How a Plant-Based Diet Can Prevent & Reverse Heart Disease

Today I delve deep with the magnificent and one and only Joel Kahn, M. D. to discuss the power of diet and lifestyle on heart health and long-term wellness. Joel calls himself an Interpreventional Cardiolgist. What is that? It means that he treats his patients with a blend of traditional interventional cardiology (stents) as well as preventive cardiology. It's this rare combination that makes Dr. Kahn unique in his field. But let there be no mistake – Dr. Kahn is no new age hippie. In additional to several post-doctorate certifications, he graduated Summa Cum Laude from the University of Michigan's prestigious Inteflex program (a 6-year undergraduate / graduate program that developed doctors fresh out of high school) and has served as a Clinical Assistant Professor of Medicine (Cardiology) at Wayne State University School of Medicine since 1993. In addition, Dr. Kahn has authored over 130 articles on heart disease, over 10 book chapters (as well as a new book due out in February 2014), and several monographs and video national presentations. He is a frequent lecturer on heart disease and its prevention. He has performed thousands of cardiac catheterizations and stent procedures and has been advising patients on heart healthy programs for over 20 years. In other words, Dr. Kahn knows what he is talking about. And his message is powerful — if you want to experience true long-term wellness, then you must focus on implementing sustainable long-term preventive protocols into your lifestyle. And this starts and ends with diet and active lifestyle. It was an honor to spend 90 minutes with Dr. Kahn, and his message is invaluable. Simply put, the world would be a better place if we had more doctors like him. So listen up people. Take his message to heart. Literally. And enjoy! Rich Learn more about your ad choices. Visit podcastchoices.com/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Rich Roll?

  Eating well rarely falls apart because of one big failure. It's the daily question that wears you down. Like, what am I actually going to make tonight? What's in the fridge? And it's exactly why we built the Plant Power Meal Planner. It's a personalized, plant-based meal planning program that matches you with recipes based on your taste, your allergies, your cooking skills, and how much time you actually have. You build, through this program, a balanced, nutrient-dense plan for your entire household in a few minutes. Then it generates a grocery list for you with one click that plugs right into our delivery partners. All the recipes in the program are built by dietitians with culinary training. Plus, you get your own food coach to help you problem-solve along the way.

• 0:44Rich Roll?

  It's kind of an amazing thing. For listeners of the show, all you special people, we're offering an exclusive $20 off an annual subscription right now. To get it, go to meals.richroll.com, take your quick personalization quiz, and enter promo code RICHROLL20 at checkout.

• 1:04Rich Roll?

  Welcome to episode 44 of the Rich Roll Podcast with Dr. Joel Kahn.

• 1:22Rich Roll?

  Hey, everybody. Rich Roll here. Welcome back to the Rich Roll Podcast. Episode 44 today. A couple of show notes before we get into the interview scheduling. On September 7th, I'm going to be at the Toronto Veg Fest. I went last year. It was a really good time, and they were kind enough to ask me back this year. So I'm going to be doing a keynote presentation that Saturday, the 7th. I think it's at like 5:30 at night or something like that. And I believe I'm also doing an athlete panel with a couple of other guys like John Pierre, who's a plant-based trainer, and James Wilks, who's a former guest on this show. He's the MMA, UFC fighter. We're going to talk about plant-based nutrition for the athlete.

• 2:07Rich Roll?

  And we're also going to talk about a documentary project that James is working on called Game Changers, which is pretty exciting. It's all about kind of eating plant-based and being athletic. And it gets into all sorts of issues that come up and surround that, like issues of masculinity, what it means to be a man, and how we approach diet as men. So that should be pretty fascinating. I'm hoping I can record that panel and, and put it up on the podcast. I'm gonna have to see if they'll let me do that, but fingers crossed, hopefully they'll let me do something like that. If you, if you're in the Toronto area or you wanna learn more, go to festival. veg.ca and it's all the information you need. On the 21st of September, I'm gonna be doing

• 2:51Rich Roll?

  another keynote in Tucson. If you wanna find out more about that, you're in the Tucson area, go to healthyunetwork.org. Plant-based nutrition, you wanna learn more about plant-based nutrition? Julie and I are pretty excited. We just launched our complete, or I guess it's called the ultimate guide to plant-based nutrition in partnership with Mind Body Green. It's a really comprehensive video, online course, three and a half hours of online video, broken down into small, bite-sized little videos that are five to 10 minutes each, all, all sort of divvied up according to theme and section to address different

• 3:33Rich Roll?

  subject matters. Basically, every single thing that you need to make that transition to getting more plants into your diet. So whether you're just plant curious, you're eating the standard American diet, you wanna learn more about how to eat this way and do it the right way, it's great. If you've been eating plant-based or vegan for a long time, still tons of great information that you can glean from it. There's also an online network forum where you can ask questions and Julie and I interact with you. We've got recipes, we've got all sorts of downloadable tools. It's pretty cool. I'm really proud of the program. It's doing great. We're getting great feedback on it. So go to mindbodygreen.com and you can check it out. It's right there on the homepage if you just scroll down.

• 4:16Rich Roll?

  The other cool little product offering that I wanted to mention is my buddy Matt Fraser at No Meat Athlete, nomeatathlete.com. He's a great guy, fellow runner, fellow plant-based runner. He just did his first 100-mile ultra. Congrats, Matt. He just came out, he's got a series of these downloadable PDF ebook courses called the Roadmap Series. He did one for the marathon, he did one for the half marathon, and he just came out with one for triathlon. It's called Triathlon Roadmap: Plant-Based Guide to Conquering Your First Triathlon. So-

• 4:53Rich Roll?

  If you're interested in checking out triathlon, you've never done one, maybe you're intimidated, you're not sure where to start, how to train, how to eat, what to eat before your workout, after your workout, during your workout, and stay plant-based, then this guide is great. You know, I've written a lot on this subject, obviously, and I just released my online course, but I've never done like a specific training plan for your first triathlon, or like a meal plan that will take you like every day through how you prepare. And it's been something on my list of things that I thought would be great for me to do, but Matt beat me to it. His product's great, so I strongly urge you to go and check that out.

• 5:35Rich Roll?

  You can go to mattnomeadathlete.com, but if you want to support this show, then go to richroll.com. My most recent blog post up is all about this program and his other programs. And if you click through the hyperlinks to his program and end up purchasing it, we have an affiliate relationship, and so Matt will kick a few dollars our way. And that's a great way to support the podcast. It won't cost you anything extra on those products. It's the same price if you go to nomeadathlete.com. But if you click through from my site, from my blog post to his site through those hyperlinks, then it helps support what we're doing here, and we love you for all the support that you're giving.

• 6:16Rich Roll?

  Other ways to support the show, the Amazon banner ad at richroll.com. We're all buying stuff on Amazon, so if and when you're going to buy something on Amazon, go to richroll.com on the blog page, podcast page, you see a little banner ad for Amazon. Click that, takes you to Amazon, get whatever you're going to get, like Finding Ultra, perhaps, in case you haven't read it. And it won't cost you anything extra. Again, it's just an affiliate relationship, and Amazon will kick us a few pennies. Helps keep the bandwidth flowing and you're supporting the plant power movement because this is a movement, right? This is a movement that's picking up speed, picking up steam,

• 6:58Rich Roll?

  and we want to keep it going. So, thank you, everybody who's been doing that. We've gotten a lot of support from all you guys out there. This audience is blowing up and we love it. So happy, proud of the show and just really feels great to have an audience out there that's interested in what we're doing and is responding positively to the message. What else? Well, you can also donate to the Rich Roll Podcast. There's a donate button on my site. You can throw us a few bucks on a one-time basis, on a weekly basis, on a monthly basis, and that has been fantastic. Also, we've picked up some new equipment. We're building up a new studio that we're going to be broadcasting out of soon. And it's, all your support is

• 7:42Rich Roll?

  allowing us to do all of that. And we're going to start videoing podcasts and we're going to start eventually live streaming them and picking up the episode frequency up to twice a week. So, thank you, thank you, thank you. Onto today's guest, the wonderful and magnificent Dr. Joel Kahn. Who is Dr. Kahn? Well, he's an interpreventional cardiologist. In fact, I believe he's the first in the world to be certified as an interpreventional cardiologist. Well, what does that mean? Well, it means that he is a typical Western medicine practitioner in cardiology, hence the term interventional. He puts stents in, he performs everything

• 8:25Rich Roll?

  that you would expect a Western practicing cardiologist to do. But what distinguishes him is his strong bent and opinions when it comes to preventive medicine. He's a vegan himself and a strong proponent of a plant-based diet with respect to treating his patients and as a means to optimizing your health. And this guy's no hippie dippy. He's got 25 years of experience and he's a really smart guy. He graduated summa cum laude from the University of Michigan's Inteflex program, which no longer exists. But what it was, was essentially a way to Immediately enter medical school right after high school. You go to University of Michigan

• 9:08Rich Roll?

  right out of high school. You begin medical school right away. I think it was a six-year program. And when you graduate, you're a doctor. So it's sort of like fast-tracking doctors. And we get into talking a little bit about what that program was like and what motivated him to participate in it. And all aspects of his practice, everything from how he treats patients typically, to his opinions on everything from GMOs to supplements, to exercise, to yoga, to meditation, and how he interacts with his patients with respect to trying to get them to improve their diet. He's written like 130 articles. He's a very frequent collaborator, collaborator. I guess, what would you call that? He submits many

• 9:51Rich Roll?

  articles. He's a contributor. That's the word I was looking for, to MindBodyGreen.com, which is how I kind, he kind of came across my radar. He's friends with Jason Waka, the CEO of MindBodyGreen. And Jason threw up an Instagram picture of having brunch with him a couple of weeks ago back in New York and said, I'm here with the wonderful Dr. Joel Kahn, plant-based cardiologist. And I messaged Jason, I said, that sounds like a guy I gotta have on the podcast. And Jason got back to me and said, yeah, well, as a matter of fact, he's gonna be in LA. So we hooked it up. The doctor was in downtown LA giving a talk at a conference. And he was kind enough to take time out of his day

• 10:33Rich Roll?

  and his conference for us to sit down and have a conversation in his hotel room with the mobile podcast studio. And it's a great conversation, very illuminating, very interesting. His opinions are fascinating, actually. And what I love about him is he's very grounded. And everything that he says, all of his opinions are based on the science and the research. And that's how he practices medicine. And we need more guys like this. We need more doctors, more cardiologists that are coming from his perspective when it comes to treating patients from a preventive, I always want to say preventative, it's preventive, from

• 11:14Rich Roll?

  a preventive perspective. So enjoy the interview. He's a great guy. This podcast has allowed me. To meet a lot of fascinating people and this guy's right up there at the top of the list. So I'm really glad that I got a chance to meet him and to share his message with you guys so that you have some takeaways to take home and incorporate into your own life to not only maximize your health and your long-term wellness, but to unlock and unleash the best, most authentic version of yourself.

• 11:57Rich Roll?

  Without further ado, ladies and gentlemen, Dr. Joel Kahn.

• 12:08Speaker 01

  Believe me, exciting to be amongst you.

• 12:12Rich Roll?

  Wow, don't say that. It's exciting to be with you. It's funny because I think Jason Walker from Mind Body Green posted an Instagram picture of, I guess you had brunch with him or dinner with him in New York.

• 12:24Speaker 01

  Yeah, about two weeks ago.

• 12:26Rich Roll?

  Yeah, the plant-based cardiologist. And I emailed him. I was like, that's a guy I need to talk to. And he said, oh, he's going to be in LA. You got to sit down with him. So here we are.

• 12:35Speaker 01

  Yeah. Well, thank you for driving a distance and meeting me here.

• 12:38Rich Roll?

  Oh, my pleasure. So what were you doing here in town?

• 12:41Speaker 01

  Um, I came in yesterday. There's a conference in this hotel of anti-aging physicians, a small group of cardiologists amongst a larger crowd. And fortunately, I was invited to be faculty. So I gave a lecture today about what gluten can do to the heart and kind of meshes with athletic performance.

• 12:59Rich Roll?

  Oh, that's interesting. I feel like the gluten conversation doesn't get enough airtime amongst the kind of plant-based movement. I don't think it gets sort of the attention it deserves. So what is your, what's your perspective on that?

• 13:14Speaker 01

  Well, I mean, I call it the gluten movement, the gluten-free vegan movement, the gluten.

• 13:18Rich Roll?

  The gluten.

• 13:19Speaker 01

  The gluten. Yeah.

• 13:20Rich Roll?

  Meet the gluten. The road just keeps getting narrower and narrower, doesn't it?

• 13:24Speaker 01

  I just wrote a little Mind Body piece about kosher, yes, no, vegetarian, yes, no, vegan, yes, no, gluten, yes, no, now I gotta do GMO, yes, no. Leaves me about air.

• 13:37Speaker 01

  But I agree with you. So do I think gluten is real? Yeah, I do. It's not genetically modified, but it's changes in wheat structure and amino acid content. And I think people are reacting to it. And of course, we talk about the gut and immune diseases related to it. But it looks like the heart has taken a hit in some people, too. That's what I talked about today.

• 13:56Rich Roll?

  Right. So in other words, there's, I mean, my understanding, and correct me if I'm wrong, I'm certainly no doctor, is that there's a kind of spectrum of sensitivity to it. Some people react very negatively to it. Some people don't seem to have a problem. I mean, is it something that everybody should avoid? Or just if you seem to have kind of a negative, adverse reaction to it?

• 14:17Speaker 01

  We actually had at this conference, probably two of the world's experts right now. One is Bill Davis, wheat belly cardiologist.

• 14:25Rich Roll?

  Yeah, for sure.

• 14:26Speaker 01

  Pretty successful. And he'd like to see wheat, wheat would be a word. Wheat, he'd like to see wheat booted. Wheat booted from the American scene, probably the world scene. He's that passionate about its little effects. But the famous Harvard professor, Dr. Fasano, thinks that's way too radical. And he is the biochemical expert on gluten and what it does. It is too radical. I mean, there are people that it isn't affecting, or they're going to live a good life. But for people that are not thriving, or trying to achieve amazing athletic performance, or do something to enhance their vitality, talking about gluten is a topic.

• 15:01Rich Roll?

  Right. And so do you think, is it inherently wheat, like all kinds of wheat? Or is it because nowadays wheat is so processed, and the GMO wheat, and the way wheat has changed, and the way we use wheat?

• 15:15Speaker 01

  Yeah, a couple of things. I mean, without question, the refining and processing has left us with a nutrient poor, calorie rich, boost in blood sugar, high glycemic index food that's everywhere. I mean, it's sticky, it's pasty, it's the reason pizza dough could be thrown in the oven and caught. And it's not just in food sources, it's in cosmetics, it's everywhere. And second is, and people may not know this that are listening, but the wheat that was, there's two statements about our Our genetic breakup, until about 10,000 years ago, people were needing wheat. And for most of us, that seems like a long time. But in the history of our genes, our genes change very slowly. And our genes haven't necessarily been raised and adapted to processed wheat.

• 15:57Speaker 01

  And specifically in the last 100 years, farmers trying to create a bigger crop and better output, the changes in the wheat have involved shorter wheat that grows faster. It's actually not genetically modified, but the genetic structure has changed naturally. It's a much more complex molecule, and people are making antibodies to it much more easily. So it's on the radar screen for a lot of undiagnosed weakness, rash, gastrointestinal, joint, brain fog, a whole variety of not feeling your best.

• 16:30Rich Roll?

  Right. And so essentially gluten is a protein, yes. And like you said, it's the, it's used in so many things because it's actually the glue that makes everything stick together and baked goods and in condiments, ketchup. So I saw all these things have gluten in it. And, and my understanding, again, correct me if I'm wrong, is it, for a lot of people, it produces inflammation, right? And it produces a immune system response?

• 16:57Speaker 01

  Yeah, you can measure antibodies. If you have celiac disease, your antibodies will clearly be abnormal. But what you mentioned, there's the tip of the iceberg. There are a group of people that maybe have some clinical problem, that bloating, irritable bowel, they have no clue, they might have positive antibodies. And then there's some people that are entirely negative. There's other substances in wheat, and I'm not an anti-weatite, but the science is evolving, and then you have to stay open-minded as well. There's actually a fascinating substance called amylopectin A, which lights up parts of your brain, similar to morphine, similar to addictive opiates. And there may be the reason wheat has become so popular is that we get a high off of wheat

• 17:41Speaker 01

  in the same manner that a drug addict gets a high. And you go back to it and have the next cracker. You can't eat just one, and it may be more than just your lust for obesity. And maybe, you know, we may be preying upon our population, and, you know, we're just sitting ducks for a lot of this stuff because we barely understand the science.

• 17:59Rich Roll?

  Yeah, I'd be willing to bet everything I have that I have that.

• 18:03Speaker 01

  I would probably agree with you after reading your book.

• 18:08Rich Roll?

  So, and gluten, I mean, is gluten found in its highest concentration in wheat? Because it's not just wheat, it's all different kinds of grains. There's only a few specific grains that are gluten free, but it's across many different types of...

• 18:21Speaker 01

  And barley, it's rye, it's in spelt and some others. And like you say, quinoa is awesome and buckwheat's awesome and amaranth is awesome. But so far Dunkin' Donuts hasn't come out with the quinoa.

• 18:35Rich Roll?

  Right.

• 18:36Speaker 01

  The quinoa cruler.

• 18:37Rich Roll?

  Somebody told me recently, when I wrote my book, I said, listen, if you think you might have a gluten sensitivity or you want to find out, the best thing to do is to clean your diet up first. Because if you're already eating terribly, just removing gluten from your diet, you're probably going to feel better anyway because you're going to have to remove all this processed stuff. But clean your diet up, you know, make it clean first and then start removing the gluten and pay attention. Because although there's a blood test for celiac disease, there's really no blood test for gluten sensitivity. But somebody told me recently that now there is a test for that.

• 19:08Speaker 01

  There's actually, in fact, some of the companies that were at the meeting that I lectured at today have blood tests. You have to go to a special kind of functional medicine physician. You're going to pay probably not insurance coverage, you might pay $500 to $800. But if you want to know, there's panels of multiple antibodies of all the components of wheat. And you could sort it out and some people, that's real important. But it's like you say, you just eliminate it. I tell my patients, take a glucation.

• 19:33Rich Roll?

  Glucation.

• 19:34Speaker 01

  Glucation, just take a glucation for three, four weeks. If your arthritis and psoriasis feels better, you know, you're sensitive and it's very easy to avoid it for three, four weeks.

• 19:43Rich Roll?

  Yeah, I mean, I'd encourage everybody to try it. I certainly know that I feel better and function better and sleep better and perform better athletically and recover more quickly in between workouts when I remove gluten. There's no question about it. So like I said, it's not, that's, may not be everybody's experience, but I think everybody should take it upon themselves to figure that out.

• 20:04Speaker 01

  Athletes don't need more inflammation, ultra athletes. They're getting enough inflammation.

• 20:08Rich Roll?

  Exactly.

• 20:09Speaker 01

  From lack of sleep and excessive exercise. And if gluten is just a small component, get rid of it. You're going to probably improve your performance. Although it's a great theory, I tried to look for some science to it because I've talked about enhancing athletic performance as a topic at this lecture series a few months ago. There's still science to be done in that area.

• 20:27Rich Roll?

  In which, which, which aspect of it?

• 20:29Speaker 01

  Demonstrating in high fitness athletes are removing gluten in some measurement of, you know, maximal oxygen consumption, mitochondrial function. That is proven science. It's a very strong theory and all you need is one athlete to tell you, I feel that much better. And there's many, as you know.

• 20:47Rich Roll?

  Right, for sure.

• 20:48Speaker 01

  But not yet that you can find a study that convinces.

• 20:52Rich Roll?

  Well, who's going to pay for that study?

• 20:54Speaker 01

  Oh, yeah.

• 20:54Rich Roll?

  Somebody who's.

• 20:55Speaker 01

  The buckwheat people.

• 20:56Rich Roll?

  Yeah, exactly. The buckwheat people have to get together.

• 20:59Speaker 01

  If you're listening right now.

• 21:00Rich Roll?

  The Amaranth lobby.

• 21:01Speaker 01

  Log in, richroll.com and let's find a study.

• 21:05Rich Roll?

  We can do a Kickstarter on that, maybe.

• 21:07Speaker 01

  It'll be exciting.

• 21:08Rich Roll?

  That'd be good. But you're not just the, the, the gluten doctor. You're a plant-based cardiologist. So I want to get into your background a little bit. We have so much to talk about. I want to, let's talk about Michigan first.

• 21:20Speaker 01

  Okay.

• 21:21Rich Roll?

  Born and, born and raised in Michigan?

• 21:22Speaker 01

  Born and raised in suburbia about, what, 40 minutes from where you are, Southfield. You're at Grosse Pointe. Love Grosse Pointe. And only applied to one school. I mean, I didn't come from a family that bled maize and blue. So it just was the right school.

• 21:38Rich Roll?

  I love that. You quote, you just quoted my book.

• 21:41Speaker 01

  Like that. Hey, it's, there's a few hundred thousand.

• 21:45Rich Roll?

  Yeah, I know. That's something oft quoted, seriously.

• 21:48Speaker 01

  But, yeah, one school and, you know, it wasn't like nowadays we kids apply to 20 schools. Ann Arbor was the choice. And what I was very lucky, they had back then a program where you got into medical school at age 17 that combined undergraduate medical school.

• 22:01Rich Roll?

  Right. Inteflex, is that what it's called?

• 22:04Speaker 01

  Yeah, Inteflex. You got it. And Integrated Flexible Program. And.

• 22:09Rich Roll?

  You literally go from high school into medical school.

• 22:11Speaker 01

  You do.

• 22:11Rich Roll?

  And it's, that's a very difficult to get into prestigious program.

• 22:15Speaker 01

  It's so difficult because it doesn't exist anymore.

• 22:18Rich Roll?

  Oh, they don't have it anymore?

• 22:19Speaker 01

  They were trying to create these organic family practice yoga kind of doctor gurus. And it turned out we all became neurosurgeons and cardiologists and, you know. Highly, highly specialized physicians and they said, you know, what's the point of it?

• 22:35Rich Roll?

  Right. I talked to Sanjay Gupta, who was, who did that program. Were you guys there around the same time?

• 22:41Speaker 01

  No, he is significantly younger than me, about 10 years younger than me.

• 22:44Rich Roll?

  And another friend of mine, Compton Ram Bhatta, who's been kind of a nutritional guru to me. He ended up, I think he, he ended up not seeing it all the way through. I can't remember what his story is, but he was telling me some great stories about what it was like to be part of that program. Sounds pretty intense.

• 23:02Speaker 01

  Um, you know, it was like, uh, the Nassau program at the beginning, we got so much attention. There were 50 of us. The regular class was 225 and they just surrounded us with love and support and I loved it. It was perfect program for me. There were a lot of people took a year off to go find themselves or take more liberal arts programming and that was encouraged. But, uh, I knew what I wanted to do and it just was a perfect program.

• 23:26Rich Roll?

  Right. That's great. Yeah. I mean, like you said, uh, my family does bleed maize and blue. My mom went to University of Michigan. My dad went to law school there. My cousin Bill, uh, who now lives in the Middle East, he was a, he was editor of the Michigan Daily. And then he was an editor at the Wall Street Journal and now he works for a publication and lives in, in Abu Dhabi. But, uh, and then all sorts of cousins. I have lots of cousins that are from Grand Rapids. And, uh, my parents, and they just sold it last year, but they had a little house on Lake Michigan up by Glen Harbor, near Sleeping Bear Dune, if you know that area. So I love it up there. It's always fun to bring people from California up there because it's so beautiful and you just wouldn't, wouldn't,

• 24:08Rich Roll?

  it wouldn't occur to you, living out here, that that would be a great place to spend your vacation in the summertime. But it's, it's, it's beautiful and amazing up there. I love it.

• 24:16Speaker 01

  We've got wineries up there. We've got beautiful fishing. You're right.

• 24:20Rich Roll?

  Great, great for training too. Great for training for Ultraman. I spent many hours on the, on the road and up there training. So I love it. And then, so you stayed and then did you immediately go into private practice or what happened when you graduated?

• 24:33Speaker 01

  No, I, I, um, very brief biography, finished Ann Arbor, stayed in Ann Arbor for internal medicine residency. It was during that period that I became a full, I came out of the closet as a vegetarian. I, uh, basically I grew up keeping kosher. So there were foods that I ate and foods that I didn't eat. And when I went to Ann Arbor, I just found that hanging around Rajanani, the Indian restaurant in Ann Arbor. And, uh, Some of the other places back in those early and mid eighties, it was just easier being vegetarian. It made my religious restrictions easy to live with. But it wasn't an ethical vegan or vegetarian. It wasn't an environmental one. It just was simply the quickest meal and the quickest grab and go.

• 25:14Rich Roll?

  It wasn't even health oriented. It was convenience oriented.

• 25:17Speaker 01

  Yeah, it wasn't then. So I finished in Ann Arbor. In 1986, I moved to Dallas, Texas. I was married at the time and still am gratefully to the same wonderful woman who's a nurse. And spent three years in the barbecue kingdom of the world of Dallas, Texas. But another small but transformative thing I trained to be a cardiologist there is I took a vacation to Aspen and it was 1987 and that's the year that John Robbins' book Diet for a New America came out. And I have some person to thank that I don't know their name, that as I was leaving town to fly to Colorado, gave me a copy of that book. Knew that I had been eating vegetarian style in Dallas. And sitting out there in the room bells, looking at the sky, having a few days off of what was a pretty rigorous few years in cardiology training,

• 26:02Speaker 01

  read for the first time any kind of logical argument why the world and animal rights and health would all be enhanced by vegetarianism. And really, I was 90% of the way there. I'd go home and have chicken at my mother's on a Friday night. But that all stopped. And whoever you are out there, if you're listening, thank you very much for lending me that book. It was very transformative in my life. But John did a great job. It's a classic book. But there still was a dearth of medical evidence and I don't.

• 26:31Rich Roll?

  Right. Like what year was this?

• 26:32Speaker 01

  That was 87. So I finished in Dallas, wonderful period of training, went to Kansas City for a year, did more training in angioplasty. I'm a stent guy. I put in balloons and stents. I'd rather not have plaque. I actually own the trademark on a little term, Prevent Not Stent.

• 26:51Rich Roll?

  I saw that on your website.

• 26:52Speaker 01

  I'm a stenter. But anyways, 1990, returned to Michigan and began private practice in Ann Arbor, actually, for a few years. But that was your very, very important study by Dr. Dean Ornish in California. The Lifestyle Heart Trial came out, which really was the first scientific blow you out of the water. I was like fertile ground. I mean, give me science that says the way I'm eating and my family's being raised is not only a logical and environmentally correct decision, but make it jive with my practice. And here was some of the most exciting data that you could reverse heart blockage by using broccoli and beans and rice and plant-based eating, along with the rest of Dean's program, which was stress reduction and stretching and socialization and all. And it just did it for me. I mean, I just became excited that

• 27:37Speaker 01

  we need to incorporate this into practice. But that was the one guy in the state of Michigan, probably, that really said, you know, this isn't just another random study. The thing spoke to me. So got excited about it all.

• 27:47Rich Roll?

  And so, and you, you made those changes in your personal life at that time, too, about the way that you were eating?

• 27:53Speaker 01

  Yeah. I mean, by then, my experience had gotten us. We were a vegetarian family, never really pushed it on the kids, because I had three growing kids at the time and still do. They're very grown. But it was around that period that we started dabbling with a little raw and some vegan meals and kind of going towards that route. It took a few more years till, I don't love labels, but till we would say we were totally a plant-based family and found the work of called Bolesustan and some others that, again, it was interesting to jive what we were doing personally, what we were doing in our family, and then see the medical support for it all. And it never stopped.

• 28:30Rich Roll?

  Right. And so, at the time, were you also, sort of, you said you had a private practice. Were you also working at a hospital at the time?

• 28:39Speaker 01

  Yeah. I settled back, from 1993 to now, I've settled back in suburban Detroit. Despite all my siblings moving away, everybody now lives a mile apart. My mother lives a mile away. And we're not exactly the Kennedy enclave, but geographically, we're all close. And I have stayed since. And we all know that some of Detroit is great and some of Detroit is in the news and a bit struggling, but have stayed. And it's been a wonderful community for every reason. And it's increasingly a wonderful health-oriented community. We have really good stuff going on.

• 29:12Rich Roll?

  Right. Well, I would imagine that over the next 10 to 15 years, it's going to see, I mean, you know, it's sort of like... When SoHo in New York was just factories and warehouses and then the artists come in because it's cheap and then there's a sort of cultural renaissance that takes place. And then, you know, that begins to gentrify the neighborhood. I mean, right now in Detroit, I mean, it's the very early stages of that. But I would predict, you know, 10, 15 years from now that it's going to be kind of amazing there if they can get some certain things straightened out.

• 29:45Speaker 01

  Yeah, I mean, they get the city economics and they will, but like one of our best and most amazing resources, and you may remember is the Detroit Eastern Market. It's the oldest family farmer's market in the country. It goes back 1800s and it's this gigantic Saturday explosion of

• 30:03Rich Roll?

  Right.

• 30:04Speaker 01

  Our farmers bring in produce and draw 40, 50,000 people and just I love the mix from all the neighborhoods, from the city, young, old. People drive up in Cadillacs, people drive up and, you know, broken cars, but it's where the city gets together and there's people playing saxophone and raw juice places and smoothie places and, you know, it's not a vegan haven. There's, there's plenty of meats to buy, but that's produce city. That's where you walk out with your kale stacked to the top of your car.

• 30:32Rich Roll?

  Right, I love it. Yeah, I was just in Pennsylvania. I spoke at the Vegetarian Summer Fest out there and I met a family that lives in Gross Point and they were telling me the exact same thing.

• 30:45Speaker 01

  Yeah.

• 30:46Rich Roll?

  You know, so that's pretty cool. But just the reason that I was asking was, you know, just sort of reflecting on Dr. Esselstyn's experience of kind of trying to impose this preventative or preventive protocol on his patients and meeting that kind of resistance that ultimately led to him, you know, sort of being dismissed from the Cleveland Clinic. I mean, you know, were you experiencing that kind of resistance early on when you were proposing the idea of treating people in a different way other than just let's immediately cut them open?

• 31:19Speaker 01

  Well, it actually, yes, and it still exists. I had actually went through a job change recently that was in part due to, you talk about cabbage too much, meaning the kind that comes out of the ground and not cabbage, which is the acronym for bypass surgery and opening your chest. You need, you know, you need to make your conversation in the public more about heart surgery than about coleslaw and juicing.

• 31:40Rich Roll?

  Right.

• 31:41Speaker 01

  And that's actually just in the last 12 months. So we still got an uphill battle.

• 31:44Rich Roll?

  Yeah, well, it's still a business and that's how the business makes money and profits and.

• 31:49Speaker 01

  But yeah, there was. Really, people left me to myself. You know, it was so odd, and I'm not praising myself, but it's just what everybody's heard. And it was so odd for a physician to be speaking about nutrition at every public forum that I could grab. And I wasn't blasted too much for it because they didn't have the, in general, the fundamental knowledge to really counter anything that I was saying. And I've always tried to stay grounded in science when it's available. So I'm also working on a book that'll be published in February.

• 32:22Rich Roll?

  Oh, wow.

• 32:23Speaker 01

  Kind of organic holistic cardiology approach. And there's so much out there that's grounded in science. Nutrition is certainly the strongest component of it.

• 32:32Rich Roll?

  Right.

• 32:32Speaker 01

  You know, you can't take too many potshots when you're, when you're still basing it on science. So I don't have a chapter on colonic.

• 32:39Rich Roll?

  Right. You're trying to keep it sort of accessible.

• 32:43Speaker 01

  No sham colonic that I can talk about have been done, you know, talk about that approach to heart disease. But so much else is. So the food, the food, food is medicine, food is poison. Conversation has been very helpful to my patients and it's really well received, I'd say, in the community. But it's shocking, it's still shocking. And it's the first time, I gave a talk five days ago to a group of cardiac rehabilitation patients, patients who've been through recent bypass, heart attacks and such, about 100 of them. I gave just a standard talk that for me is just, you know, day in and day out, what I think is common knowledge. And I mean, it just blows people out of the water when you show them, eat a Big Mac, and let's talk about your arteries being sick for five hours

• 33:25Speaker 01

  in places that can be tested. And it's just, they're just blown away that, boy, I really got to reevaluate. Which is why I keep going, because I love giving that message.

• 33:34Rich Roll?

  Well, the power of, you know, marketing is palpable. And I talk about this all the time. But when we've been told, you know, essentially since birth, that, you know, milk does a body good, or, you know, eat a steak for, you know, for your protein. And, and those messages are reinforced on a daily basis, you know, funded by deep pockets and lobbying groups that have a vested interest in having you continue to believe that a certain way of eating is in your best interest. It's incredibly difficult to overcome, to overcome that and to combat that. I was just... I did, I was in Death Valley a couple of weeks ago where I crewed Dean Karnaz's in

• 34:15Rich Roll?

  this race called Badwater. It was this crazy ultra-running race across the Death Valley. And the award ceremony the following day was in a high school gymnasium. And hanging on the wall in the gym were these huge posters of really fit-looking high school students or maybe, you know, guys in their, you know, early twenties with the milk mustache, you know, sitting at the bench press saying, you know, and so, you know, saying got milk or, you know, milk, you know, drink milk to make, I don't know exactly what it said. It had some slogan on it.

• 34:46Speaker 01

  It's the chocolate milk.

• 34:47Rich Roll?

  Yeah, and the chocolate milk as the ultimate recovery drink, which don't even get me started on that. But, you know, there's, so there's, there are high school students that are filtering in and out of that gymnasium on a daily basis over the period of four years. And even if they're just looking, seeing that out of the corner of their eye every single day, that gets reinforced. And so when you come to somebody and say, actually, maybe we should rethink this, you are combating like, you know, years and years and years of indoctrination into a different way of thinking. So it's a, it's a huge uphill battle.

• 35:19Speaker 01

  And, you know, from my perspective, the biggest disappointment has been the hospitals because they could stand up and say, we've got to fund the knowledge. We have the, the database of real science and what food does to the body is still incomplete, but it's still pretty strong. So for example, if you don't mind, 1997, one of the most famous studies out there is a cardiologist, Robert Vogel, did a study, eat a Big Mac, I actually take that back, eat an Egg McMuffin for breakfast or eat a bowl of oatmeal made with nonfat milk. So it was completely low-fat breakfast. And he did a test of artery function, you just kind of a blood pressure cuff test, but a very valid test. And for five hours after Egg McMuffin, your artery function can be measured and becomes worse and worse

• 36:04Speaker 01

  and worse. And by about five hours, it starts to recover. So you can go have lunch somewhere and repeat the experience.

• 36:09Rich Roll?

  And repeat it, yeah.

• 36:10Speaker 01

  And likely people are walking around 12 to 15 hours of the 24-hour day with outside insults on their arteries and that's... Start of the beginnings of atherosclerosis heart disease, my field. But you know, Egg McMuffin, that study's been repeated all over the world in various labs in humans. If you add hash browns, it's just worse.

• 36:30Speaker 01

  Just, just a week ago, this is the sad part of the story. I'm not talking about 1987. I walked into a cardiology conference at one of the major hospitals in Detroit I'm on staff at, and what is the breakfast de jour for the trainees that should be learning about nutrition? It was, first time I've ever seen it, Egg McMuffins everywhere. And honestly, I blew my gasket. I just couldn't believe it because it, you know, I pick other foods, but don't pick a food that's been studied, that's been backed with science, and should be on the banned list, just like cigarettes, and sitting on your butts along in the hospital. And here we are. The message is so wrong. I, I actually got chastised because I put a picture of it on Facebook and the, I won't say who, but sort of the top dog in the hospital called me in and said, you know, that's not good for press.

• 37:11Rich Roll?

  You're speaking out of school, Joel.

• 37:12Speaker 01

  Come on, line up, be a Gosling. And you know, I'm 54 years old, I can't stand in line anymore with the other ducklings. It's time to scream and say, this is just wrong. It's insane. It is, it is just, you know, it's an opportunity. Hospitals don't have to be the prime example, but they should be an amazing example where people learn about, you know, single ingredient foods, whole foods.

• 37:33Rich Roll?

  Of course.

• 37:34Speaker 01

  Plant-based options and the whole thing.

• 37:36Rich Roll?

  Yeah. I mean, I get emails all the time from people telling me stories and a consistent theme is, you know, me or my friend or my loved one just had open heart surgery or some kind of surgical procedure, and then they're in the hospital overnight and the next day they bring them this meal that's just, you know, completely at odds with, it's, you know, it's why they were there in the first place. So why can't we start with the hospitals? I mean, what is, what is the, is it just because these food contracts are so huge and there's so much money at stake? And why can't we reform what's being fed to patients in the hospital?

• 38:10Speaker 01

  I think there is an economic issue. A lot of places have to feed a patient three times a day for about $8 a day, but we all know you could make better choices than the sausage, egg, cheese breakfast at a hospital. And I think it's still a lack of knowledge. That's protein, that's from good animals, and that's strengthening our patients in their post-surgical recovery. I actually think, based on this data, Dr. Vogel and others, you probably are translating, making people have lower immune responses, which isn't good for infection, probably are affecting their arteries. I can't prove it because nobody's ever looked at what's affected these kinds of meals on hospital patients, but they're already somewhat depressed to begin with.

• 38:46Rich Roll?

  Right.

• 38:47Speaker 01

  Such simple steps, I think, would make a big inroad. And the real pressure is, I think, would actually save hospitalizations and cut down time and get people out, which is all that hospitals want to see done.

• 38:58Rich Roll?

  Right.

• 38:59Speaker 01

  If done in a quality way. But, you know, you'll go through millions of dollars of various efficiency pathways and purchasing pathways, but change the breakfast seems just so ludicrous. Nobody even approaches it. And nobody's pitching it. I've actually went around and shopped all the hospitals in my area and made proposals. Let's put this program in and gain notoriety and be the first dairy-free hospital system in the world or something. And it's just, the time's not right, or we're not speaking loud enough.

• 39:26Rich Roll?

  The amount of goodwill and press that they would get from that, though, seems to supersede whatever fallout they would have.

• 39:34Speaker 01

  I understand marketing, at least I think I do. And I think they would grab national, international attention.

• 39:40Rich Roll?

  Oh, yeah.

• 39:41Speaker 01

  And, you know, you got a wonderful guy in Oakland, physician who runs a farmer's market in the hospital, which has now become not that uncommon. But the press that he got for bringing fresh fruits and vegetables on a Thursday morning to the hospital staff and patient base was amazing.

• 39:56Rich Roll?

  Yeah, everyone's going to want to go to that hospital.

• 39:58Speaker 01

  Right. Just great, great statement. We're about, you know, we're about health. And something more radical would be even more meaningful and probably economically viable for the hospital.

• 40:09Rich Roll?

  But there's so many moving parts. I mean, I had, I interviewed the administrators at PS244 Public School in Queens. They were the first public school to institute a vegetarian school lunch. And they explained, you know, kind of the challenges and how difficult it was. But, I mean, they got national press. I mean, it was on, it was on everything from CNN to the morning news and all that kind of stuff. And they've just steamrolled it into like quite a movement that has a lot of momentum right now and hopefully will be. Spilling over and into, you know, many other schools. It would be great to see the same in the hospital system.

• 40:42Speaker 01

  I think it's great.

• 40:44Rich Roll?

  I mean, especially when certain, I mean, there are certain hospitals that still have McDonald's in them, right?

• 40:49Speaker 01

  Yeah. Sort of like the Cleveland Clinic, the number one rated cardiac program in the world has a McDonald's in the last.

• 40:56Rich Roll?

  Do they really? I didn't know that.

• 40:58Speaker 01

  There's 27 McDonald's in hospitals in the United States, but there's twice as many Wendy's and you can go down the list.

• 41:03Rich Roll?

  Right.

• 41:04Speaker 01

  It still remains appalling. I mean, it's just, what can you say, 24 ounce sugar sweetened soda, french fries and a burger with bacon and cheese and that goes up to a patient's room. That's, if anybody listening to this doesn't realize how dramatically insane that is.

• 41:21Rich Roll?

  Yeah, it really is.

• 41:22Speaker 01

  Remarkable.

• 41:23Rich Roll?

  Remarkable.

• 41:32Rich Roll?

  Getting back to Dean Ornish and Dr. Esselstyn and kind of, you know, the earlier pioneers in this movement and, and kind of the work that you're doing and trying to get out there and spread this message, one of the consistent sort of themes that you hear, I don't know if it's from, if it's fair to say from the medical community, but there's this idea that, well, you can tell people to eat that way, but you know, they're not gonna, they're not gonna do it. So why bother? You know, why, why don't you just tell them, tell them to do something that's a little bit more accessible to them. Like there's still this idea that it's just so radical or so difficult to change your, your eating habits or your lifestyle to get on par with what's going to be in your best long-term health interest. I mean, is that something that you encounter?

• 42:15Speaker 01

  I think there's, there's that challenge. Um, you know, I always admire people who've been in a crisis and come out of it transforming themselves one way or another. And of course, you're, you're one of those. I haven't had, you know, a giant health challenge in my, health and life, or my wife's or my children, thank God. Um, and you know, it's that thing about, I think a frog in warm water, boiling water, you know, they'll, they'll stay in the water until they die if you turn the temperature up slowly. I mean, people just, they aren't ready to make change. Uh, and they're waiting for, you know, the big call, whether it's the heart attack, the stroke, the cancer of the colon or something, and then, then maybe they'll get the light. So I think part of it is.

• 42:57Speaker 01

  People aren't willing to make the change. And I think the other part is, we all know the society that we've got, the fast food society, it's difficult to search out the healthy options and it's, you're just, you know, what Kelly Burnell calls our toxic environment, Dr. Burnell from Yale. I mean, we all know it. You drive up and down any major street in America. So, I mean, we're all seeing the slow signs of change and the better health options and the better health markets and the farmers markets. And I think it's not going to happen overnight, unless it's legislated, and it's not going to be legislated. But I really, again, I think I call upon anybody here who works in a hospital to take the banner and run with it. And that's, we should, as a hospital-based community,

• 43:42Speaker 01

  make the changes because we have more knowledge than anybody and we have a captured kind of population and they're not going to leave if they're sick just because we start putting black beans in their brownies or something. And some do, some do. I mean, I'm not without hope. I do see things like that occurring in some of the hospital menus, but.

• 44:00Rich Roll?

  I'm optimistic, actually. I mean, I think that there really is, you know, we are having a moment right now, you know, and I think that there is a lot of energy and a lot of support for, you know, the kind of work that you're doing and the kind of message that, you know, us and many others are putting out there and people are paying attention and listening and taking greater responsibility for their health. And my approach is always like, you know, this is your life. Like, take responsibility for it. Don't abdicate that to somebody else. And you have more control over how you feel and how your body is going to perform and function than, than, than you think, or maybe you've been led to believe. So, coming at it from an empowerment perspective, you know, I think gets people

• 44:42Rich Roll?

  excited. And I think there's, you know, like, you just wrote this piece for Mind Body Green. It was about mindfulness in your eating. And I want to talk about that in a little bit. But you relate, you relayed an anecdote of having been in LaGuardia Airport.

• 45:00Rich Roll?

  And being surprised to find so many vegan options. And I had that exact same experience a couple of weeks ago. Julie and I were flying back from New York and a funny thing happened. Like, we were getting ready to leave. We were in Manhattan. We're getting ready to leave for the airport. And we're thinking, we gotta get some food for this flight. Like, what are we gonna do? We're gonna go to the airport. There's not gonna be anything. So I walked like eight blocks up to Chelsea Market. And I went to Beyond Sushi. And I dropped like 40 bucks on like, this amazing vegan sushi is a great vegan sushi restaurant. They make really awesome stuff. And I just loaded up on all this stuff that we could bring on the plane. And came back to the apartment where we were staying, we're packing up. And

• 45:41Rich Roll?

  it was in, we were cleaning out the garbage of our friend's place we were staying. And I accidentally threw all the sushi away. I thought it was like garbage in my haste to get out of there. And it wasn't until we were in the cab on the way over. And I realized that I'd thrown out our whole lunch. And we were going to the airport. And we're gonna be on a flight all the way to LA without any food. Julie's like, how could you do that? How could you do that? And then we're in the Delta Terminal. And we happen upon, I can't remember the name of the vendor. But they had more than you could imagine an airport having in terms of options. Everything from an incredible salad bar to all these pre-prepared meals and like nuts. And they had smoothies. And like, I was like shocked.

• 46:25Speaker 01

  They even have vegan sushi.

• 46:27Rich Roll?

  Yeah, they did. Yeah, so we did. We restocked. I did double down again. But when I see something like that, you know, I'm thinking that, well, things are really changing. I mean, I don't know how many people are coming in and loading up like we are. But the simple fact that these options are available in a place that's historically the most difficult to find healthy options is, is, you know, that, that kind of thing makes me feel optimistic.

• 46:50Speaker 01

  No, I'm joining in on that one. So can't stop pushing because there's so much to do.

• 46:54Rich Roll?

  Right. So when you were, tell me a little bit about what your experience was when you were in medical school in terms of education about nutrition. And maybe, you know, if you're familiar with what it's like now, or how it could be different.

• 47:10Speaker 01

  Well, I actually do not. And I'm not slamming it. I don't remember a nutrition lecture. And I don't think there was one. I read recently, I think it's true, that about the time I was in med school, 30 years ago, there were 24% of med schools in America had a six week nutrition program. Here we are 30 years later, we're all enlightened. It's Twenty-nine percent of medical schools in America, it's actually one percent less than thirty years ago, or some number similar to that, it was down a bit, twenty-four percent, twenty-three percent. I don't remember any conversation on the topic. And to this day, largely, I mean, I've been to so many hospital grand rounds and hospital presentations, some of which are required, some of which I just, you know, drop in to learn something new. The number

• 47:51Speaker 01

  that have been on nutrition, let alone, God forbid, something in the green world are pretty close to zero. So, I mean, I'm entirely self-trained because there really is no particularly good option other than that. And it's also relatable, though, because I can tell my patients. I mean, I take out my prescription pad and I give them homework that, you know, you have to read this book and watch this.

• 48:11Rich Roll?

  Oh, you actually write that on a prescription pad?

• 48:13Speaker 01

  I write it on a prescription pad.

• 48:14Rich Roll?

  Oh, that's great. I love that.

• 48:15Speaker 01

  I actually usually write my body green or something. I mean, in addition, you know, you need to start doing this. That's empowerment. You, you put in some effort, because I'm not going to see you for three months. We'll talk about your homework when you come back. And I found that pretty responsive. People actually, I can't believe it when they come back and they actually read a book.

• 48:30Rich Roll?

  Right. Well, that goes back to the empowerment thing, I think, too.

• 48:33Speaker 01

  I do, yeah. But it's still pretty abysmal out there in the medical school training world, which is, there are options where a medical student or a young doctor can go outside of formal training and get excellent exposure now, whether a video, a video series, live courses, kind of like the course I'm at today, but.

• 48:52Rich Roll?

  But you have to elect for that, right? Like, it's, you know, you have to really, you have to search it out and you have to be motivated.

• 48:59Speaker 01

  Right, right. And, you know, it, again, I'm not cynical, but a lot of it revolves around payment and such. You know, there isn't any special payment at this point for spending any time on nutritional counseling with patients or becoming more educated yourself to offer it. So, either you get the bug and have the passion, or all the mind-body nutrition field will wait to the day that we finally become a little more enlightened. And Dean Ornish waited twenty years to get his program, you know, certified by Medicare, although there's still very few of them. So, I like puns. So, I call it the day that we have re-ombursment, where we pay for home kind of activities.

• 49:35Rich Roll?

  I like that.

• 49:36Speaker 01

  That's right. Where we can pay to teach somebody to juice, or get paid to teach somebody to shop a grocery store and such, other than cash, which is still a valid way to try and approach patients and all that. But until we have that. Even, you know, there are good scientific-based studies on meditation and yoga in cardiac patients, but there's no om in the reimbursement.

• 49:56Rich Roll?

  No, no om in reimbursement. Well, the irony is so palpable. I mean, Hippocrates said it in 640 B.C., "Let food be thy medicine and medicine be thy food." It's like, it's this, you know, it is, it should be a foundation of medical education, and yet here we are, and it's still such a struggle to produce doctors who are, I'm not maligning doctors by any stretch of the imagination. They want to do right. You know, people go to medical school so they can help people. I mean, their hearts are in the right place, of course, but it just seems like there could be so many improvements made that would be not that difficult to implement, but then again, maybe I'm naive.

• 50:39Speaker 01

  I don't think you are. You know, my scope on it is that a lot of this came out of the introduction 80 years ago, 70 years ago, of antibiotics and some of the early surgeries where you had one problem, you had one quick fix, and you could create a cure of pneumonia with penicillin and take out an appendix for appendicitis. But we're so overwhelmed now by these chronic diseases of obesity slash diabetes slash high blood pressure slash, you know, joints falling apart slash heart disease slash heart failure. They're very complex. There's no single solution to them, and it's not a pill, and it's not, you know, a surgery, and it is largely lifestyle. And, you know, that reorientation, that lifestyle medicine is a specialty.

• 51:22Speaker 01

  Actually, it should be the basis of all our approach, but for these chronic diseases, if we're not at least addressing what is your lifestyle and have resources about trying to educate and motivate and empower them to recognize the power of lifestyle change, we are just drowning in these chronic diseases.

• 51:41Rich Roll?

  Right. How does it work? Can you paint a picture of kind of how it works on a day-to-day basis in terms of the pharmaceutical companies and the reps that pay the visits to the doctors and say, "Hey, we have this new thing." And you sort of hear anecdotally about, I don't know if it's pressure, but just how doctors are incentivized to prescribe and how they can sort of benefit financially or professionally from kind of getting in bed with these companies. I mean, is that conspiracy theory or is there some truth to that? I mean, what is that really like as being a practicing doctor?

• 52:18Speaker 01

  A couple of comments that are unprepared. It has changed compared to 20 years ago. 20 years ago, where you could get baseball tickets, you could get theater tickets, you could occasionally get a trip, including your spouse, to a resort where there might be a half-day conference and it was some educational content and a whole lot of pleasure. You could go out for an expensive meal. A lot of that is regulated now. Some hospitals and some universities don't allow any of that, even under the new restricted guidelines. They just don't permit a medical student or a staff doctor to go out for any kind of those programs. Most still permit it. So it is much more regulated, but the system does exist. A generic drug that might be as good as a name-brand drug will never have that kind

• 53:03Speaker 01

  of educational pitch. So at the bottom line, every week I interact with pharmaceutical reps that are in my office in the hospital. Pressure, it's pretty clear to me that they're trying to do a good job, but their job includes reporting to their manager their sales. Some are very persistent, some are a little meeker and milder and all. But it does drive the system to use the newest and the latest and the most expensive without necessarily a fair presentation of the whole big picture. I give pharmaceutical talks for agents that I feel are very good and very useful. I was saying today, I'm an integrative cardiologist, but I don't know, when I do

• 53:45Speaker 01

  the old style, am I extroverted or segregated? I don't know a term for the, I still practice a lot of traditional cardiology and traditional medicine, and they're much more regulated. I mean, I cannot say a word anymore that isn't in line with what the FDA has in a package insert. I mean, I am not there to sell a drug. I am there to give a medical lecture in tune with what they have to approve. But it is a system that has no balance. There's, there isn't a nutritional rep. We don't yet have a turmeric rep who's coming and talking about the anti-inflammatory powers this week.

• 54:18Rich Roll?

  Come on, turmeric people, you get your stuff together.

• 54:21Speaker 01

  I know. I think the turmeric growers should get some reps out there. And like, there was an article this week that turmeric was as effective as Prozac for depression. Well, I also suspect there's a whole lot less side effects to adding some turmeric in your life than Prozac. But we're not going to see anybody knocking on the door in any of the lifestyle modalities. And until it's a grand rounds topic for physicians, until it's in the journals, which there's little shreds, just like you find good food at the airport. I will on occasion find some medical literature, but it's difficult to fund the science. So you're not, you're not going to change all systems. A few pioneers like Ornish and all persist 20 years to get a scientifically proven program finally reimbursed

• 55:04Speaker 01

  by the government, which his program, as I said, is one of the two that are lifestyle change programs.

• 55:09Rich Roll?

  Right, right, right. Yeah. Do you know Dr. Michael Greger?

• 55:12Speaker 01

  Oh, yeah. I love Michael.

• 55:14Rich Roll?

  He's the best. He's awesome.

• 55:15Speaker 01

  He's the best. I mean, if anybody's listening, that's nutritionfacts.org. And he has taught me so much. I've had the pleasure of lecturing him a couple of times now when we email. But that combination of his wry humor, dry humor, and his profound knowledge and

• 55:33Rich Roll?

  You know, he's able to root out those studies. He finds, you know, he'll find the needle in the haystack and he makes those videos and presents them in a way that anybody can watch and understand and, and kind of get where he's coming from. And

• 55:46Speaker 01

  It's nowhere near the quality of your how to become a vegan video series that you've done with your wife, but

• 55:52Rich Roll?

  That's right. Of course not. Nothing is.

• 55:54Speaker 01

  We can't get Dr. Gregory in front of the camera yet to do cooking classes and blending classes and juicing classes, but the nutritional value of anybody that signs on for those free daily emails.

• 56:03Rich Roll?

  Yeah, everybody needs to do that.

• 56:05Speaker 01

  Crack me up. Um, yeah, the survival of the firmist was his most recent addition to my lexicon, which was a, a report that's well known that men with erectile dysfunction have both a much higher risk of heart disease, even if they don't know it, because an artery is an artery.

• 56:21Rich Roll?

  Right.

• 56:22Speaker 01

  A erectile artery just happens to be smaller than a heart artery, it just starts to fail quicker. Um, and, uh, men with erectile dysfunction also have a shortened lifespan is increasing the data. So the point is if you have that problem, don't hide it, get in, see a doctor, know your cholesterol, know your blood pressure, change your lifestyle, whatever it is. So, uh, yeah, he coined that term. That's survival of the firmist.

• 56:42Rich Roll?

  Yeah, I like that. He's great. I had him on the show and then I interviewed him again and I had a hard drive crash. I'm trying to retrieve the interview. I lost it. So I'm, hopefully I'll get that up and out soon for people. Cause I said, I'm interviewing him again. And then people are like, why haven't, why haven't you put that up yet? So anyway, I'm working on it. Um, but, uh, to kind of, um,

• 57:07Rich Roll?

  root it back to your, to your practice. So you start, uh, you know, you start treating your patients in a more integrative way. What are some of the results that you begin to see? Just for somebody who's listening to this, who's kind of new to this idea of Plant-based nutrition or the nexus between food and health and particularly heart health, can you attest to that a little bit?

• 57:32Speaker 01

  Yeah, so my life in cardiology still is in what we call an insurance-based model. My patients have Blue Cross and Medicare and Aetna and whatever it is. And although, you know, I'm not timed by big brother, my appointments are 15 minutes apart and you know, my office schedule is pretty full.

• 57:49Rich Roll?

  You have a couple of offices, right?

• 57:52Speaker 01

  Yeah, locations scattered across the city. But yeah, the style of practice is very similar to what most cardiologists are. There are a few physicians and very few cardiologists that have declined insurance and are going completely on a cash basis. I think we're going to see that more and more in the next five years, but it hasn't happened yet. So what I strive to do is quality time in 15 minutes, and that includes a few extra questions. My notes actually have what did you have for breakfast, lunch, and dinner in the last 24 hours? And it's always instructive to get a little bite of that. A little bit about sleep, we could talk about that in a minute, but the seven hours or more a night of sleep is increasingly coming out as a really important marker of health. And you do rob yourself.

• 58:37Speaker 01

  And, you know, people that are training hard and working hard trying to getting seven hours a night of sleep can be pretty challenging. You know, a little bit about stress, where are in life? What's, what's, what's got you upset? And what's going on in your family, your job, your kids? And there's always something, but you know, some people have good coping skills and not. So get through some of that. I mean, what's your social connection? Are you belong to a church, a synagogue, a bowling club? Do you got buddies? Are you a loner? Do you have family to rely on? Because that's very important in overall. Get the little feel of a patient. And in 15 minutes, plus a lot of other kind of related questions and examination, it's focused. And you can do some very fancy integrative cardiology, or you can do maybe five, six basics in the model I'm in and still make a big difference.

• 59:22Speaker 01

  You're probably getting 80% of it done. So I mean, I have a conversation with every single patient, and they know when they're coming in now, who they're going to see that a little bit about the power of vegetables and fruits and nuts and seeds and spices. And they're going to, G-bombs, as our good friend Joel Furman says, greens and beans and onions and mushrooms and berries. I mean, they're going to get that. They're going to get their homework list of watching Forks Over Knives, or reading a little Mind Body Green, or reading a couple of books that I like to promote. I do use, you know, whether you want to call them supplements, vitamins, nutraceuticals.

• 59:55Rich Roll?

  Mm-hmm.

• 59:56Speaker 01

  And, you know, I find that audience is very receptive. I can't even think of a patient that didn't welcome the option of not getting a new prescription drug. And I'm, I use prescription drugs. I mean, but if they're already on two blood pressure medicines and the option is the third one, or talk them about magnesium, or Coenzim Q10, or thanin, which is a great kind of anxiety reducer and lowers blood pressure, or green tea, drinking it, or green tea capsules and such. I found that patients really, really like that option, that I've not thrown the baby out with the bathwater, but the toolbox is bigger in terms of choices. And I find they're very adherent to it. I mean, when I see them back, a lot

• 1:00:37Speaker 01

  have done their homework and a lot have gone out and actually purch- I don't sell vitamins to patients. I just let them go find them and give them some ideas. But boy, it's, it's made practice much more fun. It's given me many more. I mean, I was given the same drugs over and over and over to about five years ago. And they're wonderful little devices at times, but now it's just a real panoply. Any young trainee in medicine would find practice much more stimulating to go explore mind, body, and

• 1:01:05Rich Roll?

  Right.

• 1:01:06Speaker 01

  nutrition, and nutraceuticals, and infrared sauna, and the whole host of things out there, Reiki, and, you know, the whole host of the menu that really has a lot of evidence for it.

• 1:01:17Rich Roll?

  Right. So have you had that experience with a patient where you kind of have that dramatic before and after angiogram that you see in Dr. Esselstyn's book, or you've seen these kind of turnarounds?

• 1:01:29Speaker 01

  Well, I haven't had that because I don't, he, he re catheterized people as part of a research study. If my patients are doing well, they don't go through a catheterization. And I don't. But I would make two observations. One, I know that taking a holistic approach and combining some Western and some Eastern and some mind-body, people definitely feel better. And in the world of congestive heart failure, if your grandma or your spouse or anybody listening has that very serious cardiac condition where the heart may not be strong, there is some powerful vitamin support that really is very similar to what an athlete might do to support mitochondrial function. I heard you talk about mitochondrial biogenesis, how you make those little powerhouses. Unbelievable

• 1:02:13Speaker 01

  responses of people where their heart is stronger, they're feeling better, they've got life back. I got this cute little, this is actually a cute little now 86-year-old woman who lives in Great Neck, New York. I have never met her, but she was a friend's mother and two years ago started a conversation. She's very sick, very near death. This woman is independent and running around her heart strength. They were talking about doing heart surgery and it's really probably one of my most amazing saves, although it was all digital advice, just via emails and conversations and told them what to buy. I see that a lot. And as I say, the other is just, so those are dramatic responses and they're probably,

• 1:02:54Speaker 01

  you know, I'm honest about the fact, I've talked to thousands of patients about their nutrition. I mean, I probably have 150 vegan patients that have decided to follow an Ornis and an Esselstyn, and I'm talking complete kind of submission to it. But most of them are eating much better, even if it's three salads a week instead of one, or a slice of tomato on their sandwich instead of none. And I mean, I've either guilted them or educated them or something to lifestyle change. And that's exciting now. And that's with really rudimentary tools. I don't have, I mean, with a dietitian to sit down with them or a real lifestyle change program of which there's maybe 10 or 20 around the country and only a few that are kind of vegan oriented, you could really do some good stuff. This stuff works.

• 1:03:38Rich Roll?

  It does. I mean, I get emails all the time from people that say, you know, I got off my, I got off my meds, you know, I never thought that that would happen. And, you know, by making these simple changes and sticking to them and, you know, over time, like I've gotten off it, you know, I've avoided the OR, I've avoided all these things that I thought were just, I was destined for.

• 1:03:59Speaker 01

  So, you know, my secret tool, if I can't reach out, because we all know there's that field of behavior change therapy, theory, and if somebody's in that first stage where they just don't want help, there's nothing.

• 1:04:09Rich Roll?

  No, it's, you have to be willing.

• 1:04:11Speaker 01

  You have to be at least a little open minded, but if I find people are open minded, you know, it's giving them some educational tools and giving them some encouragement, but my real like, uh, secret weapon is I talk to the guys about, uh, the secret direction.

• 1:04:24Rich Roll?

  Yeah, that tends to penetrate.

• 1:04:27Speaker 01

  Yeah, please, let's not go there. But, uh, uh, the tension is mounting in the room, but, um, you know, the power of greens and blood vessels in general, but, uh, forget about your heart, they really don't care so much about that, let's talk about the sack.

• 1:04:40Rich Roll?

  Right.

• 1:04:41Speaker 01

  Hey, I, I draw this little picture on my prescription pad, I can send them home with all this stuff, I blow through prescription pads, but the average heart artery is about the size of a number two pencil in diameter, and the average groin artery is about the size of a little stirrer you might find in a gin and tonic.

• 1:04:58Speaker 01

  It's much smaller and it doesn't take much plaque to clog that baby up. It doesn't take, you take one more french fry or one more bite out of your triple cheese whopper or, uh, one more, uh, KFC bucket to, uh, close that up and they get that pretty quick.

• 1:05:11Rich Roll?

  Yeah, it's the canary in the coal mine, really. It's, uh, it's nature's first, uh, alarm bell.

• 1:05:16Speaker 01

  That's right.

• 1:05:16Rich Roll?

  If that's not working, then there's more going on.

• 1:05:19Speaker 01

  Weeding out the weak ones, they can't reproduce or something, but it's usually a after child bearing agent. And the, and the great news is lifestyle change affects that dramatically and quickly. I mean, Esselstint's program, within two, three weeks, uh, many people, uh, experienced increased ability and interest in sex. Uh, Ornish reported it right away, that you don't have to cause, and you asked, have I seen plaques regress and reverse? Uh, the data out of all those studies and just clinical observation is arteries can get healthier with still having plaque in them. They can get some, blood doesn't clot as easily with eating greens and beans and such. Um, arteries don't spasm and constrict, and that can take two, three weeks to see those results and actually the, the, the ability of arteries to relax.

• 1:06:03Speaker 01

  It's all nitric oxide, which I'm sure you've read a little bit about in terms of, you know, athletic performance and, uh, You change your diet and put some, you know, you start chewing some greens in your mouth, you make nitric oxide right away. If you choose meat with nitrates, it doesn't happen, but it happens with greens. And if you bolster your diet, I mean, watermelon is a nitric oxide powerhouse, and pine nuts is a nitric oxide powerhouse, rhubarb is a nitric oxide powerhouse. And you can really enhance sexual performance with a plant strong or plant complete diet very quickly. And you know, you'll get their attention.

• 1:06:36Rich Roll?

  Yeah. Well, it's, it never ceases to amaze me how resilient the human body is. I mean, two to three weeks, that's like nothing, you know? You just make these simple changes and almost immediately, you can see results.

• 1:06:49Speaker 01

  Yeah, that's absolutely true. Yeah. And that's why it's like we said, the glucation or take a me-cation, it doesn't take years to get the sense that you're feeling better. People get it pretty quick.

• 1:07:00Rich Roll?

  Yeah. I think it's about just getting people used to being more in touch with how they feel and monitoring that, like paying attention, you know? I think, at least for me, in my personal experience, when I was eating horribly and not treating myself, I just got used to feeling lousy all the time, and that was normal. And it was just, well, this is the way that it is. And to actually realize like, oh, it doesn't have to be this way, to take stock of that, you know, if you have the willingness to do that, you know, you can change a lot, you know? Not just your health, I mean, it affects everything. You know, you change that, and then suddenly the way you see the world is different, and your mood is different, and then you're functioning differently in your relationship, in your profession. And suddenly, doors are open. You know, it's like it affects everything.

• 1:07:41Speaker 01

  Yeah.

• 1:07:41Rich Roll?

  So, it's powerful stuff.

• 1:07:43Speaker 01

  It is.

• 1:07:44Rich Roll?

  You were talking about nutraceuticals and supplements. What are some of the, I mean, you touched on a few, but what are some of the ones, you know, Co-Q10 you talked about?

• 1:07:55Speaker 01

  Yeah, probably if I had, you know, I take a lot. I've studied the field. I take many more than I did five years ago, but probably close to 30 to 40 individual supplements every day.

• 1:08:07Rich Roll?

  Oh, wow.

• 1:08:08Speaker 01

  Yeah, I'm pretty good. I feel great. I don't know why I feel great, and I haven't done, you know, a scientific trial. But in my patients, I try not to overwhelm them, and we might creep up to five to 10. But I like to start with three or four or five. And then the cardiac patients, Co-Q10 is just the foundation. Coenzyme Q10 is powerful antioxidant. Important in every cell in your body in the mitochondria to make energy, to make ATP. So if you're an athlete, it's important, although it's not 100% certain how much CoQ10 enhances athletic performance. The studies are a little bit all over the map. But in cardiac patients and patients on cholesterol medicine, I mean, it's another travesty. Hospital diet is a travesty and the fact that we don't automatically tell patients if they're taking Lipitor or Zocor to take CoQ10. In other countries, it is automatic.

• 1:08:53Speaker 01

  So that's always my, my base. Vitamin D has come on. Easy test to do. If you're a strict vegan, do it with mushrooms and other vegan sources. If you don't really care, most of the vitamin D3 is not vegan, but it's a helpful thing. So it's for you to struggle if it's okay or not. I don't have any problem with it in my own body to take D3. You know, blood pressure, bone strength, probably mental function, diabetic control. I like a potent multivitamin in my patients. Very controversial topic. I can't go to Harvard and debate the chief of medicine and absolutely get him down in a full Nelson for a count of 10 on the topic, but a, a good, natural based, actually there's

• 1:09:38Speaker 01

  a, there's a scientific theory that taking a couple of multivitamins before every meal for the average American, because meals are inflammatory and meals are oxidative stress and meals are artery unfriendly times. If you can flood your blood, either by eating a lot of greens with every meal. So if, that's a strategy that I teach my patients. So you're not going to eat like me, have a salad with your burger, have an avocado with your fried chicken, have a smoothie with your ribs or something.

• 1:10:06Rich Roll?

  To buffer the acidic inflammation producing.

• 1:10:10Speaker 01

  Inflammatory burn, oxidative stress burn is really cool science, but a multivitamin probably can do the same thing if somebody isn't real, real good about all that.

• 1:10:19Rich Roll?

  And the controversy with multivitamins has to do with bioavailability and the impact of these nutrients when they're extracted from the whole food and whether that really has an impact. Is that, is that what the controversy pivots around?

• 1:10:33Speaker 01

  Yeah, it's pivots around that and some science, some actual research studies that haven't been positive with even a few that have said it may be harmful. Generally low quality, kind of artificially produced multivitamins. You know, if you're familiar with the vitamin E, there's eight kinds of vitamin E. Every. Drugstore, $1 bottle of multivitamins has one of the eight forms of vitamin E in it. Nature gives us eight forms of vitamin E, so better brand multivitamins will, you know, cover the spectrum and probably are much better antioxidant.

• 1:11:05Rich Roll?

  Right, and when you eat like foods that are fortified, like breakfast cereals and things like that, they generally have the lowest, sort of cheapest, version of any of those things, right?

• 1:11:14Speaker 01

  Yeah, there's a, you know, folic acid, as long as you're talking about vitamins, was a breakthrough in terms of spina bifida prevention in pregnant moms, but it is a great example of the cheapest, probably least effective form of that particular B vitamin, and folate comes from greens. When you eat greens, you get the whole spectrum of folate. When you take, and in your breakfast cereal, you're getting an artificial form of folic acid that has to go through about five chemical reactions to finally get into the body and do its, uh, do its work. There's actually some concern that that portion of the folic acid in your breakfast cereal that doesn't make it down to folate may actually promote cancer, and it may be great during

• 1:11:54Speaker 01

  the pregnant phase, and so all cheap multivitamins have folic acid, and all good multivitamins, if you notice, will say folate. There's a subtle difference, and the public doesn't know it. So anyways, I'm, I'm big on my cardiac patients having a good antioxidant base and a good multivitamin.

• 1:12:09Rich Roll?

  And if, for somebody who's interested in maybe exploring supplements, I mean, where would you go to buy these things for, to make sure that you're getting the quality versions?

• 1:12:18Speaker 01

  Yeah, you know, I'd encourage people, and these are all things I'm saying with no financial ties that I have, there's an organization out of Florida called Life Extension, and they have a website, L E F dot org, LifeExtensionFoundation.org, and they have a magazine, you can sign up as a member, I think it's $40 a year, and you get a magazine once a month that is just so instructive, it's kind of like Dr. Greger, NutritionFacts.org of the vitamin world. Is there a bias? Yeah, they sell 300 kinds of vitamins, so most of their articles... Indirectly reflects something.

• 1:12:47Rich Roll?

  About how good their products are.

• 1:12:49Speaker 01

  But the science is so interesting and that's a good source and I think their vitamins are good. You know, a lot of the bigger chains, Whole Food does a real good job and I think the people are real, you know, intelligent and other chains like that. Again, I don't have any particular one to promote over the others, but I don't think gas stations and the national chain drugstores are the better places to be buying. I mean, it's like so much and maybe in our environment more than ever, quality, I mean, eat more, spend more, eat less is a Michael Pollan statement and similarly probably applies to if you're spending money on vitamins, you probably ought to ask a few questions, but probably 10% of the people I see taking vitamins get that or have been advised about that.

• 1:13:31Rich Roll?

  Right. All right. So what, quickly, what other, what other supplements do you think kind of top that list?

• 1:13:36Speaker 01

  If we talked about briefly a syndrome congestive heart failure, that's its own unique little mix. Magnesium would be on my list. Magnesium for all. I mean, I'm United States of magnesium, right. You know, if we eat tons of greens, we're getting a lot of magnesium in nuts and seeds and Brazil nuts and such, but most of us don't. So magnesium is important in about 300 really critical chemical reactions in the body that are helpful. And I see people all the time, whether it's blood pressure, skip beats, palpitations and such, I put them on magnesium and they come back and they say five things are better, not the thing you put me on. I'm pooping and I'm sleeping because.

• 1:14:12Rich Roll?

  And sleep is a big one, really helps with sleep.

• 1:14:14Speaker 01

  And migraines get better and really pretty amazing. And it's something you can take other than maybe a dialysis patient has to be careful. I mean, anybody could take magnesium and take it for really the rest of their life. Or just bump up your green intake and you'll get down the road there too, but it's an easy, easy one. You know, the heart failure patients take carnitine and taurine. I really like some of these adaptogens and maybe your audience is familiar with that or not.

• 1:14:40Rich Roll?

  Sure.

• 1:14:41Speaker 01

  The stress level in life, stress level of the extreme athlete, a stress level of a person working hard and raising kids, just basically most everybody stressing on our cortisol system. So I step out and put a lot of people on ashwagandha, a lot of people on L-theanine. Ashwagandha is an Ayurvedic herb that's widely available.

• 1:15:01Rich Roll?

  Explain what an adaptogen is for those who might not be familiar with that term.

• 1:15:06Speaker 01

  It sounds magical, but I just, when I finished lunch with Jason two weeks ago, I went to a, actually a lecture by David Wolf, who you're probably familiar with.

• 1:15:17Rich Roll?

  Sure.

• 1:15:17Speaker 01

  And at the center, he was talking, and I bought a book on adaptogens, so I just finished it. It's the concept that there's certain herbs and plants in this world that somehow just smooth out the roller coaster ride of our cortisol, our adrenaline, our stress, our anxiety. And without being addictive and without being valium kind of drugs, they do make you just a little calmer during the day without any sedating effect. And they're all from the botanical world, and it's really cool. And there's just thousands of years of experience in some of the cultures and a fair amount of research. So I mentioned ashwagandha and Ayurvedic Indian drug slash herb that's been used forever, but you just buy it in a health food store. I use a lot of that.

• 1:15:58Speaker 01

  L-theanine is from green tea, lowers blood pressure, reduces anxiety and stress. People come back, I use it in an 89-year-old, they come back, I'm sleeping, I just feel just a little calmer. I mean, it's a wonderful little thing. Cordyceps is a mushroom that's an adaptogen.

• 1:16:14Rich Roll?

  I love cordyceps.

• 1:16:16Speaker 01

  Cordyceps, good stuff, you know, for adrenal fatigue and, you know, the athlete preparation.

• 1:16:20Rich Roll?

  For athletes, it's fantastic.

• 1:16:22Speaker 01

  And then just to finish up the conversation, probably probiotics, which I'm sure, you know, you've studied. But our guts are just being bombarded with processed foods and trans fats and sugars and antibiotics and all kinds of toxic events with, you know, lactose intolerant, the gluten thing, which is killing our guts and causing leaky gut and probiotics, whether you get them through fermented foods, which is a wonderful way to get them, and that I've increasingly put in my diet, or whether you're taking a good quality probiotic in addition, or kefir or kombucha or whatever you like to do for it. But probiotics, it's a little hard to assess if somebody's feeling better with them, but it just, the science of what's going on in their gut is so strong.

• 1:17:04Speaker 01

  That's the whole conference I'm here about this weekend is gut health.

• 1:17:08Rich Roll?

  Oh, really? Interesting. It seems to really have taken off, just in the last year, I started seeing articles about, you know, microbial ecology, gut ecology, like way more than I did when I was researching my book. Kind of writing a little bit about that, but now it seems to really be a hot topic.

• 1:17:25Speaker 01

  Yeah, it is. And in cardiology, it's still very infant. I have no doubt if a study were done, you could document in patients some advantage. I mean, the hospital patients, I mean, put them on a probiotic in the CCU, they'd bounce back quicker. There's a lot of reason to believe that, but it's not really been studied in almost any syndrome in my field, but in so many others. And, you know, like you say, what we're learning in diabetics and obesity and depression and anxiety and ADHD and the effect of your gut flora. So go out there and get yourself a good quality probiotic and eat some sauerkraut and eat some pickles and

• 1:17:59Rich Roll?

  Right.

• 1:18:00Speaker 01

  kimchi and you'll be helping your body.

• 1:18:11Rich Roll?

  I think there's this idea that probiotics automatically mean kefir or yogurt or something like that, but there's plenty of non-dairy versions.

• 1:18:22Speaker 01

  Oh, for sure.

• 1:18:22Rich Roll?

  So if you're plant-based or want to maintain your plant-based diet, that doesn't mean that you can't take probiotics. There's plenty that are available that are non-dairy.

• 1:18:31Speaker 01

  Absolutely. Just, you know, get some pickled beets and

• 1:18:35Rich Roll?

  That's right.

• 1:18:36Speaker 01

  Anything permanent. They'll have, you know, billions and billions of calories, to quote Carl Sagan.

• 1:18:40Rich Roll?

  Mm-hmm. Billions and billions. Where do you come down on the juicing and smoothie blending kind of concept of eating? You know, there's, I don't know if I'd call it a controversy, but there's different points of view on whether this is advisable or healthy. And I certainly have strong opinions on it, but would love to hear your thoughts.

• 1:19:03Speaker 01

  Well, and I really haven't hung my academic career on it. It's so unusual for cardiologists to talk about juicing and smoothie making. I'm Little notorious in Detroit because I go on TV shows and I bring my blender and I bring my, my bullet and I bring my Breville and I kind of demonstrate sometimes.

• 1:19:23Rich Roll?

  But you don't have dreadlocks.

• 1:19:24Speaker 01

  I know, what am I doing? I don't have a vegetable as my middle name, but it's been fun and really Fat Sick and Nearly Dead, you know, kind of gave me the push about three years ago when I watched that and I met Joe Cross who was just so dynamic and awesome. The focus of that cult video, a wonderful video.

• 1:19:42Rich Roll?

  Yeah, for the listener who's not familiar, it was a very popular documentary and it's just amazing. Everybody needs to watch that. I think you can get it on Netflix or any video rental place.

• 1:19:54Speaker 01

  Fat Sick and Nearly Dead, really. Unlike Morgan Spurlock and Super Size Me, which made you gross but didn't give you any tools, Fat Sick and Nearly Dead gives you some really good tools to make some lifestyle changes. And again, that motivated me. So in terms of your question, you know, I adapted this to some degree from Dean Ornish, but I mean, in the spectrum of Taco Bell, KFC and Burger King to eating raw, plant-based, living food kind of diet of Brian Clement, Sabaccary's Health Institute, a very broad spectrum. I think smoothies and juices fit wonderfully towards the right end of the spectrum as facilitators.

• 1:20:36Speaker 01

  I don't do them and I don't recommend to my patients to go do a two-month juice fast. I think it's fine for anybody to go do a three-day one, but I'd much rather see them three, four, five days a week learn to juice as a way to get more phytonutrients in their body in a simple way. I think the bullet smoothie kind of breakfast out the door and I actually will do that too on my prescription pad. I tell them what to buy. I mean, go to viga.com. I gotta go check out your, your plant-based powder. Now that I've learned about that, I need to do that on my checklist and, oh, but whatever it is and, you know, tell them to get the ingredients to make a smoothie in the morning. And I think they're all wonderful tools.

• 1:21:18Speaker 01

  You know, I'm sure some of your listeners who are deeply into plant-based living as you do, I mean, my wife and I, we, we know when we're ready to juice because we just both feel it.

• 1:21:28Rich Roll?

  You feel it, yeah.

• 1:21:29Speaker 01

  You know, I just, I've had enough of, even though everything we eat is on the healthy end of the spectrum, there's just something about freshly, freshly juiced nutrition into the body that we just both feel better in 30 minutes.

• 1:21:40Rich Roll?

  Yeah, I mean, there's, quite honestly, there's nothing that I do that makes me feel instantly great, other than blending or juicing fresh greens. Like, I can feel it immediately, you know, and I just, for me, it's, you know, my research is done, you know, I know the impact that it has on how my energy levels and my mood and all that kind of thing. So I guess, there, I mean, the, the argument against it, it seems to me, is that if you tell somebody, you know, "Go for it," then these, these juices or these blends will quickly devolve into coconut ice cream and peanut butter and, you know, they become very calorie

• 1:22:22Rich Roll?

  dense, and people don't realize how many calories they're taking in when they're, when they're drinking this stuff, if they're not doing it kind of, you know, making sure that it's, you know, kale-based as opposed to dairy-based or something like that. I mean, is that, I think that's part of it. And then there's this other argument that is kind of part of the Esselstyn perspective, which is that you're not masticating your food, and, and so you're not giving your body the chance to properly digest these nutrients. I mean, is that fair to say?

• 1:22:55Speaker 01

  Yeah, there is, um, there's a couple of comments on chewing, and one is that there are people that advise you chew your smoothie and you chew your juice, just like you see some wine connoisseurs chew their wine as they sample it, but there is a very powerful process of chewing and activating salivary, you know, fluids that certainly when you're eating whole foods and plant foods, digestion begins in the mouth, and chewing and taking time really does aid grabbing all the nutrition out of plant-based eating and starts that pathway to nitric oxide and better our artery health. Very interesting pathway, beginning in the mouth.

• 1:23:35Speaker 01

  And I can't tell you that I know that I chew my juice and my smoothie, but my smoothies can be pretty crunchy with all the cacao nibs and everything. So I've not heard Dr. Hustleton, you know, speak specifically on that, but you can fall into a trap of very high calorie, dense smoothies and, you know, just got to educate people to stay away from 1,200 calorie smoothies for breakfast. They're not going to achieve their maximum potential. And, you know, and that argument itself is smoothie better, there's juice better. I mean, I can't resolve that. I think they're both great tools in a sort of difficult society to try and grab good nutrition. So I try to be able to do both.

• 1:24:15Rich Roll?

  Right, right, right. Yeah, I think that, you know, people grab on to this argument. Meanwhile, they're eating a terrible diet. It's sort of like, well, you know, watch Fat, Sick and Nearly Dead and see these incredible, you know, incredibly dramatic health turnaround. And, you know, there's, there's something going on there. So anyway, watch that movie, experiment on yourself, I guess.

• 1:24:36Speaker 01

  I agree.

• 1:24:36Rich Roll?

  Is the best thing that you can do. A couple of other things. You know, one of the other questions that I get all the time is, you know, why, why are you, you know, why 100% plant-based? Like, what's wrong with moderation? Like, why can't, you know, why don't you just go and have a steak every once in a while? Or what's wrong with that? You know, and I feel like what's really behind that question is, tell me that what I'm doing is okay, or give me a compelling reason why it's not. Like, why do I have to be 100%? Or, you know, I guess it's, I guess my question really is, you know, how do you deal with the moderation issue?

• 1:25:13Speaker 01

  A couple of thoughts come to mind. One is, I mean, if you're coming at it from the ethics, there's never going to be an acceptable time to, you know, torture an animal and confine it to the kind of terrible existence that it's going to have in the majority of. Animal farming that occurs in this country around the world, I just can never tolerate it. And if you're coming at it from the environmental standpoint, you'd probably come to the same conclusion with 10 billion people on our planet. Pretty soon, we're not going to have any room for using all the lands for grains for animals. We're going to need them for human beings and grains and grasses and such. From a health standpoint, I'm pretty soft on my patients. I'm looking for change. I'm looking for progress. I'm looking for

• 1:25:55Speaker 01

  advancing down that spectrum. And some of them will jump right to the endpoint and be a disciple of Dr. Ornish, you know, pretty quick. And if they got serious heart disease, I'm pushing them to make that decision pretty quick. But for the average person, I'm, there's that phenomenon now, a book called Vegan Before Six, VB6.

• 1:26:13Rich Roll?

  Yeah, Mark Bittman's book.

• 1:26:14Speaker 01

  I mean, would the world be a better place if there was a widely adopted strategy? We'd be two thirds of the way there in terms of both health and environment and animal rights and the whole thing. I don't know for sure that two or three meals a week that fall off what you're doing and I'm doing are necessary. I mean, it's so much better than the average, you know, three meals a day with cheese and three meals a day with meat and certainly every meal with dairy as a main liquid. I mean, it's so much better that I give people some permission on your birthday and on your special days if you need to. Now, as you know, and I know, when you make that transition from the unhealthy

• 1:26:55Speaker 01

  vegetarian and vegan with soy hot dogs and chick nuggets and soy ribs and when you really get into a whole food, single ingredient, plant-based eating, I don't want those things anymore. And I don't, I see my patients making that transition.

• 1:27:09Rich Roll?

  Yeah, I think you have to, you know, what I always say is like, listen, just if you started your morning every day with a kale smoothie or kale Vitamix blend or, you know, like a green, you know, something green as opposed to bacon and eggs, if you just made that one shift, you'll start to feel different and then you're on your own path. You know, you'll start to connect with your body more and then you're going to start to want to, you know. Incorporate better things in your, in your life and you have your own journey, you know, and for a lot of people, that's the best way to do it. But I think also if somebody says, well, what's wrong with moderation? I think a lot of times people's idea of, you know, moderation isn't reality. Like, I'm like, all right, well, let's talk about, like,

• 1:27:52Rich Roll?

  let's map out exactly what you're eating on a daily basis and let's see if that actually is moderate or isn't it. And more often than not, it's actually not that moderate.

• 1:28:04Speaker 01

  A food diary can be.

• 1:28:05Rich Roll?

  And I sympathize, I'm not like being holier than thou about it. Like, I'm, you know, I have, you know, harbor great denial for many years about lots of my habits, so.

• 1:28:15Speaker 01

  Yeah. No, I agree. And, you know, I don't know that every listener on your show is already on the vegan end of the spectrum, but I already mentioned a strategy that I find appealing, which is, you know, if you're not ready yet to make the transition, just be sure, just like the American food plate from the government says, half the plate is fruits and vegetables and half the plate is other things, protein and grains, strive for that. If you're gonna have a burger, be sure there's a tomato and a lettuce or a slice of avocado. This really cool study came out in March, that a hospital-prepared hamburger caused arterial damage within two, three hours, like the Egg McMuffin study of 15, 16 years ago. And a thick slice of avocado on the burger, repeated the study,

• 1:28:56Speaker 01

  did not cause the same degree of arterial damage. And other studies have shown antioxidants and vitamins, other studies have shown a glass of green juice with a meat-based meal. So there are some strategies as you're making your journey. And they're all gonna result in the same equation, more vegetable, more vegetable, more vegetable, even if you haven't reduced your animal load yet.

• 1:29:16Rich Roll?

  Mm-hmm. Yeah. Or you can just skip the burger and then you don't have to worry about it.

• 1:29:21Speaker 01

  And then they're gonna feel as good as you feel.

• 1:29:23Rich Roll?

  That's right. We don't want that, though. We can't have everyone signing up for Ultraman.

• 1:29:28Speaker 01

  A revolution of wellness, breaking out.

• 1:29:32Rich Roll?

  That's right, man. What are some of the other kind of common things that, that your patients come to you and they, they struggle with in terms of changing their habits? Or, you know, the kind of common pitfalls and how do you, how you address them?

• 1:29:45Speaker 01

  Well, probably in the lifestyle arena, you know, time for exercise, commitment to exercise is a big one. And a lot of them aren't going to find 45 to 60 minutes, four or five times a week to make kind of the magic 150 to 250 minutes a week the American Heart Association talks about. So, I mean, this, I don't know if your readers know, but they're kind of the Tabata protocols, these high intensity, shorter exercise protocols that have got some science behind them, telling them that, you know, a couple of times a week, if you've just got 15, 20 minutes and kind of instruct them what the protocol is. Dr. Tabata, a Japanese cardiologist, I mean, 20 seconds, kill yourself, 10 seconds slower, 20 seconds, kill yourself, has proven to be a good recommendation that a lot of them

• 1:30:30Speaker 01

  adapt. I'm recommending yoga as a therapy that just is scientifically proven to lower blood pressure, lower heart rhythm abnormalities, help with cholesterol control, and just seeing people blossom as they get into some of these Tai Chi, if they're a little less physically able. Tai Chi's been studied in cardiac patients, is absolutely wonderful way to lower stress and lower blood pressure. So those kind of things have been very helpful. I mentioned earlier infrared sauna, it's kind of like a hidden jewel out there. The Japanese have studied these special dry heat saunas that have ceramide kind of heating elements.

• 1:31:12Speaker 01

  They're not the typical little box in the corner that some of us grew up with in dry saunas, but spending 15, 20 minutes at high heat, even if you're a very sick cardiac patient, and then wrapping yourself in a towel and cooling off for half an hour, actually has some of the same beneficial effects on arteries as a big glass of green juice.

• 1:31:29Rich Roll?

  Interesting, I've never heard that before.

• 1:31:31Speaker 01

  Yeah, no. There's probably 25 scientific studies out of Japan that are well regarded. And it's something that for under a thousand dollars or a couple thousand dollars, you can actually buy a nice infrared sauna for your home. Many places, I'm sure, around LA for 20 bucks, half an hour, you can go in and see one. Now, if you're a cardiac patient, you probably want to... Yeah, I can't tell you to check with your doctor because I doubt your doctor will have any clue about it. I wrote an article about it on Mind Body Green earlier this year.

• 1:31:59Rich Roll?

  I'll put a link in the show notes to that.

• 1:32:01Speaker 01

  An infrared sauna, but it's not new age. It's right in the mainstream of medicine. It's just a hidden portal. So that's been a fun one.

• 1:32:09Rich Roll?

  And so what is it? What's... What is it that makes it different from a typical sauna?

• 1:32:14Speaker 01

  Infrared sauna is dry, but it... The wavelength penetrates the skin much deeper with the heating element. So you actually heat up internally pretty quickly. And the protocol for cardiac patients, the sauna is already at high heat. You go in for 15 minutes and you're done. So it's a quick entry. And, you know, unlike the signs on many saunas that cardiac patients shouldn't participate, particularly the kind of whirlpool, this has been studied. There's actually a fascinating study from Japan that actually suggests lifespan is enhanced by people that one, two, three times a week spend 15 minutes in this high heat infrared sauna.

• 1:32:50Rich Roll?

  Hmm. So what is it biologically that's occurring?

• 1:32:54Speaker 01

  Yeah, there's some data that reduces inflammation and then endothelial function, the actual health of your arteries. Like I say, you don't have to necessarily clean every bit of plaque out of your arteries, but you do want your arteries to have healthy response to stress by relaxing and that clotting.

• 1:33:10Rich Roll?

  Elasticity.

• 1:33:10Speaker 01

  Elasticity. And actually infrared sauna, they've studied that and it improves endothelial function along with the rest of the healthy lifestyle spectrum.

• 1:33:17Rich Roll?

  Mm-hmm. That gets... I mean, you hear, as an athlete, you hear, "Well, if you want to reduce inflammation, get in the ice bath." So what is it? So, you know, ice bath, you know, helps you recover more quickly, helps the muscles repair. So how does that mesh with the heat?

• 1:33:33Speaker 01

  It might be that difference between acute injury and acute inflammation and mostly these chronic diseases.

• 1:33:38Rich Roll?

  Oh, like chronic low-grade.

• 1:33:40Speaker 01

  Chronic low-grade inflammation, which characterizes most heart conditions. So it may be that, you know, we're not looking to immediately suppress a sore knee from a 100-mile ride.

• 1:33:50Rich Roll?

  Right.

• 1:33:51Speaker 01

  Just trying to get those arteries a little bit more flexible.

• 1:33:54Rich Roll?

  Gotcha. Interesting. And talk to me... Let's talk a little bit about mindfulness and mindful eating.

• 1:34:02Rich Roll?

  Explain, explain what that is.

• 1:34:04Speaker 01

  Yeah, you know, so we haven't talked about it during this interview. The one that's, one experience that's often pointed to, there are these things called Blue Zones. Dan Butner, a writer for the National Geographic, published that book about five years ago, and looked at societies where people live on average longer than anywhere else in the world. Just fascinating research. Okinawa, an island in Japan, of course, is the longest-lived society in the world. On average, more people over 100 than anywhere else. And they live by this principle that haribachi bu, that you should leave the table 80% full, not 100% full, or not like most of us, 150% full.

• 1:34:44Speaker 01

  And of course, you can't ever possibly get to a habit of leaving the table 80% full unless you're mindful about it and thinking about it and evaluating both your hunger level when you last ate and what's on your plate, and the size of your plate, and the size of your fork, and the size of your spoon and all the rest. Mindfulness has been now something that's been studied by some very interesting food psychologists, Brian Wansack and David Kessler, a former head of the FDA, in a book called The End of Overeating. And it's strategies to sit down at a table with a sense of gratitude, perhaps with a moment reflecting on how the food got on your table and be thankful for those that did that.

• 1:35:26Speaker 01

  There's times in our lives we're going to be able to achieve that kind of highest level, and times that we're probably not going to be so focused. And, you know, not rushing through every meal with standing up while doing other work and with abandon, just being aware that food is such a fundamental healing element in our life, and being aware that start to finish. Part of that is chewing, and chewing is a strategy. Some people refer to it as Chudism, as the kind of religious approach that slowly, gradually digesting food.

• 1:36:02Rich Roll?

  Chewing forever.

• 1:36:02Speaker 01

  Chewing forever, and everything can be taken to an extreme. But being, just, you know, in my tradition of religious background, there's a prayer said before every meal, and of course, there's many other religions that do that, too. And that's just introducing a bit of mindfulness, that this is a little different than brushing your teeth and clipping your nails. A meal is... A medical event, a healing event, a life celebration. And if you can, you know, think about that once in a while, it may transform your life to better choices and maybe less calorie ingestion. And some of it are tricks, and I mentioned in the article, they're not research I've done, but eating on a smaller plate, eating on a salad plate, not a dinner plate, eating

• 1:36:46Speaker 01

  with a salad fork or salad or a soup spoon, a teaspoon rather than a soup spoon, has been studied and you will eat a little bit less and a little bit slower and it's an easy thing anybody can grab onto right now.

• 1:36:57Rich Roll?

  Yeah, I mean, the thing with me is if it's, if it's on my plate or in my bowl, like I'm finishing it, you know what I mean? Like, doesn't matter how much is in there, like, and I don't think about it, you know, I just, it's not done yet, I have to keep eating until it's all gone. So for me, it is, you know, I have to check myself to say, do I need to put this much on my plate or, you know, what am I actually doing? And, you know, I would say most of the time I'm on autopilot with that, like you have to really marshal your consciousness to pay attention to that because, you know, I'm not wired that way and our society's not wired that way. It's all about, you know, fast and cheap and quick and get it done so you can move on to the next thing.

• 1:37:36Speaker 01

  No question. Yeah, one of the, another just super easy strategy, because so many of us eat meals out in restaurants all the time and, you know, the size of meals have just gone bananas, is to just ask right from the front, give me half the meal and pack half up. When you see it's one of those platter meals, so we just had our first Cheesecake Factory open in Detroit and it's being celebrated like we have just...

• 1:37:57Rich Roll?

  Why'd it take so long?

• 1:37:58Speaker 01

  Ah, they couldn't find the right real estate because there were people lined up...

• 1:38:02Rich Roll?

  Plenty of real estate now.

• 1:38:03Speaker 01

  People lined up around the store for days to be the first people into Cheesecake Factory and they have a 2100 calorie meal or something. So if you're gonna go do that, you're gonna have enough food for a week. Ask them to box up half of it and, you know, then you have two meals, but not in one setting. That's a simple strategy.

• 1:38:20Rich Roll?

  Yeah, half the meal at Cheesecake Factory is still twice the meal you need, probably.

• 1:38:24Speaker 01

  And so, yeah, I think I don't mean to pick on them specifically, but that's from my hometown, been the talk of the town lately.

• 1:38:32Rich Roll?

  That's interesting.

• 1:38:33Speaker 01

  Yeah, and they, they pretty much win the calorie per meal award, pretty close.

• 1:38:37Rich Roll?

  Uh huh, except for, uh, what's that restaurant, the Heart Attack Grill?

• 1:38:40Speaker 01

  Yeah, yeah.

• 1:38:41Rich Roll?

  They've, they've had a little controversy lately, but.

• 1:38:44Speaker 01

  They've peaked and, uh, I think Darwin is, uh, having his time with that.

• 1:38:48Rich Roll?

  Mm-hmm.

• 1:38:49Speaker 01

  It was too gross to really exist.

• 1:38:52Rich Roll?

  Yeah, I think two people have died now. There was some guy sort of recently who had a heart, heart attack and after eating, what, what is it, they challenge you to eat this preposterous cheeseburger?

• 1:39:03Speaker 01

  Yeah, the triple bypass, the double bypass, the single bypass, and if you're over 350 pounds, you eat for free and, I mean.

• 1:39:10Rich Roll?

  Just this pridefulness over, you know, doing something that's so horrible for you, you know? Where does that come from and what does that say about, you know, where we're at and, and what we think is okay and fun, you know?

• 1:39:23Speaker 01

  Another addictive.

• 1:39:24Rich Roll?

  Your work is, you'll be employed for a long time.

• 1:39:26Speaker 01

  I'm not too, I'm not too worried. As you say, just like healthy airports, there are glimmers of hope, uh, all over the place, but.

• 1:39:33Rich Roll?

  Oh, yeah.

• 1:39:34Speaker 01

  Not time to rest yet.

• 1:39:35Rich Roll?

  How does it, um, how is your interaction with other cardiologists in your field that are maybe a little bit more traditional? Do you get resistance? Are they interested or curious about what you're doing or how does that dynamic function for you?

• 1:39:50Speaker 01

  Well, you know, I see an impact. Um, medical partners in practice that I've had 20 years ago saw me eating in the doctor's dining room from the salad bar or garden burger or something, um, which wasn't the norm. We was French, uh, French fried macaroni and cheese was the norm and the doctor's dining room and still shows up once in a while. But most of them, I've seen them, you know, look at the, the revolution has started and you can't help but know that this is important and much more obvious than it was. So I see a lot of them. I never got real derision, but I was an odd bird and now I'm not so alone in my, uh, activities. We actually have probably three or four vegan cardiologists in the city of Detroit, which is refreshing. Um, but frankly, if you ask me, do I know any other vegan physicians?

• 1:40:35Speaker 01

  I don't think I can name a fifth one. They just happen to be all cardiologists.

• 1:40:40Speaker 01

  But, but in, and my physicians that send me patients is I add in vitamins and all because it's an area that's controversial. I, you know, they haven't called me to task, but I'm pretty mindful, using that word again, that I'm trying to balance my medical knowledge and what's right for patients and not get the reputation as the herbalist who has lost. I mean, I live by a statement, be open minded, but not so open minded that your brains fall out. And so, I mean, I'm careful, both because I still believe there are attributes of Western medicine that we don't want to throw away. But it's a tight walk. But honestly, for anybody who might be listening now in the healthcare fields, the growth industry is in the wellness sector and the excitement's in the wellness sector and the right answers in the wellness

• 1:41:25Speaker 01

  sector. So, I mean, don't shy back. It's not 1980 anymore. It's not your grandpa's Buick. It's our Cadillac. It's the time to get educated in functional medicine, root causes, lifestyle medicine, and know the tools that are available. And I think we're going to see really great results coming out of us.

• 1:41:45Rich Roll?

  Prevent, not stem.

• 1:41:46Speaker 01

  Prevent, not stem.

• 1:41:48Rich Roll?

  That's right, baby. Good, man. Well, that was great. Thank you. I think we can, that was a good place to wrap it up, I think.

• 1:41:55Speaker 01

  It's fine. Call to action. I mean, I really do believe the revolution is beginning. I mean, in the medical world. I'll just say, as we, and I do want to thank you for this, but I have been very, Sylvanas, ridden kind of a tight rope about how crazy to be in this and yet maintaining what I think is a very excellent reputation in my town and still invited to speak at standard academic events and wacko juicing events and all the rest. I mean, I've had the pleasure of speaking with Dr. Hasselstein and Dr. Campbell and John Sally, NBA vegan extraordinaire and such, and I've had the whole spectrum, but maintaining that balance. But it's time for us to take all this knowledge and, you know, start demanding

• 1:42:39Speaker 01

  change in the medical world, for sure. I mean, we need, and I'm just, I've got enough gray hairs on my head that I just can't tolerate it anymore.

• 1:42:46Rich Roll?

  Can't wait any longer.

• 1:42:47Speaker 01

  I've got to grab my colleagues around the country and say, you know, this, this needs to change for the, for the right message, for the honest message, for the... Ethical message and for the most importantly for the best outcome of patients. So I think we'll see in the next 10 years juicing bars in hospital lobbies and smoothie bars in hospital lobbies and you know, and hopefully the sweet bar is gone and we had Ben and Jerry's in the hospital for five years. I won that battle. Ben and Jerry's shouldn't be in the hospital lobby just like McDonald's. So I think we're going to see some good changes, but anybody out there, let's, let's, let's start it up.

• 1:43:22Rich Roll?

  Yeah, it's all about, we gotta do it together.

• 1:43:24Speaker 01

  Yeah.

• 1:43:25Rich Roll?

  You know what I mean? And, and you know, you are changing lives and you are an inspiration in your field and, and with the people that you work with. I applaud what you're doing and I think it's really important for people like yourself who, you know, have an MD or have stature in their community to look at the science and also look at what's working and what's not and translate all of that, you know, and communicate that in a way that's accessible to people, you know, and a trusted source like yourself. So it's, it's powerful and you know, that, that is, creates a responsibility for you too. And you're acquitting yourself quite well on that. So thank you for what you do.

• 1:44:04Speaker 01

  Thank you. It's been a pleasure.

• 1:44:06Rich Roll?

  Yeah, absolutely. So if people want to find out more about you, your website is Dr. Joel Khan, right?

• 1:44:14Speaker 01

  Actually, Dr. J.

• 1:44:16Rich Roll?

  Dr. J. Dr. J. Khan, K A H N dot com.

• 1:44:19Speaker 01

  Yeah.

• 1:44:19Rich Roll?

  And where else can people find you if they want to? Well, Mind Body Green, they can search your name. You've written like 25 articles on MindBodyGreen.com.

• 1:44:27Speaker 01

  I've got another one coming out this week. It'll be, I think, a popular one. But yes, Mind Body Green would be great. I will in February, actually, starting in October. I'm very grateful Reader's Digest has named me America's holistic heart doc and I'll be having it.

• 1:44:41Rich Roll?

  Oh, wow. Nice. Congrats.

• 1:44:42Speaker 01

  Very excited. We'll be having a monthly column every month.

• 1:44:44Rich Roll?

  I'd swing that.

• 1:44:45Speaker 01

  Well, I have a book coming out published by Reader's Digest in February.

• 1:44:48Rich Roll?

  Okay, cool. So what's, I wanted to, I wasn't going to leave without talking about the book. So tell me what it's called and what, what's going to be in it.

• 1:44:55Speaker 01

  As of this moment, I would say it's going to be called Heart Doctor Secrets. That's kind of the orientation, peeling the onion about starting with nutrition and fitness and mind body and supplements and sleep and on and on. But it's, it's within the medical tradition. It's just little pearls that haven't really been emphasized, but are part of the equation. And you know, people can pick and choose whether they're patients or just healthy people, some new habits. I think it's gonna be a fun book. I just didn't see another book out there. There's not gonna be recipes.

• 1:45:25Rich Roll?

  Right.

• 1:45:26Speaker 01

  I'm not doing Dr. Ornish's work or Dr. Esselstyn's work, but it's got a strong vegan voice to it and a lot of mind-body. So I'm very excited that it'll come out.

• 1:45:38Rich Roll?

  That's great. It's coming out in February.

• 1:45:40Speaker 01

  February 2014.

• 1:45:41Rich Roll?

  It's coming out. That's exciting.

• 1:45:42Speaker 01

  It's been, I told my wife last year, she's been beating on me, write something. So I gotta set a deadline and I got it done.

• 1:45:49Rich Roll?

  Maybe, hopefully you'll come back on the show when the book comes out.

• 1:45:52Speaker 01

  Okay.

• 1:45:52Rich Roll?

  We could talk a little bit more in-depth about the book if you're open to that.

• 1:45:55Speaker 01

  I'd love to. That'd be great.

• 1:45:57Rich Roll?

  Cool. And if you're in Michigan, people should just make an appointment with you and come in and see you, right?

• 1:46:02Speaker 01

  I think they should. I have offices everywhere.

• 1:46:06Rich Roll?

  Yeah, you do. You're monopolizing the greater Detroit area, aren't you? Do you have offices outside of the Detroit area too?

• 1:46:14Speaker 01

  No, suburbs.

• 1:46:15Rich Roll?

  Yeah, they're in the suburbs around Detroit.

• 1:46:17Speaker 01

  Nobody's too far away from me. I've kind of franchised my practice around.

• 1:46:22Rich Roll?

  Yeah, that's great, man. Well, thanks for taking the time.

• 1:46:24Speaker 01

  Okay.

• 1:46:25Rich Roll?

  Anything else you want to say? Feel good?

• 1:46:27Speaker 01

  Hi, Mom. Love you.

• 1:46:28Rich Roll?

  All right, good. We'll end it there. All right, everybody. Thanks. Peace. Plants.