Latest / Heart Health, Reimagined with Dr. Mona Shah, MD / What Should You Eat For Optimal Heart Health? What a Cardiologist Actually Eats

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What Should You Eat For Optimal Heart Health? What a Cardiologist Actually Eats · Heart Health, Reimagined with Dr. Mona Shah, MD

• 0:00
  SPEAKER_00: Eat the butter, don't eat the butter, cholesterol doesn't matter, cholesterol is everything, go carnivore, go vegan.
• 0:07
  SPEAKER_00: No wonder you're confused, right?
• 0:10
  SPEAKER_00: You change your diet every single day, so it should be the easiest place to affect change for your heart.
• 0:16
  SPEAKER_00: Instead, it's the most confusing.
• 0:19
  SPEAKER_00: I'm Dr.
• 0:20
  SPEAKER_00: Mona Shah, preventive cardiologist.
• 0:22
  SPEAKER_00: I'm passionate about early detection, whole heart care, longevity, and changing outcomes.
• 0:29
  SPEAKER_00: I spend 60 to 90 minutes with my patients literally pulling their food up on a big screen and reading the labels together.
• 0:36
  SPEAKER_00: Because unfortunately, marketing has made it really hard to know what you're actually eating.
• 0:41
  SPEAKER_00: So let me cut through the noise.
• 0:43
  SPEAKER_00: I'm gonna answer the two questions I get asked the most.
• 0:47
  SPEAKER_00: Is fat bad?
• 0:48
  SPEAKER_00: Is cholesterol bad?
• 0:49
  SPEAKER_00: I'm gonna tell you the truth about keto and carnivore, and then I'm gonna give you what actually lowers the numbers that build plaque in your heart arteries.
• 0:58
  SPEAKER_00: Let's get into it.
• 0:59
  SPEAKER_00: Here's the first thing I tell every patient.
• 1:02
  SPEAKER_00: The best diet out there is the one that's sustainable for you.
• 1:06
  SPEAKER_00: I don't believe in diets, fad diets, extremely restrictive diets don't work.
• 1:12
  SPEAKER_00: Plain and simple.
• 1:13
  SPEAKER_00: They might work for a few weeks, but after thousands of patients, I've watched them almost consistently fail every time.
• 1:21
  SPEAKER_00: The keto weight comes off, and 99% of the time it comes right back the minute you stop.
• 1:27
  SPEAKER_00: So instead of a diet, we build a pattern of eating you can actually live with and that's sustainable.
• 1:32
  SPEAKER_00: And the pattern that science keeps landing on is a Mediterranean lifestyle.
• 1:37
  SPEAKER_00: It's been studied for generations.
• 1:39
  SPEAKER_00: The PREDIMED study and others show it cuts heart disease risk by about 30%.
• 1:46
  SPEAKER_00: That is equivalent to what we see with some medications, just from how you eat.
• 1:51
  SPEAKER_00: I like to think of it as a triangle: Mediterranean, leaning towards pescatarian, leaning towards vegetarian.
• 1:58
  SPEAKER_00: Lots of vegetables, fruit, whole grains, nuts, seeds, some wild fish, low sugar, low refined carbs.
• 2:08
  SPEAKER_00: And you don't have to be perfect.
• 2:10
  SPEAKER_00: I tell people 8020, if most of your meals are whole, real food, then go out on a Friday or Saturday night and just enjoy yourself.
• 2:19
  SPEAKER_00: To be honest with you, restaurants don't really care, majority of them, about what they're putting and what kind of oils they're using when they cook food.
• 2:29
  SPEAKER_00: Of course, they're a business.
• 2:31
  SPEAKER_00: They want it to taste good.
• 2:32
  SPEAKER_00: So when you go out to eat, you really don't have an idea of what they are actually putting in my food.
• 2:37
  SPEAKER_00: And of course, if this is once or twice a week, it's not gonna break the bank.
• 2:41
  SPEAKER_00: But if you're eating out five to six times a week, then you might be really affecting your heart arteries and affecting your numbers and inflammation.
• 2:51
  SPEAKER_00: So nobody's gonna be perfect.
• 2:52
  SPEAKER_00: And the people who try to be are so stressed out about it that it works against them.
• 2:58
  SPEAKER_00: Progress, not perfection.
• 3:00
  SPEAKER_00: Okay, so with that foundation, let's tackle the fights, starting with fat.
• 3:05
  SPEAKER_00: Fat is not the enemy.
• 3:07
  SPEAKER_00: But not all fat is the same, right?
• 3:10
  SPEAKER_00: Here's how I want you to think about it.
• 3:12
  SPEAKER_00: Roughly two-thirds of your fat should be unsaturated, and about a third or less should be saturated.
• 3:19
  SPEAKER_00: The unsaturated fats are the ones that actually help you.
• 3:23
  SPEAKER_00: Monounsaturated fats, olive oil, avocado oil, avocados, nuts, seeds, they help lower your numbers and lower inflammation and even your blood pressure.
• 3:36
  SPEAKER_00: And the omega-3s in fish, walnuts, chia seeds, and flax seeds are really anti-inflammatory.
• 3:43
  SPEAKER_00: The one to keep an eye on is saturated fat.
• 3:46
  SPEAKER_00: That's your butter, your red meat, your eggs, your processed meats, your heavy whipping creams.
• 3:52
  SPEAKER_00: And I'll show you in a minute why saturated fat matters more than most people think.
• 3:57
  SPEAKER_00: One trap.
• 3:58
  SPEAKER_00: When something says low fat on the front, flip it over, and a lot of the time when they take out the fat, they replace it with sugar.
• 4:06
  SPEAKER_00: So low fat becomes higher in sugar.
• 4:09
  SPEAKER_00: And now you've traded one problem for another one.
• 4:11
  SPEAKER_00: So fat itself, not bad.
• 4:13
  SPEAKER_00: It's a type and the portion.
• 4:15
  SPEAKER_00: Like everything else, it's a portion that matters.
• 4:19
  SPEAKER_00: Now, the bigger fight, cholesterol.
• 4:22
  SPEAKER_00: This is where the internet loses its mind.
• 4:24
  SPEAKER_00: One side says eat all the cholesterol you want, it doesn't matter.
• 4:28
  SPEAKER_00: The other side says cholesterol is a whole problem.
• 4:30
  SPEAKER_00: And honestly, the truth is somewhere in between.
• 4:33
  SPEAKER_00: About 80% of the cholesterol in your body is actually made by your liver.
• 4:38
  SPEAKER_00: Only a smaller amount comes from your food.
• 4:42
  SPEAKER_00: And of the cholesterol you eat, a normal person absorbs about 40% of it.
• 4:47
  SPEAKER_00: So dietary cholesterol, the cholesterol in food itself, is only a really partial player, which is why a lot of people say it doesn't matter how much cholesterol you eat.
• 4:57
  SPEAKER_00: What really drives your numbers up is a saturated fat.
• 5:00
  SPEAKER_00: But here's the catch.
• 5:01
  SPEAKER_00: And this is why I never like to give just one blanket answer and tell everyone that they should be eating one way.
• 5:08
  SPEAKER_00: 30% of people are what we call hyperabsorbers.
• 5:12
  SPEAKER_00: So instead of absorbing 40% of the cholesterol they eat, they absorb 60 to 80%.
• 5:19
  SPEAKER_00: So some people really can eat the eggs and the high cholesterol foods and be fine.
• 5:25
  SPEAKER_00: But about a third of people absolutely cannot.
• 5:29
  SPEAKER_00: So when someone tells me their carnivore or keto diet is totally safe because cholesterol doesn't matter, I always say maybe, maybe not.
• 5:37
  SPEAKER_00: You don't know which one you are until you check.
• 5:41
  SPEAKER_00: And the number to check is not just your LDL, it's your APOB and your inflammation markers.
• 5:47
  SPEAKER_00: You've already heard me explain this in my cholesterol video, but here it is again because it's everything.
• 5:53
  SPEAKER_00: Think of the particles that carry cholesterol like trucks on the road.
• 5:57
  SPEAKER_00: LDL is just one of the trucks, but there are small trucks and wide trucks and big trucks too.
• 6:04
  SPEAKER_00: And every single one of them can dump plaque into your artery wall.
• 6:09
  SPEAKER_00: APOB counts all the trucks.
• 6:12
  SPEAKER_00: That's why I say LDL is in my side mirror.
• 6:15
  SPEAKER_00: Of course I'm paying attention to it, but APOB is front and center.
• 6:19
  SPEAKER_00: Risk follows APOB.
• 6:21
  SPEAKER_00: So the real test of your diet isn't how it makes you feel, it's what it does to your APOB and your inflammation markers.
• 6:28
  SPEAKER_00: If you eat that high-fat diet and your APOB stays low, okay, maybe you're one of the lucky ones.
• 6:34
  SPEAKER_00: If it's climbing, you're building plaque while someone on the internet tells you you're fine.
• 6:39
  SPEAKER_00: So how do we actually eat to drive the numbers down?
• 6:44
  SPEAKER_00: Let me show you.
• 6:45
  SPEAKER_00: If this is the kind of straight no hype answer you've been looking for, subscribe.
• 6:50
  SPEAKER_00: Every week I put out videos on what the conventional system misses about your heart and what you can actually do about it.
• 6:58
  SPEAKER_00: Okay, let's put this all together because this is the part that changes your arteries.
• 7:03
  SPEAKER_00: Start with the Mediterranean base we talked about.
• 7:06
  SPEAKER_00: That's your foundation.
• 7:08
  SPEAKER_00: Then, if you really want to drive the numbers down, there's an add-on called the portfolio diet.
• 7:16
  SPEAKER_00: It has four pieces: plant proteins like lentils, pure soy, nuts, and viscous fiber like oats, barley, and psilium.
• 7:26
  SPEAKER_00: And plant sterols.
• 7:28
  SPEAKER_00: Stack those on top of the Mediterranean, and studies show your LDL drops by 30% and your APOB by 23%.
• 7:38
  SPEAKER_00: And your inflammation markers come down too.
• 7:41
  SPEAKER_00: That's real change from food.
• 7:43
  SPEAKER_00: Now here's a study I love because it really settles a lot of arguments.
• 7:46
  SPEAKER_00: It's called the Krauss study.
• 7:49
  SPEAKER_00: They looked at protein and saturated fat together, and here's what they found.
• 7:53
  SPEAKER_00: If you eat a high saturated fat, it almost doesn't matter whether your protein is animal or plant.
• 8:00
  SPEAKER_00: Your APOB doesn't improve.
• 8:02
  SPEAKER_00: But when they combined low saturated fat with plant protein, that was the only group whose APOB actually went down.
• 8:10
  SPEAKER_00: So it's two levers working together.
• 8:14
  SPEAKER_00: Lower the saturated fat and lean more of your protein towards plants.
• 8:19
  SPEAKER_00: It's also trying to find a balance, right?
• 8:22
  SPEAKER_00: If you don't want to be vegetarian or vegan, that's fine.
• 8:25
  SPEAKER_00: But have a balance.
• 8:26
  SPEAKER_00: Don't just eat one type of protein, red meat or chicken.
• 8:30
  SPEAKER_00: Mix in some fish.
• 8:32
  SPEAKER_00: Mix in some plant-based proteins.
• 8:34
  SPEAKER_00: Have a variety so you're not just stuck with one thing.
• 8:37
  SPEAKER_00: Now, what about fiber?
• 8:38
  SPEAKER_00: I cannot oversell fiber.
• 8:41
  SPEAKER_00: Aim for about 30 grams a day.
• 8:43
  SPEAKER_00: Most people are deficient in fiber and getting enough fiber.
• 8:48
  SPEAKER_00: Three servings of whole grains a day is linked to about a 30% lower cardiovascular risk.
• 8:54
  SPEAKER_00: And there's strong data tying higher fiber to lower heart disease deaths.
• 9:00
  SPEAKER_00: Whole grains, beans, vegetable, that's your fiber.
• 9:04
  SPEAKER_00: And then cut the added sugar.
• 9:07
  SPEAKER_00: Keep it under 25 grams a day.
• 9:10
  SPEAKER_00: Sugar is sneaky because it drives up both your inflammation and the particles that build up plaque.
• 9:15
  SPEAKER_00: It's not just about your waistline.
• 9:17
  SPEAKER_00: And what about the processed meats?
• 9:19
  SPEAKER_00: The bacon, the cold cuts, the deli meats, those are very inflammatory.
• 9:23
  SPEAKER_00: They're loaded with sodium and they carry both heart and cancer risk.
• 9:27
  SPEAKER_00: That's a category I'd pull back on first.
• 9:30
  SPEAKER_00: So now you know some of what to eat.
• 9:32
  SPEAKER_00: Here's how to actually pull it off in real life.
• 9:35
  SPEAKER_00: None of this works if you can't live it.
• 9:38
  SPEAKER_00: So here's how I coach my own patients.
• 9:41
  SPEAKER_00: First, become a label reader.
• 9:43
  SPEAKER_00: This is the biggest one.
• 9:45
  SPEAKER_00: The front of the package doesn't tell you everything.
• 9:48
  SPEAKER_00: It may say heart healthy, low fat, all natural, even vegan.
• 9:52
  SPEAKER_00: And then you flip it over and it's full of artificial flavor, artificial sugars, processed oils.
• 9:59
  SPEAKER_00: My rule is simple.
• 10:01
  SPEAKER_00: The fewer the ingredients, the better.
• 10:03
  SPEAKER_00: There's even an app called Yucca, Y-U-K-A, that can help you.
• 10:08
  SPEAKER_00: It scans the food for you and helps you tell you if this is a good food to choose or not.
• 10:15
  SPEAKER_00: Second, do the swaps.
• 10:16
  SPEAKER_00: Don't chase perfection.
• 10:18
  SPEAKER_00: Try to work on more unsaturated fat, less saturated fat, more plants, fewer processed meats, whole grains instead of refined, more fiber, less added sugar.
• 10:30
  SPEAKER_00: You don't have to flip your whole life in a day.
• 10:32
  SPEAKER_00: You just start building the pattern.
• 10:34
  SPEAKER_00: Third, and this is the part most people skip.
• 10:38
  SPEAKER_00: Know your numbers so you can actually see it working.
• 10:41
  SPEAKER_00: Get your APOB checked, get your inflammation markers checked.
• 10:45
  SPEAKER_00: Because we're not doing this just to make numbers look pretty on a piece of paper.
• 10:49
  SPEAKER_00: We're doing this to affect change inside your arteries.
• 10:52
  SPEAKER_00: When you eat this way for a few months and your APOB drops, you know it's working.
• 10:57
  SPEAKER_00: That's precision.
• 10:58
  SPEAKER_00: That's the whole point.
• 11:00
  SPEAKER_00: So is fat bad?
• 11:01
  SPEAKER_00: No.
• 11:01
  SPEAKER_00: Is the type and the portion?
• 11:03
  SPEAKER_00: Is cholesterol bad for some people more than others?
• 11:06
  SPEAKER_00: And you don't know which one you are until you check your APOB.
• 11:10
  SPEAKER_00: And the diet wars, mostly noise.
• 11:13
  SPEAKER_00: The answer has been sitting in plain sight the whole time.
• 11:17
  SPEAKER_00: Mostly plant-based Mediterranean pattern, low in saturated fat, low in added sugar, and high in fiber.
• 11:26
  SPEAKER_00: And also find what's sustainable.
• 11:28
  SPEAKER_00: If you like to eat animal products, try to do it with low saturated fat.
• 11:33
  SPEAKER_00: Food really is medicine.
• 11:35
  SPEAKER_00: You just have to know what you're looking at.
• 11:38
  SPEAKER_00: I keep coming back to one number that decides whether your diet is actually protecting you or not.
• 11:43
  SPEAKER_00: And that's your whole cholesterol picture.
• 11:46
  SPEAKER_00: If you want to understand why your LD alone has been lying to you, watch my video on everything you've been told about cholesterol.
• 11:54
  SPEAKER_00: It's on your screen right now.