About Joel Kahn, MD
Best-selling author and interventional cardiologist Dr. Joel Kahn shares new research about the number one cause of premature death—heart disease. You’ll learn why high-fat diets and lots of animal protein may not be such a good idea for your gut or your heart. Dr. Kahn will tell you which are the best foods for improving the health of your gut microbiome and reducing arterial plaque buildup, and how women can reduce their risk of heart disease. You’ll also learn about functional biomarkers and how to assess and minimize your risk of heart disease.
Books Discussed in this Episode
Connect with Joel Kahn, MD
Scientific References Mentioned
Costanza, A. C., Moscavitch, S. D., Faria Neto, H. C. C., & Mesquita, E. T. (2015). Probiotic therapy with Saccharomyces boulardii for heart failure patients: A randomized, double-blind, placebo-controlled pilot trial. International Journal of Cardiology, 179, 348–350.
03:18 Dr. Kahn’s Clinic: Dr. Kahn has a busy practice. In the mid-1980s he started in the Cath Lab and became well known for his work there. His goal is to have no one need it with acquired heart disease.
05:54 Reducing Cardiovascular Risk: The majority of people who require C-pap machines are overweight. The cause is in your pantry, shopping cart, refrigerator and freezer. It is what you eat for a snack and how late at night you eat. Food is information. Food is medicine. The root cause of most cardiovascular and related diseases like sleep apnea is obesity and nutrient poor food choices. We should be hearing this from the medical community. Stress, activities, supplementation, smoking, alcohol, social connectedness and sleep issues also impact risk.
08:32 Improving Social Connectedness: “The meaning of life is a life with meaning” Volunteering is a great way to begin becoming connected. Support groups for specific medical problems that you might have can help too. Dr. Kahn has a grass roots nutrition support group. They thought maybe 25 people would attend, but about 1,000 people are attending. They bring in speakers, have small breakout groups, and now local restaurants are responding.
11:29 Carnitine and Heart Disease: A Cleveland Clinic study measured a chemical called TMAO in the blood of thousands of heart patients. The more severe the heart disease, they found higher levels of TMAO. A small number of people (omnivores) were fed a steak and quickly developed high blood levels of TMAO. It is believed to clog our arteries. A small number of vegans were fed a steak, and they did not develop the chemical. It shows that the microbiome of meat eaters and vegans are different. Perhaps a plant-based diet protects from heart disease. We need more information. They did not take people who had been through a complete detox with perfectly functioning guts, who only ate grass fed organic meats and see if they also developed TMAO. Processed meats are associated with disease: early death, rectal cancer, early cardiovascular disease, diabetes and congestive heart failure. Don’t eat junk meat.
14:41 Paleo Diet: The only paleo diets ever studied were not high in fat, contained lean meats and were rich in vegetables. There are a great many variations of the paleo diet with high fats and lots of bacon. Dr. Kahn believes that ¾ of any plate should be a mix of raw and cooked organic vegetables, fruits, nuts and seeds. Ninety-five percent of Americans are eating meat that was raised in an awful manner. A diet full of vegetables and fruit is also better for the environment. Dr. Kahn does not worry about protein levels for his patients, except maybe the elderly, as long as they have a wide variety of plants as the mainstay of the diet. Most of us have too much protein in our diets. The longest lived physically active people of Okinawa eat only 10% protein.
21:44 High Fat Diets and Our Hearts: There is good data that saturated fat participates in releasing bacterial endotoxin through the gut wall into the blood stream. Endotoxin is inflammatory, creates arterial damage and harms heart function. Both recent meta-analysis that stated that the case for saturated fat as a cause for heart issues have been flawed, leaving studies out and changing some of the definitions and criteria. Dr. Kahn is not comfortable with high consumption of any saturated fat in excess. There is little data about coconut oil and heart disease. Palm oil studies show a worsening of heart disease in people who already have heart disease.
25:26 High Fat Diets, Cholesterol and Heart Disease: Fats are broken down into triglycerides and reformulated as cholesterol particles. There are a number of informal case reports about high fat diets causing cholesterol levels to sky rocket. Five to ten years down the road, that may manifest as a stroke, a heart attack or erectile dysfunction.
26:10 Benefits of Vegetables: Rosemary, turmeric, ginger and spices are great, especially fresh spices. In one study, hamburgers on white bread buns from a hospital cafeteria were fed to volunteers. Within 30 to 60 minutes of eating the hospital hamburger, you could measure deterioration in the function and health of arteries. The study was repeated on the same subject on another day with the same burger, but either with a big slice of avocado with a plant-based topping on the burger and nearly all of the negative effects of the burger was negated.
27:32 Benefits of Probiotics and Heart Disease: There is now data showing that probiotic use can lower blood pressure and cholesterol. Many heart conditions are endotoxin leaking conditions, even with a healthy gut, based upon poor blood flow to the gut. Congestive heart failure is where there is not enough circulation to the vessels of the gut. A study involving saccharomyces boulardii, probiotic yeast, with congestive heart failure patients showed tremendous improvements in shortness of breath measures, measures of heart strength, and ability to walk distances without impairment. Probiotic lactobacillus reuteri has shown some benefits in cholesterol reduction.
30:18 Testing for Arterial Health: Best used for cholesterol is a calculated rather than direct measure. Advanced lipid profiles including LDL particle number and particle size is very important for determining cardiac risk. Include inflammation testing for C-reactive protein, myeloperoxidase and plaque test. When you are 45 or 50 years old, at your physical they recommend a mammogram, and/or a colonoscopy. However, if you say you feel well, you are not given an electrocardiogram, a stress test, or a stress echo or nuclear. For 5 to 10 years prior to a silent heart attack, cardiac issues could have been detected with simple low cost testing.
35:34 When to Do Testing: Before we reach the age of 20 we should have a routine cholesterol profile. One person in 400 to 500 has inherited heterozygous familial hyperlipidemia; where a teenager can have a cholesterol level in the 400s or 500s. In your 30s, advanced blood work is reasonable, though not routine. Don’t assume anything by outward appearance. The CIMT carotid imaging study would be appropriate about age 40. A CT scan involves radiation, so there should be other signals or risk factors like diabetes, heavy smoking, lost immediate family member to early heart attack, before embarking upon this test. This might be delayed until you are in your late 40s.
39:02 Women and Heart Disease: As many women as men die from heart disease, but they tend to develop it about 10 years later in life as a post-menopausal condition. A 35 or 45 year old woman may have heart disease from heavy smoking, diabetes, or family history of abnormalities in cholesterol or homocysteine. It is not too early to begin a lifestyle management program. Know your numbers. With obesity and metabolic syndrome climbing, we are seeing much younger people who are 100 pounds overweight, do limited exercise, have HDLs that are way too low and have triglycerides of 600. They look like 70 year old people in 34 year old bodies. Women should get checked early. Women can have the classic symptoms of pressure and angina. Sometimes is it palpitations, fatigue, often short of breath with exertion, or unusual sweating. There could be many causes for these symptoms. Heartburn in both men and women could be heart, not heartburn. Women have less of the typical angina and less warning before the heart attack. Fortunately, women do not drop dead (sudden death) as often as men.
42:26 Chest Pain: Classic angina (angina is Latin for choking) is brief, maybe 2 to 8 minutes. It is not a specific sharp pain. It is pressure, tightness, heaviness, squeezing, or choking, usually brought on by exertion, emotion, a cold, or sexual activity. It can be in the jaw, the back or shoulder, even rarely the earlobe. If it comes on with exertion and goes away when you stop, that may be a prelude to a big one. Go get checked.
44:54 Triglycerides Link to Heart Disease: Triglycerides are lifestyle makers; a weight marker, insulin sensitivity marker, and an insulin resistant marker. People bash satins as worthless. There are frequent side effects, but they can be an important part of the program. There is less data that lowering triglycerides with medication will make you feel better or make you live longer. Green tea is great for lowering triglycerides. Dr. Kahn treats with lifestyle modifications and avoids prescription drugs.
46:30 Stress Management: There is tons of data that shows that stress is the driving factor for lifestyle choices and inciting disease and inflammation. It needs to be part of modern medical treatment. Dr. Kahn insists that his patients learn some hack for stress. The easiest is HeartMath and its heartrate variability. This breathing program has a positive impact in as little as 10 minutes per day. Another useful produce is Holosync. A study of heart attack patients showed that at the end of 5 years, those who were trained in meditation had fewer repeat heart attacks, deaths and repeat hospitalizations dropped 50%.
49:55 Dr. Kahn’s Favorite Nutrient: Although maca is a great adaptogen, stress reducer, and sexual stimulant and he really likes it, he would choose rhodiola. There is more data on the cardiovascular system and rhodiola. It is an adaptogen that helps people to chill. There is data that it improves cardiac function.
50:53 One Health Tip for America: Stop funding the meat and dairy industry and stop supporting GMO and glyphosate. We need support for the fruit and vegetable industry. Get everyone walking. Educate people about standing at work. Data shows that 30 minutes after sitting, our metabolism slows, our insulin resistance goes up, our HDL falls. If we sit long enough, our blood pressure goes up. Calcification of our arteries is linked to how many hours each day that we sit. Get America up and moving.
Rhodiola helps manage stress, a huge and silent contributor to cardiovascular disease.
#1 Health Tip
Stop subsidizing GMO foods, and increase exercise for everyone, including children.