Preventing Disease through Metabolic Health with Dr. Philip Ovadia

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Hey, it's jj and welcome to Ask the Health Expert. But this isn't just any old Ask the Health Expert Expert session. This is your bonus session. Yes, it's the weekend.

And because it's the weekend, we are.

Going to take some time with an amazing expert. So be on the lookout for these Saturday Ask the Health Expert bonus sessions where we're going to go deep into an amazing subject with an incredible expert to give you actionable items that you.

Can put into your life.

I had a great doctor once say, you know, you don't lose weight to get healthy. You get healthy to lose weight. And you got to fix your metabolism. And today we are going to be talking about that. We are going to be talking about metabolic health and what that means. And I have a perfect person to talk about this. This is a cardiothoracic surgeon who was morbidly obese. And as a cardiothoracic surgeon and trying everything. And you know, I always say, if you're struggling with your weight and you're not able to accomplish your goals, like, you're probably following the wrong set of rules. It's not that it's your fault. You've got issues with your metabolism. Right. You've got to heal that. So he's going to be talking about just that. He's got a new book out, Stay Off My Operating A Heart Surgeon's Metabolic Health Guide to lose weight, Prevent disease and feel your best every day. And it talks about metabolic health and how to assess your metabolic health, which, by the way, we're going to be able to share with you how to do that@jjvirgin.com methealth so let me tell you a little bit about my guest, Dr. Phil Avadia. He has Avadia Heart Health, a virtual clinic to people all over the world where he focuses on preventing and treating heart disease. His big goal is to keep you off his table and that. And so he uses all the metabolic health methods that he has in his books. Stuff off my operating table. And again, this is a cardiothoracic surgeon who has worked in Pennsylvania, in Florida, and now he's traveling around the world, around the country doing that as well. So I'm super excited to share Dr. Phil Avadio with you.

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So, Dr. Philavedia, what I would love to start with is your story. I will tell you. I went on your website sniffing around and holy smokes, everyone's got to go. And I'll put it in the show notes. I'll put your website link because you've got some crazy pictures on your website and tell everyone about those before and afters and what happened.

Sure thing, jj. You know, and I think it is pretty important that my personal and my professional, you know, kind of stories interact so well. But my background is, you know, I've been a cardiac surgeon, a heart surgeon now for coming up on 20 years. And during much of that time, and really going back to my childhood, I was, you know, obese, progressively unhealthy, and had gotten to a point where I was morbidly obese and pre diabetic. And I kind of realized that I was going to end up on my own operating table, so to speak. But I was at a loss because, you know, I had tried everything that I had learned in medical school and all the advice that I was giving my patients over the years to eat less and move more and pay attention to the US Dietary Guidelines, and. And they were failing me, and they had failed my patients. And thankfully, I started to come across some alternative information, some different perspectives on why we get unhealthy and what leads to us becoming obese and developing heart disease and diabetes and these chronic medical problems that plague our society so much these days. And ultimately, you know, by focusing on metabolic health, I was able to improve my own health. I was able to lose over 100 pounds, and I've now maintained that weight loss for five years. I was able to reverse my prediabetes. And I came to realize that those same concepts would help the patients that I was seeing every day and would help people to stay off my operating table, which has now become my focus and my passion, which is awesome.

And the title of your book, I love it. Stay Off My Operating Table. So let's talk about metabolic health. When you say that, what exactly do you mean?

Yeah, so the basic concept is that when someone is metabolically healthy, their body is properly utilizing the resources that you are giving it, mostly in the form of what we eat. So when we eat, one of three things is supposed to happen. You know, some of that food gets turned immediately into energy to fuel all of the, you know, activities that we do each day and all of the cellular activities that are going on in our bodies constantly. And then some of that food is supposed to be used to build and rebuild the tissues of our body, another process that is constantly going on. And then a little bit of it is supposed to be stored in case there are times when food isn't readily available. But our modern food environment has basically hijacked that in a number of ways. And what ends up happening for most people is that we end up storing too much energy and never really using those energy stores. And that is essentially what being metabolically unhealthy is. And that ends up affecting, you know, everything that goes on within our bodies.

Yeah, it seems that we've gotten really good at storing.

Exactly.

So let's talk about that then. Like in The United States right now. Because I was just looking at some stats lately which I had hadn't looked at the statistics for just a couple of years, and I was kind of shocked at how much things have changed. Like, what is the current state of metabolic health the United States?

Yeah. So, you know, the most recent data that we have actually comes from, you know, now 2016. So it's five years old. But that data showed that 88% of the adults in the United States are not metabolically healthy. So only 12% of the adults are metabolically healthy. And again, that data is five years old. We have some recent data coming out looking at things like obesity and diabetes trends over the past five years that continue to worsen and perhaps have even accelerated, you know, over the past year or two with everything that's been going on. So, you know, unfortunately, we're probably even worse than those quite scary statistics would, you know, would suggest.

Yeah, I remember I was doing a lot of lecturing and had the 20. The 2010 statistics, and then I had to go do something. So I looked and I saw the 2016. I was like, I can't believe how much different these are. And those were. They were not including the pandemic statistics. And I remember seeing something that just in. In terms of weight gain alone, it was like the average person gained 20 pounds. I'm like, okay, you know, what is going to go on? I'd heard a statistic, I think, 10 years ago, and I remember when I heard it, I go, there's no possible way that could happen. And it was a statistic that said, if we do not change, if we stay on the same trajectory, by 2030, the entire population will be diabetic. And I'm like, no way. And now I'm like, oh, well, wait a minute. It could be definitely heading that way. And now why do you think this is? I mean, why. Why have things gotten so challenging? Take the last year out of it. But just in general, what. What has happened?

Yeah, I think, you know, there's no way to get around the fact that it. It is, you know, due to our food environment. And as our food environment has shifted towards more and more processed foods and away from the whole real, you know, natural foods that we evolved on as humans, it is clear that our health is worsening. You know, we can argue, and certainly there are different dietary camps that argue about, you know, what particular aspect of the food it might be. And in reality, it's probably multiple aspects of the food. But the inescapable fact is that the more processed our diets become and the less that we are eating whole, real food, the more unhealthy we become.

Yeah. And so what do you think it is? I've been looking a lot at processed food because someone in my community is like, well, but, you know, you use protein powder and you do this. And I'm like, going, well, the reality is almost everything we eat nowadays has been processed in some way or another. I mean, if you're eating wild salmon, it got processed. If you're eating wild rice, it got processed. It's really. Is it a clean processed food or a dirty processed food? Because sadly, most of us aren't able to go walk outside and pick some vegetables and, like, you know, get fresh eggs from a chicken. So what is it? What are some of the top things you see in these processed foods that are really wreaking havoc on our metabolism?

Yeah, I think the two, you know, most prominent, you know, ingredients, I guess you would say, of these foods that seem to be uniquely damaging to our metabolism are the fake fats, the, you know, highly processed vegetable and seed oils, and then the highly processed, highly refined carbohydrates. And, you know, the unfortunate reality is when you look at, you know, 90% of the foods that are in supermarkets these days, they contain those two things, you know, in combination. So, you know, it becomes hard to separate out one from the other.

You know, it becomes hard to go in a supermarket and call it food.

Exactly. You know, there's a. There's a term that I borrowed from someone that I use called near food objects. And, you know, it's in my book. And the majority of what's in the supermarket these days are near food objects. They're not actually food.

That is funny. Well, we're going to talk about what role they play in chronic health and chronic disease. So hang out with us. We'll be right back. We're going to take a short break.

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All right, so let's talk about this, because it seems to me like you mentioned These seed oils rich in Omega 6 is overly processed, probably oxidized, creating a lot of inflammation. All of these processed carbohydrates, I think.

Of a lot of the stuff with.

Gluten and corn, again creating a lot of inflammation. What's the role between chronic disease and a lot of these things that are causing death? Heart disease, cancer, diabetes and poor metabolic health?

Yeah. So when you look at the top 10 causes of death in the United States each year, seven out of the 10 of them can be, you know, attributable to poor metabolic health. And these are things like heart disease, many forms of cancer, diabetes, Alzheimer's disease, kidney disease, that you can just go down the list and, you know, really for last year, 2020 and 2021, we're going to add sort of an 11th top cause of death, Covid. And that is clearly attributable, you know, to poor metabolic health as well. You know, you are more likely to get Covid and you are more likely to get sick with COVID if you are metabolically unhealthy. So, you know, the common factor as to, you know, what caught, what particular aspect of, you know, kind of poor metabolic health causes these diseases does seem to be inflammation. You know, for me, I most commonly, of course, deal with the heart disease issue and the inciting process for heart disease is inflammation and damage to the lining of the blood vessels. But, you know, it's what is most sort of concerning to me about the way that we handle these modern, these, these chronic diseases in our modern medical system is that we miss that connection. You know, we look at all of these diseases individually and we fail to see the common root cause, which is the poor metabolic health.

Now you've got on your website and in your book, which I'm going to encourage everyone to grab, how you can track your five metabolic health markers. And by the way, we're going to give you a way to assess your metabolic health as well. So stay tuned for that. When you're tracking those, what are you tracking?

Yeah, so five real kind of simple measures that I think everyone needs to be aware of. And if you know, you don't know these numbers and your doctor doesn't know these numbers and discuss them with you, that's a real problem. The first measure is your waist circumference. So this you can just measure at home. You take a tape measure just above the level of your belly button. Best measure it first thing in the morning. And if you are a man, you want that to be less than 40 inches. And if you are a woman, you want it to be less than 35 inches. Next, you look at your blood pressure again. You can check it at home, you can go to any pharmacy or supermarket these days and get it checked, or you can go to your doctor's office and you want your blood pressure to be less than 130 over 85. And that needs to be without the use of medications. So if you are on medications because you have high blood pressure, that is already a sign that you are not metabolically healthy. And then the other three numbers are going to come from some basic blood work that everyone should be getting checked as part of their routine exams. Your fasting, blood glucose level, so the amount of sugar that's in your blood when you haven't eaten for about 8 to 12 hours. And that should be less than 100 milligrams per deciliter. These are the United States units. And again, that needs to be without the use of medications. And then we look at your cholesterol numbers. What I importantly point out to people is that the one cholesterol number that most doctors focus on, the LDL cholesterol, so called bad cholesterol, is not a determinant of metabolic health. It's not a factor that we consider. We look at the other two numbers that are commonly on your cholesterol panel. Your HDL cholesterol, so called good cholesterol. And as the nickname implies, the higher the better for this. So if you're a man, you want it to be over 40. If you're a woman, you want it to be over 50 milligrams per deciliter. And then the final number we look at is your triglycerides. And you want that to be lower. You want it to be under 150 milligrams per deciliter. So you look at those five measures. If three of those are in the unhealthy range, you are officially diagnosed with what we call metabolic syndrome. And that means that you are at very high risk of all of those chronic diseases that we listed before. And if you have one or two of those abnormal, it's a warning sign because we know that you are likely to progress to have three or more abnormal within the next 10 years or so. If all five of those measures are where they need to be, congratulations, you're one of the 12% that is metabolically healthy. But it's important that you look at those five measures as a starting point for figuring out your metabolic health.

It's crazy, dude. 12%. So this is an important thing to understand because you can be at normal weight and be metabolically unhealthy.

Exactly. The statistics show that, you know, people who are normal weight or even underweight, you know, still have about a 50% chance of not being metabolically healthy. So, yes, being obese makes it very likely that you are not metabolically healthy, but being a normal weight in no way guarantees that you're metabolically healthy. And you need to look at these numbers to know for sure.

You know, it's interesting, I was reading some research. This was probably. It's probably 10 years old and I haven't seen, seen it replicated. That needs to be. It was MRI research that was looking at body composition and what they found was that people who. About 50% of the population. So it made me think of this because it correlates with what you just said. 50% of the normal weight population is actually tofi thin outside fat inside. And those people were the people who maintained that normal weight without exercise so that they looked fine, but they were fluffy, not solid, like a rock. They had high body fat relative to their weight. And so if you have a normal weight but high body fat, you're not going to be metabolically healthy either. So it's really where we have to look at. Body composition is super important. So someone's got some of these markers that are elevated. What are some of the things that they can do right now to start shifting that?

Yeah. So, you know, in my book, I list seven principles of metabolic health that are going to help you get metabolically healthy and maintain it once you're there. Eat whole. Real food is, you know, probably the best action item I can give to people if you are not metabolically healthy or if you're trying to stay metabolically healthy. Some other important things that I go through in the book are to move enough, get, you know, enough quality sleep and to manage your stress as best you can. Those are all going to have, you know, an impact on metabolic health. But first and foremost is what we eat. And, you know, the best rule that I give people is eat whole real food to be metabolically healthy.

It is amazing how quickly you can change things by changing what's at the end of your fork.

Exactly. You know, we have very good data showing that within 30 days, you can have a measurable impact on your metabolic health. Now, you're not going to undo all the years of damage in 30 days. You might not be able to reverse your diabetes or fix your heart disease in 30 days, but the markers of metabolic health can start to show significant improvement within 30 days of just changing what we eat.

Well, if it took you 20 years to get here and it takes you like six months to correct it, that's still pretty good. I'm always amazed at someone who's been this way for 20 years and then they're expecting in two weeks for everything to be changed. I'm like, come on. But as long as you start to see the indications that you're going in the right direction, just keep going. So let's look at what you do since just the fact that you were able to go from morbidly obese, that's 100 pounds or more of our weight, if you didn't know what that meant to now having lost all the weight and kept it off, which blows all the statistics. Right?

Right.

What's a typical day look like for you?

Yeah, so, you know, I largely maintain a carnivore diet. I eat, you know, mostly animal products. Probably 95% of what I eat are animal products, including, you know, various types of meat. Seafood, dairy, eggs are a very important part of my diet. And that works for me and it has worked for me. And so I keep doing it. But, you know, I point out in the book that it's not the only way to do it. You know, in the book, I go through literally both the vegan and the carnivore diets and lots of options in between, things like keto and paleo and mediterranean, to talk about, you know, how each of these dietary strategies can support your metabolic health. And I also point out some of the things within each of them that may not support your metabolic health. And ultimately, I think, you know, everyone needs to sort of experiment for themselves and figure out, you know, what works for their lifestyle, their preferences, to get them metabolically healthy. But I think the important thing is that you need to focus on metabolic health. That needs to be the measuring stick of what you're doing is being successful or not being successful.

I just wrote my next book, and the big premise of the book is that everyone says diets don't work, diets do work. It's really finding the right diet that works best for you and getting the information, trying something like, I know I've tried vegan diets don't work for me, don't work. You know, I. I do way better on more animal protein as well. And so it's information. You pull it in and you go, what. What if this is working for me? What isn't? So I love that you said that. I think that is so key important is to go through these and figure out what works best for you. Now you have a metabolic health assessment tool and I'm going to put that@jjvirgin.com MetHealth Met Health. So is this a little quick thing that they can do on your website? What is it?

Yeah. So basically it takes you through those five metrics that I mentioned and it allows you to enter your numbers and see where you fall in terms of your metabolic health. And then you know, it's going to give you an assessment at the end with some, you know, potential actions to take depending on where you fall on the metabolic health scale. And you know, that may be you're doing great and keep doing what you're doing or that may be you're in trouble, you are not metabolically healthy, you need to make significant changes. And you know, my book, the other information on my website is a great place to start to try and figure out what you know, what you might need to do to improve your metabolic health. And then if anyone's interested, I do have a telemedicine practice. I work with people all over the United States on improving their metabolic health and helping them to avoid the need for heart surgery. I would much rather people meet me at my telemedicine practice than meet me at the operating table.

Nice. Love that. Again, it's going to be@jjvirgin.com J Met Health plus all the information on Phil's book and Dr. Phil Avadia, thank you so much for taking the time with me today.

Thank you jj. It's been great.

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