A Doctor's View

Metabolic health and losing weight | Dr Philip Ovadia

February 10, 2022 Dr Polyvios / Dr Philip Ovadia Episode 49
A Doctor's View
Metabolic health and losing weight | Dr Philip Ovadia
Show Notes Transcript

For this episode we are joined by a medical colleague in the USA. Dr Philip Ovadia is a board-certified Cardiac Surgeon and founder of Ovadia Heart Health. Once a morbidly obese heart surgeon, struggling to lose weight Dr Ovadia learnt about the importance of metabolic health. This helped him lose over 100 pounds.

Dr Ovadia has since been determined to help patients improve their metabolic health and ultimately teach them new habits which could save their lives.
He has written a book about my metabolic health methods called Stay off My Operating Table: A Heart Surgeon’s Metabolic Health Guide to Lose Weight, Prevent Disease, and Feel Your Best Every Day. Stay Off My Operating Table shares the truth about metabolic health so people struggling with chronic disease, heart problems, and obesity can finally discover what’s been holding them back and keeping them sick.

Together we discuss:

  • What is metabolic health and why it is so important.
  • Markers for metabolic health.
  • Cholesterol (LDL/HDL) and its relevance to diet.
  • The principles of metabolic health outside of diet.
  • How improving your metabolic health can help you not only lose weight but improve your health.
  • And much more...

Dr Ovadia's website: ovadiahearthealth.com

Stay Off My Operating Table (Book by Dr Ovadia):

Stay Off My Operating Table (Apple Podcasts):
Click Here

Thank you for listening! For more information please visit adoctorsview.uk
email: adoctorsview@gmail.com
instagram: @adoctorsview
twitter: @DrPolyvios

Metabolic Health

Dr Philip Ovadia: [00:00:00] The only reason that, you know, animal products, red meat in particular gets. So demonized is because of the saturated fat issue. And when you go back and you look at the data around saturated fat, the reality is, is that there is no good scientific reason to think that scientific that, uh, saturated fat, uh, Any relationship to really any negative health outcome, but specifically to heart disease.

Welcome to a doctor's view with Dr. Ovadia's a podcast discussing everyday topics in health, fitness, and mental wellbeing, as well as providing an insight into medical. And its challenges. Please note that all opinions of the hosts and guests should not replace advice from your own doctor. Now, sit back and enjoy the show.

Dr Polyvios: Hello everyone. I'm Dr. Ovadia, this is a [00:01:00] doctor's you podcast. And I have with me a special guest on the show today. I've got Dr. Phillip of idea, who is a cardiac surgeon, and since losing a hundred pounds. Of his own weight has become an advocate for metabolic health. And I'm very happy to have you on the show.

That's idea. Hello, welcome. 

Dr Philip Ovadia: Hi, great to be here with you, Paul. 

Dr Polyvios: Thank you. Um, I have to start with your weight loss. A hundred pounds is quite a considerable amounts. And how did you go about doing this? And when did you feel that you needed to do something about. 

Dr Philip Ovadia: Yeah. So, you know, my background is that a, I was overweight my entire life, you know, throughout my childhood and into adulthood.

And I had taught, tried to lose weight many times, you know, as I went through. Um, college and medical school. And I would do, you know, what I was taught to do at that time, which [00:02:00] was eat less, move more, count my calories and eat a low fat diet. And you know, like most people, I had some short-term successes, uh, but I would always gain back the weight.

I had lost them. And about, you know, six years ago. Now I really found myself as a, at a cross roads. I was in my early forties. I was morbidly obese. I was pre-diabetic and I realized that I was going to end up on my own operating table, so to speak and, uh, You know, but I was kind of at a loss of what to do, because as I said, I had tried and not succeeded many times.

Thankfully at that time I started to come across some different ideas about, you know, why we get obese, why we get unhealthy. Uh, I came across, uh, Gary Tobbs, who just happened to be one of the invited speakers at a medical conference I was attending. And, you know, he was the [00:03:00] first. One, the first time that I had heard really the concepts that the types of food that we eat might be more important than the amount of food that we eat and that real, you know, kind of hormonal influence on, uh, weight specifically.

And I read his books and I started, you know, eliminating sugar and ultimately, you know, went through a low carbohydrate. Uh, kind of diet, uh, and was able to lose a hundred pounds of now maintained that weight loss for over five years. Uh, but what I really came to understand. As you know, I went through that journey was what metabolic health was, why it was so important.

Uh, and you know, how focusing on your metabolic health, uh, is really what ultimately leads to successful. Long-term not only weight loss, but, uh, prevention of, you know, all these chronic diseases that are plaguing [00:04:00] our society today, including the one that I was treating, that I am treating every day, which is heart disease.

Dr Polyvios: Sure. Thank you. And how much did exercise play a role in the weight loss? 

Dr Philip Ovadia: You know, it really played a very little, uh, role in the weight loss. You know, I, what I have found is, you know, as I've gone through my health journey, you know, I'm more interested in exercising. Uh, and certainly along the way, I've always tried to stay active.

Uh, but I don't think that the traditional approach to exercise, you know, dedicated hours at the gym or, you know, running or doing cardio is necessarily. You know, it's certainly not necessary. And, uh, it's probably not as beneficial as we think, uh, when it comes to weight loss. What I have come to realize the importance of is building and maintaining muscle as we age, uh, we know that [00:05:00] muscle.

You know, is the most metabolically active tissue. Uh, we know that the more muscle mass you have, uh, the better that's going to be able to support your metabolic health. And of course we have all of the data, um, around aging and. You know, main maintenance of muscle or sarcopenia, you know, muscle loss and what devastating effects that has on, you know, both our lifespan and our quality of life as we age.

Uh, so that has really become my focus around exercise. Uh, both with myself and with the patients I work with is to build and maintain muscle. 

Dr Polyvios: I see. And you mentioned carbohydrates and that, that played a big part in, in this sweater. Shane is that, is that, um, we hear a lot about carbohydrates and about sugar.

And in your opinion, has this been the biggest. Problem with our modern diets. 

Dr Philip Ovadia: Yeah. I think, [00:06:00] you know, I'm not sure that it's carbohydrates specifically anymore. You know, what I do know is that people who are metabolically unhealthy are not able to tolerate carbohydrates well in any form, um, in terms of what gets us metabolically healthy.

Is it the carbohydrates in particular? Is it the processed carbohydrates in particular? Is it other components of processed food such as the seed and the vegetable oils. Uh, and the honest answer is, I don't know for sure. What I do know is that when we eliminate processed food and we eat, you know, we stick to eating whole real food.

Our metabolic health gets better. And, you know, it's hard to separate the processed carbohydrates that are in those foods, from the other stuff, the vegetable and the seed oils in particular that are in those foods and say, is it one or the other? Um, but for. For the average person, who's just looking to get metabolically healthy.

The [00:07:00] answer is eat whole real food, eliminate the processed food as much as possible. And it doesn't really matter which particular component of the process food it is. Uh, it just matters that you get yourself metabolic. They have. 

Dr Polyvios: That leads on to what is metabolic health? 

Dr Philip Ovadia: Yeah. So for me, you know, the definition that I use is that when we are metabolically healthy, our bodies are taking the inputs that we're giving it mostly in the form of food and where you're doing the proper things with it.

Uh, so there were three. You know, main things that are supposed to be done with the foods that we're eating. Some of that food gets turned into immediate energy to be used for fueling all of our, you know, cellular and, you know, kind of macro level activities. Some of that food gets used to build and rebuild our tissues, a process that's always going on in our bodies.

And finally, some of that [00:08:00] food is supposed to be stored in case there are times when energy isn't available. Now when we become metabolically unhealthy, that balance gets thrown off and we end up storing too much of the energy and not having enough of the energy available to us, you know, to, to fuel our activities anymore.

We're no, we're not able to tap into the stored energy, despite the fact that we have plenty of stored energy, uh, so that, you know, it was kind of the working definition of metabolic. That I use. And then, you know, the next question always becomes, how do you measure your metabolic health? Yes. Yeah. So, um, you know, I, for me, I go, I go to five basic measures of metabolic health and these are, you know, kind of the ones that are used, uh, in the, uh, most of the medical studies and.

Those five measures. Are [00:09:00] your waist circumference, uh, easy to measure at home, uh, your blood pressure, you know, you get it checked every time you go to the doctor or you can go to the, uh, you know, go to your, uh, local, uh, pharmacy or grocery store and get it checked. Uh, and then you have three blood measurements that we look at your fasting, blood glucose.

Your triglyceride level and your HDL level, and you look at those five metrics and if they are within range, uh, you know, all five of them, you're metabolically healthy. Understand that. That is very unusual. You know, the recent data we have here in the United States is that only 12% of it. Can meet all five measures of optimal metabolic health.

So 88% are not metabolically healthy. Um, if more, if three or more of those measurements are abnormal, you know, it's the official medical diagnosis of the metabolic [00:10:00] syndrome. What we used to call syndrome X, uh, and it puts people at very high risk of diabetes, heart disease, Alzheimer's disease. Many forms of cancer, uh, and many of the other chronic diseases that plague our society have all been shown to have roots in poor metabolic health.

And that's why I think it's so important to focus on metabolic health. Um, you know, when you get metabolically healthy, You are going to get to a healthy weight. Uh, but getting to the healthy weight doesn't necessarily make you metabolically healthy. 

Dr Polyvios: I see. And research must be going on all the time. In terms of a few years ago, I never had.

Metabolic health to the extent that it's been talked about now, nowadays, and finding out new things each time, and what's been like the most recent discovery with metabolic health that you can think of. [00:11:00]

Dr Philip Ovadia: Yeah. So it's very interesting because it turns out that we've known about and heavily research metabolic.

For quite a long time now, you know, uh, Gerald Raven, you know, has done much of the Seminole work, uh, you know, back in the 1960s, 1970s. And unfortunately it sort of got it, got buried or forgotten about as we became more focused on, you know, cholesterol and some of these other issues. Um, I think, uh, you know, probably the most important paper.

Uh, you know, from 2021, for me, uh, was the, uh, women's health initiative study that came out. It was published in JAMA and basically it showed the relative risk, uh, attributable to different factors when it came to the development of heart disease. And what that paper clearly showed was that having poor metabolic.

They measured it with insulin resistance, uh, specifically a measurement, we call lipoprotein [00:12:00] insulin resistance. Um, and they showed that that was a much more significant predictor of early onset heart disease. Then having an elevated LDL cholesterol level was. And so I think, you know, that reinforced, uh, the importance of metabolic health.

But the reality is, is when you go back through the literature from the 1970s and the 1980s, um, it was, you know, very well known that. That you know, insulin resistance, uh, was an important, was probably the most important risk factor, uh, perhaps next to a smoking, uh, when it comes to heart disease in particular.

Dr Polyvios: So the, you mentioned before pre-diabetic year in a pre diabetic states when you were overweight and what, what does that mean?

Dr Philip Ovadia: Yeah. So, you know, [00:13:00] honestly, um, we talk about in medicine prediabetes, and specifically, that's usually referring to people who have an elevated hemoglobin A1C level, uh, that hasn't quite met the threshold for diabetes, but it's above, what's considered normal, you know, here in the United States, 5.7% is, uh, you know, the cutoff for normal.

Uh, 6.5% is, is considered a diagnostic of type two diabetes. And, you know, between those two, which is where I was, uh, is considered pre-diabetes, uh, what, one of the things I have come to realize, uh, you know, is that. Pre-diabetes is diabetes. Uh, and you know, the warning signs, uh, that go along with that, uh, really should be recognized even before you get to the elevated hemoglobin A1C level.

Um, you know, if we were to pay more attention to fasting insulin levels as a metric, [00:14:00] we would pick up earlier that people are, you know, headed. Down this pathway and are headed towards poor metabolic health. And going back to those measurements of metabolic health, it's interesting to point out that triglycerides and HDL are both markers of metabolic health.

And we know that the ratio between your triglycerides and your HDL is reflective of. You know how insulin resistant you are, uh, you know, specifically, you know, again, when using the U S unit tier, um, if the ratio, your triglycerides divided by your HDL are more than two, uh, that is an indicator that you are likely insulin resistant and have hyperinsulinemia high level of insulin, um, in the fasting state.

Uh, so, you know, indirectly. That is in the measures of, um, of [00:15:00] our metabolic health. But I would much prefer that more practitioners actually measure insulin levels on their patients because we know that fasting insulin levels will become elevated as much as a decade before the development of type two diabetes.

Dr Polyvios: Let's see, and it's interesting, you mentioned the ratio between triglycerides and the HDL LDL, the actual triglycerides and cholesterol. So we've been, at least when I was at medical school, we were, we were bombarded with and had this idea with the, or fixated with the ratio of the LDL HDL ratio. We just, the cholesterol early triglycerides was very rarely mentioned.

So I want you to tell us what your take was on the. Good and bad cholesterol ratio that we hear about all the time in the media and in the news. 

Dr Philip Ovadia: Yeah, I think, you know, in [00:16:00] the end, LDL cholesterol is a fairly weak marker of risk specifically when it comes to heart disease and it really has no relationship to metabolic health.

Uh, it is not a useful marker of metabolic. The big question that, you know, kind of remains unanswered is if someone has an elevated LDL cholesterol level, an elevated so-called bad cholesterol level, and they are metabolically healthy, is that a situation that, you know, uh, Is putting that patient at risk.

And the honest answer is we don't know for sure there are studies underway to try and look at that. Uh, we haven't really looked at that population before, uh, because you know, quite frankly, As I said 88% of the adults in the United States are not metabolically healthy. Um, so yes, for them having elevated LDL [00:17:00] cholesterol levels is certainly adding more risk on top of being metabolically unhealthy.

Um, now again, Since we know that metabolic health is a bigger risk factor for heart disease than LDL cholesterol by itself. I would rather focus on the metabolic health part of it rather than being so focused on the LDL cholesterol part of it. Uh, and, uh, you know, in the end, the, you know, the people that I work with, um, if you were metabolically, And your LDL cholesterol level is elevated.

I'm not sure that that puts you at any more risk. I think you need to look into it more. There are, you know, more detailed, uh, lipid, uh, markers that we can look at as, you know, particle sizes and, uh, eight Bobi counts and LP little a and all of these things play into the risk equation. Um, I just think we've simplified this question too much.

And for the average physician, [00:18:00] And the average person that their only focus is your LDL cholesterol number. That one number I think is doing a large disservice and, uh, clearly, you know, we're not seeing the results of that. Realize that statins have been the most prescribed class of medications now for 30 plus years and heart disease remains the number one killer, uh, worldwide.

You know, for all of that time. So we're really not seeing the impact that we should be seeing if it was true that LDL cholesterol is the sort of number one risk factor for heart disease. Like people are led to believe. 

Dr Polyvios: Hmm, that's interesting. I just did the flip side of that coin. Would you say because also our population is increasing in terms of their body mass as well.

That that also has some confounding. That's the way that, so regardless of this stats in prescriptions and [00:19:00] what we're doing medically 

Dr Philip Ovadia: yes. You know? Yes, it does, uh, from a number standpoint, because, you know, being overweight high, having a high BMI. Um, you know, puts you at a higher risk of being metabolically unhealthy.

Uh, but one of the other important things, I point out that people is that it is not only possible, but it is common to be a normal way and still be metabolically unhealthy. Uh, and, uh, you know, we see this, uh, in, in all of the studies, you know, in the U S study that are referred to. That, you know, showed that 88% were metabolically unhealthy.

When you look specifically at the normal weight, a portion of that study, almost 50% of them were metabolically unhealthy still. So, you know, you can't make the assumption that just because you're not overweight, you're metabolically healthy. And this is why I think we need to be focused on metabolic health, not, you [00:20:00] know, just on weight or not just on cholesterol level.

Dr Polyvios: Sure. And I appreciate that you don't have to be overweight to be metabolically unhealthy. Um, and I saw that in your book as a chapter as well. And one thing that struck me whilst working with quite unwell, um, treating quite unwell COVID patients during, during the last couple of years now, um, it seems to affect the overweight patients very badly.

Um, and to the point where. It seems to be that most of ITU was so intensive care was, was filled with patients that were either had other co-morbidities or were actually relatively fit and well, but overweight, um, as in, they weren't taking any medications, but they were, they were very overweight and. I'm going to obviously leading questions is, is science to do with metabolic health.

And if so, what, what's the mechanism as it were, is it this constant [00:21:00] state of an inflammatory response that your body's always in and in terms of like a metabolic syndrome, what is it exactly? 

Dr Philip Ovadia: Yeah. So I agree with you, you know, some of the earliest data we had around COVID, you know, when we think back to, you know, early in 2020, and we were getting the data out of China and Italy and New York where the bad outbreaks were, it was very clear that, you know, The people that were obese, uh, the people who had high blood pressure, uh, you know, the people who were metabolically unhealthy, uh, were the ones that were most prone to getting COVID and getting sick with COVID.

Um, and really my, you know, my biggest sort of criticism of the response to COVID has been. That we haven't focused on that aspect of it. You know, if we had told people early on, you know, get metabolically healthy, uh, I, I think we would have come through this, you know, a lot differently than we have, and that's [00:22:00] not a substitute for anything else that doesn't mean you should, or shouldn't get vaccinated while you're getting metabolically healthy.

Uh, you know, it's just that if we were metabolically. Uh, we, we are able to tolerate infection or, you know, we have a much lower risk of getting infected with COVID. Um, what it is particularly about being metabolically unhealthy, that makes you more prone to get more sick with COVID. Um, I think there are a number of factors, like you mentioned, you know, we know that being metabolically unhealthy puts you at a baseline state of, you know, inflammation throughout the body.

And, um, when you, you know, if the body is already sort of in a mildly elevated inflammatory state, and then you add another cause of inflammation, like COVID on top of it, uh, the body isn't going to have, uh, you know, the capacity to respond to that. At, or it might set off that, you know, kind of Situs cytokine [00:23:00] storm that we, uh, you know, see in these patients that get sick with COVID.

Uh, we also know that being metabolically unhealthy, specifically having elevated blood glucose levels, uh, interferes with immune function. Um, and so, you know, you're able, you're less able to. Respond, you know, from an immunologic standpoint, uh, when you are metabolically unhealthy. Uh, and then there's just the simple fact of, you know, if you're not in great shape to start with, and you're short of breath because you're overweight, uh, and you get a, you know, you get a virus that's going to attack your lungs.

Uh, yes, you're going to be more prone. You're not going to have the capacity to, you know, be able to tolerate that as someone who. Metabolically healthy to start with, uh, or not overweight, you know, and has good lung function. Uh, so I think all of that comes into play. And like I said, ultimately, you know, I was saying, uh, from the beginning of the COVID pandemic, you know, [00:24:00] I continued to say, and many of the other physicians, uh, you know, who were kind of, uh, plugged into the importance of metabolic.

We're all been screaming that, you know, we've had two years, we could have made significant impacts. If the public health officials were talking about this, you know, discussing with people how to be metabolically, more healthy, uh, so that you could better deal with this pan. 

Dr Polyvios: Yeah, it's not being taught.

Well, at least it wasn't when I was a medical school. Um, I didn't really hear much about metabolic health at all. And is that still the case or is it becoming more of a thing now? 

Dr Philip Ovadia: Um, you know, I think I'm starting to see some glimpses of hope on that front, you know, as it becomes more talked about, uh, you know, both the.

Sort of popular press and in the medical, uh, circles, you know, we're starting to see some headway there. Uh, for instance, I know of a few, you know, current medical [00:25:00] students who, you know, are on social media, talking about metabolic health, or they've reached out to me to ask about metabolic health. Uh, there are, there are.

Um, medical conferences now geared towards metabolic health. Now realize they're still small. It's still a very small percentage, uh, of physicians who are knowledgeable about this and are, you know, talk about it. Uh, but it is at least a start. Um, and I think, you know, ultimately. The best way that we're going to get this message to keep spreading is that the practitioners who understand it, uh, fi you know, and the patients who are open to this information, uh, you know, continue to work together.

And, uh, just kinda, it's a grassroot efforts and it continues to spread and, uh, you know, one person influence. Many other people then, and that's how we continue to get this message out there. One of the [00:26:00] things that's been most interesting to me is, you know, when I go to these low card medical conferences and I talk to the other physicians that are there, almost all of them have a similar story to me, you know, they had to overcome their health problems.

They found this information themselves, and then, you know, it worked for them. Started trying it with patients and it worked for their patients. And, uh, you know, that's how the journey started for them. Unfortunately, I don't hear, you know, any physicians yet who say, oh yeah, I learned this in school. It was real interesting to me.

And I started putting it into practice, but I think we'll get there one day. 

Dr Polyvios: The initial journey as you put it say with, with patients. And we both know, and I think many, many healthcare workers can relate to this. Obviously you can give the best advice in the world to a patient. And it's another thing them [00:27:00] falling through through various reasons and compliance can be, can be an issue.

How do you start this journey of. Someone comes into your clinic and you do the parameters. They are mitzvah metabolic, the unhealthy they're overweight. Where do you start? 

Dr Philip Ovadia: Yeah. So, you know, I usually try and frame that conversation as a choice to the patient. I say, listen, you know, and you know, this especially applies to the patients who have come to me because they have advanced heart disease.

We're discussing doing heart surgery. And, you know, I say to them, you know, you. Doing this stuff, you know, you've been following the advice of your physician. You've been taking your medications and yet you're still here, you know, coming to see me for heart surgery, you know, let's, let's talk about why that may be.

And, you know, ultimately I frame it to them as an option, you know, because that's what it is. You know, all of our medical treatments are [00:28:00] options. Even when I'm saying to them, you know, you would benefit from heart surgery. I'm never saying you have to have heart surgery, but they say for whatever reason, they don't want to have heart surgery, then, you know, See what else we might be able to do for them.

Um, you know, and again, that's something that the medical system, I think oftentimes, you know, doesn't do a great job at, but I find when I give patients the option of, you know, uh, you can continue on a lifelong of medications. You know, those medications are probably going to increase. Uh, they are going to slow the progression of your disease, but they're not going to undo the disease or.

You can change some things about the way you eat, the way you live your life, and you can actually get off of these medications. You can undo the disease. In many cases, we know now, um, you know, most of them are going to say, I want to make those choices. Uh, and, and that's how I kind of frame it. You know, it, [00:29:00] it needs to be a positive mindset.

It needs to be a, uh, empowered mindset that we are doing this to make ourselves better. Not that, you know, you have to restrict this thing, uh, you know, to make you better that. Find is not sustainable in the longterm, but when you give the patient the proper goal and you say, listen, you know, you can get off your medications for your type two diabetes.

You can get off your blood pressure medications. We can stop the damage that's being done by any heart disease that you have, perhaps, uh, you know, they feel empowered. They want to do that. And then you give them the tools that are necessary to actually carry that. 

Dr Polyvios: Interesting. And what, what's the first kind of, um, a bit of advice you, you give the patient, is it start with these types of foods cut out this type of food.

What's typically, what's like the first step in that journey. 

Dr Philip Ovadia: Yeah, so it, it, you know, first step for me is eat whole real food. Uh, and I [00:30:00] explained to them what that means is, you know, eat the things that grow in the ground and then eat the things that eat the things that grow in the ground. Uh, you know, your animal products and your.

You know, and vegetable products basically. Uh, and that's, you know, that's one of the key principles that I outlined in the book, you know, in the book, I have seven principles of metabolic health that I go into. Uh, and that is, you know, that's principle number two, uh, principle number one actually goes back to the mindset issue that we talked about.

When I say that you need to think of your health as a system, not as a goal. And basically what that means is that, you know, you, you don't want to be focused on those short-term goals. It's not about losing 20 pounds. It's about making yourself metabolically healthy, and we need to find those habits that are going to be sustainable for your metabolic health.

And, you know, the first habit is eat whole real food. 

Dr Polyvios: Yeah. On the [00:31:00] note of the animal products, there's been this again, similar with the cholesterol debate that we've been hearing quite a lot about saturated fats, and I wanted to hear. You as a cardiac surgeon. So he about saturated fats and also with the metabolic health side of things.

What's your take on it? Yeah. 

Dr Philip Ovadia: So, you know, I, and again, those, those two are related. The only reason that, you know, animal products, red meat in particular gets, so demonized is because of the saturated fat issue. And when you go back and you look at the data around saturated fat, the reality is, is that there is no.

Good scientific reason to think that scientists that a saturated fat, uh, has any relationship to really any negative health outcome, but specifically to heart disease. And this has been, you know, covered in, uh, Uh, unbelievable detail at this point by many people, uh, you know, guys like Malcolm Kendrick and the SEMA [00:32:00] hall tra uh, over there in the UK and, uh, you know, David diamond and many others, uh, have gone into this.

The data is really quite clear, you know, when we go back and we try and reconstruct why we came to believe that saturated fat. You know, something to be concerned about may have been contributing to heart disease. You know, we go back to the work of ancil keys, uh, and we see that much of that data was either.

Poorly done, uh, or, you know, maybe intentionally fraudulent, depending on how you look at things. Uh, but either way you can't get past the fact that, uh, when you look at the, you know, randomized controlled interventional studies around saturated fat reduction. They have not shown a benefit. Um, and it's only, you know, poorly done epidemiologic studies that can show any relationship between saturated, fat intake and heart disease.

And even those have problems because we know, you know, [00:33:00] France, for instance, The highest intake of saturated fat of any westernized country and one of the lowest incidences of heart disease of any westernized countries. So those two facts, you know, can't simply, uh, you know, can't go together. If you're believe that saturated fat is causing heart disease.

Uh, so in the end, Uh, and the other thing to realize that I think most physicians don't realize most lay people don't realize is that the, the USDA, the us dietary guidelines actually removed the limit on saturated fat. Uh, now going back, you know, more than five years ago, they specifically say that, you know, there is not, there is not sufficient data to support.

Um, you know, the concern, you know, to support saturated fat as a nutrient of concern, uh, is roughly how they phrase it in the report. Uh, they weren't very public about that. You know, there wasn't the huge announcement that there should have been that, you know, you don't have to worry about your saturated fat [00:34:00] anymore.

Um, but, uh, the reality is, is that, you know, again, I have no concerns around eating saturated fat. Uh, I have no, you know, that is the ancestral diet that humans evolved. And, um, you know, I, I do not limit my saturated fat consumption. I do not tell my patients to eliminate, uh, to, uh, limit their saturated fat consumption.

And the science does not support, uh, you know, making those recommendations to patients. 

Dr Polyvios: Am I correct in saying. That the American heart association has also removed something about saturated fats within their guidance. I haven't looked into it in great detail, but it was something that I overheard from someone I just wanted to see if that was something that, that is true.

Dr Philip Ovadia: Yes, it is true that they have a backdoor. I believe they do still have, you know, a mention of it. Um, and they've kind of, you know, they they've sort of backed off, but they haven't really [00:35:00] taken it out yet. Uh, and again, they certainly haven't come out and say, you know what? I think they should say, which is we were wrong about this.

And, you know, It's okay. To be wrong in science, you know, sciences evolving. Uh, I don't know if you hear the same thing, you know, in the UK that we hear in us while we're going through medical school. But I was told many times during medical school, that half of what. Was learning in medical school was going to be proven to be wrong.

By the time I retired, we just don't know which half. Uh, and so again, you know, I think that the American heart association and these other organizations should come out and say we were wrong about saturated fat. Uh, but you know, of course there are other interests there, uh, you know, that, uh, maybe prevent them from doing so, and, uh, You know, so, uh, as an individual practitioner, I am comfortable telling my patients and quite [00:36:00] frankly, it's how I live my life.

That, you know, there is no reason to be concerned about the amount of saturated fat that you eat. One of the other, uh, you know, sort of paradoxes around saturated fat, uh, is. That, you know, there are other fats, there are other fat sources that are, you know, purported as being healthy by the same people, uh, that are higher in saturated fat than animal products.

Coconut oil is a great example. Coconut oil is actually one of the highest, uh, you know, saturated fat percentages of any, of any, you know, fat that you can consume any oil that you can consume. And yet you hear many of these. Same, you know, organizations that say avoid animal products will say, you know, that coconut oil, uh, is a healthy fat to cook with.

So, uh, it's just another thing that really doesn't make sense. When you start looking into the saturated fat. Yeah, 

Dr Polyvios: we, I, I, when I was growing up and you know, it was [00:37:00] the don't eat, uh, don't eat too many eggs because of the high cholesterol count, um, olive oil. Cause it was unsaturated, polyunsaturated fats.

They were, they were good for you. Um, and that was kind of the. Credo that I grew up with as it were. And I think many, many people did and I'm still still abide by, but yeah, it seems to be, as time has gone on, there is definitely been a shift towards that from different people that I've been chatting to.

And talking about this, this kind of, this kind of thing says interesting. Um, One thing. I wait, saucy weightless aside, the benefits of becoming metabolically healthy. What, what other things will people notice? Because I appreciate they can come off potentially come off. Um, some medications that they need for their blood pressure and for diabetes, if, if things can get back under control, but in terms of the way they feel, cause that's, uh, that's.

Then go [00:38:00] to feel better as well. 

Dr Philip Ovadia: Exactly. I think, you know, the most consistent thing and, uh, probably one of the earliest things people notice when they improve their metabolic health is just better energy levels, you know, not being tired all the time. Uh, I certainly remember, uh, you know, thinking back, uh, 10 years ago before I was metabolically healthy.

How, you know, I would be tired in the afternoon. I would sometimes be taking naps in my office, uh, you know, after a long day at work or, you know, a long day in the operating room. Uh, and, uh, just that, you know, kind of being tired a lot. Uh, and now, you know, that's just simply not true. I mean, I have more energy now than I, than I did.

In my twenties. Um, you know, I can go through very long days in the operating room, do all the other things that I do. You know, I am a cardiac surgeon. I have my own, uh, medical practice on the side of telemedicine practice. You know, I'm out [00:39:00] there speaking. I wrote the book, uh, all of these things that I do, and I just seem to have, you know, nearly endless energy.

Uh, and I think that's probably the best benefit of metabolic health. What I tell people is, you know, many of these things that we perceive as being normal, as we get older, uh, the aches and pains, uh, you know, in our joints, the muscle aches, uh, the tiredness, uh, the, the, the brain fog or, or loss of, you know, kind of mental sharpness that many people experienced many, if not, most of these things are related to metabolic health.

And when people get metabolically healthy, You hear about all of these things getting better. Um, you know, and then as you said, there are the practical, you know, sort of medical, uh, you know, applications of, you know, we have shown that type two diabetes is reversible with a focus on metabolic health. We have shown that [00:40:00] many people can correct their high blood pressure when they focus on their metabolic health.

Um, and then we know all of these downstream effects. Like the heart disease and the cancer and the Alzheimer's disease, uh, that we are, you know, preventing, uh, when we remain metabolically healthy. 

Dr Polyvios: Hmm. Thank you. And you talked about, you mentioned before that the principles you've got these seven principles that you are alone in your different chapters.

And a lot of those things are outside. Diets there other things, things like sleep. And, um, and, and like you said, mindset before, how much of an impact to those things have overall, because I appreciate diet is going to be the main one to some extent with, in terms of your, uh, what, what you, what you consume having an impact on, on your metabolism and your metabolic health.

But. How much of the other stuff is, is important. 

Dr Philip Ovadia: [00:41:00] Yeah. You know, ultimately what I tell people is that what we eat is the most important determinant of our. Um, but all of these other things are important. And as you mentioned, you know, the other things I talk about are, you know, making sure you get good quality sleep, uh, making sure that you get enough activity, uh, throughout your day, uh, making sure that you, you know, deal with your.

I don't talk about eliminating stress because we all have stressful lives, but you need to have some way of, of, you know, dealing with your stress so that it's not a constant, um, you know, negative in your life. Um, we know that all of these things play into metabolic health. Um, there's, you know, kind of a feedback loop where, um, we see that when people get metabolically healthy, a lot of these other issues also get better, their mental health, you know, their, how they deal with stress, I should [00:42:00] say, uh, seems to improve.

They sleep better. They want to be more active when they are metabolically healthy. Um, and you know, so I always start with the, what we eat part of it, because I think that is the primary determinant, but certainly these other things come into play and I encourage people as they're going through their metabolic health journey to start focus on those other aspects as well.

Uh, but ultimately I think if you're not eating the right foods, It's going to be very difficult, if not impossible, uh, to, you know, to do all the other stuff perfectly and get the, you know, kind of get the outcomes you're looking for. If you haven't started with what you're eating. 

Dr Polyvios: Sure. I, one thing I really liked actually, um, when you talk about the different diets in terms of how, how to, how to eat and you don't specify one specific diet, you, you, you break it down into how to eat [00:43:00] metabolically health.

As a vegan diet, how to eat metabolically healthy as a carnival diet and the Mediterranean diet and so on. And so you have all these different lists of diets that people can choose as it were, and still eat metabolically healthy, uh, which is quite unusual. Usually hear someone advocating one specific thing.

You must eat this diet. You must eat this. You, you seem to have like a core principle around the, each kind of that. What is that kind of main. Thing to eating metabolically healthy that you can do no matter sort of what diet you're following. 

Dr Philip Ovadia: Yeah. It really comes back to what we talked about before, which is eat whole real food and, you know, eliminate the processed food.

And when I was writing the book and I was, you know, kind of thinking about the book, uh, that was a very intentional decision because it's the reality, you know, I know what has worked for me, you know, I know how I eat [00:44:00] now. Uh, but I also know that that's not the right thing for everyone. And depending on, you know, many different factors, you know, where you are from a metabolic health standpoint, uh, you know, what you enjoy and don't enjoy when it comes to food what's available and not so readily available to you when it comes to food.

Uh, these are all things that are going to come into play. Um, and ultimately, like I said, I'm not looking for that short term, you know, 28 day diet plan. That's going to, you know, get you some short-term success. I'm looking for people to establish the lifelong habits, the habits that are going to be sustainable for them to be able to maintain metabolic health.

And, um, that's why I, you know, outlined it that way in the book. Um, it's the reality of how I work as a physician. I literally do work with both vegans and carnivores and you know, everything in between and our focus is on metabolic health. [00:45:00] And if you can find a way of eating that is. Improving and, you know, supporting your metabolic health, then I'm in favor of it.

And I don't care what it is, you know, I don't care which of those it is. Uh, but the basic principle that there's no getting around when it comes to metabolic health, is that we need to eat whole real food and we need to eliminate the processed food. Uh, and you know, that's ultimately, what's going to make us metabolically healthy and then it's up to each person within that framework to find what they enjoy and what fits into their lifestyle.

Dr Polyvios: Thank you. And finally, where, where do we go from here? Um, as you say in the last short period of time, even though we've had research going on, since, since, as you said the sixties and we're finding out new, new things, where do you think sort of the next step for this metabolic health trajectory? Is is taking us.

Dr Philip Ovadia: Yeah, I think it's, you know, just getting this message out to people, um, because it is very much counter, [00:46:00] uh, you know, the, the sort of public health messaging, the mainstream messaging from, uh, healthcare. So, uh, you know, my. Besides working with the individual people that I work with is to kind of network with as many physicians as possible who are, who are paying attention to this.

Uh, I am proud to be one of the founding members of the society of metabolic health practitioners. Uh, it's an organization that is looking to really bring together. Not only physicians, but you know, all of the various healthcare, uh, practitioners, the, the, you know, the, the dieticians and the nutritionists and the nurses and everyone who's, uh, you know, interested in this type of stuff, uh, together, give them educational materials, you know, both.

Own sort of professional education and then to be able to pass along to patients, uh, hopefully ultimately, you know, lead to being able to fund a research efforts and things like that, [00:47:00] um, within the community. And then I think, you know, One of the things that gives me hope, I guess I say is that we got into this epidemic, this pandemic of poor metabolic health relatively quickly, you know, within the past 50 years, essentially.

Uh, maybe, you know, some of the things that set it off are going back a hundred years or so, but I think that means that we can also get out of it, you know, on the large scale, uh, you know, kind of evolutionary timeframe. Uh, this is just a small blip in time. And I am confident that we will be able to undo this.

It's just that right now in the thick of it, uh, you know, it seems very difficult because as I said, we look all around us and all of us are unhealthy essentially, you know, nine out of 10 people are not metabolically healthy, so it becomes hard. To start to think about how do we get out of this. Uh, but I'm just hopeful that as more and more of, [00:48:00] uh, us on the professional level are working on it and more and more people are paying attention to it because they want to be healthy.

And they realize that the mainstream advice is not getting them there, uh, that, uh, we're going to, you know, continue to, uh, grow these efforts. 

Dr Polyvios: There's been, it's been an absolute pleasure. Thank you so much for. Chatting and I've learned a lot and it's actually made me want to read more and more about, about this and to try some of your principles and see how it see how we get on safe, have more, more energy.

Cause I definitely would love to have that actually sometimes. So it's been, it's been wonderful. Thank you so much. I will also leave a link to your book in the podcast description for anyone who would like to have a look and, um, yes. So good. Good for you. 

Dr Philip Ovadia: Yeah, thank you so much for having me on, you know, the book is widely available.

It's called stay off my operating [00:49:00] table. And then, uh, you know, anyone that's looking for more information about what I do looking to connect with me, uh, please go to my website. It's Ovadiahearthealth.com and you'll find all the information there. 

Dr Polyvios: Amazing. Thank you so much. 

Dr Philip Ovadia: Thank you.

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