The Link Between Emotion & Heart Health

Introduction and Dr. Batiste's Background 0:00

Well. Hello, everybody. It is time for Heart Disease Reversal Summit 2.0. And we have one of the really key people to talk to tonight. I'm very excited. We did not have Dr. Batiste last year, but it is a better summit this year because we do Dr. Columbus Batiste His bio will be in the materials. Please review it. And if you're in the Orange County area, you probably know him already or if you've been to many conferences across the United States, you know him. Thank you, Dr. Batiste, for taking your time.

Always a pleasure. Good to see you again. Thank you. Cardiologist, hospital administrator, making policies to make people healthier all throughout Orange County Kaiser system. And a few minutes today to talk about Reversing Heart Disease. Naturally, I know you have a passion to talk a bit about stress and heart disease. So just how does stress cause heart disease? And a few thoughts there. Yeah, yeah. You know, we understand really this role in this relationship between stress and disease. You know, it's estimated somewhere, as you well know, that probably nearly 80% of the hospital are doctor's visits are due to stress to some degree.

You start to dig and pass through the visits. That's really where it is, whether or not we're looking at walls, whether or not we're looking at raising kids or relationships, things of that nature. There's stress all about us. And it's been seeing me out this pandemic. And what's so interesting is, is that when you look at stress, that it actually impacts the thing that we always treat, which are the vessels, it impacts the endothelium, and we don't really appreciate that. But our mental stress can be as impactful on what's called flow mediated

How Stress Drives Heart Disease 1:51

dilatation, how well the vessel dilates or relaxes, how well it constricts as many other substances, foods and things of that nature. So, you know, a lot of times I say that stress equals demands minus resources, and our health equals resiliency divided by by stress. And so the higher the hour. And so we have to look really in terms of the higher our stress, the poorer our health. We see this distinct relationship there. So many say they've shown that when you look at stress, apart from other factors, there's a level of increased risk for diabetes, for high blood pressure that we see it, for all of it, for cancers, for malignancies when people are succumb to this stress.

And the years ago, I believe it was around 2004, the inner heart study basically told us that workplace stress and home stress nearly two times the amount of risk for heart attacks and this has been replicated time and time again. Now, here's the thing that may ring true for many of the listeners out there that we see this and in areas of bias, we see this in gender discrimination and racial discrimination. We see it in terms of times of stress that's there, that people actually have a heightened level of stress.

And that form of stress begets disease, specifically heart disease. I think the most interesting or not interesting, that's about choice of words right there is the one that wasn't taught to me in training is really tackle civil disorder, broken heart syndrome, stress induced cardiomyopathy. And so, you know, I only time ever thought about a broken heart. It wasn't the broken hearts I was given. I was receiving broken hearts from women back little girls back in the day. But when when you succumb to this massive amount of stress, the heart and doctor, you know, this the heart does all of a sudden it ceases to contract.

Instead of squeezing in, it actually dilates out, it expands out, it balloons out. This apical ballooning syndrome. And so it mimics acute heart failure, mimics an acute heart attack just from the weight of stress. And so although this was described and based upon a Japanese octopus put strapping container there, this is something that's been well-described in Asian countries for a while. Kurosaki and other things have high, intense levels of stress begetting sudden death and sudden cardiac arrest.

So we understand that stress is so important in that pathway, that mechanism. It really rides through the endothelium, the highway throughout all the entirety of the of the body. Wow. That's you unpacked a whole lot of important topics. And just in case any of the listeners are familiar, there actually is a diagnosis called Broken Heart Syndrome. And Dr. Batiste been the good looking man he is is making a little joke about all the women in his life earlier on. I don't know how many. And let's not go there in honor of your dear wife, but it was a joke only.

But there's actually an illness called Broken Heart Syndrome. It also has a Japanese name if you want Takotsubo, and it's the ultimate example that you brought up so appropriately that stress isn't just something that we people don't handle. Well, we all have it. God knows you have it. You're running a big administrative effort and you're an interventional cardiologist taking care of sick people and their lives depend on you. I have it. Everybody listening has it. If you don't manage it well, there's something called the broken heart syndrome.

You do not want it. It's just another version of a heart attack, but not due to a blood clot in a big artery like you have removed from heart attacks. And I have to, but thank you for that. You know, plea to focus on stress. And obviously we need techniques to manage stress. What's nutritional stress? I've heard you talk about that. Yeah, well, you know, when you look at the idea of the health equation, that that our our health is tied to our resiliency, develop our stress, and everything in life contributes either to our resiliency or to stress.

We can't avoid stress first and foremost. Right. Stress is just a natural state. You have you stress and you have distress. And to a certain point, that amount of persistent stress that it gets what we call allosteric load, right? This weighs on you and begins to erode you over time. And so we look at nutritional stress is very comparable. We look at nutritional stress. These are things that add to our are instead of adding to our health and resiliency as far as stress. And those can be the form of oxidative stress.

This rusting of pipes and so forth. And we understand that certain things, you get oxidative stress from the environment, but you also have it from foods, right? And you have this acid from animal proteins and products that are there.

Nutritional Stress and Oxidative Damage 6:34

We were uncovering this that not only that we have the advanced glycation end products that are happening. We have this molar reaction which occurs, which is like Browning. You know, I grew up, my family's from New Orleans and so grew up making something called root improves is where you brown you brown like a little flour and you're making the gravy that's there. And it's beginning of mini stews and mini gravies are there. The same thing happens in the vessels of your heart, your heart. And so we understand that it's the connection between your proteins and sugars that begin to happen.

Emit the high temperature levels of some of the heart reaction begins to occur. Advanced Glycation end products predominantly occur inside animal products. Yes, they can occur in in some plant sources, but at very low amounts. And these are the things that age advanced glycation. It impacts age on the inside and on the outside. They're the things that begin the wrinkles and so forth. So you understand why many of the movie stars they had moved towards the plant estate many years ago, not necessarily concerned about their health, but concerned about their appearance, but not but unbeknownst to them, prevention of wrinkles.

And that talking about surgery and so forth also can actually help their arteries and their health in general by eating in a healthful state. So these are all the things that begin to to lead to stress in the body. Now, here's the way I describe it, because saying terms like oxidative stress are very it's it's it's not very practical. It's not something people can grab hold of. And so the easy way I think of it is that imagine if you're in a good mood and I walk in and I meet Dr. Kahn and he says to me, Man, that's ugly shirt.

I'm happy when I walk in and see him. I have all this happiness all around me. And he says, That's an ugly shirt. Why do you look the way that you look? All of a sudden? He steals my joy. He snatches an electron away from me. Now I become unstable. Now I'm irritable in that moment. And now I turn and I say something to his nurse and I steal her joy. And you begin to get this erosion that begets cancer, that begets diabetes, that begets heart disease. And this is what begins to happen when you have free radicals that enter your body.

They steal the joy from stable electrons and you have this oxidative stress that begins to happen. And so the same thing, this really occurs from a lot of the foods that we eat. So we have to have antilock stents. So I always described I know you asked me this question, but here's the thing. I always say that we, the celebrities of the food now we need the Beyonce's, we need the Jay-Z's, we need Lebron, we need the Kobe's out there. They're known by one name, a singular ingredient, beans, broccoli, kale, potatoes, right.

Rice, all these things. These have singular names. And guess what they carry with them? Antioxidants, bodyguards, just like the celebrities. What's the job of a bodyguard to keep people from causing harm? And so in a very similar fashion, the more you can load your body up with bodyguards, the safer you are. It doesn't mean it's impossible for you to see harm, but it means that you increase the odds exponentially the more you load with these nutritious foods that build the resiliency in the armor inside your system.

And that's where the power lies. Wow, wow, wow, wow. Good, good stuff. And again, everybody listening. Plants have 60 times more antioxidants and animal foods. At a minimum, some have more. So pack your plate with plants, is what Dr. Brodie told us. What's it about getting selfish? How is being selfish a cure for stress? Well, you know, I mean, listen, I'm going to tell you, there's so much stress right now. When we look around the news, we look around social media and everything of that sort. And food is a central core component.

It is the buttress towards health and wellness, but it's not the only piece. It is supported by a complete package. And so some in the Midwest might call this person the greatest basketball player to have ever played Michael Jordan. All right. And so Michael Jordan once says said that in order to be great, you have to be selfish. And so I don't mean selfish in those terms of moving yourself, but it means that you have to seek purpose or selfish. Stands for an acronym of spiritual. And I don't mean this sincerely a religious standpoint, but really getting in tune the focus of meditation, a prayer.

It could include religion in that belief system that's there. Because what begins to happen, we understand what the prefrontal cortex is, that all of a sudden your decision making, your ability to plan and see those plans for fruition begin to take hold is what we call a keystone habit. It's a building block towards success. We understand that people who engage in meditation and prayer that all of a sudden that their blood vessels may dilate a little bit, their blood pressure may lower a little bit, that they become more focused and intentional.

And so it's the beginning portion of of this process that's there, because in this fast paced environment, we oftentimes don't take we don't take the time to really focus and really come to a peace, a calm and peace, which is what the spirituality does for us in nature of seeking a higher power, whatever your belief system is going from there, we know to as well that he stands for exercise. Now, it doesn't just mean just getting on the date with Peloton or or any of these other systems. It could be simply going for a walk in nature forest bathing, you'd like to call it.

I was wondering the first time I heard that what that meant. But getting out in nature, it lowers the stress hormones, believe it or not. All of a sudden the air into the sunlight in measured doses does miracles for your body.

SELFish: Spirituality, Exercise, Love, Food, Intimacy, Sleep, Humor 12:22

Studies have shown just the benefit by simply walking to the 10 minutes in your diabetic foot, really lowering your blood sugar level, improving the control. We can know that for heart stabilization, all you have to do is walk. The L stands for love. But anyone who's a doctor. Dr. Khan, how long have you been married? How many years? 40 to 42 years. I'm buying your book. Okay. I need to buy your book. I'm way behind you. I'm buying the book on how. How do you get to 42 years for anyone who's loved anything, anybody for a while.

You understand that love is not a noun. Love is a verb. It takes action, it takes forgiveness. My wife has forgiven me many times over my 25 years. Right. That's love. It takes gratitude. It takes. It takes moving beyond yourself. Some like to call that volunteering. It takes acts of kindness that are there. It's an action where it is a verb. And studies have shown that when you engage in simple tools like forgiveness, they actually show improvement in blood flow to the heart muscle. When they took individuals who went through forgiveness training compared to those who didn't have anger, recall that studies have shown that by doing these things, you actually can improve your health and well-being by being grateful.

Blood pressure, longevity, weight loss, all of these aspects by engaging in love something were missing in this world is love, is empathy, is love in putting ourselves in other shoes. The F stands for food, of course. Come on. Whole food, plant food, rich food, food that's nutritious. It's resilience to your body. It's adding to your future. So the eye stands for intimacy of relationships, right? Not a sexual way, but intimacy, something we lost that we understand that simply that when your your immune system is more powerful, when you come together as a community, that studies have shown that loneliness is comparable to like smoking 15 cigarets a day.

So we understand that sleep is where the second is. And that stands for rest. That could be a day of rest. That could be an issue in terms of going on vacation. It can be an issue of trying to get 7 to 9 hours of sleep at night. Maybe you can't tackle that all at once, but maybe you increase it by 15 minute increments. You get closer. We know the power that it's going to do. We've all lost our keys and four separate over a problem and we wake up and all of a sudden the solutions as clear us as we can think.

Right? That's what the power is of sleep, of rest, like our phones need to be recharged. Our are battery operated cars need to be recharged the same way our body needs to be recharged. And lastly, the age stands for humor, for laughter, for joy of life. And it's so important that laughter truly is medicine. Norman Cousins demonstrated this years ago. We have Patch Adams who talked about this, but believe it or not, there's actually studies. The one study I loved the most, I love to quote something doctor Dr.

Kahn is definitely aware of, is that when we look at cardiac rehab patients, I'm over the cardiac rehab for my organization. It's such a powerful tool that's been that's been implemented for all these many, many years. But when we implement cardiac rehab, that focuses on nutrition, exercise, stress reduction, appropriate use of medications that are there, psychosocial issues, smoking cessation that people do better. So this interesting study did one thing. They put everyone into this group or to one group.

They said, I watched you watched 30 minutes of a comedy show. Anything that can make you laugh, it could be a dirty joke, a dirty comedian. It could be a regular comedy show. And surprise, surprise, surprise, guess what happened? The group that actually started laughing, they did better. They had less angina. They had less admissions to the hospital with recurrent events there. There. That's the power of laughter. I'm here to tell you that small things matter, that every little bit matters towards your health, into your wellness, and your overall well-being.

Because the goal of being selfish is not just so what you achieve health. So what you achieve the weight loss you're looking for now what the now what is so you can live a life of purpose that's was selfish is is being getting selfish so you can live a life of purpose that entails more than just eating right. You have plenty of people you write in there angry as as can be, right? You need to live a life of purpose so we can make this world a better place for our kids. I can say that as I'm getting older, my kids are getting older, my kids, my unborn grandkids.

I better not having grandkids for many years now, you know? But that's really what it's about when you reach a certain point in life, you're recognizing, I'm not going to be here forever, but I'm trying to work on my health span. All right. That's what it's about, is my health span. We don't know today from tomorrow, but we understand that I want to live vibrantly. I want to thrive as all of you want to do. And this is something that studies have shown that you can achieve when you're committed, because when you're committed, you don't let life circumstances derail you from your goal.

You're committed. You stick to it irrespective of how you feel. It's not about how you feel. It's about what you need to do. Oh wow. I think you have just provided as one of the most passionate and deep and purposeful summaries about starting with this stress heart connection and ending up with a life of purpose. All right. So let's go unscripted here. You gave the most beautiful description of stress, in your view on just life and how the heart interacts. But I want you know, we have a reversing heart disease naturally summit.

I think we still have so much work to do to convince people that you can diagnose heart disease. But it is a I don't tell people completely reversible condition, but it is reversible to an extent that may make their life much better. You know, you bend a plan forward now completely plan B's guy for your whole life. Growing up in the Adventist Church, as we talked about a couple of days ago when we conversed, but, you know, you're practicing how many years you've been in cardiology practice? 16. Okay.

And you've been able to incorporate educating patients about nutrition, you know, while you're doing what I did for a long time, I don't do it anymore. But cath lab, crazy life. I mean, what have you seen in terms of people's willingness to consider major dietary change? What kind of tools maybe have you been found most effective in helping them move forward and maybe, you know, some of the results and outcomes just a few minutes on actually the perspective in your practice in reversing heart disease?

Yeah. No, it's you know, I think the old adage that stated by many that preceded me myself is that it's not the timing at which you you start to engage, it's the amount of effort you put in. And so for those who've gone in fully and they've embraced it, they've had a full resolution. Now, one of the best examples of this and when I started out, let me take a step back. When I started out like everyone else, I was a bit guarded, whatever it was back in 2010 to really go for it wasn't as as popular as where it is right, quite right now.

And I was hesitant being an African-American interventional cardiologist, the only one who I knew in the area who look like myself of being that guy who's saying something different than everyone else. But I felt obligated to go ahead and do it. And I'll tell you, the first three patients that I may recommended Asians to, I didn't even have an elevator pitch. I didn't have any script. I didn't have anything. I think I gave them Dr. Affirm, his book, and as with the book, they gave it to live is all I gave them.

No spiel. I was like, You need to change your diet. And I said, I tell you, you need to go consider, you need to go. Plant based is all I said. I believe three patients, they all three came back with incredible life stories losing weight. One patient and they never forget had so much symptoms walking in. And he came back and saw me and talked about how he was doing better and I was like, Would you do it? Because I listen to you and I read the book and all of a sudden I start walking and and eating better.

And he changed his whole entire life. That's what really kind of took things off at that point. And after that, it was more of an issue of every patient, every time the evolution of things came to where I start writing a list now. I called it my green sheet at that time and I start writing. I realize that most people don't love to read. So I wrote like YouTube videos and I wrote down Hate Rather documentaries that I want them to watch, and then with some books and then for some cooking plants. That was the first iteration of things that we just had the people and give them that.

And it was my green. She did the same thing in the cap lab. I would talk with them. I did a challenge with the staff to get them going, to get buy in with them, nurse practitioner work with this. She completely went whole food plant based. She started giving out my information and slowly but surely my interventional colleagues started to a they didn't they have not moved towards eating tofu plant based. But when patients asked them what they should do, they tell them, do Patti's diet this is not my it's not my diet, but I'll take it.

That's fine. And they'll give them my information. Some of them will actually ask them. I hired a dietitian in my practice when I was a local chief. I actually started a cooking class to start a lecture on my free time that I had their volunteer time I would do a lecture for and with. Interestingly enough, I started being staff, having pharmacists, having patients come to it. The cooking class we called the cath lab cooking alternative to health, the place where you change and transform your disease and have a wonderful time doing that.

Reversing Heart Disease in Practice 22:08

COVID kind of stopped it, as did many things at that point. And then I hired another cardiologist who has similar passion, who began taking on the the mantle and doing the lectures and so forth as I got a bit busier and really taking that on. And so that's it. So when I started seeing in terms of patients, I've seen the patient who came to my office and he saw me out. And like you, I believe in a combine integrative approach is the right therapy at the right time and understanding. And so he ate what I felt were unstable symptoms at that point.

I didn't feel as if comfortable that saying I'm just going to treat you medications alone. I took him and didn't answer grandma on him and his vessels were just horrid. They literally were. I'm surprised that he wasn't in the hospital with the way that they hit. They looked and they all began as I was scared. This now I've been doing this plant based approach for quite some time, but I was scared for him and I said, You know, you do need to actually consider surgery in this moment. And through his grogginess, he said, Oh, Doc, I want to see you back in clinic.

And he said, No. And his wife said, Well, he said no. And I said, okay. I said, Well, see, I'm back. And like I'm back in clinic. Walked in and talked. He said, I'll do whatever you say, doc. I'll do whatever I say, whatever I say. I haven't heard that in a long time without ever. I say whatever you say. So I did what we did write a poem on completely fiber, rich diet, whole food plant base. At that point, no oils, no salt, no sugar. We went in hard in the paint and his wife was fully committed, even though she didn't eat everything that she cooked for him and he transformed, got off his medications.

All of a sudden he literally came back to see me. I got scared. I hadn't seen him for a while and his only complaint to me, after suffering with intractable angina, was foot pain from plantar fasciitis, from walking a golf course. And so this is a person where he really set the table. He wasn't the first, but he showed me and the interesting part is that data within the American College of Cardiology tells us we're for people who refute the fact that you can stall heart disease, that you can lead it to remission.

They've shown and demonstrate throughout the years, of course, to pharmaceutical agents that subtle regression in coronary artery stenosis. And when you look at the law of physics, that's enough to improve blood flow and decrease mortality events substantially. Why is it that we think we can accomplish that through food and nutrition? The power when we understand that, that through aggressive fiber, rich plant, rich foods, we can decrease our cholesterol, inflammation and inflammatory burden that says that we can decrease both not just our large buoyant LDL, but our small dense LDL, that we can decrease apolipoprotein B, that all these things begin to happen, that we can decrease our blood pressure, that all of a sudden we decrease the burden of stress on the heart.

It's not surprising that we can cause subtle regressions of fresh, newer plaque and that through the adoption of aggressive, dark, green, leafy vegetables with vitamin K and some degree of K two, which has been shown to decrease the calcification, the vessels that you see transformation that begins to happen. So it's not surprising to anyone. You know, Alexandra Chase said, you know, a surprising event ceases to become a surprise and then occurs on a daily basis. You know, when I see this on a regular basis, as I have had the good fortune, I'm no longer surprised.

It's just the matter of is are my patients going to take the prescription to help them prescribing them? And if they won't take one, then you have to take the other because people will say, well, doc, you still prescribe pills. I do, because guess what? Sometimes people won't take my prescription to to nutrition, but they'll they'll rather take a prescription pills. And sometimes they'll take they won't take either. It's so it's a matter of seeing what is it that what do you want? What are you willing to do to get what you want and what won't you do to get what you want?

In the words of Kelly McGonigal in her book, The Willpower Instinct, those are three important such an important imperative questions to ask What do you want and what are you willing to do to get what you want? And what won't you do? Well, that's a great, great, great summary. The Green Sheet. So I guess I still use the green sheet. I have a little bit more time than most. Then I have a cardiologist on with a patient and they love when I pull out a legal pad, although I have it with my practice logo on it.

And I just I write pretty clearly for a doctor. And as you write documentaries, books, podcasts, recipes, suggestions, and I think there's more impact of that than maybe just handing them a pre-prepared list, which is better than handing them nothing. But, you know, and then they come back and I'm blown away like you were blown away by that patient you're talking about that six, eight weeks later, there's substantial changes and they bought in. And any time you can get if they're a couple, a husband, wife or significant other and get them both on the team, it's certainly a challenge to many, particularly maybe to a guy who's never stepped in the kitchen, never cooked, trying to make a lifestyle change.

And I've used some of these, you know, food delivery services, if it's within the budget of a person like of my favorites I'm sure you've heard of wholeharvest.com you want to go a few weeks and pay a little bit more to try some foods when you've never really dabbled in cooking in the kitchen plant based and it's made it a bit of it easy win so you do believe that heart disease can be reversed and patients out of hear about it. Now you've got a pretty substantial position with Kaiser and Kaiser Health has over the years had a little of a reputation of being a more open about plant based.

There have been some you know, guides to nutrition for physicians that have come out. You see it, you know, stalled, you see it going down, or there's still a vibrant interest in plant based nutrition within the Kaiser system. Well, you know what I say? What I would say is that there's providers who are very passionate about plant based nutrition, and there's a growing ranks of dietitian, fans and nurses and physicians that are I mean, organizationally, they've never there's never been a strong statement advocating a particular dietary approach other than eating well and thriving.

So very comparable to our guidelines. Right. You they'll say the first line of every guideline for cholesterol, diabetes is live a healthy lifestyle. But what exactly does that mean? And you're not enacting any smart tool approach, being specific, measurable, achievable relevance or at all. So there's not necessarily that. But what I will tell you that's unique about our organization and and compared to many other is that our sole goal is to keep people healthy. When you're healthy, when your numbers are controlled, when you're doing well, then you're going to be better.

And guess what? It's been official for you. It's beneficial for us from a cost perspective. It's not an issue of withholding care, but it's an issue of let's do everything max maximal to either early detect and to treat before it happens as best as possible. And so I think because of that, that's what's opened the door for this plant based revolution to to to seep into Kaiser into within the Kaiser organization. But I won't I won't say that it's it's something that's full and widespread. But I think there is this awareness.

The importance of lifestyle. And so some of my colleagues do a wonderful job of educating physicians and in going through the literature of why this is so important and how it impacts lives. Well, good. Well, listen, I have taken a lot of your time. You're a busy man. You got kids and wife to get back to. And I want to thank you so much for sharing. People want to learn more about you. Where do they go? What's a great website? Yeah. So right now it's thehealthyheartdoc.org. I'm going to be changing that name there as a book is coming out SELFish you know a cardiologist guide to curing a stressed and broken heart is coming out soon.

And so but that right now is the site that you can you can find me appreciate. thehealthyheartdoc.org Thank you. And then there'll be a book coming out called SELFish. Yes SELFish. Well, I'm sure you just got a large number of people going to be looking for, maybe preorder that book when it's available and that'll be awesome. And I will be don't send me a copy. I want to buy a copy. Although if you do want an endorsement, feel free to ring me up and be a great honor to do that too, but appreciate much, much gratitude and appreciation for your time and your brilliance.

Really. Thanks, sir. Well, listen, appreciate always appreciate being in your presence and in your work that you've done before me. I've always appreciate your work and and looked at admirably. So it's always an honor. Thanks so much. Thank you.