heart disease number one killer in the U.S over 600 000 people die each year
from it a lot more affected by it worldwide the number one killer as well and it's been that way for 50 plus years
why do we have heart disease they already saw the noticeable increase from 1900 to 1950 and it's really been an
exponential growth uh since then we said we're putting all our resources we're going to figure out what's causing heart
disease and here we are 70 years later essentially we've made no progress our
medical system is structured to take care of sick people it's not really designed to understand why people get
sick in the first place that lady had been misdirected by the medical system
if she had been seeing her doctor she had been taking the medications that she was told to take but no one talked to
her about the underlying root cause of her high blood pressure and her obesity
and her diabetes unfortunately that then led to devastating unsolvable problem do
we believe that being on the right medicines is the best way to manage our health and we can't do anything better
than that do we think that it's normal that 88 of the adults in the United
States are not in good metabolic Health what would be those top three things in
order that you believe lead to heart disease it really is one factor that it comes down to
[Music] Dr Philip ovadia welcome to the ketocam podcast
yeah great to uh be here with you Ben uh for us to finally uh connect I know
we've been uh trying to get this together for a while really been looking forward to this conversation love uh
everything that uh you've done and are continuing to do with uh keto camp
Thank You Phillip you know I am so looking forward to today's conversation I have a whole bunch of notes Here I was
so excited just preparing for this interview I the work you're doing is transformational and for those who have
not even heard of you before you're in for a treat and if you have heard of Dr Philip you know exactly what I'm talking
about I actually came across your work um two years ago not not too long ago and it was via Clubhouse uh that app
that a lot of us were was on and I don't know if you're still on there I'm not so much active on there but in the
beginning I was and we were in the same room and I heard you speak and I'm like who is this guy he's super smart and
Brilliant then I just started following you and I fell in love with what you're teaching and that was about two years
ago so it's cool to see that come full circle and now we're on this podcast interview here's where I want to start
the conversation heart disease of course 600 000 people per year are plagued with heart disease
prior to 1950 it wasn't this High what changed and was it that our genes just
dramatically changed in that amount of time or was it something else yeah so as you said you know heart
disease number one killer in the U.S over 600 000 people die each year from
it a lot more affected by it uh and uh worldwide the number one killer as well
and it's been that way for 50 plus years so you know when we go back to the early
1900s we have reports from some of the leading Physicians of the time and heart
disease is an exceedingly rare condition uh you know like I said leading
Physicians uh the leading hospitals of the time and you know it's rare it just
doesn't exist for the most part um and then you know through the early 1900s it starts to uh become more
prominent and 1950s it really reaches the crisis point and you know uh Dwight
Eisenhower has a heart attack while in office as president of the United States and of course you know that set off the
alarm bells and people start started asking why you know why do we have heart
disease why has this they already saw the noticeable increase from 1900 to 1950 and it's really been an exponential
growth uh since then and um the question that I think is so
important to ask today uh is okay 1950
we declared war on this like we said we're putting all our resources we're going to figure out you know what's
causing heart disease and here we are 70 years later and essentially we've made
no progress um heart disease like I said Remains the number one killer by a pretty wide
margin and you know we had a little bit of an improvement here and there uh but
actually the last decade we have seen the rates of heart disease increasing
again at an exponential rate so our understanding of what causes heart
disease uh I would say went awry in the 1950s and you know in the 1950s there
were two prominent hypothesis about what was contributing to heart disease and
they both had to do with the food that we were eating um it was sugar is causing heart disease
or it was dietary cholesterol and saturated fat is causing heart disease and for various reasons you know we
chose to go down the saturated fat and cholesterol pathway and we started
making all of these changes uh with the goal of lowering our dietary intake of
saturated fat and cholesterol and then it turned into pharmaceutical manipulation of our blood cholesterol
levels and this was supposed to cure heart disease and it simply hasn't
and you know we can get into a lot of aspects of this uh but at a high level when I look at that the question I ask
is okay we've done the things that successfully manipulated diet you know
cholesterol levels blood cholesterol levels more and more people are on medications we've changed our food
environment and the problem is continuing to get worse and the only way that that can be is if it was never
cholesterol that was the real problem in the first place and so that's led me you
know now to re-examine uh kind of our approach to heart disease and of course
this overlaps with my personal health Journey as well uh but thankfully you
know starting about seven or eight years ago I started asking different questions I started coming across different
information and that has now allowed me to be able to do a better job of not
only treating the patients that come to me with heart disease as a heart surgeon but also now my focus on keeping people
off my operating table and helping them to prevent the heart disease from progressing to that point
and that's exactly what you're doing and I love that that's the title of your book um and also the title of your podcast
which is uh an incredible podcast as well stay off my operating table yes
that is the goal for all of us there were a couple of moments the Pinnacle moments in your career as a heart
surgeon that led you down the path of what you're teaching today one of them you talk about in chapter
one of your book a very young patient who had metabolic syndrome who uh came
into for surgery and maybe you could share that story and then after you know part of that was also some of the
deterioration with your health becoming obese uh in your late 30s so if you could share both of those moments in
your career and how that led you down this path yeah and you know they really did intersect uh and it kind of started on
the personal front you know I had I was a heart surgeon um you know had struggled with obesity
my entire life uh but you know in my mid-30s I found myself as a morbidly
obese pre-diabetic heart surgeon and I recognized that I was going to end up on
my own operating table so to speak um you know I was traveling down that same path that so many of my patients
had followed and like so many of them I didn't know how to change you know the
direction I was traveling in uh because I was following the advice that I had learned to give my patients you know eat
less move more count your calories follow the food pyramid all of the stuff
that we've uh heard and it wasn't working for me and it wasn't working for
my patients and like I said I was fortunate to start to come across some
different different information my journey really started with hearing
Gary Tobbs talk at a medical conference ironically enough and you know he at
that time had just ridden the case against sugar and of course before that had written why we get fat and it
resonated with me you know it was a different idea about what was causing us to be overweight obese and unhealthy and
so I eliminated sugar from my life went low carb uh ultimately you know kind of
Keto now carnivore really for the past four plus years and I am in the best
shape of my life and you know as I saw my personal health
improving that led me to ask different questions why did I hear about this from
Gary a journalist and I don't mean that in any disparaging way uh but why didn't
I hear about this from my medical school professors my colleagues uh you know why
was I learning more about the disease that I had dedicated my career to and
was treating every day from you know Engineers computer scientists in some
cases uh then you know I could get from the American Heart Association and the
leading medical societies uh so you know that opened my eyes to how our medical
system is structured to take care of sick people it's not really designed to
understand why people get sick in the first place and prevent them from getting sick and that is a much better
approach because ultimately no matter how good a heart surgeon I am you know no matter how good all the heart
surgeons and the cardiologists out there might be you're never as good after you have heart surgery or after you have a
stent as you would have been if you didn't have that in the first place and you know the opening chapter of my book
demonstrates the problem with the approach of waiting till people get sick because I tell the story of a woman in
her late 30s with young children who ended up on my operating table with a
devastating cardiac problem and ultimately it turned out to be an unfixable cardiac problem and you know I
then had to go inform her family inform her children that you know she didn't
survive and that was preventable that lady had been you know misdirected
by the medical system it wasn't that she didn't take care of her health she she had been seeing her doctor she had been
taking the medications that she was told to take but no one talked to her about the underlying root cause of her high
blood pressure and her obesity and her diabetes and unfortunately that then led to you know
a devastating unsolvable problem you're so right with uh prevention and
that should be the mindset it reminds me of the Einstein quote uh he said intellectuals solved problems Geniuses
prevent them and that is the best thing we can do is to be proactive and thank God for conventional medicine
because sometimes it's it's so needed to save lives you've done that so many times with your surgeries but we don't want to even need you we don't want to
ever need you uh doc we want to make your job obsolete right we want to make sure we're never on that medical uh
table that uh getting a surgery or just it's unfortunate because till this day
people want to be healthy they're it's not that they want to stay unhealthy they're just getting the wrong information and they're putting so much
value in the authorities and it reminds me of and you went to Tufts universities so this is really relevant to you it
reminds me of what we saw last year with uh Dr mosifarian and the food compass that came out and it's interesting
because this just happened today and I'm bringing it up because it's perfect timing I I lectured at ketocon um with
Dr Mindy Pals we did a keynote lecture together a couple months ago and I was talking about that food compass and I
was showing that chart you know as they put Lucky Charms and Frosted Mini Wheats and all these processed foods above
essentially like eggs and and beef and uh I got a clip from that lecture it was
like a 45 second clip that I re uh purposed on Facebook reels Etc and I
went on Facebook this morning and I saw that it went viral it has like 1.4 million views and I'm like oh cool this is getting out there and I wanted to see
some of the comments and I came across one comment and I screenshot it I'm gonna read it and then I want to hear
your thoughts on this but somebody named Daniel Martinez I'm gonna say his name he said did the crowd pay to get this
terrible nutrition advice or was it free and I was wondering what he meant did he
think I believed in the food Compass or did he think you know me going against it was the bad advice so I I said could
you please elaborate and then he responded please elaborate on an egg fried in butter and random
beef parts ground up not being healthy I can't help you if you don't know that
and he said underneath that you're just a modern day pet rock salesman that's
what he called me I don't mean so anyways that's 2023 I'm getting comments like that so what are your thoughts on
this yeah you know and it it doesn't surprise me you know this narrative has
been so ingrained in us and you know again you know this has been the narrative since 1950 uh that you know
saturated fat cholesterol fat in your diet you know which then gets extended to animal products in general is bad for
our health and you know so I understand that people so believe it because it's
the only thing that they've heard uh but I also asked them to look around them and see what the results of that are do
we really believe that the best that we can accomplish is that at you know sixty
percent of the adults who are over 50 years old are on multiple medications do
we believe that being on the right medicines is the best way to manage our health and we can't do anything better
than that uh do we think that it's normal or it should be acceptable that
88 of the adults in the United States are not in good metabolic Health
um you know and again these are the questions that I have started to ask uh
but for a lot of people they don't even have the capacity of asking those questions
they are so trapped in their belief system and their information environment that they just can't see that there's
another possibility uh you know I know many in our space uh you know will often
refer to uh The Matrix you know the movie uh as the sort of analogy for this
but it really is you know a lot of people just can't believe that there's an
alternative thought around how to be healthy they think that the U.S dietary
guidelines are the end-all and be-all and of course those have been constructed you know with the only goal
of making people healthy and of course they're based on the best science and the best studies and you know uh and of
course they must be right because we've been told they're right our entire lives and people need to start waking up to
the fact and thankfully more and more people are waking up to these facts uh that it just isn't true
um it hasn't had the effects that it was intended to have and you know unfortunately it's not based on the best
science and it's not only Guided by what's best for people and patients and
their health but there are other influences there that have corrupted that whole process and that's what we
need to continue to bring awareness to yeah and it's exactly the point the conversations like this your book your
podcast it it brings awareness to individuals so they actually could go and dig a little
bit deeper like we all had to do right for me too I believed in the government guidelines for quite some time you did
too and it led us down a path I was also morbidly obese uh at the age of 24 years old and I had you know I figured things
out I I dug a little bit deeper and this gentleman Daniel Martinez who commented
like I pray he digs a little bit deeper very very soon and sees the truth I want to take a minute to share
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to today's video um you know when it comes to heart disease I know that it's multifactorial
similar to cancer and a lot of diseases out there there's a lot of factors at play but if you were to kind of rank a
hierarchy of maybe the top three things that contribute to heart disease and it
might change in the future so I won't hold you to it but at this point what would be those top three things in order
that you believe lead to heart disease yeah so you know it turns out that it's really not multifactorial it really is
one factor that it comes down to now there are different things that lead to that factor uh but when we're talking
about and just this needs to be made clear you know because there are different forms of heart disease but the
most common form is what we call atherosclerotic heart disease the buildup of plaque within the arteries of
the heart uh that can ultimately lead to things like heart attacks and when you
look at atherosclerotic heart disease it really comes down to one major factor
and that is damage to the blood vessel wall that is the inciting event that has
to happen for these plaques to start to build up um now what causes that damage that's
where we get into some different factors yeah yep the big ones are going to be
insulin resistance uh first you know and foremost the probably the most common
problem today uh smoking is another big one uh now we've done a pretty good job
at cutting down on the smoking rates and you know that ultimately is what led to
some of the improvements we saw around heart disease uh you know throughout the 1980s 1990s uh and you know up until
about 2000 when that downward Trend that we were seeing started to go back up
again um and um you know probably high blood pressure
is the other most common one we see but again high blood pressure acts via
insulin resistance so it really comes down to insulin resistance and then other toxins that damage the blood
vessels smoking being the most common but there are other things like
um heavy metals uh air pollution things like that that can cause that as well
but ultimately we have to come back to damage to the blood vessel wall to the
lining of the blood vessel as the root cause of heart disease would you put vegetable industrial seed
oils in the in the category of other toxins or would that be a different category yeah so vegetable and Seed oils
are certainly a contributor to heart disease and I know again that's going to be a very controversial question you
know statement because you look at the bottle of the vegetable oil and it has the American Heart Association stamp on
it saying it's heart healthy um but yeah vegetable and Seed oils contribute to this and what's
interesting about vegetable and Seed oils is they also act through a number of those mechanisms
um you know they are mitochondrial poisons uh when we really get down to it
uh they cause insulin resistance they contribute to insulin resistance and
um you know the um the fatty acids that are in those vegetable and Seed oils the omega-6
fatty acids that are in them in amounts that do not occur in nature which is the
problem are pro-inflammatory and again inflammation is one of the things that causes damage to blood vessel walls so
vegetable and Seed oils I do think are very problematic and you know I acknowledge that it's hard to separate
the effects of vegetable and Seed oils from sugar and processed carbohydrates because our modern food environment
combines those things no one really consumes vegetable and Seed oils in
isolation it's in all of these processed foods that have all of these other problematic ingredients in them as well
that's a fair point yeah they'll usually come combined together okay so you you said there are several
reasons why the there's damage to the blood vessel but damage to the blood vessels the only cause of of heart
disease but what cause what is leading to that many different things you mentioned insulin resistance smoking
high blood pressure which is linked to insulin resistance other toxins heavy metals and of course vegetable oils
which is something we talk a lot about if that's the case and I I agree with you then when the average person goes to
their annual checkup with their doctor there's no fasting insulin on that blood test there might be a fasting glucose
and maybe an A1C but why isn't there a fasting insulin if that is one of the most important things to pay attention
to with the leading killer of disease in America yeah it's a great question
um you know it's certainly a test that I use with my patients and you know I know
many other doctors who are uh you know aware of this now use it um I believe the reason that it's not
used in mainstream medicine is because we don't have an answer for that problem
so when if you get that insulin test and you see the patient has a high insulin level there isn't a prescription to
write to bring it down uh and that I think is really you know at the root at
the root of why we don't look at this blood test
um it's it you know it's also very misunderstood by physicians it's it's really just not part of our educational
environment um you know I think back to my medical school days and my training and you know
there was no mention of insulin levels you know of course we learned what insulin was what it does you know its
role in diabetes um but no one talked about checking fasting insulin levels uh and throughout
my early career again I never saw a fasting insulin blood test done and it was only as I
said when I started getting into the you know this other information and I learned the importance of that test and
I learned how we deal you know how to manage that problem of hyperinsulinemia
uh that you know I started checking it but you know we can go back to again
much of this work was done in the 1960s 1970s uh Joseph Kraft and Gerald Riven
uh you know two instrumental uh Physicians and scientists uh who
demonstrated this specifically when it came to heart disease uh you know Gerald
riven's work uh shows us that over 90 percent of the patients who present with
heart disease heart attack or or you know uh some other presentation of heart
disease are insulin resistant if you test for it
in the right way uh and that's the key you know but even the mainstream
statistics point us this way because we know that about 60 percent of the
patients who you know either have a heart attack need a stent or end up needing bypass surgery are overtly
diabetic or pre-diabetic and you know those are just the late stages of the
insulin resistance Continuum so um no matter how you want to look at it
it's obvious that that's the problem and unfortunately mainstream medicine has
kind of ignored that because they don't have the solution yeah now yeah when they get meds for it
they might start testing for it so if you if go get your fasting insulin done that's the point let's look at where
that's at because your glucose and your A1C might be it might not change that
much for several years meanwhile you are developing or you might have insulin resistance and your body your pancreas
is working so hard to keep those glucose levels in check until it doesn't and then that's when you're diagnosed but we
want to be proactive proactive not reactive um what about the role of stress I remember reading a book
by a medical doctor his name is Dr Larry dossey now this is a book from the late 80s so I know things have changed but
the book is a great book called recovering the soul just the title alone inspired me to get
the book and read it it's such a phenomenal title but the book essentially is about finding your
purpose your passion and living on purpose with that purpose which I'm very much about but I remember reading that
book and in the book he talked about a study he was referencing late 80s so things may have changed maybe got worse
maybe you got better but the study showed that in America when individuals had their first heart attack
85 percent of the time when they had that first heart attack it was Monday morning between 8 A.M and 9 A.M going to
a job essentially they hated the stress that caused it so what is the role of stress with heart disease yeah so we
know that stress plays an important role in heart disease and it's one of the pillars of Health that I talk about you
know the difficult part of stress is we don't have a great way of measuring it you know uh we all know what it is uh
but we don't have that test that we can say okay your stress is X and you know someone else's stresses why and be able
to what about heart rate variability would that be a good gauge for that it may be you know and it's something to
certainly look at uh but you know I I just kind of keep it higher level with people and uh you know I'm also
realistic with them I know we can't eliminate stress you know we can't all go uh you know live on the island and
and surf all day and whatever it is you know whatever that stress-free life looks like and even that isn't stress
free but uh you know it's about managing your stress and making sure that it's
not you know kind of internalized but it's real interesting to look at some of the scientific studies around stress and
see that you know stress ultimately affects these same kind of metabolic biochemical hormonal
Pathways that we're talking about and you know to see the relationships between stress and insulin resistance
and stress and inflammation and so you know again it leads us to the same place
uh and it's very well described uh that
you know the relationship between stress and heart attacks there's actually a
um uh well-described uh cardiac condition uh that's basically a stress-induced
heart attack so these are people that have stressful events in their life they have what looks exactly like a heart
attack uh but there's no blockages in their arteries uh and it's called
takasubo cardiomyopathy is the fancy uh kind of name for it uh but uh you know
it is a stress-induced heart attack and it occurs in people who do not have blockages in their arteries in many
cases so um you know like I said we know that stress plays a role we see how stress
affects these same Pathways uh that you know ultimately lead to heart disease
and um it's a very important aspect of
mitigating your risk for heart disease is managing your stress 100 especially
in this day and age that we live in the last three years A lot of people are dealing with a tremendous amount of
mental emotional stress um so that it's so important to to manage your stress Mastery your stress do what you have to do you're also big
on teaching sleep the book talks about that that would go hand in hand with stress when you're not getting quality sleep you will have higher levels of
glucose and cortisol and it'll be a Cascade of issues in a vicious cycle I do want to talk about
what we can do in terms of uh getting metrics done some lab work done that give us a good idea whether we are at
risk of heart disease or we're at a low risk because one of the most common questions I get being in the keto space
and also the car I love carnivore too on YouTube especially is I started doing keto I started doing carnivore my
cholesterol increased or my LDL increase now my doctor wants to put me on a Statin I'm worried that's the most
common thing I get I'm sure you get it all the time so what would you say to that and let's have a full conversation on the labs to get to assess our risk of
disease especially heart disease yeah exactly and you're right it is the most common question I get as well it's the
most common thing that I work with uh you know uh patients on uh is that exact
question ultimately what I think it comes down to is understanding the role
of cholesterol in this process and you know one thing uh that I try to make
clear to people is that it's not that cholesterol doesn't matter it's not that
I'm telling people to ignore cholesterol as I often get accused of doing
um it's that the amount of cholesterol isn't the right thing to be looking at
we need to be looking at the quality of the cholesterol that you have in your
body and again we need to be looking at is there damage to your blood vessels
because you know I challenge anyone to bring me evidence showing that
cholesterol in and of itself without damage to the blood vessel wall can be a
problem there's just no way that it can happen you know cholesterol is in our bloodstream from birth until death
um it is a vital part of many systems in our body and until you get damage to the
blood vessel and until you get damage to the cholesterol particles themselves going back to the Quality that I talked
about you cannot produce heart disease and plaques uh in the blood vessels of
the heart so that is what I try and you know help people to understand and to
focus on now the difficulty is that's not how medical doctors are trained
medical doctors have been trained to understand that all cholesterol and
really we can specify it I guess the LDL cholesterol in particular it's all bad
and it needs to be lowered at all costs and like I said that has led us to do a
number of different things pharmaceutical manipulation dietary manipulation and I would just point to
the evidence and say those haven't worked and in fact the dietary
manipulation part of it changing our diet to avoid saturated fat and lower
the amount of dietary cholesterol has made our health measurably worse you know because since
we've been giving that advice really starting in 1980 with the first version of the U.S dietary guidelines our rates
of obesity have skyrocketed our rates of diabetes have skyrocketed uh and you
know with that heart disease has not been impacted uh which is the very you
know disease we were trying to take care of in the first place isn't that interesting yeah it is very interesting
so you know when people come to me with that issue that's what we work on we
evaluate the quality of their cholesterol we evaluate whether or not they have damage to the blood vessels in
their heart and we then work on manipulating those factors uh and those
factors can really only be manipulated by diet and lifestyle interventions
I want to get into the specific markers that we'll look for before we do um question for you because I remember
when I first met my fiancee Natasia eight years ago she was working at a corporate job and she told me something
wild she told me that her company would reward I think the top 10 people who had
the lowest amount of cholesterol with a bonus um and I think they're probably still doing things like that
that is wild to us right but they're probably still doing things like that so are you more concerned
with somebody who has low cholesterol versus somebody who has high cholesterol
um you know in certain situations you know and really like I said what it comes down to me
uh with me is the quality of your cholesterol so I am more concerned about
someone that has a low amount of cholesterol that's mostly damaged cholesterol then I am about someone that
has a high amount of cholesterol in their bloodstream but it's not damaged cholesterol it's good quality
cholesterol uh and so that's you know that's what I want to look at that's
what I want to know about yeah well said okay so we're getting a full panel done we're getting total
cholesterol which is you know it's okay to get that just add it to the you know the lipid panel we're getting LDL but
let's talk about LDL because we know that that total LDL is not giving you the full picture so how do we know how
much of that LDL is actually the oxidized small and sticky kind versus the large and fluffy okay kind
yeah so you know again you really need to test for it there are some indirect things that we can look at but
ultimately ask your doctor to get a uh it's called an NMR panel or it will be
called an advanced lipid panel and what that will do is break down the size of
these different categories of cholesterol so understand first of all that LDL HDL these are categories of
cholesterol particles families of cholesterol particles and they come in different sizes and when we're talking
about LDL cholesterol we can really divide it into small and large particles
we call them small dense particles and we call them large buoyant or large
fluffy particles and the small dense ones are the ones that are problematic those are the ones that end up in the
plaques in Our arteries the large fluffy ones are not problematic they're the
ones that are doing what they're in the body you know designed to to do they're participating in our immune system
they're the precursor for many of our Vital hormones like testosterone and
estrogen uh and you know they are not the problem uh but again the standard
lipid panel that your doctor is most likely to get is only going to report LDL
and the standard view from the medical system is that we need to get that number as low as possible so you know
you should push them for an NMR panel and you know you're probably going to get pushback you're going to get told
it's too expensive um insurance won't cover it uh uh one of
the things they won't say to you is I don't know how to read that but that's oftentimes a barrier quite frankly
because again this is not something we're routinely trained to do uh the
reality is is that it's not that expensive a test if you want to get pay out of pocket for it there are websites
that you can get it for about 50 bucks um it's usually covered by Insurance in
my experience uh and you know and yeah of course your doctor has to know how to
interpret it uh although you know it's really not that hard they give you uh
they give you a lot of numbers so it looks complex But ultimately they're going to give you a LDL pattern they'll
call it and it's either going to be pattern a or pattern B uh and basically
just remember B is bad uh b means that you have more small dense particles a
means that you have more large fluffy particles and usually they'll also give a number to that they'll report an LDL
Peak size but that is a key piece of information because like I said if you
have a low amount of total cholesterol but your pattern B and all you know most of
your LDL particles are small dense particles that's a problem right and
it's a problem that doesn't get fixed by the medications this is something else for people to understand uh that you
know statins if anything they disproportionately lower the large
particles so actually the data shows that they shift people towards Pattern b
or you know put them deeper into pattern B if that's where they're starting and that's one of the reasons that I believe
that I see so many patients end up on my operating table despite the
fact that they've been on statins for decades in many cases uh and that's why
I think statins are not as effective as you know they should be if it was really
you know a purely amount of cholesterol problem well there you go a heart surgeon
telling you the dangers of statins that's uh that speaks volumes right there question on on these uh particles
right let's say somebody gets the LDL the NMR the nuclear magnetic resonance test done and they see at least
according to the lab report that I look at with my clients I believe it's 527 or under would be they're considered optimal range for the small particles
let's say that's around a thousand let's say it's double so there's just double of what the reference range shows for the small part yeah but they have
optimal HDL optimal triglycerides optimal inflammatory numbers should they still be concerned even though
everything else looks good or should they continue to monitor it what would be your advice yeah so again we have to
be careful this is where the Nuance of these tests comes in and you need to know a doctor who knows what they're looking at uh because that the number of
small LDL particles that's going to be reported uh we have to interpret that in
context uh because if you have a lot of particles to start with
um that number might be above the reference range uh but as a percentage
of the total amount of particles it might still be low so that's why the the pattern and the peak size numbers are
better numbers to look at because they kind of take that into account uh so
um you know I may or may not be concerned you know if that number is high I really then look at you know okay
are they pattern a or pattern B what's their Peak size um and uh that's you know that's what we
really should be focused on makes total sense so would you say that would be the best test to assess damage
to the blood vessels or is it a full picture that we're looking at well you know we do need a full picture and you
know ultimately what I say is if it's damage to the blood vessels that we're interested in let's look at that let's
not try and guess at that based on indirect markers uh and so one test that
I think is essential for people to get it's not a blood test it's a scan uh and it's called a coronary artery calcium
scan it's a type of cat scan um it's uh very easy to do the test they
don't have to put an IV in you you just lay down on the table it takes like less than five minutes to do
um unfortunately insurance won't cover it in most cases but it's a very
worthwhile investment in your health and it's not that big of an investment at most places here in the US you can get
it done for around a hundred dollars I see it as cheap as fifty dollars in some places and that's going to show us
whether or not you've had you know whether or not you're accumulating damage uh to the blood vessels in your
heart it's specifically looking at calcium Now understand like everything
it's not a perfect test uh because it's only looking at calcified plaque it
doesn't see the non-calcified plaque but it's a pretty good screening test and I think it's the most important screening
test we can do when it comes to our heart health uh and so you combine that with the
blood work and the blood work also gets you know there are other things we want to be looking at like you said we want
to measure that fasting insulin level we want to you know figure out if we're insulin resistant uh we want to be
looking at our glucose and our A1C levels uh there are lots of other things
that you know become important in this uh but you know those are some of the big ones and
um in terms of kind of bang for your buck where I usually Point people to
First is if you know your insulin level you have an advanced lipid panel and you
have a coronary artery calcium scan we're probably getting a pretty good picture of where you stand in regards to
your heart health yeah great advice especially with the calcium scan you know if your doctor is pushing that
Statin that could be a test you just get and you could show the doc look I have zero
and that's what you want you know the power of zero we call it so we want zero on there let's say somebody does have
um a score of like a 150 or 200 on that calcium score the CAC test
um when you go on Dr Google and you look and ask the question can you lower that
number uh most of what you what I have found is that you cannot now I've seen with a few clients that it has been
decreased but I want to see what you've seen uh is it possible to lower that score yeah I've seen the same thing now
uh you know with a number of clients that have been able to lower that score some you know I haven't seen anyone go
from 300 to zero uh but I've seen 10 to 15 percent decreases now uh and more
importantly and what I talk to people about is I see it stop getting worse uh
because I think that's the real key here if you're not at a point where you have you know clinically significant heart
disease uh whatever your coronary calcium scan is today if it's the same score a year from
now and five years from now you're probably going to be just fine uh and
again we have the scientific studies showing this uh but if it's going up 10
to 25 percent per year which is the average progression or if it's going up more than that certainly that's someone
who's in trouble uh so the goal really becomes stop it from getting worse and
sometimes yes we do see some reversal and lowering of these scores and that's great uh but focus on stop it from
getting worse is really the first thing I work with people on some some practitioners say you
shouldn't get that calcium score unless you're 40 or older what do you think about that yeah what I think about that is I now
see 30 and 40 year olds upper you know ending up on my operating table so I
think that we should be looking at this earlier uh and again you need to interpret it in the proper context you
know having a zero score at 25 or 30 doesn't mean the same thing as having a
zero score at 60 or 70. uh but if your score is non-zero in your 20s or in your
30s that should be a major red flag and I really mean non-zero I see 30 year
olds with a score of five or ten and you say well that's you know just a little dot of calcium uh but you know that is a
major red flag because that means that you've already had that significant damage and it's already progressing to
these Advanced stages and we really need to stop that from getting worse uh
because you can do the math that if you're five today and you're going up 25 50 per year it's not going to be too
long until you're in a couple of hundreds and you have significant disease and like I said I now routinely
see 40 year olds ending up on my operating table so certainly especially
if you have some of these other you know metabolic risk factors going on if
you're diabetic if you're obese if you have high blood pressure if you're a smoker uh get that scan early so we can
detect it early and we can intervene early what's the highest CSC CAC score you've
seen in a patient uh I've now seen uh actually I saw one a few weeks ago that
was over seven thousand uh that gosh do you know what their A1C was as well um
yeah their A1C was not good uh that was someone who uh had already started making some changes so I believe it had
been as high as like 11 or so in the past and was now down to like eight or seven or so uh that uh that that person
um you know it and it's interesting uh I've seen scores as low as two or three
hundred that actually ended up being significant disease um I've also seen scores as high as you
know 12 1500 that don't end up having significant disease so you know one of
the things about the CAC scan you know like everything else it's not as simple as one number to look at your total
score uh because understand that what that total score is is the amount of
calcium that you have uh in your blood vessels but you know you can have you
know one or two spots that have a lot of calcium that's built up very densely and
associated with that there's going to be a lot of plaque so that might be a significant blockage or you can have
kind of thin layers of calcium that are really spread out throughout the blood vessels that aren't going to cause
blockage but you know you get the same score uh when you total those so that's
you know again why it's important to have a good doctor who understands this I look at the pictures myself for all my
patients uh because I want to see that detail that you know the the uh the
Radiologists the doctors that are reading these scans don't really give you in the report uh they usually just
report the total score uh and that's not enough information that's an important tip right there make
sure the the practitioner reading is looking at the full picture and understands not just the total score we want to pay attention to
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today's video last thing on the topic of lab test before we move on here
what are your thoughts on high sensitivity C-reactive protein as it relates to risk of cardiovascular
disease yeah so I think it is another important task that I you know I certainly check on all my patients it's
one of the better inflammation markers that we have um and you know so it's again it's kind
of a screening test uh if it's low that's good and you're probably in
pretty good shape um if it's high the issue is that it really doesn't tell us where that
inflammation is and that's where sort of the detective work starts to come from you know is that inflammation in your
blood vessels is that inflammation in your gut is that inflammation in your joints um you know where is the inflammation
coming from uh is an important question but ultimately yes we know that having a
high CRP level it is a marker of increased risk for heart disease uh so
it's it's a it's a red flag it's something that I advocate for people to
get as part of that routine panel uh because inflammation as I mentioned is a
very important part of this process and CRP is one of the better ways of measuring that not the only way and
there are different things that we can you know start to look at I now um with my patients there are Advanced
markers that are more specific to vascular inflammation that we start to
look at things like myeloperoxidase or What's called the plaque test
lppla2 or you'll see it called plac test the plaque test and these are markers
that are getting to more specific vascular inflammation and they can be helpful in certain cases they're not you
know they those tests I kind of put in a secondary bucket like they're not the
test that everyone should be getting routinely but if there are warning signs if we already know someone has heart
disease based on a CAC scan for instance those are the tests that you know I now
get to do the advanced work around uh you know uh figuring out what's going on
stopping the progression and hopefully even reversing some of this disease great breakdown right there I have a
question on something that I used to I wrote I've written four books and my first book was
a 2018 called the perfect health booklet it's like a really hundred page simple booklet for health and I promoted fish
oil a lot for many many years and then I started to really dig into the research on fish oil and I did a
whole 180 and now I'm so anti-fish oil I know you're a big anti-supplement guy in general you believe you should get
everything from nutrition but whenever I make videos and content looking at the research on fish oil and why but I
believe it's it's more harm than it is good I get a lot of heat for it and when you think about a lot of conventional
cardiologists they are recommending fish oil and when I reviewed the Cochrane collaboration which does a good job
assessing different studies to tell you if it's works or not they essentially said there's really no benefit to taking
fish oil as it relates to cardiovascular health and as a matter of fact in some cases it actually could create a higher
risk so I want to ask you the question what are your thoughts right now on fish oil yeah so
um I'm also not a big fan of fish oil uh you know I look at the question this way
um why are we recommending the fish oil and the reason that fish oil gets recommended is because it's thought to
be anti-inflammatory inflammatory and that that sounds pretty good you know like I said inflammation is bad we want
to get rid of inflammation uh but the fish oil becomes like you know a pharmaceutical product where we're only
trying to treat the symptom and we're not asking about why do we have the inflammation in the first place so my uh
you know what I would advocate for people to do is let's figure out what's causing the inflammation let's eliminate
the inflammation and then we don't need anti-inflammatories uh and you know this
can be expanded some to all these things that we're told are antioxidants uh you
know again if you're not oxidizing things in the first place and you're not causing inflammation in the first place
you don't need anti-inflammatories and antioxidants there are many reasons that
I think uh the fish oil question becomes so complicated um you know a lot of the fish oil
products out there are manufactured in vegetables seed oils which are then
pro-inflammatory so you know any potentially beneficial effect uh is uh
causing things um but you know my answer for most people is okay well why don't you just
eat some fish you know and um you know and like I said get on a low
inflammatory lifestyle in a low inflammatory diet and you don't need the anti-inflammatory benefits uh and I did
air quotes there for people who are listening uh of these fish oils yeah I'm
glad we're on the same page there you're so right and get the EPA and DHA through eating the fish you know eat some some
wild caught salmon or some sardines or something like that you'll get enough I I was looking at what the requirement is
at least according to the NIH and the the NIH says uh an adult man six foot tall requires about 7.2 milligrams of
EPA and DHA daily to meet its needs their brain does and then I looked at
the average fish oil capsule it's a thousand milligrams and people are taking King two three four grams of it maybe per day it's a it's a super
physiological overdose that is very um the body's not going to know what to do with it and to your point part of the
reason that vegetable oils are so bad is because the way it's processed yes but
also the amount of double bonds that it contains and then at the high temperatures it's attracting so much
oxygen and it's oxidating fish oil has more double bonds than linoleic acid and
vegetable oils right so it's like you're actually taking something you think is anti-inflammatory and maybe some companies process it better than others
but over time it becomes inflammatory and it's just not what we want to do and
fish oil I think is actually has been adopted by a big Pharma now it's a multi-billion dollar com industry
so uh yeah it it kind of you know becomes a
cover-up for the vegetable and Seed oils because you know when we do the testing of people's fatty acids you know uh
compositions in their blood and we see this omega-6 to Omega-3 ratio and uh you
know we acknowledge that having too high a ratio is problematic um but we're so believing that you know
the vegetable and Seed oils are good for our health because they're lowering our LDL cholesterol uh that you know okay
you know that's where you're getting all the excess omega-6 from so the message became well you just need to take more
omega-3 to balance it correct and again the real answer is eliminate the omega-6
and you know and your omega-3 levels you know you can get adequate amounts from
diet um and you don't have to supplement with it yeah well said 100 agree with that
all right we're going to finish the conversation and land the plane with the question people are wondering all right
now that we discussed how uh the the blood vessels get damaged some of the testing and we did a master class and
what's happening there the history of heart disease now what do we eat I know yeah you're a big meat guy you're a big
carnivore guy but we see other plant-based doctors promoting that so what what can we agree to what are your
what are the general protocols we could follow in terms of yeah and you know this is what I really tried to do in in
my book uh is kind of you know clarify that question because same thing
you know I was going through this journey myself and you know I heard all these different uh arguments you know go
vegan go carnivore go keto go low carb you know like I said I really started with Gary Tobbs and go low sugar
um and of course I had heard my entire career go low fat so you know where is the truth what can we point to and
really what I found at a high level is um eat whole real food that's what it
comes down to first and foremost um it is clear that since the introduction of processed food uh our
health has worsened our bodies are not designed to handle this processed food uh you
know one of my favorite sayings to repeat uh and I'm not even sure where it came from at this point is humans are
the only species smart enough to invent their own food and dumb enough to eat it that's actually from me my friend is it
we go it only comes full circle uh but yeah you know that's what it comes down
to so true eliminate processed food first and foremost then you know your
balance between eating you know whole real animal proteins and eating whole
real you know vegetables and plants and fruits a lot of that is going to be
dependent on your situation um I would put forward that if you're
metabolically broken uh if you're insulin resistant um you need to lower your carbohydrate
load as much as possible and that includes the carbohydrates that are coming from whole real food I would also
say that if you have an autoimmune condition uh something like Hashimoto's
thyroid disease that I see so commonly um you know and many others
those autoimmune triggers are most likely coming from the plant kingdom uh
so you know this is an argument for going towards a carnivore diet or you know doing a strict carnivore diet but
if you're metabolically healthy and you want to have some carbohydrate you know whether it's fruit or vegetable and it's
whole real food and it's you know as clean as we can get it um I don't have any issue with that and
you know in my book I go through really all of these dietary strategies I talk
about the vegan diet I talk about the carnivore diet I talk about Mediterranean and keto and Atkins and
you know a bunch of others and I point out that they each have their pluses
they can each be done in metabolic publicly healthy ways and each of them also have their drawbacks you know and
uh you know there are some pitfalls that you have to watch out for uh but ultimately what I come down to is really
two questions you know are you metabolically healthy or getting metabolically healthier and how do you
feel and if you can say I feel great and I'm metabolically healthy on the food
you know strategy that you've chosen the answer is great keep doing what you're doing
um but if you're not we got to look at where the changes need to be made
well for being real most people are going to say no to that those questions and you know it's your point 88 of
American adults are unhealthy that was before covet it's probably much worse and I think the majority of Americans
also have some autoimmune conditions so to me all roads are kind of pointing for most people to start with a carnivore or
a low plant toxin sort of approach as they heal some things and maybe they could introduce some things back in I'm
a big fan of carnivore I I don't do it as strict as maybe you do it or maybe some other people in our space but all
I'm primarily meat based and I'll have some lower oxalate Foods maybe some fruits some white rice things that agree
with me in a metabolically healthy but I had to get to that point that is that is the goal for everybody to get to that
point is what Philip is saying here but you know real quick on the topic of carnivore as it relates to heart disease
and oxidation I've seen a lot of post-menopausal women and men who are doing carnivore for
quite some time get higher levels of iron saturation and ferritin levels and
would that put them at a higher risk of heart disease and what can we do for that yeah so you know it's interesting uh
I've actually had a couple of people bring this up to me um my observation is that the you know
increased ferritin is usually a inflammation problem and uh that is one
of the things that when I see it I've become really you know curious about
where do we still have some inflammation and I think a lot of people you know who have started on Carnivore diets
um you know still have a lot of inflammation to resolve and uh that ferritin can be an indicator of that
um beyond that you know if you've truly made sure that there's no inflammation and your ferritin is still high and we
think it's a true iron overload problem you know again I would say it's not
likely that it's you're taking in too much iron it's that there's something
amiss in the way that your body is processing iron and again we need then
need to start chasing that down we have been eating meat as the primary
part of our diet for essentially our entire evolutionary history
it just doesn't make sense uh that you know there would be something bad about
eating uh meat uh so you know and I acknowledge that yeah there are
these situations that some people they just for whatever reason they can't tolerate meat uh you know they've had
problems with their digestive enzymes um you know sometimes you have to do some manipulation you have to play
around with different types of meat and that is something that I encourage people to do you know I'm not a kind of
beef only carnivore um I do think it's important to have some diverse protein sources there uh
and you know for some people yeah you know B for maybe beef that's raised or
processed in a certain way doesn't agree with them and you have to look at other uh sources this can get pretty complex
um you know on one level I want the answer to be yeah just eat a you know animal protein based low-carb diet and
you're going to be fine but the reality of the situation is that our environment has become so difficult to manipulate to
manage uh that you know some of these problems get pretty complex and that's
where you have to find the good practitioners to work with ah so we're so well said yeah you're so right you
know somebody who's been taking antacids for years they go and they increase their meat and eat carnivore they're probably not going to feel good right so
it's like we gotta do something different for that person and you do a good job explaining that um final
question for you is around a supplement now I said you're not a supplement guy but this one you're going to love this
supplement because it is not only anti-inflammatory it automatically puts you in this amazing Happy State and I
call it vitamin G because it's the supplement of gratitude my shirt actually says it there so you don't have
to pay for this supplement and my question to you Philip is what are you grateful for right now what are you grateful for today
yeah you know I'm just grateful for the opportunity to be in this space uh to be
having these conversations and to be helping people in the ways that I'm now
able to help people uh and um you know it really you know when someone reaches
out to me on social media and says I read your book and I changed my life and you know all of these great things
happen you know that's that's what I'm here for uh that's what I believe you
know I was put on this Earth uh to do and so uh being able to have
conversations with people like yourself uh you know go to the conferences now
and meet the people that are doing all the great things in this space uh that's
where that's what I uh you know uh am most thankful for I love it it's such an
exciting time and uh you've been growing and reaching so many more people uh and I'm excited for you it's just the start
Dr Phillip ovadia thank you so much for coming on the show everybody his book is
called uh stay off my operating table a heart surgeons metabolic Health guy to lose weight prevent disease and feel
your best every day you can see it's right behind him if you're watching on YouTube podcast is of the same name stay
off my operating table anywhere else you want them to go Phillip yeah you know uh iFix Hearts is where
you can find me on most of the platforms you can go to ifixsharts.com find out about all the you know ways that uh me
and my team work with people and then uh Twitter iFix Hearts uh over on Instagram
I'm ovadia heart health uh uh but if you just put in my name uh OVA Dia you'll
find it and uh really look forward to hearing from people connecting with people I love getting messages and uh
please reach out and let us know how we can help you I acknowledge you Dr Phillip for your
dedication and the big heart that you have no pun intended there people you want to the lives you want to change the
disease you're preventing it's just it's so important it's so needed I love forward-thinking doctors like you
actually care about human beings so thank you for coming on the show I'm grateful for you next time we'll do
round two right here at keto Camp okay it sounds good and and special uh you know uh preview in a few weeks we're
gonna have you over on stay off my operating table podcast so uh be on the lookout for that one as well there we go
can't wait doc thank you
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