Insulin Doctor: The Fastest Way To Burn Dangerous Visceral Fat! I'm Finding Mould In My Patients!

If you have a belly sticking out, you

have a problem because the fat that's in

the stomach, that's called visceral fat.

This is very detrimental fat. And that's

the epidemic that we have today. But the

only thing that will make you lose that

fat very quickly.

Dr. Praep Jam Nadas is a worldleading

cardiologist

who has treated more than a quarter of a

million patients with chronic heart

disease.

Now he's using his voice to help

millions more prevent ending up on the

operating table through simple lifestyle

techniques. This is crucial. Glucose

actually is toxic inside the bloodstream

and the body cause insulin into the

bloodstream to push glucose out. But

frequent consumption of carbs, sugar,

processed foods is causing insulin to

stay up which can lead to insulin

resistance and you're going to be more

prone to heart disease which is the

number one cause of death all over the

world right now. But this is where

fasting comes in because after 12 hours

you start pulling the fat out. And the

first place the fat comes out of is

going to be visceral fat. But with

modern living, we have lost this

physiology of fasting. So we'll go into

that.

And there must be certain things which

people aren't aware aren't healthy as it

relates to my cardiovascular health.

Yes. So I see that people who overly do

aerobic activity, they end up with more

coronary artery disease than patients

who do short sprints and resistance

exercises. Then there's mold. And almost

70% of homes these days have some form

of mold toxicity in them. But also one

night of bad sleep, you become insulin

resistant the next day. And there's

calcium supplements, excessive fruit.

White rice.

White rice.

You'll be surprised how much arsenic

there's in rice these days.

I watch a lot of true crime. People kill

each other with arsenic.

Yes. And it'll slowly kill you. And

lastly, this is going to surprise you.

I see messages all the time in the

comments section that some of you didn't

realize you didn't subscribe. So, if you

could do me a favor and double check if

you're a subscriber to this channel,

that would be tremendously appreciated.

It's the simple. It's the free thing

that anybody that watches the show

frequently can do to help us here to

keep everything going in this show in

the trajectory it's on. So, please do

double check if you've subscribed and uh

thank you so much because in a strange

way you are you're part of our history

and you're on this journey with us and I

appreciate you for that. So, yeah, thank

you

[Music]

Dr. Pep Gnardas.

What is it you spent the entirety of

your career especially the last few

decades of your career focusing on

prevention of heart disease which is the

number one cause of death all over the

world right now. You see the heart is

made up of many parts. So this is

important. It's a pump. So it's a

muscle. So you have diseases of the

muscle and it's rampant these days.

Cardiomyopathy,

weakness of the muscle. Then you have

the arteries on top of the heart and

that's called coronary artery disease.

Diseases of the arteries they block up.

Then you have the valves. The valves

tend to get damaged as well. For

example, aotic stenosis. And then you

have the peripheral circulation. All the

blood vessels that go to your corateeds,

your brain, your legs and to all the

organs of your body. And then you have

microvascular disease which is the tiny

capillaries

that they become dysfunctional as well.

What's a capillary?

Capillary is the branch of the branch of

the branch.

Okay. So like the tiny little veins

final ones. Yeah. So when they become

dysfunctional that organ becomes

dysfunctional as well. So cardiology

affects all these aspects.

And how long have you been operating on

people's hearts? about 35 years now.

And how many hearts do you think you've

treated?

In excess of 30,000.

And what what's the age range of those

patients?

They were used to be mostly older people

over 65. Now I would say 50% of them are

under 65 and 50% are over 65. So the

demographics is changing. The younger

people are developing heart disease. So,

the youngest patient you've ever

treated?

28.

And what what was the predicament in

that case?

He was having a full-blown heart attack.

So, that means that one of his arteries

was completely clogged up. It had a

blood clot in it. There was no

circulation past that artery and

therefore he was having acute chest

pain, sweating, blood pressure was low.

He comes straight to the hospital. I

rushed to the hospital, take him

straight into the kath lab and try to

open up that blockage. And we did open

up that blockage and put a stent in it

and got rid of that blockage immediately

to restore that blood flow to the heart

muscle.

And at 28, how does one get a heart

attack? You said it was blocked up.

There's a lot of nuance in that. Most

people don't understand what a heart

attack is. So, in a nutshell, I'm going

to tell you what it is. When you have a

plaque, a plaque is a buildup of a

little

fibrous material inside the artery

and that doesn't cause a heart attack. A

heart attack is caused when one of those

plaques

cracks. Now in this diagram for example,

it's showing that the plaque is closing

up the artery and this will cause

angina. That means a lack of blood

supply over here. So this patient may

complain of chest discomfort or he may

not complain of chest discomfort because

remember when you have a blockage like

this only 20% of the patients actually

get chest pain.

That means that you could have a

blockage like this in a patient and you

may not have any chest discomfort and

the only way you're going to pick that

up is by doing a stress test or a

coronary calcium score or some other

modality to see whether he has blockage

or not. A heart attack is when a minor

blockage which is not causing much flow

disturbance suddenly cracks

and what happens to the the plaque that

come that cracks off

and when it cracks open the blood that's

going past it sees the crack and wants

to repair it and forms a blood clot on

it. So the final thing that shuts down

that artery is a blood clot. It's not

the plaque that shuts it off, it's a

blood clot. So a heart attack is caused

by a blood clot at the sight of a

rupture and what causes rupture is

inflammation.

Okay. So when people say that heart

disease is the number one killer of

people generally that are that are

diseased. Is it that process that's

causing it alone or is there a multitude

of processes that lead to heart disease?

There's a multitude of things that lead

to heart disease. Look,

that was a heart attack. That's right.

So, one, you're making plaque. You

shouldn't be making plaque.

A plaque is an inflammatory

area inside your arteries. It's reacting

to something. And I can go into the

nuance of what's actually what's the

body reacting to? What's inflammation?

Inflammation is reacting to something.

What is that something? And I think it's

important for your audience and

everybody to know what that something

is. Now, you've got this pimple. Think

of it as a pimple on the inside of the

artery.

Now, one day when there's enough

inflammation in your body systemically,

that pimple is going to crack open just

like a pimple on the skin breaks open.

Now, that artery has this little pimple

on the inside and it cracks open and a

blood clot forms on it and that's a

heart attack. So, you don't want plaque

formation. You don't want plaque

instability which is rupture of that

plaque and you don't want a blood clot

to form on it. There are factors that

affect each of these processes and all

three processes are going wrong today

and that's why we have so much plaque

formation and instability of the plaque

which then leads of course to heart

attacks and our blood in general. We

have more coagulation issues today than

we ever did before. Which means our

blood because of inflammation is more

ready to clot more easily. So we having

the perfect triad.

It's the perfect storm. That's why we're

seeing an epidemic of this. And that's

why we're not making a dent in it. Yes,

you can have a plaque rupture and have a

heart attack and we put a stent in you.

Okay, that's fine. But what did we do to

look at the underlying reason as to why

you formed that plaque and why did you

rupture it and why was your blood so

clotty in the first place that made you

actually seal off the artery?

Is this an increasing problem?

Yes, it's a it's a huge problem because

those factors have been identified now

and that's what we go for in my

practice. We look for the factors. Why

did you make this plaque?

Why is there so much inflammation in

your body? Inflammation is a reaction to

something foreign. What is that foreign

stuff? What is that abnormal physiology

in you that your body is reacting

against? Cuz that's what inflammation

is. And inflammation, of course,

whenever there's going to be

inflammation, there's going to be

increased tendency to make blood clots.

So, we go in, we chase all these things

in patients to find out. And that's the

real prevention.

that 28-year-old that came in um and you

treated him, was it was that a surgery

you did?

We call it a surgery, but it's not. It's

a it's a angoplasty. So, we go in from

the wrist.

Yeah.

Or we go in from the groin with a

catheter and we go into the coronary

artery.

A catheter being like a tube.

It's a hollow tube. And we put it into

the coronary artery. We shoot the dye

inside. We can see where the blockage

is. And then we thread a tiny wire into

that artery through the blockage and

then bring in a balloon and squash the

blood clot out of the way. Restore the

circulation

and then bring in a stent. A stent is

like a spring that opens the artery up.

We leave the stent inside there. We

remove everything else and now you have

an open artery and you have blood flow

going down that artery.

And what had that 28-year-old done to

end up in your surgery? What were the

decisions that they had made that

brought them there?

So, he was number one, he was

overweight, but he wasn't just

overweight. The overweight was all in

his belly and he had a fatty liver and

he had what is known as visceral fat. He

was not a diabetic, but he was a

pre-diabetic.

That means he had a lot of insulin in

his body and his glucose levels were

good. So, if you went to his family

doctor, they would say, "Oh, you're not

a diabetic. your hemoglobin A1C which is

a blood test that you do for diabetes is

actually okay but actually that patient

had a very high insulin blood level. Now

insulin is a very aogenic molecule. It

causes smooth muscle proliferation.

Smooth muscle is in the walls of the

arteries. It causes vasoc constriction.

It makes your blood more clotty and it

causes inflammation.

So this patient was a pre-diabetic

and this is very important and this is

what caught my attention because when I

looked at my patients that were coming

in with heart attacks and hardening of

the arteries and when I tried to

identify why they doing this none of

them were diabetics

but then I did a glucose tolerance test

on them and what happened it was just by

chance that I happened to have these

tests in my office where you can measure

the blood glucose. So I had about 120 of

them. So I said, "Look, let's just do

some random testing on these patients

and I found that at least half of them

had no diabetes but their glucose

intolerance. That means that the sugars

went up but not enough to make them a

diabetic but it did go above the normal

range. We did not have insulin testing

at that time. About 10 years later, we

started testing insulin in the office.

And I bought a machine for this purpose

in my office to measure insulin levels

and life was never the same again.

Why?

Because it's all about insulin when it

comes to the metabolic derangement. So I

found that these patients the sugars

were going up to 150, 160 after giving

them a glucose drink.

Mhm.

So you say, okay, he's not a diabetic.

Look, the sugar didn't really go high,

but when you measured the insulin level,

the insulin was off the roof.

So, when you say this is an insulin

problem, can you explain this to me?

Like, I have no idea what glucose and

insulin are for for any of my listeners

out there that have a inexperienced

understanding of these these these terms

and what they what they do and mean.

It's crucial. Everybody needs to

understand the relationship between

sugar, which is glucose, and insulin.

When you consume sugar or glucose, the

body has to get rid of that glucose very

quickly from the bloodstream because

glucose actually is toxic inside the

bloodstream. Even though it is what the

body uses for energy in the bloodstream,

it glycates all the blood vessels and

the walls and the components in blood

and hemoglobin as well glycates it. That

means a glucose attaches itself to that

molecule. So now that molecule can't

work properly. That is why the higher

your blood glucose,

all your chemicals don't work well, your

enzymes don't work well, your hormones

don't work well, nothing works well, and

you age prematurely because you're

getting glycation. Glyca, a glycated

molecule can't work normally. It doesn't

function normally.

So when you consume the glucose, the

glucose has to come out of the

bloodstream. And how does the body do

it? It sends a message to the pancreas.

The pancreas says, "Aha, I'll make some

insulin." It pours insulin into the

bloodstream. Insulin comes into the

bloodstream, pushes the glucose into the

cells. And where does it pushing it?

Into the liver, into the muscles, into

every cell in the body. Insulin will

push glucose out. Now, how much insulin

is the question.

If I'm eating every 3 hours and I'm

consuming glucose or I'm consuming

starchy foods or I'm consuming

carbohydrates. Now watch where I'm going

with this because you're already

beginning to know where I'm going with

this. I'm consuming glucose and carbs

every 2 three hours. I'm stimulating my

pancreas. I'm stimulating my insulin. My

insulin goes up, it comes down. But

before it even gets a chance to come

down, it goes up again.

So the repeated consumption of and

frequent consumption of glucose is

causing my insulin to stay high because

insulin stays a little bit longer in the

bloodstream than the glucose. The

glucose will come down in about 2 to 3

hours but the insulin stays higher for

about 4 hours. Now what happens is that

you continue this lifestyle for a few

years.

Now the body because these are all

hormones will say well you know it's I'm

going to need to make more insulin now

you become insulin resistant. Any

hormone that stays in your body for a

long time the body becomes immune to it.

So the next time I eat the sugar I'm

going to have to make more insulin to

produce the same effect. That is called

insulin resistance. So now you got this

patient who's been eating carbs,

sugar,

processed foods. What does that mean?

Processed foods that means foods that

are quickly absorbed into the

bloodstream. Processed foods, these are

products without fiber. So the

absorption is very quick. So the poor

pancreas has to react just like that.

Produces a whole bunch of insulin. And

then the frequent eating and the

frequent consumption makes you insulin

resistance. So now you produce a whole

bunch of insulin in order to bring that

sugar level down. So then you say, okay,

well it doesn't matter because insul the

insulin is bringing the sugar level

down. So what's the harm done? Because

your A1C is still good. You're not a

diabetic. No, but it's that background

high insulin that is destroying your

metabolism.

It's that high insulin level in the

background. So insulin pushes glucose

into the liver and you develop a fatty

liver.

It pushes the calories into production

of new fats around your viscera. The

viscera means in your belly around your

pancreas you get visceral fat. Now this

fat is produced from glucose. It's a

different kind of fat. Look if I gave

you a high calorie diet right now of all

sorts of foods you put on weight

everywhere. Okay?

But if I give you glucose, you put it on

mostly in your stomach and your stomach

will protrude and that's called visceral

fat. It's on the inside. You can't pinch

it. It's on the inside

around your organs

around the organs. This is very

detrimental fat. And that's the epidemic

that we have today. And that's a direct

result of eating, you know, starchy

glucose, carbohydrates, which creates

insulin, which creates this downstream

effect on

wrong foods and eating too frequently.

Too frequently. Okay?

Because remember, it's also the

frequency of eating because before that

insulin gets a chance to come down.

You're already popping yourself with

more food and hence you develop insulin

resistance. You get a very high insulin.

It takes this much insulin now just to

bring that sugar level down. And then

the one day when you cannot control that

sugar now that sugar will go out and now

your doctor will say you're a diabetic

but by that time you've already had 10

years of hyperinsulinemia.

So what happens if by the time you make

a diagnosis of diabetes to say well now

your sugar is really high it is high

because your body has not had the

ability to keep it down. Why? Because

even that high insulin could not keep

your sugar level down. You became a

diabetic. You lost that whole

opportunity of prevention. It's those 10

years. Look, by the time you're a

diabetic and you come and see Dr. Jay in

his cardiac clinic, you already have

coronary artery disease. Like that

28-year-old, that 28-year-old didn't

have diabetes. He already has coronary

artery disease. By the time you are

diagnosed as having diabetes, you

already have coronary artery disease. We

have a great opportunity here to

actually start screening these patients

with insulin levels very early on. But

most doctors don't have the ability or

knowledge to do the insulin level

testing, but it should be done.

In someone like me, I'm 33 years old

now. When does the damage begin?

It starts right now. It starts right

now. As soon as you around 30, you're

already starting to have trouble. You

have to But you know, this is what I do.

I look at that patient walking into my

room and if I see that he's got a belly

sticking out, I already know he's

probably got insulin resistance because

all the fat is in here. Because the fat

that's in the stomach, sideways, he

looks terrible. From the back, he looks

great. His waist is increased.

Mhm. He doesn't have all the fat

everywhere else in his body. That's the

phenotype of somebody who has

hyperinsulinemia.

That same person goes on a cruise, he'll

come back 5 to 10 pounds more because

he's got so much insulin in his body.

Insulin is a storage molecule. Puts

everything away. And it's very hard for

him to lose weight.

Why is it harder? you the only thing

that will make you lose that fat very

quickly is to change your diet of course

but you have to do fasting because

fasting brings your insulin level. See

this is where fasting comes in. So what

does fasting do?

Do you mean fasting or a calorie

deficit? Is it or is it the same thing

in your view?

No, they're not the same thing. They are

not the same thing. You see when you

don't eat your insulin levels come down

because you not stimulating your

pancreas anymore. So you want to bring

your insulin levels down. the best thing

you can do in the world is to do fasting

because there's no look if I just simply

cut down on my calories

then there's a different physiology

that's going to take place in the body

and when you fast there's a totally

different physiology when you cut down

on calories the body senses that this

caloric deficit your metabolic rate

changes actually slows down and the body

will start breaking down everything

muscles

included. So you lose fat and you also

lose muscles. On the other hand, when

you're fasting, it's a different

physiology.

Fasting is I've put on fat. Now I'm

going to take it out of the bank. Now

the bank is going to be available for me

to pull out my calories and use it now.

And you start burning the fat. So in the

first 12 hours of a fast, you take out

all the glucose in the form of glycogen

from your muscles and your liver. After

12 hours, you start pulling the fat out.

And the first place the fat comes out of

is going to be visceral fat. That is why

fasting benefits you so much because it

gets rid of that worst fat. The fat that

is very inflammatory. You see, if I did

a biopsy of your visceral fat versus a

biopsy of let's say a fat form on your

buttock,

two different types of fat. One is full

of inflammatory molecules. The other one

is not full of inflammatory molecules.

One is producing interlucan 6 and tumor

necrosis factor and this other fat is

not. These are two different fat

stoages.

Visceral fat is very toxic. It's very

inflammatory. And that is why patients

who have visceral fat make all these

molecules. So when I do the blood test I

see that oh you've got so much

inflammation. You've got interlucan 6 is

high tumor necrosis factor is high. Your

CRP is running high. And one of the

reasons for this is not just leaky gut

and other things that I look at, but in

your case is also because you have a lot

of ectopic fat. Ectopic fat. Ectopic fat

is now we realizing is not just only

around the liver and around your

pancreas, it's also around your heart.

So when we look at the coronary arteries

and we see all those fat around the

coronary arteries, you had a very nice

diagram right there and you can see that

around each artery

there's that yellowess that yellow is

all plaque

fat. There's fat around that and it's

plaque forming. It's plaque forming. It

stimulates plaque. It's inflammatory.

And now we can do CT scans that will

actually detect how much inflammation is

in the fat around the arteries as well.

Ectopic fat is in the around the

coronary arteries. It's in your liver

and in your pancreas and it is very

inflammatory.

On this point of fasting, so if you have

someone come to you and that, you know,

they have that physique where there's a

bit more of that protruding belly fat,

you said that fasting is a much better

approach than just sort of a calorie

restriction. was looking at some studies

that said research shows that calorie

deficits of any kind can reduce fiscal

fat, but fasting will give it an edge

because of the insulin sensitivity stuff

that you talked about as well. What kind

of fast should one be doing? Because

there's so many different names for

these fasts. People do these 40-day

water fasts and they do intermittent

fasting.

It's a great question. So, there are

many, many different types of fasting

depending on your goal on what you want

for that particular patient. So if a

patient is just simply looking to reduce

his visceral fat then I start with 1212

which means 12 hours you don't eat

anything. You just drink liquids with no

calories in it and then 12 hours is your

feeding period. We start with that and

we do that for about 2 to 3 weeks. Then

we quickly move to 186.

186 means 6 hours you get to eat. 18

hours. It's only

water, black tea, black coffee, green

tea, no calories. 186.

186. And then that's one type of

fasting. Now, if a patient is very

overweight, a patient has diabetes and

your goal is to reverse the diabetes,

the patient needs to lose 60 pounds,

then those patients have a special type

of need. For them, I will take them to a

48 hour fast once a week. Sometimes I'll

go to a three-day water fast every 9

days.

Every 9 days, you will do OMAD. OMAD

means one meal a day only, every day for

9 days. And then you're going to give me

a three-day water fast.

Is the same advice applicable to women?

because obviously they're contending

with a variety of hormone fluctuations

and estrogen and I know that the the

female body responds differently to

these kinds of stresses like fasts.

I've been asked that question so many

times from patients as well. Most of the

women can actually handle it. The only

women that cannot are those who are

trying to become pregnant or or they

have um or they're already pregnant. I I

I think that women are not that

different when it comes to the fasting

programs. So, in my experience, I've

been able to get women to fast. I just

finished a fast on one lady just now for

72 days. 72 days. She was terribly

overweight. She had diabetes. She had

hypertension. She had hyper lipidmia.

She was having hip replacements, knee

replacements, joint problems. She had

skin problems. And we fasted her for 72

days.

What did she have in those 72 days in

terms of drinks, electrolytes, coffee?

What was she?

Great question. So she would have black

tea, black coffee, water, and in the

water once a day I tell her to put some

electrolytes in there. So there's a

electrolyte called element or sometimes

I just tell them to go buy some Celtic

salt and put half a teaspoon in there

and once a day you take that. If you get

cravings and you feel really really

hungry, take some MCT oil, a teaspoon,

and put it in your water and you can

drink that as well. I

think it's worth saying that probably

you shouldn't try this at home, ladies

and gentlemen, because obviously medical

supervision is critical here. But in the

case of that lady, what was the before

and after of that 72-day fast? So,

diabetes gone, blood pressure

normalized,

weight loss, tremendous weight loss. I

mean, I think she lost about 55 60 lbs.

Wow.

Okay. And not only did she lose all that

weight, yes, all that weight from her

belly was gone, but even her face under

the arms. So, when you lose weight in a

fasting program, it's very different

from losing weight when you are

restricting calories. you actually

retract your your skin. So you get real

changes in your entire body. These

patient I had one patient that fasted

for 183 days under supervision. Okay. So

he went from 400 lb to 210 lb. And when

he walked into the office, you would not

recognize that he's just lost all this

weight because he did not look like skin

on top of bones and then having to have

surgery to remove all that excess skin.

Fasting is a totally different

physiology.

In fasting, you you you you the body is

doing a whole lot of things that are

very different. And we can go into the

physiology of fasting because that's

fascinating. It's a physiology that has

not been used by us. We've lost it. So

one of the things about modern living,

modern living, we have lost this

physiology of fasting. First of all, why

do we still have that physiology in us

is because it's supposed to serve a

purpose because we're supposed to be

fasting and feasting, but now we're only

feasting all the time and we're not

fasting.

In order to go back to normal, you

should be fasting. Fasting is supposed

to be a normal part of your existence.

That's the way you were designed. Not

this modern industrialized living that

we've been doing in the last fraction of

a millisecond in the total existence of

the human race. We've changed our

lifestyle so much. Modern man has. But

our genetics and our physiology has

lagged behind. We were supposed to use

fasting and feasting as part of our

normal program, as our normal

physiology. That's why we still have it.

That is why after 12 hours you start

making some more ketones in your body

and the ketones come from fat. You're

moving that fat out of storage.

What is a ketone?

Ah ketones. So ketones are a energy

molecule produced by the liver. How does

it make it? It makes it from fat. So the

fat gets liberalized. And by the way the

fats only start moving when your insulin

levels are down. So because of fasting

your insulin levels are really low now.

Okay? Because you've been fasting right?

So now the fats start dissolving. So you

get free fatty acids. The free fatty

acids float into the bloodstream. Free

fatty acids are fat products. They float

into the bloodstream. They go to your

liver. Your liver converts those into

ketones. Now ketones are an energy

source of the body, an alternative

source to glucose. So in general terms,

you are either going to be running on

glucose and glucose metabolism or you're

running on ketones. Okay? And so ketones

basically show up in the when glucose

isn't around.

That's absolutely right. So ketones and

ketones are actually a cleaner fuel for

the body. And in terms of producing

reactive oxygen species in the

metabolism, the way your mitochondria

work, you actually produce less reactive

oxygen species, which is damaging to

your physiology when you're in ketones.

And ketones are signaling molecules that

also change your physiology in a number

of ways. Number one, it causes the

production of brain derived neurotropic

factor that occurs under ketogenesis.

Brain derived neurotropic factor which

means that you become smarter, you're

growing new cells, your reflexes are

better, your visual acuity is better.

Why? Because nature wants you to become

a better specimen so you can go out and

get your next kill. So, why don't we all

just stay in a state of ketosis then if

it's so miraculous?

Well, that's a great question. You don't

want to be in ketosis all the time

because that's not what ketosis what

what our physiology was made for because

then you'll just be burning fats,

burning fats, burning fats all the time.

And that's not a good state to be in

constantly either. So, you want to be

able to do both. You're supposed to get

your current account and your deposit

account. You're supposed to work with

both of them. That's the normal

physiology. So not only brain derived

neurotropic factor increases but also

stem cells. Stem cells are amazing.

And in my patients of course I see that

what what is a stem cell?

Stem cells. So stem cells are we all

have stem cells and we all still make

stem cells and they are produced by the

bone marrow. These are pur potent cells.

Cells made that will then go out and

become whatever they need to become. So

they can go out into your circulation,

become a muscle cell, they can become a

retinal cell, a skin cell. They can

transform into anything. So what happens

is that when you break your fast Mhm.

you get a surge of stem cells coming out

of your bone marrow. Some of them become

immunocytes. That is why we know that

fasting also boosts your immunity.

People who fast get less infections, get

less sore throats and coughs and colds

and the viruses that are going around.

The immunity is better. The stem cells

are not I'm particularly interested in

the stem cells because of a thing called

the progenitor cells, endothelial

progenitor cells. Progentor cells are

you see you're always hurting your blood

vessels the lining of the blood vessels

and the lining of your blood vessels

have to be constantly repaired and they

they are repaired by the progentor

cells. When you do intermittent fasting

and timerestricted feeding you will

produce more and this has been shown in

numerous studies more progenitor cells

and these progentor cells go and repair

your blood vessels. So I do what why am

I interested in this? Because I'm a

vascular doctor, I want my blood vessels

to constantly be repairing themselves

from the damage that we do in day-to-day

life. So stem cell mobilization, brain

derived neurotropic factor, growth

hormone, you make more growth hormone in

fasting.

So when should you exercise when you're

fasting? At the peak of your fast. So,

if I'm going to break my fast at 6:00

p.m., I tell patients to go out to the

gym at 4:00 in the afternoon.

But I said, "But doc, how can I do

that?" You will find that you will put

on more muscle and you'll retain more

muscle as well because you have higher

growth hormone. The fastest way and the

best way to actually increase your

growth hormone production is to do

intermittent fasting.

When I sat with um Dr. Stacy Sims, who

does a lot lot of um work on women's

physiology and women's performance. One

of the things she said to me is that if

a woman in particular

tries to do a workout fasted, the body

will break down the muscle in a woman

because she said a woman's body is much

more the hippamus. It's much more

sensitive to changes in a woman's

glucose levels because it's trying to

defend against, you know, pregnancy and,

you know, all these kinds of things. So

it shuts down the menstrual cycle if

there's not enough glucose in the blood

and and so she said for women in

particular you do you do want to have

eat something before you work out or it

will your body will take from the muscle

and it will definitely won't the body's

very sensitive. It won't want to to help

you build muscle if there's not enough

glucose energy in the body. She said for

men it's slightly different because

we're a little bit more robust and we

were meant to hunt. So if we were

fasted, our body is, you know, designed

to kind of keep up its normal processes

to help us complete a hunt, per se. So I

guess I throw this question out to you

about about women exercise and fasting.

Yeah, I think that's a great

observation. So again is what kind of

exercise is the woman doing? You see,

now there's two kinds of basic

exercises. One is aerobic activity

and one is uh resistance exercises. And

you can also throw into that

highintensity interval training. Mhm. So

when it comes to the training that I'm

talking about in a fasting state, I like

resistance training. So in resistance

training, that glucose issue is not

going to become a problem. Now, if

you're going to put that female patient

on a treadmill and make her run for a

long period of time, let's say you're

going to make her run for 40 minutes on

the treadmill. I think that yes, you're

absolutely right. You are going to

deplete her glucose and you may cause

some problems and then the muscle will

start breaking down. But I do believe

from all the experience that I've had

with my patients that when I tell them

to do HIT, which is high intensity

interal training, all the women do just

as well as the men because all you're

doing is you're intensely working the

muscles and you're doing some resistance

exercise and then you're totally resting

as well. And I see fantastic results

with that.

In terms of ketosis,

do you cycle in and out of a ketogenic

diet? And just for anyone that doesn't

know what know, a ketogenic diet is a

diet that's very, very low in

carbohydrates. So less than 50 grams of

carbohydrates a day typically. Do you

cycle in and out of that diet?

Yes. Yes, you have to because I don't

want them to stay in a ketogenic state

all the time. So I do I do I do I tell

them, look, look, what is your goal

here? What is your goal? If your goal is

that, okay, I need to lose 70 lbs. Then

you're going to do this till you get to

your goal. Once you get to your goal,

then you're going to go back to

timerestricted feeding, which means 186.

So, you'll still make some ketones. And

then intermittently, you can still do a

36-hour fast. That means normal, healthy

people, you and me, we should still be

doing one 36-hour fast at least once a

month. So, we'll go to that. We'll go to

that. Fasting must still become part of

your pro, but you don't need to stay in

ketogenesis all the time. Remember also

that when you are in ketogenesis you are

you are also in autophagy.

How much autophagy can you do? That

means you recycling all your your partic

all your organels inside your cells.

What does that mean in simple terms for

someone that doesn't know the term

autophagy?

So bottom line is the cell senses that

there is no new parts coming in here. So

it takes the redundant

organels inside the cells and breaks

them down, packages them up into these

little packets and exports them out of

the cells. So these cells, all your

cells in the body now are functioning at

a much more efficient level. So

mitochondria

also have autophagy. So you're getting

new mitochondria. You're repairing your

mitochondria. And you know it's all

about mitochondria, right? Your energy

mitochondria are those organs organels

inside each cell. And we just think of

them as only an energy source that oh

yeah my mitochondria they make ATP.

That's not the whole story. Yes, they

produce ATP, but they also produce this

thing called reactive oxygen species

and thereby they influence

the metabolism of your of your cell as

well. They send signals they send

signals to your to your chromosomes so

you start producing new proteins. You

start producing new molecules. So your

mitochondria are very important. If you

have old mitochondria, you're going to

have fatigue, tiredness. But when you

get mphagy, one reason why you feel so

good after a fast because you have new

mitochondria, they are much more

efficient in producing ATP and less

reactive oxygen species. So you have

mphagy, recycling of your parts,

cellular function improves, toxins get

out of your cells as well, toxins.

Do you think there's a preferable or a

best exercise for heart health? Like if

you were going to say Stephen to make,

you know, my my I think my family has a

history of heart related issues. One of

my my uncle died from a heart attack. So

I'm very aware of

my own susceptibility to heart related

illnesses. I think there's other people

in my family um that have heart related

issues as well. Is there a particular

exercise that is best for the heart? Cuz

I'm guessing resistance training, i.e.

strength training might not be the the

number one recommendation for good heart

health. You mentioned HIT. I'm wondering

if that's

Yes. So, I'm just going to tell you

broadly speaking what I see in my

practice. I see that people who do

overly do aerobic activity. That means

they cycle 100 miles a day or they're

running on their treadmill for two hours

at a time every day. They're doing a lot

of lot of marathon training all the

time. They actually end up with more

inflammation in their body and they end

up with more coronary artery disease

than patients who do short sprints and

patients who do resistance exercises and

patients who do hits. So in terms of

cardiology, you look, you need some

aerobic training. Why? Because you want

to develop some endurance, right? You

don't want to be running behind the bus

and and get short of breath just in a

few hundred feet. So for some endurance,

you do aerobic activity. How much

aerobic activity which is running on the

treadmill for example or just sprinting?

Only about 15 to 20 minutes. That's it.

So I tell patients you want to run on

that treadmill, you want to bicycle 15

to 20 minutes and then you got to go

into resistance exercises. The

resistance exercises that I have seen

work best in my patients is simple

things. You don't have to go crazy. You

do flow exercises. You use your own body

weight as resistance. So you can do the

planks and leg lifts and all these other

exercise and you can do hit but they

have to be very specific. So you

exercise really hard for about 30

seconds to 45 seconds and then you

completely rest for another 30 to 45

seconds.

Okay?

And that's allowing your body to clean

up the reactive oxygen species you just

created through that exercise. Because

your rate limiting step in cleaning up

the metabolic mess that you get when you

get too much exercise, it's a rate

limiting step. your glutathione

production, your superoxide dismutase

production. These are chemicals that

clean up the metabolic mess that you get

when you get too much activity. That's a

rate limiting step. So when you rest,

you exercise and you rest, you exercise,

you rest, you are going to get a cleaner

physiology

with your patients. How many patients do

you think you've treated or worked with

in your career?

Did

you have to guess to the nearest

thousand?

It would have to be at least nothing

less than nothing less than quarter

million.

How do you deal with the heartbreak? And

that's no pun intended, but I'm saying

like how do you deal with the heartbreak

of watching people's lives

either them losing their life or their

their lives being changed permanently

forever or dealing with the families of

of people who lose their husband or wife

or or or son or daughter.

It it's very difficult especially when

we've been trying everything and still

things can go wrong. Based on that, I've

realized that sometimes you can do

everything to try to extend life, but

you cannot. Life is still finite. We

will pass. Yes, but we want better

health span and we want a longer

lifespan. I want to give the patients a

better quality of life also. I can't

make you live forever. I will see people

die. Sometimes they die in front of me

while I'm even holding their hands.

They'll pass away in the hospital right

there. But what I do want to do is to

give them a quality of life until then

that's going to change. And in all this

education,

it's all so that you can live an optimal

life and then pass away just like that.

Have you seen many people that made all

the right decisions? They were healthy.

They had a good diet. They were doing

exercise and they still end up passing

away on your hospital table because of

heart related illnesses.

Yes. Yes.

Give me one such example.

Typical example of fellow in the 60s.

His coronary calcium score was over

1,000. So you know that's a CT scan that

we do and it looks at calcium on the

arteries of the of the wall. So all this

plaque that you you you showed this

yellow stuff here, all that has calcium

in it. So the more calcium you have, the

more plaque you have. So he had a

calcium score of over a thousand. So sit

down and talk with him and say, "Okay,

so tell me why do you have all this

calcium? No diabetes, no high blood

pressure. Doc, I don't even drink. I

don't do anything. I don't smoke. I

exercise regularly. I go to the gym."

And then the question is, why do you

have all this coronary calcium in your

coronary arteries now? And it turned out

that ever since he was a kid, he had a

bad microbiome.

And in him, I found that that was the

reason why he got it. So he was shocked

when he left the office. He was totally

shocked because he thought that being

constipated and having a bowel movement

every three or four days

is just normal because it was always

like that for him until I dug into it

and found out that he's actually got a

lot of GI problems and that's what

probably caused him to have inflammation

and that's what's probably caused him to

have coronary artery disease. That's why

he's got all this coronary

calcification.

Yeah. So let's talk about the gut

microbiome then. You you mentioned

earlier that that's really pertinent in

cardiovascular issues. Can you explain

to me exactly why and how that happens?

The biggest difference between you and

your outer environment is actually your

gut, not outside your skin. It's

actually the gut. There's a 100 trillion

bacteria sitting in there and there's

probably 400 trillion viruses sitting in

your gut and they're not just hitching a

ride for you. They are there doing

something. There's a symbiotic

relationship between the gut and you.

They produce micronutrients which get

absorbed into your bloodstream. If the

right microbiome is not present, you are

being deprived of those micronutrients.

For example, short chain fatty acids

which are special kind of uh thing but

also they maintain the integrity of the

lining of the intestines. If the lining

of the intestines is breached then

bacteria wall products get into the

bloodstream and the first place they'll

get to is the liver. Hence you get a

fatty liver. There are basically three

reasons for fatty liver. Either you're

drinking too much alcohol or you get a

leaky gut or you have too much insulin

because insulin causes the conversion of

glucose into fat. Right? So you get a

fatty liver.

When you say leaky gut,

so that's a leaky gut.

Oh, okay. So leaky gut is when the

microbiome is dysfunctional.

The microbiome that is dysfunctional

causes the integrity of your intestinal

lining to be compromised.

Ah okay.

Yeah. So now molecules that are supposed

to stay in the gut, dead bacterial wall

products, they call lipopolyaccharides,

they're supposed to stay in the gut, but

now they get into the bloodstream, they

go up the portal vein, and up the portal

vein, they'll end up going straight to

the liver. And when they end up in the

liver, they cause that fatty liver. Now

you get this big fatty liver, which

causes a lot of inflammation. a fatty

liver. There's an epidemic of this going

on today. At least 25% of the population

now have a fatty liver.

And what is upstream from that? Is it is

it alcohol and all these processed foods

and things like that or

it's basically processed foods, sugar

and leaky gut and of course toxins.

Alcohol being the biggest toxin.

Okay.

This is the seat of metabolism. So, as a

cardiologist, I became interested in

this because I found that if you have a

fatty liver, you're going to be more

prone to inflammation

and you're going to be more prone to

coronary artery disease. When we fix the

fatty liver, we change the diet through

fatty by by changing your diet and now

you start eating real food and not

processed foods and products. when we

increase the fiber intake so that the

good bacteria start coming back into

your gut and when I give you certain

supplements to restore all your

nutrition in your body then all of a

sudden the progression of coronary

calcium flattens out. You see let's say

you came to me for a test and I did a

coronary calcium score and it's 500 and

two years from now it's 800. That means,

wait a second, something's not right

here, right? Your coronary calcium

should not be going up. Now, I can't get

rid of the coronary calcium because

that's plaque in the walls of your

arteries, but it shouldn't keep going up

because one day it's going to be 2,00.

So, how do I follow how well my

treatment for you is? Is I follow the

coronary calcium score.

And again, the coronary calcium score is

a marker of the amount of plaques,

correct? around the heart and in the

vessels of the blood.

Yeah. In the walls.

In the blood vessels. Okay. So, you want

low coronary calcium.

Like my calcium score is zero. You

shouldn't have any coronary calcium in

the walls of the arteries. So, we have

the yard sticks now.

We should probably we should probably

differentiate between calcium

supplements and the calcium that you're

talking about.

So, pertinent. Calcium supplements

actually increase the risk of

cardiovascular events. Calcium

supplements should not be taken. The

problem is not calcium supplements. The

problem is lack of D3 and lack of K2.

So, we shouldn't be taking calcium

supplements.

Absolutely not.

Absolutely. I stop all calcium

supplements on all my cardiac patients

and I tell them you should take vitamin

D3 so you'll absorb calcium better into

your gut and you take vitamin K2 because

vitamin K2 is going to make sure that

you don't get the calcium build up in

the wrong places in your vascule for

example

just to give some context on the

research some some large observational

studies suggest that highdose calcium

supplements which is especially um above

1,000 milligs a day from pills may

increase the risk of heart attack and

stroke while others find no clear link.

Yeah.

Okay.

Yeah. No, I look also they advise high

calcium supplements in women to prevent

osteoporosis for example, right? And

osteopenia. I live in Florida and all

these young women they come to me in

their 30s. They all have osteopenia. And

the question is that they got calcium

supplements put inside the milk in the

orange juice has calcium in it and

they're taking calcium supplements. Then

why would they and they have sunshine

and why would they have osteopenia? And

the reason is D3. You need D3 and K2.

That's what you need. It's a hormonal

thing. It's not the elemental thing.

So when people are on blood thinners, do

they typically have low vitamin K1?

If you're taking couadin, couadin is a

type of blood thinner. Yeah.

That lowers your your vitamin K1 levels

and it'll also lower K2. So couadin will

lower K2 as well. So you will get

increased coronary calcification and

that's been documented. So patients who

have who are taking warrin for example

or couadin have been shown to have

increased coronary calcification because

of the fact that the K2 levels come down

as well as the K1 levels both come down

both. So you need vitamin K2.

And you just do you supplement that or

do you get it from dietary? I supplement

it on all my patients because diet comes

from fermented foods and we don't eat

enough fermented foods to contain enough

vitamin K2. So one of the reasons why I

do like my supplements is because

today's food is not as rich as it was in

the past.

So we're not eating the variety of

foods, but also we're not getting enough

vitamin K2 in our regular diet. So, if

you want to give me advice then on

having a great gut so that I don't end

up with leaky gut which will cause all

of these downstream effects. What is um

what is the advice you'd give me to have

a perfect gut? Number one, lots of fiber

because the fiber is going to be eaten

by your bacteria and you're going to get

a wide variety of good bacteria eating

fiber. If you eat a lot of sugar, you'll

get bacteria too, but there are the bad

ones, the ones that you don't want. So

you're going to get a condition called

SIBO, for example. But you want to eat

lots of fiber. So because our diets

today don't give us enough fiber, I do

advise all my patients to take inulin

with FOS. It's called inulin with FOS.

It's a powder. It's a soluble fiber. And

I just tell them to take one scoop in

your water every day or put it in your

whatever you're going to have, whatever

liquid you're going to have. Number two,

fermented foods.

The fermented foods will give you not

only the bacteria themselves because,

for example, kefir has so many different

strains of good bacteria, but they also

have the postbiotics. What is a

postbiotic? A postbiotic, for example,

vitamin K2. It's a product that the

bacteria make.

Short chain fatty acids. That's a

product that the bacteria make. So, you

want bacteria. You want good bacteria in

your gut and they will stabilize the

ratio of all the other bacteria in your

gut. So the keystone species have to

come back into your gut.

I was reading some research around fiber

and it says that in the United States

women are 40% fiber deficient and men

are roughly 50% fiber deficient. And in

the UK we're about 40% fiber deficient.

I don't think people know that. Where do

I find fiber? What what do I need to be

eating to increase my fiber?

Fiber is found in anything that's

nonprocessed

because the very act of a processed food

is to take out the fiber so that you can

increase the shelf life of it. So any

processed food, anything that's

manufactured in a factory for example,

anything that already comes ready made,

they've taken the fiber right out of it.

So you got to eat real food. So you're

going to eat real vegetables and that to

a variety of vegetables. You see, you're

supposed to eat 30 to 40 different types

of vegetables a week and we don't tend

to do that. So you want fiber from a

variety of sources. So we got to eat a

little bit of all these different

different kind of vegetables including

spices. They all count as one vegetable.

So that's something I I stress to

everybody that you got to have variety.

You got to have all these different

fibers because they will foster the

growth of different types of bacterial

species in your gut.

What about lifestyle? recommendations

for improving my gut things like I don't

know stress sleep exercise anything

sleep absolutely important so the the

the next thing is actually actually

sleep and stress because lack of sleep

causes a change in your gut microbiome

you got to sleep 7 hours a night and

cutting down on sleep is going to affect

your entire physiology in your body and

your repair processes and your vagus

nerve and your delta sleep

But also your gut microbiome. One night

you'll get insulin resistance. One night

of bad sleep, you become insulin

resistant the next day.

If you're changing

if you're changing time zones very

frequently,

the liver dysfunctions

and the gut microbiome also

dysfunctions.

So we got to be more cognizant of that.

That lifestyle is very important.

And we have to have plenty omega3 in the

diet.

If you're starting a business, that

means you're one person doing the

workload of probably about 50 people.

When I first founded this podcast, I had

no idea that I was about to step into a

hundred different roles that I'd never

trained for. Things like researching and

production and scheduling and branding,

all of it all at once. And this

experience isn't unique to me. But for

millions of founders around the world,

the tool that changes all of that is our

sponsor, Shopify. Shopify now powers 10%

of all US e-commerce. From names like

Gym Shark and Mattel to first-time

founders just getting started. It's like

having your very own design studio,

content creator, and marketing team in

one with hundreds of online store

templates, AI tools to create product

pages, and easy to launch email and

social media plugins. Behind the scenes,

Shopify manages your inventory,

international shipping, and even your

returns. So, if you're ready to sell,

sign up for your $1 a month trial at

shopify.com/bartlet.

That's shopify.com/bartlet.

$1 a month. No way.

You talk you talked earlier on about

toxins.

Yeah.

What do you mean by toxins and how what

role is toxins playing in my physiology

and my heart health and my gut health?

Yeah. So,

and what is a toxin?

A toxin is a molecule

that should not be in your body. You

should not have been exposed to it. So,

let's take a pesticide or a herbicide.

These are chemicals

which man has made and not perhaps

adequately tested it in in um in

rigorous studies. And yet these

chemicals get into the body and we know

that many of them are estrogen receptor

disruptors and that causes inflammation

as well. So if you look at pesticides

and herbicides,

we look at plastics

forever chemicals for example PAS and

other chemical BPA.

These chemicals all disrupt our

metabolism in our body. And then of

course mold is a toxin. And lastly,

heavy metals are toxins.

When the gut is not working properly,

you're going to be more prone to

toxicity because the gut bacteria

normally grab a lot of those things and

take them out in your stools. So when we

look at toxicity, we look at gut health

and the liver health. The liver is

supposed to get rid of lot of toxins.

But in today's day and age, because of

the foods that we're eating, the

environment that we breathe, the

environment that we walk out into, we

getting too many toxins and this poor

organ here is getting overwhelmed and

cannot detoxify adequately. So when I do

a blood test, urine sample, and a stool

sample, I get a very good bird's eye

view of what's going on with their

ability to detoxify and which levels are

high. And I'm finding

that many of my patients who have gut

issues and liver issues are very, very

high with not only heavy metals, but

they also have a lot of pesticides,

herbicides, and mold in their body.

and mold. I'm finding a lot of mold and

mold and all these extraneous toxicities

cause inflammation. Inflammation is a

reaction to something that your body

shouldn't have.

Where is the mold coming from?

Mold is very interesting. I've only

started researching it in the last one

year.

Basically,

almost 70% of homes these days have some

form of mold toxicity in them, either

from previous water damage or exposure.

And mold is ubiquitous. It's it's just

about everywhere. And it can

reininoculate you every time you're in

that environment. and it causes your

innate immune system to start reacting

to it and causes lowgrade inflammation

in your body. And when I get rid of the

mold, all of a sudden I'm noticing that

the patients are not only feeling

better, but the rate of progression of

coronary artery disease flattens off. I

have this uh steam room in one of my

houses and uh I went in there the other

day and I smel I could smell it smelt a

bit funny and I recognized that smell

from when I was younger as being mold.

So I like I googled it what what is that

like earthy strong pungent smell in my

steam room. I think what's happened is

part of the like seat has come away from

the wall so it's not sealed anymore and

I think the moisture has got in there

with the water and I think it's moldy

and chachi said to me when I was asking

chap said smell near the like cracks

yes

and if you smell if it smells really

strong near the cracks then that's mold

and I smelled near the crack and it was

really really strong remember thinking

oh like so I had I not known that would

have been sitting in there 30 minutes a

day inhaling all of that strong mold

smell. And from doing this show, I've

I've learned that the downstream impacts

that can have on your body and your

cardiovascular health and everything in

between is really, really bad. So, I I

had a team come over and just uh fix

everything, repair it, and do a deep

clean. But I don't think people are very

aware of how mold, which we kind of

think of as like, oh, the the the bread

has gone green,

whatever, can have a chronic downstream

impact. And also this mold can come in

and then become part of your microbiome.

So it can actually come into your so

let's say you get out of this place. But

if the mold is still in your gut or if

it's in your sinuses for example and you

get chronic sinusitis you're

reininoculating yourself over and over

again with this mold. And this is an

area of great interest and a lot of

research needs to be done. It is real

and we've known about it for a long

time. But the medical profession as a

general has not really taken this and

run with it, but it is very important

and we certainly looking at mold

toxicity in our practice because we find

that it is actually more prevalent than

we ever ever imagined before and we know

the chemistry. We know that it causes a

a systemic inflammatory reaction in the

body and it's reflected in the blood

work. We see that the CRP is up. We see

that the compliment levels are high. we

see that the certain ratios of certain

inflammatory molecules are off. So we do

want to treat mold. Um we want to treat

sources of mold toxicity both in the gut

as well as in the sinuses. And yes,

people are surprised when I tell that

that affects the cardiovascular health.

When we talk about the clogging of

arteries, why is it that healthy people

still end up sometimes with these

clogged arteries? I think it's because

they have sources of inflammation that

we have not identified. For example, we

say, "Oh, you have no cholesterol, you

have no smoking, you have you're

exercising, you're not overweight, you

don't have diabetes." Well, then I don't

know why you got all these odd. No,

there's always if you dig deeper inside,

there's always something. And we'll find

the source of the inflammation. There's

always a reason why you get hardening of

the arteries.

What's in that list?

In that list is mold.

Mold. Yeah.

Licky gut. Yeah,

huge food sensitivities. Oh, let me tell

you about food sensitivities. So,

another reason for the leaky gut is that

certain foods punch holes into your

intestines in a in a in a sense and

causes a leaky gut. And I've had at

least one patient in the last 6 weeks

that I can remember who actually has

celiac disease and he didn't even

realize he had celiac disease because he

had no constipation, diarrhea and he had

premature coronary artery disease and we

identified that he had celiac disease.

We cut out all weight from his diet and

that's going to stop this inflammatory

process from occurring. See, it's all

about inflammation. We need to get rid

of inflammation in order to get rid of

coronary artery disease. Any source of

inflammation,

get rid of the source. So if the

pesticide levels are high, herbicide

levels are really high, get off that

source. Maybe you maybe you're living on

a golf course and you smell those

chemicals every day. Maybe you're using

it yourself in your yard. Maybe you have

toxicity coming from mold as you

mentioned. But we got to find the source

of it. So, a thorough evaluation of the

gut microbiome, a thorough evaluation

of toxins in your body, and a

nutritional status.

Your body is able to work and get rid of

this type of pathology if you have good

nutrition. We don't have good nutrition

today.

Let's talk about nutrition then. If I

wanted to end up on your surgical table,

if I if that was my goal, what would you

recommend

that I ate and yeah consumed?

You should eat nutrient

deficient

processed foods every day.

Give me some examples of of things.

Pringles and

correct. So it'll be things made out of

wheat, refined wheat, biscuits, cookies,

cakes, lots of bread. Basically,

fast foods,

foods that come in a box, readymade

food with labels,

anything that comes in a packet that you

open up,

including some of these

that are high protein bars or some of

these because they have all sorts of

other chemicals in them.

And I would have lots and lots of um

artificial colorings in my food in all

those processed foods. Um artificial

sweeteners,

lots and lots of diet drinks and sugary

drinks.

Orange juice.

Orange juice is is certainly on my list

because that produces such a profound

increase in my glucose level and then my

insulin spike that I'm going to get

afterwards will cause me to become very

hungry 3 to four hours later. So yeah, I

would not eat real food

and you'll end up on my table.

See alcohol smoking

alcohol, no fiber because none of those

foods will have fiber in them. None of

those processed foods have fiber in

them.

Your patients must come to you at times

and tell you what they're doing in terms

of what they're eating and lifestyle

choices. And there must be certain

things which very people aren't aware

aren't healthy. You actually mentioned

bread.

Yeah.

Is all bread bad?

No, not all bread is bad. Most bread is

bad. I don't mind some sourdough because

it's fermented. So, it's going to get

rid of some of those lectins that are

already in the flour. So, those lectins

are gone out because they've been

fermented. So, it's probably a little

bit okay. But again, not large amounts

of it. You know, a slice once or twice a

week is fine, but really it's a survival

food. Bread is a survival food. Just

empty calories. That's all it's going to

do.

Is there like a worse bread? Is there

like one bread which is

Yeah. Pure white bread. Simple white

bread. The simple light white bread.

It's pure calories, 70 calories right

there. You're talking about just eat

have 10 teaspoons of sugar instead in

one slice. I mean, it just doesn't make

any sense whatsoever.

White rice.

White rice. I white rice is a staple

food of many people and they cannot live

without it. So I run into this problem

all the time. So I tell them that this

is what you're going to do. You're going

to first and foremost soak your rice in

water and then discard the water after

an overnight soak because it contains

arsenic in it and other heavy metals.

You'll be surprised how much arsenic

there's in rice these days. You see see

the problem we have our sourcing of our

foods. I mean here as a cardiologist has

to talk to his patients about how to

cook rice.

What is arsenic for people that don't

know?

It's a heavy metal that is found in the

soil and the water is in contaminated

soil and water and in these patty fields

are now full of arsenic.

It's a poison, isn't it? People I watch

a lot of true crime. People kill each

other with arsenic.

It's a very very strong poison and it'll

slowly kill you. Is there anything else

on that list of thing misconceptions?

So, so the rice has to be soaked. Then

you get rid of the water. Then you cook

it with lots of water. Throw away the

rice again. I mean the throw away the

water, not the rice. And then you cool

the rice in the refrigerator

and then you eat the rice the next day

by reheating it. Now what you've done is

you've created resistance starch.

Now, what's going to happen is that that

rice is not going to have the same

insulin effect in your body and weight

gain effect and changes in your

metabolism because it's now got

resistant starch. Resistant starch means

that those molecules have all bound to

each other. They don't they resist

absorption and digestion until they get

to your colon. And then who's going to

eat it? Your bacteria. So, you're

basically feeding the bacteria with your

rice. So, if you're going to have rice,

this is the way you're going to do it.

So,

is there anything else on that list that

people should be thinking about that

they probably consider to be healthy

right now?

Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. So,

it's also what you do to your food.

Look, you take a nice piece of fish, for

example, and if you burn it and you

blacken it really bad, you're creating

what is known as advanced glycation end

products. You fry something, you're

creating advanced glycation end

products. So, let me define that for

you. If nature does not have the ability

on its own to take

glucose, protein and fat and combine

them at very high temperature,

but you can do it in your air fryer

and you can do it outside when you when

you're blackening your food and over

blackening your food. It's called

advanced glycation end products. So when

you over burn your food, when you

overcook your food, you're creating

these molecules. Now you're consuming

these molecules and they have been shown

to cause a radical increase in the

inflammation in your body because your

body reacts to those products. There's

receptors to get rid of those they

called rages and they get rid of these

products but you overwhelm them and now

you get inflammation.

And is there any other watch out foods

that you know people think are healthy

but maybe if if I was trying to have an

optimally healthy heart I should avoid

it.

Is this going to surprise you? excessive

fruit

because I'm not a very big follower of

fruit. Fruit should be eaten only in

season because it has too much fructose

in it.

Fructose being the sugars.

Fructose is sugar and fructose causes

fatty liver. So our overconumption of

fruit is another factor that is

contributing to coronary artery disease

and diabetes and fatty liver. And we

think of fruit as being a healthy thing.

You see, but fruit should only be

consumed really in the fall and in

season and in small amounts because that

high fructose level really causes major

changes in your metabolism. So, I'm not

too front of fruit. You can eat fruit in

season, small amounts of it, but you

know, people go crazy about fruit. I

mean, I had a patient who was having

mental problems as well as

cardiovascular disease. And he that's

all he lived on is fruit morning, lunch,

and dinner. And the moment we stopped

that his health changed completely. He

got so much better.

So excess of fruit is also no good.

Excessively cooked foods, processed

foods, refined products. And another

one, vegetable seed oils. So any food

that you prepare or you buy that

contains vegetable seed oils is a no no

because vegetable seed oils are a

product. And if you look at all of them,

they're exceedingly high in omega6. And

the ratio of omega 6 to omega3 is what

the problem we have today.

We have far too much omega6, very little

omega3. So anything that contains

vegetable seed oils. So I always tell my

patients, get rid of that vegetable seed

oil bottle from your home.

So what oil should I use instead? The

oil at home, if you're going to use any

oil, is going to be olive oil, extra

virgin olive oil for your for your

salad. And if you're going to do high

temperature, put a little pat of butter

or use a little bit of ghee or you can

use a little bit of coconut oil. This is

a bit more of a different question, but

you said earlier on that when a patient

walks into your office, you can kind of

look at them and generally see if their

cardiovascular health is intact. And

we're generalizing here, but if I'm sat

at home right now and I'm trying to

figure out if I'm healthy as it relates

to my cardiovascular health, what are

the symptoms of cardiovascular poor

health? Like what throughout the whole

body? What what should I can I sort of

obviously don't want anyone to self

diagnose at home, but what kind of

symptoms should I be looking at when I

you when you look at me? Let's do this

on me to make it easier.

Yeah. So number one, look at your

weight.

Okay. If you're overweight, that's a

that's a that's one strike against you

already. Number two, if you're

overweight, where is it? It's mostly on

the belly.

I'm overweight according to the BMI.

But again, you got to look at BMI, you

know, is a little crude. It's not a very

accurate way of actually looking at it

because some people are very muscular

and the BMI of 28 is actually perfectly

okay for them. It's the constitution I

look at and it's visceral fat. Now, I

can't measure your visceral fat by

looking at you, but I can tell if your

belly is protruded. Now, in my office, I

do visceral fat analysis.

So, what else? I've I've I don't have a

protruding belly per se. Um, what else

should I be looking for to understand if

my cardiovascular health is intact? Is

there I know

just by looking at you physically.

Yeah.

No, I that's it basically is your BMI

and your overall weight and must not

have a belly. Just don't have a belly.

If you have a belly, you have a problem.

And what about my joints and stuff like

that? Is that an indicator of

Yes, if you have joint now symptoms, if

you're having joint pains, look, if

you're having joint pains, people think,

"Oh, it's just degenerative joint

disease." In my experience, what I have

seen, it's all inflammation. Because

when I change the diet, when I fix the

gut issues, when I fix the inflammation

in the body, they all come back and say

the joints got better. All of them

uniformly. Especially patients who have

autoimmune disease.

For example, many patients have

rheumatoid and the moment we change

their diet, their lifestyle, the

frequencies of eating, introduce a

little bit of fasting. So, we do

everything right. Right. We've changed

the gut microbiome. We've we've made the

liver better by by by giving them some

supplements. We do intermittent fasting,

we do some exercises, we give them some

stress management, we improve their

sleep. All of a sudden the joint pains

get better, rheumatoid gets better, skin

diseases get better, psoriasis gets

better because it's the fundamental

underlying part is all inflammation.

This is a random one, but I'm just

connecting dots from different podcast

guests I've had on the show. What about

bad breath?

Bad breath. Bad breath is real.

But what is it? Is my oral microbiome

linked to my heart health?

Yes. There's a there's a microbiome that

goes all the way from your nose, mouth,

all the way down to the anus. And each

one is specific and can predict whether

you're going to get cardiovascular

disease or not. There's unequivocal data

to show that if you have bad teeth, bad

dental hygiene, bad bacteria in your

mouth, you're going to get valvular

disease such as aotic stenosis,

premature calcification of your aotic

valve, and you're going to get coronary

calcification. That's been proven

unequivocally. Patients who have chronic

sinusitis in your So you think that

that's benign? If you have chronic

sinusitis,

what's chronic sinusitis?

Chronic sinusitis, infections inside

your maxural sinuses, frontal sinuses

constantly and you get these headaches

and and you get the cold and your block

nose and you constantly cog up inside

here. That's inflammation. And often

times that's also linked to premature

coronary artery disease and inflammation

in your body. Especially when it's

fungal. There's a condition called

fungal sinusitis. Again it comes down to

mold. And this mold it causes that

lowgrade inflammation in your body. And

this has been linked to coronary artery

disease. See what's happening is we

transforming the whole definition of the

causes of coronary artery disease. We

have been so myopic in our definition of

what causes coronary artery disease

whereas everything your entire lif style

mental physical eating everything will

affect your coronary arteries everything

everything

do you think much about

over stimulation so I mean really mean

like too much caffeine does does too

much caffeine play a role and I say this

in part because I think there's been a

few times where I've had like a pre-work

workout or too many glasses of coffee

and I've got like heart palpitations and

you almost like feel like you're dying.

Yes. Yes. Yes. Caffeine. Caffeine is

very similar to the adrenaline molecule.

Now, why would you want to have too much

adrenaline in your body? Because then

you're living in a state of existential

threat constantly and then what happens?

You don't get the offset either. So, you

don't get the parasympathetic. You're

only in sympathetic all the time.

Fight or flight

all the time. So caffeine generates that

and the physiology it'll look caffeine

is not as benign as we think it is. Now

there's nothing wrong with having one or

two coffees a day. That's fine. Okay.

But I know people who drink about six

glasses or six cups of coffee a day and

and I think that that's just that's

toxicity. You see that's toxicity. Too

much caffeine. And it's a diuretic. And

a diuretic will cause intravascular

volume depletion and that also turns on

your neuro hormonal activation. So you

become more sympathetic. You see? So

it's a vicious cycle makes you

dehydrated.

I was reading about this earlier cuz I

did have heart health palpitations one

day because I think I drank too much

coffee. Um and what I what I see here in

the research says that moderate caffeine

is safe and even heart protective for

most people. But excessive caffeine when

you get, you know, above 600 milligrams

a day

um can raise blood pressure, trigger

arythiums,

arrhythmias.

Arhrihythmias and stress the heart. Yes.

Now, I want to tell you why coffee is

good. It's not good because of the

caffeine. And so, it's not good that,

oh, I'm getting that caffeine, so it's

good for me. No, cuz believe it or not,

coffee has a lot of soluble fiber in it.

So, there is some soluble fiber in it

and it has polyphenols.

So, coffee has polyphenols just like how

cocoa has, you know, cocoa, cacao, 85%

cacao, chocolate, that's fantastic. It's

got soluble fiber cuz who's going to

consume the soluble fiber? It's actually

the bacteria. So a coffee a day is

actually good for you for a different

reason. It's good because it's good for

your bacteria because it's getting

soluble fiber and it's getting

polyphenols and all those polyphenols

are consumed by your bacteria.

They they call cacao, don't they? The

something of the heart. My girlfriend's

quite spiritual and in her practice they

call it like the heart medicine. Cacao.

Cacao. It is because it has a lot of

antioxidants and it has a lot of soluble

fiber. So wait a second. It's a soluble

fiber. Yes, because that's fostering the

growth of the good microbiome. The good

microbiome is then going to produce

postbiotics and the postbiotics are

going to give you all the benefit that

you're going to need. So, it's going to

cause less leaky gut, less inflammation

and your entic nervous system, your

vagus nerve, your vag nerve is going to

be protected because we're destroying

our vag nerve right now with the leaky

gut. When people get heart palpitations,

I imagine a lot of them message you

because it's quite scary, isn't it, when

you feel your heart beating,

what is typically going on and when is

it cause for concern if you've got heart

palpitations?

Yeah. If you have underlying structural

heart disease, let's say you have

blocked arteries, let's say you have a

cardiopathy, a valvular disease, and

you're having an arrhythmia, which is

palpitations, that is definitely

life-threatening. They need to come

straight to the office and we need to

monitor you and find out what's going

on. But let's say you're otherwise

perfectly healthy, young person,

perfectly healthy, no heart disease

whatsoever, and you're having

palpitations, then it's usually an

imbalance of your sympathetic and

parasympathetic nervous system. You're

too stressed.

It's basically either too much

sympathetic or not too much sympathetic,

but you have too little parasympathetic.

And that is one thing that I want people

to realize that if you've knocked your

vag nerve off because you have a leaky

gut or because of your lifestyle and

your vagus nerve is not working very

well, you will have this imbalance

because the imbalance is not with

absolute levels. It's the relative

levels of sympathetic versus

parasympathetic. So for example, I see a

lot of young women in their 30s and 20s

who come to me with tachicardia. They

have a rapid heartbeat all the time and

especially when they stand up, they get

a rapid heartbeat. This is called

postural orthostatic tachicardia. And

when they come to me, I find out that

it's actually the gut. I fix their gut

and the tachicardia gets better because

by fixing the gut, I'm fixing the vagus

nerve. By fixing the vagus nerve, the

heart rates come down.

I've built companies from scratch and

backed many more. And there's a blind

spot that I keep seeing in early stage

founders. They spend very little time

thinking about HR. And it's not because

they're reckless or they don't care.

It's because they're obsessed with

building their companies. And I can't

fault them for that. At that stage,

you're thinking about the product. How

to attract new customers, how to grow

your team, really how to survive. And HR

slips down the list because it doesn't

feel urgent. But sooner or later, it is.

And when things get messy, tools like

our sponsor today, Just Works, go from

being a nice to have to being a

necessity. Something goes sideways and

you find yourself having conversations

you did not see coming. This is when you

learn that HR really is the

infrastructure of your company and

without it things wobble and Just work

stops you learning this the hard way. It

takes care of the stuff that would

otherwise drain your energy and your

time automating payroll, health

insurance benefits and it gives your

team human support at any hour. It grows

with your small business from startup

through to growth even when you start

hiring team members abroad. So if you

want HR support that's there through the

exciting times and the challenging times

head to justworks.com now. That's

justworks.com.

I've just invested millions into this

and become a co-owner of the company.

It's a company called Ketone IQ. And the

story is quite interesting. I started

talking about ketosis on this podcast

and the fact that I'm very low carb,

very, very low sugar, and my body

produces ketones, which have made me

incredibly focused, have improved my

endurance, have improved my mood, and

have made me more capable at doing what

I do here. And because I was talking

about it on the podcast, a couple of

weeks later, these showed up on my desk

in my HQ in London, these little shots.

And oh my god, the impact this had on my

ability to articulate myself, on my

focus, on my workouts, on my mood, on

stopping me crashing throughout the day

was so profound that I reached out to

the founders of the company, and now I'm

a co-owner of this business. I highly,

highly recommend you look into this. I

highly recommend you look at the science

behind the product. If you want to try

it for yourself, visit

ketone.com/stephven

for 30% off your subscription order. And

you'll also get a free gift with your

second shipment. That's

ketone.com/stephven.

And I'm so honored that once again, a

company I own can sponsor my podcast.

Let's talk about the V Vegas nerve then.

Um before we do that, I had a little a

little incident actually caused by

Jamaima who's out there. Jamaima We were

in this little fitness competition and

Jamaima decided that she wanted to beat

me and so she cycled 100 kilometers one

day. She cycled for 4 hours which meant

that she had more minutes in this

fitness competition than I did. So my

rebuttal was to do the same but more. So

the next day I cycled just over 100 km

on my Pelaton at home. Funny enough, it

took me like 4 hours to do it. And then

I came off the Pelaton. I was

celebrating whatever, you know, won this

gold medal emoji as my reward that

month, but also I won heart palpitations

that stayed with me for a little while.

And I was wondering like why that

happened. So I did this big vigorous

exercise which was kind of outside of my

usual exercise regime and then for a a

couple of weeks I could like feel these

heart pulpitations

and is that because of what you were

saying about my parasympathetic?

What do you think happened there?

Yes. Yes. Yes. Yes. over exercise.

This has been shown when you do what you

just did, you're diverting blood from

your gut to your muscles because your

muscles at that point really need all

that blood supply. And this has been

well documented. So what happens when

you overly exercise like that? You're

causing relative eskeeia to your gut.

Essia. Essia. What does eskeemia mean?

Lack of circulation to your gut. So your

poor gut at that point had lack of

circulation relative. Not to the point

where it's going to go gangrous. No,

don't don't get me wrong. But it affects

your gut and in the gut is the entic

nervous system. The vagus nerve ends in

your gut lining and the vagus nerve got

affected. So your vagus nerve didn't

work very well. When you get vagus nerve

not working well, you get too much

sympathetic. You're going to get

tachicardia. You're going to get

arrhythmias, palpitations. So tell me

what the vagus nerve is and what I can

do to get my vagus nerve in check. By

the way, Jamaima, it was totally worth

it. But just tell me what I what I can

do to get my Vegas nerve in check and

like what role my Vegas nerve plays.

I've got this photo here of the Vegas

nerve.

Yeah, you know, the Vegas nerve is

fascinating.

It is the largest nerve in the body

and it it it basically is sending

messages from the brain to the whole

body and receiving messages back to say

what is the state of affairs and the

largest distribution believe it or not

is all in your gut. Now that tells you

something right there that

what is the brain most concerned about?

It's most concerned about the most

treacherous border in your body which is

your gut.

Your gut health is so important that the

body has dedicated a huge nerve called

the vagus nerve just to take care of

your gut because your gut is that

important. That is why by the way it

also has endings on the heart in your

lungs in your face. So there's lots of

endings of the vagus nerve

and what is it doing? Is it telling is

it basically the communication channel

between all your gut, your heart, your

brain

state of affairs? What is going on in

the gut? What should I be doing? Back

and forth traffic information going back

and forth. So when you when you the body

is supposed to be in a state of

sympathetic followed by parasympathetic.

What does that mean?

You run away from the tiger. You hide

behind the rock. The tiger is gone now

and now you're supposed to be

parasympathetic.

So sympathetic is the fight.

Parasympathetic is the the relaxation,

rest, relaxation, repair. Guess what?

We're not getting enough repair these

days because we constantly in the fight

flight fight. We never give our chance

to go into repair. That's what the

problem with the Vegas nerve that we

have today is. So we don't get a chance.

So that is why don't we do it? Well, one

is our lifestyle. Two, our gut is not

right because it has disade our vagus

nerve dysfunctional. When I fix the gut,

one of the things I notice is heart rate

variability gets better. What does that

mean? Heart rate variability. That means

your pulse with each breath in and each

breath out, there's a little variation

in your heartbeat. H that's called heart

rate variability. Now, when you lost

your heart rate variability, it means

that your vagus nerve is not working

very well. In all patients when I fix

the gut the heart rate variability gets

better as well. When you fix the gut

your vagus nerve will be able to work

more efficiently and you'll be able to

repair yourself after the sympathetic

drive. So you get the ying and then you

get the yang as well. And the nice thing

about the vagus nerve that I find is

that you can repair it through the gut

but you can also hack it and you can

give it some nutritional supplements.

The nutritional supplements are omega-3

which right now 50% of the population is

very low in omega-3 and you need DHA and

omega-3 to to to make their vag nerve

work optimally. You need to fix the gut

and thirdly you can hack the vagus

nerve. So how do you do that? You do the

breathing exercises. So when you do the

deep expiration, you stimulate all those

parasympathetic nerve endings and your

heart rate goes down, blood pressure

goes down.

What kind of breathing exercises?

So breathe in to the count of four,

breathe out to the count of eight. Very

simple. I tell that to all my patients.

Breathe in to the count of four. Breathe

out to the count of eight. It's a

deliberately long expression. You do

that for about 10 minutes a day.

And when you do that, your vagus nerve

is getting stimulated. And any nerve

that is stimulated frequently enough

will work more efficiently.

What about this eyeball thing that I've

heard you talk about where you

eyeball does affect the vagus nerve

function too. So when you look to the

right, look to the left at the top, look

down, look left, it stimulates the vagus

nerve. There's a nerve on the ear.

There's also the vagus nerve that can be

stimulated here in the neck that can be

stimulated. The facial nerve also uh has

branches that go to the vagus nerve. So

there are a few hacks that people can

use. I even have a small contraption

that I give patients that wear around

the neck and it it it releases little

signals onto the vagus nerve over here

and I've placed it on patients and they

in front of me and they'll say, "Oh my

god, I really feel so relaxed and nice."

And it's I was shocked when they did

that. I heard you talk about massaging

the eyeball.

Yes. And cold water on the eyeballs. So,

I don't advise massaging too often, but

cold water and gentle massage on your

eyeballs stimulates the vagus nerve. And

you can do it yourself. You'll notice

that if you're on a monoton, you do

that, your pulse rate goes down. It's

the deep dive reflex that we have in all

of us. We dive into water.

What about putting an ice pack on the

back of your neck?

I think that's fantastic. Back of the

neck, but I prefer the front of the

neck. Okay.

Because the front of the neck is closed.

The vagus nerve is very close to the

karate sheath over here. And when you

put ice packs on it, the vagus nerve is

stimulated.

Humming for 10 minutes.

10 minutes. Both sides.

What do you mean by humming? Give me an

example.

Oh, humming. Oh, humming. Oh, yeah. That

sound is transmitted

to the vagus nerve. So, it's like

shaking that vagus nerve and it creates

electrical impulses uh in the vagus

nerve. That's been shown. Singing,

singing, singing. humming,

laughing.

You know that there are laughing clubs.

Maybe you should start a laughing club.

Laughing clubs. Yeah, laugh for no

reason. Just sit there and laugh. So

that diaphragmatic movement, that

constant diaphragmatic movement in

laughing stimulates the vagus nerve.

I heard you talk about this valva

maneuver.

Yeah.

What's that?

The valva is when you breathe in

and then you breathe out, but don't let

the air out and you're straining. And

that straining compresses the thoracic

cavity but also the abdominal cavity and

stimulates the vagus nerve. And that is

also found to be very very helpful.

And remind me again if I have a healthy

vagus nerve, if I have a calm healthy

vagus nerve, what is the downstream

impact going to be across my life?

Downstream impact is going to be faster

healing,

less coronary disease, less high blood

pressure. Your blood will not be so

sticky and make blood clots less

inflammatory markers.

The blood tests that we do, the

interucan 6, the tumor necrosis factor,

the CRP levels, small dense LDL, we

didn't even talk about LDL, but LDL, the

bad cholesterol, all those get better.

And what is the the the role of LDL as

it relates to heart disease? Because

I've heard this word cholesterol. I

really don't really understand what it

is. or I know there's good cholesterol,

there's bad cholesterol. I I guess that

bad cholesterol comes from fast food and

processed foods and stuff, but simply

what do I need to understand about the

role cholesterol plays in heart disease

and how to not have bad cholesterol?

The LDL car carries most of the

cholesterol in the body. It's not

complicated.

LDL is what

is LDL is a lipoprotein.

Yeah.

Right. And you have HDL which is good

cholesterol. LDL, bad cholesterol, total

cholesterol and triglycerides. Okay,

these are the four tests.

So the LDL is a reflection of your

cholesterol. Now cholesterol is a normal

molecule in your body and you should

have cholesterol because if you don't

have cholesterol, I don't think you live

too long and you need to move this

cholesterol around your body. Every cell

in the body makes cholesterol. Your

liver makes most of the cholesterol

actually. Now what happens is that when

that LDL molecule becomes damaged, it

becomes a small dense LDL particle. A

damaged LDL causes inflammation because

now you have a molecule that's floating

around your body. It's been damaged.

It's small. It's dense. Now your white

cells, your macrofasages see that and

want to gobble it up. That's number one.

Number two, these molecules get oxidized

in the lungs and then they the first

place they come out from after the lungs

is the coronary arteries. So it's the

small dense LDL particles which are now

oxidized

they destroy the glycoalix which is the

lining of the coronary arteries and they

activate the endothelium.

When they activate the endothelium which

is the lining of your coronary arteries

that's when you're going to start

getting aosclerosis. So atherosclerosis

and LDL are related but it's not the the

total cholesterol. It's when you have

small dense damaged LDL. So let me

explain the impact in my practice.

Patients come to me because they either

cannot tolerate cholesterol medications

or they don't want to take cholesterol

medications. What I do then is I look

and say okay your LDL

is it high or low? Is it is that what

I'm really concerned about or is it that

it's small dense LDL? So I do a

subfractionation and this is important

for you to understand because they don't

do it in every country in the world.

It's very difficult to get some of these

blood tests abroad. But in the United

States is easy to do it. It's called

subfraction of your LDL. So it tells you

whether you have small dense LDL or not.

So let's say you came to me and your LDL

is 150. But if it's all made up of

large, fluffy, good, normal LDL, it's

not going to be implicated in your

inflammation or in your coronary artery

disease. I leave that alone. But if you

have small dense LDL, that also is a

problem because it's pointing me towards

inflammation. Because what causes small,

dense, damaged LDL are glucose, omega6,

advanced glycation end products, toxins,

and lipopolyaccharides that come from

the gut, leaky gut. So now I just gave

you the primer

for treating coronary artery disease.

These five things

promote coronary artery disease and it's

small dense LDL. Those macrofasages they

engulf small dense LDL and those

macrofasages become foam cells. The

endothelium has been already activated.

So they

bind to the endothelial lining.

What's the endothelium?

The endothelium is the lining of the

artery in your coronary artery. So these

white cells that are full of fat, the

bad fat attach themselves to it and then

become endothelialized. That means they

become part of the wall.

So they become a plaque.

That's now you got it. That's making the

plaque. You just hit it right on the

head.

So how would I naturally lower my LDL

without taking statins or any of these

other medications? Is there a way to to

do it naturally?

You you stay away from from meat. Yes.

You've gone on a vegetarian diet. Yes,

it'll come down. But there's no need to

or meat.

Or meat because they'll all have

cholesterol.

Even chicken.

Even chicken. Yeah. If you want to bring

it down. But the question is, do you

really want to bring it down? Do you

really want to bring it down? Later. The

most recent data is very scary. It shows

that patients who have the highest LDLs

actually make it into the '9s and live a

healthier life. It's not the LDL, it's

the damaged LDL that's the problem. So

this the medical profession as a whole

and all of us are having a problem

grappling with this. Is it the total LDL

that we should be concerned about? Point

to your question. What is a normal

cholesterol and should we be lowering

cholesterol and the answer really is not

that simple. What we should be doing is

not to have small dense LDL. So the

question is that's the issue

and small dense LDL five things. Sugar

causes it. Omega6,

advanced glycation end products, toxins,

and leaky gut. They make your

cholesterol become small, dense

particles.

A lot of people are concerned about

eating eggs because they think it might

raise their cholesterol levels.

Absolutely no concerns whatsoever.

And what about statins? So a lot of

people are prescribed statins when they

have heart related issues. Are they safe

in the long run? Are they effective?

Okay, first part, are they safe? For the

most part, they are. But at least 20 to

30% of patients will suffer from

psychopenia which is loss of muscles. So

they'll get weakness, aches, pains.

They'll get diabetes because it causes

mitochondrial dysfunction. So they'll de

sugar problems and many of them also do

developmental diseases. So I've seen

that they become forgetful and they just

can't think right and I stop the statins

and all of a sudden they start feeling

better. So no, not all statins are safe.

You need to monitor statins also. They

can cause liver dysfunction. So you need

to watch that. Number two is that the

statins are they effective. Effective in

what? If the end point is to reduce your

LDL. Yeah, statins will bring your LDL

down. But does that translate to a

decrease in cardiovascular event rates?

That's a totally different question. You

see? So, is your goal just to reduce the

LDL or is your goal to reduce the

damaged, oxidized, small, dense LDL

levels? And when people say they have

high blood pressure, that's because

there's potentially a narrowing of their

blood vessels. So, the the the blood has

less space to go through. So, it's kind

of like squeezing a host pipe that it

gets it gets shoots out faster. Is that

typically what it means by high blood

pressure?

Sort of. Let me explain. When your

insulin levels are running high, all

your blood vessels and your capillaries

all don't vasoddilate properly.

Oh, okay. And vasoddilation is the

expansion and shrinking.

Yeah. So, they don't vasod dial

properly. So, you will get high blood

pressure. So, one of the biggest things

I've noticed with diabetes patients is

when I bring the insulin levels down

through my fasting program and dietary

changes, the blood pressures go away.

See, that's another thing that there's

no such thing as essential hypertension.

Essential hypertention meaning that you

just have high blood pressure. There's

always a cause. Either you have sleep

apnea or you have hyperinsulinemia

because sleep apnea also causes

hypertension. So hypertension does not

always necessarily mean that you're

going to be committed to blood pressure

medications for the rest of your life.

I've heard you talk quite a lot about

breakfast. People ask you about what

they should have for breakfast because

everybody wants to know um how they

should be starting their day. What is

your advice on what we should be eating

for breakfast to have a healthy heart

and cardiovascular system?

Breakfast is a tough one. I tell most of

my patients that if you absolutely have

to have a breakfast, have a couple of

eggs and if you are a vegetarian, it

makes it a little bit more tough. Um,

but you can have some kefir with two to

three blueberries, two to three

blackberries, and about four blueberries

in it. And then you put your inulin

powder in it and that's your breakfast.

That's all you should have. But a heavy

breakfast and also breakfast in my

opinion breakfast should be we should

pass breakfast for most adults and just

go for lunch and dinner only cuz then

you can do your 18 six. If you

absolutely going to have breakfast then

you have breakfast and lunch and then no

dinner. But you got to plan 18 hours. 18

hours is optimal and we can do it. A lot

of people say they can do it, but most

of us can do it. You will notice how

much more energy you have. You know,

when I do my OMAD, which I do at least 3

to four times a week, which I only have

one meal a day, at 6:00 in the evening,

I actually have more energy than I do in

the morning.

What does your diet look like, doctor?

My diet? Yeah,

I do eat meat and I do eat fish,

chicken, and turkey and but I'll have I

source it right. Always make sure that

it's grass-finished. Always make sure

it's organic and I'll have small amounts

of it.

Grass-fed grass-fed.

Grass finished.

What does that mean?

Grass-fed just means they took it out

one day and put it out in the field and

they fed it some grass. So, this

advertising that industry does is a

little deceiving.

And I had to investigate this to find

out. It's a lie. It has to be grass-fed

from beginning to end. So then it's

going to have more omega-3 in it. It'll

have more K2 in it. It'll have more

nutrition and have less toxins also in

it. So less omega6 because if your cows

are eating corn,

then you're going to get all that

omega6. And the cow is not supposed to

be eating corn. Cow is supposed to be

eating grass.

So I do eat some meats and I eat some

vegetables with it. Coming from a

background, my great-grandfather's from

India. We do eat Indian food as well. So

we have some lentils

and some curries of course. So we can

cook the meats in a in a curry form as

well. I don't eat much chapatis because

those are very full of carbs. I love the

taste of it. I love naan once in a

while.

And what do you supplement with? What's

your supplement stack look like? I take

D3 K2

omega3 fish oil. So I take two two

capsules every day. Vitamin C 1 g inulin

kefir. I drink that every day and I

count it. Magnesium

and I take nattokynise.

Nattokynise. Nattokynise I take about

8,000 units a day. What it is is that

it does thin the blood a little bit so

that you're less likely to make blood

clots. Part of metabolic syndrome is a

tendency to make blood clots and have a

high fibbrin level. My frigen level was

at the upper limits of normal. So I just

take nattokinise. It doesn't cause any

bleeding or any problems like that. And

then I also take a probiotic and I it's

it's basically is called mega spores

probiotic. So there's it's spores.

There's no real bacteria in there. It's

all spores.

What's a spore?

A spore a bacteria

can survive

by sporulating. So it becomes a spore.

So it's no longer a bacteria, it's a

spore, but it'll germinate under the

right circumstances. So these little

things, they have they are the spores of

the bacteria that are in soil. So soil

has certain species of bacteria, the

basilus species.

The spores

I consume, they go in my gut because

remember if I take a probiotic,

the acidity in my stomach is going to

kill most of the bacteria.

So what does a spore do? Sorry.

So the spore passes through the stomach,

goes all the way down to your intestines

and then it germinates there. It grows

there. So now the spore becomes a

bacteria.

Okay?

So it gets past that acidity of your

stomach. So, I do take that as a

supplement as well.

Dr. Jay, what is the most important

thing we didn't talk about that we

should have talked about for the people

at home that have clicked on this

episode? And you know, I guess one way

that you might tackle this question is

just by thinking about the most popular

questions you get asked from your

audience on a daily basis that we might

not have covered today.

How can I screen myself right now? What

test should I do right now to see

at what stage of inflammation and

coronary artery disease am I in? Because

coronary arteries is the number one

cause of death and inflammation is the

underlying cause. So what test should I

be doing right now? That is an important

question. If you're over the age of 30

and you have concerns, one, get a

coronary calcium score.

If your coronary calcium score is zero,

you have no calcium,

then you're in a good place. If you have

coronary calcium,

you need to go see a good cardiologist

that's going to do a prevention program

because it means you already have

athoscerosis.

Athoscerosis meaning plaque

hardening of the arteries.

Yeah.

Number two, you need a good blood test

to look for inflammation. The blood test

that I order is called a Cleveland heart

labs. In it you get your HDL, LDL,

cholesterol. But you look at particle

sizes.

Is my LDL small dense? If it is small

dense particles, is it oxidized? Yes, I

have a problem. My CRP level,

other inflammatory interucan 6,

timonucosis factor, hemoglobin A1C,

sugar level,

all these are part of that panel of

tests. So you should get a good

inflammatory panel which is the

Cleveland Heart Labs. So those are the

two things that everyone must do. Get a

coronary calcium score all adults and do

an inflammatory panel. Inflammation you

got to know whether you look you know

you may not feel inflammation. It's not

like you get a big pimple and it's going

to hurt you but if you have inflammation

in the body yeah you could know about

it. How you have mental fog? I'm not

optimal doc. My memor is going down. I'm

depressed. Depression is inflammation.

Depression is not something

psychological. Okay? Now, this I have to

stress to you and I tell all my

patients, you come in, I'm depressed.

You're depressed because

that very symptom of depression is a

symptom of your inflammation.

You can't be depressed about something

that oh my car is not working very well.

That's a difference from depression.

Depression is is is inflammation in the

brain. So you'll be surprised how many

patients go on my anti-inflammatory

diet, which is I change the diet and fix

them all up and the depression goes

away. So ask yourself not just questions

about physically how you're feeling but

mentally also.

And if the answer is that doc I'm not

optimal I'm forgetful I'm depressed I'm

having sleep dis disturbance I'm

relation things my I've changed my body

is also you have inflammation

we have a closing tradition on this

podcast where the last guest leaves a

question for the next guest not knowing

who they're leaving it for and the

question that's been left for you is

what was the most difficult day of your

life and how did you overcome it

the most difficult day of my life

was was a very personal one for me, you

know, when when when when my my dad

passed away and you know, and I'm Dr.

Jay

and uh

and when he he was sick and he didn't

want to go to the hospital

and then he passed away in his sleep and

then you always ask yourself, could I

have done something differently? you

know you second guess yourself and that

second guessing happened with him of

course it was very very painful but it

happens with patients as well but how

did I overcome it it taught me a lot

about my own limitations as well as a

physician as a son as a scientist as a

reader

and that's why I'm motivated to do what

we are doing here also is to do the best

you can to educate people What was he

sick with? What was his predicament?

He was a cardiac patient already and

he's he's got a very interesting story

actually. He was told that he only had a

few years to live after he had bypass

surgery. But then I put him through all

the things we talked about today. He

lost a lot of weight. He went from 185

lbs to 135 lbs. He changed his diet and

he lived another 30 years and he did

another six world tours and traveled and

he had a wonderful life. Okay. the

impact of simple things that we can do

to change his life. So he stopped

drinking all alcohol as well and he he

really had a very clean diet and

everything else. But that night he came

down with some sort of infection. He had

massive diarrhea and massive massive

explosion. And I think that what really

happened is he he got overwhelmed. You

see it's the gut. He got overwhelmed

with a toxin from his gut and then he

passed away. But but here's a man who

who lived to 89 who was supposed to have

passed away in his 60s and the impact

but but the thing is that you know we we

we shouldn't second guessess ourselves.

We don't want to live in the past.

I want to live in the present moment not

even in the future.

So all these things have taught me to

live in the moment. And one of the

skills I've developed is just that that

when I'm with you, I'm only with you. If

I'm doing your surgery, I'm only doing

your surgery. If I'm having a

conversation with you, you and I are the

only people that matter right now. And

this being in the moment, that that

ability to be that is something I

learned over time because before you

know something bad happens, your next

case, you're still reminiscing about

that and you're regretting that. You

can't do that. Life is only expressed in

this moment right now. So learning how

to live in the moment applies not only

to me but to everybody. We all living in

the past otherwise and or we're worried

about the future. So how do you learn

present moment awareness and live in

this moment so that we will be happier.

We can do what we want to do. Make the

changes we need to make. get the courage

and make the and have the willpower to

go out and make a difference to yourself

and to everyone around you starts with

you being here. Are you here or are you

in your past or have you gone off into

the future? That's a skill that medicine

has taught me and I've become humbled by

it. And this is something that I have

learned and I want to pass on to all my

patients too as well that okay you've

got all these things going on but learn

to live in the moment.

Dr. Jay, thank you so much. Thank you so

much for the wisdom that you've shared

with so many people. If people aren't

familiar with you, you're extremely

prolific and well loved across the

internet for the the public education

work you've done and the the heightening

of awareness of people's heart and their

cardiovascular health more broadly. And

until really before you started making

videos online, a lot of this stuff was

opaque. It was a mystery to a lot of

people. And your YouTube channel has

almost a million subscribers now. And

you you go through some of these

subjects that we've talked about today

in even greater detail. So I'd highly

recommend people go and check you out

there. But also just thank you for

saving so many people's lives cuz you

know that's what you do day in day out

and that's an incredibly I mean there's

probably not a higher calling one can

answer. So thank you for doing what you

do and I can see now why people love

you. so much on online and on YouTube

because you're so incredibly engaging, I

guess is the word, engaging, wise, and

you make the information accessible in a

way that I don't think has been done

before. So, thank you so much. It's a

pleasure to meet you and to have this

conversation with you, and thank you for

enlightening my audience.

The pleasure was mine. Thank you.

This has always blown my mind a little

bit. 53% of you that listen to the show

regularly haven't yet subscribed to the

show. So, could I ask you for a favor?

If you like the show and you like what

we do here and you want to support us,

the free simple way that you can do just

that is by hitting the subscribe button.

And my commitment to you is if you do

that, then I'll do everything in my

power, me and my team, to make sure that

this show is better for you every single

week. We'll listen to your feedback.

We'll find the guests that you want me

to speak to, and we'll continue to do

what we do. Thank you so much.

[Music]

Heat. Heat. N.

[Music]

[Music]