
Unlocking The Secrets Of Aging & Heart Health

President, Nutritional Research Foundation

NutritionFacts.org
Unlocking The Secrets Of Aging & Heart Health
Michael Greger, MD, FACLM
Full Transcript
Introduction and Dr. Gregeru2019s Background 0:00
Hey. Welcome, everybody. I'm glad you're so glad you're joining us on this. You know, reversing cardiovascular disease, reversing heart disease summit. It's so critical that people get this information. And today, I'm excited to have with us Dr. Michael Greger, one of the heroes in this plant based movement. And a friend of mine and a you know, and so respect the work he does. It's so terrific to have him join us today. So here he is, Michael Greger. And let me just give you a brief bio of Dr. Greger for a minute, and then we'll get started with his wisdom.
And that is Dr. Greger has been a founding member of the and a fellow of the American College of Lifestyle Medicine. So way back, you know, 30 years ago when this all of stuff was started, he was one of those people, as I had to, actually. And he's a physician, an internationally recognized speaker on nutrition and nutritional science, and his science based nonprofit NutritionFacts.org is a free online portal hosting more than 2000 videos. You can get information on most any subject related to nutrition and health science.
He's presented at the Conference of World Affairs at the World Bank. He's testified before Congress. He is an expert witness in Oprah Winfrey's defense trial on the infamous meat of defamation trial. And now he's also an acclaimed author. A bestselling book is selling How Not to Die and the How Not to Die Cookbook were huge bestsellers and then the How Not to Die- How Not to Diet Book became an instant bestseller, too, which was so proud of him and and grateful for his work. And then and remarkably, all of Dr.
Greger's all these proceeds that he receives from his books and speakings are donated to charity. So he's just an incredibly powerful individual, putting forth goodwill and good vibes out to the world, trying to make the world a better place. So welcome, Dr. Greger
Heart Disease Is Reversible, Not Inevitable 2:12
There you are, exercising as usual. Thank you so much. I'm honored to be here and so excited that you're doing the summit. Great. Great. And we're talking about heart disease and how not to die, so to speak. Right. That's what we're talking about, because the number one cause of death for adult Americans is heart disease and strokes. But so let's start with is it just aging or is it a longer time of eating unhealthily that causes it causes heart disease and strokes? Or are you just inevitably going to get heart disease as you age?
What do you think? Yeah, so that's what we used to think. We used to think that for high blood pressure, we think that for heart disease until we started looking around the world and realized that there were populations that did not die of epidemic of heart disease epidemics, rheumatoid arthritis and osteoporosis and obesity and on down the list. So wait a second. Then we have these migration studies that show it's not genetics when people move and start eating and living like Americans, they start getting sick and dying from American diseases.
And so this is a tremendously kind of hopeful approach. And then, of course, it wasn't until people started putting it to the test, like Nathan Burdick and and Dean Ornish, who what the famous lifestyle heart trial in 1990, proving for the first time with something called quantitative angiography, that you could indeed reverse heart disease, open up arteries without drugs, without surgery, just a plant based diet and lifestyle program. Right. So it's reverse heart disease. But we can also stop people from having like a clot that can propagate and cause a heart attack or cause a stroke.
And it's this is not just not forming clots and the increased ability of the blood to stick together and from from just aging us. It's right. It's kind of like it's what they're putting in their mouth. You know? Absolutely. And so it's not just it's not just the level of cholesterol in your blood, but the so called cholesterol years, just like we had pack years for smoking. It's not just how much you smoke, but how long you smoke for. Same thing. What's your cholesterol? How high is your cholesterol and how high has it been for how long?
That's critically important. So there are these there's this rare genetic condition, this PCSK9 mutation, affecting the rare lucky individual where they have lifelong LDL is not that low, but they have it for their entire lives and have dramatically lower cardiovascular disease rates. I'm suggesting and you say, wait a second, you know, how can you be walking around with an LDL of, you know, 100 and still not get any, ah, disease? Well, that's because they've had it. They haven't been accumulating, you know, cholesterol in the walls of their arteries their entire lives.
Whereas if you've been eating unhealthy, we really want to get your LDL down more like 70 for primary prevention and then 30 to 50 are really as low as possible for secondary prevention. You already had a heart attack, already have known heart disease. We want to push those numbers as low as possible. Right. So I think you're saying that there's like the LDL, that if you're eating unhealthy it, you've got to push it down higher. Eating healthy is going to go down as far. But wouldn't you think that like a statin lower LDL is not going to be as protective?
Generally speaking, as a dietary and lifestyle?
LDL, Cholesterol Years, and Medication Limits 5:36
Lower LDL right is right. The reason is because there's this panoply of benefits of eating healthy, healthy beyond just what the what the statin offers. Now, the statin is not just cholesterol lowering that has an anti-inflammatory effect, but you look at diet and exercise, look at healthy eating, and there is this long list of benefits like the blood rheology, which you talked about, the the flowability of one's blood lowering blood pressure. Statins don't do anything with blood pressures. Lowering excess blood sugar levels stands actually increase rates of type two diabetes, whereas healthy diet, the same healthy diet that can prevent and reverse reverse heart disease can prevent reverse type 2 diabetes and so on.
Down the list is an anti-inflammatory diet. And so so you, you, you only get a small, a narrow spectrum of benefits when you're taking these lifestyle drugs as opposed to treating the underlying cause of the disease. If we look at the absolute risk reduction, even in a secondary prevention scenario where someone already has heart disease, really only talking about a 2% absolute risk reduction over a period of maybe six years, dropping one's risk of a subsequent heart attack from 6% down to 4%. Big Pharma likes to advertise that as a 33% drop in heart disease rates, which is true technically, but it is just that 2% drop.
So about one in 50 benefit. 98% of people during that time frame would not be benefiting from these drugs. And so, look, if you are unwilling or unable to change your diet and lifestyle, these drugs can be lifesaving, particularly in a population scale. But for the individual, they're really quite important. And we overestimate the efficacy, both patients and physicians alike. Right. So that's what this summit is about, to get people really, truly protected. And that means they got to make a radical change in how they're living.
Of course. So what do you say? They've already done it. Yeah. So let's go over. What do you think are the most important lifestyle changes to let's say you weren't eating healthfully for the first 60 years of your life and then you have high blood pressure. So what do you think is the most important changes a person can make as they age now? They change their diet. They're starting to exercise. What should they do specifically? The most important things they can do to reduce their risk at this point.
Well, you know. How much they reduce once they've eaten unhealthy, how much can they reduce their risk and what should they do? Yeah, I mean, so so first of all, it's important to note that, for example, in Orange is lifestyle Heartthrob. These were people already in their sixties. They've been eating these terrible diets their entire lives and yet still able to reverse the accumulation of plaque even late in life after a lifetime disease. So it's never too late to start eating healthier, to start moving, to stop smoking.
We really do have the power, unfortunately. Of course, the the number one way most people, a slight majority of people die from heart disease, some something called sudden cardiac death, meaning you don't even know you have heart disease. And then all of a sudden you're dead within a few hours of showing symptoms. And so that's why you can't just wait until you're diagnosed with heart disease to clean up your diet and lifestyle, because an ounce of prevention is worth way more than a pound of cure.
Since there is no cure for dead right. I always say the food doesn't taste that great once you're in the coffin. It's exactly, exactly. The taste buds just don't quite work as well. Right, exactly. So in terms of if we really were to prioritize according to the global burden of disease study, sodium reduction would probably be the number one thing. Just because salt contributes to mortality for so many different ways high blood pressure, stroke, kidney failure, heart failure, etc. So reducing certain consumption, which predominantly really is about reducing the consumption of processed foods in the United States.
Well, okay. So after sodium consumption reduction, you take the sodium every day, cut the processed foods out, then what food should they focus on to facilitate this reversal of heart disease? What are the foods you want them to focus on the most? All right. So yeah, so in terms of the things we want people to cut down on, we want to cut people cut down on sodium primarily.
Diet Priorities: Sodium, Saturated Fat, and Plant Foods 9:54
I would used to say trans fats, although trans fats, thankfully, have been removed from the U.S. food supply. But if you have people in this summit internationally, there still may be these partially hydrogenated oils in their in their food systems, which they should avoid. But with trans fats largely out of the way, at least industrial produce, trans fats, saturated fat would be the next predominately found meat, dairy, but also these tropical oils like palm kernel oil, palm oil, coconut oil. These are not healthy oils.
These are these rare, highly saturated plant fats found in a lot of, you know, vegan junk foods, which people really need to reduce. And the third thing would be dietary cholesterol concentrate mostly in eggs that encourage people to draw from their diet as well. In terms of flipping to the positive side, we'd like people to be centering their diets around whole unprocessed plant foods. So fruits, vegetables, whole grains, legumes, beans, Poppy's chickpeas, lentils, nuts and seeds, mushrooms, herbs and spices.
Basically real food that grows out of the ground from fields, not factories. Those are our healthiest choices. Yeah. How does the, you know, the man? I mean, the advertising in America and brainwashing people, how do they get people to think that eggs are healthy for the heart, you know, and the egg yolk. Right. Is the most cholesterol concentrated food. And they've convinced people who think, oh, cholesterol is not going to hurt you if you eat it, only if you fat that it's unbelievable because isn't there more Asian cholesterol?
Doesn't it distort the instant receptors and making millions means. Oh my god so much and I'm down the list on that list. Well, how do they do it? Because they have this checkup program. Every single egg sold, they need to send money into a fund which is operated by the federal government that goes into general egg advertising like the Egg Nutrition Center. And so they have tens of millions of dollars every year to pump out this message. So it's the same reason some way that, you know, Coca-Cola tries to, you know, muddy the waters in terms of sugary beverages, consumption, basically all these I mean, there's just that's where the money is.
And so they're able to really push out their message despite the overwhelming consensus in the peer reviewed medical image. Hmm. Right. So okay, so then if you're, you know, there's the medications that doctors use, you know, which as we get older, you know, they're they're having some people who, you know, doctors have to wean people off medications that are so medication more harmful for the elderly, you know, that their doctors are using and more critical to come off the medications. Oh, my God.
There's more medications like doing more harm than good, even, you know? Well, there's yeah, there's this epidemic of polypharmacy in terms of the number of drugs that people accumulate over time. Oh, my. And I forget this. I have the stats in the book in terms of the percentage of Americans at different ages on multiple medications and how many, it's really quite shocking how many people are on drugs and really needs to sit down. Why are we on these drugs? In fact, some of these drugs aren't even indicated for something like the PBS proton pump inhibitors, drugs like Prilosec, Prevacid.
These are drugs that really only have FDA indication for a few weeks maximum unless you have something like a, you know, as a creating tumor or something. Yet people end up on these drugs for years, increasing the risk for bone loss, increasing risk all cause mortality on down the risk on down the list. All drugs have side effects. All drugs have downsides. You only want to be on drugs if the benefits outweigh the risks. And if there's no other alternative, non-pharmacological alternative that can do the same thing or better.
You know? Yeah. All right. Well, and what about, you should say, certain testing, certain blood tests, certain markers? Do you think people should be watching as they get older to protect their heart? You know. Well, according to the USPSTF, United Services Preventive Task Force, the really the only lab test that you would get regularly to look at hard is is cholesterol.
Testing, Animal Protein, and Cancer Risk 14:00
So following the LDL cholesterol, actually the first the recommendation now first LDL cholesterol taken early in life just to make sure you don't have this familial hypercholesterolemia. But then at regular intervals, we want to make sure your cholesterol is low. And this is this is important as well for people who, you know, think they're eating healthy diets. We want to make sure because heart disease is the number one killer of men and women, as you said, want to make absolutely sure that your changes in diet are actually translating into what we would expect it to be.
So just because, you know, the average LDL cholesterol of someone in a strictly plant based diet comes in at about 68, which is right where we want it for primary prevention, it's a bell curve. And some people, just because of genetics or other factors end up higher and have to just work harder or have even a cleaner diet to shove their cholesterol even lower. So regardless of your diet, you really should be getting tested. Make sure your cholesterol goes down. Stays down. Right. All right. And of course, you know, eating cholesterol, eating saturated fat.
What about animal protein? Does that also in itself, like what about if people go to the lower fat animal products like white meat, chicken or, you know, it does that and that is that what the effect of that. Yeah well I mean even so-called white meat chicken there's still more fat and then protein by 20% fat by calories. So I mean a century ago chicken was can be considered a kind of a high protein food and only about 2% fat. But they've been so genetically bred to to have excess body fat that that is no longer a anywhere near a low fat food.
The the concern about animal protein is largely about not killing number one, but killing number two, cancer. When we animal protein increases, the risk increases levels in our blood of what's called insulin like growth factor one two growth grueling cancer promoting hormone, which at high enough protein levels, doesn't matter if you're eating plant versus animal protein, but at recommended protein levels only, the animal protein was actually boosted, you know, randomized people to cut animal protein from their diet and their levels fall quite rapidly into the reverse.
And so when I think animal protein, I'm more concerned about cancer in longevity than I am about heart disease. The heart disease is more about animal fat and proteins, more about excuse me. Yeah, animal fats, more like heart disease and animal proteins more like cancer. That's exactly. Exactly. Although. Wow, how about neither? Sign me up for neither and try to get your macronutrients from the healthiest foods which are whole plant foods. So we're getting older and people are feeling I don't know what they're feeling. Not feeling is good.
How do they know if they have to worry about their heart? And I think I think I got the answer from you. I think you're saying is that don't wait. Are you feeling something right now? Right. And what? So what do you think about what could you say to help motivate people to get the fat off their body, start to get off the chair like you are, and start to make a radical change in their diet. So let's see, you know, let's see what could come, what you have to say about just pushing people to make these more significant changes.
Based on autopsy studies of children in the United States who tragically died 100% of children on raising the same American diet have called fatty streaks are building them. So there is this a first stage of heart disease already by age ten, in their twenties, 60% of these are these streaks of turn into actual plaques within their coronary arteries. 60% twenties coronary plaque, coronary artery plaques. And so no, so so this is a long disease, in fact, that's similar with many cancers. So the so-called latency time, but the time between a cancer start and the cancer is actually diagnosed can be decades long.
Colon cancer, about average latency time, 50 years.
Exercise, Prevention, and Closing Remarks 18:30
And so, you know, you know, this is you know, I know we're talking about heart disease, but there's a lot of people who, you know, change their lives, start eating healthier and be like, oh, I don't have to worry about colon cancer screening because I eat so healthy. Well, yeah, but the colon cancer might have started in your teens when you weren't eating so healthy. And yes, eating healthier can slow down the doubling time, slow down the growth of that cancer. But still critically important, maybe particularly important to get colon cancer screen. Why?
Because you're going to live so long, right? We and the colon cancer screening often at a certain age because look, who cares if you have cancer, you're not going to live that long. You can have a heart attack. Right. But if you're not going to have heart attack, you're going to live long. Well, then we really need to snip out any any budding tumors. It's even more important to make sure to ensure our survival. But. Yeah, so. But for heart disease, my right. You cannot wait until your first symptom.
Because particularly for women, first symptom may be your last. But the good news is it's reversible. And, you know, one of the most amazing things I learned in all my medical training was that I've been in about 15 years of stopping smoking your lung cancer risk approaches, that of a lifelong non smoker. It's just so amazing like your lungs and clear out all that tar and eventually it's almost as if you never started smoking at all. Right. And every morning of our smoking life, that healing process starts to win first cigarette of the day reentering our lungs with every puff, just like we can re-engineer arteries with every boat when all we had to do all along the miracle cure is just stop re damaging ourselves, stop re injuring ourselves Let our body's natural healing processes bring us back towards health.
Sure, you can choose moderation and hate yourself with a smaller hammer, but why beat yourself up at all? Right. So yeah, because y you know, I guess the why beat yourself up is because these people become addicted to this self-destructive food that changes the brain. It's just crazy. But we got to get people to understand these concepts and okay, so the person is getting motivated, they're going to eat better, they're going to make this radical change. So how much time do they should they put aside each day to exercise?
Well, I mean, the most important message is any exercise is better than none. So I don't want and in fact, the reason why physical activity guidelines really only recommend about 20 or so minutes a day actually, which has been progressively going down because they wanted to be doable for people to be approachable. They don't want to scare people away. But the science actually suggests you get increasing benefits in terms of all cause mortality up to 90 minutes a day of moderate intensity activity or 45 minutes of vigorous activity.
And and then then maybe it plateaus. We just really don't have studies of people that that exercise longer than that. But we know at least it goes up to that point. So that really should be the recommendation. Ideally, we should be getting as much as 90% of moderate activity, moderate intensity activity like brisk walking every day. But again, any amount is better than none. And even studies suggesting 15 minutes a day of walking is associated with significantly longer lifespan. Terrific. All right.
Well, I think people got an amazing benefit from this. A hit right The most important point. So thanks for being here, for being part of the summit. We're so grateful to you being be part of it. And everybody, we're so grateful to you being here as well and being part of this community, sharing, learning and spreading this word of obviously that we can take charge of our health destiny and you don't have to be sick. And it happened to you. What happens to other Americans. So take care of yourself.
Take care of your friends, your family, your neighbors. And let's all do this together. All right, by everybody. Thank you, Dr. Greger and Thank you so much. I am honored to be part of anything you're ever doing. Never hesitate to reach out. Keep up the fantastic work. Thanks so much. Thank you so much.
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