Change Your Diet to PREVENT DISEASE & Reduce Inflammation w/Dr. Roger Seheult EP 1156

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This is episode number 1156 with Dr. Roger Schwelt.

Welcome to the School of Greatness. My name is Lewis Howes, a former pro athlete turned lifestyle entrepreneur and each week we bring you an inspiring person or message to help you discover how to unlock your inner greatness. Thanks for spending some time with me today. Now let the class begin.

Lee Hunt said, the groundwork of all happiness is health and Deepak Chopra said, the way you think, the way you behave and the way you eat can influence your life by 30 to 50 years. My guest today is Dr. Roger Schwelt, who is quadruple board certified in Internal Medicine, Pulmonary Diseases, Critical Care Medicine and Sleep Medicine through the American Board of Internal Medicine. He is the co founder of medcram, a medical education company where his mission is to demystify medical concepts for people around the world. And you guys so much enjoyed the first time we had Roger on a year ago that we wanted to have him back on and talk even more about the concepts that we dove into. And a lot of this information is so fascinating and so necessary that I've split this into two parts. The second half will be out later this week, but in this episode we discuss why inflammation is the root cause of disease, the best steps you can take to prevent diseases in your life, how different diets affect our overall health, what happens in your body when you're an infected with COVID 19, how our immune system works, and how to minimize the effects on your immune system when you have COVID 19 and are quarantining at home, and so much more. If you're enjoying this or you have someone you care about you think would enjoy this as well, make sure to share this with them. Quick reminder to subscribe to the School of Greatness over on Apple Podcasts and leave us a review. And we've got incredible reviews every single week. This one is from Kim in the US who said, I love your approach and nature and the way you interact with your guests. You have some of the most interesting and informative people on your podcast. I've gained so much and I've made great strides in my personal growth and development as a result of tuning in. Thank you so much. Big thank you to Kim and again, feel free to leave us a review of your biggest takeaway from this episode. And without further ado, in just a moment, I bring you the one and only Dr. Roger Schwelt.

Welcome back everyone, to the School of Greatness. I'm very excited about our guest. Dr. Roger Schwelt is in the house. Good to see you, sir. Excited to have you back here. Our last interview took off online. People loved it. And I love that you're a type of doctor that is very data driven. You look at the data. You also have an intensive care unit here in California. So you see people coming in who are going through challenges every day. But you also are studying the data that's happening all over the country and all over the world, around viruses, around inflammation and everything else that's happening right now. So I want to start with a a statistic that I saw, according to a report in the Journal of Nature Medicine, that inflammation is the root cause of disease and it contributes to 50% of deaths in the U.S. and I'm curious, why do so many people suffer from inflammation and how is it contributing to so much loss that's happening right now?

That's a great question, Louis. So right now we're talking about coronavirus and COVID 19, and that's a whole section by itself.

Yes.

But as you may know, people get into the hospital because they can't breathe. And the reason why they can't breathe is because their lungs aren't able to get oxygen into them. So if you were to actually take someone's lungs and spread it out. So it was paper thin. Okay. Because that's exactly what we're talking about. What's about paper thin? It would be about the size of a tennis court.

Wow.

So think about a tennis court being wrapped up. That's the kind of layer that oxygen's got to diffuse through. So you know what happens if you hit your finger in the door? It swells up. So that's basically inflammation. And, you know, the Romans had a way of describing this. Everything in medicine is described in the Latin language. There's calor, which is hot. It feels hot. There's rhubor, which it appears red. Okay. It's swollen. That's two more. And there's the last thing. Dolor. And if you speak Spanish, you know what dolor is? That's pain.

Yeah, yeah.

So those are the four cardinal things that you see with inflammation. So imagine that happening to this paper thin thing that you're trying to get. It starts to swell, fluid goes in it. And now instead of oxygen being able to pass right through this paper thin sheet, it's now thickened, it's now inflamed, and you can't get the oxygen. That's why people are dying, because of inflammation in the lung. But it's not just the lung. The number one killer in the United States is heart disease, or it used to be. We're becoming very good at treating heart disease. We'll talk about that. Heart disease and cardiovascular disease is completely. Is a disease almost completely from inflammation.

Really.

It is. So if you were to see angiograms of. An angiogram is where they shoot contrast into the blood vessels of your body. And the ones that we're particularly concerned about are the blood vessels that actually supply the heart muscle. They have to beat continuously every day for the rest of your life. And so they need a good supply of oxygen, which they get from the blood. If those blood vessels become diseased because of inflammation, they start getting ratty. Cholesterol starts to break, and they get clots forming. And that's what happens when you get a heart attack, is those blood vessels close off and that heart muscle which still needs to beat is now being strangled to death. And that's tremendously painful. That's why they get that painful feeling when they have a heart attack. So we just talked about COVID 19. We just talked about heart disease. So let's go down and talk about cancer. A lot of the risks with cancer come as a result of inflammation, really. So, yeah, people who have reflux or heartburn. There's cancers that can come as a result of that. If you have that for very long, called Barrett's esophagus, it's not very common, but it can happen. Hepatitis. Hepatitis is an inflammatory condition of the liver. People can develop liver cancer that can come from viruses. So, yeah, I mean, when nature says that up to half of the people in this country are dying from inflammation, that may actually be a short sale. It may be larger than that. Inflammation is a big deal.

So how do we. How do we eliminate inflammation? What are the main factors that support us?

Yeah, so inflammation by itself is actually not that bad. It's useful when we're in pain. Exactly. Well, it's useful when you need it. So, for instance, how does the body get rid of a virus? It gets rid of it by finding those cells that are infected with the virus and calling all their friends in to destroy that cell. And part of that is inflammation. The problem is when the inflammation goes out of control. And we talked about last time.

Or chronic inflammation.

Chronic inflammation, yeah. So we talked about in our last interview, vitamin D. Vitamin D is one of those substances that looks. If you just look at. Just Google the structure of vitamin D and you'll find out very. That it looks like cortisol. It looks like a lot of the steroid hormones. And these steroid hormones go into the cell, go into the nucleus and they go down to the actual DNA and they can manipulate and they can regulate, that's probably a better term, regulate the transcription of messenger RNA and tell the cells to be more inflamed, to be less inflamed. Vitamin D can do that, Vitamin D. And so that's part of the thought process about how vitamin D might be helping people with these inflammatory viral infections. We don't know for sure at this point how vitamin D, if vitamin d works in COVID 19, but we certainly have good evidence from going back to 2018, published in the British Medical Journal, that steady supplementation on a daily basis or weekly basis with vitamin D can reduce the incidence of acute chest infections. That came out of Ireland, that came out of the UK. Big meta analysis, 25 different randomized control trials.

And that was before COVID Consistent vitamin D supplementation.

Yes.

Reduces chest inflammation. Is that you said?

Chest infections?

Chest infections, yeah. And what happens when you have a chest infection?

Chest infection is like a viral. It's like a cold and it goes down and becomes a bronchitis. And this is what causes a lot of mortality, death. Pneumonia used to be known as the. As the old man's friend. Because it would just put him out of his misery. Really? That's what it was. Yeah, look it up. Old man's friend pneumonia. You can Google that and you'll see. So this idea that vitamin D, lacking vitamin D especially in those northern latitudes may be contributing to that. That's why a lot of countries in the northern latitudes have introduced programs to supplement vitamin D in the dietary. Oh yeah, absolutely. Wow.

Okay, so would you recommend vitamin D for everyone then? Or if you're in sunlight, you're outside a lot, you don't need extra supplementation.

So who are the people that are susceptible to vitamin D deficiency? It would be people who are older because as you get older it's harder to make vitamin D in your skin. Number two, people who have darker skin. This vitamin D is made literally from the ultraviolet B light from the sun. And it's made deep, deep, deep in the sun. So if you've got a lot of pigmentation above that, it's going to be harder. You're going to have to spend more time out in the sun.

Wow.

People who live in northern latitudes, people, you know, living in northern Europe, people living in Canada, the Northwest, actually, anybody living above what we call the 35th parallel, which is sort of the southern border of Tennessee, is not really able to get enough vitamin D. And Luz, we can talk about where we have come as a culture in the last hundred years. So think about this just to sort of set up the rest of the talk. 100 years ago, we spent a lot more time outside in the sun all day than we do. Absolutely. The other thing that's really important is we spend a lot more time sleeping A lot of back 100 years ago.

Absolutely.

What have we done in the last hundred years? Just look at a nighttime satellite image of the United States.

Lights are on.

The lights are on. We have basically turned night into day. And that has tremendous implications for us as human beings, as our culture, our health, our not. I mean, let's just take out, let's just take off the table the fact that we have severely cut back the amount of time we've allowed for sleep. That's number one. Number two, the socio culture in this country that if you need to get some sleep, you're somehow weaker. Right, Right. So there's that stigma. Let's just put that off to the side. There's a whole other aspect to it and that is that light, especially at those very sensitive times before you go to bed, stimulates receptors in the back of Your eye to shut down melatonin production, which is essential. And it's a very powerful anti inflammatory. So you mix all of that together. So think about all of the socioeconomic things that have happened the last hundred years. Think about cities, think about commute times. Think about how early you've got to get up in the morning to get to work, and then how long you've got to work. And then when you get home, what do we do? We want to relax. We turn on the.

The lights.

The lights or the iPhone. And this is hitting our eyes. There's a recent study that showed that the blue light filters don't do a thing.

That's what I heard.

Yeah.

You mean like the blue block, like.

The blockers, Blue light filters? Because it's the blue light particularly, we know this from. From academia that, that seem to. To respond to those receptors the most or stimulate those receptors. The blue light filters don't work.

So you're saying wearing sunglasses or some type of glass blockers and watching your iPhone here isn't that effective?

It could work at a certain point. The sunglasses. What I was referring to was the. Was the actual machine itself has a switch in it that will make the light a little bit more redder, but.

It still doesn't work. Doesn't work.

Gotcha.

So sunglasses might work.

Yeah.

Might help out, but not. Gotcha. Okay, cool.

And then. Okay. Now on top of all that from 100 years ago, we're very agrarian culture. We weren't as rich as we are today. And so as a result of that, we couldn't afford to eat a lot of the substances that we eat today. Processed foods. Let's just talk about vegetarian versus meat. That's a hot topic. Back 100 years ago, it was. Every piece of square footage of land was very valuable. Even though we had lots of it, it was hard to farm. And we didn't have the big industries with the big machines. Right. So we didn't have a lot of that money. So anything that if we grew this off of this part of land, we had a choice to make at that point. Do we feed it to the cow or us, or do we feed it to us? Right. Much easier to do the. To do the former than the latter. Nowadays, since we have so much grain, so much machinery, we actually have vast amounts of acreage in this country that are used to feed cattle. And so we are able to probably more than any other time in our life, eat meat more today than we were able to before, abundantly.

Whereas 100 years ago was probably maybe once a week or something. Yeah.

If you look at per capita meat consumption in the United States, it has never stopped. It's continued to go up.

Really?

Yeah. We're eating more meat today per capita than we've ever eaten before. Per capita.

Yeah. I was just interviewing Dr. Matthew Walker, who's like the sleep expert in Northern California, I think in Berkeley. And he saying a lot of same things that you're talking about. Like even if you, you take down one hour less of one night of sleep, how it impacts the immune system is exponential. And if you do it every night, you sleep less and less. So you have one hour less sleep or two hours less sleep or you miss a few hours. It really impacts the brain and impacts the immune system and all these things. So sleep is a massive factor for having a healthy immune system as well.

Absolutely. No question about it. I mean, they did this study once on some college students. Okay. College students are our favorite. They'll do anything.

Yes.

Pull an all nighter.

Got you.

I'll just put it this way. There's a way to determine where the circadian rhythm is and it's to find the coldest temperature in the 24 hour period in your core body temperature. And the way that the scientists like to do that is to put something up the backside.

Really?

Yeah, that's part of the study. So college students will do anything. But the interesting thing about this study was they had them do an all nighter. How many times as a college student did you do a. Pull an all nighter?

I probably did once a quarter when it was finals, you know, something like that. Yeah.

So the next day they, they checked hundreds of different proteins and they found all sorts of derangements. Things that were supposed to be high were low. Things that were supposed to be low were high. And these are really important substances that regulate immune system function. Looking for cancer cells, some of them have to do with diabetes, had to do with hunger. So all of these things were manipulated just with one night.

One all nighter.

One all nighter, man.

Okay, so sleep is a big thing to help prevent disease, it sounds like. But also inflammation, having inflammation. What are some other factors on how we can prevent inflammation? So get a great night of sleep. What is the research you've shown? Seven to nine hours.

Yeah. So actually the American Academy of Sleep Medicine has come up with some really good recommendations. Once you get out of high school, generally speaking, it's seven to nine hours of sleep. Seven being the bare minimum. Right. And who gets seven hours of sleep? I mean, I mean, I'm preaching, right?

Yeah, yeah.

I should be preaching to a mayor because I need to get more than that. But when you are school age, you know, teenagers, if anyone is watching, it's. It's 8, 9, 10. It's like elementary kids, like 9, 10.

Yeah. Now you're in med school.

When.

When were you in med school?

I was in med school from the age of 21 to 25, which was like 96 to 22,000.

Now why did they put you through such rigorous hours and keep you up late and, and not allow you to sleep that much when they should have known. They should have known. Right. They should know that if you want to be. Make less mistakes, have better decision making, have more like emotional regulation, they should help. I guess med students really learn during the day and have them breaks and.

Right, exactly. And so they figured this stuff out. But to turn the Titanic ship of medical education took a long time. So they knew all of this stuff. The irony is I went from being a third year resident to being a chief resident. That was the next step for me. This was around 2003, 2004, and this is when the 80 hour work week came in. So you're thinking 80 hours, like it's supposed to be 40 hours, right? No, the rule came in at that. Medical residents could not work more than 80 hours in one week period of time. That was the ceiling. And we had to really work hard.

To get that, to not go past.

That, not go past 80 hours.

That's crazy.

So when I was a third year resident, this is in 2003, I was under. There was no rule then the next.

Day, work as much as you want.

Work as much as you have to. Wow.

To get the job done.

I mean, you already had a salary. I don't know if you know this, but residents are paid a salary. I think at the time it was like, I think I was getting like $40,000. Right.

100 hours a week.

Yeah. Worked out the less than minimum wage, but it's all part of our education. Right. And then the very next day, July 1, I walk in and now I'm the chief resident and I have to enforce on those people who are now residents. No more than 80 hours a week. I remember that very clearly.

And you're like, this isn't fair. I had to deal with this and they get to do this.

Exactly.

So why don't they just have you cut it down to a certain amount of hours, less than that and make sure you guys are also healthy and.

Sleeping and clear and it's a balance. Obviously, we want. We want to be working at the. At the highest abilities that we have no question about it. There's a lot of factors that come involved, but basically the dirty secret is, is that medical care in the United States is put a lot on the back of residents because we just don't have enough attendings and medical professionals to take care of all these patients.

Right, Gotcha.

That's. That's basically the bottom line. And so anyway, that's gotcha. Yeah.

So what are some of the main things to help us prevent inflammation? So that if we attract a virus, it doesn't hurt us, you know, or it helps us minimize the pain or the side effects or anything that could hurt us?

Yeah. So we have known for a long time that there are certain risk factors that increase the risk of death in viral infections. Let's say COVID 19 in this case. So BMI is one of those things. Body mass index, age is another one. Obviously, older people get into the hospital and don't do as well. Diabetes, hypertension, all of these things may sound familiar as to who is having the problem. And very early on, we knew that the ACE2 receptor, this is. This receptor on the cells, was the focal point for where the SARS CoV2 virus came in. The spike protein that we've all heard about interacts with the ACE2 receptor. Now, that ACE2 receptor, that ACE2, is not just a receptor to the entrance of the cell. It actually has a very important function in all of the cells, in the respiratory cells, in the GI cells. What it does is it reduces the amount of oxidative components, oxidative stress pro. Oxidative stress components, and it reduces that and it increases the amount of antioxidants. So ACE2 is like this humming engine in each of your cells that is regulating the amount of oxidative stress that's going on. And when that virus binds to it, it shuts it down. So now all of your. So your oxidative stress goes up in that cell and your antioxidants go down.

Okay?

So if you can imagine you're on the edge of a cliff. You are balanced. You are just sort of. And there's. Imagine this cliff, and there's people standing in different places. Okay. There's some people that their oxidative stress balance is right on the edge. Right. And you could probably tell who these people are.

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They're older, they have some diabetes, hypertension, they're on a lot of blood pressure medications, maybe have some renal problems. They're standing right on the edge. And then there's the younger people who don't have these medical problems. They're far away from the edge. Okay. And then this massive gust of wind comes called coronavirus, knocking people off the edge. And who are the people that are gonna knock that? Exactly. It's the ones that are on the edge. And so it's kind of like a stress test. This spike protein comes in, binds ACE2 receptor, and it causes problems. And remember now that when the virus comes into your body, it replicates and replicates and replicates up to some. Some studies have shown a billion to a trillion copies of itself inside one human being.

That's crazy.

And it spreads everywhere. It goes through it, goes to the brain. They've done autopsies. I've looked at the autopsies. That goes to the brain. I've seen slides in the bladder, in the bone marrow, in the heart, in the lungs. It's everywhere. And each one of these trillions of viral particles have spike proteins all over it. So you can imagine the load of spike protein and the complete shutdown of the ACE2 receptor, among other things. Okay, so that is one of the things that we talk about in terms of inflammation. So how do you prevent that from happening? How are you getting away from the.

Edge of the cliff?

Exactly. Because you know, there's a big gust of wind coming. Some of the things you can do for a long time, it takes a long time for it to work. Other things, sometimes you have to implement. You don't have time to do it. Somebody comes in, someone's sick, their diet is their diet or whatever. It is that they've had. Right. So one of the interesting things that's come up in that, there's a guy named Dr. Varki in San Diego that's been studying this thing called sialic acids. This is the newest thing and it's actually very interesting.

Sialic acids.

Sialic acids. So I won't even talk about the fact that some people believe that the virus actually uses sialic acids to enter into the cell. That's a whole other topic. What I will mention though is we're all used to seeing the outside of cells on these, you know, these animations that they see on the tv. And they've got proteins coming up, right?

Yes.

So imagine my arms are the proteins and imagine I don't have a hand. That's kind of how they've been describing it. But that's actually not reality. Reality is that you've got proteins and then my hand. Think of on my hand as glycoproteins. Glycoprotein, that's a sugar and a protein put together. And then my fingers are the sialic acids.

Okay.

Okay. Yeah. So really, it's the part of the cell that is the first thing that gets touched. Sialic acids are really important.

Okay.

Okay. It's a 9 carbon sugar. And actually, if you were to go to, let's just say, HIV vaccine convention, almost the entire convention would be on sialic acids. Why? Because the HIV virus masquerades itself with sialic acids. That's why we haven't been able to get a vaccine for hiv. Because sialic acids are sort of like, put it this way, the Christmas tree is the protein, the decorations. Sialic acids.

Okay?

That's what we're talking about.

Gotcha.

So here's the problem. The problem is with sialic acids is that the human body can only make one type of sialic acid. Let's call that new neu5ac. I'm going to get a little wonky here, okay? But people want to look this up, so I'm just going to call that ac. So a human being makes a certain type of sialic acid on its glycoproteins, on its proteins, on its cells. That is called ac and that is self. Now, we used to have a gene. Apparently we used to have a gene. It's non functional now.

Really.

That used to make a different kind of sialic acid called NEU5GC. Okay, but we don't make it anymore.

Okay, why don't we make it? When did we stop making it?

Good question. The Biologists have their theories millions of years ago and all this sort of stuff. Yeah, but we don't know, right? We don't know for sure because we weren't there. What we do know is that animals makes both AC and gc.

Okay.

Cows make ac, gc. Any mammal makes AC and gc.

Okay.

Okay. So here's the problem. When you consume those animals that make AC and gc, okay.

What happens?

What happens is, is it goes into your digestive tract and it breaks it down. And the body absorbs the AC and the gc. It can't tell the difference between the two. And then it gets. It gets absorbed whole in the body and the AC and the GC gets put onto your cells.

Okay, okay, so we're getting animal GC now.

Yes.

What does that mean to us?

The problem is, is that you have antibodies against gc because it's not self.

It's not self. It's not us.

It's not us. We have antibodies in our system. It's not hardwired. But almost all humans develop antibodies against GC by the age of one.

Okay, okay, so if we're consuming gc, what does that mean?

That means that now that GC gets put onto our cells and our cells start to look to our immune system as foreign.

So our cells are what, defending themselves against it.

Then the antibodies start to react against the cells with the GC on it. And what they get, what they call it is a sialitis. Sialitis, itis. Anything in medicine with an itis at the end is inflammation.

Okay.

Pancreatitis, appendicitis, all of that meningitis, just inflammation. So you get the sialitis. And that they believe is one of the potential reasons for low grade inflammation. So they always consuming meat. Yeah. So they always wondered, okay, how come people who eat white meat, chicken, fish, how come they don't get the levels of heart disease?

Why is that?

This is what they think may actually be the reason they could never figure that out. They did studies, huge epidemiological studies in the United States and in Europe, and they found that in some of the studies that it was only processed meats that were associated with cardiovascular disease, and regular meat was not. But.

And what's the difference between processed and regular?

Good question. So processed meats would be like sausage. Yes. It would be like cold cuts. It would be like those. Yeah. Right. So those are. But red meat looks like the pure red meat that you'd buy at the supermarket. Okay, so that's the difference. But newer studies are now starting to show that it doesn't matter if it's processed or not processed, that you still.

Get red meat you're talking about.

Correct.

So white meat doesn't have the gc.

It does not.

Interesting. Okay.

Fish does not fish.

Not chicken.

Yeah. So here's a study that was done, and they said, okay, so let's connect this together. So here's an interesting study that they did. They got a bunch of people and they said, give us exactly your dietary habits for, like, 30 days. And so they wrote down. It was meticulous. And then what they did was they went out and they looked at the food and they figured out in that particular food item how much GC was there. And you should see this list. It was a French study. I'm glad it was a French study. And I'll tell you why. Because they listed every type of cheese you could possibly ever imagine. Wow. So because cheese is part of it. So you had, you know, mozzarella at the bottom, and you had hard cheese at the. I mean, and so they listed it because there's a big spread. Some. Some cheeses have hardly any GC in it, really. Other cheeses are just packed. Certain meats have a lot of pork, has a lot of gc. Other meats don't have as much. And what they did was they. They stratified it and they weighted it, and then they looked at the diet and they tried to figure out, okay, how much anti GC antibodies did they have? And they matched it up, and it was this perfect correlation. So the more you ate of high GC foods, the more inflammation you had, the more antibodies you had. And they linked it to colorectal cancer risk.

Oh, man.

So the antibodies. The more GC you have, your body's creating antibodies.

Correct.

And those antibodies cause inflammation.

That's correct. This is an immune system response. So when that antibody attaches to that antigen, that triggers an immune response because it's a foreign substance, and that's what causes inflammation. So what you have then is inflammation in the. In the blood vessels, inflammation in the colon that can cause colon cancer. So again, getting back to that nature article, Inflammation probably causes more than 50% of deaths in the United States.

Now, you are practicing near the Loma Linda area.

Right.

You're not in Loma Linda, are you?

I'm not in Loma Linda, but I practice close to it.

Yeah. Very close to what, 10 minutes, 20 minutes away.

Exactly. Yeah.

And so some people might say, well, is he influenced by the blue zones and by being in this region where it's most primarily vegan, in Loma Linda, I think that's right. It's mostly vegans. So does that play any influence into you?

It sort of gets me interested in that topic.

Interesting.

But here's, here's.

Do you eat meat yourself?

I used to.

Not anymore, no. Because you saw the data or because of other reasons?

Because I saw the data.

Really?

I stopped eating meat in college.

Really?

Yeah. And I didn't start getting into this until like a year ago. Started looking into this.

So why did you stop eating meat then? Was it.

I think it was the influence of me being in Loma Linda. Really? Yeah.

And just being around.

But here's the interesting thing. So if you look at the Adventist health study too, Adventist health study too.

Which is Loma Linda, Adventist, pretty much.

Actually, basically California, Southern California. 50% of the people involved in that study, which were Adventists, 50% of them were not vegetarian. Really? And this was the interesting thing about the study was because a lot of times when they do these epidemiological studies on diet, there's a lot of confounders. Right. Okay. So here you had a unique opportunity to take a very narrow set of people, people living in Southern California, subject to the same air quality, had the same values, went to the same kind of churches. But because there's. It's not a strict religious requirement in the Adventist church to be vegetarian. It's a dietary lifestyle, they were able to eliminate a lot of those confounders and compare the vegetarians with the non vegetarians, with the pesco. Vegetarians, vegans. Oh, yeah.

So what do they find in this study?

Well, if you line up, let's say you got vegans right here. Okay.

There's some unhealthy vegans. I've seen some really unhealthy vegans who eat tons of processed potato chips, soda, sugar. Absolutely. You can eat sugar all day and bread.

Absolutely.

And create a lot of information still.

Right?

You're absolutely right.

Okay.

But I would say in the Adventist church, people who are vegan tend to be that way because they're health conscious. And that's the argument that a lot of people used, was that, yeah, vegetarians and vegans have a better mortality rate because they tend to be health conscious people. And it's their health conscious activities, like smoking in general that's doing it. But here, see, now you've got the ability to kind of eliminate those confounders because generally nobody in the adventure smokes. Right.

Okay.

So you can see what I'M saying, so if you got the vegans here on the right or on the left to you, I guess, and then the vegetarians, and then the, what they call the pesco vegetarians.

Fish only.

Exactly. And then you have basically the non vegetarians. It was a step.

Any type of meat.

Any type of meat.

Okay.

Any diet. Yeah. You have this stepwise approach in terms of BMI and the same step wise approach in terms of diabetes and the stepwise approach in terms of hypertension.

Really?

Absolutely, yeah. It was published.

There's so many people that are not going to like this conversation that swear by this carnivore lion meat eating diet.

Absolutely.

That say I had all these inflammations, diseases, physical ailments, pain, when I was only eating vegetarian. I only need these certain types of food, raw, vegan, vegetarian, whatever it may be. And then when I went on the steak only diet or this diet, it went away.

Yeah.

And I lost the fat and I felt healthier and I felt clearer. Yeah, I've heard that by many people over and over again. What would be the cause of that, do you know? Or is it just certain body types?

Maybe, you know, it's. There's a Gaussian distribution of people. And so we can't. All we can really say is look at the, the data. Right. In terms of that data though, I would, I would. There was an interesting article that came out. Like we're talking about Paleo, basically.

Right.

Paleo diets, Atkins diet, what was referred to the Atkin diets before. I'm sure there's differences between keto diet, Keto diet. So. So there was a study that I found that was really interesting. This was a study that just came out, it was published. I have it here in front of me here. And my eyesight is going bad. I don't know.

You need some meat.

So the name of the study was plant based diets, pescatarian diets and COVID 19 severity, a population based case control study in six countries.

So plant based diets.

This is plant based diets versus pescatarian versus and other diets. So there was this, there was this network of health care providers in Spain, Italy, France, Germany, UK and the United States. Okay. Pretty western. Yes. And most of these were healthcare providers. There basically was this network talking about, what are you doing for Covid? What are you seeing over there? What should we be doing here? They used this network to send out a very detailed dietary questionnaire where they had at least 18 different meals that had been surveyed. Detailed. Okay. So it was very good and these are all, most of these were male physicians. Okay, I'll just put it out there. Okay. I think it was like 70% male, 30% female. There were some nurses involved in this, but all of these were healthcare providers. They were all, I mean, you can imagine we're not talking about low socioeconomic versus high socioeconomic. So again, we're narrowing the field here. We're trying to get rid of these confounders. And they asked them, you know, what kind of diet do you have? And then the reason why they went for this is because these were the people that were highest at risk for getting Covid.

They're in the hospital, the healthcare providers.

Exactly. They're treating patients.

How many people were in the state?

This was a 3,000. So they said here that 2,884 frontline healthcare workers from six countries with these different.

Yeah, yeah.

France, Germany, Italy, Spain, UK and usa individuals who reported following plant based diets and plant based diets, or pescatarian diets that were higher in vegetables, legumes, nuts, and lower in poultry and then red and processed meats. Okay, so those. And they, what they were able to do is divide these people into the plant based diet versus and they specifically said this, high protein, low carbohydrates, keto.

Paleo type of diets.

So. Because a lot of times people say, you know what, in those studies where people had high fat diets, high protein diets, did they ask them were they eating a lot of carbs? Because it's the carbs that cause the inflammation, at least, as the saying goes. Right, right. The bread and the breads and all.

Pastas and all that stuff.

So here you have physicians and most physicians that I know that would say, yeah, I eat a high protein, low carb diet. They're doing that because they want to be healthy. Right, right. So they're not probably engaging in other health risky behavior. So when they actually looked at all of these and they, and they checked them out for where they worked in the hospital. Right. Because that's important. The pulmonologist is probably going to get a higher chance of getting Covid than a radiologist. Right. It's not going to come through the screen. Right, right, right. So when they did that, it was astounding because what they found was that those physicians and healthcare workers that said that they had a high protein, low carbohydrate diet had four times the risk of moderate to severe COVID 19.

Really?

Yes.

Four times the risk. That means they were getting it.

They were getting It. They were contracting it. So they said here that how many actually contracted it? There were 568 COVID 19 cases and 2,316 controls.

Got it.

And they said here that I'm assuming.

They'Re all wearing their masks. Are they all vaccinated or non vaccinated?

This is before the vaccine.

Gotcha.

So they're all wearing their masks. Who knows if we don't know how many more people they're in contact with who had it. But you'd assume that they're all wearing their mask and.

Right. So this is not a causation study up front. This is an association. And we all know that association does not mean causation. Yes. So all we can say is that it was associated.

Right.

So we can say that it's not.

The cause, but it's associated with.

Well, we don't know that it's the cause. It could be the cause, but we don't know. It's kind of like, you know, having a cigarette lighter in your. In your pocket and then saying it's associated with lung cancer. But is the cigarette lighter actually causing the lung cancer or is it associated with the smoking? Exactly. Okay, so that's the same thing. So the question really boils down to what are those doctors doing that say they're on a high protein, low carb diet that's causing them to have four times the risk of severe COVID 19. Is it the diet or is it something else? They're doing the study can't answer that. Right.

But those people were eating a different diet.

They were eating a different diet. Whether that's the cause or not, we don't know. But it's associated with it.

Right. So do they have a lighter in their pocket too? We don't know.

But when you put that together with what we were just talking about, with that cliff. Right. And the fact that that kind of a diet is probably going to have higher sialic acid. New 5 GC.

Yes.

Is that what's pushing them to the edge and causing them to fall over or at least getting them to the point where they're almost falling over.

Right. So essentially we want to eliminate every factor that could be closer to the edge.

Right.

And GC is one of the factors. And this is what that is associated with.

Meat.

Correct.

But not fish. Is that right?

Not fish.

Not fish or chicken.

Right. And so not fish or chicken. And so that's the interesting thing there is that they mentioned pescatarian or vegetarian. So pescetarian was grouped in with that Interesting. Yeah, it's really interesting. So it's this kind of this Swiss cheese model of how I look.

Explain the Swiss cheese model.

Yeah. So people say, are you pro vaccine? Are you anti vaccine? Are you pro vitamin D? Are you antivitamin D? And I look at it, say, look, people hear me talk about vitamin D and hydrotherapy and all these great things that we can do to treat Covid that have nothing to do with the vaccine. And they automatically think that, well, he's saying that because he doesn't want to take the vaccine. And then I talk about the vaccine and the things that it does, and people say, well, you're just talking about the vaccine. You're not? No, it's the Swiss cheese model. So what's the Swiss cheese model? So imagine a big block of Swiss cheese with all the holes in it, you know, like you see on Tom and Jerry. And you chop it up, and if you were to pull out any one of those slices, you would see that there's a hole in it somewhere. And you pull out a different slice, and maybe there's a hole somewhere else. But the point is, is that when the bullets start flying, hopefully the Swiss cheese stops it. But when the bullets start flying, the holes are in different places. So if you were to wear like a bulletproof vest, if you just wore one sheet, you could get hit, Right? But the more sheets you put on, because each intervention works in a different way, the advantages of one intervention are going to help out where maybe there's disadvantages of another intervention.

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The whole Swiss cheese model helps. It's kind of like in the operating room. We don't want to have post operative infections. It's really important that we don't have postoperative infections because they can be lethal. So think about all the things that we do in the operating room to prevent that. Surgeons wear masks.

Wash your hands.

We wash our hands. Exactly. Gloves, we put on sterile gowns. We have positive pressure ventilation in the room that we have a scrub nurse who monitors everything. We sterilize the equipment. Right. So if we say that sterilizing the equipment works, we don't say, well, sterilizing the equipment works. Why are you wearing masks? We don't say that. Right.

You fill all the holes.

Exactly. We want to make sure that we approach 100%. And the best way to approach 100% is answering the test question. All of the above. And that's the, that's the method I take.

So what are all the above ways to prevent contracting this or any type of virus?

You know what, it's redundant. The good news is, is that if you, if the evidence shows that if you line up your lifestyle to prevent diseases in general, you're going to do great. Against COVID 19 and any variant that comes along with it. Okay. So. So you really need to, to set yourself up. And that, that is really. There was another study that showed that a. Another study, this is not the different study that showed that a vegetarian diet reduced the risk of severe COVID 19 by 73%.

A vegetarian diet?

Yes.

Wow.

A history of a vegetarian diet in there. Yeah. So that's just one. Okay, so what are the other things? Sleep. We could talk about fresh air, we could talk about sunlight. We could talk about stress. We could talk about so all of those things. But you know what? I have seen people and I'm in the intensive care unit. I work in an intensive care unit and it's a one unit hospital. What I mean to say is that if anything happens on the campus of that hospital, whether it's a surgery, whether it's a hangnail, whether it's a delivery and it goes wrong, it shows up in my unit.

Really?

So nobody dies in that hospital without coming through my unit first.

Wow.

Sometimes I'm the last person they see.

They get sent to you if something really bad.

That's correct. We don't have a surgical ICU and a medical ICU and a cardiac icu. One icu, one icu and it comes.

It's a baby. If it's a grandparent baby goes to the nicu.

They would go to a different hospital.

Gotcha.

Because I'm not a pediatrician, but. Yeah, other than the mother. The mother would come. If she was in danger, she would come to our unit. Absolutely. So the point is, is that I see all of this stuff and I can tell you that I have seen people with COVID 19 in my unit that didn't have risk factors. And they were pretty young.

They didn't have risk factors. No.

Really?

Yeah.

They ate.

They ate well, they seem to be. They weren't obese, let's put it that way. Maybe. And I didn't ask them if they, if they had had a vegetarian or non vegetarian. So. So. And that was back when we didn't have the delta variant. We are seeing now with the delta variant that it is hitting younger people. It's hitting people without comorbidities harder than they are in the non delta. Oh, yeah, absolutely.

So.

So what I am saying is, is.

That are the, are the, the younger generation that you're seeing in this unit, are they recovering? Are they passing away? How's that?

It's been so. It's been so recent. Like here in Southern California. We're Talking here. What? April. Sorry, August17 today. Right, yeah. So we're talking. This is early August. We're just starting to see a couple weeks. And they're still on the ventilators.

Really?

Yeah.

How young are we talking?

30S.

Really?

Yeah, late 30s. Wow.

So they come in because they're at home quarantining, they can't breathe and they're like, I need to come in.

That's right.

Gotcha.

Yeah. And there's, there are. So we, we've talked about lifestyle and obviously you can't do lifestyle changes. When you get COVID 19, you can do it, but the effects are not going to kick in right away. So the question is, what things can we do? We know what we can do in the hospital. We have treatments in the hospital like dexamethasone. We have treatments in the hospital like anti inflammatory mediators. Like we talked about inflammation as the problem in the lung. Right. So there are medications like something called tocilizumab, which is an antibody against IL6, which is supposed to reduce inflammation. We're not really seeing it help with oxygenation early on. That's something we can do in the hospital. We can talk about all of the things like getting enough sleep, like making sure your vitamin D levels are good, like making sure that you're getting enough fresh air and sunlight. And that can happen on the way to it. But what do we do during that period of time where you've contracted COVID 19, but you're still at home, you're not sick enough to be admitted to the hospital. That's a very important period of time.

What should you do then?

That's about seven days. So to understand what you need to do during that period of time requires you to understand what's happening. Okay, now, so let's talk about the immune system. There's two parts to your immune system. We talked a little bit about this last time, but let's get into it. There is the innate immune system. The innate immune system are all the cells that go around your body and eat up things, macrophages. And they're not educated on what the protein specifically looks like. They just know that it shouldn't be there. This is the innate immune system. The innate immune system is very powerful when you are young. As you get older, the innate immune system becomes less and less powerful. The innate immune system is the immune system that is responsible for making a fever. Kids get a viral infection at the drop of a hat. They've got a fever. It's very.

The fever helps fight against it.

Yes, exactly. And that's where we're going with this. And but on the other hand, adults who get infections, they rarely get fevers. They don't get fevers as often as kids get fevers. And the reason is because the innate immune system in the young is very strong. The key here is that you need a very strong innate immune system because it shuts down viral replication. One of the products of the innate immune system is a substance called interferon. You may have heard of this. It's a very well named substrate. It's a very well named substance because it interferes with the virus.

Okay, Interferon.

Interferon. So remember that. Interferon.

We want to have that.

We want to have that.

Yeah. How do you get that?

You get that from your cells and having a very strong immune system. But there's another way you can get it. We're going to get to that. Now, that's as opposed to the adaptive immune system. The adaptive immune system is a different part of your immune system. It's the part that comes afterwards. It's the part of your immune system that recognizes antigens and makes antibodies. The problem is, is that the adaptive immune system comes in about seven days later. And what happens is that it starts attacking all of the cells in your body that are infected. So this is the typical scenario for somebody that ends up with COVID 19 in the hospital. The innate immune system is there. It's trying to fight this virus. There's this tug of war going back and forth for the whole week. The virus is suppressing the innate immune system. The innate immune system is trying to suppress the virus. The virus does a workaround and gets into cells and starts infecting many, many, many cells. Okay. And so the person's just sort of, just sort of going along for the week. Then all of a sudden, day seven, day seven, the adaptive immune system comes online and they see what's happened. It's kind of like the parents just came home. Sure, okay.

Yeah, right.

And they're like, wow, all of these cells are infected. Go to it. And now you have an immediate reaction that goes against all of these cells, especially the cells in the lungs, because that's where the virus got into. And that's why these people start to have inflammation in the lungs. You got your tennis court now being swollen.

Interesting.

Exactly. So the problem is in COVID 19 failures is that the innate immune system is too weak and the adaptive immune system is too strong.

So what can you do in those first seven days to make sure. It minimizes that.

So what I propose, and we're looking at this, but if you look at history, if you look at history, this seems to pan out. Boosting, enhancing the innate immune system is a great way to suppress it. How do you do that? Well, interferon, one of the ways that has been tried, looked at is by increasing core body temperature for about 20 minutes at a time at a time.

Multiple times a day, up to two.

Or three times a day. It's been done. Yeah. And then cooling it down. And then doing a brief cool down. Hot. I mean, very, very hot. And then cold. So where did this come from? A couple things. There's a guy by the name. We talked about this before, I think Dr. Yorag, he took these neurosyphilis patients in his clinic and he noticed that when they got a fever, they got better. So he injected them with malaria. Okay. So he took out blood from people with known malaria and then injected the blood into. Oh, yeah.

That's crazy, isn't it?

That's what he did. I mean, it was well controlled. He monitored him very carefully. And they developed high fevers. The high fevers caused the interferon to go up. There was a study, experiment where we checked in a study, the amount of interferon coming out of cells at various temperatures. By the time it got to 39 degrees Celsius, which is about 100 and. 102 somewhere in there, don't quote me on that. But around that area, a fever. Interferon level spiked tenfold. Tenfold. Interferon does a great job at killing viral infections. Do you know we used to have patients with chronic hepatitis C? Hepatitis C was a big problem. I was trained in the VA system. We had people, they got it from tattoos, from intravenous drug use. Hepatitis C. Chronic hepatitis C. It's basically a bloodborne virus and it infects the liver and causes cirrhosis after many years. Do you know today we can cure hepatitis C? Do you know how we do it? High doses of interferon. It's called pegylated interferon. And we can do that.

Does that cause a fever?

No, it makes you feel like you have the flu.

Really?

It does. Because it's exactly what it does.

Fights against it, it kills.

It just eliminates the virus.

So.

So do you want to. So when you. When someone gets a fever in general.

Yeah.

Do you not want to eliminate the fever? Do you want to keep the fever?

Exactly.

You want to keep it.

Exactly. Unless it's causing problems. Now, remember, not Fever is a good thing. Fever is a good thing.

Wow.

It's a great thing to have. And so what are we doing with fevers? We're giving Tyler paracetamol in Europe.

We don't want to do that.

We don't want to do that. Unless the fever is so high that it's causing the heart rate to race or the patient is becoming delirious.

I used to always just put, like, a cold rag on my forehead, and it made me feel better. But do I not want to do that if I have a fever?

That's fine. Cooling down. Your head is fine.

Okay.

The rest of the body. So what do they do in these things? And it's interesting what has been done in history. If you look at the 1918 pandemic in the army hospitals where these soldiers were coming back and they had the flu, they thought. The doctors at the time thought that they were dying from the symptoms of the flu. Fever, muscle aches. Hey, we have aspirin. Aspirin just came out in 1899. So they were dosing them up the wazoo with aspirin.

For the muscle pain?

For the muscle pain and for the fever. It took care of the fever. Some of these people were probably toxic. I mean, we killed a lot of people, unfortunately, with aspirin. The saying was that the German Bayer aspirin killed more patients than the German bullets.

Oh, my goodness.

In the first World War. Now, there was a group of hospitals at the time in northeast United States that was not doing that. What they were doing was the opposite. Instead of bringing the fever down, they were doing these treatments, the fever up. They were putting them. They were placing very hot packs on them, increasing the temperature so they were sweating. They were putting their feet in hot baths. This is 1918. These sanitariums, as they were called, those hospitals, they didn't have the modern medical things that we have today.

Hot, cold, hot cold. That's about it.

And so what they found was this. This is really interesting when they looked at how many people came down with the flu and then progressed to pneumonia and then finally to death. They found that in the hospitals where they were practicing what they call fomentations or hot packs, that they did the best job at preventing the patient from going to pneumonia. But once they got pneumonia, it's hard. It didn't work. There was about a50.50 chance of them dying, by the way. It was about a 40% chance of them dying in the army hospitals. So the army hospitals were doing a little better job at once they got pneumonia going to death. But the thing was is that in the sanitariums hardly anybody was going to pneumonia. And so at the end of the day there was about a 1.5% case fatality rate in the sanitarium and over 6% in the army hospitals. So what happened? So, you know, this led to a lot of intrigue and studying this. And this is where Wagner Yorag got his idea from. It was this melu, this environment of understanding of heat and cold and hydrotherapy and this sort of stuff. And he got the Nobel Prize for doing this in 1927. Very intensive. It's difficult. You've got to place the patient down. It takes time. You have to set it up, you have to heat the water up, you have to do all of these things. And so by 1928 we discovered penicillin. Penicillin is a pill. Manufacture it, you can give it to people and it's a lot easier to do. So you have a choice, do you do the hot fomentations or you just give them the pill? That's a lot easier to give the pill. And so that's where we as a, as western society. And look, I'm, I'm a critical care physician. I give medicines out all the time. It's useful when a patient comes in with a stroke, I give TPA to break up the stroke. I'm going to do that before I do hydrotherapy. That's. That has to work really quickly. So just because I'm talking about these things doesn't mean that I'm not. I want the best of both worlds. I'm the Swiss cheese model.

Yes, everything that works, let's do it.

Exactly. And so, and not to say that because this works, we don't have to do this. Not to say that because we're sterilizing the equipment we don't have, the surgeon doesn't have to wear a mask. Right. Everything. All of the above. Because that's really what we deserve.

Thank you so much for listening to this episode. If you enjoyed it, make sure to share it again. Don't forget to check out part two coming soon in a couple of days later this week. Make sure to check that out. It'll be the next episode coming out. And if this is your first time here, thank the person that sent you, whoever texted you this link, whoever posted this on social media, just send them a message, message back thanking them and also click the subscribe button right now. Leave us a review. Let us know what you enjoyed most about this and spread the message of greatness to someone that you care about. You can text a friend, you can put it in a WhatsApp group chat, put it on social media. Just make sure to tag me when you post on social media so I can stay connected with you as well. And I want to leave you with this quote from Dennis Waitley who said, time and health are two precious assets that we don't recognize and appreciate until they have been depleted. Time and health. That's what it's all about. Maximizing our health, maximizing our time, making sure we're taking actions, doing the things we enjoy to do the most. I'm so grateful for you. And I want to remind you, if no one's told you lately that you are loved, you are worthy, and you matter, and you know what time it is, it's time to go out there and do something great.

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