Full Transcript Summit Introduction and Guest Welcome 0:00 Welcome everyone to the Gut Health and Longevity Summit. 0:02 I am so glad you're here, and I want you to take a breath right now, 0:06 because what you're going to hear over these sessions could genuinely change 0:10 the way you think about your health, your food, and your future. 0:15 We built the summit because the science connecting your gut 0:18 to every other system in your body has never been more compelling, 0:22 and most people have never heard it in plain language. 0:25 Our experts are here to change that, and today's conversation is one 0:29 I've been genuinely excited about the link between your gut microbiome 0:33 and your heart. 0:35 So first off, I want to talk about my guest here. 0:39 I have Doctor Joel Kahn here. 0:41 He has spent decades doing something most cardiologists do not do. 0:45 He's trying to put himself out of business. 0:48 His entire practice is about building around the idea that heart 0:52 disease does not have to happen, and he has clinical results to back it up. 0:57 So Doctor Joel Kahn graduated summa cum laude from the University of Michigan 1:01 Medical School and holds a triple board certification in internal medicine, 1:07 cardiovascular medicine, and interventional cardiology. 1:10 He is a clinical professor at Wayne State University, 1:13 and was the first physician in the world to certify in metabolic cardiology. 1:18 He is known as America's Heart healthy Doc, 1:21 and he has founded the center for Cardiac Longevity in Michigan. 1:26 He has authored a number of books 1:28 Your Whole Heart Solution, The Plant Based Solution, 1:32 and A lipoprotein a The Heart Silent Killer. 1:36 And we are going to talk a lot about all of this. 1:38 And you've likely seen him on the doctor show, Doctor Oz and many other places. 1:44 So, Doctor Kahn, welcome. 1:46 I have so many questions for you. 1:49 And I know our audience does too. 1:51 So let's dive right in now. Perfect. 1:54 Thank you for having me. 1:55 Yes, absolutely. 1:56 Well, welcome. 1:57 So let's start where most people are. 2:00 Heart disease is the number one killer. 2:02 But I think a lot of people 2:04 still picture it as something that happens suddenly, almost randomly. 2:08 So can we talk about what is actually going on 2:12 inside the arteries and how early does this start? 2:16 Yeah, it's so important to keep beating that statistic in the public. 2:21 7 to 8 times more women die of our disease. 2:24 In breast cancer, 2:25 even women with breast cancer are more likely to die of our disease. 2:29 7 to 8 times more men will die of heart disease and prostate cancer, 2:34 and more will die of heart disease in all cancers, in both men and women. 2:38 Very tragic. 2:39 And there's a crazy data that if you go to a search engine 2:44 or the New York Times or other outlets, the amount of press that heart 2:49 disease gets is so small compared to cancer, 2:53 terrorism, suicide and all important topics. 2:55 But it's so important. So let's just keep going. 2:58 And really we know I mean, you can actually say from age 3:01 18 on you can actually identify in the United States using an ultrasound 3:06 of the carotid arteries, no CT scan, no radiation plaque. 3:10 And a lot of young people, we know that soldiers that died in Korea 3:14 in and Desert Storm on autopsy, they died of trauma. 3:18 They were in a war, but they had plaque in their coronary arteries 3:21 and they were often 21, 22, 19. 3:24 So, you know, this may or may not have been the case 50 years ago. 3:29 There is some data that coronary disease goes back a years. 3:32 The mummies in Egypt, if you put them in a Cat scan, have Coronado disease. 3:37 There's a 500 year old man named Ötzi 3:40 who was found in an ice formation in Europe, had coronary disease. 3:44 So it's not a new disease, but it's very slowly. 3:48 It's very much like cancer 3:49 if, you know, or or dementia, they say dementia is a 20 year process. 3:53 Cancer might be a ten year plus process. 3:56 A coronary disease, by the time you're in an emergency room, 3:59 had a heart attack, had a stent, and people get frustrated. 4:03 They want to get rid of their coronary disease. 4:04 Well, took 20 years to get it. 4:06 We're not going to get rid of it in a week, but we can make many measures
How Heart Disease Develops Early 4:11 that halted and even reverse it to some extent. 4:14 So and now we're learning, as we're going to talk today, 4:17 that our wonderful gut has a lot to do with our disease. 4:21 And it's so obvious, but it's really a pretty new topic. 4:24 Yeah. 4:25 So you've already mentioned that it can occur 4:29 in onset of early age, like even they've seen it in young military people. 4:34 But what is it that you actually start seeing as early signs 4:39 like if people are like, oh, well, let me start thinking about this. 4:42 What could be some early signs that they might want to consider? 4:46 I know, like for me, as a pathologist, I've looked at plaques, I've done 4:49 carotid Antarctic where I'm like literally looking at the calcified plex. 4:53 But what is it for the listeners and viewers 4:57 to go, oh, okay, I need to think about my cardiac health. 5:00 Yeah, in bold statement. 5:02 But if you wait till you have symptoms, you probably waited 15 years too long. 5:07 We have to take a more aggressive approach, like we do for breast 5:11 cancer screening and colon cancer screening and prostate cancer screening, 5:14 and maybe by age 40, which is too late, but at least it's a whole paradigm shift. 5:20 Start doing an ultrasound of an artery. 5:22 It could be the carotid arteries, or the brain could be a femoral artery. 5:26 In Madrid, Spain, there's a famous ongoing research study called paisa PSA, 5:32 where they do a femoral artery ultrasound in asymptomatic people average age 45. 5:37 And well over 50% of them already have plaque. 5:40 Or my favorite test, there's a CT scan called a coronary artery 5:44 calcium CT scan in asymptomatic people aged 40 and up. 5:48 Very inexpensive, very safe. 5:50 And that's a whole nother, you know, topic. 5:52 If you wait to have symptoms, they might be shortness of breath 5:56 on exertion, might be pressure, tightness, squeezing. 5:59 Burning on exertion would be most typical cold 6:02 weather sexual activity a big heavy meal. 6:06 And then you go to activity and you just don't feel well 6:09 because you're trying to get blood flow to your GI system after a big meal. 6:13 And if you're exercising to your heart, just like mom taught us 6:17 when we were six years old at the beach after big lunch, men may get erectile 6:21 dysfunction years before they have symptomatic heart disease. 6:25 Every man with erectile dysfunction should have 6:28 a thorough cardiac workup, even if there's absolutely no symptoms. 6:32 Even if they look good, looking good on the outside matters. 6:35 Not at all. 6:36 There's a famous doctor, Peter Diamandis, M.D., 6:40 who says the body has an amazing ability to hide disease, 6:44 and I couldn't believe I couldn't agree more with that statement. 6:47 So we have to take the same approach. 6:49 People don't go get a mammogram because they have a breast lump. 6:53 They go get a mammogram because they're told it's a reasonable option. 6:56 And 30 years later, this coronary artery calcium 6:59 CT scan, it was in the New York Times in the last week. 7:03 Is it prime time for CT scanning of the heart? 7:06 Yeah, it was actually in 1995. 7:08 But it took 30 years and millions of people dying who could have learned 7:14 when they were 44 years old that they were in obvious heart patient. 7:18 Yeah, that's a great point that we need to relook at. 7:22 What are the preventative technology tests, blood tests, all of this 7:28 that we can do because we don't want to wait for disease to develop. 7:32 So you practice very differently than most cardiologists. 7:35 And so when somebody's sitting across from you and they want to understand 7:40 why their heart is at risk, what are you looking at? 7:43 What are the real drivers that you find in 7:47 our modern world are putting people at heart risk. 7:51 Yeah. 7:51 Well, Joy is going to be in my clinic in Detroit. 7:54 License in 20 states. I see people all over. 7:57 And as you know, in the winter, I'm now what's called the snowbird. 8:00 I open the clinic in Florida and see people live in Florida 8:04 because, ten below zero just doesn't fit my metabolism anymore. 8:08 But, it's a very welcome you to Florida. 8:12 Yeah. 8:12 Well, you know, become more and more over time. 8:15 It's a very thorough history. 8:17 Physical exam hasn't changed, but history. 8:19 It has to be everything you eat breakfast, lunch, dinner, snack. 8:23 When you eat it, when you don't eat. 8:25 Where are you eating? Home restaurants. 8:28 You know, it doesn't take that long. 8:29 And it's fascinating to find out what people are eating. 8:32 It's obviously every detail and exercise, smoking, history, family history, 8:35 personal history of diabetes or blood sugar problems, blood pressure problems, 8:39 blood cholesterol problems. Those are the classics. 8:42 But we got to ask about oral health until we got to ask about stress 8:46 and coping mechanisms for stress, we got to ask about 8:50 air pollution, water pollution, plastic pollution. 8:53 These things are not crazy anymore. 8:55 These are causing disease and a simple little tip like, you know, 9:00 you really ought to be drinking out of a stainless steel cup, 9:02 not a plastic cup is a small little step forward. 9:06 You know, 9:06 it may take 50 small little steps forward, but they're small and they can be done. 9:11 But then we're going to get a lab panel beyond the average primary care doctor. 9:16 Great primary care doctor. 9:18 But we're going to get homelessness thing and lipoprotein little a and inflammation 9:22 like chess at least I love a little test called the BNP 9:27 heart hormone level B and B vitamin levels. 9:31 Diamond D omega three B 12. 9:34 You can go way beyond that. 9:36 But we're going to pick up so much more disease with about ten extra blood tests.
Screening, Risk Factors, and Advanced Testing 9:41 Very often can be appropriately builds her insurance. 9:44 Then they probably got in their family doctor's office, advanced 9:48 cholesterol panels and like a pro lipoprotein B, 9:52 perhaps you know about that one. 9:54 It's just another way to measure cholesterol. But it's a good one. 9:56 Yeah, I like to think of it that when we have the general tests 10:00 that you might go to your primary care doctor, it's really waiting 10:04 for advanced disease to show up abnormalities like the standard 5 or 6. 10:09 So these additional tests that you have mentioned, the inflammatory markers, 10:14 the and also the advanced lipid testing markers, all of this 10:17 is in addition to the imaging is going to provide you valuable insight, 10:22 especially since this is the number one killer in the US. 10:26 Right. So we want to look at all of these factors. 10:29 Just to finish your question. 10:30 We're not you know, we're not really doing 10:34 gut testing and stool 10:37 testing as a routine screen and heart patients. 10:40 I think that'll be more common in about ten years. 10:44 Now, we're still in the infancy of understanding the gut and the heart. 10:48 There is that one blood test everybody should ask for, in my opinion, called TMA. 10:53 Oh, It's available from quest and LabCorp and others. 10:57 It's inexpensive. 10:58 It has a billing code, and it can reveal if your diet and supplements 11:03 are fighting you or working for you because of its abnormal. 11:07 Something's not working well, and it does 11:10 cause disease in both the heart and the kidneys. 11:13 And it's easily correctable with some diet changes. 11:17 Yes. So that is actually where we do connect that. 11:20 So I do gut testing, I do microbiome testing. 11:23 And I truly believe that the gut is the origin 11:26 of most diseases and also the way you're going to address treating it. 11:29 So if we get into this molecule that you're talking about team, 11:33 can you explain that a little bit more? 11:35 I've been reading about it for years. 11:37 Let's talk about where it comes from, why 11:41 every cardiologist and every patient should really care about it. 11:45 And what is that mechanism that's happening? 11:48 Yeah. 11:49 So, you know, from this big topic, the connection between our GI tract, 11:53 our gut and our heart, there's some obvious ones. 11:56 We can almost skip over them, but there's hundreds of articles that the 12:00 health of your gums and your mouth and your root canals and your fillings 12:04 a matter for heart disease and many other conditions. 12:07 And then obviously, what we eat, 12:09 that's sort of our gut and our heart health has been connected. 12:13 Is it going to be beef tallow or is it going to be olive oil. 12:17 The great Maha versus the American Heart Association argument 12:20 that's going on right now in this year. 12:22 And I know the American Heart Association 12:24 got it right and got it wrong with the whole crazy beef stuff. 12:28 But it all takes a bright mind that's willing to ask questions. 12:32 And I'm fortunate to say I'm good friends with the Cleveland Clinic researcher 12:38 director of preventive cardiology named Stanley Hazen, MD, PhD. 12:42 I just spent an hour in his office last week in Cleveland, a wonderful time, 12:46 and he asked the question, and we all should be asking this question. 12:50 There's got to be more things causing heart disease. 12:53 And what's known now, because there are people that show up 12:57 and they appear to be fin and they appear to have a reasonable diet 13:00 and fitness and they don't smoke and they got heart disease. 13:03 So he screened, the blood of a few thousand people 13:08 at the Cleveland Clinic with an array of markers that are called 13:12 metabolite, things that develop in the body from our diet choices. 13:16 And he found three there were suspicious and ultimately identified 13:20 this team a molecule which was known in biology. 13:24 It's the reason fish don't freeze in cold water. 13:28 It's like an antifreeze for fish that live at low temperatures. 13:31 But it turns out humans can make it or humans can eat it. 13:36 And he quickly did a very exhaustive 13:39 basic science series of studies, animal studies, human studies 13:43 that showed if you're elevated in your blood, 13:46 which is now a very simple, available, inexpensive blood test of which I've drawn 13:51 15,000 or more, it became available in 2015, 13:56 and every patient has had it at least one since. 13:59 If it's elevated, they're going to have him more than once. 14:02 That can cause atherosclerosis, 14:05 that can damage kidneys, cause scarring. 14:09 In diabetes. It's prognostic very important. 14:11 So it's not just a biomarker of a gut heart abnormality. 14:15 It's actually causal. 14:16 And he went on to show there's only a few things that caused her to Mayo to go up. 14:22 We don't know of any genetic influence at this point. 14:24 It's do you eat egg yolk? 14:26 Some people won't like hearing that. 14:27 But that's the research. 14:29 Do you eat red meat? 14:31 It's not white meat. 14:32 This red meat, there's carnitine in red meat. 14:35 It doesn't matter if it's grass fed is regenerative red meat. 14:38 It's still going to raise your team. 14:40 And they did research that a few fish and shellfish naturally have male. 14:45 And I'm like cod, like blue crabs. 14:47 And 24 hours after a big meal of God 14:50 your blood team meal level maybe I now it comes right down. 14:54 If you limit or eliminate egg yolk, red meat, certain fish, it's not all fish. 14:59 And then there are people that take supplements and there's only two 15:03 choline CHOLINE. 15:05 Some people take it for their brain and carnitine, 15:08 something that we do need in our body, but in excess. 15:11 If you're swallowing down 1000mg or more day, 15:16 maybe for your heart, your blood pressure, 15:17 your light bulb protein A and others, it can raise dramatically. 15:21 So I've seen it, you know, 15:24 of times High 15:26 and then quickly come back down and people have to make a decision. 15:31 These diet changes are willing to make long term for the potential pathway. 15:36 Looks like it's certain animal foods red meat to yolk from eggs, 15:41 certain fish that contains this choline and this compounds. 15:47 And what the gut microbiome and how that relates is 15:50 there's gut bacteria that will convert it to a team A 15:55 and then the liver gets involved, which is the liver 15:58 is still part of your GI tract and turns it into the mayo. 16:02 And the mayo, as you mentioned, 16:04 is what makes and promotes atherosclerosis and clotting. 16:08 And that's what we're thinking about 16:09 when we're thinking about cardiovascular disease. 16:11 Would that be correct? 16:12 You know, you have nailed it completely right. 16:14 And you know, there's ongoing research already. 16:17 We know there are certain bacteria that are more likely to convert 16:22 your choline and your carnitine and your foods or your supplements to TMJ 16:26 at the border of the GI tract, and then the liver will convert it. 16:31 We don't have a probiotic yet. 16:33 We don't have a prescription drug yet. 16:36 Those are being worked on. 16:37 The Mediterranean diet may lower it. 16:39 Of course. 16:40 It is naturally a lower egg lower red meat diet, 16:43 although it depends which fish you eat. 16:45 For the Mediterranean diet. 16:46 If you eat fish, it may or may not work for you. 16:49 Little data that balsamic vinegar has the ability to lower mayo. 16:53 So a few little tips there. 16:55 But the best thing is just change your diet and get your level done. 16:59 It takes days to repeat the blood test if you're unsure. 17:04 Well, so now the audience is probably listening, 17:07 going, well, I thought fish was good for heart health. 17:11 Now you're telling me that fish has this compound? 17:14 So how can we clarify? 17:16 It's almost like a nuisance that we are talking about here. 17:19 And it's an important nuance. Yeah. 17:22 You know, fish in my reading is a spectrum going from, you know, process.
TMAO and the Gut-Heart Connection 17:28 Red meat, bacon, pastrami, baloney, pepperoni. 17:31 Everybody hopefully understands those are the worst food choices on the planet. 17:36 Fried bacon probably is the worst food choice on the planet. 17:40 Worse than a donut that's called processor and eat over, 17:44 you know, unprocessed red meat. 17:46 You know, some data that white meats are healthier than red meats. 17:49 And generally we feel that fish because they do sometimes if you eat the cold 17:54 water, fish have omega three fatty acids, which can have a benefit is a better 17:59 it's a better choice than process red meats and maybe unprocessed red meat. 18:04 It's more commonly part of the Mediterranean diet to eat fish, 18:07 but there's no clear data that fish is actually therapeutic. 18:11 It's a better choice. 18:13 But is it the best choice? 18:15 There's actually a least one animal study that I've read a number of times, 18:19 that fish actually promoted atherosclerosis in an animal model. 18:23 It still has saturated fat. 18:25 It has absolutely no fiber. 18:28 Fish are called I think it's called bio accumulators. 18:32 We know their mercury likes to exist in fish 18:36 and so does DDT and bees. 18:39 And now probably microplastic, microplastic, microplastics 18:43 and all the rest. 18:43 So there are problems with fish. 18:46 But in my own clinic, although I used to plant diet completely, 18:51 I encourage people to move from the bacon 18:55 or the burger over to fish is at least a temporary step. 19:01 So this is probably the question people have been waiting for. 19:04 If you're if we know that these diets produce this compound, 19:10 what exactly does a plant based diet due to the TMA 19:14 pathway, does it really change the trajectory of heart disease? 19:18 Like where is the evidence? 19:19 They're like, we want to know will plant based 19:23 diet change heart disease? 19:26 Yeah. 19:26 Well, we have evidence to answer that final question from a very famous internal 19:32 medicine doctor in Los Angeles named Lester Morrison in the 1950s from Mr. 19:37 Nathan Britain, the famous crazy engineer 19:40 who did research over 100 research papers 19:42 that plant based diets help stabilize and reverse heart disease. 19:47 If anybody's ever read How Not to Die by Michael Gregor, M.D., 19:51 you know that he talks about his grandmother 19:53 who couldn't walk to the mailbox and met Nathan. 19:57 Prediction. 19:57 And, you know, within a few weeks was walking Miles and lived for 35 years 20:01 when they told her she was, you know, near death in her mid 60s, the famous 20:06 Dean Ornish, the famous Caldwell SL stone at the Cleveland Clinic and others, 20:10 we know that utilizing a largely or completely fiber 20:14 rich, colorful, whole food plant based diet can help manage heart disease. 20:18 And if you started early, I started eating that way at age 18 and at age 67. 20:23 Now I have no coronary disease. 20:25 I know that I mean, been through all the test and I credit, 20:28 you know, almost 50 years of eating a fiber rich, colorful diet. 20:32 I have it in my family, so I should have had it by now. 20:35 And I don't have a naturally low cholesterol. 20:37 But enough about me, you know? 20:39 So those are all good reasons to adopt a largely 80%, 20:43 85%, 90% or completely hopeful plant die. 20:47 Plus cancer risk goes down at least some cancers. 20:51 Breast cancer goes down for sure 20:53 with whole food plant based diets, it seems to be very therapeutic. 20:56 And people have been diagnosed with prostate cancer. 20:59 Yeah, we don't make claims that it's a therapy, but 21:01 it's an adjunct support mechanism. 21:04 Absolutely. 21:06 Because you're not eating red meat and you're not eating a yoke 21:10 and you're not eating cod or fish sticks. 21:12 Generally, the Cleveland Clinic data show that your male levels should be very low. 21:17 In my 11 years of drawing thousands of male levels, 21:22 I have encountered a few vegans who have mildly elevated levels 21:26 and absolutely swear that they don't ingest any of those supplements or foods. 21:31 And when I've discussed that with the team at the Cleveland Clinic, 21:34 they really have been unable and they've seen that too. 21:37 They just can't identify why that's happening. 21:40 Yeah. 21:41 So basically, plant based eaters will have microbiomes 21:45 that don't produce this male because the fiber that they're feeding 21:49 the gut microbiome by eating more plants crowds out these teammates 21:53 producing bacteria essentially. 21:55 So that's really where you could make that shift by, 21:59 you know, with the next meal, starting to eat more plants. 22:03 Now, what about something else that's been in the news lately 22:08 about artificial sweeteners and heart risk especially 22:13 has made some headlines. 22:15 What is the current emerging data say about that? 22:18 Because maybe people are like, 22:19 okay, well, if I'm not going to eat meat, I'm going to have these diet foods. 22:22 So they might use one crutch to go to another one. 22:25 And now what's the problem with these artificial sweeteners. 22:30 Yeah. And I don't like to be a Debbie Downer. 22:32 You know we have to eat. 22:33 I certainly encourage people. 22:35 We think breakfast, if you're skipping breakfast, I'd add it back. 22:39 The date is very strong. 22:40 That breakfast is a very healthy meal. 22:42 And so many of my patients don't need to 1:00 or even later. 22:46 And I, I tell them that that's not what the science says, 22:49 but the same team at the Cleveland Clinic, their next project, 22:52 they have so many projects has been these alcohol sugars. 22:56 They usually end in ol. 22:58 So erythritol, xylitol, there's others 23:02 and but arithmetic has the most data and they've reported now several times. 23:05 And this has always now been reproduced by the research groups. 23:09 That is, you know, which is found in a lot, 23:12 a lot of keto friendly foods, Kato diet foods, you know, 23:16 you go to the grocery store and I do this and I walk by the frozen food section, 23:20 I really need a little bit of a plant based ice cream. 23:23 You know, this is a few times a year. It's not a regular thing. 23:26 And there's all those wonderful low calorie, 23:29 dairy free ice cream to turn them over in. 23:31 The first ingredient is arithmetical. 23:33 There's longevity vitamins. 23:35 That's my patients take. 23:37 And I want to completely pimp a company that has a big following. 23:40 But the sweetener, it's a large amount of arithmetic. 23:44 So they have shown that erythritol could accelerate 23:47 blood clotting and accelerate atherosclerosis. 23:51 And there's some very up to date papers on this. 23:53 Does that mean, you know, immediately throw all those products 23:56 away in your house? I honestly, I probably would die. 23:59 Little were not far enough along the dentist love xylitol. 24:02 It's in certain chewing gum. 24:04 Of course, it certainly is a better choice than sugar. 24:07 I have to wait and see how that all occurs. 24:09 But you know, what we put right there is such a strong 24:13 determinant of the diseases we're going to develop, 24:17 are not in xylitol and are on the watch list for sure.
Diet, Fish, and Plant-Based Heart Health 24:21 Yeah, absolutely. 24:22 And what I've seen also is that the influence on the gut 24:26 microbiome, what happens when we have these artificial sweeteners 24:29 is it creates pro-inflammatory compounds. 24:32 I have patients that have done just, you know, diet sodas 24:36 and they have inflammatory markers that are leading to autoimmunity 24:41 because we're affecting the microbiome in this way. 24:44 So if would you say this is a never touch it message. 24:49 Or is there like dose and context 24:52 like if the person's like going from I only drink a soda a day, 24:57 but that's seven days a week, but like, where are we at? 25:00 We don't want to touch it. 25:02 Like, if this was your family member, what would you say? 25:04 Touch it. 25:05 Where's it dose related? 25:06 I definitely would set up your home. 25:09 That is just not in your home. 25:10 That are all rich foods and are not in your freezer, your fridge or your pantry. 25:15 That sodas are not in your fridge freezer. 25:18 You know, I don't drink soda out, but you're not going to drink 25:22 as much if you limited to only when you're out. 25:24 And some people certainly do enjoy that. 25:26 There's no question. 25:27 We've used the statement the dose is the poison about a lot of things. 25:31 Can you get by with one Canada cocoa or diet burners? Pop. 25:37 That's a Detroit brand, you know, compared to ten a week, 25:40 of course, it's going to be just like cigarettes, less of a risk. 25:43 So again, we're not trying to make people, you know, so 25:46 anxious that they break down and cry and go back to eating donuts, 25:51 cookies and cakes because it's too complex, but, 25:55 you know, artificial, you know, highly processed foods. 25:59 You know, there's a statement out there. 26:01 If it's from a plant, eat it. 26:02 If it's made in a plant, skip it. 26:05 That's a cute little one. 26:06 If you can buy it in a gas station, skip it by only when there is the bananas. 26:11 I don't know why the best bananas in the world are 26:15 on the road. 26:17 You know that can be breakfast, lunch and dinner. 26:19 Just slamming down bananas. 26:21 All right, so there's a question I get a lot from my patients. 26:25 And almost all the time is that if you have a plaque in your arteries, 26:31 can it be reversed, not just slow down but reversed? 26:35 And if so, what does this look like realistically? 26:39 Like when we're talking about the difference in types of plaques, 26:43 you know, whether they're the lipid rich plaques or the calcified plaques, like 26:47 can it be reversed? 26:48 What part of this whole process could be affected? 26:52 Yeah, we don't have enormous data. 26:54 We have data and the data goes back. Really. 26:57 Mr.. Prediction and how patients responded was some early data. 27:02 And then really the definitive study, although it's small, 27:06 was done by doctor Dean Ornish in San Francisco. 27:09 And he used what we call invasive cardiac catheterization, 27:13 which all of us in the cardiology world have high respect for. 27:17 And he did it in a way that's very objective, not subjective. 27:20 And then some other examples. 27:22 And then there are some drug trials using, you know, very powerful cholesterol 27:26 lowering drugs, looking at carotid arteries or images, the diaries. 27:31 The answer is yes. 27:32 And we probably are shrinking. 27:34 You already took the lead. 27:35 What's called soft black non calcified black, 27:39 which is the current language in 2026 of advanced cardiology clinics. 27:43 You know Mr. 27:44 Smith Mrs. 27:45 Jones you have a lot of plaque and half of its hard 27:49 calcified black half its soft non calcified plaque. 27:53 You have to have advanced ultrasound machines to do this 27:57 in the carotid arteries. 27:58 With special software you have to have an advanced 28:01 CT scan of your heart arteries with Ideen die. 28:05 These are, you know, not simple tests. 28:07 That can be expensive tests, but they are becoming, 28:10 you know, both scientifically validated and widely available. 28:14 So you can you're never going 28:17 to get your arteries back to a 15 year olds state. 28:21 If you're starting at age 66, it's not going to happen. 28:24 But we can slow the process, probably stop the process. 28:27 And I mean, I have patients to make lineage. 28:29 I can, you know, hundreds of them 28:31 that we can actually verify in a couple of years, three years. 28:35 We're reversing the process. All right. 28:38 You brought up two things I want to touch upon is about the statins. 28:43 So you mentioned that using statins can lower it. 28:48 I've noticed that there's some patients that are being put on statins preventive 28:54 because that well if everybody's going to get cardiovascular disease 28:58 can we just protect them by putting them on statins. 29:01 What is your thought on that? 29:02 I don't agree with that. 29:04 I don't think of statin. 29:05 About 20 years ago, a society called shape 29:09 say GP proposed not in the bypass patient. 29:13 They probably need prescription drugs for cholesterol 29:16 or the stent patient or the stroke patient or the heart attack patient. 29:20 But how about the rest of us that have never had a cardiac event? 29:24 Do we need to be on prescription meds? 29:26 I, you know, in my clinic, probably years, I'm still going to teach them 29:30 as much as I can about lifestyle, food choices, the portfolio diet, 29:35 which is a diet specifically to lower cholesterol and all, 29:40 but many won't achieve the very low cholesterol levels we want to get. 29:43 So the shapes of the city said. 29:45 Step one look for silent atherosclerosis. 29:49 And if you find silent atherosclerosis, you're not in a symptom that, 29:54 well, you may be symptomatic, but you're not a non hurt. 29:57 You're just an asymptomatic heart patient. 29:59 So get a carotid study, get a calcium CT scan. 30:03 And that's what I do. 30:04 If you have no disease you don't get on prescription drugs. 30:08 With rare exception diabetic smokers, people with LDL 30:12 cholesterol in the 200 they might but rarely low dose. 30:16 And if you have, you know, minimal disease. 30:18 We're going to work with lifestyle for a very long time. 30:22 But, you know, I clinic is full of people with very advanced heart disease, 30:26 no symptoms, only identified because we did these advanced tests. 30:31 They need therapy is a bad disease. 30:34 You know a few people will get a diagnosis of breast cancer. 30:38 Prostate cancer. 30:39 Say I don't want any treatment. 30:41 I'm just going to eat broccoli sprouts. 30:42 I mean, nothing I usually recommend to my patients. 30:45 They get treatment and heart disease. 30:47 There's a book published in early 2024 called Fight Heart Disease Like Cancer 30:52 two Boxing Gloves and Cover from a cardiologist at Stanford. 30:56 I just like the title and the picture. 30:59 We need to get aggressive and you know better 31:02 to identify it in the 2030s and prevent it from progressing. 31:06 But most people are diagnosed, you know, in their 50s and 60s. 31:11 And then there's another 31:13 recent information that came out that I saw 31:16 about the values of lipid panels that we're looking at, 31:22 like total cholesterol levels, LDL levels, 31:24 HDL should be significantly lower 31:27 than what maybe the parameters that we've been currently looked at.
Artificial Sweeteners and Plaque Reversal 31:31 Can you share a little bit more about where that's coming from 31:35 and what patients should really be looking at? 31:37 Yeah, that's the most recent update organizations that people have heard of, 31:41 the American College of Cardiology, the American Heart Association, 31:46 the European Society of Cardiology are, 31:49 you know, periodically put together recommendations for practitioners. 31:53 And in 2026, we got the first update on cholesterol management 31:57 in about eight years. Created headlines everywhere. 32:00 It was much more aggressive I love it get more calcium scores. 32:04 But they made it very clear. 32:05 If you have a diagnosis of corner disease, under 100 32:08 is an old standard and it's not enough under 70. 32:12 We're talking for LDL cholesterol milligram per deciliter. 32:15 Good goal. 32:16 Get you down the road a bit, but not good enough. 32:19 And under 55mg per deciliter 32:22 for LDL cholesterol very often 2530, 40, which is going to take diet and fitness 32:28 and sleep and stress and prescription drugs, sometimes very inexpensive. 32:33 Sometimes that's an expensive is going to get you there. 32:36 So that's we've been practicing now. 32:38 There just was in 2026 a big study in Korea. 32:42 About 3000 heart patients study for three years randomized to let's 32:47 get that LDL cholesterol to 70 or let's get that LDL cholesterol under 55. 32:53 You basically got to use more drugs to get the second group to that goal. 32:57 And they showed I think three years is a very short time for heart patient 33:01 that there were fewer cardiac events, more so in the men than the women, 33:06 but there were fewer cardiac events by getting the LDL cholesterol. 33:09 So it was a hypothesis. 33:11 But now it's I would say proven getting 33:14 the LDL cholesterol under 55mg per deciliter. 33:17 Now, again, I don't want to talk about myself, but I have a calcium scored zero. 33:22 And I've done more advanced studies in criticize. 33:25 I don't keep my LDL cholesterol that low. 33:27 I have to personalize it. 33:29 So everybody that sees me and probably that sees you, they're all unique. 33:34 And in the heart disease world, we have the tools. 33:36 You don't have to be a multibillionaire to get this. 33:39 You know, it's $100 for a calcium score, maybe $200 for this ultrasound, 33:45 and you can get a insanely detailed array of labs for under $400. 33:50 So, you know, if you're spending $1,000 on a vacation, 33:54 you can easily spend it on your heart health and get every test you need. 33:59 Yeah. 34:00 And so these values for LDL that you mentioned, the specifically 34:04 for people who have been diagnosed with coronary arteries 34:06 or cardiovascular disease, not for the average person. 34:09 Or would you say it's for everybody? 34:12 Now it's not for everybody. 34:13 It actually may benefit everybody. 34:15 But we're not going to put people without disease proven not to have disease 34:20 or proven that minimal disease on prescription drugs for life. 34:24 That's the job. 34:25 Let's teach them about whole food, plant based diet and the role of fiber. 34:29 And his famous research study from the University of Toronto called 34:33 the Portfolio diet or the Dash diet or the Mediterranean Diet. 34:37 And let's give, you know, 2 or 3 months and recheck their blood work. 34:41 And very often, you know, just again, in 2026, an old topic came back up. 34:47 We in the 1980s, everybody was making open 34:50 muffins because oatmeal and oh, bran, lower cholesterol. 34:53 So there was a beautiful study 34:55 putting people on three meals a day of oatmeal for two days. 34:58 The cholesterol fell a lot in just two days. 35:01 And then moving forward, just oatmeal in the morning. 35:04 You're probably not going to enjoy only eating oatmeal three times a day. 35:07 And it was quite successful. 35:09 Lowering cholesterol just with food, just with the gut gut. 35:13 Get the fiber in there so the little bacteria can chew on the fiber. 35:16 And you're going make a lot of those short chain fatty acids 35:20 and improve the integrity of your gut wall. 35:23 Yes, absolutely. 35:24 So let's talk about that a little bit. 35:26 So you've been reversing heart disease for decades. 35:30 And can you tell us a story about a patient without breaking any privacy. 35:34 But where the gut, the diet, the heart connection 35:37 was absolutely central to what happened to them? 35:40 Yeah, I have a very good friend in Detroit, 35:43 and I've gotten permission from him to tell a story named Paul, 35:47 who is in the telecommunication business. 35:50 Very bad family of heart disease, mid 50s, cholesterol was high. 35:55 He didn't really have any symptoms. 35:57 I didn't really care. 35:59 Thought, you know, I have a salad two times a week. 36:01 I go play tennis two times a week. I'm fine. 36:04 And then unfortunately, in this case, we didn't pick anything up 36:08 till he became symptomatic, which means very far down the road, 36:12 you know, go out on the tennis court, feel some burning, some pressure, 36:15 some tightness, cardiac workup, 36:17 stress test ultimately, and angiogram, very severe Art disease. 36:21 And very interesting. 36:22 This is about 12 years ago. 36:24 He went down in the Cleveland Clinic to get an opinion. 36:27 And they scheduled him for bypass and maybe 36:30 a valve replacement, a very extensive surgery the next day. 36:34 And a cardiologist came up to him at the Cleveland Clinic and said to him, 36:38 you know, 36:39 we do have a gentleman here who teaches people 36:41 how to reverse heart disease just with diet. 36:44 And that's the famous senior physician, Caldwell, M.D., 36:49 who's written a book that's just legendary called Prevent a Reverse Heart Disease. 36:54 And in that Paul called him at nine at night and doctor Assisted 36:58 Eyes answers the phone. He's now 92. 37:01 And listen to him go on. 37:04 You feel fine. 37:05 I'll have a phone call with you tomorrow from Detroit. 37:08 So he discharged himself. 37:09 Long story short, 12, 13 years later. 37:12 Actually, Paul did end up needing a stent a couple years ago. 37:16 Never had bypass, never had valve replacement. 37:18 He's got a strong heart. 37:20 He goes to the gym an hour a day. 37:22 He eats an all plant based diet as top ten. 37:26 It's been very diligent on that. 37:28 You know he does. 37:28 His medical care is phenomenal. 37:31 In fact, he's on Around the world cruise right now. 37:34 Six month cruise because he needed to celebrate this 1213 years of health. 37:39 And he's become a great educator to tell people, you know, if I could do it 37:43 with a crappy diet and really no support, you can do it too. 37:47 So I love that Paul, literally, you know, beat the system. 37:52 No, no. 37:53 Stent until just recently, no bypass ever. 37:56 And a great quality of life and a great, you know, quantity of life too. 38:00 Yeah. 38:01 So if people want a timeline, if someone commits to serious 38:05 dietary changes today, Whole foods, plant based, no processed food,
Statins, LDL Targets, and Treatment Strategy 38:10 when can they realistically expect 38:13 to see measurable change in their labs or in their imaging? 38:18 Yeah, that's a tough fee. They're labs. 38:20 They can see changes in eight weeks for sure. 38:22 Maybe even four weeks. 38:24 You know, doctor assistant at the Cleveland Clinic I mentioned has a son. 38:28 Many people know him. 38:29 He was an athlete and a firefighter. 38:31 Rip S10 and he took his firefighting buddies 38:35 because rip was an athlete and in good shape and played bass. 38:39 But his buddies at the firehouse are in terrible shape. 38:42 And for just one week he cooked for them. 38:45 It's it became a documentary in a book. 38:47 Engine two diet is the name of the book scrapbook. 38:50 And, you know, for one week he made them oatmeal for breakfast. 38:53 He made them bean chili. They liked beef chili. 38:56 It became bean chili. He made them pancakes. 38:59 But instead of butter, there were other ways to dress him up. 39:02 And in one week, the cholesterol levels were much better. 39:05 I mean, it can occur that quick. 39:07 This oatmeal study I mentioned, two days of oatmeal cholesterol was 10% better. 39:12 So you can see that. 39:13 But to actually expect to see much in the arteries give me a year. 39:17 Now if people are symptomatic, burning chest 39:21 pain, pressure on exertion, they may feel better in 2 or 3 weeks. 39:25 The endothelium can heal that quick 39:28 before you have time to actually shrink the software. 39:32 Okay. All right. I would agree with that. 39:35 Now let's talk about some something controversial. 39:38 But it is you know, there's a mass cultural shift happening right now 39:42 around protein carnivore diets, lab grown 39:45 meat, the idea that more animal protein is the key to longevity. 39:49 And as a cardiologist has been in this space for decades. 39:52 What's your honest read on the movement and where the evidence actually lands? 39:57 Yeah, you know, I'm certainly aware. 39:58 Number one, I'm friendly. 40:00 I have a few patients that are carnivore. 40:03 They use the are so sheepish 40:05 knowing that I'm more plant based that they don't come in very often. 40:08 I don't yell at them. 40:09 Number two, I have actually lecture the conferences that are carnivore 40:13 conferences, debated, had symposiums. 40:17 So I'm well aware, you know, my favorite nutrition 40:21 researchers, Doctor Valter Longo, who's 40:24 the University of Southern California, head of what's called bio gerontology. 40:28 And he talks about anytime you talk about nutrition. 40:31 And if you want to read about this, you go to his book called The Longevity Diet. 40:35 Amazing book that there's five pillars of nutrition research 40:40 that before you come to a conclusion, whole food plant based eating is healthy. 40:44 Carnivore eating is unhealthy. 40:46 You got to consider and you know, a small part of that are testimonials. 40:50 And I'm aware there have been people Jordan Peterson for a while, 40:55 his daughter blinking her first name for a while, 40:58 other people with autoimmune and conditions for a while. 41:02 But you know, if you want to live a long and healthy life, 41:05 if you're adopting a carnivore diet, it doesn't meet the criteria. 41:09 The biochemistry isn't going to tell you that a high meat diet is good for you. 41:13 Where's your vitamin C? Where's your fiber? 41:15 Where's your, you know, optimal gut health? 41:17 When we really know, you know, 30 or more different plants 41:22 a week include spices and seeds and nuts and fruits and vegetables 41:27 and greens and the gums actually gives you the most optimal gut health, according 41:31 to what's called the American Microbiome Project and Doctor Jim Spector. 41:36 So these people are having, you know, potentially zero, 41:39 not 30 plus plant based food sources a week. 41:44 So I don't laugh at them. 41:45 I don't belittle them. 41:46 Those that say they feel better. 41:48 I mean, that is one outcome in life. Feel better. 41:51 That's an important one. 41:52 But let's make sure we're doing your blood work 41:54 eight weeks after the carnivore diet. 41:56 Let's make sure we know your calcium score. 41:59 Let's make sure we know your carotid health, 42:00 and you evaluate the pros and the cons and the chance, 42:05 you know, you might trigger an event like art attack, which has happened. 42:09 There's no doubt I've seen it. 42:10 Other people have seen it. 42:12 Yeah, absolutely. 42:13 And I think I also we're both in the same circles. 42:16 So I have a lot of colleagues who are carnivore 42:18 and they'd say they feel better, which I can understand 42:21 in the short term because you've taken out a lot of things maybe. 42:24 But in the long term, without that fiber creating, 42:29 you know, what we talked about earlier, all the mayo, it makes it 42:32 very challenging for me to believe that, like you said, 42:36 where you might look good on the outside, but in the inside, 42:40 your cells, the cells that are creating disease will continue to create disease. 42:44 So it's a lot of what's hidden inside the body. 42:47 And so if we were to talk about protein 42:50 from a plant based perspective and protein adequacy, 42:54 what would be your recommendation for protein for cardiac health?
Patient Success Story and Timeline for Change 42:58 And if people were like, okay, yeah, I want to consider this and maybe, 43:02 maybe shift what I'm eating. Yeah. 43:05 There is no data that a high protein diet is necessary 43:08 for our patients or beneficial. 43:10 And there is an amazing wide array of voices and noises out there. 43:16 Again, I bring up Doctor Valter Longo, 43:18 another various theme professor in the United States, Doctor Chris Gardner 43:22 at Stanford or away on this end of the spectrum, 43:26 that high protein diet, particularly of animal origin beef, 43:31 they have a tremendous risk for aging and a tremendous 43:34 disadvantage for longevity and should be avoided. 43:37 And you can gain weight eating pinto beans and gaining weight in terms of muscle 43:42 eating pinto beans and black beans and chickpeas, 43:44 you just got to lift the weights, and there's plenty of data 43:46 that says that's true. 43:47 You can gain muscle on fava beans or you can gain muscle on beef. 43:51 I mean, you just got to do the same exercise 43:54 and then you've got way over here, you know, Doctor Gabriel Lyons 43:57 and some others that are now 44:00 not very much heard of Doctor Peter Attia, you know, 44:04 talking about three dynes as much protein in the diet as these actual researchers, 44:10 actual professors, actual people that publish, 44:13 you know, basic science and human science are recommending. 44:17 So I drift over here. 44:19 There are some concerns that are very high animal source protein diet. 44:24 Again, it comes with saturated fat, comes without fiber, comes with pesticides, 44:29 herbicides and contaminants that are just in our food, hormones 44:33 that are in our animal food borne 44:34 plant food, the fish bio accumulators we talked about. 44:38 So I'm not a fan for our patients. 44:41 And if they do it, they got to get bloodwork repeated quickly okay. 44:46 What if I want to have a grass fed burger? 44:48 Now I've removed some of the pesticides and all that. 44:52 What would you say to that? 44:54 Yeah. 44:54 You know, it's more hype than actual strong science. 44:58 It's expensive. It's a lot. 45:00 You know, the data is very clear that 95% of Americans 45:04 that eat meat are eating, you know, factory created, 45:08 not artificial meat, but, you know, Cafo meat, 45:12 confined animal factor organization, 45:15 you know, horrific torture institution, meat full 45:19 of antibiotics and pesticides and hormones and herbicides. 45:23 That's what people are eating. 45:24 And I've talked to people doing the carnivore diet to get to eat 45:28 only, you know, regenerative grass fed beef. 45:31 You know, it's for an elite high income person. 45:34 It's not going to work for your average family. 45:36 So I'm not sold over, 45:38 you know, I'm all for my God and trying to protect our planet. 45:42 And a whole food plant based diet does the best job 45:45 of minimizing your carbon footprint while you're on the planet. 45:49 When I go, there's a little website you can put in. 45:52 How many days, months, years, decades have you been plant based, 45:56 and how many gallons of water 45:58 and how many carbon dioxide particles have you saved from being emitted? 46:02 Once you do it for a while, it's pretty unbelievable. 46:05 Yeah. 46:05 All right, well, a few more questions. 46:07 One is omega three. 46:09 So, you know, omega three is whether from nutrition 46:13 or even supplementation maybe both. 46:16 We could talk about where do you see that playing a role 46:20 in cardiovascular health and versus doing fish omegas or algae omegas. 46:26 How would you recommend it to a person who does want to go more plant based? 46:29 Yeah, and in my own clinic where we do very advanced lab panels, the number one 46:35 most common nutritional deficiencies is omega three by far.
Carnivore Diets, Protein, and Omega-3s 46:39 People are not told that we need it 46:42 for our brain and our eyesight and our heart and our cholesterol. 46:46 People are not being taught that we can't make it in the human body, 46:50 so we have to either eat it or supplement it, eat it with 46:53 what's called the smash fish, sardine, mackerel 46:56 and jovi salmon and herring. 46:59 Those are the five fish that have a decent content of omega three 47:03 Baja flax, hemp, walnuts, leafy greens, or take a vegan 47:07 omega three or take a fish based omega three. 47:10 So it's like every day, five emails a day to patients. 47:15 Your labs came back, you're drastically low in omega three, and you see patterns. 47:20 When their own mega threes low, 47:21 their inflammations up, their triglyceride levels are up. 47:24 Often their cholesterol particles are unacceptable 47:27 and you get them on something food or supplement or both. 47:31 And you see major improvement. 47:33 Sometimes they feel better if there's some inflammatory symptoms. 47:37 So it's a huge factor. 47:39 And I don't think it really matters how you do it. 47:41 Personally, I do it with food and some algae based omega three. 47:45 And what dosage of algae omega do you prefer, or do you do it 47:49 based off their testing? 47:51 Yeah. Well, I do embrace off their testing. 47:53 The more severely deficient they are, the more I'm going to recommend, 47:57 you know, usually around 1000mg a day combined EPA and DHA. 48:01 Very good. 48:02 All right. 48:02 So our last question for you and I want to be very concrete. 48:06 Somebody is watching and listening to this right now. 48:09 And they might have had a heart scare. 48:10 Or maybe they just want to now protect themselves before it even happens. 48:14 What are the three most important things they should do starting this week 48:18 to change their gut heart trajectory? 48:22 Okay, three for gut heart number one would be increase 48:26 the number of different plant based foods in your diet. 48:30 And again make it easy. 48:32 That includes spices and herbs. 48:35 Now if you've got ten year 48:36 old spice bottles in your kitchen just throw them out there. 48:39 No good. 48:40 Buy yourself some fresh, organic rosemary time. 48:44 Cumin. 48:45 Yeah. Two cinnamon. Nutmeg. 48:48 All spice. 48:49 All these great ones. 48:50 And start using them the amount if you need to. 48:52 So one increase the number and you know make a salad. 48:56 You can get 12 different vegetables. 48:59 And you could do that in about five minutes or less. 49:01 You know few chops and peppers and different beans and put some tofu. 49:05 And I've been doing a 30 49:08 plant foods in one jar, mason jar salads. 49:12 And it's not the quantity. 49:14 It's like the different different foods. 49:16 And I've been able to get 30 in 1 mason jar salad. 49:19 And it I tell you it's it's amazing. 49:22 That's crazy wonderful and good. 49:24 And there is I know of at least one commercially available product 49:28 called 30 plus. 49:30 That's a nice little nut mix with 30 plus and you can just season yourself. 49:34 So number one would be increase the number of different ones, 49:37 even if there's still some fish, chicken and beef in your diet. 49:41 Shellfish number two would be, you know, the rainbow of those plants. 49:45 Be sure there's some purples and some whites 49:48 like cauliflowers, lots of leafy greens. 49:49 We know lots of, you know, dark berries and red from red peppers 49:53 and watermelon and the rest you want to eat the rainbow.
Three Steps to Improve Gut and Heart Health 49:58 And number three, for gut health, I would decrease your egg yolk. 50:01 I would decrease your red meat. 50:03 I'd be a bit suspicious about fish. Fish? 50:06 I think you really want to be high quality. 50:08 You know, you probably do it too. 50:09 I check a lot of mercury levels in my patients. 50:12 And you know, these are nice people eating in nice restaurants. 50:16 And their mercury level is so toxic and they're trying to do the right thing. 50:20 Doc, I eat, you know, fish. 50:21 I'm not even that BLT anymore. 50:25 Because you told me that wasn't good for me. 50:26 And you know, you just can measure how much toxicity is in their body. 50:30 And mercury is not our friends. 50:32 So that would be a big three rules. 50:34 Perfect. 50:35 Anything that I haven't asked you that you want to mention. 50:38 No. It's been great. 50:39 Okay, great. 50:40 All right. Well thank you Doctor Kahn so much. 50:43 This has been genuinely eye opening. 50:46 The idea that what we eat today can shape 50:49 the bacteria that are going to protect or damage your heart. 50:52 That's the message I want everybody to carry with them. 50:55 And Doctor Kahn, he can be found at drjoelkahn.com. 51:00 I encourage you to look up his books, particularly 51:03 the Plant based Solution and The Lipoprotein, a book. 51:06 He also, if you really want to go more into 51:09 heart health, he also leaves his own annual summit reversing 51:13 heart disease naturally, which is worth bookmarking. 51:17 And here's the key takeaway for the audience. 51:19 Your gut and your heart are in constant conversation. 51:23 The food you eat is the message you send. 51:26 And I want to thank you for joining us on this episode. 51:30 And we don't go anywhere 51:31 because we're definitely going to have another episode right after this.
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