Latest / Fork U with Dr. Terry Simpson / Tofu Isn't a Statin: Food as Medicine

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Tofu Isn't a Statin: Food as Medicine · Fork U with Dr. Terry Simpson

• 0:03
  >> Dr. Terry Simpson: You've probably heard the phrase, food is
• 0:06
  medicine. It sounds good, right? Ancient
• 0:09
  wisdom, supposedly from Hippocrates, the father of
• 0:11
  medicine. Except here's the problem.
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  Hippocrates never said it. Not once.
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  It is not in any of the surviving writings. Zero
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  evidence. Chances are someone a couple hundred years
• 0:23
  ago just slapped his name on it to give their
• 0:26
  idea more weight. And even Robert F.
• 0:28
  Kennedy, Jr. The chief grifter currently running
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  Health and Human Services, quoted it as
• 0:35
  well. If RFK Jr. Is your historical reference,
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  you're already in trouble. But the phrase stuck,
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  and people cling to it like it is carved in marble. And
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  as someone who's certified in culinary medicine, you
• 0:47
  might think I'd be all in on that idea. And sometimes
• 0:50
  I am. But food isn't the cure for everything.
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  And let me be clear. Food is one of the
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  most empowering tools we have. And
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  I absolutely prescribe food for
• 1:02
  patients. The right food can prevent, slow, and sometimes
• 1:05
  even reverse some, but not all, chronic diseases.
• 1:08
  But here's the catch. While tofu, tempeh,
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  almonds, and oats are fantastic, they're not going to
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  replace your pharmacy.
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  Which brings us to today's episode,
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  the Portfolio Diet and why Tofu
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  isn't a Statin.
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  I am your Chief Medical Explanationist, Dr. Terry
• 1:29
  Simpson, and this is Fork U Fork
• 1:32
  University, where we make sense of the madness,
• 1:34
  bust a few myths, and teach you a little bit about food
• 1:38
  and medicine.
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  The Portfolio Diet was designed by Dr.
• 1:45
  David Jenkins, the same scientist who gave us
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  the glycemic H index. The idea
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  is simple. Combine a portfolio of foods that each
• 1:54
  lower cholesterol just a little, like
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  nuts. Plant proteins like soy.
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  Viscous fiber like oats, barley, psyllium.
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  Plant sterols from fortified foods. Together,
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  they act on cholesterol recycling through what's called the
• 2:08
  enterohepatic circulation. Okay, here's
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  how that works. Your liver makes cholesterol,
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  it packages it into bile and and sends it
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  down into your gut through your common bile duct.
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  Normally, most of that bile and the cholesterol in it gets
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  reabsorbed back into your bloodstream. But when
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  you eat viscous fiber and plant sterols,
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  those foods bind to the cholesterol and carry it out
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  of your body. That's one of the reasons your bowel movements are
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  brown. Bile is brown. And when fiber
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  catches it and drags it out, you flush away
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  some of the cholesterol with it. It's a win win. You feed
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  your gut microbes and you keep cholesterol from sneaking
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  back into circulation. The issue is
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  can you stick to eating that much fiber every
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  single day? That's the rub. It's a
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  lot easier just to take Crestor like I do.
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  There's some clinical data and here's where it gets
• 2:59
  impressive. The portfolio diet
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  isn't just theory. It's been tested.
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  A randomized control trial published in the Journal of the American
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  Medical association compared the portfolio diet against
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  standard low saturated fat diets in patients with high
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  cholesterol. And here's what they found. If your starting
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  LDL was about 171 with the
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  portfolio diet, LDL dropped by
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  about 13 or 14%, or about 24 to
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  26 milligrams per deciliter over six months.
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  In the most adherent patients,
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  the reductions exceeded 20%
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  at one year. Now this wasn't a one off.
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  Multiple meta analysis and systematic reviews
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  confirm these results showing that mean LDL, which
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  is the bad cholesterol reduction of about
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  17%. The portfolio diet also
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  improved other cardiometabolic risk Factors including
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  non HDL cholesterol, apolipoprotein
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  D and the estimated 10 year coronary
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  heart disease risk. So yes, the
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  portfolio diet works. It is
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  especially true in the most motivated adherent patients.
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  The LDL reduction is actually comparable to first
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  generation statins like lovastatin.
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  But let's make this real. What does it take to
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  get those results? So here's a day in the life of the
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  portfolio diet. Breakfast bowl of
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  oatmeal made with soy milk that gives you viscous fiber and
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  soy protein. One Shot Snack handful of
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  almonds, about 25 or 30 grams. Not Trail
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  mix, which I love. The candy coated
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  stuff. Nope, this is just plain almonds. Lunch A cup of
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  lentil soup, maybe with a slice of whole grain bread.
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  More fiber, more plant protein. Dinner
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  Tofu stir fry with vegetables and barley on the side.
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  That's more soy, more viscous fiber. Somewhere in
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  the day you'll need plant sterols, usually in the form of a margarine
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  spread, about 2 grams worth. That's how you
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  hit the therapeutic doses. Soy protein,
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  viscous fiber, nuts and sterols every day
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  consistently. And that's the challenge. It
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  takes planning and honestly, it takes
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  motivation. It's not impossible, but it's
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  harder than taking medicine.
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  Now you might be thinking, wait a minute, isn't this basically the
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  Mediterranean diet? And the answer is kind of
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  both diets are plant forward, emphasize nuts, legumes,
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  whole grains and fiber. Both lower LDL cholesterol, both
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  reduce cardiovascular risk, but they are not
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  identical. The Mediterranean diet is a broader
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  lifestyle pattern. It has olive oil, fish, vegetables,
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  legumes, limited red meat. It's flexible, delicious,
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  and a lot more embedded in most of our cultures. The
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  portfolio diet is more prescriptive.
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  You need specific amounts of soy protein,
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  viscous fiber, almonds, and plant
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  siderols every single day. It's less about
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  lifestyle and more about hitting cholesterol with targeted
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  foods. If the Mediterranean diet is the whole restaurant,
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  olive oil, fish, vegetables, joy, the
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  portfolio diet is just the cholesterol lowering section
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  of the menu. You can actually fit the portfolio diet
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  in the Mediterranean framework. And when you do, you'll probably get the
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  best of both worlds and maybe a lot of
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  sadness. But now let's
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  continue. Let's, let's do some comparison. Let's go to the
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  world of pharmacy. Let's take statins like atorvastatin
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  or rosuvastatin, which is Crestor, the medicine. I take
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  those two typically lower LDL by
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  double that amount, 30 to 50%. That's
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  double or sometimes triple what you get on the portfolio diet.
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  And they don't just change cholesterol numbers.
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  They reduce heart attacks and strokes by 25 to
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  40%. And here's the kicker.
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  When you add zdia, also known as
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  ezetimide, it also, it's another drug. It
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  blocks cholesterol absorption in the gut. So
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  that's basically the portfolio diet on high
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  octane. On its own, ZD can lower
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  LDL by about 15 or 20%, similar to the diet.
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  But when you combine zdia with a statin, LDL
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  drops another 20% on top of what the statin does.
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  So a statin alone might give you a 50% reduction in
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  LDL. At Zetia, you're at 65 or 70%. That's
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  massive and far more consistent than anyone can
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  manage with oatmeal and tofu alone. Let me give you a real life
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  example. Me, I have familial
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  hypercholesterolemia. My father had a heart
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  attack when he was 55. My brother had a heart attack
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  at age 50. I have high cholesterol.
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  My LDL, the bad cholesterol, runs at about
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  190 if I do nothing with it. But I
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  take both Crestor, Rosuvastatin
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  and Ezetimibe. And my LDL
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  is in the 40s, which is remarkable
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  because that is lower than the number we think that is
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  needed to have me continue to form
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  atherosclerotic plaque. It's great.
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  So what about red yeast rice? There's a story here. And
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  here's the before we had prescription statins,
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  we had red yeast rice.
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  It's a traditional Chinese food that produces something
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  called Monacolin K, chemically
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  identical to lovastatin, the very first
• 8:00
  statin drug. Sounds great, right? A, uh, natural
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  statin, except the dose is
• 8:05
  unpredictable.
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  One batch might have none, another might have near drug levels.
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  Many samples are contaminated with a, uh, kidney
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  toxin. And the FDA said if there's enough monoclin
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  K to work, it's not a supplement, it's an unapproved drug.
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  So even when it works, Red rice yeast
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  is basically a first generation statin. And here's what that
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  means. It's less effective than fourth generation
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  and it has far more side effects than modern fourth
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  generation statins. So meanwhile, Crestor
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  and atorvastatin or Lipitor are more potent,
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  safer and consistent. So if you want a
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  statin, go to your doctor, not the supplement
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  side. So here's the takeaways. The
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  evidence is clear. The portfolio diets lower LDL
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  by 17% at best, more if you stick with
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  it. And that's real meaningful. And that's why
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  diet always matters. The Mediterranean diet
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  is broader, easier, proven to reduce events
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  when followed long term. But statins, they're
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  stronger, safer, have the best evidence for
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  preventing heart attacks and strokes. And when you combine them with
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  zdia, the pharmacologic version of the portfolio
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  diet, you can lower LDL by nearly
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  70%. The best outcomes happen
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  when you do all three, though. Eat Mediterranean,
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  weave in portfolio elements. Take a statin
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  if your doctor prescribes it. Take Xetia if you can,
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  or some of the newer Drugs like the PCSK9 inhibitors
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  or bempeditic acid. Diet is
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  always a foundation. It is the empowering thing that
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  you can do. Medicine builds the house, and, uh,
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  together they keep the roof from caving
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  in.
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  This has been episode one of a new series where we're
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  calling Food isn't a Prescription Pad. And up
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  next, we're going to revisit the dash diet and blood pressure.
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  How beans, bananas and leafy greens can lower your numbers.
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  But maybe not enough to toss out the pill bottle just yet.
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  I'm Dr. Terry Simpson, your chief medical explanationist.
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  Remember, tofu and almonds are great, but they're not
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  Crestor. I have researched and
• 10:08
  written, obviously this episode, but
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  remember, while I am a board certified
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  physician, I am not your physician.
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  This podcast is for education, not personal medical
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  advice. If you need to talk about lowering your
• 10:22
  cholesterol, or if you have a history, family history, please
• 10:25
  see your own doctor. And if you need dietary advice,
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  a registered dietitian before making any
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  changes to your healthcare. Please don't see a chiropractor. They
• 10:33
  can't prescribe anything and they're oftentimes anti
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  statin and anti whatever. Please don't see an eastern trained
• 10:39
  shaman, a real doctor. This is in
• 10:41
  their wheelhouse. Also,
• 10:44
  for more deeper dives into this, please see the
• 10:47
  blog associated with this podcast
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  either@yourdoctorsorders.com or
• 10:52
  or4q.com and for more
• 10:54
  Mediterranean style types of foods go
• 10:57
  to my website terrysimpson.com
• 11:00
  thank you everybody. Have a good week.
• 11:07
  You know Ivo, some people think if they eat oatmeal,
• 11:09
  soy milk and almonds, they can ditch a statin. But
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  that's like saying you can patch a leaky roof with duct tape.
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  It'll hold until the microburst monsoon or
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  whatever big storm hits you. And in this case, it. It's worse than
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  a storm. It's like a heart attack or a stroke.
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  So I'm going to keep my statin and let's keep both
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  of our cholesterols down. Because you know what? We're coming up on
• 11:30
  100 episodes of 4Q and we've got
• 11:32
  about 900 more episodes to go before
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  we can retire.
• 11:39
  Wait, hold on. I get retirement benefits with
• 11:41
  this gig. Sweet
• 11:46
  SA.