with this study. 17:26 Although the sample size is large, it represents 17:29 a retrospective study, not a randomized control study. 17:33 The availability and reliability of information is therefore limited. 17:37 For example, self claiming information lifestyle cannot be validated. 17:41 They weren't absolutely certain how healthy these people were living. 17:45 The study did not 17:46 include follow up interviews, things that change in the patient's life. 17:50 No current information on the long term benefits of the participants, 17:54 and the study is based on a record review there. 17:58 There are no further data available to allow us to investigate the mechanism. 18:02 Oh yeah, the kindness. 18:05 I do have to point out that 12345 the authors were employed 18:09 by the company that made Neda kinase for the study. 18:14 So it is something that one has to be aware of. 18:17 In summary, the studies suggest that medications may have activity. 18:22 Now, when you look at what's been, blasted 18:25 all over social media, you'd think that this was a perfectly done, 18:29 prospective, double blind, randomized study with long term follow up. 18:33 And in fact, it wasn't. 18:35 It's intriguing. 18:36 I do use Natta kinase, and some of my patients, 18:39 a lot of them use it when they first come to the clinic. 18:42 They're already on it. 18:43 Most of them are not at this dose 10,800. 18:46 And I would be very cautious if somebody was on warfarin coming in. 18:50 Our fanatics are Eliquis Xarelto 18:53 serious orally active blood thinners 18:56 because the potential for bleeding in the combination. 19:00 All right. Let's switch to another supplement. 19:01 Pomegranate juice consumption for three years 19:05 by patients with carotid artery stenosis reduces 19:08 common carotid into media thickness, blood pressure, and LDL oxidation. 19:13 A paper that's 22 years old. 19:15 There are other papers on pomegranates and what they found was that oxidized LDL. 19:21 These people drank eight ounces of unsweetened bomb juice, pomegranate juice. 19:26 This was not the whole kernel. 19:28 This was not a tablet. This was the juice. 19:31 Oxidize LDL, dropped 19:33 systolic blood 19:34 pressure, dropped about 12%, up to three years. 19:38 Serum lipid oxidation drop suggests a pomegranate juice consumption 19:44 by patients with carotid artery stenosis decreases 19:49 carotid interval, medial thickness measurements, and systolic blood pressure. 19:54 So an interesting study that can be read. 19:58 And the others, that can be searched. 20:00 But there isn't a brand new overwhelming one that's convinced me 20:04 I have to have all my patients eating and drinking pomegranates. 20:08 If you like them, do it. Good food. 20:11 All right. 20:12 What about the controversy all over the map on omega three fatty acids? 20:17 Could be foods like chia seed, flax seed, hemp parts, walnuts, leafy greens. 20:22 Could be a vegan algae oil or ahi 20:25 flour supplement could be, of course, eating fish. 20:29 The cold water fatty fish like, salmon, mackerel,
Pomegranate Juice and Carotid Health 20:33 anchovy, herring and sardines could be fish oil capsules. 20:36 So this paper in 2021 is one of the few that looked at in 53 20:42 people that were taking fish oil and 53 people that were not. 20:47 But it was not a randomized study. 20:49 They found 53 on fish oil and found 53, not a fish. 20:53 While they did match them as much as possible for similar age, 20:56 gender, risk profile and lifestyle habits. 21:00 And they did a study, Andrew Graham on them. 21:04 But it was not the kind of study that we've seen previously 21:08 where they did want a baseline. I want to follow up. 21:10 Why did they conclude those that were on omega three 21:14 fish oil, fatty acid supplementation 21:18 had less of a high risk plaque called lipid rich or low 21:22 attenuation plaque and lower total non calcified plaque burden. 21:27 Our study suggests there may be a direct anti 21:30 after genic effect of omega three polyunsaturated fatty acids. 21:35 I think you'd agree this is intriguing. 21:37 Many people need to supplement omega three through food and supplements, 21:42 because blood tests show such low levels and there may be a benefit, 21:47 but we can't get as excited as a 12,000 21:50 patient study that we get with pharmaceutical agents. 21:54 All right. 21:54 And I just wanted to give a shout out 21:56 for a supplement I've been using for a long time. 21:58 My clinic, bergamot Bergamot had some people called bergamot. 22:02 And there are a number of different 22:03 brands, including a brand called Burger Veet used in this study.
Omega-3s and Plaque Reduction 22:07 It looks like a lemon grows in southern Italy, in a region 22:11 called Calabria, almost exclusively in that region. 22:15 50 years ago, it was an observation that people that ate this bergamot 22:20 citrus in their diet in southern Italy had exceptionally good health. 22:24 So they created supplements and there are many dozens of papers. 22:28 But in this paper, bergamot reduces plasma 22:31 lipids, antigenic, small, dense LDL and subclinical 22:35 atherosclerosis in subjects with moderate hyper cholesterol. 22:39 Amy has a six month prospective study. 22:42 Doctor Peter Toth, the first author, is 22:45 a very well known American cholesterol expert. 22:48 As you can see by the names of many of the other authors are Italian, 22:51 which is where they produce and research. 22:55 Bergamo. 22:56 This is the first study investigating the effects of bergamot 22:59 flavonoid supplementation on cardio 23:03 metabolic risk and dyslipidemia. 23:05 Subjects. People with abnormal cholesterol panels. 23:08 Verkhovna a bergamot juice extract as a capsule supplementation 23:13 significantly reduced plasma lipids at a class called venom 23:17 and improve the lipoprotein profile. 23:20 CMT crossed into bone meal thickness was also reduced 23:24 significantly over a relatively short timeframe of six months. 23:28 So I wanted to include that. 23:30 And we're going to end with the discussion that comes up all the time. 23:34 My clinic, vitamin K2, in this case vitamin K2 with vitamin D.
Bergamot for Lipids and Atherosclerosis 23:41 After years, really decades of conversation, 23:44 the vitamin K2 may help prevent calcification of vascular structures. 23:48 We finally got 1.5 studies, basically 23:51 because the study was really looking at calcification of the aortic valve. 23:56 You can read the title here. 23:57 Published four years ago. 23:59 The first randomized double blind control study. 24:02 I could find a vitamin K2 and vitamin D versus placebo. 24:06 Looking at did it halt calcification, the Arctic valve. 24:09 Now it turns out hidden in the paper was data on the corner artery calcium score. 24:16 This was not a coronary CT angiogram study. 24:19 We can't talk about soft plaque, a low attenuation plaque and what they found. 24:25 I'm going to read you the conclusion and the results of progression 24:29 in aortic and corner artery calcification score was not significantly different 24:35 between the patients treated with NCS and vitamin 24:38 K2, plus vitamin D and patients receiving placebo. 24:43 There was no defense of red to heart valve surgery or cardiovascular events 24:47 compared with patients in the placebo arm, there was a significant reduction 24:53 in a marker of oxidation in those taking the vitamin. 24:56 Conclusion. 24:57 And elderly men 24:58 were they aortic valve calcification score greater than 300 in the Arctic. 25:03 Now, two years of an K seven plus vitamin 25:06 D did not influence air valve calcification progression. 25:09 So number one, the dose used in this study was high 25:13 720 micrograms of vitamin K two Mk7. 25:18 If you're taking vitamin K2, you're probably taking 100 microgram 25:23 or 150 microgram. 25:24 This was 720 microgram. 25:27 Number two, it wasn't a very large study, you know, in the range of 300 patients. 25:32 It wasn't a very long study in the range of two and a half years.
Vitamin K2 and Vitamin D for Calcification 25:35 It's hard to do this research. 25:37 In fact, just two years of follow up. 25:40 Number three, 25:42 if you read the paper 25:43 detail, the key word is statistical significance. 25:47 You know, a typical evaluation. 25:50 Can we claim that it wasn't chance? 25:52 And more likely than not, the vitamin K2, vitamin D combination, 25:56 reduced valve calcification. 25:58 And also the date is in the paper and Coronado calcification. 26:03 So it turns out there was a trend of less calcification progression 26:08 in both the Eric valve 26:09 and the heart arteries, but it wasn't statistically significant 26:13 if they had 3000 patients, or if they did this for six years, 26:17 would they have found and come to a different conclusion? 26:21 I suspect that's the case, but I don't know. 26:24 So to conclude, supplements may reverse atherosclerosis. 26:29 And remember, on top of lifestyle, as doctor Dean Ornish and others 26:33 have shown, along with prescription medication if needed, 26:37 the combination of Pic knowledge and the French maritime bind back with 26:41 Centella gum. Asiatic, 26:43 which is available in a combination in a capsule, is well supported. 26:47 Aged garlic reasonably well supported arteries 26:50 sell the green seaweed product 26:53 reasonably well supported in case studies. 26:57 Now the kinase we talked about some limitations 27:00 pomegranate omega three high dose vitamin K two and bergamot. 27:03 So thank you for paying attention to this presentation 27:07 and I hope you enjoy the rest of this. 27:09 2026 summit. 4.0. Thank you.
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