Ella Magers, MSW :

All right. Let’s do it. Well, hello there, Dr. Khan. So happy to have you on.

Dr. Joel Kahn (05:06):

Oh, I wish I was with you in Miami instead of, it’s a ritual now in Michigan where I am that every Friday we’re getting a squall, so we’re going to get hit again. I mean, it’s not like Hurricane Ian, but I’ll share your sunny complexion and smile. I hear from cold and bitter Midwest United States.

Ella Magers, MSW (05:27):

Well, when do you make it back to Miami? Because you’ve just,

Dr. Joel Kahn (05:29):

Yeah, I just had five heavenly weeks of perfect Miami weather, but maybe April, I’ll be back a little fun, functional cardiology practice that can move where I want it to move, which is cool.

Ella Magers, MSW (05:43):

Nice. That is super cool. Well, I want to start, I’ve heard you say you are an on fire doctor as opposed to a burnout doctor and listening to you speak, and that includes your podcast you host, it’s apparent, you’re totally energized by your work. What do you attribute your ongoing fire to after so many years practicing medicine and educating people?

Dr. Joel Kahn (06:07):

Yeah, that’s a good point because I am, in my early sixties, I’ve been doing this practice of cardiology for 34 years, about seven, eight years of training before then. It is a long time, and there’s a lot of requirements. I take it seriously. I got to answer emails and texts and see patients and look at their labs and adjust. I mean, I love it all, but it’s not fitting you for a wedding dress and not seeing again for 25 years. It’s an ongoing, intense relationship. Oh, it was a bizarre analogy I just made, but I can’t think another one. No, it’s not like a one time relationship. And it is one the amazing need in my field for sure. I think it’s a lot of field, but as a heart specialist, we are so poorly managing the prevention of heart attacks and strokes with early assessment starting at your age, what are you about 25 starting at your age?

Ella Magers, MSW (07:04):

No, I’m turning 43 this year.

Dr. Joel Kahn (07:07):

God bless you. You’re looking good. But yeah, literally defining early in life, you’re at risk. You’re not at risk. You should really embrace lifestyle. We’re not talking drugs at a young age, but you know, how critical is it to really embrace lifestyle? Of course, I’d like everybody to do it, but the reality is not everybody’s going to really embrace it. There’s such a pressing need that’s one answer to the question. And there’s so much potential to truly drop heart attack, stroke, early death rates across the United States. It’s such a simple program. Number two, it’s not being taught. So there has to be some people that stand up and scream out loud, I’m mad as Allen, I can’t take it anymore. Enough. Heart attacks, enough heart attacks. And third is the pace of the science. I, I guess I’m a scientist. I’ve done research in the past.

(07:54):

I published papers, but I am just a junkie for reading the latest, the greatest. How did that change? What do I need to incorporate? What do I need to bring in my practice? How can I better patient care? And a lot of it right now falls under a title. Precision medicine, we’re really, really bad at individualizing patient care. Why do you get different recommendations than your friend or the next person in the waiting room or whatever? And we’re getting better at it using artificial intelligence and genetics and genomics and microbiome and the rest. But it’s really there and I’m just, it’s the best medical care I’ve ever seen. So I don’t want to stop because I want to ride this out for a while and see where we’re going. In the longevity world and the prevention world, it’s good stuff and it isn’t really elitist. Some things are expensive, but a lot of this stuff is, I mean, lifestyle is not expensive necessarily, and getting tested appropriately isn’t necessarily expensive. It’s relevant to everybody.

Ella Magers, MSW (08:57):

Awesome. I have a lot of really interesting questions that I want to ask you specifically about medicine and specifically related to.

Dr. Joel Kahn (09:05):

Okay, I’ll just say if you just popped in my clinic and said, I don’t have any problem, but curious. I eat a healthy diet and I’ll just simple blood work, obviously. What’s your vitamin D? What’s your b12? What’s your omega-3 blood level? A very simple blood test. Nobody gets What’s your homocystine blood level? Your C-reactive protein? Of course, I’d like to know at least your basic cholesterol level and something called your lipoprotein a, I mean, eight 10 tests, you’re not going to get at your general internist. You’d have to be in the functional medicine world. There’s places you could pay on your own and get the last, and I see this and patients bring their 18 year olds or 20 year olds, and there’s so metabolically messed up and there’s so much joy in getting them corrected at age 18 or 20 through nutrition, through supplements, through fitness.

(09:55):

We’re not talking drugs of that age. So I mean, even just riding the ship a little bit, when you multiply it by your young age and all the years ahead, it’s a huge difference. And truly, there’s a little hashtag I use all the time test, not guess. It does take, you got to check your blood pressure to know your blood pressure. You got to take some labs to know your metabolic vitamin nutrient status as you get a little older, you might want to do more advanced stuff, but I wouldn’t do any x-ray studies on a young fill. It would be not appropriate.

Ella Magers, MSW (10:28):

Well, before we get into some specific questions, would you mind just sharing kind of your backstory in a nutshell, like how you got so passionate about heart health and using plant-based nutrition as medicine?

Dr. Joel Kahn (10:39):

Yeah, about four or five bullet points through my life. I was born with a heart murmur, caused my mother and my father great grief. When I was a few days, a few weeks old, I was assigned a pediatric cardiologist. Obviously I don’t remember that first year, but I did have some cardiac testing. Long story short, I’m fine. It all was a little whole in the heart that healed up. But I started going to pediatric cardiologist by age 10. If you would’ve ask me what I want to do. I want to be a heart doctor. And there were no docs in the family. There were good people, but they were more in retail and merchandising. So I made a decision pretty early. Number two, I grew up in a Jewish home where we kept kosher and I therefore, at least for a minute thought before I ate, does that have bacon?

(11:22):

Is that a cheeseburger? Is there pork in that? And that momentary pause before you open your mouth is rare. We call it mindfulness and all, but it was kind of built into me at an early age. And when I attended University of Michigan where I was accepted at age 17, they had a program. We got accepted undergrad and med school combined. So it’s really a wonderful program when you’re that young. The dorm only had a salad bar that met my dietary needs. So I started transitioning rapidly and almost completely to an all plant diet at age 18. And interestingly, at the same time, my parents went to the Precan Center, totally unrelated to anything going on in my life, just a little health cleanse. And my mother came back making lentil loaf rather than meatloaf. And I’d come home on the weekends and there was a lot of plant-based entrees, so I’d been now a hundred percent for years, but really essentially for over 40 years.

(12:20):

And as I went into cardiology training, I started to hear about Ornish and Kin and eventually Joel Furman and Dr. Eston, and I was well schooled for that. I mean, I was eating that way. I didn’t realize it, so I sort of always combined. I was a cath lab stent, heart attack guy, but I would teach my patients, you know, don’t need to have this heart attack a second time, and maybe you want to read a book by this Dr. Dean Ornish that Sunday New York Times bestseller list in 1990, and it’s always been part of my practice 10 years ago. I said, screw it. Done putting in stents. We’re going to see if we can make a practice out of just prevention, just lifestyle, just advanced testing, just cutting edge stay. There has been a wonderful ride, and that’s why I’m excited because there’s an old business book called Blue Ocean, red Ocean that if you’re doing the same thing everybody else is doing, it’s called a red ocean full of bloody, bloody competition, you know, can make a success by being superior, but you’re just another cog in the wheel. Blue ocean means you’re kind of in a field where nobody else is in. And right now really preventive cardiology, particularly integrative plant-based, preventive cardiology. I mean, I can’t find 10 other people in the country kind of doing what I do. So yeah, you got to be excited about it and there’s sort of a responsibility. I mean, I could go play golf, but I’d rather see eight patients and maybe change some lives for the better. Good stuff.

Ella Magers, MSW (13:46):

Great stuff. All right, so I would love to cover some topics in our short time today that have a lot of conflicting and misinformation surrounding them. I have a whole list to go through, but we’ll see how far we get. Sure. Now it taken into consideration, I think most of our audience is relatively, has some relative good knowledge and it’s doing pretty well. Can we talk about cholesterol first? And this is something, and I’m going to kind of sprinkle in my own story because high cholesterol runs in my family and I’ve, I’ve done a ton of research myself and I’ve got borderline high cholesterol. I’ve been vegan for 27 years. I’ve been primarily whole food. What do I need to be concerned about? What do I need to be doing? Can you talk a little bit about that? Because I do hear more and more plant-based people that say, I’ve got high cholesterol, what’s going on?

Dr. Joel Kahn (14:46):

Yeah, and generally what we’re talking about when you ask the question, we really are asking what about L D L cholesterol and does it matter? Because that’s the primary focus of cardiology research and treatment. We care about triglycerides and total cholesterol and HDL cholesterol, but it’s really L D L cholesterol and I have to give a shout out. One of those blood tests that I would do on you if you popped into my clinic, would be a second kind of cholesterol called lipoprotein little a, and maybe that was one of your questions, but very few people unfortunately are aware that all of us make L D L cholesterol in our liver, whether we’re vegan or carnivore or keto or paleo, but 25% of us 25, why not very four people get a genetic gift from their parents, one or both parents where they can make two kinds of cholesterol that are potentially not very good for your artery health long term.

(15:36):

The second one is called lipoprotein little. A discovered 60 years ago, available as a blood test for 20 years cost you 20 or $30. One out of every four people could develop a heart attack, a stroke, a bad heart valve from a genetic input that is just one little check mark on the lab slip that your primary care doctor, your gynecologist, your internist, your functional medicine doc, your nurse practitioner, but one or 2% of healthcare providers in the United States, check that extra box. You should ask, I’ve written six books. My last book to date is called Lipoprotein A, the Heart’s Quiet Killer. It’s full of amazing plant-based recipes, but it’s also the only book in the world on the topic, and I really coach a lot of people what to do with their high lipoprotein A, but both lipoprotein A and back to your question L, LDL cholesterol, they’re risk factors.

(16:28):

They’re not definitively indicating that you’re going to develop plaque that could lead to heart attack and stroke. You might not get back to hashtag test not guess. All the data in the world is that elevated L D L cholesterol is a risk factor, and I say a risk factor, not the risk factor. There’s 25 things that cause aging of your arteries and put you at risk for guys having erectile dysfunction and the rest of us all having risk of heart attack, stroke, early death, family histories of heart attack. There’s 25 things. There’s your blood pressure, there’s your blood sugar, there’s your stress level, your sleep, obviously, your diet, your fitness. There’s the lipoprotein little A, there’s something called T M ao and I won’t go on and on. You can measure at least a dozen of those 25 or 15 of those 25. We’re getting better at measuring genetics.

(17:21):

You can do a cheek swab, you can spit in a little saliva tube, send it off for a few hundred bucks and really find out if you’re a genetic time bomb. I went over that with a patient in the clinic today, a 52 year old Greek dentist who genetically, he’s messed up and he’s got to work on his lifestyle even harder than somebody who genetically got good gifts. So when you put all that together, we’ve had data since I, I’d say the sixties and the seventies that you have to admit and certainly cardiology and I’m still, I’ve got my foot in integrative lifestyle, vegan and medicine, but I mean you have to be aware of what’s going on in cardiology that the major cause of plaque and arteries is the uptake of L D L cholesterol into the wall of arteries, causing arteries to get stiffer, calcified hardened, and ultimately narrowed over time, which we call plaque, we call hardening the arteries.

(18:16):

If you have a very low L D L cholesterol, people are born with a genetic, a variation where they have low L D L cholesterol for life. They have much lower risk over their lifespan in developing strokes and heart attacks than people that are genetically born with slightly higher d l cholesterols for life starting as kids. So if you have a crappy diet from childhood, you’re probably going to have a higher cholesterol and l d cholesterol from childhood. You’re at more risk. If you somehow were eating well and then adopted a crappy diet due to maybe work stress and life stress and midlife, you’re a little less risk because it’s all area under the curve. How many years did you have an elevated level and how elevated was it? Can you be 43 years old, have a cholesterol of 300 and l D L of 200 and perfectly clean arteries under easy testing?

(19:05):

You can, and that sort of causes the question mark. Cholesterol isn’t always dangerous, but it’d be very risky to ignore that and not know your numbers at least. And there’s not too low a cholesterol. That’s the other flip side. There has been concern in the functional medicine world, well, isn’t cholesterol the backbone of sex hormones and vitamin D and cortisol? And isn’t your brain made up of cholesterol and just to dispel, there’s a system in your brain to make cholesterol. When you go to your doc and you get a blood cholesterol of 182 or 212, that is not what your brain is seeing. Your brain has its own method. So if you can lower, you go plant-based, you start to exercise, you take some red juice, rice or add some ground flax to your diet and your cholesterol goes down, doesn’t in any way imply that your brain isn’t getting all the cholesterol it needs and cutting edge cardiology research.

(19:57):

Now with all the medications we have available, some are a little riskier, some are not, that can lower cholesterol, ridiculously low. People actually do fine. They feel well, they don’t have brain fog. The hormones are fine. That’s only appropriate for really advanced heart disease patients, not the general public. So the real big fork in the road, and you’re a little young for it, but not necessarily if you knew your arteries were starting to develop a little plaque, you might conclude, I don’t really like that. My LDL cholesterol is 150 and I maybe ought to explore natural supplements or something called the portfolio diet, which is a variation on a plant-based diet that Toronto researcher, David Jenkins, md. But go search the portfolio diet a little way to add a little more soy-based foods, soluble fibers, nuts and seeds, sesame seeds and sunflower seeds and plant-based steriles from food.

(20:52):

I don’t like plant-based as a supplement. That’s another story. And if you knew your arteries were perfectly clean, you might have a relaxed attitude. That’s what I do in my clinic. So if you’re a little older than you are, you can go for this simple CT scan of your heart called the heart calcium CT scan, 50 bucks, 75 bucks, comes back zero, forget about it, forget about your cholesterol. That’s actually the cutting edge science. My podcast last week was on that topic, new science from Denmark, 24,000 people with a calcium scores CT of zero and a high L D L cholesterol. You did fine. You can ignore it. It’s curious, but you can, and then you want to recheck down the road, but if you were developing plaque, you can also do a little ultrasound to the neck like you’ve heard of lifeline screening. That’s not a really good way to do it.

(21:38):

I was just in Miami and we brought a really high end company and to do super accurate digital carotid imaging, but if you knew, damn, I’m 42 and I’ve got a little bumps of plaque in my carotid, that’s when you have to check other things like your blood sugar, your blood pressure, this lipoprotein A, your inflammation. So cholesterol, oh matters, but it matters really if you have plaque in your arteries, which leads again to hashtag test. I guess a simple protocol would be by age 50, get all of the labs and maybe get that heart calcium CT scan. I might even wait a little longer on a premenopausal woman of low risk. But if you’ve got heart disease in your family, these are simple things you can do that don’t cost a lot of money. I will tell you too, 45 years vegan or something, whatever, 46 years vegan, my cholesterol is not under 200, and there’s a lot of ground flax seed and a lot of tofu and a lot of sunflower seeds and not processed crap. I don’t eat impassible burgers. I don’t do coconut oil. I am putting olive oil in my coffee lately. That’s my

Ella Magers, MSW (22:44):

New Oh, tell us about that because I was just about to ask you about coconut oil, if that’s something that we should avoid. If you are,

Dr. Joel Kahn (22:49):

There’s a little buzz in the media that at Starbucks in Italy, they’ve created a line of drinks called oto, which is like lattes and oat milk lattes that have a tablespoon of organic extraversion olive oil, and they’re bringing it of course to Southern California, and then they’ll spread it. It’s an interesting idea because I still have a substantial number of patients that are putting butter and mc t coconut oil and ca of course, bulletproof, creamy coffee, right? I’m very against have had patients have very bad outcomes. Their cholesterol shoots up like crazy. The difference is coconut oil and butter are very high in saturated fats as well as they contain dairy, which a lot of people have intolerances to dairy and get irritable bowel kind symptoms and gas and bloating, whereas extraversion olive oil has the whole Mediterranean diet experience is generally reducing heart risk, being fairly neutral to cholesterol.

(23:46):

It’s got a smaller content of saturated fat, a chemical version of fat as opposed to butter and coconut oil. So it’s an interesting idea. I’m not pushing on anybody, but if you had to choose between the two, I’d rather you take a nice mug of black coffee, put a tablespoon of olive oil, and use it as a way to stretch your period without a big meal to lunch. Although I’m not a big fan of that progress, I’m a breakfast eater. The data strongly suggest breakfast eating is a good plan. Maybe work out and eat some breakfast. But if you’re enjoying skipping breakfast, the olive oil coffee thing is an interesting little twist. A coconut oil, as I say, it’s about 85% saturated fat palm oil. Similarly, M C T oil is sometimes super purified. Coconut oil using what’s called the C eight version, short chain version of coconut oil.

(24:42):

It’s debatable if it’s healthy or not healthy, but overall, even like with the stodgy American College of Cardiology, American Heart Association or beware, beware coconut oil, where they’re gaga about extroversion olive oil, and I know there are some plant-based physicians, my colleagues, that are no oil, no oil, no oil. They’re wrong. They’re wrong. They’re wrong. The latest, greatest data, if you have any interest out of Spain, it’s called the Cordio prep study, C O R D I O P R E v a thousand heart patients given five tablespoons of olive oil a day or none. They’re flourishing on the high olive oil diet, and it really has broadened the question the last 20 years of hearing over and over. No oil, no oil, no oil. So for most people it’s so much better choice than butter. Gee and lad, super high saturated fat foods.

Ella Magers, MSW (25:35):

Well, you just made my day because I love olive oil and I put it on I, well, maybe I’ll ask you wasn’t going to ask you about this because it’s not maybe specific related to cardiovascular, but I love olive oil on kale, like I massage kale with olive oil and now there’s all these research studies that I’m seeing that eating raw kale is hazardous to my health. Do you buy into any of that?

Dr. Joel Kahn (25:59):

I don’t. There’s a talk that it’s a nitrogen that it can affect the function of your thyroid. I think in the whole world, there’s one or two case reports of people eating, I think it was actually two pounds of bach choy a day. I don’t think it was actually kale. All the benefits, the fiber, the phytonutrients, the incredible chlorophyl load. What are you going eat? If you don’t eat kale, you’re going to eat fried plantain or something. No, so I’m pro, but I do like to rotate greens, get some arugula, get some bre, get some iceberg, get some romaine spinach. Although I’d like to rotate spinach, just a few people get kidney stone swim like Chris Hemsworth from crazy spinach content. It just makes sense. Rotate it around a little bit and purple cabbage, get some organic raw purple cabbage and chop it up and throw it in all your salads. Such a incredible super food.

Ella Magers, MSW (26:57):

Love it. All right, so you just mentioned, you’re mentioning all the things that I want to ask you about intermittent fasting, your professional opinion on that.

Dr. Joel Kahn (27:06):

Yeah, and that’s just quick terminology. What most people are doing is officially called in the fasting world, t r e, time restricted eating i e between 12 and seven. That’s officially according in my guru is Vaulter Longo, PhD, university of Southern California, the amazing book, the Longevity Diet 2018, the amazing product, which is largely plant-based except for little honey called ProLon, the five day fast amendment can diet. We use that like Gaga in my office with great results. Love the science, the newest science for ProLon, the five day Fasting Me diet was actually a skin analysis of incredible advances in collagen and skin appearance and cosmetic appearance. So it makes you beautiful to do the five day fasting diet inside and out. Actually, that was in the literature about two weeks ago, but so time restricted eating. I have black coffee maybe with olive oil, maybe with just black coffee, and I eat from 12 to seven.

(28:03):

It sounds great, and people do flourish on it and others don’t. People lose weight on it and others don’t. But when it’s been put to the test, a famous cardiologist at University of California, San Francisco, friend of mine, Ethan Weiss, md, he could not prove that doing that versus 12 hours of eating led to any advantage in his patient group, and he was a huge advocate of that. He was sorely disappointed when he actually organized more than a hundred patients. So there was a study in 2022 out of China. We eat 1500 calories a day and we eat it in 12 hours or we eat it in six hours. They were unable to prove a benefit. There’s been a couple papers, scientific papers in the last couple months, one in animals that’s skipping breakfast, impairs your immune health and another human study that’s skipping breakfast. There may be a stress to going prolonged periods without eating. It’s stressful. Even the pro on five day, you don’t go without eating. You just eat three little snack lits a day that give you 800 calories, but you are providing consistent nutrition in your body. So I think it’s controversial. If it’s working for you and you feel good, I don’t know that you need to disrupt, but don’t,

Ella Magers, MSW (29:28):

Oh, let, we lost him. Let’s see if we get him back. The joys of being backstage with a podcast recording. While we’re waiting, dse, if you have any questions, just raise your hand and I’ll get to it at the end. Or there’s a raised hand or there’s a q and a option. If you have any specific questions, I’m sure he’ll be back in a few minutes. Fingers are crossed. I could talk to him for hours. So many questions I want to ask. He’s so knowledgeable. Yay.

Dr. Joel Kahn (30:52):

Oh,

Ella Magers, MSW (30:54):

Amazing. You’re back.

Dr. Joel Kahn (30:56):

Yeah, the carnivore people got us. Hi, everybody. We’re back. I’m glad. I have no idea what happened.

Ella Magers, MSW (31:04):

I don’t either, if that’s okay. Oh, where

Dr. Joel Kahn (31:05):

I was about to make a comment. You want me just to pick up?

Ella Magers, MSW (31:08):

Yeah, pick on up.

Dr. Joel Kahn (31:09):

I was just saying that skipping breakfast scientifically has suffered some hits lately is being unsafe, and it goes back to that old statement. I don’t know where it comes from, but eat breakfast like a king, eat lunch like a prince and eat dinner like a popper. I think clearly we want to try, except for social events. When you’re out and you have to live your life, try and get your meals done by 6, 6 30 if your schedule will allow. So many of my patients are just running in the house at seven 30 and eating big meals, particularly if it’s kind of an Eastern European ethnic thing, but try and fight that. And I sometimes laugh. I mean, they call it eating dinner at five o’clock, they call it Boca Midnight. That’s a late man. Five o’clock is late, but it’s a good way to eat actually. So yeah,

Ella Magers, MSW (31:58):

No, I’ve been trying to get my meals in early and I do. I start to, I’m like, wow, I feel like I’m grandparents. You think about eating. Yeah, exactly. Yeah. What about the vegan or I don’t know how they call it, diet, the plant, paleo, vegan. Do you have any thoughts on that? And I want to ask you about the blood type diet just because I have a friend who drives me crazy with the blood type diet,

Dr. Joel Kahn (32:25):

The vegan diet that was kind of created just to sell as many books as possible so people don’t know. I was sitting on stage in 2014 with Mark Hyman and let’s see, mark was in the, I was to his left and Frank Lipman pretty well known functional medicine doc in Manhattan was to his right. And we were being interviewed about what we eat, and it was pretty clear that Lipman was a paleolithic eater, and I was a very strong hearted vegan eater. I think I had a T-shirt on that said, same about vegan. So Hyman in his very clear way said, I guess I’m a vegan. And from that came this idea that if you don’t offend anybody, you sell more books. And it’s true. What’s the vegan diet? Isn’t that called the Mediterranean diet where you minimize the amount of animal protein and you make it high quality and you have lots of grains and cut out butter and use olive oil.

(33:20):

I mean, it’s pretty much the same, but there’s no real science to it, and unfortunately there’s no real strict definition either. I mean, the Mediterranean diet is a pretty clear cut pattern of fish and plants and grains and olive oil and minimizing dairy and minimizing red meats and no processor junk food and low sugar heads out be eat poor people in the Mediterranean basis. So vegan, some varied on that. The other diet you asked about was blood type. Yeah, the famous, and sometimes I sit on the shoulders, I sit on the shoulders of giants, but I think around 2014 there was a tremendous video by Michael Gregor on nutrition facts.org, really dissecting the blood type diet. And that book was published about 20 years ago and sold 15 million copies, made a lot of money for the author without a doubt who promised to deliver the goods.

(34:18):

After this book is published, I’m going to provide all the research that substantiates the idea that type O should eat meat and type A is more inclined to be plant-based. I happen to be a type A blood type, but I don’t think it has an influence, but it never appeared, and the majority of the data says there is no consistent relationship between your blood type and your diet. There may be between your immune health or may be between your covid response. Some data came out, it’s not unimportant to know your blood type, but to say, use it as an excuse. I’m type O, so I’m going to eat a lot of, or organic meats or it’s largely nonsense. I think anybody can do well on a whole food plant-based diet. They give themselves some time and variety and have a loving and intolerant family around them.

Ella Magers, MSW (35:10):

Sweet. I love that. I was actually talking, chatting with Dotsie vouch yesterday. Yeah. And she mentioned I, I’d mentioned I was going to be chatting with you today and she mentioned how helpful you were to her and how grateful she was to you for helping her get through Covid, and she mentioned that you had her swabbing the inside of her nose six times a day with Betadine. Can you can share anything with that? Yeah. There’s

Dr. Joel Kahn (35:35):

A protocol mean we’re off track vegan, but I’m happy to talk about it. Obviously it was interest in early treatment of Covid and there were drugs that were repurposed. They weren’t horse drugs, they were human drugs, and they seemed to benefit people in 2020 and 2021 when people were so sick. But what clearly is substantial and it’s controversial, but what clearly is substantial in the literature for any kind of virus, whether we’re dealing with the flu, respiratory, sensorial, common cold, perhaps covid, which fortunately most people are not super sick anymore. There’s still people getting it, if you will. Gargle, gargle, gargle 4, 5, 6 times a day. It can be diluted salt water. It can be hydrogen peroxide diluted down like maybe one part hydrogen peroxide, four or five parts water. You can do it with Betadine, which is also known as povidone iodine solution. You buy at the drugstore diluted goggle spit four or five times a day.

(36:33):

It can really, there’s a statement in medicine dilution is the solution to pollution, and if you’ve got a load of virus in your oral pharynx and you dilute it down, you should recover low, quicker. You want to do that in your airway too. So you have diluted salt water diluted betaine or diluted hydrogen peroxide and maybe a Q-tip or you get a Neti pot, and if you’re sick, you do that four or five times a day, you’re like, I don’t do it anymore. Because thank goodness, I think we’re very close to declaring covid as a really low grade risk anymore. But I used to, I was come back from a music concert or a wedding or a large lecture, I would gargle a couple times and take care of my nose, and I think it’s a science backed approach. There’s real value to it. Cool.

Ella Magers, MSW (37:21):

Cool. Thank you for sharing that. All right. There is

Dr. Joel Kahn (37:23):

Some data that plant-based diets improve our immune system and made plant-based eaters more resistant to severe covid illness that’s published in the literature. It’s got a little bit of bravado we brag about, but it’s actually seemingly true.

Ella Magers, MSW (37:40):

Awesome. All right. Monkfruit sweetener I had been using with the erythritol. Can we spin just a moment since that’s that’s kind of recent on your

Dr. Joel Kahn (37:51):

Hottest science in America?

Ella Magers, MSW (37:53):

Yeah. Well, Peter Atia, I get his newsletter and he came out and said it was you. It was more harmful to be reading it and freaking out about it than actually be consuming it. So

Dr. Joel Kahn (38:05):

Well, there really is. We don’t know. So everything starts with one paper in the scientific world, and then there’s people all over the world have a reason to pursue it and validate it or discredit it or amplify it. So I wrote a quick blog on the topic. I know the authors, these are some of the most respected scientists in the world. They happen to be at the Cleveland Clinic led by a guy named Stanley Hazen md, and about 12 years ago, he published a paper, that’s what I wrote in the blog, that they had identified a molecule in the blood, never found in humans before. They had to create a blood test. The molecule was called T M A O. Their research showed when you ate egg yolks and red meat, your blood level of T M A O went up. They checked it in a large group of heart patients.

(38:53):

It seemed like the higher your blood level, which they created the blood test, the higher was your risk of C clogged arteries. They went to mouse studies and looked like that T M A O might actually cause atherosclerosis to accelerate. And then they went to some volunteers and they fed a typical person in Cleveland, a steak. Their tm A O level went up and their platelets got sticky and they gave them to vegans, and the vegans didn’t have a rise in T M A O because our microbiome is different if you’re a hardcore vegan, but I guess if you’re a hardcore vegan given a 250 bucks to eat a steak in a research study, you might do that. And that was one paper. And did they get criticized? Yeah. Did the egg board like the paper? Did the meat board like the paper? No, no, no, no, no. They didn’t come out. None of the researchers are vegan researchers. They didn’t come out and say, you got to abandon these foods. Of course, people like me jumped on the wagon.

(39:48):

Now, there is a blood test for T M A O. Now there are 2,500 research papers. There’s an active field of developing T M A O blockers and other things. So the whole field is mature. The erythritol story is like that first paper. There was no blood test for erythritol, but they had some background reason and previous research to suggest that our bodies make erythritol. Maybe we make more when we’re in poor metabolic shape. But there’d been an explosion in the last 10 years with erythritol as a sweetener added to many foods, particularly keto ice cream, keto cookies. And they did the exact same thing. They did a general study suggesting maybe erythritol is related to heart disease. Then they developed this blood test, and they more specifically in like 3000 patients, big, big numbers in England and United States, the higher your blood level, the higher was your degree of plaque in your arteries.

(40:48):

Now, some of that may be coming from your own metabolism. Some of them may be coming from the foods you eat, no doubt. Then they went to the mouse model and they showed that that erythritol can make platelets stick together, kind of like they did with T M A O, which means you might have a increased risk of clo, and then they took eight normal volunteers and they gave them a load of erythritol, showed that it quickly showed up in your blood and then made their platelet sticky too. So it makes human platelets sticky. Did they prove that it causes heart attacks and causes stroke? No. Yeah, they’re going to be a thousand papers in five years on this topic. Sure. Is there probably going to be a blood test on erythritol available in the future because of this as another way to assess your metabolic health and risk and all?

(41:34):

There probably will. I think this is just one opening the door a crack of what could be a very exciting pathway. I think we should congratulate these people. Everybody’s been criticizing and they don’t understand this is a huge breakthrough. Their quest at the Cleveland Clinic is what is causing heart attack and stroke that we don’t know about. Everybody knows about smoking, diabetes, blood pressure, cholesterol, lipoprotein later, a, what don’t we know about? And what a fascinating research field that is. So should you use your erythritol sweeten or not? I probably wouldn’t. I would use liquid stevia, although the risk to you is probably infinitesimal to use it, but now that the cat’s out of the bag, there’s no nutritional value to using erythritol, and we really don’t need to be eating keto ice cream and keto cookies anyways. If you’re going to do the ketogenic diet, do it clean if you’re going to do it. There was a paper in the medical literature, it’s been, again, beat up all over the web that people doing the ketogenic diet might have two to three times the risk of heart attack and stroke of people eating other dietary patterns. And the keto people are going gaga because it’s not a perfect study. It’s a study, not a perfect one, but that’s the nature of nutrition research. Everybody gets threatened and everybody fights and pushes back.

Ella Magers, MSW (42:53):

Understood. Thank you for that. All right, last question, because I know we are needing to wrap up here. You personally, what are some of your habits that you rely on to keep yourself as healthy and happy as possible?

Dr. Joel Kahn (43:09):

Yeah, and we have to self-care. Turning 64. I got an example to my patients. Write about it, talk about it on my podcast. Number one, in sleep. I grew up in the medical era where it was absolutely routine to wake up at four 30 and go to the gym for an hour and show up at the hospital at 6:00 AM and make those early rounds. And there were two of us always there before everybody else. We would high five each other, not anymore. I one, I changed my practice, but two, the flood of data that generally seven to eight hours really working on it with all the sleep hygiene. And if you need supplements, if you need a face mask, if you need a white noise maker, if you need to get away from E M F and wifi and all the rest, do what you need to do.

(43:55):

But sleep is and get a home sleep study if you need to tape your mouth at night. If you’re a mouth breather. I mean, there’s just so much to say. Number two, I work out every day, but you wouldn’t call it a workout. My wife doesn’t call it a workout. I do something. It might be 15 minutes of yoga. There’s a particular pattern called the five Tibetan rights that I like to do because it’s not like 12, 13 minutes. It’s a very well established same flow every day. It’s not like Ashtanga. It’s sort of got a ritual around it that it’s an anti-aging longevity yoga flow. But there’s a book written called Five Tibetan Writes, R itts. It might be other cardio and weights, and on a weekend I’ll up it. But there’s so much data lately that 10, 15 minutes of hit training is really quite amazing.

(44:41):

I have a little bike at home called the Carroll Bike. It comes from England. Anybody could get a C R O L that’s a nine minute bike workout that totally depletes all the glycogen out of your leg muscles and causes an increase in your oxygen consumption. You just spent 35 minutes on the elliptical. It’s pretty cool. It’s good. Short time. Three, I eat very clean and very well, two meals a day, three meals a day, always pack my lunch. I enjoy eating at restaurants. I’m picky, but I’m a little more relaxed. It’s always plant-based. Four amazing extroversion, olive oil, five supplements. I take a variety of supplements. Magnesium, coq 10, vitamin D. I take plant-based kind of replacement supplements. I don’t think it’s a major apology. All my meat eating patients have huge nutritional deficiencies. One of ’em today has no omega-3 in their body because they’re eating meat all the time.

(45:38):

Wow. You know, don’t have much brain power there. If you have no omega-3 in your diet or you don’t supplement it one way or another, and your triglycerides and your metabolic status is off a sense of humor, sense of faith, mission, purpose, all those things. I’m far from ever board, but I can, what do they call it in the blue zones, slowing down downtime a little bit. Have to do that. Got puppies all over the house. So rescue puppies, which are nothing but a bundle of joy. Oh, connection to family, connection to friends. Trying tot think of was any other. I have a lot of weird, I have infrared sauna in my house and photo biomodulation red light panels. I’m kind of not a full-blown biohacker, but pretty close to it. I think P E M F pads, I was very skeptical about them. Pulse electromagnetic frequency pads, little bit elitist because they’re expensive. There’s a particular brand that people sell in multi-level marketing that I resisted, resisted for many thousands of dollars. But I did my research better, and if you got aches and pains and Achilles tendonitis in a frozen shoulder, there’s like so much restorative benefit that seems to come out of these P pads. I dunno. So what I got and a little red wine most nights I want, I’m not an anti red wine knight. I’m a give me a very low sugar, low alcohol European ante, and I’m a happy glam.

Ella Magers, MSW (47:10):

I’m so glad you said that. Alcohol was on my list and we didn’t get to it today, but I appreciate you. You’re so knowledgeable and so generous with your time and your energy and your wisdom, so thank you so much. Where can people find you? How can they work with you? Yeah, tell us.

Dr. Joel Kahn (47:26):

Yeah. I’m in Detroit, but I’m sometimes in Miami, licensed in about 20 states, and I do a lot of telemedicine and preventive integrative cardiology. I love it. I have a website, Dr. Joel Kahn, d r j o e l k a h n.com, and there’s a weekly podcast and blogs and I don’t know, a couple videos and some fun stuff. Got six books out, so I appreciate so much. You’re doing great stuff. You’re reaching it’s, it’s in just the right place. You want to really reach people in their late thirties, early forties, and smack ’em around a bit. Everybody feels like you’re invincible at that age, but it doesn’t always work out that way by, you’re in mid fifties and mid sixties, so know earlier the better.

Ella Magers, MSW (48:13):

Ah, thank you. Thank you so much, Dr. Khan. I appreciate you.

Dr. Joel Kahn (48:17):

You have a great, great, great day. Thanks.

Ella Magers, MSW (48:19):

See you too. Awesome.