Stay Off My Operating Table: A Heart Surgeon Discusses Metabolic Health

Welcome to the Living to 100 Club Podcast. Here's our host, Dr. Joseph Casciani.

Greetings to everyone joining us today for the Living to 100 Club Program. I'm your host, Joe Casciani. Each week we bring you thought-provoking discussions on topics related to living longer and celebrating aging. Here at the club, we're building a community of everyone who embraces the reality that we are now living longer than any generation in history. Club members want to establish new habits, learn new information, and make decisions that impact our mental and physical health. And most importantly, how do we make it over those hurdles and obstacles and keep moving forward? We have an exciting guest on our program today. Dr. Philip Ovadia is a cardiac surgeon who has written a new book titled Stay Off My Operating Table. He will share with us his medical views on preventing disease and optimizing our health. After years of performing heart surgeries, he shares with us his experience and insights and recommendations for sustainable long-term approach to staying healthy. Dr. Ovedia, welcome to our program.

Hi, Joe. Thanks for having me on. I'm excited to have this discussion with you and connect to your audience. I love what your community is trying to do, you know, live to 100, live longer, and live healthier.

Great. Yeah, I'm looking forward to our conversation too. You have a lot of information. Some important messages for our listeners. I know I always like to begin by asking our guests to tell us a little bit about the journey that brought you to where you are today.

Sure thing. You know, so I have both a personal and professional journey that kind of got me to where I am today. Um, you know, I'm a heart surgeon by training and I continue to work as a heart surgeon. I went through,, you know, kind of traditional college, medical school, and then a residency program in first general surgery and then cardiothoracic surgery to become a heart surgeon. And I was in practice as a heart surgeon for, you know, the past 15 years. And during all that time, during my childhood, during college, during medical school, I always struggled with obesity. I was overweight as a child. I got more obese as I went through college and medical school and multiple times along the, you know, along my path, I had tried the usual things to lose weight, eat less, move more, eat a low-fat diet. All of these things that, you know, we all heard and I had learned in medical school was the key to being healthy. But it wasn't working for me. And about 5 years ago, I figured out that I was going to end up on my own operating table. I was morbidly obese by that point, I was pre-diabetic, but I really didn't have a good solution. And I was fortunate at that time to come across some of the information around low carbohydrate diets. I heard a lecture by Gary Taubes, uh, probably a lot in your audience are familiar with him, but he's a journalist that wrote the book, uh, The Case Against Sugar and Why We Get Fat. And I learned about low carbohydrate approaches to nutrition and the impacts of the true impact of what we eat on our health. And ultimately I have been able to lose over 100 pounds, maintain that weight loss. And more importantly, I came to realize the importance of metabolic health to really all of the chronic diseases that we face, but specifically to the chronic disease that I battle every day, which is Heart Disease with my patients and realizing how important metabolic health was to preventing heart disease and preventing the other common diseases that shorten our lifespan has allowed me to refocus my career now on not only continuing to do heart surgery but helping people to stay off my operating table.

I love that title. We'll get some more of those strategies in a minute. I just want to ask you first, As I want to announce, you're a board-certified cardiac surgeon and founder of Ovadia Heart Health, and your, your mission really is to optimize the public health and help people stay off the operating table. Before we get into those strategies, let me ask you a little bit about your, your current practice, your current surgical practice. What types of patients do you see and surgeries do do you perform?

Yeah. So, um, as is the case for most of the heart surgeons in this country, the most common operation I perform is a coronary artery bypass. And that is a procedure that is done to deal with blockages that have built up in the arteries on people's heart. And while the most common age group that I end up doing that surgery in is 60 and 70-year-olds, It is becoming more and more frequent that I am doing that, those types of operations on 40 and even 30-year-olds.

Ouch.

So there's clearly a trend that, you know, this is getting worse. This is moving in the wrong direction. Um, there are, you know, multiple indicators of that. We've all seen the statistics around the, you know, increasing incidence of diabetes and obesity. In young people in the, in the United States and throughout the world. And the simple fact is, is that heart disease has been the number one cause of death in the United States and worldwide for the past 30 years and shows no evidence of slowing down.

Yeah, 40s and 50s, that's an alarming observation, uh, for all that coronary bypass surgery So we are getting sicker as a nation, as you mentioned, incidence of diabetes and heart disease increasing. What's going on? Is it just fast food and, and sitting on the couch too much? What's going on?

Well, you know, that's, that's the debate that continues to go on. You know, what is the cause of this? It seems, you know, to most you know, most line up with the foods that we eat. I think that the foods that we eat are the biggest influencer on our health. They're not the only influencer, but they are probably the biggest influencer. And that has been the most obvious change, you know, that affects society as a whole over the past 50 years or so that we've been seeing these trends develop. And, you know, there is debate about what in the food supply in particular is causing it, and in the end it's probably not just one thing that we can isolate, but I think the overall movement away from eating whole real food and eating sort of the ancestral foods that, you know, we evolved on as humans seems not to be having a positive impact on our health.

Yeah, it's the processed foods, right, that are so common in our diets today.

Yeah, exactly. And the interesting thing is, you know, no matter where you fall in sort of the diet war camps, you know, that go on, we have everything from carnivores to vegans and the paleo people and the, you know, you know, low carb and Mediterranean and all of these various diets that people use, the commonality between the ones that are successful is that they eliminate processed food. So I think, you know, there is certainly no evidence that I've ever seen that processed food is beneficial to our health. Processed food is beneficial to the food manufacturers in the end, but it is not— it is not beneficial to our health. It is not essential for us to eat processed foods. And therefore, I think if one is interested in optimizing their metabolic health and giving themselves the best chance of living longest and living healthiest, I think eliminating processed food and eating whole real food should be at the base of that strategy.

Right, right. In your book, let me give the title, Stay Off My Operating Table, A Heart Surgeon's Metabolic Health Guide to Losing Weight, Preventing Disease, and Feel Your Best Every Day. So what's the, what's the main message? I mean, we're talking about it, but what's the, what's the main thrust of your, your book?

Well, I, I think the most important message for people to get from the book is that understanding what metabolic health is how to assess it and how to optimize it is ultimately what's going to lead us to having the best overall health and to preventing the chronic diseases that plague our society and shorten our lifespan.

So it's the metabolic syndrome that is really an umbrella term for the collection of these chronic diseases, congestive heart failure, diabetes, high blood pressure, maybe even some cases of cancer and dementia. Is that the overarching, um, call it diagnosis, the metabolic disease?

Correct. Yeah. Clearly, um, all of those diseases you mentioned, and, uh, you know, those are most of the top causes of death, uh, are relatable to poor metabolic health. And the issue is, you know, our healthcare system has evolved to a point where we don't really recognize that, you know, we focus on treating the individual diseases that occur because of poor metabolic health. So we focus on treating the high blood pressure and the heart disease and the diabetes and the cancer and the Alzheimer's disease. We don't focus on preventing these diseases or trying to reverse these diseases by addressing the underlying root cause, which is the poor metabolic health and the metabolic syndrome.

Hmm. Okay. So let's talk about that. Let's drill down a little bit. So current nutritional guidelines, you say, are off target.

Yes.

I think, you know, that was your observation.

Yeah.

Nutritional guidelines, just not, not right.

Clearly. And, you know, again, I think the, the evidence of this on a high level is that the US Dietary Guidelines have now been in place since you know, 1980 for 40 years. And, you know, the food pyramid and all of the evolutions that they've undertaken during that time, our health as a nation has only gotten worse. Diabetes, obesity, heart disease, all of these things have gotten worse during that time. So clearly the US Dietary Guidelines are not serving us well from a health standpoint.

Yeah. So we have this metabolic disease and standard medicine, you think, you feel, you believe is just not addressing that as a collective combination of all these. And they're treating the individual chronic diseases, high blood pressure, heart disease. So how do we go about addressing the metabolic disease?

Well, I think as with anything, you know, if you, if you don't measure it, if you don't assess it, you can't improve it. So I, you know, the basic assessment of metabolic health really relies on 5 metrics, and I go through these in the book, but, you know, briefly, they are your waist circumference, your blood pressure, your fasting blood glucose level, your HDL cholesterol level, the good cholesterol level, and your triglyceride level. And the first thing I you know, I put, I lay out in the book and I work with my clients on, my patients on, is assessing those 5 metrics and figuring out where you are. And if you do not have optimal metabolic health, which by the way, 88% of the adults in the United States do not have optimal metabolic health, they don't meet all 5 of those metrics. So if you do not have optimal metabolic health, you then need to start making changes to improve it. But again, the focus of those changes need to be on improving your metabolic health on those metrics. It is not about losing weight. It is not about getting one particular number to change, whether that's a blood metric or the number on the scale or whatever it is. When you improve your overall metabolic health, the rest of these issues work themselves out. People lose weight or they get to an optimal weight. People, you know, feel better. Their diabetes, you know, can be reversed. Type 2 diabetes can be reversed. They get off of medications for high blood pressure. All of these things can happen with a focus on metabolic health.

Okay. So when we address these 5 metrics, as you say, let me just highlight them: waist circumference, blood pressure, fasting blood glucose level, HDL level, and triglycerides. So when we address these, when they're out of whack, if they're too high or they're not— they're not within normal limits— that will in turn address the metabolic disease.

Exactly.

Yeah.

And, you know, that those numbers reflect your underlying metabolic health. So, you know, there are certainly other numbers that I look at with my clients. There are other things that you can, you know, look at to assess your metabolic health, or if you're interested in, you know, a particular kind of, you know, disease, you know, heart disease, for instance, is the one I deal with most commonly. There's other testing we might do around that, but the central focus is focusing on and optimizing your metabolic health.

Okay. So in a way we're indirectly addressing the diabetes by addressing these, any of these metrics, right?

Correct. Yeah. One of the metrics is your fasting blood glucose, which of course that being elevated is the hallmark of diabetes. Mm-hmm. But important to realize that if you're looking at the proper metrics and the proper things, you know, up to a decade before someone gets diagnosed with type 2 diabetes, there are indicators that their metabolic health is not where it should be. And by focusing on it early, we can actually reverse that underlying process and prevent them from getting to the point of type 2 diabetes.

I see. Kind of a subclinical measure then. It's there before the diabetes is, is full-blown.

Correct.

Mm-hmm. Yeah. Yeah. So this also is related to cancer, would you say?

And yeah, so, you know, not all, but certain forms of cancer have been related to poor metabolic health. So again, when you look at the common, the most common cancers that affect us, you know, so lung cancer being very common, and we know the strong association with smoking for developing lung cancer. But interestingly, as the incidence of smoking has gone down, we got people to stop smoking, lung cancer has continued to be a problem. And in women especially, its incidence is actually continuing to rise despite the lower smoking rates. So there's something else going on. And again, we have evidence that, you know, that something else might be metabolic disease.

Really?

Colorectal cancer, which is another very common cancer, has been clearly attributable to metabolic disease. The people who have poor metabolic health are at higher risk of developing colorectal cancer, and a number of other cancers have a similar association. So, you know, I certainly don't want to tell anyone that, you know, being metabolically healthy guarantees you won't get cancer because there are other things that contribute to cancer clearly. And once you have cancer, you know, if you are metabolically unhealthy, improving your metabolic health isn't going to undo the cancer. You know, you can't reverse it like you can diabetes or high blood pressure. But we do have increasing evidence that it can be a very good adjunct to whatever cancer treatments you're undergoing. Is, you know, improving metabolic health and things like a ketogenic diet.

Interesting. Sure. And how about dementia? Some, some evidence of links there?

Yeah, there are many, you know, physicians in the Alzheimer's and dementia space that, that refer to Alzheimer's as type 3 diabetes or diabetes of the brain. There is evidence that the same processes, you know, the inflammation, the high blood glucose levels that come that come with diabetes affect the brain. And again, there is a clear, you know, linkage between metabolic disease, the risk factor, you know, poor metabolic health and the risk of developing Alzheimer's disease.

Mm-hmm. So conceivably then this might be a reversible dementia as opposed to the irreversible dementias that we see.

Well, again, I think it depends on what, when you get, you know, when you get to it, you know, the best thing, again, I always tell people, better than trying to reverse or treat a disease is preventing the disease in the first place. So first and foremost, you know, if you don't have Alzheimer's disease already, address your metabolic health and give yourself the lowest risk of developing Alzheimer's disease.

Sure.

Once you have Alzheimer's disease, again, there is some evidence starting to come out that things like, you know, a ketogenic diet can help slow the progression and improve some of the symptoms. Of Alzheimer's disease. You know, the ketogenic diet addresses poor metabolic health. So there is, there is reason to believe, you know, that we can improve that process. At least you might not be able to completely reverse it, but at least improve it with a focus on metabolic health.

Slow it down. Yeah, because there are some dementias that are reversible. I mean, we don't hear about them too often, but there are cases that certain conditions could produce a dementing-like condition that is reversible. And if this is also true for Alzheimer's, that's, that's pretty remarkable because we always think of Alzheimer's as being irreversible. But, you know, as you say, there is that linkage, and that's really crucial. That's really important to know.

Yeah, and like I said, more important in my mind is trying to prevent these things from occurring in the first place. And I think it's clear that that having optimal metabolic health throughout your lifespan lowers the risk of developing Alzheimer's disease among the other, as well as the other chronic diseases.

Right. So from your experience, your history as a heart surgeon, this is what you're seeing. This metabolic health is really the key to staying off the operating table and so many other adverse events. Yeah.

Yeah. Yeah. Specifically when we look at atherosclerotic heart disease, the most common condition I end up operating on, you know, we have always been told that the most, you know, important risk factor for that is an elevated cholesterol level, specifically an LDL cholesterol level. But the reality is, is when you look at the data around heart disease, having poor metabolic health, being insulin resistant, which is essentially a synonym for metabolic health, puts you at a much higher risk of heart disease than having an elevated LDL cholesterol level. And probably the combination of the two is the worst, worst of all. But, you know, I think you can get more impact by focusing on the metabolic health aspect of it rather than only focusing on the cholesterol aspect of it, as we tend to do.

So in terms of the medical community, I'm just curious, Of course, we have all the specialists, and we're really essential specialists, but, um, where does the metabolic health come down as a specialty, or is it just a kind of a one dimension of any specialist practice?

Well, you know, and that's one of the problems, you know, with the healthcare system as it exists, is that metabolic health doesn't fit into a particular specialty. And each particular specialty focuses again on the diseases that result from poor metabolic health within their specialty and oftentimes fail to recognize the importance of metabolic health. So I think, you know, as we look, as you know, if we're looking to ways that we can change the healthcare system, I think you know, getting metabolic health specialists is one thing we can look at. And more importantly is probably, you know, reaching out across the specialties that touch all these diseases and trying to get the message out about the importance of metabolic health.

Is there some resistance to this, you think?

Well, there is in the sense that, you know, it's, it's just not what we do. You know, we, you know, the healthcare industry has evolved to a point that the focus is on, you know, treatment of these conditions, mostly with pharmaceutical drugs or interventions, surgeries, stents, things like that. We really do not have that focus on preventing the diseases in the first place. And, you know, I would argue that we should. I mean, everyone knows it's obvious that, you know, the cost of healthcare is literally bankrupting our society, our country, and countries, you know, across the world are, are literally collapsing under the weight of the cost of healthcare. And all of this treatment that we're doing is not changing that. It's really only worsening the problem. And if we got back to a focus on metabolic health and we were able to prevent most of these problems. It turns out that that benefits pretty much almost everyone. It benefits the patients because they stay healthy. It benefits the physicians because they are actually seeing better results from their patients. They, you know, end up not having to be putting out fires all the time and treating emergencies. And, you know, they largely have a better quality of life. It's been very impressive talking to the internal medicine doctors that I know who have refocused their career on focusing on metabolic health and how much happier they are in their practice. So it benefits the patients, it benefits the physicians, it benefits society as a whole in reduced cost. And again, this is demonstratable. Virta Health, for instance, is one organization that has been able to show amazing cost savings in their treatments of type 2 diabetics by focusing on metabolic health. And so then you say, okay, why hasn't this taken hold? And you start to look at who doesn't it benefit? And it doesn't benefit the pharmaceutical industry. It doesn't benefit the healthcare industry in the sense of the hospitals that need to, you know, generate income. And, you know, the whole incentive system behind our healthcare system is, is still geared towards treating illness. It's not geared towards preventing disease. So those are the entities that it's not benefiting. And unfortunately, those are very powerful entities that are working against this.

Yeah. So you're the anomaly, so to speak, as a specialist heart surgeon. I mean, your practice could be reduced if people stay healthier and stay off your operating table, right? I mean—

Correct. I always joke what a horrible business person I am because I'm trying to put myself out of business.

Yeah, but that's the, that's the name of the game, isn't it? It's really prevention, and it doesn't take an MD. I would say it takes anybody who is a healthcare provider to educate the individual about good diets, good nutrition, fitness, exercise, and all that. So it's important that the, of course, medical community is behind it, but that's the whole nature of interdisciplinary care where we can get all disciplines on board with the same message, right? It's, we don't have to wait or we don't have to rely solely on the medical community for this.

Yeah. That's, you know, one of the other things that's, that's real important to realize that, um, you know, it doesn't necessarily take, you know, a, a doubly board-certified heart surgeon to, to show you how to do this. Um, these are simple concepts that I think, uh, you know, most people can do. And my role, I view my role as that of an educator, as a guide. And again, that gets back to the roots of what physicians are supposed to be. The Latin word doctor is an educator, is a teacher. And that is really what physicians were meant to be., and so, you know, I, I view it as getting back to our primary role as physicians.

Yeah. Yeah. That's such a vital message to continue to get out to, to the consumer. And I know when we talked, um, you'd mentioned about the top causes of death in the US there, 7 out of 11 are preventable, right? I mean, this is what you're talking about. If we address a lot of these conditions early on or prevent any onset, They are preventable.

Yeah, exactly. And, and, you know, I say this year I've been saying 7 out of 11 referring to the, the 2020 data from last year, because of course we had the new entry on that list, which was COVID, uh, which was, you know, the number, uh, 2 cause of death behind heart disease last year. And, you know, one of the statistics that has been clear from the earliest data we had on COVID was that it was, the outcomes were worse in people who were metabolically unhealthy. And those people are more likely to get COVID to start with. So, you know, we can have all the arguments around all the other things around COVID, you know, treatments and vaccines and all of that. But, you know, I don't think it's arguable that if we were to improve our metabolic health as a society, we would be at a lot lower risk from COVID and COVID probably wouldn't have been the pandemic that it has turned out to be if we weren't so metabolically unhealthy.

Right. So we talk about, um, the vaccines, even the boosters, being ideal for the medically compromised. That's— that in some ways is probably the same group, the metabolic— metabolically unhealthy.

That's exactly the same group. And, you know, unfortunately, one of the things that I see going on is that, you know, there'll be, you know, it will be on the news about the young, healthy person that, you know, got COVID or died from COVID you know, all these unfortunate things. And, you know, you can see by looking at them, or it might, you know, have a little bit of information about them in, in the article, that it is clear that these people are not metabolically healthy But it's not recognized, you know, like we talked about earlier, this isn't something that's commonly assessed and tested for in the medical system. So someone, you know, who shows up with COVID and it's assumed that they were healthy because they were not on any medications, they haven't been diagnosed with any of these diseases yet. But the reality is, is that most of those people are not metabolically healthy. As we said earlier, 88% of the adults in the United States are not metabolically healthy. Not being obese does not guarantee that you are metabolically healthy. 40% of people who are normal or underweight are metabolically unhealthy. So, you know, we tend to make this assumption that someone isn't obese and they haven't been diagnosed with diabetes or high blood pressure, and so they're healthy. But then, you know, the reality is that a lot of those people are not healthy, and those are likely the people who are, you know, getting these bad outcomes from COVID even though they're considered to be young and healthy.

So the weight factor, um, if, if there is obesity in the picture, it's likely related to being metabolically unhealthy.

Correct.

But if obesity is not in the picture, that doesn't mean the person is healthy.

Exactly.

Yeah. So we— obesity really is a big factor here. And as you mentioned, you have a history of that problem yourself. You learned to wrestle with it and you overcame it. So what do we do for people that really want to lose weight? Do you have some— are we talking about the basic tried and true recommendations that we hear?

Well, we're not, you know. So the basic tried and true recommendations are to eat less and move more and eat low-fat diet. And so basically, you know, the, the common approach to obesity is to, you know, just eat less of the same foods that you're eating. And I think the approach to obesity should be, and again, this is what has benefited me, this is what has benefited many of my patients, and, you know, we have plenty of data to show that this works, is eat the right foods and then the amounts may not be as important. And the other thing that's real interesting is when you're eating the right foods, when you're eating whole real food that is nutritionally dense and is giving your body what it is actually looking for and needs, you naturally start to eat less of those foods. So, you know, it ends up working. You know, there's always this debate that goes on around low carb specifically about, you know, well, low-carb only works because people eat less and they're eating less calories, so it really is the calories. But, you know, it's kind of a circular argument, and in the end it doesn't matter. In the end, what we know is it works well for people and they're able to sustain it, whereas the other approach of just trying to eat less of the same foods that you're already eating, we know is not sustainable and does not work for people as a whole.

Wow. So we're talking about plant-based diets, a lot of vegetables, grains, nuts. I mean, what's on your shopping list?

Or so, you know, again, I tell people to eat whole real food that's minimal, you know, that eliminates processing. So the things that grow in the ground and the things that eat the things that grow in the ground. So, you know, those are your animal products, your meats, your seafoods, uh, you know, and what they produce, like dairy products. Those are your vegetables and, you know, maybe your fruits. You know, fruits are kind of an interesting thing because they have sort of been processed. You know, the fruits that we tend to eat today are not the fruits that grew naturally, you know, 100 years ago or 200 years ago. They've been modified and processed while they're growing. So, I'm a little cautious around them. But You know, it is interesting, like you said, that can include a plant-based vegan diet and that could be a carnivore diet, two complete opposite ends of the spectrum. But what they have in common is that they're eliminating the processed food. And I think that's most important. I do have some concerns around a pure vegan diet because it does require supplementation, but it can be done. And I work with many patients who, who do it. And as long as your focus is on metabolic health, and this is another thing I go through in my book, that all of these diets that can be done metabolically healthy, like a vegan plant-based diet or a carnivore diet, can also be done in ways that they are not metabolically healthy. And so if you're eating a lot of processed food, even though it's vegan, I mean, people know that Oreos are vegan, but they're not going to benefit your health. So rather than focus on plant-based versus carnivore versus, you know, Atkins versus all of these things, I just try and get people to focus on eating in a metabolically healthy way. And that starts with eating whole real food.

Yeah, that's really a simpler distinction, processed or not processed. As long as it's not processed, we can cover the whole range there, right? We can do the vegetables, we can do the protein, we can do the seafood, the, the beef, the pork, whatever, the chicken. So it's that, that distinction. That's where all of this rests on, uh, non-processed, much healthier for us.

Right. And then I think again, the, the important feedback that you're measuring the metrics of metabolic health as you go along. And you're adjusting based on those metrics. You know, one of the other concepts that I think it's important for people to understand is that there is no one right diet for everyone. And even within individuals, you know, the, the best food to be eating might change some over time. So when you are metabolically healthy, you can tolerate a wider range of foods. Than when you are not metabolically healthy and you're trying to get metabolically healthy.

Great. Now, getting back to these 5 metrics, is there a composite score, or do we look at each of the 5 high or low or average? I mean, could I go to my primary care doc and say, look, I, I want to know what my metabolic health is, use these 5 metrics?

Yeah, well, hopefully you could, although most physicians, a lot of physicians, you know, you know, as I said, aren't really in tune with this and don't understand quite what they're looking at. But the reality is, yes, each of those metrics, you know, has a cutoff for healthy or not healthy. They're in my book, or if people want to go to my website, ifixhearts.co, so ifixhearts.co, it actually takes you through the metric. It has a little assessment tool on there that you can put in your numbers for each of those metrics. And, uh, it will guide you through that. Um, if 3 of the 5 metrics are abnormal, that is diagnostic of metabolic syndrome. If 1 or 2 of those are abnormal though, it's a warning sign that you're headed in the wrong direction and you need to address this. And again, you know, to repeat the statistic, 88% of the adults in the United States do not meet all 5 metrics of metabolic health. Only 12% of adults meet all 5 of those metrics. So that should be your goal to meet all 5 metrics. And they're each, they're each individually important. But overall as a collective, you certainly don't want to have more than 3 of those abnormal.

Okay. So ideally 4 out of 5, 5 out of 5, even 3 out of 5 is better, but it's not great. Correct. Okay, that's good, good to know. So I'm curious, what would you hope our listeners— what's the main message you'd like our listeners to take away from our conversation today?

Yeah, so I think the main message is, first of all, you know, the best way to live long and to live healthy is to focus on your metabolic health, understand what it is, do the assessment, partner with a physician, a healthcare practitioner that understands what metabolic health is and how to optimize it.

But that's great. Very good information. And your website again is ifixhearts.co, correct?

And I also very active on Twitter at iFix Hearts. Um, and then the book is called Stay Off My Operating Table. It's going to be published on November 11th. It should be up for presale, uh, probably by the time this releases on Amazon and Barnes Noble and all the major online booksellers. It will be in an audiobook version and Kindle as well as the print version.

Great. Well, congratulations on that. I'm looking forward to reading that myself. That's good. That's an important document for the American consumer, any consumer, I think, around the world, not just the US. Yeah. Well, it looks like we're out of time for today, but before we wrap up, I just want to remind our listeners about a few items. I'm pleased to announce a co-sponsor for our podcast, A Mighty Good Time. Are you looking for ways to stay engaged and active? Check out amightygoodtime.com. It's a one-stop shop. For events and activities for those 50 and over. It's free to search and it's free to post. Amightygoodtime.com. And also, there's an offering on our website where individuals can arrange one-on-one coaching calls with Dr. Joe— that's me— to discuss bouncing back from setbacks. How can we tap into our resilient self? How can we find ways to make it over those obstacles we face on our different journeys. Take a look at the Work with Dr. Joe tab on the website livingto100.club. Also, be sure to subscribe to our email list to receive our newsletter and other announcements. And pick up a copy of my book on Amazon, Living Longer Is the New Normal. I think that whatever age you're at, inspiration and a positive mindset can be put to good use. That's my message in the book. Well, thanks again, Dr. Arvedia, for being a guest on our program. For those who might want to contact you, can they go to your website?

Yes, go to the website. And if anyone's interested in, uh, joining my practice, working with me as a physician, uh, after you take the metabolic health assessment tool, uh, you can book a discovery call with me or, uh, find out how to sign up for my practice.

Great. Well, thanks so much and keep up the good work. That's important work that you're doing, important conversation to have. So thank you for being a guest on our program.

Thank you, Joe.

You're welcome, and thanks, Jaryun, for listening to this episode. Hope to see you next time.

It's time to rethink, renew, and reimagine retirement. Hey everybody, Jared Sebaste here, host of Retire Repurposed. Now, this podcast is about the non-financial parts of retirement, which many times can be even more challenging than the financial. We believe retirement is not the end, rather the beginning of what could be the most impactful, purposeful, and fulfilling season of a person's life. So don't retire, become repurposed. To listen now, search Retire Repurposed on your favorite podcast platform, Senior Resource, or Life Audio.