So hello and welcome, everyone. Lucas Rockwood here with the Yoga Talk Show. I’ve got a very special guest today. I’m pleased to introduce medical doctor Joel Kahn. He’s a leading authority in heart disease prevention and reversal. He’s the author of the soon-to-be released book called The Holistic Heart Book. You may have seen him on TV or read his Reader’s Digest column or visited his popular website which is DrJoelKahn.com. Joel says an ounce of wheatgrass juice is worth a pound of Lipitor.

So Joel, welcome to the show.

Thank you very much. Excited to be with you.

Well great. We have a wide spectrum of listeners on this show, people of all different backgrounds, different stages in their health journey, and many of them are at different extremes. There’s the raw foodies and the vegans and the vegetarians who are big fans of the show, and we also have this big fan base of Paleo and low-carb and Crossfit people on the other. Probably about 80 percent of the people listening, who are probably like 80 percent of most of the people in the world, fall somewhere in between. They’re trying to figure out how and what to eat, and with everyone, everyone listening to this, what they have in common is that they care about their health, they care about the planet, they want to do the right thing but they’re totally confused.

And so I wanted to bring you on the show. With that in mind, I know you’re using a plant-based approach. I know you’re getting really, really great results. So I’m curious. (01:56) Preventing, reversing heart disease, to some people this sounds totally logical, focus on plant-based foods, to others it’s a total revolution, so tell us, as a medical doctor, how did you get into all of this?

Well wonderful. I just want to say to the Paleo crowd and the Crossfit crowd, I do burpees and I do pull-ups and I’ve been a Crossfit gym member, and you can do it green or you could do it *** (02:18). It works either way. It’s a good place to be.

(02:22) But very briefly, I grew up observing some Jewish dietary laws, the laws of Kosher, and I only mention that because there were things I ate and things I didn’t eat. There always was a border. It required at least a second thought before I put something in my mouth. I think it’s a really good habit for everybody, to engage brain before engaging mouth. As I went to university I found that being a vegetarian just proved to be the easiest way to follow those laws that I chose to continue to observe.

(02:52) And then 1987, somebody handed me a copy of John Robbin’s book called A Diet for a New America. Made the case about animals and the environment, animals and ethics and it made the beginnings of a medical case why eating a plant-strong diet would be a very healthful thing. And made some changes in my diet further, and then 1990, Dean Ornish, Dr. Dean Ornish, cardiologist in California, did one of the most sophisticated studies ever done. People with bad heart blockages, the very thing in 1990 I was treating, that’s the year I finished training and began practice, and I was the hotshot with the balloon, the hotshot with the stint, I had just finished training at the best place in the world on those kind of treatments.

(03:35) And this guy was out there in California showing you could make blockages melt away over a year or two, treating people with plant-strong diets, really essentially vegan diets, low-fat vegan diets, no oil, along with meditation, walking and quitting smoking. And you can’t dispute his data, because it was done with the most sophisticated technology then and he’s followed it up now with thousands of patients. It just made a transformation in my practice. I continued in the Cath lab, I continued to put stints when people really needed urgent car, but I tried to slap them alive with love that there was the opportunity. They held the power, that a fork was as powerful as a stint, in terms of a long-term outcome, and the data’s continued to support — in fact it’s more urgent now that the world has gotten more toxic, you know, plastics and the whole issue of genetically modified, the whole issue of pesticides and hormones in meat and dairy. So it’s even a tougher world than 1990 that Ornish was facing, and plant-based is one way to hide from a lot of those chemicals.

This is great. I’m a big fan of Dean Ornish’s work as well, and that’s one of the things that turned me onto plant-based diet. But one thing that people say sometimes, which makes me ask more questions than I have answers for and I’m curious what your response is, but people will look at that research and they’ll look at people reversing heart disease and reversing these chronic conditions using a plant-based approach and they’ll say this is a healing diet but it’s not necessarily a lifelong diet.

For me it’s just a big question as well, so I’m curious how you would respond to that suggestion.

(05:16) Yeah, and I’ve actually never heard that because I can’t imagine it not being a lifelong diet. Again, just from the strict medical background, scientific background, Dr. Esselstyn, another pioneer in scientifically proven reversal of heart blockages using a no-oil, plant-based diet. He’s followed his patients for 20 years. He’s published them out to 12 years, but he’s got data that goes 20 years-plus now. Dr. Ornish was required by the government to get data more than 10 years in duration follow up, because then his program got actually reimbursement from Medicare. There’s only two programs for heart disease reversal that have Medicare approval, and Dr. Ornish and then the Pritikin Program which is a very plant-strong program out of Miami. So they had long-term follow up. If you’ve ever watched the movie, whether it’s propaganda or whatever I don’t think so, forks over knives, these are a group of people that have been eating in this manner for 20-plus years. I myself is an example. I’ve been a vegetarian now for about 30 years.

(06:18) So it is very much a lifelong diet. I don’t see any cracks in that armor. I only see more data, such as we can talk about the Adventist Heart Study out of Loma Linda that say this is a strategy to extend your life, reduce or eliminate the risk of chronic disease, enjoy sexual function longer and the whole plate full of quality of life.

Fantastic. And with everything there’s always a plus and a minus, and I have a hard time finding minuses with a plant-based approach, but one of the minuses that people point out, which again is one of these things that’s a big question mark for me, is what happens with what inevitably tends to be a higher glycemic diet, when people switch over to a plant-based diet. (07:02) Do you see that becoming a problem, when people start eating more grains and even fruits perhaps, which is much higher glycemic than perhaps if they were eating a higher animal-based diet? Have you seen problems with that? Or is this kind of a thing that kind of goes away when somebody gets clean?

(07:18) Well, I agree with you, you have to intelligently approach a plant-based diet and many of us, including myself, started out with the chick nuggets and the hot dogs and the imitation bologna. Not every meal but many of the meals, and realized somewhere along the path that this wasn’t really whole food, plant-based, this was some bridge, and I think it’s a good bridge. Dr. Neal Barnard of Physicians Committee for Responsible Medicine has done an excellent job getting people over to the vegetarian world, using a lot of these as bridges and then moving beyond that to more whole foods.

(07:53) But it’s that rainbow diet, it’s that colorful diet. Meat-strong diets are going to lack much more of the central nutrition than plant-strong diets. Fiber, if you’re not getting 40, 50 grams a day of fiber, which is only going to be coming if the bulk of your diet is plants, you’re not going to move your bowels, you’re not going to eliminate toxins, you’re not going to lower your cholesterol and you’re not going to enjoy optimal health, if you’re not getting a large quantity of plant-based vitamins, phytonutrients, antioxidants, same thing. You’re not going to be optimizing what is now called epigenetics and your ability to actually alter your DNA transcription to more favorable DNA and RNA production. So you’re going to miss all that.

(08:37) It’s true, if you are a fruitarian you are going to get a lot of fiber but you do need to watch that. It’s the juicing of fruit that is, and it’s certainly commercial fruit juice that deserves to be put almost close to soda pop and energy drinks. Even home juiced fruit has some higher glycemic index for sure. A piece of whole fruit has, as some people say, the antidote with the poison. It has the sugar and the fructose, but it has the fiber, the vitamins and the phytonutrients that do balance it.

(09:11) So I in my practice, I do not see people developing diabetes or developing glycemic issues, actually have reversed many patients tendency to diabetes by introducing very plant-strong diets and eliminating certainly the processed food, the simple carbs so white sugar, white rice, white flour and lowering their animal product intake.

People like to make generalizations about medical doctors and they kind of throw them all in one camp, and it doesn’t really seem very fair to me, but these days I talk with doctors who seem just as divided on the nutritional plane as everyone else. (09:47) So I’m curious, with your stance, taking this approach to reversing heart disease, is this now very well accepted or do you still get a lot of resistance or how do things fall these days?

Well, it’s a good question. (09:58) Is it scientifically well accepted? Absolutely. I mean, does anybody really question Dr. Ornish and Dr. Esselstyne’s data? If they do they’re just living in some lala land, because this is peer-reviewed research. It was good enough for Medicare, and you go and try to convince Medicare that your program’s sound, you better have bullet-proof data, and that’s specifically Dr. Ornish and the Pritikin Center.

(10:23) Is there dispute? Oh my God, I call it — well, Dr. John McDougall calls it the food wars. I mean, it’s food insanity out there, the whole spectrum, and I’m concerned by the wheat belly, grain brain approach, which number one go to the medical library and go find all the peer-reviewed studies that support that approach and we’re still sorely lacking that kind of data. There is one nice study in 2009, on a very nice Paleo diet with very lean protein intake that shows some improvement in diabetic and cholesterol parameters. It’s a wonderful study of, I think it was 13 patients.

(11:04) But we can also find over 1,000 medical research studies using vegetarian/vegan diets and the whole host of medical improvements, and I think it shouldn’t be a war. I’ve written in some blogs that the U.S. food plate has 50 percent of the plate as vegetables and fruit, and healthy Paleo approaches to diet are going to emphasize it at the bottom of the pyramid. Organic, whole vegetables and fruits as the basis. I’m concerned when people talk about 70 percent of calories coming from animal fats, as some of our friends, Dr. Mercola and others do write. I think you’ll die of a heart attack before you’ll have to worry about Alzheimer’s, and taking one system and emphasizing it like prevention of brain disease, even coconut oil and the whole medium chain triglyceride and such concerns me, because it may be beneficial for the brain but when you have coconut oil at 90 percent saturated fat I’m worried about the coronary disease. I sent a 33 year old to bypass last week, 33 years old. I routinely put stints in people under age 40 all the time. These are often non-smokers, but they’re eating the Western diet, the standard American diet, and some of them, I don’t have any data to support it, are particularly following kind of the trend. There isn’t one Paleo diet, like there isn’t one Mediterranean diet, but it is confusing out there.

(12:29) I think the bottom line is where we can all unite is the basis of every food pyramid, the majority of any food plate has to be a large quantity of organic fruits and vegetables, to provide fiber, phytonutrients, antioxidants and vitamins. My protein and your protein may different, but we can still be friends.

I love it. I’m a foodie and I love food and I’m a plant-based guy, so I’ve taught nutrition classes and I’ve taught cooking classes for years and years, and so that’s always my emphasis and it’s always my bias, too. One thing I’ve noticed more and more is just the impact of stress and the benefit of emotional support in health, and sometimes I look at these different groups, whether it’s a raw food group or a Paleo group who has a Crossfit community or like Dr. Ornish’s program where they have meditation and they have community support, or even like a Weight Watcher’s where support is one of the key elements.

(13:24) And I’m curious from your perspective, how big of a role or how small of a role or how potentially big of a role could support, spirituality, community and these kinds of things play in peoples’ health?

(13:37) Well I agree with you, it’s huge and I totally share your opinion on it. Just a couple quick unscripted comments. One, I’ve gotten involved with Saddleback Church in Las Angeles. So I’m in Michigan, some of you may know the phenomenon called the Daniel Plan, where Pastor Rick Warren himself became extremely obese about three years ago, his church of 35,000 followers became extremely obese and they brought in Dr. Oz, Dr. Mark Hymen, Dr. Daniel Amen and some others, and constructed a very wonderful health program of lean meats, fruits and vegetables, exercise, stress in small group settings and they’ve lost a ton of weight.

(14:16) I was out there about six weeks ago at a giant health rally. I sit on one of their wellness boards, and it’s all based on people supporting people supporting people. None of this has really been done in medical clinics. It’s health in the church, health at work, health at home, health with friends. It’s a wonderful phenomenon.

(14:36) Support groups, Weight Watcher’s has been successful, and others because of those group meetings. It’s funny you ask that question, because tomorrow night in my hospital in Michigan, a very large, well-known hospital, we’re kicking off an Esselstyn, Ornish support group. We had a little article in the paper, we got 300 emails of people saying I’m out here all alone eating no oil, vegetarian and it’s a lonely world and I want to meet some other people doing it. So we’ve actually already got some restaurants locally who are willing to host us as a group and support it. So kind of a wonderful phenomenon, and I’m really excited about what’s going to happen tomorrow night.

Sounds great. Yeah, more and more I just see, especially in our yoga communities, just the impact. Just having people around you who love and care about you, the changes kind of come from within. People read 1,000 diet books and then they make a healthy friend, and that healthy friend makes a bigger impact than anything.

I’ve got to share with you, there’s an African proverb that says if you want to walk fast walk alone, if you want to walk far walk with someone. And it’s really a thing. It’s a lifelong plan, having somebody or a group to support you is just a bedrock.

Yeah, people always give me a lot of credit for eating the way I do, but if I wasn’t for my wife who supported me and my kids who play along, it wouldn’t really work. I’m curious about one thing. (16:00) You mentioned before, low-fat approach and obviously for heart disease reversal that seems to be really proven effective. I’m a guy who has a tendency towards epilepsy. I have a minor epilepsy condition, and really — well not too early on, but in my early 20s I was exposed to a keytogenic diet. And it sounded horrible to me, eating super high-fat, and I kind of left it by the wayside. But later in life I found a keytogenic approach using primarily coconut oils, and it just makes my brain really, really happy. I couldn’t really explain it in a much better way, but mental clarity, concentration, mood and all of these things.

But of course, like you mentioned, what are the long-term effects of eating a high-fat, cyclical, keytogenic, plant-based diet? Nobody really knows.

(16:44) I’ve got to tell you, you’ve hit the one — and I’m not a neurologist, but you’ve hit the one niche, and there’s no question that for 100 years keytogenic diets have been used before there were anti-epileptic drugs for seizure control. Whenever and wherever something like that can help a person, and I’ve also seen just some other people that have done remarkably well with keytogenic diets. The question is, is that the recommendation for the large majority of American population, and that’s where I think there is a weakness in the argument. So go for it, good work.

I’m curious. (17:21) For someone like me or for anyone listening who wants to start paying attention to some simple biomarkers, what are the kinds of things you recommend patients? Is it the scale, is it cholesterol, is it their fasting blood glucose? What, for you, are the big things to look out for?

(17:38) Well, depending on your age, and these are advanced tests that should be widely available, it will depend on your community, one is you can image arteries to detect very early Atherosclerosis. The most attractive one, but still not the most widespread, is you can do a special ultrasound of the neck over the carotid artery. You can measure the thickness of the wall of the carotid artery. There’s huge data that tells you for any age what that should be, and if the thickness of the wall of your artery is well beyond where it should be you’re developing early Atherosclerosis, before it’s a plaque. You’re starting to get thickening of the wall of the artery. It’s called a carotid intima-media thickness measurement, CIMT. Unfortunately, in about 48 states in the United States it’s not covered, it’s not reimbursable, although it’s inexpensive, it’s accurate and it is not harmful because it uses ultrasound.

(18:33) There’s a complimentary test of the heart arteries, which is a CT scan. It’s called a calcium coronary CT scan. It takes 10 seconds, no dye, and we have hospitals in Detroit charging $75 for it because the insurance companies, with rare exception around the United States, haven’t caught onto 20 years of research, very high recommendations from cardiologist societies to incorporate it into a screening program. But since it’s a CT scan, I don’t like doing it on people 20s and 30s. I hesitate in people in their early 40s, unless they’ve got multiple risk factors.

(19:06) And then you get all the lab work, and it’s gotten very sophisticated and better. There’s something called the LDL particle number, there’s measures of inflammation. You can measure oxidized LDL, although there’s very little support. Scientifically a lot of support, treatment-wise very little support. And I do that. I like to check extra markers, homocysteine, lipoprotein A. Somebody comes to me and their family history is pretty remarkable and they’ve got a few risk factors, we will usually find something that’s the lipid paneling beyond that can help them. Maybe it’s B vitamins, maybe it’s Niacin, maybe it’s just standard lifestyle, what you do with your fork and your feet every day.

Sure. So for your average person who’s listening right now and they have heart disease in their family, which is basically everyone, and they want to take care of their heart and they want to make choices that are long term, if you had to pick a couple of things to get people started, again, most people don’t want to jump straight into some vegan thing or some vegetarian thing. Most people, for better or for worse, are not interested in everything that comes along with that, but at the same time they do want to take some positive action. (20:19) What kinds of things do you recommend to clients, and what are some little things that are going to make big changes for people?

Sure. One, I encourage everybody to watch the video Forks Over Knives, and I’m amazed when I talk to my patients that probably 80 percent of them actually figure out where to get it or download or stream it, and they watch it with their spouse or their children and it’s made a big impact. It’s a powerful and medically based piece and I think it’s very credible.

(20:48) Number two, and I’d try and get them to become students. I love the website Dr. Michael Greger has called NutritionFacts.org, free daily video. You can become a nutrition scholar within a year by just watching two-minute, three-minute videos that come daily.

(21:08) Number three, I’d suggest to people make three changes. This is my standard fare. I tell them you can be a vegetarian in a year, vegan in a year, but I want you to eat one red apple a day, organic, I want you to get off of dairy and get onto one of the other milks that are in the store, I don’t care if you like help or soy or rice or almond or whatever floats your boat, but do that. And number three I want you to try a non-beef burger. If you’ve never had a bean burger or garden burger in your life, I want you to try it. You’ll see how simple it is to make a few simple changes, and when I see you back in a month let’s talk about those three steps.

(21:40) I will often point them, just to give one more appropriate regard, to Dr. Neal Barnard’s site, PCRM.org, PhysicianCommitteeResponsibleMedicine.org because the 21-day program to trying a vegetarian diet that they have is — well it’s free and it’s so well done and daily emails and recipes and encouragement. That is very helpful. If somebody does say okay I’m ready to try three weeks of plant-based eating. And it’s very simple plant-based eating that doesn’t require culinary experience.

Awesome. And on the flip side of that, people are always worried, what am I going to be missing and what about this B12 and this D3 and this vitamin K thing. (22:25) I’m curious, do things pop up right away for you when you make those recommendations for people? Do you ask them to supplement? Do you make suggestions, or is that less of a concern?

(22:34) Yeah, well the basics, there’s no doubt, for vegans, those that are strictly plant-based should take B12, they could take it sublingual, they could take it oral. They’re probably going to get it in some of the rice, soy, almond, hemp milk, commercial products if that’s what they’re buying, but there’s just no reason not to. Frankly, all of America should take B12. It’s a water-soluble vitamin, it will give your urine a pretty color if you don’t need it, and there are issues, particularly with so many people taking acid reflux medications that can inhibit the absorption of B12 in the general public. The general public would be smart to generally adopt it.

(23:13) Beyond that, there are some supplements that I will talk to vegans about, taurine is an amino acid that’s very low in vegan diets. Totally unproven if it makes a difference, but it helps blood pressure. It’s a bit of a natural diuretic. With some of my heart patients it’s been very helpful. But no, beyond that the whole vitamin issue right now is, to some degree, in a bit of turmoil. I think it’s bad science, but I think there is a role for supplements. But B12, B12, B12 and eat your rainbow.

Great, well awesome. (23:46) Well tell us a little bit more about your book and how people can get in touch with you and your work, if they want to learn more.

That’s kind of you. (23:53) And actually, the book has been out now about five weeks, it’s called The Holistic Heart Book. It’s the only one with that title out there. It is published by Reader’s Digest. I’ve been very lucky to be writing for the Reader’s Digest Magazine for half a year and they’ve been a great publisher. There is a website that they have, it’s right now where you get the book, it’s HolisticHeart.com. The book has a two-week sample period. Because they’re handling it you can actually return it if you’re not happy, but don’t you dare by not happy. There’s 78 health prescriptions. It’s not a purely vegan book. It’s a realistic book that you’re on your way. It’s a journey. Somebody at a Crossfit gym will love probably 76 of the health prescriptions. Maybe there’s a couple that are fully green, but really good stuff on fitness and sleep and stress and yoga and meditation and infrared sauna, on sex and joy, things that have scientific basis for heart health.

(24:52) And I can be found, as you mentioned, it’s DrJoelKahn.com, free email newsletter, welcome to meet friends on Facebook. You asked me a question a while ago and I just want to go back. My one passion beyond just talking about health all the time is improving hospital health. I hate to see patients and family members being fed the very food that causes the visit in the hospital. You go in to buy a new car and somebody’s poking holes in your tires at the same time or something. It makes no sense. It’s time to change and realize we have food science that says food is medicine and we need to use food just like chemotherapy in the hospital. It’s not there. There’s bacon everywhere, processed red meat. It’s not a health food. It’s everywhere. There’s sweets and doughnuts and all the rest.

So I’m working on that on a large scale and hope to see improvements all over the country. And anybody happens to visit a hospital and sees wonderful food examples or disgusting food examples, I’d love if you’d shoot them to my website and I’ll try to share them around and a hall of fame and a hall of shame until we get them all to be famers.

That’s great. Well Joel, thank so much for coming on the show. Thanks for your information. I look forward to reading your book, and I hope we can connect again very soon.