Full Transcript 0:02 The best time to treat cardiovascular 0:02 The best time to treat cardiovascular disease is a decade before the heart
Preventing Heart Disease Early 0:05 disease is a decade before the heart 0:05 disease is a decade before the heart attack. 0:05 attack. 0:05 attack. >> Correct? 0:05 >> Correct? 0:06 >> Correct? >> You know, in this case, my family 0:07 >> You know, in this case, my family 0:07 >> You know, in this case, my family member, his doctor was saying, "Wait 0:08 member, his doctor was saying, "Wait 0:08 member, his doctor was saying, "Wait till you have a heart attack. I know 0:09 till you have a heart attack. I know 0:09 till you have a heart attack. I know exactly what to do." And that's actually 0:10 exactly what to do." And that's actually 0:10 exactly what to do." And that's actually quite frankly until Congress mandates 0:12 quite frankly until Congress mandates 0:12 quite frankly until Congress mandates otherwise. [music] Insurers do not 0:15 otherwise. [music] Insurers do not 0:15 otherwise. [music] Insurers do not consider cardiac prevention medically 0:18 consider cardiac prevention medically 0:18 consider cardiac prevention medically necessary. Therefore, they're not going 0:19 necessary. Therefore, they're not going 0:19 necessary. Therefore, they're not going to cover screening [music] and not going 0:20 to cover screening [music] and not going 0:20 to cover screening [music] and not going to cover intervention unless they're 0:22 to cover intervention unless they're 0:22 to cover intervention unless they're now, of course, they'll pay for 0:23 now, of course, they'll pay for 0:23 now, of course, they'll pay for medications and stuff.
Introduction to the Discussion 0:28 Hi, I'm Dr. Charles Mo. I'm here with 0:28 Hi, I'm Dr. Charles Mo. I'm here with Dr. Baraha from uh Synergy Longevity. 0:31 Dr. Baraha from uh Synergy Longevity. 0:31 Dr. Baraha from uh Synergy Longevity. Firstly, thank you for having me. It's 0:32 Firstly, thank you for having me. It's 0:32 Firstly, thank you for having me. It's always a pleasure to be here. I want to 0:34 always a pleasure to be here. I want to 0:34 always a pleasure to be here. I want to talk about kind of some conventional 0:35 talk about kind of some conventional 0:36 talk about kind of some conventional treatments and what I think about is a 0:37 treatments and what I think about is a 0:37 treatments and what I think about is a little bit more unconventional 0:39 little bit more unconventional 0:39 little bit more unconventional treatments that that are 0:42 treatments that that are 0:42 treatments that that are clearly beneficial now, but it the 0:44 clearly beneficial now, but it the 0:44 clearly beneficial now, but it the world's too new to know about it. So, 0:47 world's too new to know about it. So, 0:47 world's too new to know about it. So, talk about conventional treatments that 0:48 talk about conventional treatments that 0:48 talk about conventional treatments that you use in your practice, maybe some of 0:50 you use in your practice, maybe some of 0:50 you use in your practice, maybe some of the more um highline treatments that you 0:52 the more um highline treatments that you 0:52 the more um highline treatments that you do. It's great because some of the newer 0:54 do. It's great because some of the newer 0:54 do. It's great because some of the newer treatments are becoming conventional and 0:56 treatments are becoming conventional and 0:56 treatments are becoming conventional and we'll touch on that in a second. But
Lifestyle and Risk Factor Management 0:58 we'll touch on that in a second. But 0:58 we'll touch on that in a second. But when when people are are low to medium 1:00 when when people are are low to medium 1:00 when when people are are low to medium low risk, I always start with lifestyle 1:02 low risk, I always start with lifestyle 1:02 low risk, I always start with lifestyle and then jump into into therapeutics. 1:05 and then jump into into therapeutics. 1:05 and then jump into into therapeutics. Those therapeutics can be 1:06 Those therapeutics can be 1:06 Those therapeutics can be pharmacological, they can be 1:08 pharmacological, they can be 1:08 pharmacological, they can be supplemental. Um and and we have a very 1:11 supplemental. Um and and we have a very 1:11 supplemental. Um and and we have a very frank discussion about it. You know, 1:13 frank discussion about it. You know, 1:13 frank discussion about it. You know, it's it's easy to tell somebody, "All 1:14 it's it's easy to tell somebody, "All 1:14 it's it's easy to tell somebody, "All right, well, you know, you need to work 1:15 right, well, you know, you need to work 1:15 right, well, you know, you need to work out for a half hour of resistance 1:17 out for a half hour of resistance 1:18 out for a half hour of resistance training and a half hour of of, you 1:19 training and a half hour of of, you 1:19 training and a half hour of of, you know, cardio training a day and get back 1:21 know, cardio training a day and get back 1:21 know, cardio training a day and get back to me in 3 months." Well, if the person 1:24 to me in 3 months." Well, if the person 1:24 to me in 3 months." Well, if the person travels for 4 days a week and, you know, 1:26 travels for 4 days a week and, you know, 1:26 travels for 4 days a week and, you know, doesn't have access to those things or 1:28 doesn't have access to those things or 1:28 doesn't have access to those things or can't monitor their nutrition as much as 1:30 can't monitor their nutrition as much as 1:30 can't monitor their nutrition as much as you'd like, you want to make a a real 1:32 you'd like, you want to make a a real 1:32 you'd like, you want to make a a real sustainable plan for them. The next we 1:35 sustainable plan for them. The next we 1:35 sustainable plan for them. The next we can touch on to supplemental uh you know 1:37 can touch on to supplemental uh you know 1:37 can touch on to supplemental uh you know supplements or or pharmacological uh 1:40 supplements or or pharmacological uh 1:40 supplements or or pharmacological uh interventions and for modifying risk
Pharmacologic Prevention and Lipid Control 1:44 interventions and for modifying risk 1:44 interventions and for modifying risk factors. You know, smoking is a huge 1:47 factors. You know, smoking is a huge 1:47 factors. You know, smoking is a huge huge risk factor for ASCVD, right? 1:49 huge risk factor for ASCVD, right? 1:50 huge risk factor for ASCVD, right? You're causing constant uh essentially 1:53 You're causing constant uh essentially 1:53 You're causing constant uh essentially scraping of your endothelium and that 1:56 scraping of your endothelium and that 1:56 scraping of your endothelium and that scraping of the endothelium is a perfect 1:57 scraping of the endothelium is a perfect 1:57 scraping of the endothelium is a perfect place for plaque to sit and form and 2:00 place for plaque to sit and form and 2:00 place for plaque to sit and form and that's one of the mechanisms that 2:02 that's one of the mechanisms that 2:02 that's one of the mechanisms that smoking causes uh ASVD. Hypertension, 2:06 smoking causes uh ASVD. Hypertension, 2:06 smoking causes uh ASVD. Hypertension, which is high blood pressure, a a very 2:09 which is high blood pressure, a a very 2:09 which is high blood pressure, a a very strong risk factor as well. Lastly, with 2:11 strong risk factor as well. Lastly, with 2:11 strong risk factor as well. Lastly, with with lipids, it's it's a similar 2:14 with lipids, it's it's a similar 2:14 with lipids, it's it's a similar approach. If people can modify their 2:17 approach. If people can modify their 2:17 approach. If people can modify their nutrition, can modify their diet, can 2:19 nutrition, can modify their diet, can 2:20 nutrition, can modify their diet, can get into the gym and exercise. And 2:22 get into the gym and exercise. And 2:22 get into the gym and exercise. And although exercise in and of itself 2:23 although exercise in and of itself 2:24 although exercise in and of itself doesn't impact the the lipid, it's 2:26 doesn't impact the the lipid, it's 2:26 doesn't impact the the lipid, it's through another mechanism which exercise 2:28 through another mechanism which exercise 2:28 through another mechanism which exercise helps. But uh if people can do those 2:31 helps. But uh if people can do those 2:31 helps. But uh if people can do those things, optimize their sleep and focus 2:34 things, optimize their sleep and focus 2:34 things, optimize their sleep and focus on on their their nutrition, that is 2:37 on on their their nutrition, that is 2:37 on on their their nutrition, that is hugely important for for lipid 2:39 hugely important for for lipid 2:39 hugely important for for lipid management. But I think by far and no 2:42 management. But I think by far and no 2:42 management. But I think by far and no doubt pharmacological intervention for
GLP-1 Drugs and Cardiovascular Risk 2:44 doubt pharmacological intervention for 2:44 doubt pharmacological intervention for lipid management is the most potent and 2:47 lipid management is the most potent and 2:47 lipid management is the most potent and the most effective. And what I like to 2:51 the most effective. And what I like to 2:51 the most effective. And what I like to explain is firstly the decision needs to 2:53 explain is firstly the decision needs to 2:53 explain is firstly the decision needs to be personalized. So let's talk about 2:55 be personalized. So let's talk about 2:55 be personalized. So let's talk about some of the unconventional things. um 2:57 some of the unconventional things. um 2:57 some of the unconventional things. um the GLP-1 drugs, the SGLT inhibitors and 3:01 the GLP-1 drugs, the SGLT inhibitors and 3:01 the GLP-1 drugs, the SGLT inhibitors and other things that are kind of like 3:03 other things that are kind of like 3:03 other things that are kind of like showing up. They're showing some 3:04 showing up. They're showing some 3:04 showing up. They're showing some definitely some signal of promise 3:07 definitely some signal of promise 3:07 definitely some signal of promise certainly in people with heart disease, 3:09 certainly in people with heart disease, 3:09 certainly in people with heart disease, but also in people that don't have heart 3:11 but also in people that don't have heart 3:11 but also in people that don't have heart disease, but have a risk for it such as 3:13 disease, but have a risk for it such as 3:13 disease, but have a risk for it such as diabetes. Um what's been your kind of 3:15 diabetes. Um what's been your kind of 3:15 diabetes. Um what's been your kind of thoughts on those those drugs? Yeah, I 3:17 thoughts on those those drugs? Yeah, I 3:17 thoughts on those those drugs? Yeah, I think you know I was a little bit 3:18 think you know I was a little bit 3:18 think you know I was a little bit skeptical on the mechanism for GLP1s to 3:23 skeptical on the mechanism for GLP1s to 3:23 skeptical on the mechanism for GLP1s to impact cardiovascular risk and what I 3:26 impact cardiovascular risk and what I 3:26 impact cardiovascular risk and what I had initially assumed was well people 3:29 had initially assumed was well people 3:29 had initially assumed was well people are losing weight you know obesity and 3:32 are losing weight you know obesity and 3:32 are losing weight you know obesity and visceral fat is is a predisposition for 3:36 visceral fat is is a predisposition for 3:36 visceral fat is is a predisposition for athoscorotic cardiovascular disease and 3:38 athoscorotic cardiovascular disease and 3:38 athoscorotic cardiovascular disease and so that's kind of the mechanism that it 3:40 so that's kind of the mechanism that it 3:40 so that's kind of the mechanism that it works but in the last year or two 3:42 works but in the last year or two 3:42 works but in the last year or two there's actually been some literature 3:43 there's actually been some literature 3:43 there's actually been some literature that the GLP1 uh RA in and of themselves 3:48 that the GLP1 uh RA in and of themselves 3:48 that the GLP1 uh RA in and of themselves are showing improvement for 3:51 are showing improvement for 3:51 are showing improvement for cardiovascular risk. I think the the 3:53 cardiovascular risk. I think the the 3:53 cardiovascular risk. I think the the mechanism is still being studied and 3:56 mechanism is still being studied and 3:56 mechanism is still being studied and looked upon, but it seems to be much 3:57 looked upon, but it seems to be much 3:57 looked upon, but it seems to be much more than just weight loss. So, I think 4:00 more than just weight loss. So, I think 4:00 more than just weight loss. So, I think they're phenomenal medications. Again, 4:03 they're phenomenal medications. Again, 4:03 they're phenomenal medications. Again, has to be personalized, has to be for 4:04 has to be personalized, has to be for 4:04 has to be personalized, has to be for the right patient and extremely 4:07 the right patient and extremely 4:07 the right patient and extremely extremely important to focus on not 4:10 extremely important to focus on not 4:10 extremely important to focus on not losing skeletal muscle. I think that
Longevity, Insurance, and Personalized Care 4:12 losing skeletal muscle. I think that 4:12 losing skeletal muscle. I think that that's that's where it becomes a little 4:15 that's that's where it becomes a little 4:15 that's that's where it becomes a little bit more work sometimes when people want 4:17 bit more work sometimes when people want 4:17 bit more work sometimes when people want to do it cuz a lot of times it's the 4:19 to do it cuz a lot of times it's the 4:19 to do it cuz a lot of times it's the thought of I'll take the shot, I'll keep 4:21 thought of I'll take the shot, I'll keep 4:21 thought of I'll take the shot, I'll keep doing exactly what I'm doing and I'm 4:23 doing exactly what I'm doing and I'm 4:23 doing exactly what I'm doing and I'm just going to lose weight and you know 4:24 just going to lose weight and you know 4:24 just going to lose weight and you know my my health is going to get better. But 4:27 my my health is going to get better. But 4:27 my my health is going to get better. But if you're not if you're not focusing on 4:29 if you're not if you're not focusing on 4:29 if you're not if you're not focusing on skeletal muscle, working out, getting 4:31 skeletal muscle, working out, getting 4:31 skeletal muscle, working out, getting the right amount of protein in, you're 4:33 the right amount of protein in, you're 4:33 the right amount of protein in, you're actually doing more harm than good for 4:36 actually doing more harm than good for 4:36 actually doing more harm than good for your longevity. spin on this with my 4:37 your longevity. spin on this with my 4:37 your longevity. spin on this with my bias is that I think it's almost an 4:39 bias is that I think it's almost an 4:40 bias is that I think it's almost an excuse for people to overeat because if 4:41 excuse for people to overeat because if 4:41 excuse for people to overeat because if you're not exercising 4:44 you're not exercising 4:44 you're not exercising and you're taking a GLP-1 drug and 4:45 and you're taking a GLP-1 drug and 4:45 and you're taking a GLP-1 drug and you're relying on taking say 2 and a 4:47 you're relying on taking say 2 and a 4:47 you're relying on taking say 2 and a half milligrams per kilogram of protein, 4:49 half milligrams per kilogram of protein, 4:49 half milligrams per kilogram of protein, you got to eat ultrarocessed food to get 4:51 you got to eat ultrarocessed food to get 4:51 you got to eat ultrarocessed food to get it because you're having to eat a 4:52 it because you're having to eat a 4:52 it because you're having to eat a supplement or just a bunch of red meat. 4:54 supplement or just a bunch of red meat. 4:54 supplement or just a bunch of red meat. So, I've got this double-edged sword 4:55 So, I've got this double-edged sword 4:55 So, I've got this double-edged sword when I'm thinking about longevity and 4:58 when I'm thinking about longevity and 4:58 when I'm thinking about longevity and the um you know, occasionally have 5:00 the um you know, occasionally have 5:00 the um you know, occasionally have people protein restrict to have them to 5:02 people protein restrict to have them to 5:02 people protein restrict to have them to create longevity. So, we had a great 5:04 create longevity. So, we had a great 5:04 create longevity. So, we had a great discussion. And I kind of want to leave 5:05 discussion. And I kind of want to leave 5:05 discussion. And I kind of want to leave this with the idea that dying of a heart 5:08 this with the idea that dying of a heart 5:08 this with the idea that dying of a heart attack can be optional. And 5:12 attack can be optional. And 5:12 attack can be optional. And the I think the biggest mistake somebody 5:14 the I think the biggest mistake somebody 5:14 the I think the biggest mistake somebody can make is thinking that well my 5:16 can make is thinking that well my 5:16 can make is thinking that well my insurance won't cover it. My doctor 5:18 insurance won't cover it. My doctor 5:18 insurance won't cover it. My doctor won't order it. Therefore, it should not 5:20 won't order it. Therefore, it should not 5:20 won't order it. Therefore, it should not be done. Your doctors in general, 5:22 be done. Your doctors in general, 5:22 be done. Your doctors in general, they're they're burdened with whatever 5:24 they're they're burdened with whatever 5:24 they're they're burdened with whatever the insurance company tells them. That's 5:25 the insurance company tells them. That's 5:25 the insurance company tells them. That's all they're going to do. So, we've 5:27 all they're going to do. So, we've 5:27 all they're going to do. So, we've stepped outside of that world. then 5:29 stepped outside of that world. then 5:29 stepped outside of that world. then doing very unique things such as doing 5:30 doing very unique things such as doing 5:30 doing very unique things such as doing the hormone replacement, doing some we 5:32 the hormone replacement, doing some we 5:32 the hormone replacement, doing some we do some longevity specific aggressive 5:35 do some longevity specific aggressive 5:35 do some longevity specific aggressive treatments we do. We want to help people 5:37 treatments we do. We want to help people 5:37 treatments we do. We want to help people live a long healthy life. And we use the 5:42 live a long healthy life. And we use the 5:42 live a long healthy life. And we use the traditional healthcare method plus all 5:44 traditional healthcare method plus all 5:44 traditional healthcare method plus all the additional kind of supplements and 5:47 the additional kind of supplements and 5:47 the additional kind of supplements and services [music] 5:47 services [music] 5:48 services [music] that uh and when I say supplement I mean 5:49 that uh and when I say supplement I mean 5:50 that uh and when I say supplement I mean the additional testing and uh blood work 5:52 the additional testing and uh blood work 5:52 the additional testing and uh blood work and things like that to supplement 5:53 and things like that to supplement 5:53 and things like that to supplement [music] what traditional healthcare does 5:55 [music] what traditional healthcare does 5:55 [music] what traditional healthcare does so that people can live a long healthy 5:57 so that people can live a long healthy 5:58 so that people can live a long healthy life.
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