Latest / Hardiness with Dr Paul Taylor / Preventive cardiology, exercise, nutrition, stress, and longevity with Dr. Ross Walker

Transcript

Preventive cardiology, exercise, nutrition, stress, and longevity with Dr. Ross Walker · Hardiness with Dr Paul Taylor

• 0:08
  Speaker 1: Dr. Ross Walker, welcome to the podcast.
• 0:11
  Speaker 2: Thank you, Paul.
• 0:13
  Speaker 3: So we met recently. Actually, before that, I met your daughter,
• 0:18
  Speaker 3: who's brilliant. She's a great speaker. She was actually emceeing
• 0:21
  Speaker 3: at a conference I was on. I was chatting to
• 0:23
  Speaker 3: her and she said who she was.
• 0:24
  Speaker 1: And I'm like, is your dad Ross Walker?
• 0:25
  Speaker 2: She's like, yeah.
• 0:26
  Speaker 3: And I'm like, Oh, I happen to be emceeing a
• 0:29
  Speaker 3: conference that he's talking at next month, which was really
• 0:33
  Speaker 3: quite funny. But you, I mean, I knew about you
• 0:37
  Speaker 3: before this thing because I'd heard you on the radio
• 0:40
  Speaker 3: lots of times and talk a lot of sense. I
• 0:43
  Speaker 3: think every Australian will probably have heard of you or
• 0:47
  Speaker 3: every Australian over a certain age because you're an extremely
• 0:51
  Speaker 3: famous preventative cardiologist in Australia, not many preventative.
• 0:55
  Speaker 2: Ones kicking around.
• 0:57
  Speaker 3: But for our international listeners, can you just give us
• 1:01
  Speaker 3: the quick, it has to be the quick summary of
• 1:03
  Speaker 3: your background because I know it's very, very extensive.
• 1:07
  Speaker 2: Right. Well, I've been a doctor for 47 years and cardiologist, obviously,
• 1:11
  Speaker 2: for most of that. And about 30 years ago, I
• 1:14
  Speaker 2: started focusing on prevention because this is going to shock you, Paul.
• 1:17
  Speaker 2: The best treatment of heart disease, cancer, Alzheimer's, osteoporosis, diabetes
• 1:23
  Speaker 2: is not to get them in the first place. Yeah.
• 1:25
  Speaker 2: My whole career is based on the concept of prevention.
• 1:29
  Speaker 2: And I believe over 90% of modern diseases are preventable.
• 1:32
  Speaker 2: I've written seven books. For the general public, my eighth
• 1:36
  Speaker 2: book's about to come out in the next six months
• 1:38
  Speaker 2: called Healthspan. Because again, I don't believe in lifespan. I
• 1:42
  Speaker 2: believe in being as healthy as you possibly can up
• 1:45
  Speaker 2: to the time you go into your death phase and
• 1:47
  Speaker 2: make your death phase as short as possible. So that's
• 1:50
  Speaker 2: a quick summary of my career.
• 1:52
  Speaker 1: I think you're very much like me.
• 1:53
  Speaker 3: I want to be out playing golf when I'm about 92,
• 1:57
  Speaker 3: come back, go to.
• 1:58
  Speaker 1: Bed and just not wake up.
• 2:00
  Speaker 2: Yeah, or 100.
• 2:01
  Speaker 1: Yeah, yeah, yeah. So that's clearly the way ahead. So
• 2:07
  Speaker 1: tell us this.
• 2:07
  Speaker 3: Why did you move from, I term it, the sick
• 2:12
  Speaker 3: care system into the health care system? Because I think
• 2:16
  Speaker 3: In Australia, and I think it's very similar, lots of
• 2:19
  Speaker 3: developed nations, about 98, 98.5% of all government spending on
• 2:24
  Speaker 3: healthcare is on tertiary treatment. And as we both know,
• 2:28
  Speaker 3: primary and secondary prevention are cheaper, they're more effective, and
• 2:31
  Speaker 3: they're less painful.
• 2:32
  Speaker 1: When did you, 30 years ago, I mean.
• 2:35
  Speaker 3: That's pretty progressive, 30 years ago. What was the driver
• 2:39
  Speaker 3: for you to make the jump?
• 2:41
  Speaker 2: But my interest started, back in the 1980s when I
• 2:44
  Speaker 2: was a cardiology registrar. And this is where I had
• 2:47
  Speaker 2: my light bulb moment. I was going down to the
• 2:50
  Speaker 2: post cardiac surgical ward and I saw people down there
• 2:55
  Speaker 2: having this mutilating operation on their chest. So having their
• 2:57
  Speaker 2: chest split open, not once, but sometimes two or three times.
• 3:02
  Speaker 2: And they were still fat and they were still smoking.
• 3:06
  Speaker 2: And as Albert Einstein said, there's nothing that's a more
• 3:08
  Speaker 2: certain sign of insanity than to do the same thing
• 3:10
  Speaker 2: over and over again, expect a different result. I thought
• 3:12
  Speaker 2: to myself back then in the 1980s, there's got to
• 3:15
  Speaker 2: be a better way of treating coronary artery disease, which
• 3:20
  Speaker 2: is obviously my main focus, than having your chest split
• 3:23
  Speaker 2: open on multiple occasions. And see, the problem is back then,
• 3:27
  Speaker 2: there's an old joke, Paul, what's the difference between God
• 3:30
  Speaker 2: and a cardiothoracic surgeon? God doesn't think he's a cardiothoracic surgeon.
• 3:35
  Speaker 2: And back then, the cardiac surgeons, I'm not saying they
• 3:37
  Speaker 2: are now, but they were a tad arrogant. So they
• 3:41
  Speaker 2: thought that once they did the operation on you, you
• 3:43
  Speaker 2: were cured. So people would go home from the hospital
• 3:46
  Speaker 2: with no medications, no lifestyle advice, just go home, I've
• 3:50
  Speaker 2: cured you. And it was just complete nonsense. So back six, seven,
• 3:54
  Speaker 2: eight years later, this is when we're doing vein grafts
• 3:56
  Speaker 2: rather than the mammary grafts. But then I just progressively
• 4:00
  Speaker 2: got more interested in the concept of prevention because it
• 4:02
  Speaker 2: was just logical to me. Why put up with the
• 4:05
  Speaker 2: misery of chronic disease, of being on buckets of medications?
• 4:09
  Speaker 2: And I'm not saying you can walk away from medications
• 4:12
  Speaker 2: if you've got a chronic disease, but I now have
• 4:14
  Speaker 2: developed what I call my 80-10-10 protocol. 80% is lifestyle.
• 4:20
  Speaker 2: So how you look after yourself, what I call the
• 4:22
  Speaker 2: five keys of being healthy, which I'll go through, is
• 4:25
  Speaker 2: four times more powerful than anything a damn doctor can suggest.
• 4:29
  Speaker 2: So what are the five keys? From the least important
• 4:32
  Speaker 2: to the most important. Number one, you cannot be healthy
• 4:35
  Speaker 2: and have any addictions. You cannot be healthy and smoke
• 4:38
  Speaker 2: or vape, smoke marijuana. You cannot be healthy and drink
• 4:41
  Speaker 2: too much grog. You cannot be healthy and use any
• 4:44
  Speaker 2: illegal drugs. Number two, good quality sleep. Seven to eight
• 4:47
  Speaker 2: hours of good quality sleep is as good for your
• 4:49
  Speaker 2: body as not smoking. Number three, third best drug on
• 4:53
  Speaker 2: the planet is good nutrition. And nutrition's simple. Eat less food,
• 4:58
  Speaker 2: eat more natural food. That's all you need to know.
• 5:01
  Speaker 2: It's a tragedy, Paul. that only five percent of the
• 5:04
  Speaker 2: modern world has two or three pieces of fruit per day,
• 5:08
  Speaker 2: three to five servings of vegetables per day, only five percent.
• 5:11
  Speaker 2: And those who do have the lowest rates of heart disease, cancer, Alzheimer's,
• 5:15
  Speaker 2: et cetera, doesn't do zip to your cholesterol. It keeps
• 5:18
  Speaker 2: your immune system healthy. Number four is the second best
• 5:22
  Speaker 2: drug in the planet that you and I are very
• 5:24
  Speaker 2: strong proponents of. It's called exercise. Yeah. Three to five
• 5:28
  Speaker 2: hours a week of exercise, two thirds cardio, a third
• 5:31
  Speaker 2: resistance training. And again, tragically, only 25% of adults do that.
• 5:35
  Speaker 2: And even worse, only 10% of people over the age
• 5:39
  Speaker 2: of 65 have a three to five hour a week
• 5:42
  Speaker 2: exercise habit. And just by doing that, you reduce your
• 5:44
  Speaker 2: risk by 30%. Heart disease, cancer, Alzheimer's, diabetes, 50% reduction
• 5:50
  Speaker 2: in osteoporosis and depression. You drop your blood pressure and
• 5:53
  Speaker 2: you sleep better. There's no pharmaceutical preparation known to man
• 5:57
  Speaker 2: that comes anywhere near the strength of exercise. And I
• 6:00
  Speaker 2: say all the time in my professional talks, There is
• 6:03
  Speaker 2: no such thing as healthy aging without exercise. Then finally,
• 6:07
  Speaker 2: number five, which is easily the most important drug on
• 6:10
  Speaker 2: the planet, it's a thing called happiness. And there's this
• 6:13
  Speaker 2: little known university in America called Harvard. Harvard have been
• 6:18
  Speaker 2: doing for the last 85 years the grant study, which
• 6:21
  Speaker 2: shows beyond a doubt the one key to health and
• 6:24
  Speaker 2: happiness is to have someone else in your life who
• 6:26
  Speaker 2: loves and cares for you, who you love and care for.
• 6:30
  Speaker 2: And so it's really important to do those five keys. Now,
• 6:32
  Speaker 2: there are two studies, two major studies, one called the
• 6:35
  Speaker 2: Morgan Trial, M-O-R-G-E-N, out of Holland, showed that if you
• 6:40
  Speaker 2: practice those five keys to being healthy compared with the
• 6:42
  Speaker 2: people who do it the worst, so the highest quintile
• 6:45
  Speaker 2: versus the lowest quintile, you reduce your risk for cardiovascular
• 6:49
  Speaker 2: disease by 83%. Whereas something like a standard statin drug
• 6:55
  Speaker 2: in standard doses is probably about a 20% to 30% reduction,
• 6:58
  Speaker 2: with the potential for side effects, but we can talk
• 7:00
  Speaker 2: about that later. Now, that's 80% of your management. 10%
• 7:04
  Speaker 2: of your management is the appropriate use of orthodox medicine
• 7:07
  Speaker 2: and all of the techniques that go where, the pharmaceutical drugs,
• 7:10
  Speaker 2: the procedures, whatever. And the final 10%, which most doctors
• 7:14
  Speaker 2: don't even believe in, is the use of evidence-based supplements.
• 7:18
  Speaker 2: Supplements have to have an evidence base, not just because
• 7:22
  Speaker 2: you're in a health food store and it's claiming something.
• 7:24
  Speaker 2: That's often nonsense. And we should probably at some stage
• 7:28
  Speaker 2: talk about one of my favorite topics, which is the
• 7:30
  Speaker 2: MTHFR gene. But anyway, we can talk about that later.
• 7:33
  Speaker 2: But that's 80-10-10, and that's how I practice medicine. And
• 7:37
  Speaker 2: those principles are there for all my patients. And I've
• 7:40
  Speaker 2: got to tell you, tragically, only 10% of my patients
• 7:43
  Speaker 2: follow it to the letter, and they're the ones long-term
• 7:46
  Speaker 2: who do the best. Brilliant.
• 7:49
  Speaker 3: There's so much in that. I think there's five different
• 7:51
  Speaker 3: podcasts there. There's a podcast on each one of the keys.
• 7:54
  Speaker 2: Sure.
• 7:55
  Speaker 3: But let's double click on a couple of them as
• 7:58
  Speaker 3: we go through this. I want to talk about exercise first.
• 8:02
  Speaker 3: Do you know the thing for me? Actually, let me
• 8:04
  Speaker 3: take a step back. The world's biggest killer, everybody knows,
• 8:08
  Speaker 3: is cardiovascular disease. I think in Australia now, for females,
• 8:12
  Speaker 3: it's dementia. But overall, it's cardiovascular disease. But I actually
• 8:18
  Speaker 3: think that the biggest driver of it is sarcopenia.
• 8:23
  Speaker 1: And I want to get your opinion on it, right?
• 8:25
  Speaker 3: Because we know that falls are the fifth biggest killer
• 8:29
  Speaker 3: of people in their 70s, and that comes from muscle wasting.
• 8:32
  Speaker 1: But if you.
• 8:32
  Speaker 3: Have poor levels of muscle, and therefore you're not getting
• 8:37
  Speaker 3: all the myokines that come from the muscle contraction, poor
• 8:41
  Speaker 3: muscle and poor exercise, as you said, dramatically increases your
• 8:44
  Speaker 3: risk of cardiovascular disease. If you're sedentary, it dramatically increases
• 8:49
  Speaker 3: your risk of neurodegenerative diseases, which I think are the
• 8:51
  Speaker 3: second biggest killer. If you're sedentary, it dramatically increases your
• 8:55
  Speaker 3: risk of metabolic diseases and significantly increases your risk of cancer.
• 9:00
  Speaker 3: So I think here we have the fifth one directly
• 9:02
  Speaker 3: and then all four pulling the levers massively. And I
• 9:08
  Speaker 3: don't think there's anything else that does that.
• 9:11
  Speaker 2: No, no, no. I totally agree with you. I think
• 9:14
  Speaker 2: that everyone talks about osteoporosis, but what they don't realize
• 9:18
  Speaker 2: is one of the major drivers of osteoporosis is exactly
• 9:21
  Speaker 2: what you said, which is sarcopenia. If you don't have
• 9:23
  Speaker 2: strong muscles to support your bones, your bones are in
• 9:27
  Speaker 2: big trouble. And if you don't have strong muscles that
• 9:29
  Speaker 2: allow you to get out of a chair. So we
• 9:31
  Speaker 2: know things like grip strength and your ability to get
• 9:34
  Speaker 2: up from a chair without any issues is a great
• 9:38
  Speaker 2: marker for sarcopenia frailty. And all of these things are
• 9:41
  Speaker 2: so bad for you. And Now we're getting people in there,
• 9:44
  Speaker 2: and I've just turned 70, but we're getting people in
• 9:47
  Speaker 2: their 70s and 80s who are on multiple medications and
• 9:51
  Speaker 2: they're incredibly frail and they're not doing anything to support
• 9:55
  Speaker 2: their muscles. And so that's why I say, people say, oh, doctor,
• 9:57
  Speaker 2: I go for a walk every day. Yeah, but do you...
• 10:00
  Speaker 2: do any resistance training do you do pilates or yoga
• 10:03
  Speaker 2: or have some weights and i i do half an
• 10:06
  Speaker 2: hour on my bike every day that sort of thing
• 10:08
  Speaker 2: over my shoulder there's my exercise bike i've broken four
• 10:11
  Speaker 2: since i gave up soccer at 52. um and from
• 10:15
  Speaker 2: over years i'll do a half an hour when we
• 10:16
  Speaker 2: finish this podcast on that and i do that every
• 10:18
  Speaker 2: day but i also do 15 minutes of weights and
• 10:21
  Speaker 2: stretching every morning to keep the muscles strong and i
• 10:23
  Speaker 2: think that's so important because it there's no doubt that
• 10:28
  Speaker 2: that exercise habit reduces your risk for the four horsemen
• 10:31
  Speaker 2: that you just mentioned.
• 10:32
  Speaker 3: Yeah yeah absolutely and mental health like the impact on
• 10:36
  Speaker 3: mental health is massive as well.
• 10:37
  Speaker 2: Well again just on that studies have shown i mentioned
• 10:41
  Speaker 2: the reduction in depression but The studies have shown beyond
• 10:44
  Speaker 2: a doubt that having a regular exercise habit is probably
• 10:47
  Speaker 2: good as an antidepressant.
• 10:49
  Speaker 3: The British Medical Journal, 218 studies, looking at, importantly, they
• 10:55
  Speaker 3: were looking at the clinical outcome. I can't remember what
• 10:59
  Speaker 3: it's called. Geez, I'm forgetting now. Where the individual feels better, right?
• 11:02
  Speaker 3: Not statistical significance, but whatever it was. But they found
• 11:06
  Speaker 3: that every exercise intervention was, absolutely trumped an SSRI, right?
• 11:12
  Speaker 3: But let's, I want to talk about actually something that
• 11:15
  Speaker 3: just came to mind. Like this is the.
• 11:17
  Speaker 1: Slam dunk for heart health and exercise.
• 11:20
  Speaker 3: I'm not sure if you're familiar, I'm sure you are,
• 11:22
  Speaker 3: the Dallas Bedrest and Retraining Study by Ben Levine, where
• 11:26
  Speaker 3: they took these people, it was in the 60s, I believe,
• 11:31
  Speaker 3: four or five, I think it was, young men, put
• 11:34
  Speaker 3: them in complete bedrest for two weeks, imaged their hearts
• 11:37
  Speaker 3: at the start, and then imaged them at the end.
• 11:40
  Speaker 3: And at the end of three weeks, their hearts had
• 11:42
  Speaker 3: aged for 30 years. And then they trained them and
• 11:47
  Speaker 3: they got all their VO2 max back and actually had improvements.
• 11:51
  Speaker 3: But then they found them again in their 50s, brought
• 11:55
  Speaker 3: them into the lab and found that in their 50s,
• 11:58
  Speaker 3: their hearts were in better shape than they were after
• 12:00
  Speaker 3: three weeks of bed rest in their 20s, right? And
• 12:03
  Speaker 3: then they trained these guys again. And they improved on
• 12:08
  Speaker 3: all measures of heart function, whatever they may be. But
• 12:12
  Speaker 3: then the same group did another bunch of people in
• 12:15
  Speaker 3: their sixties who were recently sedentary. And they find that
• 12:18
  Speaker 3: they didn't get anywhere near the benefits of doing it
• 12:22
  Speaker 3: in their fifties. So I think for me, you know,
• 12:25
  Speaker 3: as you will know, early doing this stuff early, not,
• 12:29
  Speaker 3: not thinking to yourself, my career is a priority. I'm
• 12:33
  Speaker 3: going to leave fitness until I retire. because then it's
• 12:37
  Speaker 3: nowhere near as effective.
• 12:38
  Speaker 2: As it is. And the reason being, and let me
• 12:41
  Speaker 2: be brutal to most people listening to this podcast, our
• 12:44
  Speaker 2: body evolutionary-wise was only designed to work well for 30,
• 12:48
  Speaker 2: 40 years running around a jungle with a spear, and
• 12:50
  Speaker 2: then you died from either trauma or infection. So old
• 12:54
  Speaker 2: age is actually a disease process. And part of the
• 12:57
  Speaker 2: old age process is fibrosis and scarring of all the tissues.
• 13:02
  Speaker 2: And if you throw on top of that metabolic syndrome
• 13:04
  Speaker 2: with fat buildup in the heart and the brain. So
• 13:06
  Speaker 2: the reason these GLP receptor agonists have gone nuts is
• 13:09
  Speaker 2: because they also take the fat out of the organs
• 13:11
  Speaker 2: as well. So you've got aging organs. So every decade,
• 13:16
  Speaker 2: the heart gets stiffer, the arteries get stiffer. So for
• 13:19
  Speaker 2: all us men over 50, everything stiffens up apart from
• 13:21
  Speaker 2: the bit you want to. Sorry, I have to throw
• 13:27
  Speaker 2: in the jokes every now and then. But everything gets
• 13:30
  Speaker 2: stiffer apart from that bit. And so therefore, that's why
• 13:33
  Speaker 2: it if you start your exercise in your 60s, it
• 13:36
  Speaker 2: doesn't work as well as if you start in your 50s.
• 13:38
  Speaker 2: But I don't want anyone listening to this to say, oh,
• 13:41
  Speaker 2: I'm too.
• 13:41
  Speaker 1: Fat, there's no point.
• 13:42
  Speaker 2: You will always get a benefit from having an exercise habit.
• 13:46
  Speaker 2: But it's also important, I say this to a lot
• 13:48
  Speaker 2: of people, when you're 80, don't push yourself as hard
• 13:51
  Speaker 2: as you did when you were 50 because your body
• 13:54
  Speaker 2: won't cope with it. And again, another thing I say,
• 13:57
  Speaker 2: the only joint you blow over the age of 50
• 13:58
  Speaker 2: is your hip or your knee. So you don't want
• 14:01
  Speaker 2: to push that too hard either. And that's why I
• 14:03
  Speaker 2: prefer an exercise bike with exercise or a cycle than
• 14:07
  Speaker 2: people who run on treadmills because you're really pounding your
• 14:10
  Speaker 2: knee and your hip when you do that. Yeah, yeah, yeah, yeah.
• 14:12
  Speaker 2: I agree.
• 14:13
  Speaker 3: And I, like you, in my 50s have given up
• 14:15
  Speaker 3: soccer and moved to an exercise bike.
• 14:17
  Speaker 1: I'm also doing a bit of crossfit.
• 14:19
  Speaker 2: Well, my knee made me give up soccer, which I
• 14:21
  Speaker 2: had replaced six years ago, unfortunately.
• 14:24
  Speaker 1: Yeah, well, it happens, doesn't it?
• 14:26
  Speaker 2: Yeah.
• 14:26
  Speaker 1: Just on the exercise, I want to get your.
• 14:29
  Speaker 3: Opinion on this, and it's probably going to be an
• 14:31
  Speaker 3: educated guess. So when we look into all of the,
• 14:35
  Speaker 3: and look, it is observational data, but they've got a
• 14:38
  Speaker 3: lot of it, looking at the optimal dose for exercise,
• 14:42
  Speaker 3: and there's that hormetic effect, right, where none is bad
• 14:45
  Speaker 3: for you, some is good, more is better, but there's
• 14:48
  Speaker 3: then the extreme exercise hypothesis.
• 14:51
  Speaker 2: Yep, yep.
• 14:51
  Speaker 3: And for cardiovascular, we know that's a shitload, right? We
• 14:55
  Speaker 3: know it's the triathletes and stuff. It's like 15 hours
• 14:58
  Speaker 3: high intensity exercise a week. That's where you lose the
• 15:02
  Speaker 3: benefits or start to erode them. But with resistance training,
• 15:08
  Speaker 3: it seems to be about 90.
• 15:11
  Speaker 1: Minutes a week. And I'm like, Jesus, why would that be?
• 15:15
  Speaker 3: Now, I have two hypotheses that are not tested, but
• 15:18
  Speaker 3: I wanted to run them past you. One is, We
• 15:22
  Speaker 3: only now have 30 years of data on resistance training
• 15:26
  Speaker 3: from people who started in our 30 or 40 or
• 15:29
  Speaker 3: 50 years for people who started in the 70s and 80s.
• 15:31
  Speaker 3: And most people who were doing resistance training then were
• 15:33
  Speaker 3: probably taking anabolic steroids.
• 15:35
  Speaker 1: That may have had a negative effect.
• 15:37
  Speaker 3: So I think that may be clouding some of the
• 15:40
  Speaker 3: longitudinal data. But the only thing that I can possibly
• 15:44
  Speaker 3: think of is the blood pressure effect that when you're
• 15:47
  Speaker 3: doing heavy resistance training, like your blood pressure goes through the,
• 15:51
  Speaker 3: especially if you're doing heavy isometrics or negatives. Have you
• 15:56
  Speaker 3: any inclination as to why the dose in terms of
• 16:00
  Speaker 3: time is much lower for resistance training than it is
• 16:04
  Speaker 3: for cardiovascular training?
• 16:06
  Speaker 2: No, no, I really can't. I can't give you any,
• 16:08
  Speaker 2: even an educated guess there, but, One point I'd really
• 16:11
  Speaker 2: like to make about all forms of exercise is that
• 16:15
  Speaker 2: one of the best drugs on the planet is a
• 16:17
  Speaker 2: thing called vasodilatation and the best vasodilator. And this is
• 16:22
  Speaker 2: pretty simplistic stuff, but I think it explains it well.
• 16:25
  Speaker 2: The best vasodilator anyone can do is exercise. And three
• 16:29
  Speaker 2: to five hours a week of exercise vasodilates your artery.
• 16:32
  Speaker 2: And this is what it does. This is why it's
• 16:33
  Speaker 2: so good for dementia because you're flushing blood through the
• 16:37
  Speaker 2: microcirculation in your brain, flushing all the toxins out. So
• 16:41
  Speaker 2: dementia is a vascular disease. It's just a wash down
• 16:44
  Speaker 2: effect from the big vessels. So I say to my patients,
• 16:47
  Speaker 2: just imagine a dam with the big arteries, like the
• 16:50
  Speaker 2: big pipes coming out of the dam. They're your carotid arteries,
• 16:53
  Speaker 2: your coronary arteries. The branch vessels are the pipes in
• 16:56
  Speaker 2: your street and the microcirculation of the pipes in your
• 16:59
  Speaker 2: house and the tap. So if you have some bigger
• 17:03
  Speaker 2: vascular disease, you get the wash down effect into the
• 17:06
  Speaker 2: smaller vessels. So you get sludge in the smaller vessels.
• 17:09
  Speaker 2: So Every time you have a thought or an emotion,
• 17:11
  Speaker 2: you create a waste product that has to be washed out.
• 17:14
  Speaker 2: So as you get older, your immune system in the brain,
• 17:17
  Speaker 2: the glial cells don't work as well. The microcirculation becomes sluggish.
• 17:21
  Speaker 2: So all of these toxic proteins accumulate in your brain
• 17:24
  Speaker 2: and destroy your neurons, thus Alzheimer's disease. So vasodilatation that
• 17:29
  Speaker 2: you get from exercise, one of the most important things
• 17:32
  Speaker 2: you can do. Now, again, on my radio show a
• 17:35
  Speaker 2: couple of weeks ago, I spoke about a major study
• 17:38
  Speaker 2: on what I call vitamin V and vitamin C. Vitamin
• 17:42
  Speaker 2: V and C are Viagra and Cialis. And this study
• 17:45
  Speaker 2: showed that men over the age of 40, who were
• 17:48
  Speaker 2: the highest end users of Viagra and Cialis, had, well,
• 17:52
  Speaker 2: this is quite extraordinary, a three-year study, had a 56%
• 17:56
  Speaker 2: reduction in all-cause death, a 55% reduction in dementia. And
• 18:02
  Speaker 2: this study showed a 36% reduction in heart attack and stroke,
• 18:05
  Speaker 2: but in other studies, a 50% reduction in in cardiovascular events.
• 18:09
  Speaker 2: And there's even pointers that it reduces cancer. And I
• 18:11
  Speaker 2: think the reason for this is that they're vasodilators. They
• 18:16
  Speaker 2: don't just open up the most important artery in the
• 18:18
  Speaker 2: male body. They open up all other arteries as well.
• 18:21
  Speaker 2: So that's why I'm now encouraging all of my male
• 18:24
  Speaker 2: patients over the age of 50 to use these drugs
• 18:27
  Speaker 2: as often as they like, because you get the benefits.
• 18:30
  Speaker 2: But don't see it as a replacement for excise. Excise
• 18:32
  Speaker 2: is easily the best vasodilator. I hope there is never
• 18:36
  Speaker 2: a pill that replaces exercise because we need to get
• 18:40
  Speaker 2: out and do it. And we need that three to
• 18:42
  Speaker 2: five hour a week commitment. And to get back to
• 18:44
  Speaker 2: what you were saying, people who are very high level athletes,
• 18:49
  Speaker 2: there's a subgroup of them who will develop more coronary calcification,
• 18:53
  Speaker 2: the more exercise they do. And just think of it,
• 18:56
  Speaker 2: they're just pounding those arteries just too much. And the
• 18:58
  Speaker 2: more you pound the arteries, the more you lay down
• 19:01
  Speaker 2: plaque in the wall of your arteries from going overboard.
• 19:04
  Speaker 2: But you see, this is what I say all the time, Paul,
• 19:06
  Speaker 2: Every single condition is genetic. Your genes load the gun,
• 19:11
  Speaker 2: your environment puts the trigger. So in 47 years of
• 19:15
  Speaker 2: being a doctor, I've never seen one person who had
• 19:18
  Speaker 2: a heart attack, stroke, stent, bypass, who wasn't under some
• 19:22
  Speaker 2: form of stress at the time, but that's with genetic predisposition.
• 19:26
  Speaker 2: So I tell the story about my fat mate, who's
• 19:30
  Speaker 2: a 71-year-old retired pediatric surgeon. He's a human vacuum cleaner,
• 19:35
  Speaker 2: this guy. He loves food. Hates exercise. But his diabetic
• 19:40
  Speaker 2: hypertensive is on 20 pills for these things. And his
• 19:43
  Speaker 2: coronary calcium score is four. He's got almost nothing in
• 19:46
  Speaker 2: his arteries. Now, I'm not saying that justifies his obesity
• 19:49
  Speaker 2: or his diabetes because his body's a wreck from obesity,
• 19:53
  Speaker 2: but I'm saying he probably won't have a major heart
• 19:55
  Speaker 2: attack because his calcium score is so low. I said probably.
• 19:59
  Speaker 2: I'm not saying definitely won't. But the worst coronary calcium
• 20:04
  Speaker 2: score I have, now we have a gradient in these
• 20:06
  Speaker 2: calcium scores. Anything above 400 is serious. is a 68-year-old
• 20:10
  Speaker 2: man in the fitness industry, doesn't have an ounce of
• 20:13
  Speaker 2: body fat, normal cholesterol, blood pressure, never smoked, not diabetic,
• 20:19
  Speaker 2: and no family history. So none of the five major
• 20:23
  Speaker 2: risk factors for heart disease, but his lipoprotein did lay
• 20:26
  Speaker 2: as high. Ah, yes. His coronary calcium score at the
• 20:30
  Speaker 2: age of 68 was 8,100. Holy guacamole. The biggest I've
• 20:33
  Speaker 2: ever seen. And he needed bypass surgery 12 years ago.
• 20:41
  Speaker 2: He sent me an email a few years back with
• 20:43
  Speaker 2: a picture of him and his mates winning their latest
• 20:45
  Speaker 2: basketball grand final. And tragically, he died last year from
• 20:49
  Speaker 2: pulmonary fibrosis, which is unrelated to his heart disease. But
• 20:53
  Speaker 2: had he been a profligate self-abuser, had he stressed his body,
• 20:57
  Speaker 2: he probably would have died from his lousy genes 20
• 20:59
  Speaker 2: years before. So even though you might have lousy genes,
• 21:04
  Speaker 2: you can do something about the lousy genes. You can
• 21:07
  Speaker 2: change the phenotype. not the genotype.
• 21:10
  Speaker 3: Yeah, look, 100%. I know all my genetics have been tested,
• 21:13
  Speaker 3: as have my family's. We are shocking for diabetes. My
• 21:16
  Speaker 3: mother and brother have diabetes. I don't because of the
• 21:20
  Speaker 3: hard work, right? And I always say you either do
• 21:23
  Speaker 3: the hard work in terms of the lifestyle, I mean
• 21:25
  Speaker 3: the five keys that you talk about, when you're doing
• 21:28
  Speaker 3: their hard, but you either do the hard work now
• 21:30
  Speaker 3: or you pay the hard consequences later on.
• 21:32
  Speaker 2: Absolutely. It's choose your heart, right? I don't walk into
• 21:35
  Speaker 2: this room every day and go, wow, I'm about to
• 21:38
  Speaker 2: get my excise bike, how exciting. But at the end
• 21:41
  Speaker 2: of it, I feel a sense of achievement. And if
• 21:43
  Speaker 2: I don't do it, Paul, I feel dreadful. I feel
• 21:45
  Speaker 2: guilty and I think I've got to do the excise.
• 21:47
  Speaker 2: So it's become such an important part of my life.
• 21:50
  Speaker 1: And do you know another thing?
• 21:51
  Speaker 3: I think there is a neurobiological mechanism that's going on here, right?
• 21:57
  Speaker 3: Something called the mid anterior cingulate cortex is the part
• 22:02
  Speaker 3: of the brain that's associated with doing hard things.
• 22:05
  Speaker 1: And when people who do.
• 22:07
  Speaker 3: Hard things, that part of the brain grows. And people
• 22:10
  Speaker 3: who have a larger part of that brain, that part
• 22:13
  Speaker 3: of the brain, have more persistence, more grit, and they
• 22:16
  Speaker 3: put in more effort. This is the challenge muscle in
• 22:19
  Speaker 3: the brain. And every time you or me are jumping
• 22:22
  Speaker 3: on an exercise bike when we don't want to, we
• 22:24
  Speaker 3: are exercising and developing that part of the brain. I
• 22:28
  Speaker 3: think it's use it or lose it. And I think
• 22:30
  Speaker 3: that's an underappreciated thing effect of when you said earlier
• 22:35
  Speaker 3: on i hope they don't have an exercise pill because
• 22:39
  Speaker 3: i think an underappreciated effect is the impact on those
• 22:43
  Speaker 3: neurobiological areas that that get you to do hard things
• 22:48
  Speaker 3: totally that's hugely important.
• 22:50
  Speaker 2: I completely agree i mean look you and i both
• 22:52
  Speaker 2: ex-soccer players and i it was one of my joys
• 22:55
  Speaker 2: turning i was the captain of the team sweeper at
• 22:57
  Speaker 2: the back and i never I used to love breaking
• 22:59
  Speaker 2: forwards legs. And I've lost that joy. When I drive
• 23:03
  Speaker 2: past a soccer field and see these old farts playing soccer,
• 23:06
  Speaker 2: I think, oh, I'd love to be back on there.
• 23:08
  Speaker 2: But after the knee replacement, one bad tackle and I'm gone.
• 23:12
  Speaker 2: So therefore, I've lost that joy. And I don't get
• 23:15
  Speaker 2: anywhere near the same joy when I sit in the
• 23:17
  Speaker 2: excise bike, of course, because that mateship and just the
• 23:21
  Speaker 2: skills and everything else that goes with it was such
• 23:23
  Speaker 2: so wonderful. But I think this is the problem with
• 23:25
  Speaker 2: getting old. you have to accept certain things that you
• 23:29
  Speaker 2: could have done 20, 30 years ago that you can't
• 23:31
  Speaker 2: do now and just adjust to it. And I think,
• 23:34
  Speaker 2: I think life is so precious and I love life.
• 23:37
  Speaker 2: I love every aspect of it that I just think
• 23:39
  Speaker 2: I want to live for another, well, I'm 70 now.
• 23:42
  Speaker 2: I want to live for another 30 years.
• 23:45
  Speaker 1: Get the three digits.
• 23:47
  Speaker 3: Let's come back to stress because you've, you've hinted at
• 23:50
  Speaker 3: it about stress in the cardiovascular system. Um, I often
• 23:55
  Speaker 3: talk about this research paper by Professor Mark Seary from
• 23:59
  Speaker 3: the University of Buffalo. And it's all about psychology. It's
• 24:02
  Speaker 3: about psychophysiology. It's about challenging threat when we are faced
• 24:06
  Speaker 3: with adversity. But he was the first to show, this
• 24:09
  Speaker 3: has actually been replicated, that if me and you are
• 24:13
  Speaker 3: presented with the same potential stressor, you make an immediate
• 24:19
  Speaker 3: decision in your brain that this is a challenge. And
• 24:21
  Speaker 3: I make the decision that this is a threat, right?
• 24:23
  Speaker 3: It's just called a stress appraisal. It happens like that.
• 24:27
  Speaker 3: Mark's theory shows you activate the fight part of your
• 24:30
  Speaker 3: fight or flight nervous system. You activate adrenaline and noradrenaline,
• 24:34
  Speaker 3: which opens up, vasodilates the cardiovascular system. When I view
• 24:39
  Speaker 3: something as a threat, it releases cortisol, which constricts the
• 24:43
  Speaker 3: cardiovascular system. And that, for me, is one of the
• 24:47
  Speaker 3: reasons why this chronic stress that's to do with hypercortisolemia
• 24:53
  Speaker 3: really impacts on heart disease.
• 24:55
  Speaker 2: Yeah, but even, I'll quote some studies from really elegant
• 25:00
  Speaker 2: work done by Professor Geoffrey Toffler from Royal North Shore
• 25:03
  Speaker 2: in Sydney, where he showed, and I talk about the
• 25:05
  Speaker 2: five categories of stress, so I'd like to go through those.
• 25:08
  Speaker 2: Category number one is emotional stress. So Jeff showed that
• 25:12
  Speaker 2: within two hours of you getting acutely angry or anxious
• 25:16
  Speaker 2: about anything, you increase your risk for a heart attack
• 25:19
  Speaker 2: eight times or any cardiac event eight times. So the
• 25:23
  Speaker 2: first is emotional stress. The second is mental stress. So
• 25:28
  Speaker 2: from the Whitehall studies that have been going on for
• 25:31
  Speaker 2: 30 years, and interestingly, they found that it was the
• 25:34
  Speaker 2: middle managers who copped it. So they copped it from
• 25:37
  Speaker 2: a thing called job strain, which is high demand, low control.
• 25:40
  Speaker 2: It has much more cardiovascular disease, hypertension.
• 25:45
  Speaker 1: Lack of autonomy, right?
• 25:46
  Speaker 2: Yeah, yeah. And number three, you've already alluded to, which
• 25:50
  Speaker 2: is excessive physical stress. Now, physical stress isn't just too
• 25:54
  Speaker 2: much exercise. We all hear about the people who drop
• 25:57
  Speaker 2: dead in marathons or running the city to surf or whatever,
• 26:00
  Speaker 2: but that's unusual. It's much more dangerous to sit at
• 26:03
  Speaker 2: home and do nothing and be a fat slob. You're
• 26:05
  Speaker 2: going to drop dead much more from that. But what
• 26:08
  Speaker 2: I'm saying is if you do physical stress, especially under
• 26:11
  Speaker 2: extremes of environment. So I had a 78-year-old man, thought
• 26:14
  Speaker 2: it was a good idea on a 45-degree Celsius day
• 26:17
  Speaker 2: to play singles tennis and ended up with a stent
• 26:20
  Speaker 2: in his artery. So he obviously had the underlying coronary disease,
• 26:24
  Speaker 2: but just the extra environmental stress just tipped him over
• 26:27
  Speaker 2: with the exercise. Or like these fools who go running
• 26:30
  Speaker 2: when it's heavy days of pollution or bushfires, any of
• 26:33
  Speaker 2: these things, or even freezing cold. Now, we all know
• 26:36
  Speaker 2: the benefits of, say, cold water swimming, but not if
• 26:39
  Speaker 2: your body's not used to it. If you just jump
• 26:41
  Speaker 2: into freezing cold when you don't do it that often,
• 26:43
  Speaker 2: I've seen people get severe coronary vasospasm and have myocardial
• 26:47
  Speaker 2: infarctions as a consequence. We all know, just going back
• 26:49
  Speaker 2: to the emotional stress, the old Takotsubo's cardiomyopathy from emotion-induced
• 26:54
  Speaker 2: severe vasoconstriction. So number three, physical stress. Number four, and
• 26:59
  Speaker 2: people don't talk about this as much as they should,
• 27:01
  Speaker 2: is pharmacologic stress.
• 27:03
  Speaker 3: Yeah.
• 27:04
  Speaker 2: So if you've got a lot of plaques in your
• 27:06
  Speaker 2: arteries and even a heavy night on the grog can
• 27:09
  Speaker 2: do it, and a lot of people don't realize this,
• 27:12
  Speaker 2: one of the studies have shown that within two hours
• 27:15
  Speaker 2: of smoking one joint, you increase your risk for a
• 27:18
  Speaker 2: heart attack five times. Jesus. Yeah, when I hear this
• 27:22
  Speaker 2: nonsense about smoked marijuana is just recreational and good for you, crap.
• 27:28
  Speaker 2: this is going to surprise you, Paul, but you've got
• 27:29
  Speaker 2: a couple of things in your body called your lungs.
• 27:32
  Speaker 2: They were strangely designed for a thing called breathing, not
• 27:35
  Speaker 2: to put a stick in your mouth and suck the
• 27:37
  Speaker 2: smoke in, whether it's cigarettes, vaping, or marijuana. It is
• 27:41
  Speaker 2: not good for you. And THC, the active component, of course,
• 27:45
  Speaker 2: of marijuana, is an endothelial cell killer. So it really
• 27:49
  Speaker 2: destroys the endothelium if you get THC in it.
• 27:52
  Speaker 3: So the people who are thinking, all right, I'll stop
• 27:55
  Speaker 3: the vape and I'll get on the gummies.
• 27:57
  Speaker 1: The THC still has an effect, right?
• 28:00
  Speaker 2: Of course it does.
• 28:00
  Speaker 1: Even if it's not smoked.
• 28:01
  Speaker 2: If the gummies are high in THC, I have no
• 28:04
  Speaker 2: problems with medical cannabis where there's a little bit of
• 28:07
  Speaker 2: THC to balance the CBD. So there's two receptors, CB1
• 28:11
  Speaker 2: and CB2. You need them balanced with a bit of THC,
• 28:15
  Speaker 2: a bit of CBD, but it's the high dose THC
• 28:18
  Speaker 2: that's the problem. And that's what damages the endothelium. But also,
• 28:22
  Speaker 2: I'll give you another example. I had a guy in
• 28:24
  Speaker 2: his 30s with a strong family history of heart disease.
• 28:27
  Speaker 2: went out one night in a box and I'd had
• 28:28
  Speaker 2: a few lines of coke, wiped out half his heart
• 28:31
  Speaker 2: from a major infarct.
• 28:33
  Speaker 3: So is it true, sorry, just while we're on, Jogs,
• 28:38
  Speaker 3: is it true that the worst drug for the heart
• 28:41
  Speaker 3: is cocaine?
• 28:42
  Speaker 2: Yeah, yeah. Cocaine is dreadful. And crystal meth's not much better,
• 28:47
  Speaker 2: but cocaine is, and crystal meth's worse for all the
• 28:50
  Speaker 2: other things it does. But But people shouldn't be using
• 28:52
  Speaker 2: illegal drugs. They're just disgraceful. And what they do to
• 28:55
  Speaker 2: people's health is outrageous. But I'll tell you, the commonest
• 28:59
  Speaker 2: used drug on the planet, which you and I have
• 29:01
  Speaker 2: probably had today, is coffee. And a couple of cups
• 29:04
  Speaker 2: of coffee a day is actually good for you. So
• 29:07
  Speaker 2: the studies show, beyond a doubt, a couple of cups
• 29:09
  Speaker 2: of coffee a day reduce risk for gallstones, kidney stones, Parkinson's, Alzheimer's,
• 29:14
  Speaker 2: many common cancers, type 2 diabetes, depression. and heart failure
• 29:19
  Speaker 2: and stroke. So there's nothing wrong with having a couple
• 29:21
  Speaker 2: of cups of coffee a day, but I had a
• 29:22
  Speaker 2: 35-year-old guy, he doesn't know why I did this, but
• 29:26
  Speaker 2: in the space of an hour, had three double-shot cappuccinos
• 29:30
  Speaker 2: and sent his heart into overdrive atrial fibrillation.
• 29:35
  Speaker 3: Ross, I've heard of teenagers like drinking heaps of cans
• 29:39
  Speaker 3: of mother.
• 29:41
  Speaker 1: And you know.
• 29:42
  Speaker 3: There's something like 160 milligrams of caffeine in one of those.
• 29:47
  Speaker 3: And I know teenagers who have three cans a day.
• 29:50
  Speaker 3: That's like one here at four. That's over 600 milligrams
• 29:55
  Speaker 3: of caffeine.
• 29:57
  Speaker 2: That's horrible. You see, again, It's like anything. I mean,
• 30:00
  Speaker 2: all the studies with alcohol, it's like who the alcohol
• 30:03
  Speaker 2: is hanging around with. So for example, if you look
• 30:06
  Speaker 2: at all the alcohol studies, and I'll come back to
• 30:09
  Speaker 2: the energy drinks in a second, but if you look
• 30:10
  Speaker 2: at all the alcohol studies out of America, absolutely no benefit,
• 30:14
  Speaker 2: except for one study in Boston where the male doctors
• 30:18
  Speaker 2: in Boston had a glass of red wine a day,
• 30:20
  Speaker 2: had an 80% reduction in sudden cardiac death. But they're
• 30:24
  Speaker 2: combining that with a better diet. But if you look
• 30:26
  Speaker 2: at the standard crappy American diet, If you combine alcohol
• 30:30
  Speaker 2: with that, you're really looking for trouble. But when you
• 30:33
  Speaker 2: look at the Mediterranean data where they combine, say, a
• 30:37
  Speaker 2: couple of glasses of red wine with Mediterranean-style food, 50%
• 30:41
  Speaker 2: reduction in heart disease and cancer in those people. But
• 30:45
  Speaker 2: if you look at the spirits, when you look to, say,
• 30:47
  Speaker 2: the Copenhagen Heart Study, a couple of spirits a day
• 30:50
  Speaker 2: compared with teetotalers, 30% increased risk for heart disease and cancer.
• 30:55
  Speaker 2: And if you drink alcohol because you're lonely or depressed,
• 30:59
  Speaker 2: you're combining a toxic chemical with other toxic chemicals in
• 31:02
  Speaker 2: your skull. That's alcohol. But when you look at caffeine, again,
• 31:08
  Speaker 2: it depends on who the caffeine is hanging around with.
• 31:10
  Speaker 2: If the caffeine is in with the polyphenols of coffee
• 31:13
  Speaker 2: or the polyphenols of tea, you'll probably get a benefit.
• 31:16
  Speaker 2: But the lack of polyphenols and the sugar and all
• 31:20
  Speaker 2: the other crap that's in standard soft drinks and in
• 31:23
  Speaker 2: energy drinks, which I think energy drinks should be banned,
• 31:26
  Speaker 2: but that aside– what you're saying, these teenagers who think
• 31:30
  Speaker 2: they're great and they keep them all hyped up and focused,
• 31:32
  Speaker 2: it's so dangerous. And we're going to be seeing increasing
• 31:36
  Speaker 2: rates of things like atrial fibrillation and other problems in
• 31:41
  Speaker 2: these teenagers who are using these drinks, not to mention
• 31:44
  Speaker 2: the phosphoric acid, which is the food acid in all
• 31:47
  Speaker 2: these soft drinks and energy drinks, which rip the calcium
• 31:49
  Speaker 2: out of your bones.
• 31:50
  Speaker 1: Yeah, it destroys your bones.
• 31:52
  Speaker 2: It's outrageous. And the final stressor is infective stress. So
• 31:59
  Speaker 2: during COVID, we saw a marked increased risk for myocarditis,
• 32:05
  Speaker 2: heart attack, atrial fibrillation, pericarditis. To quote the Donald, I
• 32:10
  Speaker 2: don't like quoting the Donald, but the initial China virus.
• 32:14
  Speaker 2: So the Wuhan strain had a 3% death rate and
• 32:18
  Speaker 2: huge cardiac complications. And they did a big study in
• 32:22
  Speaker 2: American veterans. I think it was about 153 American war vets.
• 32:26
  Speaker 2: followed them for 12 months. Those who had COVID versus
• 32:29
  Speaker 2: those who didn't have COVID had about a 50% increased
• 32:33
  Speaker 2: risk for all cardiovascular complications. But it's not just COVID,
• 32:37
  Speaker 2: it's any infective stress. So within days to weeks of
• 32:41
  Speaker 2: you having a virus or you having pneumonia or a
• 32:44
  Speaker 2: urinary tract infection or a tooth abscess, or even just
• 32:48
  Speaker 2: bad dentition, there's a marked increased risk for cardiovascular disease.
• 32:51
  Speaker 2: So those five stressors.
• 32:53
  Speaker 1: Sorry, Ross, is that because of the inflammation?
• 32:56
  Speaker 2: Yes, absolutely. So you see, I see cardiac disease and
• 33:00
  Speaker 2: most diseases really, genes at the top, underneath that is
• 33:04
  Speaker 2: chronic inflammation. So chronic inflammation, as I said before, We're
• 33:09
  Speaker 2: designed to only live 30, 40 years and then die
• 33:11
  Speaker 2: from either trauma or infection. So our immune system has
• 33:15
  Speaker 2: only really evolved to deal with trauma or infection. Our
• 33:19
  Speaker 2: immune system hasn't evolved to deal with chronic stimuli. So
• 33:23
  Speaker 2: in my field, in cardiology, you have the small oxidized
• 33:27
  Speaker 2: LDL crosses into the endothelium and then follows in there
• 33:31
  Speaker 2: as the macrophage. So it's basically... the stuff shouldn't be
• 33:35
  Speaker 2: there in the first place so all the chronic inflammation
• 33:37
  Speaker 2: is due to stuff that shouldn't be there in the
• 33:39
  Speaker 2: first place so the macrophage follows it in swallows it
• 33:43
  Speaker 2: and says gee this tastes nice and then the macrophage
• 33:46
  Speaker 2: becomes fat like human beings become fat doing this and
• 33:49
  Speaker 2: they turn into these things called foam cells and the
• 33:51
  Speaker 2: foam cells get bigger and bigger and bigger and rupture
• 33:54
  Speaker 2: more macrophages come in same process vicious circle and so
• 33:58
  Speaker 2: basically it's the chronic inflammatory response to the stuff that
• 34:03
  Speaker 2: shouldn't be there in the first place, which is small
• 34:05
  Speaker 2: oxidized LDL. It's a vicious circle. And then calcium grows
• 34:09
  Speaker 2: into the plaque to act as a scaffold to stop
• 34:12
  Speaker 2: it from breaking down. So that's a reparative response by
• 34:16
  Speaker 2: the body, but then your arteries get stiffer over time.
• 34:19
  Speaker 2: And then if you do rupture a fatty plaque, a
• 34:22
  Speaker 2: clot forms to try and block the rupture up, but
• 34:25
  Speaker 2: that clot then blocks the artery. So The only thing
• 34:28
  Speaker 2: that's wrong is the LDL being there. Everything else is
• 34:30
  Speaker 2: a reparative response to the LDL that's being there.
• 34:34
  Speaker 3: Now, that's a beautiful segue to LDL. So let's talk
• 34:37
  Speaker 3: all things cholesterol. So I think my sort of view
• 34:42
  Speaker 3: on this, I want to road test this against you,
• 34:44
  Speaker 3: is that just looking at your LDL, at a population level,
• 34:50
  Speaker 3: we get it, but at an individual level is really suboptimal.
• 34:54
  Speaker 3: You should be looking at, The particle size, whether it's oxidized,
• 34:58
  Speaker 3: you should be looking at ApoB and LpA, which you.
• 35:01
  Speaker 2: Mentioned earlier on.
• 35:02
  Speaker 3: Because you can have high LDL. Like me, I've got
• 35:06
  Speaker 3: quite high LDL. But when I got my particle size measured,
• 35:10
  Speaker 3: it's all big, fluffy LDL.
• 35:12
  Speaker 1: There's no small, dense LDL.
• 35:14
  Speaker 2: There's no oxidized LDL.
• 35:16
  Speaker 3: So what are my cardiovascular risks or someone like that?
• 35:20
  Speaker 3: versus somebody who's got relatively low LDL, but it's all small, dense,
• 35:25
  Speaker 3: and oxidized, and it's got high LP little a and
• 35:28
  Speaker 3: high ApoB. So can you go through this, talk through this.
• 35:32
  Speaker 2: For our listeners? Oh, sure, sure. And look, in 1999,
• 35:36
  Speaker 2: I introduced into Australia in conjunction with the Sydney Advanced
• 35:39
  Speaker 2: Hospital in Wurundjeri, one of my colleagues, Dr. David Grout,
• 35:42
  Speaker 2: a test called coronary calcium scoring. So I was one
• 35:45
  Speaker 2: of the pioneers of that in Australia. We had the
• 35:48
  Speaker 2: first machine. And I still believe 27 years later that
• 35:54
  Speaker 2: that is still the best predictive test for the degree
• 35:57
  Speaker 2: of atherosclerosis. So that tells you how bad your disease is.
• 36:01
  Speaker 2: It's never wrong. If you've got a zero score, you
• 36:04
  Speaker 2: have low level coronary atherosclerosis. Everybody living in this society
• 36:08
  Speaker 2: who has a cholesterol above three and a blood pressure
• 36:11
  Speaker 2: above 100, which is almost everybody, has a degree of atherosclerosis.
• 36:16
  Speaker 2: But the coronary calcium score tells you how bad it is.
• 36:20
  Speaker 2: And you can still have a heart attack with a
• 36:21
  Speaker 2: zero score or a low score, but I believe it's
• 36:24
  Speaker 2: a different type of heart attack. So that tells you
• 36:28
  Speaker 2: where you are, but it doesn't tell you what's put
• 36:30
  Speaker 2: it there. What tells you what's put it there is
• 36:33
  Speaker 2: how much atherogenic particles you have. And you get the
• 36:37
  Speaker 2: best indication of atherogenic particles because ApoB, apolipoprotein B, carries
• 36:43
  Speaker 2: all of the atherogenic particles that it gets from the
• 36:47
  Speaker 2: atherogenic bits of LDL cholesterol, VLDL cholesterol, LP little a,
• 36:51
  Speaker 2: occasionally IDL, which is not as important. But all of
• 36:54
  Speaker 2: these things then give you this atherogenic LDL. Now, again,
• 36:58
  Speaker 2: you've mentioned the size of your LDL, and there's very
• 37:01
  Speaker 2: good work to show that it is small, dense LDL
• 37:04
  Speaker 2: that is atherogenic, whereas the large, buoyant LDL, in most cases, Paul,
• 37:09
  Speaker 2: not in all, in most cases is not so atherogenic.
• 37:13
  Speaker 2: But for example, one of the big exceptions there is
• 37:17
  Speaker 2: a condition that people rabbit on about so much, but
• 37:19
  Speaker 2: it's only really one in 250 people who get it.
• 37:22
  Speaker 2: Whereas with L-pillet lay, it's one in five people have
• 37:25
  Speaker 2: a high L-pillet lay. But in this condition, familial hypercholesterolemia,
• 37:29
  Speaker 2: it's only one in 250. And again, it's often misdiagnosed
• 37:34
  Speaker 2: even by cardiologists. So for example, Your cholesterol might sit
• 37:37
  Speaker 2: at 7.5, but your triglycerides are 0.5 and your HDL
• 37:43
  Speaker 2: is 2.5 and your chlorine calcium score is zero. And
• 37:46
  Speaker 2: people say, oh, you have familial hypercholesterolemia. No, you don't.
• 37:50
  Speaker 2: You're what we call a lean hyper-responder. You don't have
• 37:54
  Speaker 2: an issue. Your large LDL particles are being processed well
• 37:57
  Speaker 2: by the liver. If they're not particularly atherogenic, don't worry
• 38:01
  Speaker 2: about it. You don't need a statin. Forget about it.
• 38:04
  Speaker 2: But You also might have familial hypercholesterolemia where your cholesterol
• 38:08
  Speaker 2: sits at 7.58, but your HDL is only one and
• 38:12
  Speaker 2: your triglycerides might be normal at one or 1.2. But
• 38:15
  Speaker 2: your LDL, even though it's large, mainly large, it's a
• 38:19
  Speaker 2: different configuration and doesn't fit into the standard receptor as well.
• 38:23
  Speaker 2: And it's still very atherogenic. So that's where the calcium
• 38:26
  Speaker 2: score tells you. Now, here's the thing about FH, that 50%
• 38:29
  Speaker 2: of people with FH will have a vascular event by
• 38:34
  Speaker 2: age 50. But if you're an optimist, 50% of people
• 38:38
  Speaker 2: with FH won't have a vascular event. That's where I
• 38:42
  Speaker 2: use the calcium score. So I'll give you one great example.
• 38:44
  Speaker 2: This is just an anecdote, not a clinical trial.
• 38:47
  Speaker 3: Sorry, Russ, how does that compare with the population who
• 38:50
  Speaker 3: doesn't have familial hypercholesterolemia what percentage of those would have
• 38:55
  Speaker 3: a cardiovascular event by 50?
• 38:56
  Speaker 2: Yeah, that's a great question. And the answer to that
• 38:59
  Speaker 2: is very difficult. At a population level, you can say
• 39:03
  Speaker 2: up to the age of 50, it's probably only 1%
• 39:05
  Speaker 2: to 2% of those people as opposed to 50%. But
• 39:08
  Speaker 2: once you get to 60%, 70%, 80%, I mean, the
• 39:10
  Speaker 2: greatest risk for heart disease is getting old. Is it age? Yeah, yeah.
• 39:13
  Speaker 3: So you're talking a 20% to 25% increase if you.
• 39:17
  Speaker 1: Have a medial hyperplasia.
• 39:18
  Speaker 2: If you've got FH. But I saw a woman age 58.
• 39:21
  Speaker 2: whose lifelong cholesterol was 9.5, triglycerides 1, HDL 1. And
• 39:26
  Speaker 2: every scaremongering doctor said, to her, if you don't take
• 39:30
  Speaker 2: a statin, you're going to die. And so she'd take
• 39:32
  Speaker 2: the statin for three days. In her case, just couldn't
• 39:35
  Speaker 2: lift her arms. And it's my clinical experience of having
• 39:38
  Speaker 2: used these drugs for 35 years that around 20% of
• 39:41
  Speaker 2: people who take statins get muscle symptoms.
• 39:44
  Speaker 1: Now, The research says seven, doesn't it?
• 39:47
  Speaker 2: Well, even less than that. But let me tell you why.
• 39:49
  Speaker 1: The pharmaceutical-sponsored research.
• 39:52
  Speaker 2: Yeah, to an extent. But even the non-pharmaceutical-sponsored even said
• 39:57
  Speaker 2: even less than 5%. But this is why. Their definition
• 40:00
  Speaker 2: of myalgia is muscle pain with a CK three times
• 40:05
  Speaker 2: the normal range. So what I'm saying to you, mate,
• 40:09
  Speaker 2: is that the 20% of people that I see with
• 40:11
  Speaker 2: muscle symptoms get muscle pain, stiffness, weakness, cramping, and even
• 40:16
  Speaker 2: loss of muscle bulk, often with a normal CK. So
• 40:19
  Speaker 2: they don't fit the definition. So I'm talking, I practice
• 40:23
  Speaker 2: in the real world, not in the rarefied research environment
• 40:26
  Speaker 2: where these guys don't actually see patients. I talk to
• 40:30
  Speaker 2: people and these people tell me, doctor, I was on
• 40:33
  Speaker 2: these drugs and I stopped them. The pain went away
• 40:35
  Speaker 2: within a day. Now, is that all in their head?
• 40:37
  Speaker 2: I don't think so. So anyhow, this woman came to
• 40:40
  Speaker 2: see me I organized the coronary calcium score, came back
• 40:43
  Speaker 2: a big fat zero. And I said, look, you've gone
• 40:46
  Speaker 2: 58 years with your 9.5 cholesterol not spilling into your arteries.
• 40:52
  Speaker 2: You've got very low level disease with a zero score.
• 40:55
  Speaker 2: If it was me, I'd practice the five keys. I'd
• 40:58
  Speaker 2: take some supplements, but I wouldn't take a statin.
• 41:00
  Speaker 3: Okay.
• 41:01
  Speaker 2: For the next eight years, Paul, every scaremongering GP said, well,
• 41:05
  Speaker 2: if you don't take a statin, you're going to die.
• 41:07
  Speaker 2: She listened to me, not to the GP. Came back
• 41:10
  Speaker 2: eight years later. I told her to come back five years,
• 41:12
  Speaker 2: but she came back eight years later for another coronary
• 41:14
  Speaker 2: calcium score. She's now 66. It had rocketed from zero
• 41:18
  Speaker 2: to zero. And so I said, look, you've made it
• 41:22
  Speaker 2: 66 years without a vascular problem. The statins knock your
• 41:25
  Speaker 2: body around. And she probably qualifies for that. PCSK9 inhibitors.
• 41:30
  Speaker 3: That was going to be my next question is statin
• 41:32
  Speaker 3: versus PCSK9.
• 41:33
  Speaker 2: Okay. And I'll explain that to you as well, but
• 41:36
  Speaker 2: she probably qualifies for them, but why bother with a
• 41:39
  Speaker 2: zero calcium score? So now this is the thing. Everyone thinks, oh,
• 41:42
  Speaker 2: it's a needle. It's an injection, the PCSK9. It's got
• 41:45
  Speaker 2: to be stronger.
• 41:46
  Speaker 3: No.
• 41:48
  Speaker 2: Statins are easily the best drugs to lower vascular risk.
• 41:51
  Speaker 2: They're not as powerful as lifestyle, but they're still the
• 41:55
  Speaker 2: best drugs we have that lowers your vascular risk. maybe
• 41:58
  Speaker 2: not lower the LDL as much as, say, Repatha, the
• 42:01
  Speaker 2: fortnightly injection. I think that's Evalucumab, but it's the fortnightly
• 42:06
  Speaker 2: injection of this PCSK9 inhibitor, markedly lowers your LDL, but
• 42:11
  Speaker 2: only reduces your vascular risk maybe 20%, 30%, statins maybe 30%.
• 42:17
  Speaker 2: So statins are better than the PCSK9s at lowering vascular risk.
• 42:21
  Speaker 2: But I just think there's more side effects with statins.
• 42:24
  Speaker 2: And I think, really, The public gives statins far too
• 42:27
  Speaker 2: much pain. The medical profession gives statins far too much power.
• 42:31
  Speaker 2: It's an extra layer of protection if you're at high risk.
• 42:34
  Speaker 2: So who do I use statins in? I use them
• 42:36
  Speaker 2: in people who have high coronary calcium scores, so well
• 42:39
  Speaker 2: above 50%, the 50th percentile for your age. So for example,
• 42:44
  Speaker 2: a 70-year-old male, the average calcium score for a 70-year-old
• 42:48
  Speaker 2: male is 200. Now I'm 70, my calcium score is zero,
• 42:52
  Speaker 2: but that's just pure genetics. My fat mate, four. But
• 42:56
  Speaker 2: if I see a male who's 70 with a high
• 42:59
  Speaker 2: cholesterol and his calcium score is 150, there's no way
• 43:02
  Speaker 2: I'd give him a statin. So if you're below the 50%
• 43:04
  Speaker 2: off range, I don't use statins. But if you already
• 43:08
  Speaker 2: had heart attack, stent, or a bypass, and you have
• 43:11
  Speaker 2: known atherosclerosis, then I'd definitely use a statin in that situation.
• 43:16
  Speaker 2: But somebody, for example, who's got a low calcium score
• 43:19
  Speaker 2: and had a heart attack for another reason, maybe plaque
• 43:21
  Speaker 2: erosion or something, or SCAD or something else, there's no
• 43:25
  Speaker 2: way I'd use a statin. But my colleagues all use
• 43:27
  Speaker 2: statins once you've had a heart attack, stent, or a bypass.
• 43:30
  Speaker 2: I prefer to individualize my management for the patient.
• 43:32
  Speaker 3: Now, I've read research, and that was years ago, so
• 43:35
  Speaker 3: this may be out of date, that in terms of
• 43:38
  Speaker 3: the efficacy of statins, that they only are effective in
• 43:43
  Speaker 3: producing cardiovascular death in people who've had a previous MI.
• 43:47
  Speaker 1: They may reduce your risk of vascular disease.
• 43:50
  Speaker 3: But it was only basically people who had a previous
• 43:53
  Speaker 3: MI that they would prevent death significantly.
• 43:56
  Speaker 1: Is that true?
• 43:57
  Speaker 2: Yeah, yeah, yeah. Right.
• 43:58
  Speaker 3: But there is a vascular benefit outside of the death prevention.
• 44:02
  Speaker 2: So if you look at your risk for heart attack,
• 44:05
  Speaker 2: a non-fatal heart attack, it's definitely reduced by statins, about 20, 30%.
• 44:09
  Speaker 2: The evidence is overwhelming.
• 44:11
  Speaker 1: So coronary events.
• 44:12
  Speaker 2: But there's still residual risk. There's significant residual risk due
• 44:16
  Speaker 2: to the fact that no one is really addressing LP
• 44:18
  Speaker 2: little a, and I've been, Look, doctors have been measuring
• 44:21
  Speaker 2: LP little a, which is, for the people who don't
• 44:23
  Speaker 2: know what it is, it's an ApoB molecule attached to
• 44:28
  Speaker 2: an apolipoprotein little a protein. So the ApoB puts fat
• 44:31
  Speaker 2: in your arteries. The apolipoprotein little a protein thickens the blood.
• 44:36
  Speaker 2: So two things you don't want to do. And doctors
• 44:39
  Speaker 2: have been measuring it for two or three years because
• 44:41
  Speaker 2: we're now developing drugs to lower LP little a.
• 44:44
  Speaker 1: I've seen them and they're astounding, aren't they?
• 44:46
  Speaker 2: Astounding results. Yeah. Yeah, but what we have to see...
• 44:49
  Speaker 2: For example, there's a yearly injection that lowers LP to
• 44:53
  Speaker 2: the late 90%, but we want to make sure that
• 44:56
  Speaker 2: that then lowers coronary events. There's no point lowering a
• 44:58
  Speaker 2: number in your bloodstream. It's not going to do anything.
• 45:02
  Speaker 2: And I've got to say, the two-year data on this
• 45:04
  Speaker 2: stuff doesn't look that promising. But we've got to look
• 45:07
  Speaker 2: at the five-year data to see what it does.
• 45:09
  Speaker 3: Yeah, I just saw this study came out, and it
• 45:12
  Speaker 3: was like, well, it's not that promising at the minute.
• 45:14
  Speaker 1: But as you say, we need more data.
• 45:17
  Speaker 3: So somebody who's going in, right, who's pretty healthy, but
• 45:23
  Speaker 3: their LDL is pretty high. The GP is gone. You
• 45:26
  Speaker 3: need to go on a statin. They might have a
• 45:29
  Speaker 3: little bit of calcium, right? So they're in their, say me,
• 45:33
  Speaker 3: in their 50s, but fit and healthy. Like, would they
• 45:39
  Speaker 3: be better off on a statin or would they be
• 45:40
  Speaker 3: better off taking Viagra or the other option that you
• 45:44
  Speaker 3: talked about?
• 45:45
  Speaker 2: Vitamin V and vitamin C, Viagra, Cialis. No, look, I
• 45:49
  Speaker 2: think what they're better off, I certainly wouldn't give someone
• 45:52
  Speaker 2: a statin under those circumstances, whereas most of my colleagues would.
• 45:55
  Speaker 2: And the reason being, I base it on a major
• 45:58
  Speaker 2: study done by a guy called Mitch Folleans out of Philadelphia, 2018,
• 46:01
  Speaker 2: the Journal of Merit and College of Cardiology, where he
• 46:05
  Speaker 2: took a 13,000 people over 10 years between the ages
• 46:10
  Speaker 2: of 50 to 75. And he looked at the benefits
• 46:13
  Speaker 2: of them being on a statin based on their calcium score,
• 46:16
  Speaker 2: not based on their cholesterol. And he found if you
• 46:19
  Speaker 2: have a zero calcium score, there is zero benefit from
• 46:23
  Speaker 2: being on a statin. You get no benefit at all.
• 46:26
  Speaker 2: If your calcium score is below 100, which typically is
• 46:30
  Speaker 2: below the 50th percentile, there is no statistically significant benefit.
• 46:35
  Speaker 2: The number needed to treat there is 100 people for
• 46:37
  Speaker 2: five years to prevent one heart attack with no difference
• 46:41
  Speaker 2: in death rate. But once you get well above 100,
• 46:45
  Speaker 2: then the number needed to treat becomes 12. The p-value
• 46:50
  Speaker 2: is less than 0.001. So it shows that once you
• 46:54
  Speaker 2: have a significant atherosclerotic load, then that's where the statin
• 47:00
  Speaker 2: benefit kicks in. And this is interesting. A lot of
• 47:02
  Speaker 2: my colleagues now believe that this CT coriangigram, where you
• 47:06
  Speaker 2: squirt people with dye, is better than a coronary calcium score,
• 47:10
  Speaker 2: and that's nonsense.
• 47:11
  Speaker 3: I actually had a cardiologist on who was talking about that. Now,
• 47:15
  Speaker 3: he was a big fan of CT, because he said
• 47:19
  Speaker 3: you can look inside, it's like a 3D model of
• 47:22
  Speaker 3: the heart.
• 47:22
  Speaker 2: Of course you can. It gives you beautiful pictures of
• 47:24
  Speaker 2: the coronary arteries. But a guy called Mortensen, I think
• 47:28
  Speaker 2: it was a few years back, again in the Journal
• 47:30
  Speaker 2: of the American College of Cardiology, compared the two in
• 47:33
  Speaker 2: asymptomatic patients. People will often... quote what's called the Scott trial,
• 47:37
  Speaker 2: SCOT trial, or it could be the ASCOT trial, which
• 47:42
  Speaker 2: showed in people who were symptomatic, there's a definite benefit
• 47:45
  Speaker 2: of CT coronary angiography. I don't dispute that. But in
• 47:48
  Speaker 2: people who are asymptomatic, when you compare the two, so
• 47:52
  Speaker 2: the coronary calcium score is a measure of the degree
• 47:54
  Speaker 2: of atherosclerosis, whereas the CT angiogram is a measure of
• 47:57
  Speaker 2: the degree of blockages that you have. Yes. That the
• 48:01
  Speaker 2: degree of atherosclerosis easily beats finding a few blockages in
• 48:05
  Speaker 2: your arteries. So again, I focus on the coronary customer school,
• 48:10
  Speaker 2: but there is a caveat here. Coming into Australia soon,
• 48:14
  Speaker 2: it's already available in some centers in America, and I
• 48:17
  Speaker 2: think there's a couple of people in Australia doing this.
• 48:19
  Speaker 2: They're now doing, with CT coronary angiogram, plaque analysis. So
• 48:24
  Speaker 2: even the soft plaques, they can analyze the plaques look
• 48:27
  Speaker 2: for features like lower tenuators.
• 48:29
  Speaker 3: That's what this guy was talking about because he was
• 48:31
  Speaker 3: an American dude and he said that they were the
• 48:33
  Speaker 3: latest advent of the CT coronary angiogram.
• 48:36
  Speaker 2: Yeah, well, I don't disagree with him. And when that
• 48:38
  Speaker 2: becomes available, and the good thing is there's only three
• 48:41
  Speaker 2: advantages of being over 50, Paul. One is wisdom. Two
• 48:46
  Speaker 2: is grandchildren, if you have them. And three, you lose
• 48:50
  Speaker 2: the cancer risk from medical radiation. So everyone worries about radiation,
• 48:54
  Speaker 2: but over the age of 50, it doesn't matter. You're
• 48:55
  Speaker 2: not going to get a cancer out of you. having
• 48:58
  Speaker 2: a ct cori angiogram but if you start throwing radiation
• 49:00
  Speaker 2: at 30 year olds right 20 years down the track
• 49:03
  Speaker 2: the cancer risk does rise so i i won't have
• 49:07
  Speaker 2: any problems at all using the ct cori angiogram as
• 49:10
  Speaker 2: a better predictive risk when i can do plaque analysis
• 49:14
  Speaker 2: yeah gotcha It's not really freely available yet in Australia.
• 49:18
  Speaker 3: That's what this guy was talking about, right, which is
• 49:20
  Speaker 3: the latest advent of the CT. That makes perfect sense.
• 49:23
  Speaker 3: So let's jump and talk about nutrition. What, in your view,
• 49:31
  Speaker 3: are the biggest do's and don'ts for heart health and nutrition?
• 49:36
  Speaker 3: I love this because I have a preventative cardiologist, who's
• 49:40
  Speaker 3: on here talking about nutrition, who's very experienced in it.
• 49:44
  Speaker 2: Yeah. Firstly, and this is so obvious, everybody eats too much.
• 49:49
  Speaker 2: So basically we were designed to wander around the jungle
• 49:52
  Speaker 2: with a spear. You killed the beast. You ate it
• 49:54
  Speaker 2: straight away because there was no prehistoric Kelvinators. And you
• 49:57
  Speaker 2: stored a bit of fat around your belly for the
• 49:59
  Speaker 2: next big feed two or three days away. And in
• 50:02
  Speaker 2: the meantime, I had a few nuts and berries off
• 50:03
  Speaker 2: the trees and water out of the watering hole. No
• 50:06
  Speaker 2: one does that. And let's face it, that sucks. So
• 50:09
  Speaker 2: people think it's their God-given right to have breakfast, lunch, dinner,
• 50:12
  Speaker 2: and sit in their bums all day. They wonder why
• 50:14
  Speaker 2: they get fat. So I say to people, you've got
• 50:17
  Speaker 2: to just cut back down. No one should eat unnecessary food. Now,
• 50:21
  Speaker 2: what's unnecessary food? Snacking. People say, well, doctor, I get
• 50:26
  Speaker 2: starving by 10.30. Get over it. My mate David Sinclair
• 50:30
  Speaker 2: is the world anti-aging guru from Harvard. He said, Look,
• 50:34
  Speaker 2: hunger is actually good for you. It's good to feel
• 50:37
  Speaker 2: a bit hungry. You don't always have to have your
• 50:39
  Speaker 2: belly fed. If you feel hungry, celebrate it. Enjoy it.
• 50:43
  Speaker 2: Don't get there and say, oh, no, this is wrong.
• 50:45
  Speaker 2: I've got to eat. So firstly, don't eat so much.
• 50:48
  Speaker 2: That's the first point I make to people. Cut back
• 50:50
  Speaker 2: your calories and don't eat unnecessary food. Number two, I've
• 50:54
  Speaker 2: already mentioned it, fruit and vegetables. Two or three pieces
• 50:57
  Speaker 2: of fruit, three to five servings of vegetables, servings about
• 51:00
  Speaker 2: a half a carrot. And then what we shouldn't be
• 51:03
  Speaker 2: eating is What I call white death. So any form
• 51:07
  Speaker 2: of sugar, white bread, salt, and to a lesser extent, pasta, potatoes,
• 51:13
  Speaker 2: and rice. We should be minimizing our intake of that rubbish.
• 51:16
  Speaker 2: And also the process package muck masquerading as food. It's
• 51:22
  Speaker 2: not food. It's empty calories. So if it's in a box...
• 51:25
  Speaker 2: or a container with the use by date. And people say,
• 51:27
  Speaker 2: you should always read the labels. If it's got labels
• 51:29
  Speaker 2: on it, you shouldn't be eating the damn thing.
• 51:32
  Speaker 1: We're very aligned.
• 51:33
  Speaker 3: I'd talk about low HI diet, which is human interference.
• 51:36
  Speaker 2: Human interference, yeah. I use that term as well. And
• 51:39
  Speaker 2: also this nonsense about saturated fat. Yes. There's a study
• 51:43
  Speaker 2: called the PURE study. 220,000 people followed for nine years
• 51:48
  Speaker 2: in 50 different countries showed that those who had the
• 51:51
  Speaker 2: highest intake of saturated fat, meat, eggs, and dairy, compared
• 51:55
  Speaker 2: with those who had the lowest incidence, had a 25%
• 51:58
  Speaker 2: reduction in death and cardiovascular disease. And I'm not suggesting
• 52:02
  Speaker 2: people should swim in red meat, dairy products, and eggs.
• 52:05
  Speaker 2: I'm not suggesting that. But just don't give me this rubbish.
• 52:08
  Speaker 1: Don't be scared of it.
• 52:10
  Speaker 3: You know, this is the thing, Ross, that I have
• 52:12
  Speaker 3: a major issue with in nutrition is is that these people,
• 52:17
  Speaker 3: and dieticians in Australia are still banging on about saturated fat,
• 52:20
  Speaker 3: which is ridiculous.
• 52:21
  Speaker 2: As are major cardiology institutions around Australia.
• 52:25
  Speaker 3: It's like, for me, if you're going to change the
• 52:31
  Speaker 3: ancestral diet or change the recommendations that we shouldn't eat
• 52:35
  Speaker 3: what humans have been eating for for millions of years,
• 52:37
  Speaker 3: for hundreds of thousands of years, you need overwhelming scientific
• 52:42
  Speaker 3: evidence and there is nowhere near overwhelming scientific. I mean,
• 52:47
  Speaker 3: all this, the studies that they promote that says we
• 52:50
  Speaker 3: should reduce saturated fat and produce with it.
• 52:52
  Speaker 1: They're flawed. They're highly flawed. I mean, you can talk.
• 52:55
  Speaker 2: Also, mate, they were done in animals. A lot of
• 52:57
  Speaker 2: these are animals who are used to eating something and
• 53:00
  Speaker 2: then you totally change their diet. It's a bit like
• 53:02
  Speaker 2: going to an Eskimo and saying, okay, from now on,
• 53:05
  Speaker 2: we're going to give the same food we give to
• 53:06
  Speaker 2: someone who lives in the equator. They haven't evolved for this,
• 53:09
  Speaker 2: and animals haven't evolved for our crappy diets.
• 53:11
  Speaker 3: And I think the other thing is that a lot
• 53:14
  Speaker 3: of the stuff where they measure the blood and they
• 53:16
  Speaker 3: talk about it is saturated fat in blood is not
• 53:20
  Speaker 3: caused by eating saturated fat. It's caused by eating processed carbohydrates.
• 53:24
  Speaker 3: This is what people do not understand, right? And then
• 53:27
  Speaker 3: they're going, hey, there's saturated fat in blood, and that's bad,
• 53:30
  Speaker 3: therefore saturated fat's bad. No, it's the freaking sugar and
• 53:33
  Speaker 3: the processed carbs that are driving it up.
• 53:35
  Speaker 2: And in fact, this all started because of a lunatic
• 53:38
  Speaker 2: called Ansel Keys.
• 53:39
  Speaker 3: Yes.
• 53:39
  Speaker 2: Who, I think in the 60s, brought out the seven
• 53:43
  Speaker 2: country studies where he looked at 22 countries and released
• 53:46
  Speaker 2: the results of six in the seven country studies. Because
• 53:49
  Speaker 2: the six fitted his hypothesis was that fat caused heart disease.
• 53:54
  Speaker 2: At the same time, a guy called John Yudkin, who
• 53:57
  Speaker 2: was from the UK, came out and said, no, no, no.
• 53:59
  Speaker 2: What causes heart disease is sugars. Sugar, that's right. And
• 54:02
  Speaker 2: the dairy industry, the sugar industry shut him down because
• 54:06
  Speaker 2: he was saying what they didn't want to hear. And
• 54:09
  Speaker 2: so since we've switched to this low-fat, high-carb diet, we've
• 54:14
  Speaker 2: seen the rates of obesity and the true pandemic of
• 54:17
  Speaker 2: the 21st century is not COVID, it is diabesity, which
• 54:21
  Speaker 2: has come from all of this rubbish, this processed package
• 54:24
  Speaker 2: rubbish from the refined carbohydrates that people are eating far
• 54:28
  Speaker 2: too much of. And just a bit of a segue
• 54:31
  Speaker 2: back to cholesterol, that when you look at someone's cholesterol,
• 54:35
  Speaker 2: you might have a cholesterol of 7, HDL of 2.5,
• 54:37
  Speaker 2: triglyceride of 0.5. As I said, lean hyper-responder, healthy. Your
• 54:41
  Speaker 2: saturated fat might make that a little bit more accentuated.
• 54:44
  Speaker 2: But if your cholesterol is 4.5 and your triglycerides are
• 54:48
  Speaker 2: 2.5 and your HDL is 0.9, your doctor will say,
• 54:52
  Speaker 2: you've got a better cholesterol. No, you haven't. That's all
• 54:55
  Speaker 2: small LDL. That's what that's telling you. It's atherogenic.
• 55:00
  Speaker 3: So one thing, by the way, we're on violent agreement
• 55:03
  Speaker 3: on nutrition. And I love that you called him a lunatic,
• 55:06
  Speaker 3: Ansel Keys, because that's fraudulent research that has affected nutrition.
• 55:11
  Speaker 1: More than anything else.
• 55:12
  Speaker 2: Absolutely. Absolutely.
• 55:14
  Speaker 3: But just to come back to what you said, can
• 55:16
  Speaker 3: you please explain the... triglyceride to HDL ratio the impact
• 55:22
  Speaker 3: on insulin and the broader conversation around metabolic syndrome and
• 55:27
  Speaker 3: secondly do you think that if you just looked at
• 55:32
  Speaker 3: HDL triglyceride ratio versus LDL cholesterol which one would be
• 55:37
  Speaker 3: a better predictor because.
• 55:38
  Speaker 1: You're not allowed to do both you're just allowed to
• 55:40
  Speaker 1: pick one.
• 55:40
  Speaker 2: Okay a better predictor I think is the the triglyceride
• 55:43
  Speaker 2: to HDL ratio because that is a marker for small LDL.
• 55:47
  Speaker 2: And small LDL is the most atherogenic component of your
• 55:51
  Speaker 2: lipid profile. So certainly triglyceride HDL, because that's just telling
• 55:56
  Speaker 2: you you've got a lot of small LDL.
• 55:58
  Speaker 1: Yeah, without actually paying the expensive test.
• 56:00
  Speaker 2: Getting back to metabolic syndrome, a lot of people don't
• 56:03
  Speaker 2: understand this. As I said, right at the start, everything's genetic.
• 56:06
  Speaker 2: So 30% of Caucasians are born with the gene for
• 56:10
  Speaker 2: insulin resistance. 50% of Asians... and close to 100% of
• 56:14
  Speaker 2: people with dark or olive skin are born with the
• 56:17
  Speaker 2: gene for insulin resistance. That's why we've never seen a
• 56:20
  Speaker 2: skinny Tongan. They're the world champions of insulin resistance and
• 56:24
  Speaker 2: the world champions of obesity. So as soon as you
• 56:26
  Speaker 2: expose anyone who's insulin resistant to Western crap, that's when
• 56:30
  Speaker 2: they bulk up. And the four features of insulin resistance
• 56:33
  Speaker 2: are tendency to or frank diabetes, high blood pressure, high triglyceride,
• 56:39
  Speaker 2: low HDL, what we were just talking about there, and
• 56:42
  Speaker 2: it's really easy to put fat around the belly. And
• 56:45
  Speaker 2: so once you've got a couple of those, we call
• 56:47
  Speaker 2: it metabolic syndrome. So insulin resistance is the cause of 70%
• 56:51
  Speaker 2: of heart disease, 20% LP little a, and throw on
• 56:55
  Speaker 2: top of that, which we mentioned before, we haven't really
• 56:57
  Speaker 2: discussed the MTHFR gene abnormalities, but all of these things
• 57:01
  Speaker 2: cause about 90% of heart disease, 10% from the less
• 57:04
  Speaker 2: common genetic abnormalities like FH and a few other things. Wow.
• 57:08
  Speaker 1: Interesting.
• 57:09
  Speaker 3: Let's talk about what's known in certain circles colloquially as
• 57:14
  Speaker 3: the motherfucker gene. Because you've mentioned the MTHFR gene. What
• 57:19
  Speaker 3: is it and what are the risks if you have
• 57:24
  Speaker 3: one or more variants of it?
• 57:26
  Speaker 2: Okay, well, the MTHFR gene is the major gene that
• 57:29
  Speaker 2: codes this methyl tetrahydrofolate reductase enzyme, which is one of
• 57:34
  Speaker 2: the major checkpoints for folate in your diet. being incorporated
• 57:39
  Speaker 2: into DNA, RNA, and protein. And tragically, one in two people,
• 57:44
  Speaker 2: and I've got the worst mutation, have one of the
• 57:47
  Speaker 2: mutations in this gene or possibly even two. One in two? Yeah,
• 57:50
  Speaker 2: one in two people.
• 57:51
  Speaker 1: I didn't think it was that much.
• 57:52
  Speaker 2: No, it's that high. And just for people who don't
• 57:56
  Speaker 2: understand this, genetics 101, every gene is paired, one from mum,
• 58:00
  Speaker 2: one from dad. That's how we are who we are.
• 58:03
  Speaker 2: So this MTHFR gene, you either have two normal genes
• 58:07
  Speaker 2: or you have– either two Cs, which is the worst,
• 58:10
  Speaker 2: the C allele is the worst one, I've got two
• 58:13
  Speaker 2: of those, two As, which is much less significant, or
• 58:17
  Speaker 2: what we call a combined heterozygote, the C and the A. Now,
• 58:22
  Speaker 2: this is the interesting thing, that if you've got two Cs,
• 58:25
  Speaker 2: your methyl tetrahydrofolate reductase enzyme is down about 80%, 70
• 58:30
  Speaker 2: to 80%. So as you get older, you're not getting
• 58:36
  Speaker 2: high quality folate into your DNA, RNA and protein. So
• 58:39
  Speaker 2: up goes your homocysteine level, which is toxic to the
• 58:43
  Speaker 2: lining of your blood vessels. And here's where all the
• 58:45
  Speaker 2: trials have been bunkum because they've used folic acid, which
• 58:50
  Speaker 2: is a poison for someone who's got an MTHFR gene abnormality.
• 58:54
  Speaker 2: They've used folic acid, B12 and synthetic B6, which is pyridoxine.
• 59:00
  Speaker 2: And this is why we're now seeing all these pyridoxine
• 59:03
  Speaker 2: toxicities because 10 to 20% of the population can't metabolize
• 59:08
  Speaker 2: inactive B6, pyridoxine, to active B6, which is pyridoxal 5-phosphate.
• 59:14
  Speaker 2: And so therefore, people are going out and taking their
• 59:17
  Speaker 2: multivitamins because they think they're good for them, which are
• 59:20
  Speaker 2: full of folic acid and pyridoxine, and they're not good
• 59:23
  Speaker 2: for you. That's why the studies aren't showing any benefits
• 59:26
  Speaker 2: in people in high homocysteine who are given these poisons. Yes.
• 59:30
  Speaker 2: what I'm doing now is I'm looking at the MTHFR gene.
• 59:33
  Speaker 2: If people have my mutation or one of my mutations,
• 59:36
  Speaker 2: which is the CLL, so I've got two of them,
• 59:38
  Speaker 2: I take activated folate, five prime methyl tetrahydrofolate, which then
• 59:44
  Speaker 2: directly bypasses that mutation and feeds into DNA, RNA, protein,
• 59:48
  Speaker 2: and lowers your homocysteine. Yeah.
• 59:51
  Speaker 1: And do you take activated B vitamins as well as
• 59:53
  Speaker 1: the activated folate?
• 59:55
  Speaker 3: Yeah.
• 59:55
  Speaker 2: So I do that as well. And I think That's
• 59:58
  Speaker 2: really important for all of us, the one in two
• 1:00:00
  Speaker 2: of us who've got this. And interestingly, and this is
• 1:00:03
  Speaker 2: a really interesting study, there's a study called the Aspirin
• 1:00:06
  Speaker 2: Folic Acid Colonic Polyp Study, where they studied, I think
• 1:00:10
  Speaker 2: it was three or 4,000 people over 10 years. And
• 1:00:13
  Speaker 2: they gave them five milligrams a day of folic acid
• 1:00:17
  Speaker 2: and 100 milligrams a day of aspirin. I think it
• 1:00:20
  Speaker 2: was a two by two vectorial design. And they found
• 1:00:23
  Speaker 2: that there was no reduction in polyps at all. But
• 1:00:27
  Speaker 2: in the men taking the folic acid, there was a
• 1:00:30
  Speaker 2: triple risk for prostate cancer. And I believe the reason
• 1:00:34
  Speaker 2: being is that probably the ones who had, the one
• 1:00:36
  Speaker 2: in two people who've got an MTHFR gene abnormality, the
• 1:00:39
  Speaker 2: folic acid couldn't be metabolized, increases in the bloodstream in
• 1:00:43
  Speaker 2: what we call strangely unmetabolized folic acid, and that damages
• 1:00:47
  Speaker 2: the immune system. And so this is why All of
• 1:00:51
  Speaker 2: the doctors who don't understand any of this, the conservative
• 1:00:53
  Speaker 2: doctors don't understand how this works. They say, oh, all
• 1:00:56
  Speaker 2: you get with vitamins is expensive urine. No, you get
• 1:01:00
  Speaker 2: dangerous urine if you use the crappy vitamins. So I
• 1:01:03
  Speaker 2: have a plea out there to all of the supplement companies,
• 1:01:07
  Speaker 2: get folic acid out of it. So pregnant women should
• 1:01:10
  Speaker 2: not be taking folic acid or one in two of
• 1:01:12
  Speaker 2: them shouldn't. They should be taking folate, activated folate. Or
• 1:01:16
  Speaker 2: if you've got the allele, I use folinic acid. So
• 1:01:20
  Speaker 2: folic acid. And that targets the ALL, whereas activated folate
• 1:01:26
  Speaker 2: targets the CLL.
• 1:01:28
  Speaker 3: Ah, no, I didn't know that. I didn't know there
• 1:01:30
  Speaker 3: was one that was better for the ALL. Because I
• 1:01:32
  Speaker 3: get the ALL, my wife has one of the CLLs, right?
• 1:01:36
  Speaker 3: And this is an issue because folic acid has been
• 1:01:40
  Speaker 3: put in things like bread and stuff.
• 1:01:42
  Speaker 1: Like that, right?
• 1:01:43
  Speaker 2: It should be taken out.
• 1:01:44
  Speaker 3: Yeah, and that's why, you know, go and get yourself
• 1:01:48
  Speaker 3: a proper artisan sardo that doesn't have any shit rather
• 1:01:52
  Speaker 3: than supermarked breads that as well as being a completely
• 1:01:56
  Speaker 3: different species, they often have folic acid in them, which
• 1:02:00
  Speaker 3: in one in two of you might be actually damaging
• 1:02:02
  Speaker 3: rather than helpful.
• 1:02:03
  Speaker 2: Yeah, causing you issues. And this is, again, the whole
• 1:02:05
  Speaker 2: concept of supplements is that not all supplements are created equal.
• 1:02:10
  Speaker 2: And many people just go into a health food store
• 1:02:12
  Speaker 2: and say, this has been advertised for this condition and
• 1:02:15
  Speaker 2: take it. And they don't realize in their case, it
• 1:02:17
  Speaker 2: may be causing problems. And also these days with polypharmacy,
• 1:02:22
  Speaker 2: many drugs that doctors use interact with some supplements and
• 1:02:26
  Speaker 2: can cause issues. So you just got to be really
• 1:02:28
  Speaker 2: careful what you're doing with all this. Yeah, you do.
• 1:02:32
  Speaker 3: And that's why integrative doctors like you, and I know
• 1:02:35
  Speaker 3: lots of integrative doctors, that they're the ones to talk
• 1:02:38
  Speaker 3: about or well-qualified naturopaths who or nutritionists who understand the
• 1:02:43
  Speaker 3: genetics and the nutrigenomics, I think that's really, really important. So, Ross,
• 1:02:49
  Speaker 3: I'm aware of your time, but what do you think
• 1:02:52
  Speaker 3: that we are now talking about in terms of cardiovascular
• 1:02:56
  Speaker 3: health that in 20 years we're going to be going, geez,
• 1:02:59
  Speaker 3: why were we saying that?
• 1:03:01
  Speaker 2: Yeah, well, I think in 20 years' time, we're now
• 1:03:05
  Speaker 2: talking about things like gene therapy and to change people's lipids. So,
• 1:03:10
  Speaker 2: for example, there's been a couple of studies that have
• 1:03:11
  Speaker 2: been released recently, I think in the New England Journal
• 1:03:14
  Speaker 2: of Medicine, where they just gave one gene therapy with
• 1:03:18
  Speaker 2: a viral vector to completely change people that had, say,
• 1:03:23
  Speaker 2: LDL receptor defects with familial hypercholesterolemia. So one therapy, 18
• 1:03:27
  Speaker 2: months later, their cholesterol was back to normal. And they're
• 1:03:31
  Speaker 2: even working on a vaccination against heart disease, which would
• 1:03:34
  Speaker 2: be dreadful for people like me out of a job.
• 1:03:37
  Speaker 2: But imagine being able to be vaccinated against oxidized small
• 1:03:41
  Speaker 2: LDLs so it just doesn't become a problem. So they're
• 1:03:44
  Speaker 2: the sort of things I think we're working towards in cardiology.
• 1:03:47
  Speaker 2: And also a lot of the techniques where you need
• 1:03:51
  Speaker 2: your valve replaced or whatever, we're now doing transcutaneous valve replacements.
• 1:03:56
  Speaker 2: We can do that with aortic valves and mitral valves
• 1:03:59
  Speaker 2: and even now things like dissected aortas or widening aortas,
• 1:04:03
  Speaker 2: just putting stents in. So- I think the jobs of
• 1:04:06
  Speaker 2: cardiac surgeons are going to drop right off. And also,
• 1:04:09
  Speaker 2: once we work on the preventative side of things, whether
• 1:04:12
  Speaker 2: it is better ways to lower cholesterol or whatever, once
• 1:04:15
  Speaker 2: we do all of that, we'll see much less people
• 1:04:18
  Speaker 2: having the severe presentations of coronary artery disease. So my
• 1:04:22
  Speaker 2: hope still is that people realize And we finish off
• 1:04:26
  Speaker 2: with a positive note on things like the blue zones. Now,
• 1:04:28
  Speaker 2: I know there's some people who've been disputing whether the
• 1:04:30
  Speaker 2: blue zones are actually real. And I think we can
• 1:04:33
  Speaker 2: debunk the debunking of the blue zones because I think
• 1:04:36
  Speaker 2: the evidence is pretty solid for them. But in the
• 1:04:38
  Speaker 2: blue zones, they've never heard of Crestor or Lipitor to
• 1:04:43
  Speaker 2: lower your cholesterol. They've never heard of gyms. They basically
• 1:04:46
  Speaker 2: don't smoke. They eat buckets of fruits and vegetables, as
• 1:04:49
  Speaker 2: we've stressed today. They live on the side of hills,
• 1:04:52
  Speaker 2: so they're moving up and down the hill all day.
• 1:04:54
  Speaker 2: They have a very strong sense of family and community.
• 1:04:57
  Speaker 2: And they're the people who have the greatest longevity on
• 1:04:59
  Speaker 2: the planet. So I hope we don't see that marvels
• 1:05:03
  Speaker 2: of modern medicine is replacing what to me is the
• 1:05:06
  Speaker 2: most important thing, which is a healthy lifestyle, especially based
• 1:05:10
  Speaker 2: around human connection, which is absolutely vital.
• 1:05:14
  Speaker 3: Yeah, absolutely. Oh, one last question. personal question here, because
• 1:05:18
  Speaker 3: you know about my condition. I think most of the
• 1:05:21
  Speaker 3: listeners know I had open heart surgery for a bicuspid
• 1:05:24
  Speaker 3: aortic valve that I was born with. And then something
• 1:05:27
  Speaker 3: chewed up a chunk of my basal septum on my
• 1:05:30
  Speaker 3: left ventricle. Um, which we think might be.
• 1:05:33
  Speaker 1: A one-off infarct.
• 1:05:34
  Speaker 3: But do you think, because I've been reading some research
• 1:05:39
  Speaker 3: about the potential of stem cells to regenerate dead cardiac tissue,
• 1:05:44
  Speaker 3: do you think that that's a possibility on the horizon?
• 1:05:47
  Speaker 2: Look, I've been following stem cell therapy and have visited
• 1:05:50
  Speaker 2: some clinics in Thailand when they were doing this 15
• 1:05:52
  Speaker 2: years ago. A lot of hype, not a lot of
• 1:05:55
  Speaker 2: science yet. And the problem is that once you inject
• 1:05:57
  Speaker 2: stem cells anywhere, they're chewed up by the immune system
• 1:06:01
  Speaker 2: almost immediately. So they're talking more about it being a
• 1:06:04
  Speaker 2: paracrine effect rather than the stem cells. The public sort
• 1:06:09
  Speaker 2: of gets the idea that the stem cells get implanted
• 1:06:12
  Speaker 2: in the arteries and regrow new cells and everything's wonderful.
• 1:06:15
  Speaker 2: But they haven't been able to do that yet. Maybe
• 1:06:17
  Speaker 2: that will happen in the future. There's been some work
• 1:06:20
  Speaker 2: with spinal cord injuries with some benefits there with pancreatic transplants.
• 1:06:24
  Speaker 2: So these things are showing promise. But they're still not
• 1:06:27
  Speaker 2: prime time. So I'm hoping that one day we'll be
• 1:06:30
  Speaker 2: able to do that. Maybe there'll be other techniques, genetic techniques,
• 1:06:33
  Speaker 2: where we can regrow myocardium. I'm sure that's another way
• 1:06:36
  Speaker 2: of doing it as well. Maybe not stem cells. But
• 1:06:38
  Speaker 2: there will be something in the not too distant future,
• 1:06:42
  Speaker 2: maybe 10 or 15 years away. But again, I've been
• 1:06:44
  Speaker 2: talking about this for 15 years, that may be able
• 1:06:47
  Speaker 2: to do that.
• 1:06:48
  Speaker 1: Yeah, cool.
• 1:06:49
  Speaker 2: I'll just check.
• 1:06:50
  Speaker 1: It's like that.
• 1:06:51
  Speaker 3: We've just got to hang on another 10 or 15 years, right?
• 1:06:53
  Speaker 3: And then there'll be so many more advances.
• 1:06:56
  Speaker 2: But Paul, the best way to do that is to practice.
• 1:06:59
  Speaker 1: The five keys.
• 1:07:02
  Speaker 2: Oh, 100%.
• 1:07:02
  Speaker 3: We are in violent agreement about those five keys for sure.
• 1:07:06
  Speaker 1: And in pretty much everything that you've talked about.
• 1:07:09
  Speaker 3: And actually, it's been great because it's opened my eyes
• 1:07:11
  Speaker 3: and cleared up some things that I was a little
• 1:07:14
  Speaker 3: bit confused about.
• 1:07:15
  Speaker 1: So, mate, this has been awesome.
• 1:07:17
  Speaker 3: I don't think anybody could have listened to this and
• 1:07:19
  Speaker 3: not learned an absolute ton.
• 1:07:22
  Speaker 2: I don't care who they are.
• 1:07:23
  Speaker 1: So, mate, thank you for your life's work.
• 1:07:26
  Speaker 3: And, mate, I hope to interview you in another 10
• 1:07:29
  Speaker 3: or 15 years when you're still practicing the five keys,
• 1:07:33
  Speaker 3: fit as a virtuous dog.
• 1:07:34
  Speaker 2: I'm about to release my new service called W Life,
• 1:07:38
  Speaker 2: which W obviously for Walker, but also W Life, which
• 1:07:42
  Speaker 2: is an anti-aging service. So we haven't even got into
• 1:07:45
  Speaker 2: the whole topic of anti-aging. But again, anti-aging is still 80-10-10.
• 1:07:50
  Speaker 2: So there's a bucket of supplements you can swallow for anti-aging.
• 1:07:54
  Speaker 2: You don't practice the 80%, forget it.
• 1:07:56
  Speaker 1: Yeah, yeah, no, 100%.
• 1:07:57
  Speaker 3: Where can people go to find out more about you
• 1:08:01
  Speaker 3: to buy– One of your seven books.
• 1:08:03
  Speaker 1: And when is your book number eight going to be out?
• 1:08:05
  Speaker 2: Healthspan will be coming out probably early next year. So
• 1:08:10
  Speaker 2: not yet. The other books are out of date, really.
• 1:08:12
  Speaker 2: I haven't written a book for about 13 years. So
• 1:08:14
  Speaker 2: this is the new one, which is my latest tome.
• 1:08:17
  Speaker 2: And I'm working on another book called Medicine Versus Healing,
• 1:08:20
  Speaker 2: which is something else we could talk about on another occasion.
• 1:08:23
  Speaker 2: So if anyone's interested, it's drrosswalker.com and also wlife.co.
• 1:08:32
  Speaker 1: RossWalker.com and WLife.co.
• 1:08:35
  Speaker 2: Brilliant.
• 1:08:36
  Speaker 1: Excellent. Ross, this has been awesome. Thanks very much for
• 1:08:40
  Speaker 1: your time.
• 1:08:42
  Speaker 2: Thanks, mate.