Dr. Philip Ovadia: A Heart Surgeon's Battle Against Sugar and Disease Misconceptions

When Dr. Philip Ovadia tipped the scales into morbid obesity, he knew something had to give. That realization sparked a revolution in his medical practice and personal health philosophy, leading to profound insights that he shares with us in our latest episode. Join us as we sit down with the heart surgeon and author who is on a mission to keep people off his operating table. Dr. Ovadia recounts the pivotal moments that shaped his career, including his brother's diabetes diagnosis and his own health scare, which led him to challenge the conventional wisdom on diet and disease.

The landscape of healthcare is shifting beneath our feet, and Dr. Ovadia is one of the trailblazers navigating new territory. We engage in a candid discussion about the emergence of doctors who are breaking away from traditional medical models in favor of holistic, evidence-based approaches to health. The conversation reveals the obstacles these pioneers face, from professional risks to the exhilaration of embracing telemedicine and the growth of supportive societies. This episode is an eye-opener on the importance of aligning with a healthcare provider who shares your values, and the empowerment that comes from taking charge of your health journey.

Sugar, that sweet but dangerous culprit in the narrative of heart disease, takes center stage as Dr. Ovadia helps us unravel its controversial history. We dissect the mechanisms through which sugar and insulin resistance wreak havoc on cardiovascular health, and discuss the dietary complexities that influence our well-being. From plant-based regimens to low-carb and carnivore diets, we examine the misconceptions and truths about what really serves our hearts. Dr. Ovadia's transformative story and expert insights will arm you with the knowledge to take proactive steps toward better health, making this episode a must-listen for anyone looking to make meaningful lifestyle changes.

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Transcript

Speaker 1: 0:02

Welcome everybody to an interview today with Dr Philip Ovedia. He is a board certified cardiac surgeon Some consider him to be one of the best in the world and he's the founder of the Ovedia Heart Health Clinic. His mission is to optimize the public's metabolic health and to help people stay off his operating table.

Speaker 1: 0:22

As a heart surgeon who used to be morbidly obese himself, he has seen firsthand the failures of mainstream diets and dietary advice and medicine itself. He is the author of the book Stay Off my Operating Table a heart surgeon's metabolic health guide to lose weight, prevent disease and to fill your best every day. He shares a complete metabolic reset system in his book. What's very interesting is that Dr Ovedia came to this new sort of mission because he himself knew that that's where he was headed, that this was an overweight doctor who was literally headed for the operating table, and he knew that that was not the solution, so that he had to change around his own life, his own health, so that he can move forward into the world with his new mission to help you do the same. Welcome, dr Ovedia.

Speaker 2: 1:15

Hi Florence, Great to be here with you again. Such a big fan of this summit and everything you're doing and really happy that I can contribute again to it and help people to understand what they need to do to stay off my operating table and the operating table of all the heart surgeons out there.

Speaker 1: 1:38

Right, Right when we go back into your own. What inspired you to pursue medicine as your career?

Speaker 2: 1:50

I always kind of knew I wanted to be a doctor. Interestingly, I probably knew that before I really knew what a doctor was. And when I think back, I was probably influenced by the fact that when I was young about five years old or so my older brother was diagnosed with type 1 diabetes, and so lots of interactions with physicians, kind of seeing. That, I think at least subtly influenced me. And then, as I went through the various stages of my education, that calling remained strong, and medicine and science, the human body, were always things that fascinated me, and so I always knew that that's what I was headed for.

Speaker 1: 2:46

That it's so interesting. The number of times I've asked doctors what inspired you to move into that field, and it almost sounds like a calling and some of them will say I was young, I was in elementary school. It's like you just knew it's so interesting. Yeah, and what? Tell us a little bit about that moment when you realized I've got to do something different or I'm headed for surgery myself.

Speaker 2: 3:11

Yeah, I had been. I was well into my career as a heart surgeon and I've struggled with obesity my entire life. Again, going back to childhood. It's something that my family shares. I'm always careful about not saying that it runs in my family, because I'm not really sure it's genetic per se, but we had the same habits and for the most part, all of my family members parents and siblings were obese.

Speaker 2: 3:48

There were many points along the journey that I recognized this to be a problem and I would lose weight. I would try and lose weight and I had some successes with the usual sort of eat less, move more approach, but invariably I would always end up gaining back the weight and more. And about seven or eight years ago is when I really, I guess, sort of came to that reckoning that I was truly headed for my own operating table and I had young children at the time, and I was kind of at a loss, though, because I truly didn't know what to do. I had been following the advice that I had learned to give. I had tried all of the various I guess you could say mainstream or traditional dietary strategies, and I was at a bit of a loss. Thankfully, I started to get introduced to some different ideas, some different concepts.

Speaker 2: 4:57

Probably the seminal event for me was hearing Gary Taub's deliver a talk. Ironically enough, at one of our surgical society meetings, he was the invited guest speaker At that time. He had just written the case against sugar and, of course, prior to that, had written good calories, bad calories and why we get fat. And when I heard Gary talk about these concepts of the types of food being more important than the amount of food and the influence that the types of food that we eat have on us, it made sense.

Speaker 2: 5:35

I read his books, it continued to make sense and I said let me give this a try. And I, for the first time, had that success that turned into a long-lasting success, and so that really opened my eyes. And then I started asking the questions of why didn't I know about this earlier? Why isn't this something I learned in school or from my mentors and my colleagues? Absolutely no disrespect to Gary, but why did I have to hear about this from a journalist when here I am a heart surgeon? And it really got me asking some very serious questions about the way our health care education system is, the way our health care industry runs, and opened my eyes to a lot of the short comings of that. I would say.

Speaker 1: 6:38

And as you were asking these questions like, why did I have to learn this from Gary, and where did we go so wrong, and why aren't more people awakened to the reality that the role that food plays in preventing health and reversing chronic disease, what answers did you arrive at?

Speaker 2: 7:00

Well, you know. So ultimately, I think there are a couple of issues that we need to look at. You know, if you're kind of thinking about your doctor, your you know average doctor out there, the reality is is that I think that they are so overwhelmed taking care of sick people that they literally do not have time to step back and say why are there so many sick people? You know what's going on here. What can we do to change that? So that is part of the problem. And then I point to the, you know, kind of outside influences that aren't necessarily concerned about keeping people healthy.

Speaker 2: 7:43

And you look at, you know you look first of all at the healthcare system at large. You know things like hospitals and you know the medical societies and you kind of recognize that they're, you know they're reliant on sick people. So you know they're not necessarily focused on keeping you healthy. The food and the pharmaceutical industries certainly aren't interested in keeping you healthy. They're interested in the air bottom lines and they have a very large influence on the entire medical system. So you know those are the problems. And at the end of the day, you know you, the individual, should be interested in keeping yourself healthy.

Speaker 2: 8:36

But you know you're oftentimes kind of powerless in all of this and you only know what you're, what you've heard from your doctor, what you've heard from the messaging that again gets influenced by food and pharma, and your doctor is sort of trapped in this system and oftentimes can't help you because you know they're suffering from the same issues. So it's, you know, only when doctors like myself, practitioners, you know, like myself and many others, start to sort of say, wait, something's wrong here, they start asking these different questions and then on their own, you know, all of this that I have now kind of learned over the past, you know eight years or so has all been on my own, essentially. You know, thankfully there's a community of other physicians and other practitioners that I can draw upon and I can learn from. But you know it's not what I, it's not the education that I'm getting, you know, kind of from the system when I go to the society meetings today. This isn't the stuff that we're hearing. We're hearing all that old stuff that just kind of reinforces the old narrative.

Speaker 1: 9:59

And the old narrative is that there's no cure, there's unknown like. The best we can do is manage it with medications and maybe make a difference with surgery.

Speaker 2: 10:10

Yeah, that's exactly it. You know the the it's basically that getting sick is inevitable and that you know, once you're sick, the best you can do is manage it, and that management is largely reliant on medications and pharmaceuticals. You know, there's some lip service paid to what we eat, but even that advice is misguided because we have, you know, such a kind of entrenched belief that fat you know, saturated fat in particular is, you know what is causing all these health problems, that that really colors all of the advice that we end up getting within the system. And it's only when you start to say, well, you know what if it isn't saturated fat, what if there's something else going on here, that it leads you to different conclusions. And thankfully, you know, and I would say this has been the most rewarding thing about this change is that I can now actually help people to reverse their disease and to prevent their disease, instead of just managing their disease, which is what, you know, I was sort of limited to in the past.

Speaker 1: 11:35

And I suppose what your little five-year-old or 10-year-old heart, however old you were when your, when your brother got sick, that's what your heart wanted for your career. Wasn't it Like to really send people off with smiles on their faces, feeling better, saying I don't need to see you again in a year, doc, I'm doing good?

Speaker 2: 11:52

Yeah, no, that's exactly it. You know, helping people to be at their best is ultimately what after, and you know, whatever accomplishes. That is what I'm willing to pursue and this is, you know, I think, another sort of mindset change that practitioners, the doctors, need to overcome. You know, undergo, which is, you know that we are going to do whatever helps the patient to feel their best to get their best results. And you know more and more that may mean, you know, not doing what I've been traditionally trained to do. You have to unlearn a lot of things, but you have to be willing to unlearn those things and, quite frankly, a lot of people, a lot of practitioners, aren't able to admit that they're wrong and that there might be better ways than they're currently doing.

Speaker 1: 12:57

I have two directions to go with that. One of them is would it be possible for you, as a doctor, to found a medical school? Can you just create a new medical school where you can train new doctors that are more holistic? Would that be an option?

Speaker 2: 13:15

No, not, at least not here in the US. It's pretty regulated. The founding and the ongoing running of medical schools is pretty regulated, so that is probably not a feasible option. I think our best approach, ultimately, is to continue to influence our colleagues, and sometimes that does work.

Speaker 2: 13:46

Just today, actually, I had one of my colleagues kind of messaging me and sending me some articles that were certainly in the literature that I usually read, but not what most traditional cardiologists would be reading, and he said, oh, have you seen this? It really kind of sounds like what you talk about. And I'm like, yeah, actually I know the author well and have seen it, but I'm glad you're seeing it. And so more and more doctors are waking up to the fact that what we're doing is not working well, and I think doctors are getting increasingly frustrated by the lack of progress that we're making. So I am optimistic that it is going to ultimately be that it's going to be a ground up movement, but it's gonna come from the practitioners and from the patients kind of working together to say we're not gonna tolerate the poor results that the system is getting for us anymore.

Speaker 1: 14:56

And what's so frustrating I can imagine as a doctor and terrifying, is that doctors who sort of step out of line in their practice and do things that are a little bit more holistic or lifestyle oriented can literally be slapped. They can be brought before tribunals, they can lose their license. I'm just thinking of a number of different doctors that I've interviewed. One was a doctor who had cancer who discovered oh my good Lord, all those drinks. They were sugary drinks. They were feeding me in the hospital while I was undergoing cancer, feeding my cancer, and he struggled with it and he kept relapsing and it was so frustrating. And he's like I'm a doctor, I'm working with the best doctors, oncology doctors, I can, my colleagues and I'm not getting better, like what's wrong. And he's like oh, eureka, I'm drinking orange juice in the hospital, I'm eating drinking like bottles of I'm gonna say, insurer like bottles of, like sugar right.

Speaker 1: 15:51

And then, once he got better and he went back to the hospital, he was well enough to continue to practice as a doctor. He was literally telling his patients don't touch sugar, eat whole foods. I'm telling you that that is gonna probably it may block your recovery from cancer and it may even bring it on. Don't touch sugar. A dietician reported him to the board because that's not what she was trained Everything in moderation and sure is good. And he was pulled before and he got his license revoked for saying don't eat sugar.

Speaker 2: 16:31

Yeah, no, it is a real concern, but at the end of the day, I couldn't live with myself if I wasn't sharing this information with my patients, and if it comes to something like that, I am quite confident now in my ability to defend my actions. We have plenty of evidence. You might notice above my shoulder here a new medical textbook on ketogenic diet therapies. So the evidence is there. What we're doing is evidence-based and I see the results of it. So, if it happens, I'll fight that fight because that's the only way I know how to be a doctor is to do what I know to be best for my patients.

Speaker 1: 17:23

Right, right, right, which is exactly the kind of doctor most people are looking for. In your book you talk about, there's different sort of recommendations you make. One of them is find a doctor who gets it. How easy is that for someone to find a doctor who gets it the way you get it?

Speaker 2: 17:40

Yeah, it can be challenging, but thankfully we have a lot of resources today that we may not have had in the past. A lot of this can be done remotely. Telemedicine is a very commonly utilized option here in the US and worldwide now, so those tools help. Having the societies now we have the Society of Metabolic Health Practitioners, we have the nutrition network, we have the various low-carb organizations, and those are all helping to consolidate some of the resources around this.

Speaker 2: 18:23

I continue to hope that it will get easier, and I'm quite optimistic about some of the projects that I'm involved in that are looking to make this process easier for people to find the resources that they need and the support that they need.

Speaker 2: 18:39

And then I'm encouraged when I go to the meetings the low-carb meetings and the metabolic health meetings and I do see increasing numbers of practitioners and practitioners from all specialties that are now waking up to this. I think we are at a point today where, largely because of what you talked about earlier, there are a lot of physicians who have kind of woken up to this, but they're still a little scared to do it with their patients and to talk with their patients about it. So by being out here on social media and doing the conferences and stuff like that. My hope is that I can give those practitioners the confidence to step out of the shadows, as it is, and talk to their patients about this stuff and tell them what they've learned, because that is what ultimately gets that community and then makes it easier for the people who are looking for the clinicians to connect with Mm-hmm and it's so it's.

Speaker 1: 19:55

I wonder I wonder how Often doctors underestimate how seriously their clients take them, Really seriously. I have had so many people say well, my doctor says. My doctor said right, like literally your gods. For many people, especially when they're sick and they're desperate and they're scared, your gods, your gods. In our system Maybe not all cultures and maybe not all countries, but in Western medicine doctors are gods and literally what they say can make or break choices people make and I can just imagine how powerful it will be when doctors say here's the deal.

Speaker 1: 20:33

I need you to get off sugar. I need you to move 30 minutes a day. I need you to get your sleep Right. I need you to look at your stress. Don't just keep coming back to me for another prescription, because this one's like you know, it's only doing so much. You need to. This is my prescription and I think that people will go. My doctor told me I need to, right, and they'll be like. They'll be in like restaurants. Oh, I'm so sorry, my doctor told me, and it's just going to go explosive, I hope, because I think doctors think that oh, no one's going to listen to me or I tell them, you know, they should look at their weight. But I don't think that soft sort of you know you should lose weight is enough. So I'm excited to see doctors being blown away by how seriously the lifestyle advice that they you know that they give will actually really be taken to heart by their clients. Is there anyone sorry? Yeah, go ahead.

Speaker 2: 21:27

Well, yeah, I think that's a very important point and I think you know, part of the problem we have is that doctors haven't done that because they kind of know the advice that they were taught to give is lousy advice and it doesn't work. So you know, I think back to. You know, I guess before my awakening, and you know I eat a low fat diet, eat less, move more, and it's kind of like, you know, I wasn't, I wasn't enthusiastic about talking to people about that because I knew in my back of my mind it didn't work. You know, I knew it wasn't working for me, I knew they had heard it before and it wasn't working, and you know. So doctors have kind of defaulted to the thinking that, well, the patients don't listen to us anyway and that's why you know they're not getting better.

Speaker 2: 22:19

But now I see it. You know, when I give the advice, like you just said, to cut out processed food and cut out sugar and, and you know, pay attention to your sleep and your activity and your stress, it does work and people get great results and I've gotten great results and you know my patients are now getting great results. So now I am enthusiastic about talking about it and I do want to get out there. You know I can't imagine you know in sort of an alternate reality. You know me being on social media all the time talking about you know how great the low fat diet is. You know that never happens because the low fat diet isn't great, it doesn't work. People don't get great results from it. And you know being able to actually give advice that works I think will get doctors more enthusiastic about giving that advice.

Speaker 1: 23:19

Fair enough. And in your book you talk about I was doing everything right, I was obese, I was a doctor who was truly I thought I was doing everything right and it wasn't working. So you know, you're like Edison, you know what doesn't work. Tell us what does work, what worked for you, what do you see working in your clinics?

Speaker 2: 23:36

Yeah, so you know the basic principles of eating whole, real food. You know elimination of the processed food and sugar is a huge component of that, and so when we do that, that you know the body starts to heal, and that's really what I've come to recognize. You know, when you stop doing damage to your body actively every day with the food that we're eating, the body has amazing capacity to heal, and even things like heart disease. That you know. Again, we have the perception that once you have heart disease you can't do anything, you know, really to improve it. When it gets bad enough, we're going to put in stents, we're going to do surgery. You know we're going to give you these medications that, again, are largely ineffective but maybe slow the process down a little bit.

Speaker 2: 24:37

But now I do see that people can meaningfully improve when you stop doing the active damage on a day to day basis. And you know I'm always kind of. You know I tell people it's simple but it's not easy, and you know that's of course. You know what this summit is all about, because knowing that sugar and processed food is bad for you is one thing and actually being able to kick that habit and you know it's just like any other addiction. In many ways. That is where the challenge is, and so that's what I, you know, now increasingly focus on and have built you know within my practice a support system with coaches to help people through that process.

Speaker 1: 25:32

Right, and what was your journey? Like? Would you say that you were hooked into sugar, or was? Were you just eating too much? Like did you have a sweet tooth yourself?

Speaker 2: 25:41

Oh yeah, most definitely. You know, I fully recognize in retrospect that I was a full on sugar addict and you know it. And it's interesting, you know, because I first kind of you know, I Lord I eliminated sugar and you know, kind of went low carb and sort of keto and you know I got pretty good results. I lost a lot of weight and I was feeling a lot better. And then I kind of took that next step and eliminated carbohydrates, you know with a carnivore diet, and I noticed how much better it was than even the low carb. And specifically what I noticed was I finally didn't have those cravings anymore.

Speaker 2: 26:29

Because even when I was eating small amounts of carbohydrates, doing low carb, keto, I still had those cravings and you know I would still give into those cravings on an occasional basis. But it was only when I really, you know, did carnivore, completely eliminated the carbohydrates, that those cravings finally went away. And now, you know, when I do have carbohydrates and even when I do have a little bit of sugar, you know I'm always very clear. You know I'm not perfect and sometimes it's not even that I, you know I don't view it as. You know I messed up. You know I sometimes make that choice that I'm going to have a little bit of the stuff and now I can regulate it. I can truly have a little bit and not have it turn into sort of the you know, those binges that I used to be so prone to.

Speaker 1: 27:29

Mm, hmm, Tell us specifically. How is it that sugar? Well, what is the root cause of heart disease in your opinion? What have you discovered so far, and what role does sugar play in that?

Speaker 2: 27:42

Yeah. So I think it's very clear that the root cause of heart disease is insulin resistance and the you know the inflammation that results from that, the damage to the blood vessels, the alterations in our cholesterol molecules that occur because of insulin resistance. This is the root cause of heart disease and of course you know, sugar is one of the major components in our diet that is promoting insulin resistance, the development of insulin resistance. So I think there is a clear line here.

Speaker 2: 28:25

Again, this is what's been so interesting to me, because when you first start discovering and learning about this stuff, you think, oh well, this is sort of a new concept, like why hasn't it spread yet?

Speaker 2: 28:40

And then what you recognize is that this is actually a very old concept and we can go back to the early days of heart disease and when heart disease was becoming more prominent throughout the early 1900s and it was pretty much decided that it was sugar that was causing this problem.

Speaker 2: 29:02

And then all of a sudden we sort of come up with this theory that it's saturated fat and we kind of pivot towards that for reasons that I would say were not completely scientifically based, and that theory then just overwhelms and everyone forgot about the sugar. But it's been clear all along, when you really look at the science and look at the literature, that sugar is a major driver of heart disease. And what's a little bit ironic is that even the major societies the American Heart Association has started to acknowledge the role of sugar and they have now started to put into their recommendations limitations on added sugar, which is a start. But, like I said, I don't think that anyone can really deny the root cause role that insulin resistance plays in the process of heart disease. It's just that most doctors don't understand how to diagnose that, how to manage that, how to reverse it, so they don't pay a whole lot of attention to it.

Speaker 1: 30:24

Right, right, right. And insulin resistance is when there's too much sugar in the body and the cells become immune to it, and then this excess sugar causes glycation. How does sugar tie in with cholesterol, and where does cholesterol come into this whole conversation?

Speaker 2: 30:43

Yeah, so again, when our bodies become insulin resistant and the cells stop responding to it and this now allows the sugar to accumulate in our bloodstream essentially at higher levels, that has direct effects on cholesterol molecules and it basically causes those cholesterol molecules to become damaged.

Speaker 2: 31:09

When we're talking about LDL cholesterol particles in particular, it causes them to be smaller and basically get more sticky is the way that I usually describe it to people so that they now get involved and stuck into these plaques that ultimately lead to the atherosclerosis, the buildup of these plaques in the blood vessels of the heart that causes the most common form of heart disease, what we talk about atherosclerotic heart disease.

Speaker 2: 31:41

Now, the sugar has other effects as well. Sugar is one of the primary things that is going to damage the lining of the blood vessels and again, the whole reason that cholesterol sticks to the blood vessel wall to start with is because there's been damage to that blood vessel wall. I describe to people that the cholesterol is like the spackle that you're using to try and patch the hole in your wall. But if you keep making holes in your wall and you keep building up this spackle, eventually you're going to have a problem there, and so it's real interesting when we go back again through the science around insulin resistance and you actually see that there are a number of pathways by which insulin resistance leads to heart disease and there are direct effects, like I said, on the blood vessels. There are the effects on the cholesterol, there are the other hormonal shifts that occur as people develop insulin resistance and these all end up contributing to heart disease.

Speaker 1: 32:57

There still is a huge body of research, clinical evidence, to suggest that actually the lower carb sorry, higher carb, low fat, whole foods, whole food, plant-based diet can be very, very helpful for heart health. Why is that? Why is that evidence there? And is that because they're pulling out the refined carbohydrates, they're pulling out the sugars? Is that why it can be effective?

Speaker 2: 33:19

Yeah, there's really two things going on there. One is they're comparing it to the standard Western diet and basically any diet is going to look better than the standard Western diet. It is kind of shocking to me in the end that when we look at the standard Western diet, it is probably the worst diet that you could design like if you were trying to harm people. So when you then take something like a plant-based diet and compare it to the standard Western diet, yeah, of course it's going to get better. Most of the studies are on.

Speaker 2: 34:01

Like you said, what I would say is a clean, plant-based diet that has eliminated the processed food, largely eliminated sugar, maybe with the exception of fruits. So, yes, you're going to see improvement when you do that. Now, that doesn't mean it's the optimal diet, but what has got in promoted and again, this is not purely based on the scientific interest. This is where the business interest and other things get pulled in. Politics, the environment, ethics, these all end up getting pulled in and they say, well, the plant-based diet is the best diet and I say nothing, says it's the best diet. All we can say is it's better than the standard Western diet and I agree with that. Ultimately, I think any diet that reduces processed food and shifts us towards eating whole, real food is going to be an improvement in your health.

Speaker 1: 35:07

I've heard that people who are on the low, low carb and the carnivore diet can potentially also have insulin resistance. Can you comment on that?

Speaker 2: 35:19

Well, I think, ultimately, people who are severely insulin resistant may not be able to fully reverse their insulin resistance, even with very low carb or carnivore diets, and or it may take a long period of time. But that doesn't mean that it's not working, that it's not improving the situation. There's really no mechanism that anyone at least has ever been able to demonstrate to me and I would welcome any evidence to the contrary as to how a carnivore diet can drive insulin resistance, because your body is not going to make enough insulin. Yes, there is a small insulin response to protein intake, but it's not going to be enough of an insulin response to create insulin resistance. But, like I said, yes, I do see people on a carnivore diet who are still insulin resistant. It's not the carnivore diet that made them that way, it's just that they haven't been able to undo the damage that was done from their previous diets.

Speaker 1: 36:38

Right, they're a sad diet. I think, if I'm not mistaken and I might have some research to send your way is it's the fat, that there's something to do with fat and cells and blocking something like that. I don't know if you're familiar with that. We don't have to go down this rabbit hole. I was just yeah, I mean.

Speaker 2: 36:56

What I would comment on is you can still be eating the wrong types of fats on a carnivore diet If you're incorporating a lot of vegetable and seed oils which most carnivores don't do but some are unaware of that aspect of it or if you're eating poor quality, non-ruminant meats, especially things like a lot of bacon, a lot of chicken, a lot of pork, and those animals have been fed poorly, you're being indirectly exposed to large amounts of polyunsaturated fatty acids. That can still be problematic. Then the other situation I see is, you know, sometimes it's not necessarily insulin resistance, it's inflammation that's coming from other sources that's driving the heart disease process, and so this is where, you know, we get into things like autoimmune disorders. And again, you know, you can be eating a low carb diet but still consuming some of these triggers for your autoimmune disease and you may be seeing worsening of your inflammation and therefore, downstream, your heart disease because of that as well. So that's another aspect of it that I think some people you know need to pay attention to.

Speaker 1: 38:26

A little complexity there. Heart disease is known as the silent killer because often it just sort of like out of the blue. I'm in the middle of my 10k run, like what happened. So what are some early warning signs of heart disease maybe in the making, and what are some tests that people can take to kind of try and catch it early and to be inspired to change their diet and lifestyle?

Speaker 2: 38:50

Yeah, so you know, the first thing I would say is that we think of heart disease as a silent killer, quite frankly, because we fail we in the medical system fail to recognize the disease at its early stages, and it's only when it gets to its advanced stages. And again, this kind of talks to the amazing machine that is the human body, because it turns out that heart disease can get pretty far advanced before a patient is going to experience symptoms from it. And this is one of the reasons why I talk so much about what we can be doing to pick up this process early on. And it's not checking your LDL cholesterol level, I'll come right out and say that. But you know, if you check an insulin level, if you do testing to determine if a patient is insulin resistant, you're going to see the problem earlier, you know, as opposed to waiting until the patient is overtly diabetic, by which time there may have been significant damage done to their blood vessels already.

Speaker 2: 40:01

The other test that I am a very big proponent of is the coronary artery calcium scan, and this is a pretty easy to do test that can show us heart disease at its early stages. I kind of refer to it as the mammogram for the heart. We've done such a great job around breast cancer and women's health for women to get mammograms, and you know, what that does is it allows us to see the breast cancer at its earliest stages, when it's manageable. And the coronary artery calcium scan does the same thing for the heart, because we can pick up the early stages of heart disease, when you're just starting to get a little bit of calcium in your blood vessels, which means that there is damage and plaque starting to form there. And then I can say to someone okay, you know, you have this heart disease starting. Let's do the things that we need to do to stop it from getting worse, even if we can't reverse it. If we stop it at its early stages, you're going to be just fine.

Speaker 2: 41:14

And so, big fan of the coronary artery calcium scan, I think really everyone should be getting this test. And you say, okay, well, how early do you get your first test? And I, you know more and more I say I'm not sure there isn't early enough, because you know, I now routinely see 30s and 40 year olds ending up on my operating table and I know that that didn't just happen overnight. So in some situations, you know, I would say 40 is probably a good average age to start this testing at. But you know, in some situations it may make sense for 20 and 30 year olds to get that coronary artery calcium scan. And what we have to recognize is that if you're younger, you know a zero score is less powerful. But a non zero score in a 20 or 30 year old needs to be a major red flag Because, again, they've already started that process and that means that by the time they're 30, 40 or 50, they may be in any advanced stages now if we don't do something about it.

Speaker 1: 42:26

Right, and the interesting thing is there's a lot of 20 year olds, I imagine, that are not overweight. They have no other symptoms that wouldn't occur to them that their heart would be would be showing early signs of heart disease. What happens if you're doctor? So it's not really about weight. I know the only person I know well, my dad, had a heart attack, but he was always then my husband's mother had a heart attack. Thin, like normal weight, so they just right. It's just not always while I'm overweight I imagine that it would be hard on my heart, but there's just, it's not that simple.

Speaker 2: 42:58

No, definitely not. You know. I can tell you that. You know a very decent percentage of the patients that I operate on are not overweight, and it really you know. Again, when we look at the data behind insulin resistance and metabolic health, what we see is, yes, you are certainly more likely to be insulin resistant if you are obese, but there are plenty of non obese people who are insulin resistant. You know the one study that showed us that 88% of the adults in the United States are not in optimal metabolic health. When you dig into that data, you see that half, 50% of the normal weight people in that study were not in optimal metabolic health. So I always tell people that obesity is a warning sign. But not being obese does not mean that. You know, you can, you can ignore this. You have to figure out if you're insulin resistant or not. That is really the key that we want to know.

Speaker 1: 44:06

So the two tests are is insulin resistance and the and the CAS, the calcium artery, something?

Speaker 2: 44:12

the CAC coronary artery calcium scan, calcium scan, and just to go into that scan a little bit more, it is a CAT scan, a CT scan. They don't have to put an IV in you. It literally takes five minutes to do the test. You lay down, you get the scan done. It is a low amount of radiation, it's on the order of you know the amount of radiation you'll get from a chest X-ray and it can be done very inexpensively. I mean here in the US, on average it costs about $100. You know insurance usually won't cover it, which is a whole nother discussion, but it's not that expensive a test and I would tell you it's a very good investment in your health. Now the tricky part is is you do need a doctor to order it for you, and so you have to find a doctor who knows what it is and is willing to order it for you.

Speaker 1: 45:14

Okay, and Dr Evidia, does your clinic do that I know you do telemedicine, right and can people from all over the world work with your team to get a prescription and to go to their local whatever to get this done and these tests done? Like, how can people work with your clinic?

Speaker 2: 45:30

Yeah, I do work with people all over the world. Now I can only prescribe things here in the US so I can directly order the test for people here in the US, people that I work with internationally. You know we're kind of helping them to negotiate their local resources to get the testing done.

Speaker 1: 45:51

Amazing. Are there any final words you'd like to share with our audience today about the topic of sugar heart disease? Lifestyle medicine your own journey.

Speaker 2: 46:02

Yeah, you know just the message of taking charge of your health. You know, I want people to understand that they need to advocate for themselves, they need to be in charge of their health and they need to put effort into their health. And you know, yes, it might be challenging to find a doctor to work with on some of this stuff, but that effort is going to be worthwhile. And if all you're willing to do is just kind of accept, you know what's given to you you're not going to get different results from the people around you. If you want to do better, you have to put the effort in. You have to invest your time. You might have to invest your money, but I think that that's a very worthwhile investment in the end.

Speaker 1: 46:51

And I will say another great investment is Dr Avedia's book Stay Off my Table, operating Table, because in that book it's his whole program. You don't even you know you can call his clinic, of course, but he's really put his heart and soul and his best advice into that book. It walks you through. He talks about mindset, he talks about specific ways of habit stacking so that you don't overwhelm yourself with all the changes that you might need to make. So that's a first great step for everybody and thank you for your time today, dr Avedia.

Speaker 2: 47:20

Thank you, florence, thank you for being here with you.