Latest / Fork U with Dr. Terry Simpson / Salmon isn't a Stent Food and Medicine

Transcript

Salmon isn't a Stent Food and Medicine · Fork U with Dr. Terry Simpson

• 0:04
  >> Dr. Terry Simpson: Long before statins, long before stents, when
• 0:07
  heart disease was the number one killer, it was four
• 0:09
  times more deadly than it is today.
• 0:12
  Part of that is because we had no real treatments. No
• 0:15
  statins, no stents, no bypass
• 0:17
  surgery. And so food was the best
• 0:20
  medicine we had. In the
• 0:23
  pharmacies of Rome and Greece, they even kept
• 0:25
  extra virgin cold pressed olive oil on the
• 0:28
  shelves for patients with what they called hardening of the
• 0:31
  arteries. Doctors would send people down to pick
• 0:34
  up a bottle almost like it was a prescription.
• 0:37
  And then research began to notice something else.
• 0:40
  In certain parts of the world, small towns
• 0:43
  and villages around the Mediterranean, for example,
• 0:45
  people seemed to live longer with far
• 0:48
  less heart disease. It wasn't genetics,
• 0:51
  because their cousins who moved into the cities
• 0:54
  eating a westernized diet developed heart
• 0:57
  disease much earlier. Those scientists didn't
• 1:00
  stop there. They followed not just
• 1:02
  Mediterranean villages, but other small
• 1:04
  villages around the world where people ate
• 1:07
  traditional foods, often those same patterns
• 1:10
  for generations. From Finland to Japan,
• 1:13
  they tracked adult men for decades
• 1:16
  and saw a striking difference. In places
• 1:19
  where diets were rich in saturated fats, arteries
• 1:22
  clogged early, and heart disease was common in
• 1:24
  places where diets look like what we now call the Mediterranean
• 1:27
  diet. High in fruits, vegetables, olive oil, legumes, and
• 1:30
  fish, heart disease was rare
• 1:33
  at the time. Diet was our only
• 1:36
  weapon. It gave us a clue and it
• 1:39
  gave us hope. I know this
• 1:42
  literature well, and while you won't often hear it
• 1:45
  promoted on social media because saying eat this
• 1:47
  way doesn't sell a lot of supplements, the
• 1:50
  evidence is solid. Eating this
• 1:53
  way decreases your risk. But it
• 1:56
  is nothing like the therapy we have
• 1:59
  today. Food is important. It's
• 2:01
  empowering. It's the thing you as a patient
• 2:05
  can do every day to change your health.
• 2:08
  And we cannot ignore it, because here's one.
• 2:11
  Bad diet filled with ultra processed food and
• 2:14
  saturated fat accelerates
• 2:16
  atherosclerosis, drives heart disease, and raises
• 2:19
  the risk of cancers. And that's
• 2:22
  what today's episode is about.
• 2:25
  Why it's not food as medicine, but food
• 2:28
  and medicine together. And why
• 2:31
  salmon is. No matter how good it tastes,
• 2:34
  salmon is in a stent.
• 2:36
  Today we're going to make sense of the madness of diet and
• 2:39
  heart disease.
• 2:43
  I am your Chief Medical Explanationist, Dr. Terry Simpson,
• 2:46
  and this is Fork U Fork University,
• 2:49
  where we bust a few myths, make sense of the madness,
• 2:52
  and teach you a little bit about food and medicine.
• 2:59
  The Mediterranean diet, if you've been following my podcast for a
• 3:02
  while, isn't one single thing. It is not
• 3:05
  from one single area. It's a pattern Lots of
• 3:08
  fruits, vegetables, legumes, nuts, olive oil, whole grains,
• 3:10
  fish, little red meat, modest dairy
• 3:14
  and wine in exceeding moderation.
• 3:17
  It's not a fad, it's based on real
• 3:19
  populations. And we have decades of data showing it
• 3:22
  improved cardiovascular outcomes.
• 3:25
  One of the most famous studies was the Lyon Heart Study.
• 3:28
  This randomized secondary prevention trial took
• 3:31
  patients who already had their first heart attack and
• 3:34
  randomized either to the Mediterranean style
• 3:37
  diet or or what the French called
• 3:40
  a prudent cardiac diet.
• 3:42
  And here's the timing. This study took place just as
• 3:45
  statins were coming onto the market. So while doctors were
• 3:48
  beginning to prescribe cholesterol lowering drugs,
• 3:51
  Lyon showed that diet itself could also
• 3:54
  have a dramatic effect. And the results were
• 3:56
  stunning. Over about four years, the Mediterranean
• 3:59
  diet group had a 70% reduction in recurrent
• 4:02
  heart attacks or recurrent cardiac
• 4:05
  events. This wasn't just better
• 4:07
  cholesterol numbers, it was fewer heart attacks
• 4:10
  and fewer deaths. It was a combination of lower
• 4:13
  cholesterol and less inflammation. But let's be clear,
• 4:17
  those patients were highly motivated and this was
• 4:19
  carefully constructed study. They weren't just
• 4:22
  eating salmon once a week. Their entire
• 4:24
  dietary pattern changed. And you can
• 4:27
  imagine Lyon, France changing
• 4:30
  from butter to olive oil wasn't always
• 4:33
  an easy sell. Later,
• 4:36
  in larger studies, like what we call the predimed
• 4:38
  trial in Spain, confirmed the benefits in
• 4:41
  high risk but otherwise healthy individuals. The Mediterranean
• 4:44
  diet lowered rates of heart attacks, strokes and cardiovascular
• 4:47
  deaths by 30%. That's
• 4:49
  impressive. It proves food matters, but it's
• 4:52
  not magic. While those relative
• 4:55
  risk reductions are large, the absolute numbers are
• 4:58
  still smaller than what we see with medications in high risk
• 5:01
  groups. And here's the can you
• 5:04
  sustain it? When we talk about dietary adherence,
• 5:07
  we usually mean people are able to stick with it 70% of the
• 5:10
  time or more. That's good. It's not
• 5:12
  perfect because we're not perfect. I'll give you a
• 5:15
  personal example. I follow the Mediterranean diet with
• 5:18
  pretty strong adherence. But I also have
• 5:20
  hypercholesterolemia with a strong family
• 5:23
  history of heart disease. Even with my diet, I could
• 5:26
  not get my low density lipoprotein, my
• 5:29
  LDL or below 180. But with
• 5:31
  two drugs, Xedia and Crestor, my
• 5:34
  LDL is now in the 40s. That's the difference.
• 5:37
  The Mediterranean diet is powerful, but for some of us,
• 5:40
  especially those with genetic risk, food
• 5:43
  alone isn't enough.
• 5:45
  Let's talk about the PISA Heart Study, which stands for
• 5:48
  progression of early subclinical
• 5:50
  Atherosclerosis. It adds another layer of our
• 5:53
  understanding. This was a long term project
• 5:56
  launched in 2010 by the Spanish national
• 5:59
  center for Cardiovascular Research and Santander
• 6:02
  Bank. They followed middle aged adults who
• 6:04
  felt perfectly healthy. Using advanced imaging,
• 6:07
  researchers found that more than 60%
• 6:10
  already had measurable plaque in at least
• 6:13
  one artery. The lesson
• 6:15
  Atherosclerosis begins silently.
• 6:18
  Decades before symptoms, it tracks
• 6:21
  directly with APOB and LDL cholesterol. The
• 6:24
  Mediterranean diet can slow that progression and
• 6:27
  statins can dramatically reduce it. But by
• 6:30
  the time you're waiting for the stent, the disease has
• 6:32
  been smoldering for years. When you
• 6:35
  see these young men on the Internet
• 6:38
  claiming that they can eat whatever they want because they're
• 6:41
  metabolically healthy, they are slowly
• 6:44
  layering atherosclerotic plaque down
• 6:47
  into all of their arteries and you won't manifest it
• 6:50
  for years to come. Now let's compare that to
• 6:53
  medicine, and we're going to start using what's called the Jupiter
• 6:56
  trial, which looked at Rosuvastatin Crestor, the
• 6:59
  medicine I take, and it looked in people with
• 7:02
  normal LDL cholesterol but elevated
• 7:05
  C reactive protein, which is a marker of inflammation.
• 7:08
  The trial had to be stopped early because the benefit
• 7:10
  was so strong. Rosuvastatin reduced major
• 7:13
  cardiovascular events by 40.
• 7:18
  And unlike a diet study where adherence is hit or miss,
• 7:21
  all you had to do was take a pill.
• 7:24
  So while the Mediterranean diet lowered events by 30%,
• 7:27
  statins cut that nearly in half. And it did it
• 7:30
  in people who didn't even have high
• 7:32
  cholesterol. And then there's the
• 7:35
  Dean Ornish program. You probably heard people say that
• 7:38
  the Ornish diet reversed heart disease, but here's
• 7:41
  the nuance. It wasn't just a diet.
• 7:44
  Yes, it was very restrictive, very low fat,
• 7:47
  vegetarian style diet. But participants also
• 7:49
  quit smoking, took statins, took blood pressure pills
• 7:52
  and did something I love yoga. So was
• 7:55
  it the food? Some of it, sure. Was it the medicine?
• 7:58
  Absolutely. Was it the stress reduction and lifestyle
• 8:00
  change? Without a doubt, Ornish deserves
• 8:03
  credit for showing that lifestyle matters. But let's not
• 8:06
  pretend his diet alone
• 8:08
  unclogged arteries. It was food and
• 8:11
  medicine, not food as
• 8:14
  medicine.
• 8:15
  Which brings me to the scam portion of my
• 8:18
  podcast, because I have to have that.
• 8:21
  Barbara o' Neill from Australia has no medical
• 8:24
  education and has been banned from giving health advice
• 8:27
  in her country and yet travels around the world
• 8:29
  charging thousands of dollars for her seminars.
• 8:33
  One of the things she claims is that cayenne pepper can open your
• 8:36
  arteries and stop a heart attack in its tracks.
• 8:39
  This is complete fiction.
• 8:42
  There is zero evidence that cayenne pepper
• 8:45
  prevents treats or Reverses heart attacks. None.
• 8:48
  Cayenne is a spice. It makes chili taste better.
• 8:51
  It might make your nose run, but it will not
• 8:54
  reopen blocked coronary arteries.
• 8:57
  My God, if it did, we would be using it in
• 8:59
  every hospital in the nation. She claims that the cholesterol
• 9:02
  guidelines were lowered just to make money for drug companies.
• 9:06
  Really? Because my three month supply of
• 9:08
  rosubastatin cost me $2.36.
• 9:10
  Meanwhile, Barbara O' Neill charges thousands for her seminars.
• 9:14
  Tell me again who's profiting here? And
• 9:17
  here's the kicker. She denies that APOB and LDL
• 9:20
  cholesterol are the primary drivers of atherosclerosis,
• 9:22
  which every major cardiologist society in the world, from
• 9:25
  the American Heart association to the European Society of
• 9:28
  Cardiology, agrees that APOB is
• 9:31
  the causal agent of atherosclerosis.
• 9:34
  Barbara o' Neill's denial isn't science, it's
• 9:37
  salesmanship. And Barbara o' Neill belongs in the same
• 9:39
  category as the shirtless salesman hawking mango
• 9:42
  flavored salt packets. She isn't offering help.
• 9:45
  She's selling false hope dressed up as empowerment
• 9:48
  and charging dearly to do it.
• 9:51
  Now let's make this real. If you're in the middle of a heart attack,
• 9:54
  grilled salmon is not going to open your artery either. That's what
• 9:57
  stents and bypass surgery do. Food
• 10:00
  prevents disease greatly, but not
• 10:02
  completely. Medicine and procedures treat it
• 10:05
  and can help sometimes reverse it. The tragedy is when
• 10:08
  people confuse the two. Thinking olive oil replaces a
• 10:11
  statin or nuts replace a stent. They don't.
• 10:14
  The Mediterranean diet is the most evidence based
• 10:17
  eating program we have for cardiovascular and many other
• 10:20
  types of health. It reduces events, improves survival
• 10:23
  and it tastes good. But it does not replace
• 10:26
  medicine. The Lyon and Predimed studies
• 10:29
  show us that food can lower risk by 30 to 70%.
• 10:32
  The Pisa study showed us that plaque forms silently long
• 10:35
  before symptoms. The Jupiter study showed us that statin
• 10:37
  lowers events by nearly half. And Ornish showed us that
• 10:40
  lifestyle works, but only with medicine alongside
• 10:43
  it. And when a heart attack hits, only
• 10:46
  stent and surgeries save lives.
• 10:49
  The truth is simple. Food is the foundation.
• 10:52
  Medicine is the reinforcement. Together
• 10:55
  they're unbeatable.
• 11:00
  This has been episode three of Food is in a Prescription
• 11:03
  Pad. Next time, when beans aren't metformin. How
• 11:05
  legumes lower blood sugar and not like medicine.
• 11:08
  I'm Dr. Terry Simpson, your chief medical explanationist.
• 11:11
  Remember, salmon is delicious, but it is
• 11:14
  not a stem. Forku is
• 11:17
  produced by producer Girl Productions and
• 11:20
  it is advertised out through the world and all
• 11:23
  things audio from Simpler Media and my good friend the paw
• 11:26
  God, Mr. Evo Terra. For references and
• 11:29
  more, please visit your doctor's orders and
• 11:31
  forku.com and don't forget to
• 11:34
  check out my newsletter on Substack, where I dive into
• 11:36
  deeper times with these topics. And here's the
• 11:39
  disclaimer. I am a board certified physician,
• 11:42
  but I am not your physician. This
• 11:44
  podcast is for education, not for personal
• 11:47
  medical advice. Please talk to your Western trained
• 11:50
  board certified doctor and a dietitian before making any
• 11:53
  changes that will affect your health or your diet. Because
• 11:56
  we want you to be around because we have a lot more
• 11:59
  episodes to go.
• 12:00
  All right, everybody, have a good week.
• 12:03
  Enjoy your salmon. I like mine baked.
• 12:12
  Hey, Evo, you know these people who think if
• 12:15
  you put enough olive oil on a salad, you'll avoid a
• 12:18
  statin or stent? That's like thinking sunscreen
• 12:20
  protects you after you've been burned. Food helps prevent the
• 12:23
  fire, but medicine turns that out. And as for cayenne
• 12:26
  pepper, that's seasoning, not surgery. Anyone
• 12:29
  charging thousands otherwise is a scam artist. I'm going
• 12:32
  to stick with the salmon. Maybe I'll put some cayenne pepper and olive oil on
• 12:35
  it. And my $2.36 statin.
• 12:38
  Anyway, hey, buddy, I'm kind of wondering what food
• 12:41
  you're up to these days because, hey, we got about
• 12:44
  900 more episodes of fork you to go before, uh,
• 12:47
  you know, we have to get a stent.
• 12:52
  Wait, wait, wait, wait, wait. You put crestor
• 12:55
  on your salmon? Man,
• 12:57
  physicians are
• 12:58
  weird,
• 13:01
  Sam.