 I want to set the record straight because chances are you'll see one of these heart health myths in just about every article you read. I know you want to stay healthy and I'm here to help. So let's bust these heart health myths once and for all. Myth number one, you need to stop eating fatty foods. Fat is terrible for your heart. The truth, some fats are terrible for your heart. Things like trans fats, hydrogenated vegetable oil, and oils derived from lectin heavy ingredients like sunflower or peanut oil. But other fats have actually been shown to help boost your heart health and you should actually try to eat more of them. I'm talking about fats like olive oil and perilla seed oil, nuts, wild caught seafood, and avocado. The truth is omega-3 fatty acids are actually connected to reducing the risk of heart disease and stroke. That's one of the reasons I eat an avocado just about every day and I suggest my patients do the same. Here's my favorite, myth number two. You need to eat more whole grains for a healthy heart. I'm pretty sure this lie was created by food companies who wanted to sell more whole grain because here's the thing, it's dead wrong. But whole grain cereals, brown rice, brad, and a whole assortment of unhealthy foods have been marketed using the heart healthy label. Even foods loaded in sugar and lectins and even the American Heart Association is hopped on the heart healthy whole grains bandwagon. But when you look at the diets of people with the lowest instances of heart disease, you'll see that they have one thing in common. They actually don't eat a lot of whole grains. France actually tops the list and they do eat a lot of bread in France, but most of it is made with refined white flour. And in Japan, white rice is common, while brown rice is practically unheard of. The takeaway? Eating whole grains won't keep your heart healthy. But eating a diet rich in omega-3 fats, leafy green vegetables, and polyphenols will. So look to the Mediterranean diet or even the Okinawan diet for heart health inspiration and leave the whole grains on the table. Myth number three, eating high cholesterol foods will raise your cholesterol. The truth? When it comes to your cholesterol, you are not what you eat. Sure, doctors used to believe that eating foods like eggs and shellfish would raise your cholesterol to problematic levels. But the truth is, moderate intake of cholesterol-rich foods, yes, even things like egg yolks and shrimp, won't raise your cholesterol. Again, take a look at the Japanese diet. One rich in shellfish, eggs, and seafood. The Japanese have some of the lowest instances of heart disease in the world, despite eating cholesterol-rich foods. That's because most of the cholesterol in your diet just can't be absorbed by your gut. And what is absorbed actually plays a role in helping your body run smoothly. So go ahead, eat your omega-3 eggs or your wild caught seafood from time to time. When they're part of a balanced diet, they're fine for your health. Myth number four, you need to work out for hours a week to improve heart health. The truth? Exercise is good for it, but you don't need hours of cardio to improve your heart health. In fact, extreme cardio, like running marathons, triathlons, or climbing mountains, can actually put more strain on your system than is healthy. Studies of triathletes have recently shown that it causes severe fibrosis of your heart. That's thickening like gristle in your heart. Doesn't sound like a good idea to me. Now, this isn't to say you should be a couch potato. Get active. But remember 30 to 45 minutes a day is a good start, especially if you're not used to a long workout routine. And it's fine to start by walking around the box or swimming laps at a pace that's comfortable to you. And you don't have to be in pain for your workouts to work. Myth number five, for a healthy heart, eat fruits and vegetables. Wait, how is that a myth? It's the fruits part. You absolutely should eat vegetables. And some in season fruit is a treat. But by putting fruit first, you're putting sugar first. And that's bad for your heart health, your blood sugar, your kidneys, and your gut. So go ahead and eat plenty of vegetables, especially things like cruciferous vegetables, tubers like sweet potatoes or jicama, and leafy greens. And when it comes to fruit, remember three things. If it has a seed, it's a fruit that includes things like peppers, tomatoes, and squash. Eat seasonally. Maybe have a little citrus for dessert this time of year or have some berries in the summer. But remember, fruit is nature's candy. So treat it like candy. The only fruit you can and should be eating every day is an avocado because it's all healthy fat and protein and fiber. And it's actually good for your heart. You know, despite modern advancement, heart disease remains the number one most common disease among Americans. And it's the case of one in every five deaths. So what's the big problem? Well, 42% of Americans are officially obese. As I say, fat in your gut, you're out of luck. So belly fat contributes directly to heart health, as I explain in all of my books, and I'm going to spend even more time in the upcoming book. But it releases bacteria and bacterial particles into your bloodstream. And that sets up inflammation. Heart disease is not a problem of cholesterol. Heart disease is a problem of inflammation in blood vessels. Most people don't realize that statin drugs don't work by lowering your cholesterol. Statin drugs work by lowering the inflammation in your blood vessels. But there's lots of other easy ways to do it. So let's start with number one, eat walnuts. First of all, fat does not make you fat. Not only does fat not make you fat, but fats in the form of walnuts or an olive oil actually benefit heart health. Walnuts are also a great source of a funny chemical called polyamines. I've written extensively about polyamines who have been shown to increase your overall health, your health span, and longevity. Now one of the miracle fats in walnuts is actually a short chain omega-3 fat called alpha-linolenic acid, abbreviated ALA. And I promise there won't be a test. ALA has been shown in numerous studies, including this one, but also in the Leon Hart diet study, to dramatically lessen the incidence of coronary artery disease in people who have coronary artery disease. ALA is present in walnuts. It's present in flax seeds. It's present in organic canola oil, but it's present in my favorite oil for ALA, perilla oil. So any way you can get ALA into your diet, including walnuts, that's what to do. Now alpha-linolenic acid is an essential fatty acid. What does that mean? It means we don't manufacture it, but we have to have it to properly function cell membranes and mitochondrial membranes. So get yourself some more alpha-linolenic acid ALA, and one of the easiest ways to get it is have a handful of walnuts every day. All right, number two, take a shot of extra virgin olive oil. Now there are multiple studies showing the benefit of extra virgin olive oil. Extra virgin olive oil is a great way of getting polyphenols into your system. Polyphenols actually interact extremely well with blood vessels. In fact, I've written several papers showing the benefit of polyphenols on arterial health, on stickiness of blood vessels, and in allowing blood vessel flexibility. There's a saying in longevity that you are only as young as your blood vessels are flexible, and so polyphenols, particularly in olive oil, are one of the great ways to do it. Multiple areas of the blue zones, for instance in Crete, Italy, in Sardinia, and even in Acciaroli, south of Naples, all use about a liter of olive oil per week. Now they even have olive oil soup in Crete. There's some fantastic polyphenols in olive oil. One of the best is hydroxy tyrosol. It's a powerful polyphenol that can have huge beneficial heart health benefits. I actually performed a science experiment showing this right here on my YouTube channel. Check it out, it's incredibly eye-opening. And once again, fat is not your enemy. So I recommend everyone should try to consume about a liter of olive oil per week like they do in Crete. But to make it easy, have a shot of olive oil every day. Bring olive oil to the table. Pour it on your meats, your chicken, your fish. Pour it on your vegetables. Pour it on your ice cream. Number three, now this one sounds like almost a non-starter, but bear with me. Swallow a whole clove of garlic. Now there's a compound in raw garlic called allicin. Chronic oral administration of allicin lowered blood pressure in hypertensive rats. If you cook garlic, it's inactivated. Sorry about that. So swallow it whole or used aged garlic extracts. Now garlic is actually well known as being great for your immune health. Now since you're swallowing garlic whole, you won't get that potent garlic breath. So it's a win-win. So how do you do it? Just peel the clove of garlic. I personally like to roll it in olive oil, pop it in your mouth and swallow it. The olive oil makes it slippery and it goes right on down. Number four, your microbiome, your gut begins at your mouth and your oral microbiome and your oral health is really just as important as your gut microbiome in terms of heart health. Heart disease begins in the mouth and gums. Bacteria get through your mouth, through your gums, into your bloodstream and actually begin to affect the blood vessels in your heart. In fact, people with gum disease have two to three times the risk of having a heart attack stroke or other serious cardiovascular event. Believe it or not, when I'm doing surgery and we've actually looked at the plaque that we take out of people when we do bypass surgery, these plaques have been shown to contain oral bacteria and how they get in there, it came from your mouth. So the benefits of brushing and flossing go way beyond fresh breath. Also speaking of fresh breath, most commercial mouthwashers destroy your oral microbiome and actually raise your blood pressure exactly what you don't want to do. So instead of mouthwash, use oil pulling and you'll get great results. In fact, I actually talk about this on episode 221 with Dr. Punit Nanda, aka Dr. Fresh. It's great watching and it's very entertaining to hear his story. Last but not least, cheese please. Now recently big news was made with a study out of Norway looking at people with stable angina. Stable angina means that these people had coronary artery disease and if they did too much activity, if they walked too fast, if they exercised too fast, they got chest pain. Angina, when they stopped doing that the chest pain went away and it was predictable. This is called stable angina. Now what they did was they looked at the effect of dairy consumption, butter consumption and cheese consumption on what happened to these people's stable angina. Now what made the news was that dairy and butter dramatically worsened stable angina. In other words, they went on to have heart attacks or needed stents. But was not mentioned was the fact that the more cheese people ate, the better their angina got. It went away. Huh? Well I've written extensively about this in Unlocking the Keto Code and I'm going into it even more in the upcoming book. But cheese has fascinating products that improve heart health in multiple areas. Interestingly enough, four out of the five blue zones actually are blue zones because they eat goat and sheep cheeses. The fermentation process of making cheese produces very important compounds that actually protect against heart disease, having nothing to do with cholesterol. Now no, you can't eat nachos and cheese sauce or other highly processed cheeses. If you're going to have cheeses look for the fact that they're made out of casein A2. These are most cheeses in France, most cheeses in Italy. All goat and sheep cheeses and water buffalo cheeses are casein A2. So enjoy your cheeses, the right cheeses please. Finally, exercise snacking. Now everyone knows that regular exercise is absolutely essential for heart health. But that doesn't mean you have to spend hours in the gym every week. Instead, try exercise snacking. It's super easy, fun, and great for even the busiest of people like me. So what do you do? Wall sit. Wall sit for up to two minutes, several times a day. Now this is hard to do. This is how I get ready for ski season. So don't give up. Just sit against a wall for as long as you can before your quadriceps are screaming and then try to push it a little bit longer every day. Get to two minutes and you'll be shot at the benefit of wall sitting. Couch planks. Get off the couch in a commercial and just do a plank against the couch. It's really easy. It's effortless. My personal favorite, do deep knee bends when you're brushing your teeth. Come on folks, you're not doing anything else twice a day. Just do deep knee bends while brushing your teeth. Kind of time your brushing with your deep knee bending. Walk and talk. Instead of taking a call at your desk, get up, carry the phone with you, and walk around the office. Walk down the hall instead of just sitting there talking. It's also incredible for your overall health, including your heart. It's really the most underestimated form of exercise. Go out and walk every single day and you'll notice better health, more energy, and a slimmer waistline. And that's what I tell all my patients. Please get a dog. A dog will demand a walk twice a day and it'll get you out as well. Let's address a question that everybody wants to know. If it's not cholesterol, what is the best indicator for determining your heart health? Well that is a great question, and I'm so glad you asked it because that is my mission in life to answer that question to as many audiences as I can. So when we wrote the first edition of The Great Cluster, 10 years ago, we knew that the search for heart disease in the HDL-LDL test was not the way to go. And we knew the particle test was a huge improvement, but we couldn't say for certain like what we should really be looking at. We knew it wasn't that. We knew there was a hell of a lot more to it than that, but we weren't quite sure. And when we did this deep dive this time around, looking to connect the dots, because remember, first I wanted to say I'm not an original researcher, I'm not the smart guy that runs the college sophomores and the rats wearing a lab coat and doing the statistical analysis and getting four stages of clinical studies done. But I can translate that stuff really well to the audience that I speak to, and I think you speak to, and I'm able to make that clear. And what I went on was a mission to see what research had been done here, and what was it, and what could we uncover. So we uncovered a very direct line of research, and it has been hiding in plain sight since the 1970s, and it is mind boggling, mind boggling that doctors do not know this. So in the 70s, there was a doctor named Kraft who discovered the insulin assay. Now insulin, I'm sure everyone who listens to you knows what insulin is, the very, very important hormone. One of its main things that it does in the body is it clears the bloodstream of excess sugar. It's kind of a sugar sherpa, goes in there, pancreas releases it, comes out, sees the sugar, takes it out, takes it into the muscle cells, drops it off, the muscle cells, great, we need it for energy, everybody's happy. But in most people, that is not how it works. And the numbers in how many, the percentage of how many people it doesn't work in is staggering. 88% in America goes the most recent figure, 52 worldwide, and we think that's an underestimate. So it doesn't work right. What happens is instead of the cells accepting insulin, they reject it. There's just too much sugar, too much noise, too much insulin, and they go, no, Moss, we gave it the office, they closed their doors. And now your bloodstream, you've got this high sugar and high insulin, the definition of pre-diabetes. All right. So this insulin resistance, the ability of the cells to just resist the effect of insulin was something very important. And Kraft figured out a way to measure it. It was a very complicated assay required his patients to sit in the office for several hours. They would be hooked up to two different infusions, one would infuse sugar, the other would infuse insulin. You'd watch how quickly or how effectively insulin was able to clear that sugar. You could really get perfect lab measures of it. And he developed this great test. And he tested it on like 14,000 patients over the course of his years. And he followed them up. He just wanted to see what happened to people. He put them in categories, 20% categories of very insulin sensitive, which means your blood sugar goes up when you eat insulin, comes right up, bum, bum, bum, bum, it clears it right up. And you're back to normal and everything works in a good, that's about 20% of the population. And it went downhill from there to the next 20%, a little bit insulin resistance all the way up to major insulin resistance. And these people with abdominal belly weight and all of the risk factors that go with that. And then he watched to see what happened to these people. So the first 20%, the really insulin sensitive ones, nobody died in 10 years, which is unheard of in a population that size, no major heart attacks or nothing. Then the second group, you start to see disease and death, and it goes up and it's just like that until you get to the highest level of insulin resistance. And he said, you know, we knew it was kind of the basic condition for diabetes, but it looks like it's connected to a lot of other stuff. Okay, this kind of got buried and nobody paid much attention to it. In the 1980s, a guy from Stanford comes along named Gerald Reven. And he invents or labels something called syndrome X and syndrome X was quickly replaced by metabolic syndrome, which is somewhat later replaced by pre-diabetes. It's all the same thing. And guess what he was talking about? Insulin resistance. And he said, you know, when you have insulin resistance, then you have high blood pressure, abdominal fat. That's a condition of a group of conditions we call that metabolic syndrome. It always is pre-diabetes. Well, we looked at all of this literature and we made the hypothesis, which is not a big leap of faith that pre-diabetes is diabetes. It just hasn't gotten the diagnosis yet. And guess what? Diabetes is pre-heart disease. 80% of diabetics die of heart disease. So when we looked at the literature that Reven had done, which was basically the same thing, he spent his career identifying this insulin resistance as a causal, central cause for diabetes and the entire cardiovascular metabolic stuff towards the end of his life and his end of his research. He said, I wonder what else this insulin resistance is related to? And he basically did what practice. He took everybody and he put them in categories. And once again, cancer, lung disease, kidney disease, there was not a disease that it wasn't linked to. And Dr. Gundry, we put our book out to great cholesterol myth late last year and we basically say insulin resistance is the cause of heart disease. Now let me put the caveat in the asterisk there. Obviously it doesn't explain every case of heart disease in the world. There are three year olds who were born with heart disease. But it tracks with heart disease as well as cigarettes track with lung cancer. I mean, cigarettes don't account for every lung cancer case in the world. There are people who get lung cancer who don't smoke and there are people who smoke a lot and don't get lung cancer. But it sure is a good tracker. It accounts for like 800% increased likelihood and it's the same thing with insulin resistance. So we wrote our book. We said insulin resistance. We think it's the cause of heart disease with that caveat. A couple months later, a great admiration for Dr. Jason Fong. He's the father of intermittent fasting. He comes out with a book called the cancer code and it says, guess what? Insulin resistance is the cause of cancer and two months later, a PhD I never heard of who's brilliant named Dr. Benjamin Brithman writes a book called Why We Get Sick and guess what he thinks? Insulin resistance is the cause of everything else. So we've got these three independent, I don't even know, workmen I met Fong once. We've got these people who are kind of coming to the same conclusion, which is insulin resistance is at the core of everything. Other than diet, what other factors can affect our risk of cardiovascular disease? Well, I'm so glad you asked that because as a nutritionist and I'm sure for you as well as a medical doctor, we tend to focus on that narrow area that we were trained in. I always looked at it in the beginning of my career. It's exercise and diet. It's diet and supplements. It's all nutrition related. What I've noticed in my colleagues over 30 years of doing this, that all the best people, no matter how they started out, and I started out as a weight loss coach at Equinox Fitness Clubs, however they started out, none of them are looking at food diaries anymore. None of them are looking at exercise laws. Every one of them has figured out that the things that really impact health go way beyond what you eat, what you do with your body. That seems almost like heresy to say that because it's so food and nutrition, food, exercise, movement are so important, but we really do forget the impact that our mental attitude, our spirituality, if you will, our calmness of mind, our ability to form relationships with other people, the amount of love in our life, the relationship we have with our animals, with our outdoors, with how much sun we get because we're walking in the actual sunlight and the greenery as opposed to just taking a pill. We forget the power of those things. There's a very, very famous story called the Rosetto Phenomenon, which we actually talk about in the book, The Great Cholesterol Myth. It's a very famous thing. You can please everybody Google the Rosetto Phenomenon, but in the 20s, there was this hard scrapple town in Pennsylvania called Rosetto. The weirdest thing happened is that the doctors there were not seeing any heart disease. These doctors would meet in these towns in these bars that were centrally located in the old exchange notes and talk shop. The ones in Rosetto were constantly saying, you guys see all this heart? We don't see any. What do you think is going on? This led eventually to some real research attention being paid to this area. The researchers started coming and saying, my God, there's no heart disease here. Now this would not have been so amazing, except if you looked at how the people in Rosetto lived. This was a hard scrapple Pennsylvania town. This made Scranton, Pennsylvania look like Beverly Hills. This was like they worked in the mines. They breathed the worst stuff you can imagine. They ate an American diet that was as bad as you could imagine American diets being. They should have been dying twice the rate of everybody else. The best the researchers could come up with after a couple of years of investigation, and this is what you'll read in Wikipedia, is that these people had such strong social bonds that it somehow overcame a lot of risk factors. No become all of them. Some did die, but these people came. They were all from the same area of Europe. They shared certain genetics. They did everything together. They had Sunday dinners, square dancing, gardening, whatever it was. It was such a community. Nobody lived alone. They believed that those things really made that much of a powerful difference. That's been supported over the years. The blue zones, that wonderful research where they went across the globe to find at first four and then a fifth place was discovered as well. Five places around the globe where people lived to over 100 and they're all fine. There's just a very high percentage of centenarians. The highest percentage of healthy people over 100. These are not people in assisted living homes. They're marching goats up the hills in Sardinia. They're doing stuff. What the researchers found, the National Geographic Team of Researchers, was that they didn't only eat the same diet. They weren't all vegetarians. They weren't. I mean, there were just lots of various big differences that they couldn't find. What's one thing? Do they all eat meat? Do they all not eat meat? The only thing that they all had in common was this absolutely unbreakable social fabric. They were all part of the community. They didn't know what it was like to be isolated. The old people didn't go to old age homes. They lived with the family. Everybody was important. Everyone felt like they contributed. This was the continual thing that was true for all five of the areas around the globe where people lived along. In our book, the last third of the book almost is about all the stuff besides what we talked about in the first two thirds. We talked about how important nutrition is. Obviously, you and I just talked about a higher, fat, lower carb diet, reversing insulin resistance, which we think is the cause of all disease. We talked about exercise. But then in that third section, we talked about meditation. We talked about stress reduction. We talked about techniques like heart math, where you can actually monitor your own physiology in a very creative way. It's almost like a video game because 99 bucks and it's fun and actually changes your blood pressure and your brainwaves. We talked about the eco therapy, the actual proven demonstrated benefits of being in greenery. They even show that there's research showing that if you're in a hospital and you view of the garden, you do better than if you don't. There are all these things that actually do change our physiology. We talked about the science of psychoneuroimmunology, which is basically the notion of what you think about affects your immune system, something I've been preaching about since the beginning of the pandemic. I'm sure you have too. So, we talk about all these things and we want people to understand that it's so easy to feel overwhelmed because you're not doing all the right things and you're not eating and they keep changing the stuff about nutrition, which supplements are good and which ones aren't, and what exercise is most effective and people can easily be overwhelmed. And what I never want people to lose sight of is all the other stuff that they are in charge of that actually are making contributions to their health bank. Every time you have a, you cook a meal together with your friend or family, you made a contribution to your health bank. Every time you take vitamin D, you make a contribution. These are little contributions and you make them every day or you can make them every day. And I don't want people to get so overwhelmed by either a lab test, it's a bad lab test because sometimes you're a bad lab test and you don't have that many risk factors because on balance, you're doing all these good things. So, I want people to be aware that it is more than just eating right and exercising right and yes, those things are vitally important, but so are the relationships that you have in your everyday life, how you sleep, how you digest the time you spend with your dog, all of those things, they matter profoundly to our health and we cannot just omit them because they don't fit under the medical establishment of pharmacology and all the interventions we do. These things are really, really important. Yeah, I couldn't agree with you more. In fact, for years I used to give a PowerPoint lecture about disease is the absence of ease and I wanted people to be at ease and ease is eating, attitude, spirituality and exercise and there you go and you just told someone how to be at ease and if you have ease, it's impossible to have this ease. One of the biggest drivers of death in women is heart disease. It now ranks number one, never used to be, cancer used to be number one, but heart disease is now the number one killer of women. Problem is, women don't display the classic signs of having a heart attack like men have been taught, crushing chest pain, an elephant sitting on your chest, achy jaw, pain going down your left arm. As a heart surgeon who's operated on many women having an acute heart attack, oftentimes the presentation is that of an upset stomach or nausea, particularly after eating and women attribute it to something I ate, but more likely women will present with this nausea or upset stomach, maybe even a little shortness of breath when they're doing the chores, not the elephant sitting on the chest, not the arm pain, not the jaw pain. So if this is happening to you, it's an alert that you got to go talk to your doctor and say, I think I've got heart disease. Don't let them not work you up for heart disease. Thanks for watching, but don't go anywhere. The next episode of the Dr. Gundry podcast is waiting for you now. Dark chocolate greater than 72% cacao has polyphenols that will dramatically improve your eye health.