Cardiovascular disease

Heart Surgeon: Why the Spike in Heart Deaths and Tips to Reverse Arterial Plaque

by Mike Mutzel


Heart Surgeon and best selling author Dr. Phil Ovadia discusses the foods and lifestyle factors driving a new wave of early-onset heart disease.


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Research Cited:


Stay off My Operating Table: A Heart Surgeon’s Metabolic Health Guide to Lose Weight, Prevent Disease, and Feel Your Best Every Day

Woodruff, R. C. et al. Trends in Cardiovascular Disease Mortality Rates and Excess Deaths, 2010–2022. Am. J. Prev. Med. (2023) doi:10.1016/j.amepre.2023.11.009.


Episode Show Notes:


01:30 Up to 95% of people with cardiac disease are insulin resistant. Insulin resistance is
largely reversible. Up to 90% heart disease is preventable. Habits get passed down in families.
03:41 Patients have been getting bad advice and bad information. It is a failure of the
healthcare system. The low-fat dietary advice push people toward a higher carb and higher
processed food diet.
04:45 Processed foods and high carbs are the two primary drivers of metabolic disease, the
primary driver of heart disease. Saturated fat as a driver of heart disease has been disproven.
06:53 Insulin resistance damages blood vessels. Blood vessels around your heart are some
of the smallest in your body. Coronary arteries on the surface of the heart are like spaghetti
noodles. They supply the heart with oxygen.
08:48 Atherosclerotic heart disease is the most common form of heart disease. It is a buildup
of plaque in the artery that will slowly or quickly decrease blood flow/oxygen to heart muscle,
damaging the muscle.
11:18 Exercise is indirectly helpful in preventing atherosclerosis. A strong heart can better
tolerate decreased blood flow. Building muscle can help protect your metabolic health.
13:10 The better you can maintain muscle as you age, the better you can deal with the aging
process. Grip strength is one of the best predictors of functional lifespan.
14:30 It is possible to reverse atherosclerosis. Dr. Ovadia has seen it in his practice.
Coronary CT angiogram shows both soft and calcified plaque. Soft plaque may be reversed
over the calcified plaque.
15:10 Stopping the progression of coronary artery calcium puts you at lower risk for a
clinical event. If you improve your diet, you can stop heart disease from getting worse.
16:30 Tests: coronary artery calcium scan (CAC) and coronary CT angiogram (CCTA). Have
the calcium scan, a screening test, to do early and repeat over time. The CCTA is more
detailed. It reports blockages. There is an IV and higher radiation exposure.
18:00 Men should do a CAC in their 40s and women in their 50s, perhaps earlier if you have
a strong family history of cardiac issues, or you are metabolically unhealthy.
18:30 People in their 30s and 40s now end up on the cardiac operating table. Plaque likely
started building in their 20s.
20:30 High LDL may not be dangerous in a person who is metabolically healthy with low
inflammation markers with a zero CAC score.
21:00 The quality of your LDL particles is important. Advanced lipid testing looks at particle
sizes along with oxidized LDL. All high LDL is not the same.
22:54 90% of adults are metabolically unhealthy, so their high LDL is likely dangerous.
23:10 Metabolically healthy people with high LDL may not benefit from lowering LDL and
may cause harm.
24:05 Statin use for over 10 years increases your risk of developing insulin resistance and
type 2 diabetes, primary drivers of heart disease. Absolute risk reduction in heart disease for
taking statins over long periods are miniscule. Dealing with insulin resistance through diet
causes a much greater magnitude reduction in risk.
26:30 Inflammation is an important part of the development of heart disease.
27:40 High blood pressure root cause is insulin resistance/metabolic disease. Assess lipid
particle size, insulin resistance, and inflammation markers.
31:41 Ferritin testing measures total body iron stores. It is also an inflammation marker. It goes
up with inflammation. Increased ferritin is a risk factor for cardiovascular disease. Blood
donation may be helpful if inflammation markers are low.
35:50 Linoleic acid LDL oxidation hypothesis: Polyunsaturated fatty acids are more
susceptible to oxidation. Any diet that eliminates processed food improves your outcomes.
37:30 Plant-based diets that eliminate processed foods are better than standard American
diets. Plant-based diets lower LDL, but may not support a better health outcome.
40:25 Lowering your intake of omega 6 improves your omega 3 index.
41:10 Low vitamin D corelates with many disease states. Improve diet and lifestyle to improve
your levels over supplementation. Exercise in the sun.
42:00 Sun exposure has been misunderstood. Your skin is more susceptible to sun damage
when there are high levels of polyunsaturated fat in the cells of your skin.
44:10 Triglycerides is a higher risk than LDL. Triglycerides is a marker of insulin resistance.
Improving metabolic health improves triglycerides. High dose EPA omega 3s can lower
48:30 Bioidentical hormones are superior to synthetic. They do not increase cardiovascular
risk and may reduce the risk. They should be used to manage menopause symptoms.
50:03 Low testosterone is a risk factor for heart disease. Low T can be from metabolic
disease. When metabolic health improves, so do T levels.
53:10 Heart surgery does not fix the underlying problem. The cause needs to be
addressed. It is not only obese people who require heart surgery and develop heart disease.
55:05 Fat on the outside of the heart is another form of visceral fat. The fat coating is
happening on all of the organs. Imaging visceral fat is a powerful tool.

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