 My man, Philip Avedia, heart surgeon, his book, Stay Off My Operating Table. Philip, we have tried to do this podcast several times now with several false starts, but I am happy to have a good friend on the show. Thank you very much for joining us today. And I guess we should just start this out with the buzzword of metabolic health. It was you who I first started hearing this term from and now I'm beginning to hear it everywhere. And it seems like the medical establishment is catching up with its importance. It is simplest explanation of metabolic health that I use for people, is that when you are metabolically healthy, your body is using the inputs that you are giving it correctly. And that input is mostly in the form of the food that we are eating. Typically when we eat, one of three things is supposed to happen. Some of that food gets turned into immediate energy for us to fuel all of our daily activities. Some of that food gets used to build and rebuild our tissues, which is a process that's constantly going on within our bodies. And then some of it is supposed to be stored, just in case there are times when food is not available. And unfortunately, our modern food environment is such, we rarely, if ever, are in situations where food isn't available. And more so, the problem is that the specific foods that we are eating causes our body, signals our body, to store too much energy. And then we never get to use that stored energy. And as we build up more and more stored energy, which most of us know as fat, then we start to see a whole host of problems that develop downstream from that. Well, I'm glad you brought that up because when we think about our food and certainly the modern diet, part of the reason we have this abundance is because it's heavily processed, because it's made to sit on store shelves and be transported across great distances to be readily available for us. But it's not necessarily the food that our body is most tuned to eat and respond well to in terms of health. So processed foods seem to be a really big part of this need for your body to then turn what you're eating into fat storage and then the whole host of health issues that come out of it. The shelves in the store are not the only place that this food is sitting on. Yeah, exactly. And the problem that we have is most of what we call food today is really a fool's gold. It is something to eat, but it's really not supplying our body with what it needs, which is the nutrients. Our bodies doesn't actually sense calories. We've all heard now for most of our lives that calories are the only thing that matters and it's all about calories in and calories out. But the reality is, is that we have no calorie sensor in our body. There is no place in our body that determines whether or not we are hungry based on how many calories we have eaten. Our body is looking for nutrients. And the problem with processed food is that it's largely devoid of nutrients. And even the nutrients that are in there, oftentimes our bodies can't actually absorb them. On the back of the cereal box that it is 100% of this vitamin and 100% of that vitamin. But the reality is, is that oftentimes our body can't absorb the vitamins in the form that they're in processed food. Our bodies evolved eating whole real food. And my kind of cheat code for that is the things that grow in the ground and the things that eat the things that grow in the ground. These are the things that we evolved as humans eating. We can efficiently get the nutrients out of those foods and those foods only. And the kind of artificial manipulated substitutes that get put into the processed food don't satisfy our body's needs. So our body then is constantly on the search for more and more food because it's not getting the nutrients that we need. Now, if you're a fan of the show, you know that Johnny and I almost never talk about health and fitness. We certainly don't talk about our diets and what I love about your book is you recommend a ton of different diets, whatever fits your lifestyle. But before our audience tunes out and thinks this is just gonna be about biomarkers and food, what are the impacts of this low quality diet on our mental health, our relationships and ultimately our mental wellbeing? Right, and you know this show is about optimizing every aspect of your life. And the reality is that if your nutrition isn't optimized, if you are not healthy and specifically if you are not metabolically healthy, it's going to be very hard, if not impossible, to optimize all those other things. What I find is the clients that come to me who are not metabolically healthy and they describe things like brain fog and lack of energy and just a general mood that they're not thriving, they're not living in abundance. When you fix the nutrition problem, when you fix the foods that you are eating, it then becomes a lot easier to address all these other issues in our lives. And I think there's a misnomer around modern medicine that we are predisposed to be our healthiest if we're just getting regular checkups and seeing our doctor. When in reality, staying off your operating table means our health is in a really poor place if we're seeing you. So unfortunately, many of us find ourselves seeing doctors when it's too late, when we haven't made the changes and now we go for surgeries and medical interventions like prescription drugs. But unfortunately, even if we were on your operating table, that doesn't mean you're gonna be right back to normal running and enjoying life. I mean, those heart procedures do a number on your life after them, right? Yes, definitely true. One of the things that I talk to my patients about is the surgery that I'm about to do on them, like you said, it's a major surgery, it involves a major recovery, but it really doesn't address the underlying problem that led to them being on my operating table in the first place. And it's basically just putting a band-aid on the problem. And yes, in the situations where you have advanced heart disease, it certainly can improve your life and extend your life. But if you don't address the underlying issues that led to you getting there in the first place, you can end up back on the operating table or you can end up with other medical problems down the line. And the sad reality is that our healthcare system has become so overwhelmed with taking care of sick people that we have forgotten and lost focus on keeping people healthy in the first place. And one of the things that I hope to accomplish with the book and with all the work that I'm doing is refocusing people on the concept of staying healthy and that it is not normal to get sick as we get older. I don't come at this only as a heart surgeon. I come at this also as a unhealthy heart surgeon. And for the majority of my career up until about five years ago, I was progressively unhealthy. I had become morbidly obese. I had become pre-diabetic. And I had tried many times to fix that. I had tried everything that I had learned in medical school, everything that I taught my patients or talked to my patients about, to eat less, to move more, to eat according to the US dietary guidelines to count my calories. And those ultimately failed me. And it was only when I started discovering some alternative thoughts around why we get fat. Specifically, there was a great book by an author by the name of Gary Tobs. It's called Why We Get Fat. And I heard Gary talk at a medical convention and his concepts about the types of food that we eat being more important than the amount of food that we eat. And the relationship between those two is really what set me down my path, what ultimately allowed me to lose over a hundred pounds and maintain that weight loss now for five years and really get me in the best shape of my life. And then what I realized is this is the same thing that could help my patients and not only could it help my patients after the operation, but it could really help people to avoid the need for heart surgery in the first place. Gary has a knack for writing books that go against the conventional wisdom. I think I first was introducing him to him. I think the book was A Case Against Sugar. He had been on Joe Rogan and I was just blown away. How could our government and many people in authoritative positions for health been so misleading to so many? And obviously it sounds like you had gotten caught up in this information as well and you were going to school for it. Yes, exactly. And one of the sections of the book is talking about these medical myths that we have been led to believe. And it's not only that patients and the public is led to believe these, it's the doctors as well. The whole medical system believes these myths and perpetuates these myths. And of course that makes it very difficult for people to figure out how to stay healthy or how to get healthy. The overarching message is that each one of us does have the power to do this and you can't be relying on other people or institutions to do this for you. What I tell people is the government isn't going to make you healthy. And even me as a physician, I can't make you healthy. My job is to educate you and to help you down this path. But each one of us has the power to do this for ourselves and to make ourselves healthy and to keep ourselves healthy. So what are some of those myths that might be duping our audience currently? Well, probably the biggest myth is the US dietary guidelines, the food pyramid. And the conception is that if you eat according to the food pyramid, you're going to remain healthy, you're going to be healthy. And the reality is the exact opposite. What we see is that in the time that the food pyramid has existed, which is basically since about 1980, our health has only worsened. We are more obese, we are more diabetic. Heart disease remains the number one cause of death in the United States and worldwide. And we just see ourselves getting unhealthier and unhealthier despite the fact that we do follow the guidelines. When you look at the foods that people are eating, specifically in the United States, we know that over the past 40 years, we are eating less saturated fat, less red meat. We are eating more grains, just as the food pyramid directs us to do. And our health continues to get worse and worse. What really strikes me about that, especially with a family of heart disease and then my own visit to the cardiologist is so rarely is the food discussed. What was immediately discussed in my case was more tests and then prescription meds to lower my blood pressure and to attempt to handle some of the symptoms that were predisposing me to heart disease. And I didn't have a single conversation with my cardiologist about what I was eating. He checked my weight, he said, well, you're way too young to be seeing me, so let's just get some prescriptions in your hand. And of course, in my 30s, the last thing I wanna be doing is taking a bunch of pills for my health. I would much rather get to the root, which is what's going in my body and why my body is reacting this way. Why is it that, especially in a cardiology field, that you're not first learning about nutrition and the fuel that we're putting in our body that powers all these organ systems that are so vital to our health? Yes, and that is another myth that I actually talk about in the book that medications are the best approach to solve most medical problems. And the reality is that the foods that we are eating are the primary determinant of our health. But unfortunately, the healthcare system has evolved in such a way and doctors get educated in such a way that almost every medical issue we face, the first thought becomes what medication or what procedure should I be using to correct this? And we can go back to the very roots of medicine. In the Hippocratic Oath, it talks about the foods that we eat and using those to heal people, food as medicine. This is a concept that is as old as medicine itself. And yet in the last 100 years or so, we have gotten away from that. And as I said, the results are not good. We are not improving people's health overall. I know another big part of all of this and when I moved to New York, we started the company, had a very tiny kitchen, didn't really have much space to cook, found myself eating out quite a bit and gained a bunch of weight. And in fact, a number of clients coming through looked at me and said, wow, I've heard you on the podcast, I didn't expect you to look this way. And it really like struck a chord, I moved to LA and I realized, okay, I need to get a handle on my weight and my health. But what I hear time and time again from clients is their supplement routine. And all of these pills that are labeled as healthy, go to GNC, that's where you get your nutrition. That's where you get all of these supplements. It just feels like we're layering on all of these additives that we should just be consuming in the food that we eat instead of in pill form. If you were eating a proper diet, if you were eating mostly whole real food, there should be minimal if any need for supplementation. And you're exactly right. We should be getting all of these things from the food that we are eating. But as I talked about earlier, most of the food that we eat these days is devoid of nutrients. And you're not going to be able to replace that adequately with the supplements for the most part. I view supplements in the same way that I view medications. They should be used selectively, only after you've corrected the foods that you're eating and corrected your nutritional approach. And then if there's still some reason that you can't get a certain nutrient or there's some reason that your body just can't absorb a certain nutrient, then it makes sense perhaps to use supplements. But we can't think that supplements are going to reverse or prevent the damage from eating a lousy diet. The book is quite entertaining, Philip, because you're going through all these things that just seem, because they have been going on for so long, these seem to be just normal place. And we don't think anything of it. And then the minute you start asking why, it all starts to fall apart. I mean, even the meal that you posted in the book as a hospital breakfast and what was in it. And this is in the hospital. And here I almost giggling about it. But reading that, I had to start thinking about the things that were on my kitchen table as a kid. There's so many things that were on my, and of course I'm 48, so late 70s, 80s. There are things that I would never, I would never have in my household. And I don't, even to this day. Yeah, so it largely mirrors what we see in society, that we've started to normalize these behaviors. And you're right, people don't even think about it anymore. These foods have been all around us, these processed foods have been so prevalent in our society now, for now we're on the second and third generation of children who are raised on these processed foods. So we don't even step back to think about it. And it is viewed skeptically when you start to question these things. I get pushed back in the hospital from the dietitians when I talk about these concepts. And I say, let's just stop eating this processed food. And people largely don't even think that's possible anymore. They are so ubiquitous around us. And you go to the supermarket and you just see aisle after aisle of processed food. It's all an illusion. We think we have so much variety in our diets because we walk down the cereal aisle and we see 50 different options for what we could be eating for breakfast. But when you really start to look at those foods and you look at the labels and you realize that they're all the same thing just dressed in different packages. Not only is it an illusion, but you even begin to start reading some of the packages and it tells you on it, this is a health bar. This is healthy processed food. It's like, first of all, if it's processed, it's not healthy, but they're sure gonna dress it up that way. And I don't even know what the criteria is for them to post that on the box, much like even if you look at how some of these supplements are made, there's no regulations that have to pass in order for these things to be sold. These labels really are meaningless and there isn't necessarily someone who is truly vetting the claims. Basically the FDA and the USDA, the two organizations that kind of oversee food and supplements and all that just wanna know that these things aren't going to kill you right away. And that's sort of the bar that's set. So we get into a situation. That's a pretty low bar. Yes it is. And so we get into a situation where people are fooled into thinking that some of these things are healthy for us and they're just not. And we need to really start to question the information that's being put in front of us. More so than the food itself, we need to question the information behind that food that led to that being acceptable as something for us to eat. Well even when you notice the nutrition facts on the box they often will highlight the nutrients they want you to see sometimes even in larger text. And then you have to really squint especially as I've gotten older just to see all the ingredients in the long list as they process the food and all of that processing is stripping out those vital nutrients. It's heated, it's denatured, it's down to the raw materials so they could jam it in with some preservatives, repackage it and send it our way. And as Johnny was saying around the hospital meal so you were remarking that it was processed foods, orange juice, all of these things that are really poor for our metabolic health which you would think in a hospital setting they're gonna serve you the food that's gonna help your health. Exactly and it really is an unfortunate reality that I routinely walk in the morning after surgery to see one of my patients and they have a plate of just processed food in front of them and this is what's considered heart healthy within the hospital. And we have to realize that the hospitals are beholden to the US dietary guidelines. The dieticians, the nutritionists that work within the hospitals need to follow the guidelines. And so they don't have the latitude to decide for themselves and to help their patients decide what is going to be healthy for them. Yeah, it's unfortunate that when we think about our health it's hard to find this information. It's easier to find information for the quick fix, the supplement, the healthily labeled food, the prescriptions that are pedaled by doctors that we visit. What exactly are we looking for in terms of metabolic health? So Johnny and I were fortunate enough to go to LabCorp, get our blood tested and you take a look at our metabolic health and there are certain things you were looking for. So I'd love for you to walk our audience through what exactly you look for in terms of metabolic health and what a healthy individual should be showing on those tests. And then also there are some markers that people are looking at that think that are telling them they're healthy such as this idea that they're skinny fat and if you could elaborate on that as well of why that misleads so many people. Yeah, so there are five basic markers of metabolic health and these are the essential five markers that everyone needs to be looking at and when you go to your doctor they need to be able to help you understand these. And the first measure is actually a real simple measure that you can do at home. It's your waist circumference. So just take a tape measure just above the level of your belly button. Best to do this first thing in the morning and if you are a man, your goal is for that to be less than 40 inches and if you're a woman you want it to be less than 35 inches. The next measurement is your blood pressure and this of course is you get it checked every time you go to the doctor. You can check it at home. You can check it at most pharmacy or grocery stores these days and your goal is for your blood pressure to be less than 130 over 85 and that needs to be without the use of medications. We should understand that high blood pressure is oftentimes one of the earliest signs of poor metabolic health and yet most doctors don't recognize that. The other three measures are gonna involve getting some blood work checked and real simple basic blood work. Most doctors do check these as part of routine physicals but they may not be looking at the test in the right way. So the first test we wanna look at is your fasting blood glucose, it's called. That is the amount of sugar that's in your blood when you haven't eaten for about eight to 12 hours and we want this to be less than 100 milligrams per deciliters as the units here in the United States and again that needs to be without the use of medication and then finally we look at the cholesterol panel and this is probably the biggest place where both doctors and patients get hung up because most doctors when they look at a cholesterol panel they're focused on one number, the LDL, the so-called bad cholesterol and the reality is that that number is not reflective of metabolic health. The other two numbers on that panel, the HDL cholesterol, the so-called good cholesterol and as the nickname implies, we want more of that, the higher the better. So specifically if you are a man, you want that to be over 40 milligrams per deciliter. If you're a woman, you want it to be over 50 milligrams per deciliter and finally we look at the triglycerides which is another number on that cholesterol panel. This one we want lower and we want it less than 150 milligrams per deciliter. So again, everyone figure out where you stand on those five numbers and if you don't know the numbers, go to your doctor, ask him to do the blood work and see where you stand because one of the misconceptions, one of the other myths I talk about in the book, the misconception is that if you are not overweight, then you are healthy and the reality is is that that is not true. I end up doing heart surgery on a lot of people who are not overweight. The statistics around metabolic health in the United States are quite shocking because when you look at those five measures that I just mentioned, only 12% of adults in the United States and this data was actually as of 2016, only 12% of adults met all five of those measures of optimal metabolic health. So in other words, 88%, almost nine out of 10 of us walking around today are not metabolically healthy and many of us don't know it. Whoa. Yeah, 12 is a much lower number than I anticipated. I'll be honest. Yeah, it's pretty scary to recognize that. And like I said, it's even more scary that most people don't realize it because even when you look at people who are not overweight, when you look in that study at the normal and underweight people, almost half of them are not metabolically healthy. So yes, being normal weight gives you a much better chance of being metabolically healthy, but in a no way guarantees that you're metabolically healthy. And that's why you need to be looking at these metrics to truly determine if you are metabolically healthy or not. I know for myself, I was losing the weight and following various diets to do so, settled on intermittent fasting, got my weight down, was looking and feeling a lot better and I had a terrible headache that just would not go away and I went to the urgent care, they read my blood pressure, they said it was off the charts, they sent me to the emergency room and then they had to put some prescription drugs in me to get my blood pressure to go down. And when I was explaining to my doctor, I'm intermittent fasting, I'm doing all these things that I thought was healthy. So therefore, well, I'd indulge with the cheat meal, I still had a ton of processed food in my pantry and growing up, that was a sign that things were well in my house, that you had a full pantry. And Amy even remarks that I keep this pantry stocked as we got to the pandemic, it was like, we have enough food, we don't need to go to the grocery store but I thought I was doing everything that I was supposed to be doing, exercising, intermittent fasting, as I had heard from various guests on podcasts as well as our clients, but yet I still had high blood pressure, I still ended up in the hospital and it was a real wake up call for me to then be prescribed medicine in my 30s that potentially I'd have to take for the rest of my life. And I didn't have a conversation with my doctor anymore about diet other than him saying, well, maybe intermittent fasting isn't for you. And I know many in our audience are intermittent fasting. So what are the potential pitfalls around our metabolic health with intermittent fasting? Yeah, so the biggest pitfall I see around intermittent fasting is if you basically make up for the time that you're not eating by overeating and specifically by overeating processed food within that eating window. So even if you're only eating six hours a day or eight hours a day, if you're still overeating during those six or eight hours and you're eating the wrong types of foods, specifically processed foods, in abundance during those six or eight hours, you're really not going to get the results that we are looking for. And so intermittent fasting can be a great tool. One of the things that I talk to my patients about, talk to my clients about is ultimately your goal should be to eat in a way that makes you hungry less often. If you are intermittent fasting, let's say, because you're just not hungry for most of the day, then you're probably eating the right foods and you're getting your body the nutrients that you need. But if you're intermittent fasting, only because you're restricting yourself, but you're hungry all the time and you're just forcing yourself not to eat, that may not be the best approach. I certainly experienced that in my own diet and moving into eating better. Intermittent fasting was one of the first things I started doing as a podcast fan. I kept hearing about it everywhere and Joe Rogan and his guests were all about it. One of the first things I learned was, number one, I wasn't hungry all the time. I just had a habit of eating so you have to work through that. And then number two is exactly what you said, making sure that you're eating the right foods. If I'm busy, if I'm working, if my head is somewhere else, it is very easy for me to miss meals or be late on them just because I am not hungry because I have been eating so well. So for those people out there who are nervous about intermittent fasting or wanting to try it, who are scared about being hungry all the time because we hear that, that is certainly, you wanna be eating much better. And one of the great things about your book is you didn't lay out one diet or any of that. You went through all the most popular diets and went through their pros and cons and we'll definitely get into that as well. Yes, exactly. One of the things that I want people to understand is that there is no one right diet for everyone. And I'm not out here selling the Dr. Ovadia 28 day diet plan. I want people to understand the basic framework that we should all be working within to find the diet that is going to be right for us. And that's going to depend on your lifestyle, your cultural preferences. There's certainly room in there to figure out what works for you. And in the book, I go through really, truly everything from the vegan diet to the carnivore diet and lots of stuff in between and point out what can be metabolically healthy about each of these strategies and what may not be metabolically healthy about each of these strategies. And ultimately, this is an experiment that everyone needs to do on themselves and they need to play around with it and realize that even for each individual it may change over time. What's right for you today may not be right for you 10 years from now because our bodies do change some. If we're focused on metabolic health first and foremost and we're using those metrics that we talked about earlier as our guide, we're going to be able to find what works best for us. And I definitely appreciated that about the book. I've found difficulties with some diets over the years and then years later it became easier to adopt that diet. So I think the most important thing is building the good habits. And what strikes me around eating for your metabolic health is the closer to whole, as you said, in the ground or those animals that eat things in the ground, the better. I love cooking. So for me, it's pretty straightforward for me to go to the farmer's market. We have one just down the street twice a week, pick up some farm ingredients and then come home and cook. Johnny, and I've lived with Johnny, he could sustain himself on a bucket of red vines and some extra burnt chicken back in the day. So how do we, if we're not chefs, if we're not into cooking, eat for our metabolic health. You mentioned lifestyle and some of us just don't have a lifestyle of chopping vegetables and going to the grocery store and getting whole foods every day. There is a convenience tie to these processed foods. So how do we adjust? Yeah, so there are a number of strategies that can be used and realize that I travel a lot. I obviously have a very busy life as a heart surgeon and running a telemedicine practice and all of these things. And it can be made simple. Eating the right foods ends up making your life simpler because you're hungry less often, you eat less often, specifically when you look at nutrient dense, animal-based foods. These are your steaks and your meat. They're actually simple to prepare. They're simple to shop for. They're readily available. And even when you're eating out, you can find these whole real foods on any menu. Stick to the simple basic things, the steak, the piece of fish, the vegetables that are just simply sauteed in some butter, for instance. And you'd want to avoid the processed foods that show up in all the restaurants. And these are things like the breads. And in most cases, the pastas and the sauces. And just stick to the basics, keep it simple. And it turns out that eating real whole food is simpler in many situations than trying to eat or trying to make the processed food alternatives. I think this was one of the biggest eye-opener for me in the book was when you're eating better, you're gonna feel better, you're gonna make better choices. When you're not eating properly, you feel worse and you're making worse choices. There was an anecdote in there about soda and how it's not natural. And it makes you yearn and hungry for other foods that are not good for you. Yeah, I know you guys talk a lot about mindset on the program as it relates to many different issues. And your nutritional strategy, your way of eating really comes down to mindset as well. And in the book, I go through the seven principles of metabolic health. And the first principle is I want you to think of your health as a system, not as a goal. And I'm sure many in your audience will recognize that. It's what Scott Adams talks about, it's what many others talk about. When you focus on the big picture, the overall system, and then you find the habits that are going to support that system, that is what leads to long-term success. And that is the mindset that is going to lead you to good metabolic health. All too often, we're focused on the short-term goals. We're just telling ourselves, I wanna lose the 20 pounds. When you do that, when you're only focused on the short-term, one of two things is gonna happen. You're either going to be successful, you're gonna lose the 20 pounds, and then you tend to say, great, now you can go back to what I was doing before, and you end up gaining back the weight and more. Or more commonly, you don't lose the 20 pounds and you get discouraged and you give up and you say, well, I might as well go back to what I was doing before. And instead, what worked for me, what works for my clients is you get that mindset of I want to be metabolically healthy and I am going to find the habits that are going to support my metabolic health. With that mindset piece, we talked about this just a few weeks ago with Dr. Barrett around setting your environment up for success. So every year in January, I do Whole30 with my fiance, and Johnny knows as a former roommate of mine, if you open my fridge, you'll find just rows and rows of sauces and ketchup and various condiments. And then typically January starts, we're starting Whole30 and I'm looking at all the labels and I'm realizing, okay, man, everything, even the savory has sugar in it. And putting yourself in a situation where you just actually remove those temptations from your environment completely. And I've cleared my fridge out of that. So in those moments where your hunger is getting the best of you, you're still set up to make the right choices, to grab the banana, to eat the apple instead of go for the processed in the pantry. And I found that to be the biggest adjustment that actually worked in my favor. When that's not around, I don't eat the red vines. I don't eat the processed foods. I'm having the fruit. Yeah, one of the things that's real important for people to understand is that these processed foods are addictive. The food industry is very smart and they hire very smart people to craft and to concoct these foods in such a way that are going to make you more hungry, going to want you to eat more of them. We all remember the potato chip commercials that bet you can't eat just one. That's a very good bet because they know that you can't eat just one. The food is specifically engineered so that you won't eat just one. And when you eliminate the processed foods, you really lose your desire to eat them. And that's the hardest thing for people to understand when they're first beginning. But once it kicks in and once you realize it, it almost becomes like a superpower because you truly can walk through that supermarket and recognize that 90% of it is not food. And you just stick to the outer aisle, the meat, the produce, the dairy sections. You realize that those are the foods that are going to ultimately support your health are ultimately going to lead to your success. And then you learn to ignore the other stuff. When you look at that marketing through this lens, it's almost like a cruel joke. You can't just eat one. Well, yeah, because you guys have put this together so that I can't. And not only that, it may not kill me right now, but it's killing me right now. Well, even the colors that they choose, right? So it's like the cheesiest items are this bright orange that we are just drawn to as humans, whether it's a Dorito or a Cheez-It or a Cheese Puff. We know it has that cheesy, savory flavor because of how bright orange it is. The neon greens, like we are wired to respond to these colors in nature, which is why you see fruit is really colorful. And they've now used it against us in the supermarket. And if you get caught in that maze of aisles, you're gonna be stocking your cart with foods that aren't healthy for your body. Ultimately, the food industry is like any other industry. And their primary concern is selling you more food. And so, health is not a concern of theirs. Again, it's one of these myths that we've been led to believe. It's one of these misconceptions that we somehow were led to believe that the food companies do have our health in mind and are interested in keeping us healthy. And it's just not true. And we need to step back and look at those kind of basic assumptions that we make. Food's in the supermarket, so it must be okay for us to eat. But ultimately, as with many other things in life, the first step is becoming intentional about what you are eating. And really thinking about it, instead of the unfortunate habit that all too many of us have, that we just sort of eat the food that's in front of us and don't really think about what the impact is going to be from eating that food. And with that, the impact not only on our health, but our loved ones, not being able to show up to the fullest, not being cognizant, able to listen. I mean, we've seen all of these challenges in our clients and some of them have come back after losing weight and getting healthy and they appear in conversation, their ability to connect with others in a completely different manner. And I used to downplay it. Oh, I was fine. It's okay if I'm a little bit overweight. I'm doing okay. And once I started to really focus in, hone in on my health, well, I've had the energy to show up, to go to more events, to break through the social anxiety, to have more confidence speaking on stage. All of those things are a result of the foundational building blocks, instead of reaching for the supplement, reaching for the easy process food to feel good, building the habits and the systems that lead to that long-term health. Now, the last thing I wanna touch on that I think metabolic health on its face sounds like buzzwords. And many in our audience probably have never even heard of it. But I was shocked to learn that most diseases that kill us are actually a result of poor metabolic health. What are these diseases that poor metabolic health leads to? Yeah, so we can look at the top 10 causes of death in the United States every year. And actually the last two years, this list has expanded to the top 11 causes of death. And we can go down the list one by one and see that most, if not all of them, are related to poor metabolic health. The number one killer in the United States and worldwide is heart disease. And that is clearly related to poor metabolic health. Cancer, number two on the list, many forms of cancer, not all of them, but many forms of cancer have been clearly attributed to poor metabolic health. Of course, the last two years, we all know that the number three on the list has been COVID. And that is clearly related to poor metabolic health. We knew from early on in this pandemic that people who are metabolically unhealthy were more likely to get COVID in the first place and then more likely to suffer serious consequences from COVID. And the biggest regret that I have around how COVID has been handled is that we didn't focus on metabolic health. We could have been telling people early on one of the key strategies to getting out of this pandemic would be focusing on metabolic health, eating whole real food, getting more exercise, getting better sleep. And instead, we kind of did the exact opposite. We closed the gyms, we told people to stay inside, we said, eat all the comfort food you want. Unfortunately, I think that has worsened this whole experience. And then as you keep going down the list, you have things like chronic kidney disease and diabetes, infections related to poor metabolic health. And number of 10 or 11, depending on how you're looking at the list is a real interesting one because suicide is in the top 10 causes of death every year. And it turns out that there is a clear relationship between metabolic health and mental health. And there's now a growing experience around this. I know psychiatrists and psychologists who are incorporating metabolic health improvement into the treatment of their psychiatric patients and seeing great improvements in mental health when you improve your metabolic health. When you look at it through that lens, everyone should be talking about metabolic health. Every physician should be talking about metabolic health. And unfortunately, we're not yet, but I think more and more people are waking up to this, people are understanding this. Well, just look at how the mental health issues and suicide had went skyrocketing through the roof during COVID. So not only are you isolated, you're out of, you don't have any more community, you're locked in your house, you're nervous, you're scared and you're trying to find anything to pacify you to get this through. So you're just sedentary, you're what, you're trying to binge on movies, you're eating garbage. No wonder. It almost seems like we did the exact opposite of what we should have been doing to deal with this pandemic and both the physical health aspects have gotten worse during the past two years as have the mental health aspects during the past two years. And ultimately, we are now in a situation where our country is on the brink of bankruptcy trying to deal with our poor health. For the first time that we have been tracking life expectancy here in the United States, it has now gone down the last two years. And that is the first time in really recorded history that that has happened. So we really need to step back now. We need to question why this is so and we really need to be starting to ask these basic questions about our food environment and our overall health environment and start taking some different approaches. Well, I know we had lunch last week and you were telling me just how incredibly busy and in demand you are, which is not a good thing for the health of this nation. When cardiac surgeons are constantly in demand because there's so many patients, many who delayed medical treatment during the pandemic because of the situation were in worse health, were making poor decisions. And that's why Johnny and I were so excited to have you come on the show, talk about a topic that we don't normally touch on. And there's one other piece that came up in your book that I've now started paying more attention to and it's seed oils. So we had the low fat craze, we had the avoid fat, it'll kill you. Then we've heard no, fat's actually good for you. So there's been a lot of back and forth around that. But interestingly enough, the oil that we're consuming and cooking our food in has an impact on our metabolic health. So what is going on with seed oils and what do we need to watch for in that area when it comes to having better metabolic health? Vegetable and seed oils are another very prominent component of processed foods. And again, we clearly see that the more processed food you eat, the more unhealthy you're going to be. And realize that vegetable and seed oils are a new invention, I guess you could call them. They've been newly introduced into our food environment. And you go back 150, 200 years ago or more and no one was eating these things, they didn't exist. And it just, I guess you could say ironic, but I would just call it very disappointing that we have been led to believe that the foods that we were eating for millions of years are unhealthy for us and these new substitutes that they came up with within the past 150 years are what was going to save us and improve our health. Ultimately, when it comes to the whole issue around fats, I encourage people to stick to the natural fats, the natural animal fats and the minimally processed kind of what we call fruit oils. So they're not actually coming from the seed. These are your olive oil, your avocado oil and your coconut oil. And if you combine those with natural animal fats like butter, lard and tallow, those are going to be the healthy fats for you to be consuming. I was pretty shocked to believe, especially now when I go out to eat thinking about all of the seed oils that are just pervasive and almost everything we consume while out. Everything. Yeah, the reality is that they're cheap and they're abundant and they're easy to make. So the food industry loves them. Restaurants unfortunately love them because they keep their costs down, their cost of their materials down, but they are not supporting our health. Another concept that I want people to understand is that cheap food is not going to be inexpensive in the long run. And you really need to consider the long-term impact of that food and on your health. And if you end up spending the last 20 to 30 years of your life in poor health or your life is cut short because of a heart attack, you really have paid for it much more than the small difference in cost to get high-quality food. And they try to stick it into everything in order to bring their costs out. And in fact, I text you over an emergency vitamin C packet, I was reading your book one morning, I got up to do my normal vitamin routine and I just decided to look on what was in this thing because it's vitamin C, I figure it's powder vitamin C and I was shocked to see how much sugar was just in that. It is really amazing when you know how to look for it, how they just put this extra stuff, the sugar and the vegetable and the seed oils in just about everything. And that's why you really have to be careful about looking at your food labels. And ultimately the best strategy is you should be eating food that doesn't need a label in the first place. I agree. Well, we definitely appreciate that you haven't taken most of the medical industry's advice too hard. I say industry because a lot of these studies that we're talking about were paid for by the food industry. We're paid for to get the results that they're looking for. And unfortunately a lot of doctors just follow suit and prescribe and don't look very closely at patients' health, especially their metabolic health. As we close, we love asking every guest what their X factor is. What is it that you think makes you unique and extraordinary as a doctor? Yeah, I think ultimately my X factor is my curiosity and that I wasn't satisfied with my poor health and with the poor health that my patients were experiencing. And I was curious enough to keep asking those questions about why and I continue to be curious about what it ultimately takes to make us healthy. Now, unfortunately we know that many in the US don't have primary care physicians. They don't have access to great healthcare. Where can our audience find more about your book and the work that you do to improve their health? The book is called Stay Off My Operating Table. It's widely available on all the major online resources. And then you can go to my website, ovediahhearthealth.com, O-V-A-D-I-A, hearthealth.com and all the information is there as well. Thank you, Dr. Ovedia, it was great having you on. Thank you. Thank you, AJ and Johnny.