The Truth About Fats And Heart Health

Introduction and Dr. Fuhrmanu2019s Background 0:00

Hello, everybody. Welcome to this basically mini-symposium, world-class interview that I get to do with Dr. Joel Fuhrman, MD. And just in case you haven't seen some of the wonderful information is sharing with us, Dr. Fuhrman is a board-certified family physician, seven-time New York Times best selling author, internationally recognized expert on nutrition and healing. For over 30 years, he has the Eat to Live retreat in San Diego Bay. Be sure you look into that is president of the Nutritional Research Foundation and be sure to check out his books.

There's many of them, but first, sure, Eat for Life. His most recent book that is just so comprehensive and one that just fits perfectly for this summit. The End of Heart Disease, a book I have in my office just a couple of feet away so that all my patients can see it easily and know that I give it two thumbs up for sure. Thanks for being with us, Dr. Fuhrman. It's great to be doing this with you, Dr. Kahn. Lot of fun. And that we feel like when I feel like we're impacting a lot of people and that's the whole goal is to impact people and motivate them to make more significant changes in their lifestyle for their own betterment.

I couldn't agree more and we're going to talk for a few minutes here about a topic that, you know, creates controversy and I would say even confusion among a number of health advocates, plant-based followers, disease reversal followers, why low fat is dangerous. And we're going to talk a little bit about seeds, nuts and Omega-3, but tell us after your, you know, decades of crafting the Nutritarian diet, using an inpatient and seeing the results, reporting that and sharing that to us, so many PBS specials, we've shared the Nutritarian diet.

What fats do you recommend? What Fats do not recommend?

Why Healthy Fats Matter in a Nutritarian Diet 2:06

People are got their pens in their papers out. They're taking notes. All right. Well, the well, first of all, the one of the features of a Nutritarian diet is that we get our fat from the Whole Foods nuts and seeds and avocado, and we don't get our fat the way other Americans get their fat from animal fats and oils. Right. Because oil is not the so walnut oil is not a walnut. I don't think any nutritional scientist in the world could argue that a walnut oil is better than a walnut or sesame oil is better than a sesame seed or flaxseed oil is better than a flax seed or olive oil is better than a than an olive.

There's no science in the world could argue that the studies are overwhelmingly consistent. And I don't it's any subject where there's more corroborative evidence of how protective nuts and seeds are for cardiovascular health and cardio than to prevent cardiovascular deaths. There's almost an unbelievable amount of information on this topic. So the fact that it's still somewhat some people can call it controversial or confusing is not true. It's not controversial if we're looking at science. The science is overwhelmingly consistent and it's not confusing because if you review the science, it's overwhelmingly consistent, shows the same thing.

And I published an article, if people are interested, it was published in the International Journal of Disease Reversal and Prevention. I have it right here, and it's called Nuts and Seeds for Heart Disease Prevention. It was published in 2020 volume two number one, the International Journal of Disease Prevention of Disease Growth and Prevention. It's IJDRP.org is the Journal. And of course, this article published in the Scientific Journal, has over 50 scientific references in it, showing all the corroboration of all the evidence showing, of course, how nuts and seeds behave differently than oils and rather than cause weight gain, they make people more satiated and more comfortable with fewer calories so they can increase feeding intervals.

They can feel more comfortable with not snacking and not eating between meals. The overall effect is to decrease calories, and because they're absorbed so slowly, they delay gastric emptying. And particularly when you eat vegetables and beans and nuts and seeds in the same meal, they delay gastric emptying and make people slowly absorption of calories in the bloodstream. Making you feel not feel like you don't need to eat for a sufficient amount of hours having the overall effect to lower your calorie consumption by the end of the day.

There's also a lot of other reasons why the heart becomes more irritable and has more higher risk of both atrial fibrillation and life threatening cardiac arrhythmias. When your diet is too low in fat. So we're saying here there's two pro two ways you can mess up. One is you can have too much of unhealthy fat in your diet and the unhealthy fats are predominantly saturated fats. But the polyunsaturated fatty acids, the pool, the pufa pufa, that deficiency in pufa polyunsaturated also increases the potential of the heart to have a cardiac arrhythmia.

So we cut the diet. So we're saying here that the American diets too high in unfavorable fats for lower heart disease. But by cutting all the fat out of your diet, okay, I'm not getting any fat now. I'm going to see if I can reverse my heart disease by eating no fat, just by eating vegetables and rice and potatoes and whatever is going to eat. You've actually could be increasing your risk of having a life-threatening cardiac arrhythmia to fatty acid deficiencies because both alpha the alpha linolenic acid found in the high Omega-3 nuts, which we'll talk which those are the which the high Omega-3 nuts and the lack of proof of the polyunsaturated fatty acids both increase the risk of cardiac arrhythmia in fatty acid deficient diets.

So when we're looking to reverse heart disease, we want to have some degree of healthy fat in the diet. And now we have what evidence do we have for this? And the answer to that is, wow, there's nothing that has more evidence. There's no subject in human interest with more evidence, because these large scale studies in different populations from all over the world, whether they've been done by the nut companies, are funded or the funded by the not the nut companies, whatever, whatever it is, they all show the same thing about a 40% reduction in certain cardiovascular death in people utilizing nuts and seeds on a rake on a daily basis in their diet, and the Seventh Day Adventist Health Study two is such an important study because they're following Seventh Day Adventists, where about 8 to 10% are vegans and about 30% of vegetarian.

And those who are meeting animal products are flexitarians, adding that much, and they generally don't smoke and drink a lot.

Omega-3 Nuts and Seeds for Heart Protection 7:00

They're a healthier population than the average American population and they showed among even among vegans and vegetarians, the lack of nuts and seeds in the diet was a risk factor for premature cardiovascular death. And the inclusion of nuts and seeds was the most powerful life span promoter. Let me say that one more time, that in that seventh day Adventists study plant proteins did not have a significant effect in extending longevity except for the plant proteins people gleaned when they ate nuts and seeds.

Those had the most powerful effect at extending all cause mortality, and that means both decreasing both cardiovascular death, stroke, death and cancer death. So we can go into this more. But I have to say that this should not be a controversial subject. One study or two studies where a person shows they can a person's blood pressure or heart disease can reverse with a low fat diet is not the same thing as putting 100,000 people under a scrutiny from 20 or 30 different studies around the world and following people till they die.

Looking at heart endpoints of cardio of death and seeing what they how long they lived, we have too much evidence. Plus, I've published studies. I have one study with more than 400 people in it which lowered. That was the most powerful effect on lowering blood pressure from following a new Criterion diet with nuts and seeds of any study I've ever seen. And I've had multiple studies that corroborate that that I've published that showed that systolic blood pressure dropped 26 points and it dropped 26 points while the people's medications were being removed from the initial level of blood pressure to the final level, blood pressure was a 26 point drop while the medications were being withdrawn.

If the medications were stabilized, then it would have saved more than 26 points. And then the only other study that looks at that in detail with large numbers of people are the deaths. The low sodium dash diet, which the U.S. News and World Report in Time magazine says is the best blood pressure lowering diet, which only lowers systolic blood pressure, 11 points, not 26 points. The neutral tearing diet is tremendously overlooked. And I think that the conventional authorities and most people think that, well, this is too radical.

People aren't going to follow a diet this strict and they don't report on the effects of it, which is which is really selling people out. It's only radical when you compare it to the disease causing unhealthy diets. People are reading now the great people who die prematurely. It's not radical. If you want to live free from disease, cardiac arrhythmia, live a long, healthy life. It's only radical if you're willing to die of these diseases of of nutritional stupidity like other Americans are dying of.

Anyway, get off my soapbox and ready for your next question. Oh, that was that was powerful, because that is so confusing to people who actually can increase your risk of serious cardiovascular events with a ultra low fat approach to plant based diet or any other diet or what. I mean, we touch on this, but I want to go a little deeper. Nuts and seeds, great sources of healthy fats, all fats, alpha and omega three for heart disease prevention, heart disease, or is it personal? What's your role? Well, that's right.

I mean, let's focus on that. But I want people to write that down because there's three seeds in one nut that have that are high in a lady. And that should be if you have heart disease, those three seeds in that one nut should be half you not intake because you would want the high ala nuts to be at least half if you're trying to reverse heart disease. Because like we said earlier, a deficiency is a common cause of cardiac arrhythmia and atrial fibrillation. The three seeds are flax seeds. Chia seeds and hemp seeds are high in LA and the one nut is a walnut.

So I'm saying when the recipe calls for cashews in the dressing or pistachio nuts, the crust, you know, the pistachio crust, tempe or the orange cashew sesame dressing. What I'm saying is take out half the cashews and put back in some hemp seeds. If you're making a banana ice cream with macadamia nuts and vanilla bean powder and soy milk, take out half the macadamias and put in some walnuts. All you got to do is modify the recipe to to substitute to take out some of the high omega six nuts and put in some omega three nuts.

And that tastes just as good because you don't even notice the difference because hemp seeds and we don't have much of a don't don't have an overwhelming taste to make it taste differently. You still have the cashew and sesame flavor. So just make that modification to make sure when the nuts and seeds you are eating, are you eating enough high omega three nuts? And the amount that you're eating, we're talking about for a person that's overweight, looking to lose weight with heart disease or diabetes, with striving to eat a half an ounce with each meal for a total of an ounce and a half a day.

A person like me who's not overweight and more physically active and not looking to lose weight, I might have an ounce with each meal or three ounces a day or something, but we're in that range from 1 to 3 ounces, preferably one and a half to three ounces by about one and a half. When you're looking to lose weight, because that half an ounce of with each meal makes you more satiated with fewer calories, and it facilitates the absorption of the phytochemicals that are anti-inflammatory to the end of feeling like nitric oxide.

So thylacine likes carotenoids, we absorb more of the anti inflammatory phytochemicals 20 to 50 times as much when there's some fat in that meal, like with the salad you reading at lunch with a fat based dressing. Also, the Seventh Day Adventist Health Study two was so informative because they showed a dose dependent relationship between the consumption of not just intakes and reversal of cardiovascular death. We're talking about a heart endpoint like death, not just the person's blood pressure was lowered or the cholesterol went down.

What I'm saying is that when people went in the first quintile from less than half an hour a day to three quarters of an ounce to an ounce to an ounce and a half in the highest quintile they were eating announced in at more than announced a half a day. And that's where we saw the dose dependent most protection against cardiovascular death with an ounce and a half or more per day.

Weight Loss, Satiety, and the Problem with Ultra-Low-Fat Diets 13:12

That's why we even utilize the ounce in at a half an ounce with each meal to get, which is about a tablespoon of heaping tablespoon of flax, brown flax, and share it with your breakfast oats and a salad dressing with a handful of nuts, with a handful of walnuts or a dinner dressing with your, you know, with, you know, three, 6 to 8 almonds or something. So we're talking about using a little bit of nuts and seeds with each meal, not snacking on them, but using them with the meals to slow gastric emptying, to facilitate the absorption of phytochemicals, to increase the anti-inflammatory effects, to increase the production of nitric oxide, to have a more beneficial effect on lowering inflammation to the end of psyllium because they have a protective anti-inflammatory effect on the lining of the blood vessels.

And when you space it out like that, you enhance their healing and beneficial capacity. So we're not overeating nuts and seeds, not overeating calories, but we're using the amounts that scientific studies maximize cardiovascular protection. Okay. I was really, really full of information and wonderful stuff. So the evidence is tart study. Two people live longer with higher nut intake and it was a large sample and a really important study. What's you know, a lot of people here would like to have a healthy heart and prevent heart events.

They also would like to lose weight. And they're challenged by losing weight. We've talked in other interviews with you about food addiction and other aspects of losing weight. What's wrong with cutting out almost all fat out of the diet to try and lose weight? You know, it's it's interesting here and we discussed it somewhat today that when you make your diet too low in fat, then you can increase the risk of the cardiac arrhythmias, the irritability of the myositis or the neurological system in the heart and the brain.

You become more that the the tissues become more irritable if you have no polyunsaturated fatty acids or no ala, those are the two particular nutrients the heart cells are dependent on. So you make a temporary benefits by feel your chest pains go away, your blood pressure drops, you lose weight on the extremely low fat diet. But long term, ten or 15 years later, you might have now increased your risk of problems of as you age with more increased risk of cardiovascular, irregular heartbeat or sudden cardiac death, which is not caused by a blockage or a platelet cloud, but it was caused by irregular heartbeat.

So we want to be careful that we can lose weight even more effectively with the judicious utilization of nuts and seeds in the diet, which is which is obviously critically important. And of course, we're talking here on the opposite effect of oil from nuts and seeds, because oil is an appetite stimulant and nuts and seeds are an appetite depressant. Let me say that one more time. This is so critical to understand that because oil goes into the bloodstream so fast, it becomes an addictive substance because nuts and seeds go into the bloodstream so slow that it actually sucks fat out of the bloodstream into the toilet bowl.

Because the mac, the fat magnets that hold on to the fat and nuts and seeds that bind to sterols and Stanleys, that are behind that, that attracts that there are fat magnet and they actually suck fat out of the bloodstream. They allow the polyunsaturated fats to go in the bloodstream and pulling out, oxidized LDL preferentially into the digestive track, increasing more stool fat. But the still fat, the nuts and seeds cause now more fat in the stool means all the fat. Calories and nuts and seeds did not come into the body because some fat was pushed out to the toilet.

But the fat that came into the toilet were bad. Fat sucked out of the fat that's on your body, allowing better fats or healthy fats to come in. So it causes a fat exchange like an iron exchange mechanism where we're sucking out inflammatory fats from the bloodstream into the bowel for excretion in the toilet bowl. So we so we're making sure people understand the reason why these type of calories, even though nuts and seeds are about 160 calories an ounce, we're still going to eat announcing half to two ounces, a day, you know, 200 to 300 calories a day of nuts and seed is not going to make your diet.

You blow your diet because you still control the amount of calories in your diet and everything else you eat. But the eating, the nuts and seeds makes it easier and make you more satisfied. Eating the right amount of calories, not less satisfied. Eating right amount of calories. You're not going to sit there with the whole bag and eat the whole thousand calories of nuts, you know, eat the right amount, because that's what a nutrient diet is. And let me make this clear right now, to be a nutritious sharing, you're eating the right food.

You're eating healthy enough to be at your ideal weight or you're eating healthy enough and you're overweight and you're moving in the direction of your ideal weight by at least £2 a week. If you're scientifically overweight, if you're not losing £2 a week, then you didn't modulate your diet appropriately because it's one kilogram a week of weight loss where we see the inflammatory markers go down. So effectively that counter the effect of the fat. Like people who go through gastric bypass there, their diabetes goes away in six weeks even though they're still overweight.

Same thing we see on a new sharing diet. People are still out there losing weight adequately that the diabetes, that 75% of type two diabetes are gone within six weeks and they're on 75% of blood pressure.

Omega-3 Index, Brain Health, and Supplementation 18:30

High blood pressure is gone within six weeks. So the body but what I'm saying is your HCR goes down, you might go for oxidase goes down, your oxidized LDL goes down, all the markers your insulin levels go down, your all the all these markers of inflammation, your aspirin levels go down. Well, there is disease markers start to move in the right direction, even if you're overweight, if you're losing at least £2 a week, if you go back and gain weight again, even if you lost some weight, gain weight back again, the markers go back in the other direction again.

If you have to keep going in the right direction. In other words, I'm still telling you, you either make progress or you make excuses, and we want you to make progress in the right direction. All right. Well, that was just great, powerful and very informative to all of us in terms of, you know, getting optimal weight, but using modest amounts of the healthy omega three red seeds and nuts that you went through. So thank you for that. So, Dr. Furman, we've been talking about why a ultra low fat diet is not an optimal diet.

You've mentioned a lot about sourcing your healthy fats from Omega three rich, not in seed based sources, the chia, the flax that hemp and the walnuts specifically, and cutting back on other nuts that aren't omega three rich. Why does a blood test and everybody needs to know there is a blood test called the Omega three index. You run it through your patient base. I run it through my patient base. A blood test widely available. Why is that index important and how does it assure that your nutrition diet reaches its ideal potential?

You know, this is a very another very important question, too. And I have to say that there are now more than a dozen studies, like 15 or more studies on this subject, that link a low omega three index to brain shrinkage and cognitive impairment in later life, but also, more recently, the low omega three index has been linked to increased risk of cardiovascular death and even all cause mortality. So much so that if your index was low enough and they equate the risk to sleep to smoking. Cigarets So there are studies that show that low omega three index risk is associated with.

So with all cause mortality deficits. One of the ways we extend lifespan is that we, you know, we're eating the right amount of calories, but we're doing it in the right fatty acid balance. And with we're not stressing out our insulin, we're not having the body to produce excess insulin. A body is glycemic. Our diet is glycemic. We favorable our diet has adequate protein. It's high in nutrients. And of course, with maintaining an Omega-3 index, it's favorable throughout decades of life. We don't wait till our level gets low and then try to fix it when we're demented already.

But I'm going to build back a shrunken brain. We have to maintain a normal Omega-3 index all through the major decades of our life. In other words, when in the 40's, 50's, 60's, 70's, we want full mental faculties when we're 90, 100 years old. Now, this may not be that important if the person's dead between 65 and 75 years old because you don't see too much dementia between 65 and 75, it mostly occurs. Dementia occurs when people live past the age of 80 and they get memory loss and dementia. So maybe these vegans who don't want a supplement are right.

They're saying that most people can live normally and not have symptoms if they don't supplement and their Omega-3 index is low and they're okay and yeah, they are okay if they're going to eat what to eat poorly and be dead at the age that most of America is going to be dead at, because most Americans are dead around 76 to 78 years old. But if we're going to eat so healthily, I'm going to push the envelope of human longevity deliberately, 95 or longer. Then we better protect our brain size and brain health in the process.

And then you need a good Omega-3 index, two decades of life to maintain the brain size free of dementia in those later years. So we have to plan now for living longer by protecting our Omega-3 index in our brain. So we do have adequate brain size and brain function in our later years. And this is what the data is very, very corroborative and solid on that later life brain shrinkage in later life. Cognitive impairment is linked to early life Omega-3 index and most vegans do not get an ideal omega three index without supplementing.

They need to supplement with a plant based omega three supplement to get the Omega-3 index above six, which is the level associated with the lowest degree, with the longest lifespan and the lowest degree of dementia in later years. So this is a critical process. And and as you may know, people might attack me and say, well, you sell Omega-3. Yeah, but the reason I sell Omega-3 fatty acids is because I've been working in the vegan community for more than for like 40 years. And all my mentors and all my people who follow the natural hygiene in America, you know, the vegan side used to be the elderly people when I was a teenager became when I became a doctor, they became my patients.

And I know so many vegans who got develop Parkinson's and dementia eating super healthily, but I got alarmed and started checking Omega-3 levels on people three four decades, seeing the relationship between the Omega-3 and later life neurologic problems and vegans. So that's right. I'm very adamant that people take a healthy Omega-3 and I started producing my own about more than 15 years ago because I wanted people to get refrigerated Omega-3 that was not rancid. That would that didn't have that would, you know, that it was kept fresh.

And so I was very concerned about this. And even today, I'm very open. And then my mission is to say, well, if you're going to follow this this diet, it's my mission. And then to make sure nobody's hurt by a vegan diet. No, you got to take B12 and you have to make sure your Omega-3 index is adequate. You know? Okay. So people that are listening to the Reversing Heart Disease Summit may not know. They may have to educate their primary care dog, their specialist,

Closing Remarks on Long-Term Heart Disease Prevention 24:36

that they can get a blood test called an Omega-3 index. There's a code for it. E 63.0 that's called an ICD code that gets it submitted to insurance. And it is in my clinic. And I know it's, in your experience, perhaps the most common nutritional deficiency. I measure more than B12, even slightly more than vitamin D deficiency. So absolutely, it is the most it's the most common cause of later life problems in vegans. Is this deficiency right. I in you know we don't share a clinic I have my own and you've had vast experience but I agree with that statement and it's so easily measurable and correctable, so do not risk it.

Well, thank you for taking your time to review this important topic of why low fat diets are dangerous and why seeds, nuts and other sources of Omega-3 are critical to make this work long term and avoid heart disease, you're the author of the book The End of Heart Disease. You should know what you're talking about. So thank you again and I hope to look forward to chat with you on other topics.