James Swanwick: We are live, I am James Swanwick from Swanwick and I'm joined today by Dr. Joel Khan. We are talking about proper nutrition, we're talking about veganism, we're talking about healthy hearts, about looking great and feeling great, well into our 60’s. And today we are joined, as I said, by Dr. Joel Kahn, who is a holistic cardiologist at the Khan Center For Cardiac Longevity in Bingham Farms Michigan. He is the number one best-selling author of Dead Execs Don't Get Bonuses. I love that it's such a cool name and a vegan he tells me just before we joined, for 43 years Dr. Khan, welcome to the show!
Dr. Joel Kahn: Thank you very much and I think as you were searching for the word you said hatha it happens to be in the States International Yoga Day it may already be in Australia past that so I think you were just giving a shout out to the yogic tradition. So it was a very fortunate stumble.
James Swanwick: Thank you. Also, a big shout out to all the fathers out there because it's Father's Day, at least in the US. I'm in Australia as we're going live and recording this, but it's not, it's not Father's Day in Australia but it is Father's Day over in the US at the moment so Happy Father's Day. Dr. Khan, you're a father of three, I think.
Dr. Joel Kahn: Exactly, three grown adults. They're coming over for dinner in about an hour, some wonderful pasta from Sardinia’s, artichokes, mixing some lemonade that I've had sitting out in the sun, just a joyful family gathering.
James Swanwick: I love that. If you're watching on Facebook, or on YouTube, please do go ahead and post a question in the comments right now. Dr. Khan would love to answer your questions. If you're watching live on Facebook go ahead and type in the comments where you're watching from and post your question. We've got Hugh saying Happy Father's Day. Mel says Happy Father's Day Gentlemen. Thank you so much! So let me just kick this off by asking you, Dr. Khan. We've got meat eaters watching, we've got vegan lifestyle eaters watching, we've got vegetarians watching, we've got intermittent fasting experts watching, we've got all these different kinds of ways to eat and nutrition. Let me just put it straight to you why veganism, and why for 43 years?
Dr. Joel Kahn: Well, okay, so I will respond in a personal way because I'm actually a bridge and commonality builder. I'd rather end the diet wars and build a uniform approach to nutrition, which I think you can do in a scientific way. And mine may be a little different than yours, maybe a little different than JJ Virgin may be a little different than Mark Hyman, whatever, but it's gonna be very similar.
I grew up in a home in Suburban Detroit, Michigan, where we kept the Jewish dietary laws called keeping kosher, no pork, no cheeseburgers. I went up to the University of Michigan in 197 I was 18 years old. I just wanted to try and continue that family tradition. Important to my parents, my grandparents. And there was truly a gigantic salad bar and really dead meat. I mean, it was not good food there’s nothing I've ever seen like my mother's a very good cook. Was not a vegan home that I grew up in just a healthy cook and really the first week I had the salad bar, let's see how this goes. I had a cute girlfriend with me and she is now my wife of 39 years. She felt so good a week later, I think it was getting rid of dairy. I was just we took the package and slowly we started to read and Ann Arbor was very friendly to do this with Indian restaurant and Thai restaurants and Detroit has an enormous Arabic population so there are Middle Eastern restaurants we found.
You know honestly, it wasn't that hard with some moments I did cardiology training in Dallas, Texas, a real meat-heavy town. All I ate for three years was okra, okra, okra, okra. It's just the official vegetable and the only vegetable in Dallas at the time. Now there were moments like that but I really was feeling good, good health. And then this science started to come out. And there was a book called The Diet For A New America by a wonderful human named John Robbins, who laid out Health and Environment and animal rights. And then the famous Dean Ornish, MD came out with a cardiology article, you could reverse heart disease with a plant diet, and I was by then a cardiologist, and I said, well, that's interesting. I took this funny little turn at that point 13 years ago. Turns out its therapy so I just stuck with it.
I think for the patients I'd see with advanced heart disease, it's very important I let them know about a lifestyle centered around a healthy diet, which is largely a plant diet. But I'm very flexible with my patients in general and as I said, I think I'm the only vegan ever to be on stage at Paleo FX and hold hands with Shaun Baker MD, and Kelly Ann Petrucci and, you know, Ben Greenfield and the others. Been on Joe Rogan kind of discussing this and I wasn't willing to try and squash my opponent, I'd rather find some unity there's a lot of unity. So that's the story in a nutshell.
James Swanwick: I would imagine that the exact opposite of being vegan or a plant, or having a plant-based diet would be the caveman diet, which is what I read recently. A friend, a good friend of mine actually did it for 30 days where he ate nothing but red meat with a little bit of grass-fed butter and a little bit of sauce inside but nothing else. Now I got a WhatsApp audio message from him saying he felt fantastic, wonderful, high energy, and was sleeping well. I was so curious about that because I was thinking, Wow, everything I hear is that red meat raises cholesterol level and you need to eat lots of plant-based, you know, like vegetables, obviously. How can eating massive amounts of red meat make someone feel fantastic? And again, I don't want to get this into like the diet but how is that possible? Can you explain something like that?
Dr. Joel Kahn: Yeah, so it's an interesting question and one of the issues with it is: there is close to no science. There was an article published in 1930 about two men for one year ate only meat. It's in the medical literature, it suggests that they maintain their health and then you fast forward to 2020 and you can't find much more science.
You do find compelling stories like Jordan Peterson and his daughter, Michaela Peterson, and others. You know, there's plenty because the movement has grown. It begs scientific evaluation, what are vitamin levels, what are hormone levels, what's happening to arteries? And I think, as a physician, my problem with that approach always wanting people to feel good is it's understudied and oversold right now. Most people feel it's the ultimate elimination diet. You know people that are gravitating to the larger people that have some health issues, autoimmune health issues, or acne or something. Well, you remove dairy and then you remove legumes and you remove grains and then you remove some other food groups and you're left with meat, which can create food allergies. There's a very well known red meat allergy so it's not completely benign, but it's less frequent than the others. So you’re removing soy you know that moving corn, you know, basically again, give a shout out to the virgin diet and our mutual friend JJ. You're doing all of her, you know, top allergens out of the diet.
I fall back a lot when I talk about nutrition. And this is the Hakuna Matata moment. There's a scientist in La Valter Longo at the University of Southern California, Ph.D. Italian born, and he spends his time between LA and Milan. He talks all the time when you're evaluating nutrition you go five pillars: What's the basic science? What's the epidemiology? What are the randomized studies? What do elderly people around the world in good health that quote Blue Zones eat? And how does it impact the environment and the entire picture of the earth when you put the carnivore caveman diet there? You have to say, does it fulfill any of them? It's mainly patient anecdotes, so not even patients. So we need to learn more.
I'm not suggesting that it's all you know, #fakenews. But I wouldn't put it up against the Mediterranean diet with thousands of studies or the DASH diet with hundreds of studies, or veganism in the medical studies, which are hundreds of studies. And so you just can't pull out your prescription pad and say, let's go do this, as a physician. But if somebody wants to try it, it is an elimination diet.
The other thing others say most are doing it with conventional meat, not organic meats. It's expensive to eat three meals a day and buy premier cuts that are also organic. So the potential burden of herbicides, pesticides, hormones, antibiotics in that diet, is untested, but we're talking about MD’s recommending it well. Just do the studies, get pre and post labs pre and post biotoxin levels. Let's find out the safety of it before we go on websites and social media and TV shows. So I've taken a few exceptions and some national TV shows with it’s Prime Time to recommend this and I know Dr. Longo would say, oh, not even close, you know, and I have a lot of respect for somebody at that level of scientific endeavor.
James Swanwick: We're talking to Dr. Joe Kahn, a Holistic cardiologist at the Kahn's Center for Cardiac Longevity in Bingham farms Michigan, and the number one best-selling author of Dead Execs Don't Get Bonuses, the Ultimate Guide to survive your career with a healthy heart. We've got some questions that have come in for Dr. Khan live here on Facebook and on YouTube. So Vani Sharkey on Facebook asks, What can I replace meat with if I go vegan?
Dr. Joel Kahn: Sure! And again, consensus because I wanna leave your audience with good information, not angry doctor and on Father's Day. But in 2011, the Harvard School of Public Health, pretty prestigious group of researchers, thousands of publications, came out with a food plate, beautiful food plate and I'd encourage everybody to go to social media go to DuckDuckGo my favorite search engine lately and go look up Harvard School public health, healthy eating plate. It's a quarter fruits, a quarter vegetables, a quarter whole grains, and a quarter protein with a glass of water, not milk and not alcohol for sure.
Just to give a shout out to your important platform there James and, and you know the protein although there is a protein in leafy greens, there is protein and whole grains there is protein, even in fruit, but when you're talking about protein recommendations of Harvard School of Public Health are legumes, beans, peas, lentils, I like organic choices that don't have to be beans, lentils, not processed meat, not bacon, pepperoni, salami, corned beef. They're the worst in terms of carcinogen burden and diabetes burden and heart disease burden and perhaps erectile dysfunction burden. But if you're going to do it have a small amount lean meat as clean as Paleolithic as you can find the little bison, little elk, little wild-caught fish.
It's really a very doable consensus so my plate that quarter is gonna be plant-based sources of protein. I have one last comment you know, and it's an easy transition, a beef chili becomes bean chili and chicken soup becomes you know, vegetable soup and if you want to try the manufactured burgers, they're a nice little transition. I don't think they're very healthy, you can make your own little black bean burger if you can eat little black beans at all much healthier, much better, Quinoa burgers, kale burgers, all kinds.
The last statement is there's been a lot of science about the protein requirements that humans need. And there's pretty good consensus from Dr. Longo from Harvard researchers that despite all the hype, you got to eat chicken to be strong, you got to eat tilapia to be strong and you know it's animal flesh makes us strong, there's actually a great impact on health, heart disease, cancer, diabetes, to overdo animal protein and head to head. I just wrote a blog on this that people can find on the web, head to head plant-based sources of protein are without some of the burdens that animal sources of protein are like aging there. These are specifically known how there's an amino acid called methionine. It ages as quickly as it promotes cancer, that's much, much more concentrated in meat and it's going to be in your bean chili. So you might be wise as every organization society. The world says to cut back or cut out but at least cut back on all animal protein substituting healthy plant proteins to some kind of hybrid mix, or you can do without it you know, the Association of Dietitians The United States has endorsed if you're pregnant, if you're raising children, if you're middle-aged or if you're elderly, you can get by without animal products, so it's always an option.
James Swanwick: Well we have a question here on Facebook from Bianca who asks: “ Dr. Khan, my dad has had two strokes. I want him to go vegan. How can I get him started? He's 65”.
Dr. Joel Kahn: I think you lock him in a room with some celery, apples, brown rice, and a can of kidney beans. But we're not gonna do that, and we're loving and it's Father's Day.
Number one, so I do see patients all the time and I'm as challenged as anybody to get them to see one of the reasons this is not a total off-track comment. The biggest enemy isn't the Caveman versus the Paleo versus the Mediterranean versus the Vegan, it's the crap that is eaten worldwide now for the majority of calories and an average person's diet that is hyper-processed food that's got refined sugars, refined poor quality oils, excess salt, very little fruit, and vegetables. The average American eats under two servings of fruit and vegetables a day. That's the enemy.
So transitioning your Dad from that poor diet, if that's where you started to any of these outcomes we talked about. But in terms of stroke and heart disease, you do want them to go plant-based. So I take out my prescription pad and I write, you've got to watch three documentaries. You got to watch Forks Over Knives 2011, you got to watch what The Hell 2017, I have a small role in that one. You got to watch the Game Changer movie that came out late 2019 and that's your homework. And when you come back, next visit, I'm gonna quiz you that you watch 343 and people do really respond to that everybody likes sitting on a couch and not opening a book.
Now, if I can get past that I might suggest a book. I've written a book, Dr. Ornish’s book, The Dr. Esselstyn, Dr. Barnard these are some of the plant-based research heroes. And finally, I'm just going to ask them a couple of easy things like adding an apple a day. Why don't you try some dairy substitute? I don't care if it's soy milk almond milk, hemp milk, oatmeal, macadamia milk, cashew milk, just try to go without, you know cow-based dairy. For a few weeks, I see so many people feel better on plant-based milk, better skin. I'm a little brown right now from a sunny Michigan weekend but not burnt. But you know better skin better digestion, better sleep. The dairy thing is the easiest ticket to show them that food is medicine, food is poison. Let's just make an easy transition.
James Swanwick: Yeah I've switched almost entirely to unsweetened almond milk, or coconut milk these days I very rarely drink dairy. I'm still surprised that when I go out to maybe a coffee shop or a restaurant or something when I asked for almond or coconut it's still like “oh no, no, we don't have that “ and you feel like they're judging you for being like a picky eater. Whereas the reality probably based on the science is that you know, this knee jerk I'm not knee jerk reaction but like this coming from a standing start off like, oh, cow's milk, that's what it is. And you asking for almond milk or coconut milk, he's crazy. That's kind of like the perception right?
Dr. Joel Kahn: Man, they charge you more. Now the good news is the market is shifted so rapidly that the price is quite comparable and we are starting to see that not only do the big coffee shops have right now oat milk is the hot one in The United States, particularly a brand from Sweden called Otley makes a great barista cappuccino, and they're starting not to charge extra. But when you talk about the mixed data on the healthfulness of dairy products, it's a no-brainer to say, Just give me oat milk for my coffee and those agreed restaurants at coffee shops should make it a little easier. I mean, frankly, I'll just say the bastion of stupidity and stubbornness is in our hospitals. Go try and find almond milk in a hospital or soy milk or oat milk. You know you won't and if it doesn't happen there, how are we gonna get the medical community to start making the changes or at least to consider that food is an important choice? But you know, I find in the Delta Sky Club I always have an option for plant-based milk at least when I used to fly we'll see if we can get back to that Everett pretties.
James Swanwick: Yeah, you know n hospitals, they have vending machines don’t they?
Dr. Joel Kahn: Oh well and you know, hotdogs and bacon three times a day the patient's played yeah, the biggest disgrace at least in the United States. I hear from my social media friends, it's the same worldwide - is the large complete ignorance and, you know, not a consideration for that patient has had a heart attack and the first meal is a burger, or the patient has just said a part of their colon taken out and the first meal is a Chili Mac sandwich. It's just insanity but your listeners are smarter.
James Swanwick: We have a question here on Facebook and if you're just joining us, please do post a question here to Dr. Khan. If you're watching on Facebook or if you're watching on YouTube, take advantage of the fact that we have a world-class expert here on all things nutrition, all things heart-related. Want to get to sleep in a second, the importance of sleep, also talk a little bit about alcohol. As you know, I help people reduce or quit alcohol re-explore their relationship with alcohol. But first, let's go to another question.
Here we have Connie Bezos on Facebook asked Dr. Khan: “Are there any studies being done now to compare a vegan diet against a diet that is primarily plant-based with organic animal protein, but at a much smaller quantity compared to the typical American diet of meat and potatoes?“
Dr. Joel Kahn: It’s a great question, Connie. I'm not aware and I'd be very surprised that it'll ever be what we call a randomized study to comments. It's very hard to do these studies. You're trying to encourage, you know, one group to maybe follow the vegan diet, let's say six months, and another group to follow the diet, you suggested a clean diet, that's a 90% plants and 10% organic meats. It'd be very difficult to do and keep people on track.
The best studies they actually have people stay in the hospital, it's called a metabolic ward. And they actually block the place and they provide the food and then make the measurements. But I don't think it's a hot enough question, not that your question was a good that will ever be done and funded, very expensive, very difficult studies. Almost all people would agree. Let me just pick 90% doc, 90% of my calories, 90% of my plate comes from whole high-quality plant foods, but I like three ounces of organic chicken or three ounces a line-caught salmon or three ounces of Venison. I think if we did those studies, there would be differences but they'd be so subtle and so challenging to parse out.
A buddy of mine, you may know John Mackey, the CEO, and founder of Whole Foods, the big, giant chain in the United States, wrote a book The Whole Food Diet, a good name for a man who founded Whole Foods. And he makes the case I can't and he had all the experts in the world around. I can't tell you if 90% or 100% is different. You have to bring in animal rights. You have to bring in the environment. You have to bring in your comfort level with the diet. When my patients tell me Doc, look at its 95% plant-based but I have a piece of fish once a week. I mean, I'm not yelling at them. That's actually what Dr. Valter Longo talks about in his own book, the longevity diet is 19 vegan meals and let’s say those aren't potato chips and Mountain Dew drinks, those are beans and peas, and greens, and beets and you know purple potatoes and the whole gamut of healthy foods and a couple of servings of fish a week. So, again, these subtle differences shouldn't be called a diet or and I don't think we need a research study just do something in that range.
James Swanwick: Yeah I think it's interesting I have a partner who is I don't know if you'd say a strict vegetarian or vegan because we do eat chicken but we go grocery shopping to an organic market each Sunday morning and only organic vegetables. And then we buy a chicken for the week which is an organically raised chicken and the chicken yesterday was $46 for one frozen chicken. Something to do with the time of year like availability some COVID-19 related issue. Like that, but to get the chicken was $46. And then, to buy all these organic vegetables, the price is up there I mean, it's up there.
Now we've had this conversation a couple of times, which is, do we tell ourselves eating organic and eating this way is expensive? Or do we just say to ourselves, oh, that's how much it costs. And it's actually that eating, what we consider the inferior way is just super, super cheap. Or we can convince ourselves that it's super, super expensive based on the fact that later on in life, we're going to be paying for it in the medical bill and all that kind of stuff. So I guess my question is, how are we going to make this become the norm to get have healthy humans encourage them to eat super, well when the price is seemingly so expensive for so many people?
Dr. Joel Kahn: Right, and that’s a great question. I mean, there has been an improved variation of, you know, quality markets and grocery stores in the States. You know, everybody knows the joke about Whole Foods being your whole paycheck, you know, pre-Amazon. Americans, on average, spend less on food than Europeans as a percentage of their income. And that's the widespread availability of processed food, fast food. It's all federal subsidies. It's been argued the $5 McDonald's burger should be $13 if the government got out of making bad food cheap, but that's the current situation and nobody seems to want to take on these amazingly powerful lobbies and long term, you know, horrible subsidies. It's a real problem.
Again if you really talk again, the caveman the Paleo, the Keto, the Ultra Organic Vegan, the 90% Plus, you're in that range. And these are sort of elitist diets, not everybody's going to have a cuisine art and a Vitamix and all the toys that might go around making these foods. We need the message to be out there that it has to be cost-effective. You can eat plant-based cheaper than your $46 chicken, you buy big bags of brown rice, they may not be organic, you buy big bags of dried beans at a bulk store. You get frozen fruits and vegetables you can buy organic or not. It doesn't really matter if you're eating no fruits and vegetables and you start eating conventional fruits and vegetables. Yes, there's a couple of downsides to it, but the benefits far outweigh the downsides.
So we just need simple approaches, just as they say have a few recipes and nice vegetable soup and nice bean chili. Know how to make a couple tacos, burritos, whatever you like. Find your favorite food and make a plant substitute. It doesn't need to be expensive. A $46 Chicken is you know you should kiss that chicken and you know maybe put it in Lucite and just have it as a table sconce. (laughs)
James Swanwick: But well she actually left it behind at the thing she bought the chicken and said I'm just gonna go and do some other groceries. I'll come back to it because it was in their frozen portable. My partner was like, Oh, I forgot the chicken. So now she's got a phone the place to get the $46 chicken like where do I get it next week oh they left it like donate the $46 chicken. I think it was 40 it was either 43 or $46 or something around there. Anyway, it was a $40 plus chicken anyway, and we didn't even get.
Dr. Joel Kahn: I can't think of a plant-based entree that I could spend $46 that you know some medicinal mushroom. It's quite amazing. You know I've been in the restaurant business in Detroit, plant-based restaurants. And you know I buy organic and we prepare beautiful hand made foods and it's expensive. But it's still far less expensive than the premier you know animal-centered restaurants there's just no way around it that you know fish coming from Norway, and meats coming from Alaska or wherever they are. It's an expensive process to get them into the store shelf and the restaurant. Grow a garden for God's sakes, you know, start to grow sprouts 30 cents of sprouts, servings on top of a salad. It's low expense ways to get super nutrition.
James Swanwick: I wonder if we just eliminate the word organic entirely. And now we just rename any food did not, you know, grown that way as substandard food,
Dr. Joel Kahn: Or just rename the organic shit free. Shit free. That's a good label.
James Swanwick: Yeah, I remember I was living in Hollywood, California for some years in the kind of mid-2000s, and I wasn't as educated on food and organic food and nutrition as I am now and there was a 99 cent store a few blocks down from my home and of course there were whole foods, many blocks from my home a little bit further and me being the cost-cutting efficient financial person that I was I thought, I'll get my vegetables from the 99 cent store. And so that's what I did for many months. And I bought you know like lots and lots of peppers and broccoli and all kinds of vegetables for the 99 cent store thinking that I was very, very clever and why would I buy the same product from whole foods or from you know, fancy store down the road for three times the price? Are those cheap foods from a store like 99 cent store incredibly inferior to what something is deemed as old Organic and if so, how? Like how inferior is it?
Dr. Joel Kahn: Well, you know, a couple-three comments number 1 - you know, try and source local I don't care if you're buying organic broccoli or conventional broccoli it's probably in Michigan been shipped from California or some process far far away and I Oh, the nutritional content does degrade with time, your best to have you know, the most recently harvested foods, whatever their source, support your local markets support your local farmers as best you can, you're paying farmers to that's one.
Number 2 - frozen is always a good option. So if there was a 99% store and they had a big bag of frozen greens or frozen peas or frozen carrots, you know, at least the better companies they actually have that processing right out in the field. I've seen this. So you know, plants are harvested, they're washed, they're clean, and they're frozen in a bag within a couple of hours. A lot of the nutrition is retained compared to that same fruit or vegetable being shipped, you know, you might be eating an apple six months after it was harvested. So still better than a donut. Everything is relative.
And the third and final answer for the price issue, there has been a study that looked at again, it's absolutely insane that the average American just there are five big factors for heart disease. -Do you smoke? -Do you have a mom, dad, brother, sister early heart disease? -Do you have high blood pressure, diabetes, high cholesterol? And then finally, do you eat enough fruits and vegetables, the one that Americans fail the most to hit the mark, because only now about 15 to 18% of Americans smoke, for example, is less than 5% of Americans eat five servings of fruits and vegetables a day and about 1% hit the target actually, in children it's even under 1%. That's a national statistic.
So if you simply double triple the amount of fruits and vegetables we eat from the 99% store, there is a study that said the health benefits are really large if you talk about across the entire world population. Yeah, so you might be exposed to some, you know, PCBs and some glyphosate and roundup and all that. And you could calculate a very small increase in cancer risk and some other diseases that might come from those environmental toxins that organic food won't have. But the benefits outweigh and I was like an enormous difference, more than 1000 to one benefit versus risk. So if the only thing you got is a 99% store, and they got wonderful frozen corn by the frozen corn.
James Swanwick: Got it. We've got some more questions coming in here on Facebook and YouTube. Just before I get to that, I want to ask you about sleep. As you can see, I'm wearing my Swanwick Blue Light Blocking Glasses which promote healthy sleep. Oh, there we go. Dr. Khan is rocking his Swannies as well.
Before we get into the importance of blocking artificial blue light as you do with a pair of blue light blocking glasses, such as the Swannies, how imperative or how important is sleep to a healthy heart, to longevity, to living well, when you compare it to say, eating your three servings of fruit and vegetables every day or being a vegan and making sure that you know, your nutrition is on point.
Dr. Joel Kahn: Yeah, great question. And this isn't set up because you're in the sleep business. This is actually my passion to always learn and develop. You know, 35 years ago in medical school the only thing we learned about sleep as if you're 450 pounds, there's something called the Pickwickian Syndrome literally just suffocate yourself like a character in the Pickwick in papers by Charles Dickens, we learned nothing else.
And yet now, it is such a big focus of health for the heart, health for cancer risk, diabetes, obesity, hormonal, and cognitive function dementia. So in my practice, I have a flip chart that all the patients look at and I teach them. I have good sleep as literally the foundation of the pyramid, if you came to be very proud of, that's actually the bigger base than nutrition, bigger than fitness, bigger than stress management, which of course interacts was bigger than supplements or sauna or yoga or all the other things.
If you sleep poorly, you will skip the gym you will grab a doughnut you will not make a healthy meal. You know you're just underperforming and I don't have to go through all, but compared to skipping a meal compared to your hydration, one night without sleep impairs your executive function, cognitive performance. It's profound.
So I spend so much time with a new patient and follow patients and hacks for sleep and it's always blue light blocking glasses. That's the honest truth. But you know, it might be an essential oil, lavender diffusers and it might be a warm bath and you know, don't eat for three hours and all the things we go through.
In terms of cardiovascular health, I think one of the most important breakthroughs I'm a big proponent of there's a scan you can get of your heart. It's by CT imaging, it's the topic of the Debt Execs book, it takes about 10 seconds to lie down the CT scan. You're 45 years old, you just want to get a checkup on your heart. If that comes back zero, you have no calcium in your arteries and you've got very youthful status that comes back 345- 600 a digital assessment of how much deterioration and damages your arteries. You got a problem now, so you need to wrap around love. So this study called the Morgans study looked at that if you sleep five hours or less if you sleep for seven or eight there’s a tremendous difference in the amount of silent heart damage in those that sleep under five hours versus the seven eight. So it's absolutely on our radar screen.
It should always be one of the questions that doctors ask and certainly cardiovascular specialists, but it hasn't really completely got there. You know, all we know is how to write Ambient or Sonesta or other prescription drugs, it's just the worst thing you know you can do. And I don't take that stuff and never will.
James Swanwick: How and when and under what circumstances do you wear your Swanwick Blue Light Blocking Glasses in terms of trying to promote healthy sleep? What's your understanding of the science behind an orange lens blocking out artificial light and how that's conducive to optimal sleep?
Dr. Joel Kahn: Yeah, in my own personal practice, always 60 minutes and sometimes 90 minutes before my anticipated bedtime and usually about 10 pm because you do want to have a routine and a schedule and not leave it up to the random whim of day or workload. And you want to follow the kind of typical circadian pattern or going to bed when the sun’s setting, waking up when the sun's rising. It's a good pattern and all.
I learned before I heard of you, probably a good dozen 12 years ago about the photoreceptors at the back of the eye was discovered in Harvard, that specifically our blue light receptors for that wavelength of the spectrum of white light, and that they are related to the production of melatonin or the shutting down of melatonin in the pineal gland. So by wearing my Swanwick Blue Light Blocking Glasses, I hope to promote the largest amount of melatonin production at the right time, which is assumed before I go to bed. And yeah, I do a lot of things to get good sleep and I do get good sleep. But I think the blue light blocking glasses are part of that program and a very simple part.
James Swanwick: If we move the conversation now to alcohol - Dr. Khan, I've got a question here from Rod via Hey, who asked Dr. Khan: “is red wine really good for the heart? It's confusing when I see articles saying that”.
Dr. Joel Kahn: Yeah, you know, and they come from as I mentioned, Dr. Longo’s five pillars. Most of red wine or alcohol data is what's called nutritional epidemiology. We asked a lot of question to an apparently healthy population could be Loma Linda the Aventis could be Harvard School of Public Health, which has enormous nurses and physician database. Every few years we updated their health status and 20 years later, 15 years later, 30 years later, did you have a heart attack? Did you have a stroke? Did you have a bypass those kinds of studies and they always trying to adjust for smoking, diabetes, so they'll pick out during those surveys. The weaker surveys only asked the question once, the better ones like Harvard School of Public Health every four years they keep asking because people's habits changed.
Those studies tend to show a trend and there's a lot in medicine we call a U shaped or a sweet spot. You know, one drink, a few drinks a week is a sweet spot for reducing the risk in these studies of having a heart attack or bypass a standard dropping dead versus actually no alcohol and certainly versus you know, excessive alcohol. So do you translate that and consider red wine a therapy that is different than a randomized study? You might go look at some of the longevity pockets.
Sardinia in Italy pretty famous for their grapes and their cannon that wine. Not true in Okinawa. Not true in Loma Linda, I'm not exactly sure in some of the others like Ikaros, Greece, if there's any typical drink that is part of their culture, but you know, there are, that's cardiovascular disease, then we got to go for overall mortality got to go for cancer. The real hot button lately has been a very common heart condition called atrial fibrillation, a lot of people 35,45, 55,65, and certainly, 75, 85 starts to get irregular heartbeats jumping all over it's called fibrillation or a fib. It's a big problem because in certain individuals it can lead to stroke and devastation and even early death and even if you have a long enough early dementia, this irregular heartbeat, there seems to be clear cut data, there's no amount of alcohol that can be tolerated if your goal is to resolve that problem. Even small amounts of alcohol can trigger recurrent episodes. Certainly overdrinking can trigger, even small amounts.
So it's a very slippery slope for a physician or other health care providers to recommend alcohol, and if so, it has to be with such careful comments about limiting the amount. But the reality is it shows up in studies from all over the world. It's like that little game where you're hitting down the frog and the next one pops up and the next one pops up. You deal with one study, but then there's a new one and there was another one that was just consistent with this in the last month or so of which there are hundreds of studies.
James Swanwick: if in doubt, yeah. Zero alcohol, I would offer or suggest is going to be preferable to any amount of alcohol. Is that a fair assessment?
Dr. Joel Kahn: I do believe, that if you really want to get your grape-based polyphenols, you can drink unsweetened grape juice. It's been studied it has the same cardiovascular effects of, you know, alcoholic beverages like red wine. So, that's always an option.
There is a very welcome trend of more and more young people going alcohol-free. That's a great trend. And if you were to be interviewing a neurologist right now, the likelihood is they would tell you that alcohol is a brain toxin. And there's no way alcohol would ever be approved as a drug because the difference between a social drink and inebriation is much smaller than it is with most drugs where there's a safety margin. I can’t view it like that so I agree with you, James. A responsible medical message would be zero.
James Swanwick: We're talking to Dr. Joe Kahn. You can find more about Dr. Khan on Facebook at Dr. Joe Khan. We'll put a link there in the comments there. If you just look under the Swanwick Sleep comments there, you can go to Dr. Khan’s page and like and follow. You can also check out his book on Amazon. We've put a link to Dr. Khan’s book there in the comments as well. The book is Dead Execs Don't Get Bonuses, the Ultimate Guide to survive your career with a healthy heart. If you're just joining us now, you're watching on the replay. Go ahead and post your question or questions. And we'll get them answered. Let's have a look here.
Dr. Joel Kahn: Melanie is telling us we've skipped two questions.
James Swanwick: Oh, okay. So let's have a look here Jerry Go asks does high cholesterol causes a heart attack?
Dr. Joel Kahn: Yeah, a good topic I lecture on. In fact, that was probably spent three hours today reading on cholesterol because it's an endlessly interesting conversation. An anecdote I did on my cardiology training, as I mentioned long ago in Dallas, Texas, the Nobel Prize in Medicine 1985, I arrived in ‘96 was awarded to two researchers in the hospital that I arrived at Dr. Michael Brown and Joseph Goldstein. They identified a group of children that lack a receptor in the liver. The bottom line is you're five years old and your cholesterol is 1000 in these kids, and that's the only abnormality, their cholesterol is 800 or 700 and thousand. And these kids were having heart attacks at age nine, age 10 bypass surgery, balloon angioplasty.
Cholesterol is a real deal, and they have never had their data challenge. It led to the development of lots of therapies to bring cholesterol down. There is universal acceptance by the medical and cardiology community, the European Society of Cardiology came out last year with a beautiful series of papers. LDL cholesterol causes atherosclerosis. Something injures your blood vessels, you’ve got 50,000 miles of blood vessels in your body, the blood is coursing by you just need a cheeseburger, you just smoked a cigar with your buddies. You did too much alcohol or any alcohol, your arteries get injured. That LDL cluster loves to get in the artery. And what happens then it's called the response to retention that the LDL cholesterol gets trapped there and inflammation starts and it's called a fatty streak.
Absolutely, if you could choose, I want my cholesterol to stay 140 my whole life or 280. There'll be somebody with the cholesterol 280 they'll hit age 100 there'll be somebody with a close to 140 that has a heart attack but across the population, you'd much rather have your cholesterol 140. Heart disease is a very complex formula and only one piece of it is cholesterol, which is why you'll hear about the 102-year-old lady who smokes cigarettes and ate bacon and ate eggs and, you know, seemed to be pretty intact 102 it's a very complex formula. But if you're, you know, a betting person, you're wearing a seatbelt when you drive and a bike helmet when your bike, you're gonna try and at least measure your cholesterol and maintain it at the low end of normal. Which is where all the hunter-gatherer populations if you looked at a chart of you know, it doesn't matter if they're meeting tribes are planted in tribes or they're in Guam or they're in Polynesia, they tend to run close fellows total of 100 hundred and 10, a hundred and 20. And you just don't see heart disease.
James Swanwick: You mentioned a CT scan before. So yeah, I had a CT scan six months ago, it came back to zero.
Dr. Joel Kahn: Yeah, I was gonna ask you go, James. You're gonna be A longtime buddy.
James Swanwick: Oh, thank you. Thank you. I have zero so I got a zero on the CT scan. Having said that when I've done blood work before it does demonstrate high cholesterol. Yeah. What could that possibly mean? Because every time I've had my cholesterol test, it's always high. Thankfully, the last couple of times is going backward because I changed them, some dodgy tips, but why would my CT scan be zero and my cholesterol be high?
Dr. Joel Kahn: And your cholesterol went down because you left the $46 chicken in the freezer. And yeah, being chilly instead of fried chicken. No, so you just hit my hot button. Although I know a lot about nutrition and I'd love to talk about that. I don't want people to have heart attacks and there's clear guidelines, you can prevent 80-85% of heart attacks: don't smoke, get exercise, get your sleep, keep your waist thin and eat way better than ever, way better than average doesn't have to be completely vegan. But it's never going to be McDonald's and Pepsi and doughnuts, can't be the average American or probably similarly, average Australian diet. It can't be.
We can prevent heart disease, we can prevent heart attacks. The problem is that people right now, or probably half the people right now have a plaque in their arteries and they have no idea, very tricky disease. It's silent to the day you die. It's silent to the day you feel horrible and go to the emergency room and you have a heart attack. And this is what's so intriguing. Why does your doctor say to a woman at age 45 go get a mammogram? I don't have any problem, Doc. Oh, just check. We can't afford diggers. Why do you get a colonoscopy at age 50 across at least the United States when you have no symptoms, and nothing is done to check the heart which is the biggest risk of dropping dead or having a premature disability. You just said I don't know what you paid for it if you had it in the States or Australia. But for more than 25 years, a test has been available. In my city of Detroit $75. You just paid cash you don't pull out your insurance card, five seconds, hold your breath done heart calcium CT scan. And when you come back to zero like you did, James, and I'll tell you, I'm 61 I had a zero at age 48-50. And at age 60, just about six months ago, because about every 10 years and I'd suggest you may be repeated yours in 10 years, there is no better certainty that you're resisting aging and about half of us aren't zeros. And as you get older, it's far less than half earned zeros and we are at risk but you and I are in an elite club. Congratulations!
Now, as I said, Why do you have high cholesterol in a zero number one, you're not 72 years old, you think you're about 39. But you know you have time to go when you do want to take care and you do want to make those changes, get your sleep, don't smoke, stay fit, manage stress, and eat a better than average which is going to be more fruits and vegetables I would not suggest the caveman diet to make the next 10 years with zero. It might work but we've studied it for plant-based diets. We have no idea what the caveman diet. You know, your blood sugar, if elevated can cause plaque. Your blood pressure if elevated can cause plaque. Family history, like I mentioned mother, father, brother, sister, grandparents raised the risk, but there's a reason why either your grandparents and your parents and your siblings had the same bad lifestyle you have. So if you’re at risk, go change your lifestyle, you'll get rid of that risk. Well, maybe there actually is a genetic component. My current passion besides just always talking about preventing heart disease. There is a fascinating kind of cholesterol that one out of every four of us inherit from our parents. It's called lipoprotein ah, why do I bring it up? It's the most common inherited risk of stroke, heart attack, blood clots, and heart valve problems like protein, and not trying to be too commercial.
I just published a book on this in March, the first book written by a doctor in the world on this topic, it turns out for about 20 bucks, you could ask your primary care doctor, you know, I'm a little worried my dad had a bypass, my mother had a stroke, somebody with one of the questions talked about a husband that had two strokes, definitely want to ask a primary care doc, please check my lipoprotein. It's a kind of cholesterol, but it doesn't show up in the routine cholesterol panel that you just mentioned, James, I would suspect you didn't inherit it from your mother and father and you get the blood test once and you never need to repeat it again for 20 or $30. Simple blood tests don't even have to be fasting. But I have a practice full of people from all over the world that inherited one gene or two genes from mom and dad and their blood levels tremendously high and they are two to four times the risk heart attack stroke, even if they follow healthy diets and good guidelines. So we work with them but you know if the only risks you have James is high cholesterol and you know you're thin you're eating better than average you're getting some fitness, you're certainly a sleep expert. You know, it's not the cause of heart disease, they have high cholesterol. You've corrected the majority of the others. But at the convention, the cutting edge day that says the response to you is not to go and Lipitor or Crestor, or if you have a zero you really don't qualify. That's good news. Just work with lifestyle, eat more oat bran and oatmeal, and maybe some edamame and so you know, fiber foods naturally bring down your cholesterol and get retested down the road but you're gonna be around for a long time Mr. Swanwick.
James Swanwick: Thank you so much stuff, you can appreciate that I have a missing me not to admit not to bring up one other health issue that I have and I, hopefully, our viewers and followers here will relate to it. I'm a 44-year-old man, I do not drink, have not drunk in a decade, but I still get gout attacks. I've had about six gout attacks now over the past four years.
For those uninitiated gouts it comes on as an attack it's a swelling in the joints, it's of formula, it's very high uric acid levels, and it causes tremendous pain mostly in the foot in the joint, often in the knee. The first gout attack I had four years ago was in my left knee and my knee swelled up like this. And then the five gals are texts that I've had subsequently had always been in the room. Four of them have been in the right foot and one of them in the left foot, always around the big toe on the joint. And it kind of feels like someone has come along with a sled sledgehammer and smashed onto the foot and feel it actually feels broken, it swells up. So I eat, I think very well I exercise consistently six times at least six times a week. I sleep well I do all those kind of things. But I do have a very high concentration of uric acid in my body and I am prone to gout attacks. Am I doing something in my diet to trigger those gout attacks are in my just cursed with genetics where I have high uric acid?
Dr. Joel Kahn: Right. And you know, I'm interested in gout because if you did a Venn diagram if you looked at gout patients and heart patients, there's a lot of overlap. This is good science and you'd rather have a low uric or normal uric acid level. And you'd rather not have gotten of course gout has been called the disease of kings and radiate rich, creamy big calorie diets with obesity, and certainly transitioning away from that to, you know, cleaner, smaller meals more plant-based may help. Genetics plays a role in so many of these conditions, and we don't have an easy way to measure your genetics I mean can talk to mom and dad and aunts and uncles that might just be friends in the family. You know, some people are doing tart cherry juice before bed as a uric acid low ring. There are some vitamin companies, not many. I don't have any affiliation with a Florida vitamin company called Life Extension. But you might look up they do have a uric acid reducing herbal vitamin that they usually have some good research behind. Never enough when you get to vitamins. And then there's a prescription drug that at least in the States and Australia, we call Allopurinol, it's generic, it's inexpensive, it will dramatically lower your uric acid level. Really cool. I actually use Allopurinol in my heart patients. It's been shown if you're a sick heart patient, it can reduce your angina pain and some of your episodes have poor circulation because again, this overlap. So you know, that's the last resort although it's kind of horrible resort. I mean, if I had had five, you know, horrible attacks of gout. And it seemed like the last resort was to take 100 or 200 milligrams of Allopurinol a day, you can get a rash from it and you know, all drugs have some potential but I would probably grab onto that if I've really cleaned up my diet and still seem to have that elevated level.
James Swanwick: So it was probably more of a hereditary thing rather than a dietary lifestyle kind of thing on initial inspection, just based on what I've shared so far.
Dr. Joel Kahn: Right. If you've eliminated the creams and the organ meats, liver, brain, you know, that would be common and Henry the eighth's plate and all that I think you're probably left with genetics be most likely.
James Swanwick: Yeah. Well, Dr. Kahn, thank you so much for your time. Let's head for home here and then last few minutes. I just want to make sure that I tell our viewers that you can grab Dr. Kahn's book on Amazon. We've put a link there in the comments here. You can also follow Dr. Kahn on Facebook, which is Dr. Joel Kahn- KAHN.
Thank you so much for the questions that have come in. Let's ask one final sleep-related question as to heart health. Can 10 hours of scattered sleep makeup for seven or eight consecutive hours?
Dr. Joel Kahn: Um, you know, you can now pretty simply measure the quality of your sleep in a reasonably reliable way. You can get a Fitbit, a Garmin, a Whoop, I'm more of a fan of the ring called the Oura ring. I don't know how you feel about that, James. We probably both know they develop early Oura ring. If you don't know about it, just look up ouraring.com it’s a pretty attractive wedding band, looking ring that really gives you some interest in detail and a lot of times actually people think their sleep is interrupted then you really get some metrics on it. It's actually better than they thought.
There are now home sleep studies used to be at a go off to the hospital and have wires all over your head to get a sleep study. Maybe you also snore, you're kicking the covers off for the rest of like, you can wear it looks like a big rapper watch. And it records everything about your action levels, your skin temperature, your stress levels, and it creates a report that's very simple and low cost to look at. And I'm always surprised that the quality and duration of sleep are better than what the patient's been reporting. You know, they may not be in the deep, it does tell you how much is deep sleep which you want to try and hack your way to a little better deep sleep. I'm still learning how to do that in my own body. I sleep well, but it's not a lot of deep sleep according to my oura ring.
But finally, you know, so seven days solid versus 10 scattered. I mean, at the end of the day if you're not tired, I mean, what does poor sleep cause besides cognitive impairment, I mean is your weight, blood sugar, even cholesterol can respond to improved sleep so if your biometrics that you can do are good if your blood pressure good I wouldn't be too worried about you know that napping app there's a lot of things you can do you take you to know point three-milligram melatonin before bed you can take some full-spectrum hemp oil before bed. You can try magnesium before bed there's a lot of herbal preparations, you can try with valerian and other roots that are non-addictive and safe and figure out all of them because you gave them you can stack them up but one of them is going to work for you.
I like to rotate them I have my own little mixture and some nights I don't take anything and it's never prescription drugs, but I really like full-spectrum hemp oil the kind that has all the chemicals found in the cannabis plant with the exception of THC, they're non-addictive and they're bought over the counter but while they're asleep sleep bombs are good.
James Swanwick: Dr. Kahn thank you so much. You wanna rock the Swannies for the final minute here.
Dr. Joel Kahn: Yeah let's do that. Let's bring them on and set up and it's not a commercial thing. I've had these for about three years now I actually have one in my living room one of my bedroom one of my office, I just need to get the daytime readers and then I'll be rocking them around the clock.
James Swanwick: Yeah, beautiful. And for those who don't know what the view looks like.
Dr. Joel Kahn: That's very cool. You know, and I'll give you a shout out. There are other companies out there, but I love that you also make clear glass and readers as a 61-year-old guy, you know, having readers without having to wear you know, glasses and glasses and looking like a freak of some kind. But if that's what you got to do this, what you got to do, this is just a great innovation.
James Swanwick: Thank you, Dr. Kahn, thank you so much for your expertise. Thank you so much for taking the time. Thank you to everyone on Facebook and YouTube. To ask questions today and thank you for those who will be commenting on the replay of this. Dr. Kahn appreciates your time. Happy Father's Day, Sir!
Dr. Joel Kahn: You stay well and good health to you and we can follow up about gout. We got to get rid of that.
James Swanwick: Thank you. Appreciate it.
Dr. Joel Kahn: You too