Dr William Li on Food, Heart Health and the Microbiome

This episode is brought to you by Nourish Me Organics, your gut health superstore. Nourish Me Organics is the premier online store for all things gut health, including probiotics, prebiotics, natural health supplements, and home fermentation kits. So head to www.nourishmeorganics.com and use the code Happy Gut for 10% off in this episode. Crib Govender A seasoned food scientist and nutritionist interviews medical doctor and vascular biologist Dr. William Lee on how to have a healthy heart.

Hey, guys. Criben Gavender from the Gut Health Gurus podcast. I've got a background in food science, and today I have an absolute superstar in the world of specifically heart health, also with Natural Eating Diet, Dr. William Lee. Welcome to the show.

Thanks very much, Krivin. It's a pleasure to be here.

My absolute pleasure to have you. And I really wanted to get William onto the show because I've never had a guest that is really an expert when it comes to the heart. And reading about William online and watching his videos, he seems to be a real pioneer in that sort of heart space. And there's also emerging research when it comes to the heart and the gut, which I really want to explore during this show. So, William, what I like to do at the start of the show is to get it straight from the horse's mouth. Who is Dr. William Lee?

Well, I am a physician. I'm an MD. I trained in internal medicine. And my emphasis area is really on vascular health. So cardiovascular, but also blood vessels throughout the body. Many people don't know this, appreciate this, but we are all filled with 60,000 miles worth of blood vessels inside our bodies. And these are the highways and byways of the oxygen we breathe, of the nutrients that we eat, and they feed every single organ and every single cell in an organ. So that's what I do clinically. I'm also a vascular biologist. So I study blood vessels at a very deep level and I study blood vessels as a common denominator of both health and disease. In other words, healthy blood vessels. If you have healthy blood vessels, you have a chance to have the rest of your body be healthy. But if you have sick blood vessels because of how important they are to overall health, you don't have a chance of optimizing your health at all. So it's one of those areas where you really want to be able to ground your health. And more recent discoveries are that our blood vessel health or vascular health is connected to our gut health as well as. And you know, I wrote a few years ago, I wrote two books, Eat to Beat Disease and Eat to Beat yout Diet, that both became New York Times bestsellers. And so then I found myself really in this sort of public figure communication space. And I've done a lot of work previously on television and elsewhere. And I thought, what better opportunity is there than to really talk about food and health? And when it comes to food and health, the key thing is it's not just about the food. All this hubris about superfoods or super supplements is. It's interesting, but really it's more about how the body responds to what you put inside it. And when you actually combine both sides of that equation. I mean, your background in food science. The food science cuts both ways. It's the size of the food, but then it's the science of what the food does in the body. And that's really what I study. So I'm also a foodist, medicine researcher.

Awesome. What an amazing introduction. There's so many rabbit holes to jump down. But being an expert in this kind of vascular field, I wanted to set the scene early. Why do we die from heart disease? Why is it one of the leading causes of death in the world?

Okay, well, listen, nothing happens without your heart. And so our heart is essentially the engine of our body. Our brain would be the computer system that now runs the modern car if you want to actually be able to shift gears and do all this other kind of stuff. But the engine is really our heart. And every pump of our heart from the time that we were first formed, in fact, when your dad's sperm at your mom's egg, and you were just a ball of cells, of shapeless, formless cells, one of the first organs that forms is your circulation. You need blood flow everywhere. And then the heart begins forming right shortly after that to be that engine. So just like a car, you know, when your engine is running healthy, you have a comfortable ride. You can get from point A to point B. And the people who take care of their engine more in a more dedicated fashion. If you're more aware of your engine and you want to make sure you put the right oil, you change your oil, and you're not trying to mistreat your engine, you're going to have a car for life. I mean, this is how the people that have been driving their car for, you know, 15, 16 years, and it's still an amazing car. That's really how our heart is. And for the people who are, you know, another topic that's really big These days is aging and longevity. And so the idea that you can actually live very long, even centenarians, people live to 100 and more. All right? Part of the secret is that their heart is actually functioning well. Now. Every drop of blood in our body passes through the heart. So whatever's in our blood will have an impact on how the heart functions. And when we eat food, our food is like the fuel to the car, the Harsi engine. Our food is our fuel, and our fat cells are our fuel tanks. We can get into that later. But the bottom line is that if you choose good quality fuel, when you're filling up your car, you're treating your engine well. And this is where nutrition comes into play as well. Because for too long, we've been unconsciously putting harmful, poor quality fuel in our body. And now some of this heart disease that you're pointing out, that's really the number one cause of death around the world is, is partly, it's partly the result, the consequence of how we're not treating our heart well over the course of our lifetime, over our life's journey. We are not feeding, we're not putting the right quality of fuel into our body and that fuel lines run, the substances that we eat everywhere. And by the way, one of the things that you know, like that is really amazing is how fast this sort of food and environmental health and cardiovascular health is all coming together. Just a few months ago, a paper came out showing that the microplastics that are found in our environment, we breathe them, but certainly they're found in our water bottles, right? Who hasn't gone for a hike or gone on vacation or get on an airplane and you are given your plastic water bottle and you just suck it down because you're supposed to drink water every day. Well, it turns out we now know that billions of plastic particles are shed into the foods that we eat and the beverages that we drink and they get into our bloodstream. And the study that I'm referring to was published actually late last year. Cardiologists, neurologists, studying people with blockages on the vessels, the blood vessels of their neck, found that those arteries with the plaque, that's the narrowing, the fatty plaque that narrows our circulation and to set up for a stroke and to set up for a heart attack, that those plaques can be embedded with plastic like little pieces of plastic particles. And the research stunningly showed that for the first time, we now know that people who have the plaque, which is not good by itself related to diet and lifestyle, plus the Plastic. The plastic in the plaque was associated with a fourfold increase in the risk of developing a heart attack or stroke. So again, this is, you're asking about a very important question which is like, hey, why do we have cardiovascular disease? And I think it's really about how we treat our body, what we're exposed to.

Great, great summary of the, the impacts of, of the what cut, what this disease is and what are the, what are the, the common, let's break it down in two parts. How do we prevent this? Because you talked about diet and what are the current treatment options if we do develop this? So we can tackle both individually. So let's start about prevention. Because prevention is a cure, right?

Yeah, no, listen, I'm so glad that you brought that up. Look, I like to discuss this idea of prevention by turning the clock back to when we came out of the box, meaning when we were born. It's like taking a laptop out of a box. A brand new laptop operating system is going to be the same for all the units of brand new laptops. You plug it in, you charge it up, you hit the start button, you hear the sound and that operating system runs. And the bottom line is that if you want your computer, your laptop to work really well for over the whole lifetime, you have to take preventative steps, measures to make sure that it is well cared for. Right? So well, you know, shut it down every now and then, run an antivirus program every now and then. Please don't spill water or coffee on it and don't drop it. Right? Don't put it in a hot car and don't leave it out in the snow. So you know, these are the kinds of ways that I want you to think about or I want your listeners to think about our hearts. We're born really, really healthy. We are born, I don't want to say the word pristine, but we're born really cut from the same bolt of cloth, all of us. And what happens is that from day one, our journey begins and where people start deviating. The people who wind up having heart disease versus the people who can make it to their 90s and be very, very heart healthy. Where that divergence happens starts very early on. So the things that we're exposed to, Diet's a great example. How many moms are feeding their kids healthy plant based foods and also proteins that actually are healthy and from sources that are ideal, you know, better treated, less microplastics, you know, and allow our bodies to be able to gain all those bioactive, the phytonutrients the, the, the, the polyphenols that allow us, our, our, our cells, our bodies to thrive and our hearts to thrive. Well, look, as you can imagine, the people who are eating those foods, where the compounds and the foods, the natural compounds help our blood vessels stay healthy. That lining, the endothelial lining, which is sort of like a piece of Saran Wrap, that's inside the blood vessels, it is slippery, smooth, like an ice skating rink after the Zamboni clears it after a hockey game. Really nice and slick. That's a healthy circulation, and that's also healthy for the heart. What happens, you contrast that to a child who's exposed to junky food all the time. Not once in a, once in a while. Look, we're pretty resilient. You eat a burger from a fast food joint once in a while, you're going to be just fine. But day in and day out, week after week, year after year, if you are constantly putting poor quality fuel into your tank, so to speak, fatty foods, artificial preservatives, artificial sweeteners, flavorings, colorings, I mean, think about what kids are exposed to. And I'm bringing this back to the, to our origins as children because that's really, I think, where the opportunity, the best opportunity for prevention is every parent, you know, while they're learning how to swaddle their kid, change the diaper, prevent the electrical cord from shocking the kid. The baby is not going to stick a paperclip into the electrical cord. They should be learning about nutrition, healthy nutrition, because their fate is partly determined by what happens in those earliest years. And they don't have the control. The parents have the control. So you go on a journey, you're exposed to high salt, high fat, artificial preservatives, a ton of added sugar. Our body's very resilient. So when you're a kid, you know, you're eating a ton of candy, you're doing all this kind of stuff, bouncing off the walls, enjoying the fast food joint with your friends, no problem. You're not going to feel it. But now extend that out. Take that. It's like an antenna, telescope that. I'll pull that antenna out a decade. You know, you're not 10 years old, you're 20. Pull that out another decade, you're 30, you're 40 or 50. You can imagine the toll that that actually takes. And I think that's really one of the reasons that we wind up inexplicably wondering, like, well, how come so and so got heart disease? But I didn't or why did I get heart disease? And so. And so didn't. I think if you were to track back that journey, it happens very early on. So then the question goes, is our fate decided so early that there's no hope for being able to prevent things if I didn't live the healthiest life at an earlier age? This is where the exciting research is. We now know that you can reverse heart disease. You can reverse the blockages in your. In your blood vessels. You can actually repave the lining of your blood vessels so it's healthier. You can actually regenerate heart tissue with our stem cells. And there are many different ways. By adopting healthy eating patterns, by being mindful in how we eat and also the amount of food we eat and what time when we eat, you know, what we eat, when we eat, how much we eat, all that stuff. Once you realize it's time for you to sort of try to get your act together and get heart healthy, taking those proactive measures can reverse heart disease. So, you know, we were talking about prevention. Let's talk about the typical person who hasn't thought about it until recently. I think the great news is that you can actually turn the clock back and get healthier.

Right. That's an awesome summary. So it's really about these interventions early in life because it almost sets the habits. Or say, for instance, you use the analogy of a child. If a child develops bad habits, they're more likely to carry that into later life. But the good news, according to what you're saying, William, is that there is ways to reverse that as well, through diet. So before we go to diet, let's talk about the conventional approaches, because I think if someone's developing heart disease, the medical approach most likely is going to be some sort of statin type of drug. So how did, how do these. Why do doctors prescribe these statin drugs in the first place?

Yeah, well, look, I mean, it starts with seeing a doctor with. And you may be apparently healthy and feel, okay, maybe not in the great shape, best possible shape, but, you know, you're going about your way and you get a physical exam at a doctor and, you know, a doctor like me would. Would see a patient, you know, like, we've already made up our mind what we need to start looking for and paying attention to and asking about. When we walk in the door and see you as a patient sitting, you know, on the. Sitting, you know, on the table, we've already, in our minds, already started to think through what are the areas that we want to probe on your, on your behalf, to be able to see how we can assess where you are and how we can get you healthier. But then we actually do things like do an ekg, which is measuring the electrical rhythm of your heart is one, you know, that's the original biohacker, right? You do an ekg, wow. You can actually measure your heart beat by beat. And then we've got blood pressure, we've got your weight. Then you go for a blood test. And the blood test reveals a lot. We call them blood chemistries and complete blood count. And we can also measure cholesterol. And you know, in the 1970s, it started to be real to re realize that if you have high cholesterol, you're more likely to actually have heart disease. Narrowing the cholesterol, being fat narrows the width of your blood vessels, so you're not getting as much blood flow. And that sets you up for blockages, complete blockages that can lead to a heart attack or stroke. And so the, the, the, the, the physical exam, the ekg, the blood tests, these are the starting points of how we assess the. Then the treatments, right? So it wasn't too many decades ago that we had no real good treatments for heart. We could lower blood pressure by dilating the blood vessels. We can slow the heart rate down so there's less exertion of the heart. Those are very helpful. But it was in the 1980s that statins came out. And a statin, for those of you who are not familiar with it, is a pill that works biochemically in the body to really lower your body's, the blood levels of your cholesterol and different types of fat. Now here's something very important. It's not all cholesterol that's bad. In fact, some cholesterol is good. This is a mystery. The deeper we get into the mystery, the more surprises we discover and realize that we can't just come to a conclusion too quickly. So even if you have higher than normal cholesterol, normal being an arbitrary level that most people accept as normal, you gotta ask the question, do you have what's your good cholesterol versus the bad cholesterol? And without taking too much time to go into that, you know, HDL is good cholesterol, high density lipoprotein, and LDL is the bad cholesterol. So then you want to see which is higher if your bad cholesterol is high. The knee jerk today, consider the standard of care is to write a statin, okay? In reality, you can take some preventative and reversal steps before that. You can do exercise, you can go on a high fiber diet, you can cut down saturated fat and salt. I like to personally give my patients a shot with awareness to really be able to kind of reverse their blood bad blood profile and get back to who they want to be. Get back to who their body wants them to be. Behavior, mindfulness and exercise. Exercise counts for a lot of those things. The body in motion stays in motion, the couch potato stays on the couch, you know, and so, you know, and so, and then eventually in the ground. So you want to really stay in motion. You want to eat healthier foods. You can actually, many people can actually lower their blood lipids just like that. Okay. And by the way, high blood lipids and lack of exercise and a bad diet often sets up for metabolic syndrome. And that's really the pre diabetic state, which then leads to all kinds of other cardiovascular diseases downstream. It's like a domino effect. If you let all your diagnosis and you push it click, click, click, click, click, click, click. Now you've got a big problem going down. So I like to. Before giving the insulin and then dealing with all the other diabetic issues, look, let's give the body a chance to heal itself, revert back to its natural state, which should be balanced. All right, let's see how much we can do. And then we write a prescription for a stat. Now, when people actually have symptoms, they clearly are in jeopardy of having a heart attack. We take them to the catheterization lab, which is a special kind of laboratory in the hospital, and a cardiologist will get involved and they will, they can actually squirt some dye into your heart. Look on a screen, you know, just like a video game, to see where the blockages are narrowing might be. And then if they see one like a video game, they can thread up a little expander and just open up the blockage. Pretty amazing. They can actually put a stent, which is like a basket, to open, to force it to be open. And then sometimes you could just carve out, you know, like if you think about like the nose picker, you can actually pick out the plaque as well and just remove it. So this is classic. Before a heart attack, after you get deeper and deeper, you might need to do bypass, which is a gigantic surgery. And then you deal with heart failure and you can treat heart failure with medication. So, you know, I know like this isn't about medical management, but I do think that before we just dive into, you know, heart healthy foods, you Got to realize there are, you know, there's like a century of really good work on figuring out if we, if you had to get a medical doctor involved, we can actually bear hug your heart and figure out how to actually deal that. Deal with heart disease in very mechanical and pharmaceutical ways. What my point is that there is a missing tool in the toolbox, and that takes us before 100 years, but now, armed by the science to say, how. How can we allow our body to regain its own equipoise?

Wow, I love that approach because it's like we, we have to acknowledge and celebrate modern medicine and how amazing it is. But then that complementary connection also with this ancient healing knowledge as well. You know, going back to diet as a preventative measure, lifestyle, exercise, it's more of a holistic approach rather than a sort of binary approach, which is one of the other. Let's work together with modern medicine and with this knowledge of nutrition, which is missing. I 100% agree with you. So what's, what's really intriguing me, I have no knowledge of this area, but I've heard some, some chatter. What is apoe?

Okay, APOE is a protein that comes from a gene that sets up for accumulating those lipid blockages, the plaque. And so it's a, you know, it really is sort of like a telltale sinus signal that can be measured to identify your risk, and it's genetically associated. So if you've got apoe, it's a gene, and you have a mutation in it, you're more likely to actually have blockages. Does that mean that you need to be on a statin? No, it doesn't. It means that you're more likely to have a problem, and so you want to take care of yourself even more carefully. I think that this is all about what are. You know, we are all individuals. We all have our own individual risk factors. APOE is just one of those risk factors. I mean, look, if you got apoe, but you don't smoke, thank God you don't smoke, okay, because that's even worse, right? So I think that there are, there are risk factors like that that you can take a look at. Smoking is another big risk factor. There are behavioral risk factors as well as genetic risk factors as well. There's also lots of different kind of genetic oddities where the blood vessel lining is very fragile and you can easily develop the aortic dissection. These are like Marfan syndrome, connective tissue diseases. And so genetics can play a role in increasing your risk. But regardless of what your genetics are. We all got to get up in the morning and live our lives. And how we live our lives can actually make a difference in terms of how well and as well as how long we live.

Awesome. Thank you for explaining. That makes perfect sense. So I'm imagining someone does some sort of genetic sequencing, they pick up, they have this particular gene. So all it is for the audience is really just a risk factor. But then there's also the epigenetics of it, which is all the other elements like diet and lifestyle that controls the activation of this particular gene. So that makes perfect sense to me.

So. And you can activate your other bodies and you can activate your other's body's. Your, your body's other health defenses that actually can help protect your heart as well. So it's so tempting in the nutrition and wellness field to try to find, you know, individual switches that you can point to as the cause and the effect. You know, I just turn it on or turn it off. I'm all set. I would say it's more like there's a dynamic, a series of dynamic things that are happening in our body and we want to find that right spot where everything's in good balance, doesn't be in perfect balance, just has to be in good balance over the course of our life journey.

Awesome. Thank you so much for explaining that, Dr. William Lee. And how about we tackle some of the dietary interventions that you recommend? So patient presents, you just, you decide that you'd rather go down a sort of a different avenue than the drugs for now. So how would you take that particular patient on this journey to recovery? Using diet?

Yeah, I mean, that's a really great question. I'll tell you what my approach is. My approach is really to find out first from an individual who's facing this kind of a situation to, to have them really evaluate, honestly evaluate how their diet actually is. Right. We, we, you know, we just go about our lives. We, we think we know what we're eating, but we don't really know what we're eating. We don't remember everything we're eating. And so I tell people, I, I have a conversation about to find out what they're eating. But also taking a food diary can be really helpful if you record everything you eat, breakfast, lunch and dinner. And doesn't have to be like an old school physical pen and paper diary. You can put it on your phone, open up the notes section and just write it down, or you can even take a picture of what you eat because most of Us carry around our mobile device and put it together, just paste it all together so, you know, you have a real record of what you've eaten. What I like to do is to talk to people to say how much of what you're eating is plant based. I'm not a vegan myself, all right, I eat like a vegetarian. I eat mostly plant based, but, but I do eat everything. But the thing is, you know, you want to mostly eat plant based foods because all the healthy polyphenols in it, that is good for your circulation and also the dietary fiber that's found in plant based foods. The avocado, the tomato, the peach, the pear, you know, the banana, all those, the dietary fiber is critical for feeding our gut microbiome. Gut microbiome on your show, as you know, has, is a, as a community of about 39 trillion bacteria. The number changes all the time, but it's about 39 trillion. And these bacteria live in harmony. To be able to help control your blood cholesterol, maybe you can actually not be on a statin. If you have better gut health. It controls your stress levels. So your gut text messages your brain to release serotonin and dopamine and oxytocin. Actually helps to lower anxiety. Really important to have gut health. You don't appreciate just how big your gut's influence on your brain, by the way. You ever had like a verbally uncomfortable crampy stomach, like you're not in a good mood when that happens. And it's not just because you're, it's not just because you're in, it's not just because you're, you're uncomfortable. It's because the gut's not sending those happy signals to your brain. Makes a big difference. Your gut microbiome also controls your insulin sensitivity, which actually is metabolic to bring glucose into your muscles so that you can end your fat so you can actually have enough energy. Right? All these things plant based foods feed your gut good for your. Good for the gut, good for the heart, good for the gut, good for the brain. All right, and the brain and the heart are also connected. So it's a gut heart, brain axis, absolutely important. And you know, so I think that I try to find that out and then I look, then I go right for the jugular to find out how much people are eating in terms of things that are definitely not good for the heart. How much soda are you drinking? Regular soda, added sugar? 9 teaspoons of regular soda in a sugar, in a can of, in a typical can of Soda. That's a lot. Artificial sweeteners. All right, non caloric soda. Isn't that supposed to be better for you? Nope. Guess what? Those artificial sweeteners damage your gut microbiome. You damage that gut microbiome, even though you actually haven't raised your blood sugar levels because of the soda, man, you've actually damaged your metabolism. So, in fact, your blood sugar goes up and because you damage your gut now your cholesterol goes up as well. You want to talk about something that's not heart healthy diet soda actually turns out to be one of those, one of those factors. I also go for how much red meat, how much saturated fat do you actually eat? Now, having some of it's probably not bad for you, might even be good for you. It's one source of protein, it's, it's a source of iron and some other minerals that are important for us. But, you know, in our world of abundance with food, which is really, I think, something that occurred after mid-1900s, you know, 1950s and beyond, suddenly the world, most of the developed world, is surrounded by food. So we went from sort of watching our food and metering the amount of food that we actually ate because we weren't sure we could get enough of it, to suddenly having being like a kid in a candy store, literally and figuratively, and stuffing ourselves with food. Now, remember I told you food is our fuel. You load fuel into your body, it's good. You need fuel in your car, in the engine of your body. The problem is think about metabolism as eating food as fuel. At the gas station, at the petrol station, we call it gallons or liters, depending on where you live in food. We don't call it gallons, we call it calories. All right? And so it's just another name for it. And if you're going to put good quality petrol in your vehicle, your vehicle is going to perform better and last longer. If you put good quality food like plant based foods with dietary fiber and polyphenols into your engine, your body's engine, everything is going to actually work better, including your gut microbiome. Absolutely critical for health.

Great summary. What's, what's your thoughts on using supplements or not even supplements, something like omega 3 from fatty fish. And then a supplement that's also touted in this space is berberine. So what's your thoughts on those two interventions?

Yeah, so I will tell you that most of us can't eat enough, get enough omega 3s. Even people who live by the shore, by the ocean, they often don't get enough of the dietary omega 3s. But obviously seafood is one source. Supplements a great cure for not getting enough Omega 3s and Omega 3s have been so persuasively, conclusively, I would say beneficial for longevity, heart health, brain health, metabolic health. That's a no brainer to be able to supplement. Another supplement that I think is really important is vitamin D. Vitamin D builds strong bones, it lowers the risk of heart disease, it lowers the risk of cancer, some cancers have, lowers the risk of dementia. That's a no brainer as well. It also builds your immunity. That's a good supplement to actually take. There's some probiotics that probably would be beneficial to take. Research is still underway on what the optimal is, but dietary fiber is also a really good way to do it. Now berberine, now I'm a food is medicine researcher, so I know quite a bit about berberine. What I would tell you is it's sort of a traditional healing approach using a natural chemical that clearly has an effect. But because it's so powerful, I think it can also have a pharmaceutical pharmacological effect, let's call it. And so the dose makes a big difference. And I think because supplements are not controlled as well as drugs, this is just my opinion, one person's opinion as a researcher. I would say berberine is something that is worth considering. Be very careful about the source and the quality of the berberine. Look at the package to see what else is in there. They might have added a lot of formulators, the supplements, you know, try to really take it to the next level and start adding all kinds of other things. Make sure you know what's in there. Be an informed consumer. And then what I would say is be careful of the dose, you know, because when it comes to most natural compounds, a little bit, a little bit can be good, a little bit more can be even better. But if you take a whole heck of a lot of it, you can overshoot. This is, and actually cause a problem. And this is a, this is actually a phenomenon called hormesis. Hormesis is, means that our body's always seeking just the right amount. Not too little, not too much. Kind of like Goldilocks and the three bears. Not too hot, not too cold, not too hard, not too soft, just right. And I think for a lot of supplements, and I would say maybe for berberine as well and it could be just, I haven't seen the data myself personally, can't know everything. And now that we're talking about this, I'LL go look it up to see if there's any new data on it. I think like many natural supplements, berberine has quite a lot of interesting scientific evidence. I would say it can be powerful though. And so this is where I think looking for that evidence on how much would be the right amount would be what I, how I would actually approach.

That 100% agreement with you, Dr. Lee. A lot of these herbal type of supplements are indeed pharmaceutical for sure. So my recommendation as a practitioner is always look for the highest quality practitioner grade product and work with someone that's knowledgeable in this space, a trained practitioner, because you don't want to get yourself in trouble by using the wrong doses. Very poor quality products, so be very careful of your source. And a lot of these practitioner grade products are controlled via medical practitioners or nutrition practitioners, naturopaths. So certainly work with someone that's knowledgeable for sure. A good little tip also is there's a website called examine.com so you can hop onto there and type in berberine or whatever supplement you're looking at taking. And that will list all the studies to support a product. They even grade it ABC as to how much literature there is to actually support the claims that have been made on that particular supplement. So a little bit of a left field question because I then you might not be fully aware across this study yet, but there was a study that came out probably only a few weeks ago and it talked about the impact of heart medications, statins were in the mix on the gut microbiome. So do you have any insights to summarize what they were talking about? These type of statins or heart medications have a downstream effect on the different species of microbes that are either suppressed or allowed to flourish. And some are better than others. So do you have anything, any information that at all? Dr. Lee?

You know, I have heard of the study. I haven't read it in depth yet. I think that, you know, prescription medicines and probably even non prescription medicines we take, especially the ones that we swallow as pills, they do affect the gut. We are just at the tip of the iceberg. We're just at the beginning of actually understanding what the consequences are. And you know, something that might be good for one organism might actually be bad for another microbe. So I think we need to, before we start to black and white and backhand and dismiss out of hand, you know, certain medications, I think we need to pay attention to the fact that we're beginning to learn more to understand whether or not there is a net net Beneficial effect. Or perhaps unbeknownst to us, we are inadvertently damaging our health as well. I mean, here's. Look, here's a, here's. So I think that, you know, pharmaceuticals are obviously really potent in terms of having multiple effects, good and bad side effects that could be good side effects, side effects that could be bad side effects. But also food can do the same thing. And the additives we put in foods can also have good or bad effects. And a great example I like to give is everyone knows that yogurt, even though it's a dairy product, actually is overall good for health. And, you know, and most people who eat yogurt would naturally go to the grocery store, supermarket when they're buying their yogurt. And many people pick the low fat yogurt because that's how we're trained to think low fat is going to be better, heart healthier. Turns out low fat yogurt does us a disservice. And ironically, even though it's low fat yogurt and it's supposed to be better for our blood cholesterol, it actually raises our blood cholesterol, ironically, like completely not direction it should be going in. And it increases our risk for heart disease. And the reason it happens is because. And again, this is again, a product that you think should be healthy, has other unanticipated effects. Turns out when you actually make low fat yogurt, the manufacturer will pull the fat out of the yogurt. And when you remove the fat out of the yogurt, it completely collapses in its texture. You know how whole fat milk compared to low fat milk? Low fat milk is kind of like watery milk right now. You take the fat out of yogurt, the whole thing just turns into this kind of sloshy mess. So nobody would eat that because it doesn't taste like yogurt doesn't feel like you're good. The mouth feels. So what the manufacturers do, they add emulsifiers, thickeners back into this carrageenan polysorbate 80. And, you know, that sounds like a scary chemical. It is. And it's now been discovered that the emulsifiers that are actually put into like low fat yogurt damages our gut microbiome. Remember we talked about it? Gut health helps you balance your blood lipids, your cholesterol helps your metabolism. You damage that bad boy, and all of a sudden your blood lipids start to rise. And so this is another example where, you know, I always. This is the saying, right? The God is in the details. Yogurt's good. What kind of yogurt? In this case, it's whole yogurt. What about the yogurt that, the whole yogurt that actually has a layer of jelly in it, you know, to make it automatically sweetened. Well, now you took something good and you've actually added some added sugar to it. And look very carefully at that ingredient label because whatever they use to color that grape flavor or strawberry flavor might be an artificial flavoring sweetener, you know, flavor enhancer. That then changes the equation. And so I relate this back to the question you asked about statins and what it could do to your gut microbiome. Look, statins actually been shown in large clinical trials to lower cholesterol for many people, not all people. We now know that one of the other effects that statins has is going to be at the level of the gut microbiome. Some studies show some benefits, other studies show some harms. So the jury's out yet, I think. But, but now that we're onto it, I think the research is going to be continued. So I'm a researcher, I try not to come to a premature conclusion on anything, particularly when, when there are people pouncing on the topic to try to learn more. We all, we all want the simple answer, yes or no. Should I do it or should I not? What's the magic bullet that's going to cure my worry? You know, what I get to have fun with as a food, as medicine researcher, is to just watch the future of food and health unravel before our eyes and to learn more things about the things we thought we knew a lot about. The more we study it, the more we learn, the more we learn, the better decisions we can actually make for ourselves.

Absolutely, Dr. Lee. And in full agreement, I think, with the microbiome. It's such a, or microbiota, two different ways of looking at it. They're highly individualized to the person. So the effect of these pharmaceuticals, the effect of even natural supplements, are going to vary from person to person depending on what their base level microbiome looks like. So it's not necessarily applicable to apply some of these studies holistically in the population, because it depends on what you have in your gut to start with. But I think what the research is showing is that these pharmaceutical compounds do have an impact on the microbiome, good and bad. So we certainly need a lot more research into this space before we can make any sort of informed decision. So watch that space. I did want to ask a question around plant sterols because plant sterols were one of these in vogue additives going into margarines and like products as a, a supplement into the product to protect against heart disease. Do you have any thoughts or, or opinions on that particular compound?

On, on. Sorry, I didn't catch. Which compound?

Plant sterols.

Oh, plant steriles. Okay. Yeah, fascinating area. You know, there's steroids which people will recognize from bodybuilding and hormones. Testosterone's a steroid. You know, estrogen is also a steroid hormone. The plants also have, not surprisingly, a similar system and we call them plant sterols. And plant steriles actually have been known for a long time, but only until recently have we begun to realize, you know, maybe there's something here that when we're eating the plants that could actually be beneficial for, for the body. And again, this is an area that I'll tell you that I'm very actively interested in and paying close attention to. There are plant sterols that improve our performance, by the way they perform, you know, they improve physical performance, mental performance in ways they call it diasterones and they're in different types of foods like spinach. And so this is, I would say an area of an intense interest. I, I don't think we know enough about it yet to be able to conclusively find a commercial application. And this is actually happens a lot, I think, in the health and wellness and supplement space, which is good science is coming out. Somebody, well meaning supplement developers, you know, get excited by it and they see an opportunity to be able to try to do something that's good for the consumer. They put it together, not necessarily realizing there's a lot more research coming up behind it that would actually give us more information on how to actually optimize the application and in some cases maybe finding out that there will be some side effects or you know, things that we should be careful. But I think plant steriles are very exciting. They're clearly very important. They've been underappreciated for, I mean they've been known about for decades. Just only now, I would say in the last four or five years have people started to say, wow, there's something in here that we should actually pay attention to that might be influential for our health. And I use that word, I choose that word very carefully because influential for our health could be a good influence or it could be maybe not such a good influence as we brought up about the microbiome we need. So we need to know that.

Awesome. Thank you for sharing your thoughts on that one final topic, and then we'll start to wrap because I, I think you'd be the perfect guest to talk about this. I'm hoping. Fingers crossed. What's your thoughts on erectile dysfunction? Because it's, it's just. It seems to be an emerging issue that I'm hearing about a lot with people, obviously men. So what's, what's causing this? And how. Is there any dietary strategies, supplement strategies, anything you can recommend to male listeners?

You know, it's really interesting, you know, to break it down into simple terms. The erection in a. Of erectile dysfunction or the lack thereof, is really blood that flows into the penis and is trapped there, held there for a period of time, which is how you get, you know, it's kind of like blowing up a water balloon. You get more water, more blood into the balloon. It's going to be a bigger, more substantive object. And our body's hardwired as males to be able to, to have that, handle that. Testosterone and many other hormones can affect that. But the key is what I said at the very beginning. It has to do with your circulation, getting blood in there and your blood flow can. Your blood vessels can dilate to deliver the blood. They can constrict to trap the blood in the penis, which is exactly what you want to do. And that entire function is connected to the nerves. A lot of people don't realize that, that erectile dysfunction is both a blood vessel as well as a nerve problem. Okay. Now, no one would argue that nerves are important in the penis, okay. If you had a numb penis, doesn't matter if you have an erection or not, Right. So you want good blood vessels and nerves. And these two tissues work hand in hand. In fact, every nerve in our body is accompanied by its own blood supply. The nerve has its own blood supply, its own circulation called the vasa, as opposed to blood vessels. Vasa nervorum. It's the nerve supply of. It's a blood vessel supply for the nerves. In conditions where you're impairing the nerves and the blood vessels, like diabetes, pre diabetes is getting you toward that stage, which is why you want to exercise, eat healthy, stay away from foods that get you into that metabolic problem. All right? Keep your blood vessels and nerves really, really healthy. You want to be able to maintain good blood flow. So how are, how can you optimize blood flow? Well, it turns out that nitric oxide. So what's it, what's an effective treatment for erectile dysfunction? Viagra. Okay. And cialis. Like, I don't get paid by. By saying any of these terms. I think they're just names of drugs that people have heard of. And what Viagra does is that it. In your body, it creates something natural called nitric oxide. Nitric oxide makes your blood vessels get larger. When your blood vessels, your penis get larger, more blood goes in there, okay? And that's how it works to help an erection. You need to be in the right mental state for it to actually give you the full effect. So, you know, people are people who are upset on Viagra, they're not going to get an erection. Okay? So you really. The nerves also count, and it's connected to the brain as well. Part of the complexity, right? Not the on, off switch. It's a complex system. So what are. What else can give you nitric oxide? All right. Nitric oxide is also created by certain foods that we eat. Good example, spinach and beets. Spinach, which we know. And beets are plants that are food plant foods that grow near. Close to the ground. The ground soil earth has a lot of nitrogen, so there's a lot of natural nitrogen from the earth, from the soil gets into beets and spinach. Now, when you actually cook your spinach and chew your spinach and savor the taste of the spinach, chew, chew, chew, as opposed to tuck it down the back of your throat and swallow it like you're a kid and you don't want, you know, you got to please your mom to clean the spinach off the plate. All right? But when you enjoy your spinach. How do. How do I enjoy spinach? Saute with a little bit of extra virgin olive oil, a little bit chopped up garlic. You can throw some golden raisins in there, a little bit of white wine to give a little flavoring. Toast some pine nuts in there. Now you got a really delicious spinach dish. Do you want to chew it? When you chew it, the tongue microbiome, the gut bacteria on your tongue interacts with the nitrogen, that natural nitrogen in spinach, and converts it to a form. The bacteria in your tongue converts the nitrogen from the spinach into a form that when you swallow, it gets absorbed into your body as. Wait for it, nitric oxide. The same thing that Viagra produces. Now, is spinach a substitute for Viagra? Probably not, but it is one way to actually lower your blood pressure by dilating your blood vessels and lowering blood pressure. That's been shown. That's been shown in clinical studies. And the other thing that it actually does, it actually protects the lining of your blood vessels. So it's protective as well. So beets will do the same thing. Two examples of foods that produce the same substance that Viagra does that helps protect your blood, your circulation, your blood vessels everywhere in your body. But why not protect it in your penis? So in terms of like, you know, we talked about prevention at the very beginning. Hey, you know, eat your spinach, eat your beets. If you want to be the Popeye of erections, you know, you know, like you want to make sure you're doing, taking good preventative measures by protecting your circulation in all the important organs of your body. So this is kind of like how we're going now to start looking into how can foods be work as medicine, Food as medicine. This is actually the beginnings of how you actually unravel that opportunity Completely agree.

The other sort of things that I agree with you because it is an integrated system, isn't it? So even by talking about a very specific issue like ed. But then all these flow on effects are also certainly going to also benefit the heart as well because it's all to do with the circulatory system. A couple of other things that come to mind that might help from my experience is I think some species of lettuce also have a lot of nitric oxide. And celery is another one that I know of supplement wise arginine, I've heard that has good effects. And also citrulline malate is another one to boost it up. And one final point is that when you mentioned about the microbiome, using something like a mouthwash or antibacterial treatments in the mouth could potentially be damaging the mouth microbiome, which could affect that conversion process of the nitric oxide in the mouth. So do you concur with that?

Yeah, so that's been studied. And the way it's been studied is not taking the fresh breath mouthwash that's mostly flavoring and maybe some artificial sweeteners that might not be good for you for those reasons. But the, but the real damage to the tongue microbiome occurs when you take the mouthwash, the antiseptic mouthwash that your dentist would prescribe to you after doing a procedure. Those are the really killer, super potent, you know, sort of the nuclear version of mouthwash that pretty much wipes out your, your healthy tongue bacteria. In fact, it's been studied that, you know the effect of the spinach and the beets that we talked about or beet juice will to do the same thing. If you take the mouthwash before it'll wipe out your ability to be able to generate nitric oxide. Your blood pressure won't go down, which should be healthy as a response to eating spinach or beets. It'll actually stay exactly where it is. All right? It will not budge because you've wiped out that health, that, that important tongue microbiome, by the way. It's also been studied. So what's a good way to actually, for oral hygiene? Right? This is another very important component of health. Brush your teeth, floss your teeth, Right? Because you don't want to actually have retained debris in there that sets up for the overgrowth of bad bacteria microbiome. Back again, it's in the mouth, is a perfect part of the gut. But, but it's been shown that if you just simply brush your tongue and rinse it out with water, that actually is good enough to actually reboot your tongue microbiome to be able to allow the healthy bacteria to grow back and dominate. Right. So here we are thinking, you know, like, we've got to do all this, like, crazy nuclear stuff to clean out our mouth. Good, healthy, regular oral hygiene. Brush your teeth, wash your teeth, brush your tongue. That's a great start. And rinse.

Right. Could you use something like tongue scraping?

Yep, Tongue scraping will do it as well. I mean, so it's like you could brush or scrape your tongue. That allows a reboot that's kind of like, you know, every now and then you want to actually reboot your. Your laptop just to clear the cache. That's kind of what it does. It clears the cage of all the bad bacteria in your tongue, allows the good operating system on your tongue to resurrect itself.

Wow, that. That's an amazing insight. I just want to ask as well. So the nitric oxide that we talked about is also going to be beneficial for women as well, right? Because that still has that vasodilating effect.

Yeah, the main, the main, the main value is really dilating your blood pressure, blood vessels, so that your blood pressure falls lower. Blood pressure is a lifesaver because high blood pressure is a silent killer. It's a setup for a stroke as well as all these other problems, hardening of the arteries in your brain and all these other problems that you don't want to have. And so nitric oxide is really kind of a hero substance in our body. Our body makes some of it, but, you know, foods can actually make more of it. And by the way, a lot of people may not appreciate this as well, but we talked about a drug that does one thing that has a unanticipated effect. You know how, you know how why Viagra was originally developed.

Nice.

It was developed as a blood pressure medicine and anti hypertensive because of nitric oxide because it dilates the blood. When you, your blood vessels widen, your blood pressure comes down. It works really well. In fact, that's one of the side effects. If you take really high doses of Viagra for men, if they don't watch out, like if they take nitrates, their blood pressure can plummet and they can get lightheaded and they can actually faint. So you want to be careful about that. But that's how it was really developed. In the clinical trial for lowering blood pressure for Viagra, they noticed that the men in the study all had erections. And you know, some clever pharmaceutical executives go, yeah, never mind the blood pressure part. Let's go for this.

That's amazing, amazing information. You've been so generous with your time, Dr. Lee. I sincerely appreciate it. We'll start to wrap. So if people are loving what you're doing, you're an amazing author, you have books out there. So how do they find your books? How do they find you online? Is there a website that people can go to?

Yeah, well, so first of all, I, I, I have a YouTube channel that I put, I pump out information on multiple times a week. So you know, like this kind of conversation, I, I do it like to that, to an exponential level on my YouTube channel. So check that out. My books eat to be disease and eat to beat your diet. You can get it anywhere where books are sold. I like small family owned private bookstores. But if you go to the big bookstores you can get it, you can order it online and have it delivered to your house the next day. And then my website, Dr.william lee li.com. Dr. William lee.com. i'm on social, that's my handle as well. You know, I, my mission is to really get information out that people can use because as a doctor who has worked on biotech for drug development, most of that stuff is not going to see the light of day for many, many years. Food knowledge, food science, food is medicine, research has immediacy. If I tell you something about spinach or beets, hey, you can make it. You can put that into action right after this podcast.

Awesome. Love that. And if there was one thing that someone could do for their gut health, because this is the gut health Goose podcast, we've got to get some sort of gut health message out. So if there's one thing that someone could do, do for their gut health today. What would that be, Dr. Lee?

You know, I, I would say enjoy a handful of tree nuts a couple of times a week. Tree nuts, Almonds, macadamias, pistachios, cashews, walnuts, pecans. You know, those are great sources of healthy fats and they are dietary fiber that feeds your gut microbiome. And they're satiating, so you're less likely to overeat the next meal. And so it's sort of like a, you know, hit multiple targets at the same time and get a snack out of it as well.

Awesome.

Love that.

Thank you so much, Dr. William Lee.

My great pleasure. Thanks very much.

We hope you enjoyed this episode of the Gut Health Gurus podcast with Dr. William Lee. If you found this podcast valuable, please leave us a kind review and five stars on Apple, Spotify or your favorite podcasting app. If you want to connect with our host, Cribban Govender, please follow him on Instagram, Facebook and TikTok at Gut HealthGurus. Also, check out our Gut Health Gurus Facebook group. With more than 19,000 members ready to help you on your journey to amazing gut health, this episode is sponsored by Nourish Me Organics. Head to www.nourishmeorganics.com and use the code HappyGut for 10% off. Until next time.