Episode 62: A Hearty Chat – Cardiovascular Disease

The content of this podcast has not been evaluated by Health Canada or the FDA. It is educational in nature and should not be taken as medical advice. Always consult a qualified medical professional to see if a diet, lifestyle change, or supplement is right for you. Any supplements mentioned are not intended to diagnose, treat, cure, or prevent any disease. Please note that the opinions of the guests or hosts are their own and may not reflect those of Advanced Orthomolecular Research, Inc.

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Welcome to Supplementing Health, a podcast presented by Advanced Orthomolecular Research. We are all about applying evidence based and effective dietary lifestyle and natural health product strategies for your optimal health. In each episode, we will feature very engaging clinicians and experts from the world of functional and naturopathic medicine to help achieve our mission to empower people to lead their best lives naturally.

 [01:08] Start protecting your heart today with AOR’s Met SYN-568R or Red Yeast Rice for those in Canada. It has been clinically shown to promote healthy cholesterol levels and promotes healthy cardiovascular function without the undesirable side effects of Monacolin K. Learn more at AOR.ca or AOR.us.

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[01:25] Cassy Price: Welcome to Supplementing Health where we explore the health and wellness space with industry experts touching on and applying evidence based natural health strategies for your optimal health. Today I have the honour of Dr. Joel Kahn joining me to discuss the reversal or cardiovascular disease through lifestyle habits and natural treatment. Dr. Kahn has practices traditional cardiology since 1983 and through his own commitment to plant-based vegan diet he began to delve into non-conventional diagnostic tools, prevention tactics and nutrition-based recovery protocols. Welcome Dr. Kahn. Thank you for joining me today.   

[02:00] Dr Joel Kahn: Well, thank you so much. I am excited.

[02:01] Cassy Price: Okay, so, cardiovascular disease is a name for a group of disorders for heart and blood vessels. Would you share some of what the conditions and disorders are that fall into this overarching grouping?

[02:13] Dr. Joel Kahn: Well, that is actually a very intelligent comment. So, I’ll compliment you. We hear over and over and we should hear over and over that the number one cause of death in 2020 in the United States, the number one cause of death in Western countries around the world is cardiovascular diseases. Some of those are heart attacks, sometimes called a subset coronary heart disease. Coronary usually refers to arteries around the heart. So, clogged arteries causing chest pain and causing heart attacks, that can cause death and need bypass, need stents, that is a big piece you hear about it all the time. You can have a heart attack that weakens the heart and leaves somebody with congestive heart failure. There are other reasons you can have congestive heart failure. Those are cardiovascular diseases affecting many people and really impacting people’s lives negatively. You can have rhythm problems of the heart, skipping beats, fast beat, slow beats, pacemakers. Those are all cardiovascular disease. We also include brain vessels, so strokes fall into cardiovascular disease. Leg circulation leading to amputation. It is really anything blood vessel related that impacts health and when you lump all of that together it is filling hospitals and filling critical care units and robbing people of life span and robbing people of quality of life. We can prevent most of it.

[03:37] Cassy Price: Awesome. So, I understand that you yourself follow a vegan diet. How long have you done this and what are the differences that you have noticed during this time?

[03:44] Dr. Joel Kahn: Yeah, I am an OG, original gangster vegan because I just turned sixty-two and I started a vegan diet at age eighteen at the University of Michigan in the dormitory. My first week of undergrad. I hated everything but the salad bar. It wasn’t really a picky thing. It was based on keeping kosher dietary laws, so the salad bar worked. I felt so good, and my girlfriend, who is my wife of forty years, after a week we both felt so good we never ate animal products again. We didn’t have a name for it. We weren’t vegan. We were just people. As the movement grew and as I became a doctor and studied the science, wholefood plant-based is a little more medical name for it all but yeah, good stuff.

[04:31] Cassy Price: So, it is well known that diet plays a major role in cardiovascular disease and reducing that risk. Researchers have found that plant-based diets are best for reducing the risk of CBD so would you walk me through some of the supporting research and the findings that are most promising in your opinion?

[04:48] Dr. Joel Kahn: Sure. I mean going way back because I am an OG when it comes to the research on this too. Going back to the 60’s and the 70’s because there had been a spike in heart attacks after world war two in the fifties like President Eisenhour. A lot of funding started going to why do people like President Eisenhour almost died of heart attacks? Fortunately, he ended up living for about fourteen more years, but he had a serious heart attack. A lot of it focused on diet. We knew smoking was a factor of course and thank god most Americans have quit smoking and other Western countries. There are still too many that do smoke. The diet thing focused more and more on fats, and to be sophisticated, saturated fats. Food rich in saturated fats are associated with a higher risk of heart attack and an early death. That is the eggs, that is the bacon, that’s the cheese, that’s the lard, that’s the croissant, that is the full fat dairy, that is the red meat, white meat, chicken and turkey. You can eat a little bit of that stuff. You are not eating that much saturated fat, but chicken is like the holy grail in the United States in the last twenty to thirty years. Chicken is healthy. Chicken is full of fat, chemicals, salt and other ill-chosen choices for your health. Then we found out what prevents heart disease. Every study around the world will suggest more fruits, more vegetables, more wholegrains, more legumes, the beans, the peas, the lentils, for avoiding heart disease and reducing the risk of type 2 diabetes and obesity and improving your brain health long term and probably for longevity.

[06:29] The study of people that live to super long age they eat very, very, plant-rich diets. There are other fats. Avocados, walnuts, seeds, nuts, maybe extra virgin olive oil, but they are low in saturated fat. The difference between butter and extra virgin olive oil has been studied in many studies and they are not the same fats. They don’t have the same impact. It is really the enemy and every medical society around the world agrees, although there are voices out there that would argue opposite, but they are the minority, and they don’t have the science to back them. It is cut back on your saturated fat which is typically to cut back on animal foods with the exception of coconut oil and palm oil. They are two super, super, high saturated fat food options and it is best to avoid them even though the science isn’t completely abundant to declare them off our menu. They should be off our menu.

[07:34] Cassy Price: So, one of the negatives that we hear a lot about vegetarian or vegan diets is that it can lead to vitamin b12 deficiencies if not very carefully planned and monitored.

[07:47] Dr. Joel Kahn: You are absolutely right. The interesting thing is, I am not here to defend anything, and I don’t criticize people who aren’t vegan. I just want them to eat a lot of salads and apples and the whole nine yards. Vegan science has identified, because in nature and in history there have been many plant-forward societies, I mean in Okinawa traditionally where they had amazing longevity in the 1930’s/40’s/50’s in that Japanese Island they were eating far fewer than 10% of calories from animal foods. So, we have to ask legitimately the question. I am forty-four years into this. You can punch me and squeeze me and see if I am still alive and in good health and thank goodness I am and I am on no medications and at sixty-two I have enough energy to take on the world but with all that said and done it is a legitimate science question. We actually know that there are a number of nutrients even with a well selected plant-based diets it can be a little deficient like b12, like vitamin d, like iodine, like vitamin k2. We have the science so you can just plan to supplement then or plan to measure them and then supplement them if you want to. Now the reality is that most diets in the United States in the last fifty years are deficient in nutrients. That is data from the 1930’s that 85% of the population was deficient in magnesium. That’s nuts and seeds and greens and leafies.

[09:23] 80% of the population in certain urban settings are deficient in vitamin d. We talk about it in the plant-based community. We test for it and we correct it. Honestly that same approach should be taken by people of other diets too. They should ask “hey, can you check my vitamin d level, my zinc level, my iodine level, my magnesium level, my selenium level?” These are pretty simple standard blood tests that are available and if you are doing an odd diet, even if you are doing an ‘average’ American diet I still would check because the odds are you are deficient. Take an inexpensive broad-spectrum multivitamin three or four times a week and it will cover the bases.   

[10:11] Cassy Price: So, phytocannabinoids are another nutrient that are abundant in a plant-based diet, especially in foods like grapes and broccoli and cabbage etc. They have been shown to have many benefits like neuroplasticity and facilitate neurological cell growth. Are there also benefits from phytocannabinoids for cardiovascular system?

[10:33] Dr. Joel Kahn: I don’t think anybody has ever asked that question better than you. Good for you. Wow. Of course, phytocannabinoids, the fact that people have been using cannabis for centuries scientists in the 1960’s identified THC and CBD and then in the 70’s we got receptors all through our body for those chemicals. What the heck is going on? Then we learned that the body makes endocannabinoids. We make our own chemicals like anandamide that actually can interact with the receptor on blood vessels to answer your question on cardiac tissue. Throughout the body, some people say there are more receptors for cannabinoids throughout our body than any other receptor system in the body like insulin receptors of vitamin d receptors. It is fascinating. Yes, eating plants, whether the cardiovascular benefits of eating plants strong diets or plant only diets is directly connected to the endocannabinoid activation. That is actually not known. It is also known not to be any harm. You take broccoli. You could spend five hours talking about all of the different pathways biochemically, the fibre, the eater, the vitamins, the nutrients, the fact that broccoli properly cooked leads to something called sulforaphane which is a very potent activator of antioxidants. You throw in that it must activate some receptors in the ECS and the endocannabinoid system is just another area of future research. I don’t think we can say right now that it is the biggest reason to eat broccoli. Not too many people put on Santana when they are eating broccoli because it gives them a little bit of a mellow feeling. It is not much of a stimulant of the endocannabinoid system. Try cooking broccoli with Santana on next time. It might give you a little different response.

[12:29] Cassy Price: It might boost you up a bit. Definitely going to have to try that. What are some of the laboratory tests that you utilize and practice to establish a patient’s baseline heart health and monitor their progress towards reduced risk?

[12:46] Dr. Joel Kahn: Good question. Number one, people can monitor it at home to some degree. You need a home scale and you definitely need a home blood pressure cuff. It is really amateur if your goal in life is to live long and healthy, I am being very bold but you’re an amateur if you don’t have a home blood pressure cuff and use it regularly. I think it is the biggest deficit in self-monitoring of our health is not doing that. There are not enough people talking about it and telling people to do it. So, get a home blood pressure cuff. In the office of course I am going to weigh you and measure your waistline because a big ole belly is not associated with good cardiovascular health. I am going to take your blood pressure three or four times because people get white coat hypertension even when I don’t wear a white coat in the office. So, I am going to measure your blood pressure. Physical exam beyond that is spotty and not all that helpful. I will tell you one with everybody listening. There is something on the earlobe called the diagonal earlobe crease. It is sometimes abbreviated DELC. If you were to go to your favourite search engine, .go or something, and look at diagonal earlobe crease you will see pictures of people like Steven Spielberg who has this deep crease that they didn’t have when they were a kid. It is a proven clue, odd as this is, to potentially having clogged heart arteries. I am sort of an earlobe connoisseur and I really sometimes have to bite my lip not to go up to somebody at a restaurant or the airport and say, “you don’t know me and this is odd but you might have heart disease because I know your earlobe suggests they do.” It is actually in science literature.

[14:31] Then we got to go beyond that. We have to do lab work. We have to know your cholesterol and your blood sugar, your vitamin d, your inflammation, high sensitivity, see how you react to protein. I am a big fan of testing something called lipoprotein-a. it is a genetic cholesterol that is inherited by 20-25% of people and it can destroy your arteries or your heart valves over life because you have it since you are a child and we aren’t yet in a medical system where yet every family doc or gynaecologist, you only have to check it once, either you inherited it or you didn’t. So, we are going to do advanced cholesterol, inflammation, vitamin levels, b12, vitamin d, omega 3 is a really easy and important vitamin level to check. Many people, it doesn’t matter if they are on a meat diet, fish diet, plant-diet are low in omega 3 and for brain health and cardiovascular health it is important. Lastly, just to be succinct, there is a screening test for heart disease. “Mr. Smith I want you to go and get a colonoscopy you are forty-five years old”. “Doctor I don’t have any problem”. “Well, you should find out if you are at risk for colorectal cancer”. Forty-five is the new recommended guideline that was just introduced recently. “Mrs. Jones you need a mammogram”. “But I don’t have any problem with my breasts”. “Just do it. We want to do early detection”. Why aren’t we saying anything about the heart? It is a very good question. Since 1990, you can now I am talking 2021 you can spend $75 maybe $99 dollars at your local hospital and you can get a CT scan of your heart that involves no injection, no radiation injected in your body. It is a CT scan so there is some radiation associated with it. It is painless. It takes about ten seconds. It is called a Coronary Artery Calcium CT scan. It looks at the heart arteries and also does look at heart valves and such for premature calcification.

[16:40] Bones and teeth calcify, that’s great. You do not want your heart arteries calcified. It is a sign of aging. It is a sign of plaque. It is a sign to get preventive cardiologist and get a deep dive and make some changes. Anyway, that is my early fix. Good history, good physical, good lab work, a little bit more than the average internist and a $99 or $75 heart CT. You are either going to come out in a really great bucket with youthful arteries or you are going to come out a little bit disturbed and make some changes to prevent the next twenty years being tragic perhaps.

[17:23] Cassy Price: Have you ever utilized non-conventional testing in your practice such as the PULS test or LPP testing?

[17:31] Dr. Joel Kahn: Everything. I am like a freak on wearables. I’m a freak on all those things. The max wave pulse which measures pulse wave velocity it is of some value but 400 years ago a scientist in England, a physician, said that you are as old as your arteries. Thirty years ago, a very prominent blood vessel specialist in Europe said that if you want to predict the presence of artery disease look at arteries. So, I find all of these nowhere near as helpful as the CT scan because it is directly looking at arteries, it’s painless, inexpensive and available at hospitals all over the United States. It just unfortunate Docs are not recommending as a routine. Mr. Jones, Mrs. Smith, Bob, Susan, whatever the name you want to put in there, you are forty-five to fifty and your dad had a bypass at age seventy-two, boda-boom boda-bing, go and spend $99. It is a big problem but conversations like this bring it up. I wrote a book five years ago and it got republished two years ago. Its called Dead Execs Don’t Get Bonuses. It is on Amazon. It is inexpensive. It’s step by step the blood work that I would recommend. The CT scan I would recommend and the response you make to it if it is not perfectly normal.

[18:50] Cassy Price: Awesome. I will definitely have to check that out. So, when it comes to weight management which is a dominant risk factor for CVD, what are your thoughts around following a BMI calculation?

[19:01] Dr. Joel Kahn: Yeah, it is okay. We all know you can have that athlete that is very muscular, and the BMI is high, but they obviously have a low body fat and that is the fall back. For most of us the BMI being twenty-five to thirty being overweight, over thirty obese, over forty morbidly obese, is still a useful way to track and monitor and it is built in so many monitoring watches. I have a scale at home that when I step on it because it already knew my height because I have an app for the scale it tells me my BMI every time I step on it. It can be a bit motivating unless you are an NFL football player or a body lifter there are some draw backs. It is better than nothing. You know there is a lot of data about your waist or hip to waist. It is better to have a small waist and big hips than a big waistline. That may be more accurate than the BMI. You can go and get a DEXA scan and find out your percent body fat. That might be more accurate. When you talk about reality, most doctors or electronic medical records have the BMI built in. It just pops up. It’s at least something to move the conversation forward.

[20:26] Cassy Price: Awesome. So, lifestyle changes though can take time to have the desired effect that people are looking for. What other protocols and treatments do you utilize and practice to help with patient’s compliance to they start to realize the benefits in a timely manner and feel like they are making progress?

[20:47] Dr. Joel Kahn: People that are in my practice, I am in suburban Detroit although I do counselling to patients all over the world, I mean they are getting weekly emails and YouTubes that I personally create and write for them to keep them on track. They are going to come back and get repeat labs and we are going to look for early wins. Maybe their omega 3 level or the vitamin d level or the inflammation level or maybe the cholesterol particles have improved. Of course, we want people to feel better and if we can get people sleeping better they are going to feel better and sleep deficits are a huge problem and even though it is a cardiac practice I spend a tremendous amount of time doing home sleep studies and using natural products for sleep aids from full spectrum hemp CBDs to magnesium to glycine to herbal practice for people who don’t like melatonin perhaps I have some herbal plant-based melatonin. So, we go on and on. If we get people sleeping that is a quick win. Weight loss is tricky. For some people I do some fasting protocols and short five-day fasts based on scientific literature. People feel real better and they drop eight to ten pounds. There are people that are just stonewalled, and it is not easy to get everybody to start peeling off some pounds but of course a lot of people that is a primary goal, so we keep working on that.

[22:12] Cassy Price: Awesome. Thank you so much for joining me today. It has been a great conversation. I mean there is so much more we can cover but unfortunately time won’t allow. So, for our listeners who do want more of your wisdom you have your website drjoelkhan.com and you also have your own podcast, correct?

[22:31] Dr. Joel Khan: I do. I put out kind of like what we just covered in twenty to twenty-five minutes, could literally save lives one after another after another. In another instance this could just decrease anxiety. People are fearful of the heart. They don’t know that they are $75 away from a CT scan that may actually give them good news, so it is not all Debbie downer necessarily. I guess now we have to call is Karen in the last year and a half of conversation in the world. I don’t particularly like that term because my darling wife is a Karen. Anyways, it is simple. I have a twenty-minute podcast once a week called Heart Doc VIP. It happens to be on covid this week. Last week I think it was on saturated fats last week actually. Quick short topics to take away and lead people to have a little healthier choice during the week.

[23:27] Cassy Price: Fantastic. Well hopefully everyone checks that out and I really appreciate you taking the time to chat with me today.

[23:34] Dr. Joel Khan: Perfect. Thank you.

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Thank you for listening to Supplementing Health. For more information about our guests, past shows, and future topics, please visit AOR.ca/podcasts or AOR.us/podcasts. Do you have a topic you want us to cover? We invite you to engage with us on social media to request a future topic or email us at [email protected] We hope you tune in again next week to learn more about supplementing your health.

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