 I am James Swannick from Swannick and I'm joined today by Dr. Joel Kahn and today we are talking about proper nutrition. We're talking about veganism. We're talking about healthy health. What's that? It's a tongue twister. Healthy hearts. We're talking about healthy hearts. We're talking about looking great and feeling great well into our 60s. And today we are joined as I said by Dr. Joel Kahn who is a holistic cardiologist at the Kahn Center for Cardiac Longevity in Bingham Farms, Michigan. He is the number one bestselling author of Dead Execs Don't Get Bonuses. I love that. That is such a cool name. And a vegan, he tells me just before we join, of 43 years. Dr. Kahn, welcome to the show. Thank you very much. And I think as you were searching for that word, you said Hatha. It happens to be in the state's International Yoga Day. It may already be in Australia past that. So I think you were just giving a shout out to the yogic tradition. So it was a very fortunate stumble. Thank you. And also a big shout out to all the fathers out there because it's Father's Day at least in the US. I'm in Australia as we're going live and recording this, but it's not Father's Day in Australia, but it is Father's Day ever in the US at the moment. So happy Father's Day. Dr. Kahn, you're a father of three, I think. Yeah, exactly. Three grown adults. They're coming over for dinner in about an hour. Some wonderful pasta from Sardinia, some artichokes, mixing some lemonade that I've had sitting out in the sun. Just a joyful family gathering. I love that. If you're watching on Facebook or you're watching on YouTube, please do go ahead and post a question in the comments right now. Dr. Kahn would love to answer your questions. So if you're watching live on Facebook, go ahead and type in the comments where you're watching from and post your question. We've got you says happy Father's Day. Mel says happy Father's Day, gentlemen. Thank you so much. So let me just kick this off by asking you, Dr. Kahn. We've got meat eaters watching. We've got vegan lifestyle eaters watching. We've got vegetarians watching. We've got intermittent fasting experts watching. We've got all these different kind of ways to eat and nutrition. Let me just put it straight to you. Why veganism and why for 43 years? Well, OK, so I will respond in a personal way because I'm actually a bridge and commonality builder. I'd rather end the diet wars and build a uniform approach to nutrition, which I think you can do in a scientific way. And mine may be a little different than yours, maybe be a little different than JJ Virgin, maybe a little different than Mark Hyman, whatever. But it's going to be very similar. I grew up in a home in suburban Detroit, Michigan, where we kept the Jewish dietary laws called keeping kosher, no pork, no cheeseburgers. I went up to University of Michigan in 1977, 18 years old. I just wanted to try and continue that family tradition, important to my parents, my grandparents. And there was truly a gigantic salad bar and really dead meat. I mean, it was not good food. There's nothing I've ever seen like my mother's a very good cook. Was not a vegan home that I grew up in, just a healthy cook. And really the first week I said, salad bar, let's see how this goes. I had a cute girlfriend with me. She is now my wife for 39 years. She felt so good a week later. I think it was getting rid of dairy. It was just we took the package and slowly we started to read. And Ann Arbor was very friendly to do this with Indian restaurants and Thai restaurants. And Detroit has an enormous Arabic population. So there's Middle Eastern restaurants. We found, you know, honestly, wasn't that hard with some moments. I did cardiology training in Dallas, Texas, a real meat heavy town. All I ate for three years was okra, okra, okra, okra. It's just the official vegetable and the only vegetable of Dallas at the time. And there were moments like that. But it really was feeling good, good health. And then the science started to come out. And there was a book called A Diet for a New America by a wonderful human named John Robbins, who laid out health and environment and animal rights. And then the famous Dean Ornish MD came out with a cardiology article. You could reverse heart disease with a plant diet. And I was by then a cardiologist and I said, whoa, that's interesting. I took this funny little turn at that point, 13 years ago. Turns out it's a therapy. So I just stuck with it. I think for the patients I see with advanced heart disease, it's very important and I let them know about lifestyle centered around a healthy diet, which is largely a plant diet, but I'm very flexible with my patients in general. And as I say, I think I'm the only vegan ever to be on stage at Paleo FX and hold hands with Sean Baker, MD and Kellyanne Petrucci and Ben Greenfield and the others, Ben and Joe Rogan kind of discussing this. And I wasn't willing to try and squash my opponent. I'd rather find some unity. There's a lot of unity. So that's the story in a nutshell. I would imagine that the exact opposite of being a vegan or a plant or having a plant based diet would be the caveman diet, which is what I recently, a friend, a good friend of mine actually did it for 30 days where he ate nothing, excuse me, ate nothing but red meat with a little bit of grass, bit butter and a little bit of sauce inside. But no, nothing else. Now, I got a WhatsApp audio message from him saying he felt fantastic, wonderful and high energy and was sleeping well. And I was so curious about that because I was thinking, wow, like everything that I hear is that red meat raises cholesterol level that you need to eat lots of plant based, you know, like vegetable, obviously. How can eating just massive amounts of red meat make someone feel fantastic? And again, I don't want to get this into like the diet, but how is that possible? Can you explain explain something like that? Yeah, so it's an interesting question. And one of the issues with it is there is close to no science. There was an article published in 1930 about two men for one year, eight only meat. It's in the medical literature. It suggests that they maintain their health. And then you have fast forward to 2020 and you can't find much more science. You do find compelling stories like Jordan Peterson and his daughter, Mikaela Peterson and others. I won't, you know, there's plenty because the movement has grown. It begs scientific evaluation. What are vitamin levels? What are hormone levels? What's happening to arteries? You know, and I think as a physician, my problem with that approach, always wanting people to feel good is it's understudied and oversold right now. Most people feel it's the ultimate elimination diet. You know, people that are gravitating to that are largely people that have some health issues, autoimmune health issues or acne or something. Well, you remove dairy and then you remove legumes and you remove grains. And then you remove some other food groups and you're left with, you know, meat can create food allergies. There's a very well known red meat allergy, so it's not completely benign, but it's less frequent than the others. Soy, you're removing soy, you know, moving corn, you know, basically again, give a shout out to the Virgin diet and our mutual friend JJ. You're doing all of her, you know, top allergens out of the diet. So I fall back a lot when I talk about nutrition. And this is the Hakuna Matata moment. There's a scientist in LA, Walter Longo at University of Southern California, Ph.D. Italian born. And he spends his time between L.A. and Milan. He talks all the time, when you're evaluating nutrition, you go five pillars. What's the basic science? What's the epidemiology? What are the randomized studies? What do elderly people around the world in good health that, quote, blue zones eat? And how does it impact the environment and the entire picture of the earth? And when you put the carnivore K-man diet there, you have to say, does it fulfill any of them? It's mainly patient anecdotes or not even patients. So we need to learn more. I'm not suggesting that it's all, you know, hashtag fake news, but I wouldn't put it up against the Mediterranean diet with thousands of studies or the dash diet with hundreds of studies or veganism in the medical studies, which is, you know, hundreds of studies and so on. You just you just can't pull out your prescription pad and say, let's go do this as a physician. But somebody wants to try it. It is an elimination diet. The other thing I'll just say, most are doing it with conventional meat, not organic meats. It's expensive to eat three meals a day and buy premier cuts that are also organic. So the potential burden of herbicides, pesticides, hormones, antibiotics in that diet, it's untested. But we're talking about MDs are recommending it. Well, just do the studies. Get pre and post labs, pre and post biotoxin levels. Let's find out the safety of it before we go on websites and social media and TV shows. So I've taken a few exceptions and some national TV shows with. Is it prime time to recommend this? And I know Dr. Longo would say, oh, not even close, you know, and I have a lot of respect for somebody at that level of scientific endeavor. We're talking to Dr. Joel Kahn, a holistic cardiologist at the Kahn Center for Cardiac Longevity in Bingham Farms, Michigan, and the number one bestselling author of dead execs. Don't get bonuses, the ultimate guide to survive your career with a healthy heart. We've got some questions that have come in, Dr. Kahn, live here on Facebook and on YouTube. So Vanny Sharkey on Facebook asks, what can I replace meat with if I go vegan? Sure. And again, consensus, because I want to leave your audience with good information, not angry, doctor, you know, on Father's Day. But in 2011, the Harvard School of Public Health, pretty prestigious group of researchers, you know, thousands of publications came out with a food plate, beautiful food plate. And I'd encourage everybody go to the social media, go to DuckDuckGo, my favorite search engine lately, and go look up Harvard School of Public Health healthy eating plate. It's a quarter fruits, a quarter vegetables, a quarter whole grains and a quarter protein with a glass of water, not milk and not alcohol, for sure. Just to give a shout out to your important platform there, James. And you know, the protein, although there is protein in leafy greens, there is protein in whole grains, there is protein even in fruit. But when you talk about protein, the recommendations of the Harvard School of Public Health are legumes, beans, peas, lentils. I like organic choices don't have to be beans, peas, lentils. Not processed meat, not bacon, pepperoni, salami, corned beef. They're the worst in terms of carcinogen burden and diabetes burden and heart disease burden and perhaps perhaps erectile dysfunction burden. But if you're going to do it, have a small amount of lean meat as clean as paleolithic as you can find a little bison, little elk, little wild caught fish. It's really a very doable consensus. So my plate, that quarter is going to be plant-based sources of protein. I have one last comment on it, you know, and it's an easy transition. Being a beef chili becomes being chili and chicken soup becomes, you know, vegetable soup and if you want to try the manufactured burgers, they're a nice little transition. I don't think they're very healthy. You can make your own little black bean burger if you can eat beans at all, much healthier, much better. Kinwa burgers, kale burgers, all kinds. The last statement is there's been a lot of science about the protein requirements of humans need. And there's pretty good consensus from Dr. Longo from Harvard researchers that despite all the hype, you got to eat chicken to be strong. You got to eat tilapia to be strong. And, you know, it's animal flesh that makes you strong. There's actually a great impact on health, heart disease, cancer, diabetes to overdo animal protein. And head to head, I just wrote a blog on this that people can find on the web, head to head, plant-based sources of protein are without some of the burden that animal sources of protein are like aging. There these are specifically known how there's an amino acid called methionin. It ages us quickly. It promotes cancer. Well, it's much, much more concentrated in meat than it's going to be in your bean chili. So you might be wise as every organization society in the world says cut back or cut out, but at least cut back on all animal protein, substituting healthy plant proteins to some kind of hybrid mix. Or you can do without it. You know, the Association of Dietitians in the United States has endorsed if you're pregnant, if you're raising children, if you're middle age or if you're elderly, you can get by very healthfully without animal products. It's always an option. We have a question here on Facebook from Bianca, who asks, Dr. Khan, my dad has had two strokes. I want him to go vegan. How can I get him started? He's 65. I think you lock him in a room with some celery, apples, brown rice and a can of kidney beans. But since we're not going to do that and we're loving and it's Father's Day. Number one, so I do see patients all the time. And I'm as challenged as anybody to get them. See, one of the reasons this is not a total off track comment. The biggest enemy isn't the caveman versus the paleo versus the Mediterranean versus the vegan. It's the crap that is eaten worldwide now for the for the majority of calories in a average person's diet. It is hyper processed food that's got refined sugars, refined poor quality oils, excess salt, very little fruit and vegetables. The average American eats under two servings of fruit and vegetables a day. That's the enemy. So transitioning your dad from that poor diet, if that's where he started to any of these options we talked about. But in terms of stroke and heart disease, you do want them to go plant based. So I take out my prescription pad and I write, you've got to watch three documentaries. You've got to watch Forks Over Knives 2011. You've got to watch What the Help 2017. I have a small role in that one. You've got to watch the Game Changer movie that came out late 2019. And that's your homework. And when you come back next visit, I'm going to quiz you that you watch three for three. And people do really respond to that. Everybody likes sitting on a couch and not opening a book. Now, if I can get past that, I might suggest a book I've written, a book that Dr. Ornish, a book that Dr. Esselstyn, Dr. Barnard. These are some of the plant based research heroes. And finally, I'm just going to ask them a couple of easy things. You know, just like add an apple a day. Why don't you try some dairy substitute? I don't care if it's soy milk, almond milk, hemp milk, oat milk, macadamia milk, cashew milk. Just try to go without, you know, cow based dairy for the few weeks till I see you back. So many people feel better on plant based milks, better skin. I'm a little brown right now from a sunny Michigan weekend, but I'm not burned. But, you know, better skin, better digestion, better sleep. The dairy thing is the easiest ticket to show them that food is medicine. Food is poison. That's just making easy transition. Yeah, I switched almost entirely to unsweetened almond milk or coconut milk these days. I very rarely drink dairy. I'm still surprised that when I go out to maybe a coffee shop or a restaurant or something, when I ask for almond or coconut, it's still like, oh, oh, no, no, we don't have that. And you kind of like that. You feel like they're judging you for being like a picky eater, whereas the reality probably based on the science is that, you know, this knee jerk, not knee jerk reaction, but like this coming from a standing start of like, oh, cow's milk, that's what it is. And you asking for almond milk or coconut milk, he's crazy. That's kind of like the deception, right? Man, they charge you more. Now, the good news is the market has shifted so rapidly that the price is quite comparable. And we are starting to see that not only do the big coffee shops have. Right now, oat milk is the hot one in the United States, particularly a brand from Sweden called Oatly. It makes a great barista cappuccino. And they're starting not to charge extra. But when you talk about the mixed data on the healthfulness of dairy products, it's a no brainer to say, just give me oat milk for my coffee. And I agree, the restaurants at coffee shops should make it a little easier. I mean, frankly, and I'll just say the the bastion of stupidity and stubbornness are hospitals. Go try and find almond milk in a hospital or soy milk or oat milk. You know, you won't. And if it doesn't happen there, how are we going to get the medical community to start making the changes or at least to consider that food is an important choice? But, you know, I find in the Delta Sky Club, I always have an option for hand-paste milk, at least when I used to fly. We'll see if we can get back to that habit pretty soon. Yeah, in hospitals, they have vending machines, don't they? Well, Pepsi, Coca-Cola and, you know, hot dogs and bacon three times a day in a patient's plate. Yeah, the biggest disgrace, at least the United States. But I hear from my, you know, social media friends, it's the same worldwide as the largely complete ignorance and, you know, not consideration for that. Patient who's had a heart attack in the first meal is a burger. The patient is just a part of their colon taken out. And the first meal is a chili mac sandwich. It's just insanity. But your your listeners are smarter. We have a question here on Facebook. And if you're just joining us, please do post a question here to Dr. Khan, if you're watching on Facebook or if you're watching on YouTube. Take advantage of the fact that we have a world class expert here on all things nutrition, all things heart related. We want to get to sleep in a second and the importance of sleep. Also, talk a little bit about alcohol. As you know, I help people reduce or quit alcohol, re-explore their relationship with alcohol. But first, let's ask, let's go to another question here. We have Connie Bezos on Facebook asked, Dr. Khan, are there any studies being done now to compare a vegan diet against a diet that is primarily plant based with organic animal protein, but at a much smaller quantity compared to the typical American diet of meat and potatoes? Yeah, it's a great question, Connie. I'm not aware and I'd be very surprised if they'll ever be what we call a randomized study. Two comments. It's very hard to do these studies. You're trying to encourage one group to maybe follow the vegan diet, let's say, six months and another group to follow the diet. You suggest that a clean diet, let's say 90 percent plants and 10 percent organic meats, it'd be very difficult to do and keep people on track. The best studies, they actually have people stay in a hospital. It's called a metabolic ward, and they actually block the place and they provide them the food and they make the measurements. But I don't think it's a hot enough question, not that your question was a good, that that will ever be done and funded. Very expensive, very difficult studies. Almost all people would agree. Let me just pick 90 percent, 90 percent of my calories, 90 percent of my plate comes from whole high quality plant foods. But I like three ounces of organic chicken or three ounces of line cut salmon or three ounces of venison. I think if we did those studies, there would be differences, but they'd be so subtle and so challenging to parse out. A buddy of mine, you may know John Mackey, the CEO and founder of Whole Foods, the big giant chain in the United States, wrote a book called The Plant, No, The Whole Food Diet, good name for a man who founded Whole Foods. And he makes the case, I can't and he had all the experts in the world around. I can't tell you if 90 percent or 100 percent are different. You have to bring in animal rights. You have to bring in the environment. You have to bring in your comfort level with the diet. When my patients tell me, Doc, look at it's 95 percent plant based, but I have a piece of fish once a week. I mean, I'm not yelling at them. That's actually what Dr. Volter Longo talks about in his own book, Longevity Diet, is 19 vegan meals. And let me say those aren't potato chips and Mountain Dew drinks. Those are beans and peas and greens and beets and purple potatoes and the whole gamut of healthy foods and a couple of servings of fish a week. So again, these subtle differences shouldn't be called a diet war. And I don't think we need a research study. Just do something in that range. I it's interesting, I have a partner who is I don't know if you'd say a strict vegetarian or vegan, because we do eat chicken, but we we go grocery shopping to an organic market each Sunday morning. And only organic vegetables. And then we buy a chicken for the week, which is an organically raised chicken. And the chicken yesterday was $46 for one frozen chicken. Something to do with time of year like availability, some COVID-19 related issues and things like that. But to get the chicken was $46. And then, you know, to buy all these organic vegetables, the price is up there. I mean, it's up there. Now, we've had this conversation a couple of times, which is, do we tell ourselves eating organic and eating this way is expensive? Or do we just say to ourselves, oh, this is that's how much it costs. And it's actually that eating what we consider the inferior way is just super, super cheap. Or we can convince ourselves that it's super, super expensive based on the fact that later on in life, we're going to be paying for it in medical bills and all that kind of stuff. So I guess I guess my question is. How are we going to make this? Become the norm to get have healthy humans, encourage them to eat super, super well when the price is seemingly so prohibitive to so many people. Right. That's a great question. I mean, there have been a proliferation of, you know, quality markets and grocery stores in the States. You know, everybody knows the joke about whole foods, being your whole paycheck, you know, pre-Amazon. You know, Americans, on average, spend less on food than Europeans as a percentage of their income. And that's the widespread availability of processed food, fast food. It's all federal subsidies. It's been argued the five dollar McDonald's burger should be $13 if the government got out of making bad food cheap. But that's the current situation. And nobody seems to want to take on these amazingly powerful lobbies and long term, you know, horrible subsidies. It's a real problem. I don't think, again, if you really talk again, the caveman, the paleo, the keto, the ultra organic vegan, the 90% plus like you're, you know, doing or in that range change. These are sort of the leadest diets. They, you know, not everybody's going to have a Cousin art and they bite a mix and all the toys that might go around making these foods. We need the message to be out there that it has to be cost-effective. You can eat plant-based cheaper than your $46 chicken. You buy big bags of brown rice. They may not be organic. You buy big bags of dried beans at a bulk store. You get frozen fruits and vegetables. You can buy organic or not. It doesn't really matter if you're eating no fruits and vegetables and you start eating conventional fruits and vegetables. Yes, there's a couple of downsides to it, but the benefits far outweigh the downsides. So we just need simple, simple approaches. Just as I say, have a few recipes and nice vegetable soup and nice bean chili. Know how to make a couple of tacos, burritos, whatever you like. Find your favorite food and make a plant substitute. It doesn't need to be expensive. A $46 chicken is, you know, you should kiss that chicken and, you know, maybe put it in a loose site and just have it as a table sconce. But well, she actually left it behind at the thing. She bought the chicken and said, oh, I'm just going to go and do some other groceries. I'll come back to it because it was in their frozen portable truck. And last night she was my partner was like, oh, I forgot the chicken. So now she's got a phone the place to get the $46 chicken. I think we'll have to like get it next week. Or they'll have to like donate the $46 chicken. I think it was 40. It was either forty three or forty six or something around there. Anyway, it was a $40 plus chicken anyway. And we didn't even get to eat it yet. I can't think of a plant based entree that I could spend $46, you know, some medicinal mushroom. I don't think it's possible. That's quite amazing. You know, I've been in the restaurant business in Detroit, plant based restaurants and, you know, I buy organic and we prepare beautiful handmade foods. And it's expensive, but it's still far less expensive than the premier, you know, animal centered restaurants. There's just no way around it that, you know, fish coming from Northern Norway and meats coming from Alaska or wherever they are. It's an expensive process to get them into the store shelf in the restaurant, grow a garden for God's sakes. You know, start to grow sprouts, 30 cents of sprouts gives you like, you know, dozens of, you know, servings on top of a salad. It's, you know, low expense ways to get super nutrition. I wonder if we just eliminate the word organic entirely. And now we just rename any food that's not, you know, grown that way as substandard food. Just rename the organic shit free. Shit free. That's free. I don't have a good label. Yeah. Is there. I remember I was living in Hollywood, California for some years in the kind of mid 2000s. And I wasn't as educated on on food and organic food and nutrition as I am now. And there was a 99 cent store. A few blocks down from my from my home. And of course, there was a Whole Foods, many blocks from my from my home a little bit further. And me being the cost cutting, you know, efficient financial person that I was, I thought I'll get my vegetables from the 99 cent store. And so that's what I did for many months. And I bought, you know, like lots and lots of peppers and broccoli and all all kinds of vegetables from the 99 cent store, thinking that I was very, very clever and why would I buy the same product from Whole Foods or from, you know, a fancier store down the road for three times the price. Are those cheap foods from a store like 99 cent store incredibly inferior to what something is deemed as as organic? And if so, how like how inferior is it? Yeah. Well, you know, a couple of three comments. Number one, you know, try and source local. I don't care if you're buying organic broccoli or conventional broccoli. It's probably in Michigan been shipped from California or some process far, far away. And I know the nutritional content does degrade with time. You're best to have, you know, the most recently harvested of foods, whatever their source supports your local market, supports your local farmers as best you can. You're plant farmers, too. That's one. Number two, frozen is always a good option. So if it was a 99 percent store and they had a big bag of frozen greens or frozen peas or frozen carrots, you know, at least the better companies, they actually have that processing right out in the field. I've seen this. So, you know, plants are harvested, they're washed, they're clean and they're frozen in a bag within a couple of hours. A lot of the nutrition is retained compared to that same fruit or vegetable being shipped, you know, and you're eating it and apple. You might be an apple six months after it was harvested. Still better than a donut. Everything is relative. And the third and final answer to James and the price issue, there has been a study to look at. Again, it's absolutely insane that they average American. Just there's five big factors for heart disease. Do you smoke? Do you have a mom, dad, brother, sister really heart disease? Do you have high blood pressure, diabetes, high cholesterol? And then finally, do you eat enough fruits and vegetables? The one that Americans fail the most to hit the mark because only now about 15 to 18% of Americans smoke, for example, is less than 5% of Americans eat five servings of fruit and vegetables a day and about 1% hit the target. Actually, in children, it's even even under 1%. That's a national statistic. So if you simply double triple the amount of fruit and vegetables you eat from the 99% store, there is a study that said that health benefits are really large. If you talk about across the entire population. Yes, you might be exposed to some PCBs and some glyphosate and round up and all that. And you could calculate a very small increase in cancer risk and some other diseases that might come from those environmental toxins that organic food won't have. But the benefits outweigh. And it was like an enormous difference, more than a thousand to one benefit versus risk. So if the only thing you got is a 99% store and they got, you know, wonderful frozen corn by the frozen corn. Got it. We've got some more questions coming in here on Facebook and YouTube. Just before I get to that, I want to ask you about sleep. As you can see, I'm wearing my Swanee's blue light blocking glasses, which promote healthy sleep. Well, there we go. Dr. Khan is rocking his Swanee's as well. Before we get into the importance of blocking artificial blue light as you do with a pair of blue light blocking glasses, such as these Swanee's, how imperative or how important is sleep to a healthy heart, to longevity, to living well? Like, where does sleep fit in when you compare it to, say, eating your three servings of fruit and vegetables every day or being a vegan and making sure that your nutrition is on point? Yeah, great, great question. And this isn't a setup because you're in the sleep business. This is actually my passion to always learn and develop. You know, 35 years ago in medical school, the only thing we learned about sleep was if you're 450 pounds, there's something called the Pickwickian syndrome, literally just suffocate yourself like a character in the Pickwickian papers by Charles Dickens. We learned nothing else. And yet now it is such a big focus of health for the heart, health for cancer risk, diabetes, risk, obesity, hormonal and cognitive function, dementia. So I actually, in my practice, I have a flip chart that all the patients look at and I teach them. I actually have good sleep as literally the foundation of the pyramid. And if you came, you'd be very proud of that. That's actually the bigger base than nutrition, bigger than fitness, bigger than stress management, which of course interacts with bigger than supplements or sauna or yoga or all the other things. If you sleep poorly, you will skip the gym. You will grab a donut. You will not make a healthy meal. You know, you're just underperforming. And I don't have to go through all the sleep about how compared to skipping a meal compared to your hydration. But one night without sleep, and when it does both your executive function, cognitive performance, it's profound. So I spend so much time with a new patient and fellow patients on hacks for sleep. And it's always blue eye blocking glasses. That's the honest truth. But it might be essential oil lavender diffusers and it might be a warm bath and, you know, don't eat for three hours and all the things we go through. In terms of cardiovascular health, I think one of the most important breakthroughs. I'm a big proponent. There's a scan you can get of your heart. It's by CT imaging. It's the topic of the dead execs book. It takes about 10 seconds to lie down CT scan. You're 45 years old. You just want to get a checkup on your heart. If that comes back zero, you have no calcium in your arteries and you've got very youthful status. That comes back three, four, five, six hundred. A digital assessment of how much deterioration and damage is your heart. Are you got a problem now? So you need to wrap around love. So this study called the Morgan study looked at that. If you sleep five hours or less, you sleep seven or eight. Tremendous difference in the amount of silent heart damage in those that sleep under five hours versus the seven to eight. So it's absolutely on our radar screen. It should always be one of the questions that doctors ask and certainly cardiovascular specialists ask, but it hasn't really completely gotten there. You know, all we know is how to write Ambien or Sinester or one of the prescription drugs. It's just the worst thing, you know, you can do. And I don't take that stuff and never will. How and when and under what circumstances do you wear your Swanee's blue light blocking glasses in terms of trying to promote healthy sleep? What's your understanding of the science behind an orange lens blocking out artificial light and how that's conducive to optimal sleep? Yeah, and my own personal practice always 60 minutes and sometimes 90 minutes before my anticipated bedtime and usually about 10 p.m. because you do want to have a routine in a schedule and not leave it up to the random whim of a day or a workload. And you want to, you know, maybe follow the kind of typical circadian pattern or going to bed when sunsetting and waking up when the sun's rising, it's a good pattern and all. But yeah, I learned before I heard of you, probably a good dozen, 12 years ago about the photoreceptors at the back of the eye that were, I think, discovered at Harvard that specifically are blue light receptors for that wavelength of the spectrum of white light and that they're related to the production of melatonin or the shutting down of melatonin in the penicillin. So yeah, by wearing my swanee blue light blocking glasses, I hope to promote the largest amount of melatonin production at the right time, which is soon before I go to bed. And yeah, I do a lot of things to get a good sleep and I do get good sleep. But I think the blue light blocking glasses are part of that program and a very simple part. We move the conversation now to alcohol, Dr. Khan. I've got a question here from Rod Villarje who asks, Dr. Khan, is red wine really good for the heart? It's confusing when I see articles saying that. Yeah, you know, and they come from, as I kind of mentioned, Dr. Longo, five pillars. Most of red wine or alcohol data is what's called nutritional epidemiology. We asked a lot of questions to an apparently healthy population, could be Loma Linda, the Adventist, could be Harvard School of Public Health, which has an enormous nurses and physician database. Every few years we updated their health status. And 20 years later, 15 years later, 30 years later, did you have a heart attack? Did you have a stroke? Did you have a bypass? Those kind of studies, and they always trying to adjust for smoking diabetes. So they'll pick out during those surveys, the weaker surveys of that type only ask the question once. The better ones like Harvard School of Public Health, every four years, they keep asking, asking because people's habits change. Those studies tend to show a trend. And there's a lot of medicine we call a U-shaped or a sweet spot. You know, one drink, you know, a few drinks a week is a sweet spot for reducing the risk in these studies of having a heart attack, a bypass, a standard dropping dead versus actually no alcohol and certainly versus, you know, excessive alcohol. So do you translate that and consider red wine a therapy? That is different than a randomized study. You might go look at some of the longevity pockets, Sardinia and Italy, pretty famous for their grapes and their canna now wine. Not true in Okinawa, not true in Loma Linda. I'm not exactly sure. And some of the others like Icaros, Greece, if there's any typical drink that is part of their culture. But, you know, there are that's cardiovascular disease. Then we got to go for overall mortality, got to go for cancer. The real hot button lately has been a very common heart condition called atrial fibrillation. A lot of people, 35, 45, 55, 65 and certainly 75, 85 start to get a regular heart beats jumping all over. It's called fibrillation or a fib. It's a big problem because in certain individuals, it can lead to stroke and devastation and even early death. And even if you have a long enough early dementia, this irregular heartbeat, there seems to be clear cut data. There's no amount of alcohol that can be tolerated if your goal is to resolve that problem that even small amounts of alcohol can trigger recurrent episodes. Certainly overdrinking can trigger even small amounts. So it's a very slippery slope for a physician or other health care providers to recommend alcohol. And if so, it has to be with such careful, careful comments about limiting the amount. But the reality is it shows up in studies from all over the world. It's like that little game where you're hitting down the frog and the next one pops up and the next one pops up. You deal with one study, but then there's a new one. And there was another one that was just consistent with this in the last month or so, of which there's hundreds of studies. But if in doubt, zero alcohol, I would offer or suggest, is going to be preferable to any amount of alcohol. Is that a fair assessment? I do believe if you really want to get your great based polyphenols, you can drink unsweetened grape juice. It's been studied. It has the same cardiovascular effects of alcoholic beverages like red wine. So that's always an option. There is a very welcome trend of more and more young people going alcohol free. That's a great trend. And if you were to be interviewing a neurologist right now, the likelihood is they would tell you that alcohol is a brain toxin. And it's so, you know, there's no way alcohol would ever be approved as a drug because the difference, the dose difference between a social drink and inebriation is much smaller than it is with most drugs where there's a safety margin. So, you know, can't view it as that. So I agree with you, James. A, you know, a responsible medical message would be zero. We're talking to Dr. Joel Kahn. You can find more about Dr. Kahn on Facebook at Dr. Joel Kahn. We've put a link there in the comments there. If you just look under the swanic sleep comments there, you can go to Dr. Kahn's page and like and follow. You can also check out his book on Amazon. We've put a link to Dr. Kahn's book there in the comments as well. The book is Dead Execs Don't Get Bonuses, The Ultimate Guide to Survive Your Career with a Healthy Heart. If you're just joining us or you're watching on the replay, go ahead and post your question or questions and we'll get them answered. Let's have a look here. We've got Melanie's time now. So we've skipped two questions. Oh, have we? Oh, okay. So let's have a look here. Jaarico asks, does high cholesterol cause heart attack? Yeah, good topic. I lecture on that. In fact, I was probably spent three hours today reading on cholesterol because it's a endlessly interesting conversation. An anecdote, I did my cardiology training, as I mentioned, long ago in Dallas, Texas. The Nobel Prize in Medicine, 1985, I arrived in 1986, was awarded to two researchers in the hospital that I arrived at, Dr. Michael Brown and Joseph Goldstein. They identified a group of children that lack a receptor in the liver. The bottom line is you're five years old and your cholesterol is 1,000. And then that's the only abnormality. Their cholesterol is 800 or 700 or 1,000. And these kids were having heart attacks at age nine, age 10, bypass surgery, balloon angioplasty. Cholesterol is a real deal. And they have never had their data challenged. It led to the development of lots of therapies to bring cholesterol down. There is universal acceptance by the medical and cardiology community. The European Society of Cardiology came out last year with a beautiful series of papers. LDL cholesterol causes atherosclerosis. Something injures your blood vessels. You've got 50,000 miles of blood vessels in your body. The blood is coursing by. You just ate a cheeseburger. You just smoked a cigar with your buddies. You did too much alcohol or any alcohol. Your arteries get injured. That cholesterol, that LDL cholesterol loves to get in the artery. And it's what happens then. It's called the response to retention. The LDL cholesterol gets trapped there and inflammation starts. And it's called a fatty streak. Absolutely. If you could choose, I want my cholesterol to stay 140 by whole life or 280. There'll be somebody with the cholesterol 280 that'll hit age 100. There'll be somebody with a cholesterol 140 that has a heart attack. But across the population, you'd much rather have your cholesterol 140. Heart disease is a very complex formula and only one piece of it is cholesterol, which is why you'll hear about the 102 year old lady who smoked cigarettes and ate bacon and ate eggs and seemed to be pretty intact, 102. It's a very complex formula. But if you're a betting person, you're wearing a seatbelt when you drive and a bike helmet when you bike, you're gonna try and at least measure your cholesterol and maintain it at the low end of normal, which is where all the hunter-gatherer populations, if you looked at a chart, it doesn't matter if they're meat-eating tribes or plant-eating tribes or they're in Guam or they're in Polynesia, they tend to run cholesterol as totally 100, 110, 120, and you just don't see heart disease. You mentioned a CT scan before. So I had a CT scan six months ago, it came back to zero. Yeah, James, I was gonna ask you, go, James, you're gonna be around a long time, buddy. Oh, thank you. Thank you, I have a zero. So I've got a zero on the CT scan. Having said that, when I've done blood work before, it does demonstrate high cholesterol. Yeah. How is, what could that possibly mean? Because every time I've had my cholesterol tested, it's always high. Thankfully, the last couple of times it's going backwards because I've changed some dietary tips, but why would my CT scan be zero and my cholesterol be high? And your cholesterol went down because you left the $46 chicken in the freezer. That's right. I had to have bean chili instead of fried chicken. No, so you just hit my hot button. Although I know a lot about nutrition and I love to talk about that. I don't want people to have heart attacks and there's clear guidelines. You can prevent 80, 85% of heart attacks, don't smoke, get exercise, get your sleep, keep your waist thin and eat way better than average. Way better than average doesn't have to be vegan, but it's never gonna be McDonald's and Pepsi and donuts. Can't be the average American or probably similarly average Australian diet. It can't be. We can prevent heart disease, we can prevent heart attacks. The problem is that people right now, somebody listening right now or probably half the people listening right now have plaque in their arteries and they have no idea. Very tricky disease. It's silent to the day you die, it's silent to the day you feel horrible and go to the murder room and you have a heart attack. And this is what's so intriguing. Why does your doctor say to a woman at age 45, go get a mammogram? I don't have any problem doctor. Oh, just check, we can't afford to take a risk. Why do you get a colonoscopy at age 50 across at least the United States when you have no symptoms? And nothing is done to check the heart, which is the biggest risk of dropping dead or having premature disability. You just said, I don't know what you paid for it if you had it in the States or Australia, but for more than 25 years, a test has been available. In my city of Detroit, $75, you just pay cash. You don't pull out your insurance card. Five seconds, hold your breath, done. Heart, calcium, CT scan. And when you come back at zero, like you did, James, and I'll tell you, I'm 61. I had a zero at age 40, age 50, and at age 60 just about six months ago because about every 10 years, and I'd suggest you maybe repeat yours in 10 years, there is no better certainty that you're resisting aging and about half of us aren't zeros. And as you get older, it's far less than half aren't zeros. And we are at risk, but you and I are in an elite club. Congratulations. Now, as I said, why do you have a high cholesterol in a zero? Number one, you're not 72 years old, I think you're about 39, but you have time to go and you do wanna take care and you do wanna make those changes. Get your sleep, don't smoke, stay fit, manage stress, and eat the better than average, which is gonna be more fruits and vegetables. I would not suggest the caveman diet to make it the next 10 years with a zero. It might work, but we've studied it for plant-based diets. We have no idea what the caveman diet. Your blood sugar, if elevated, can cause plaque. Your blood pressure, if elevated, can cause plaque. Family history, like I mentioned, mother, father, brother, sister, grandparents raised the risk, but there's a reason why either your grandparents and your parents and your siblings had the same bad lifestyle so you're at risk, go change your lifestyle, you'll get rid of that risk. Well, maybe there actually is a genetic component. My current passion, besides just always talking about preventing heart disease, there is a fascinating kind of cholesterol that one out of every four of us inherit from our parents. It's called light-poked protein A. Why do I bring it up? It's the most common inherited risk of stroke, heart attack, blood clots, and heart valve problems. Light-poked protein A. And not trying to be too commercial, I just published a book on this in March, the first book written by a doctor in the world on this topic. It turns out for about 20 bucks, you could ask your primary care doc. You know, I'm a little worried. My dad had bypass, my mother had a stroke, somebody with one of the questions talked about a husband that had two strokes, definitely wanna ask a primary care doc. Please check my light-poked protein A. It's a kind of cholesterol, but it doesn't show up in the routine cholesterol panel that you just mentioned, James. I would suspect you didn't inherit it from your mother and father, and you get the blood test once and you never need to repeat it again for $20 or $30. Simple blood test, don't even have to be fasted. But I have a practice full of people from all over the world that inherited one gene or two genes from mom and dad, and their blood levels tremendously high. And they are two to four times the risk, heart attack stroke, even if they follow healthy diets and good guidelines. So we work with them. But if the only risk you have, James, is a high cholesterol and you're thin, you're eating better than average, you're getting some fitness, you're certainly a sleep expert. It's not the cause of heart disease, it's a cause of heart disease to have high cholesterol. So you've corrected the majority of the others. But the convention, not the conventional, the cutting edge day that says the response to you is not to go on Lipitor or Crestor. If you have a zero, you really don't qualify. That's the good news. Just work with lifestyle. Eat more oat bran and oatmeal and maybe some edamame and some fiber foods naturally bring down your cholesterol and get retested down the road. But you're gonna be around for a long time, Mr. Swan. Thank you so much, Dr. Khan. I appreciate that. I would be remiss of me not to bring up one other health issue that I have. And I hopefully is that our viewers and followers here will relate to it. I'm a 44 year old man. I do not drink, have not drunk in a decade, but I still get gout attacks. I've had about six gout attacks now over the past four years. For those, for the uninitiated gout, it comes on as an attack, it's a swelling in the joint, it's a formulate, it's a very high uric acid levels and it causes tremendous pain. Mostly in the foot, in the joint, often in the knee. The first gout attack I had four years ago was in my left knee and my knee swelled up like this. And then the five gout attacks that I've had subsequently have always been in the, four of them have been in the right foot and one of them in the left foot, always around the big toe on the joint. And it kind of feels like someone has come along with a sledgehammer and smashed onto the foot and it actually feels broken, it swells up. So I eat, I think, very well. I exercise consistently at least six times a week. I sleep well, I do all those kind of things, but I do have a very high concentration of uric acid in my body and I am prone to gout attacks. Am I doing something in my diet to trigger those gout attacks or am I just cursed with genetics where I have high uric acid? Right, and I'm interested in gout because if you did like a Venn diagram, if you look at gout patients and heart patients, there's a lot of overlap. This is good science and you'd rather have a low uric, or a normal uric acid level and you'd rather not have gout. Of course, gout has been called the disease of kings, Henry VIII, rich, creamy, big calorie diets with obesity and certainly transitioning away from that to cleaner, smaller meals, more plant-based, may help. Genetics play a role in so many of these conditions and we don't have an easy way to measure your genetics. I mean, you can talk to mom and dad and aunts and uncles, it might just be friends and the family. Some people are doing tart cherry juice before bed as a uric acid lowering. There are some vitamin companies, not many. I don't have any affiliation with a Florida vitamin company called Life Extension, but you might look up, they do have a uric acid reducing herbal vitamin that they usually have some good research behind, never enough when it gets to vitamins. And then of course, there's a prescription drug that at least in the States, in Australia we call alopurinol. It's generic, it's inexpensive, it will dramatically lower your uric acid level. Really cool, I actually use alopurinol in my heart patients. It's been shown if you're a sick heart patient, it can reduce your angina pain and some of your episodes of poor circulation because again, of this overlap. So, that's the last resort, although it's not a horrible resort. I mean, if I had had five horrible attacks at gout and it seemed like the last resort was to take 100 or 200 milligrams of alopurinol a day, you can get a rash from it and all drugs have some potential but I would probably grab onto that if I've really cleaned up my diet and still seem to have that elevated level. So, it's probably more of a hereditary thing rather than a dietary lifestyle kind of thing on initial inspection just based on what I've shared so far. Right, if you've eliminated the creams and the organ meats, liver brain, that would be common in Henry VIII's plate and all, then I think you're probably left with genetics being most likely. Yeah. Well, Dr. Kahn, thank you so much for your time. Let's head for home here in the last few minutes. I just wanna make sure that I tell our viewers that you can grab Dr. Kahn's book on Amazon. We've put a link there in the comments here. You can also follow Dr. Kahn on Facebook, which is Dr. Joel Kahn, K-A-H-N. Thank you so much for the questions that have come in. Let's ask one final sleep-related question as it relates to heart health. Can 10 hours of scattered sleep make up for seven or eight consecutive hours? So, you can now pretty simply measure the quality of your sleep in a reasonably reliable way. And so you can get a fit bit, a garment, a whoop, I'm more of a fan of the ring called the aura ring. I don't know how you feel about that, James. We probably both know they develop the aura ring. A lot of bio-hackers. It's a, if you don't know about it, just look up aura ring.com. It's a pretty attractive wedding band looking ring that really gives you some interesting detail. And a lot of times actually people think their sleep is interrupted, then you really get some metrics on it. It's actually better than they thought. There is now home sleep studies used to be you had to go off to the hospital and have wires all over your head to get a sleep study. Maybe you also snore, you're kicking the covers off with the rest of the leg. You can wear, it looks like a big wrapper watch and it records everything about your oxygen levels, your skin temperature, your stress levels, and it creates a report that's very simple and low-cost to look at. And I'm always surprised that the quality and duration of sleep is better than what the patient's been reporting. They may not be in the deep, it does tell you how much is deep sleep that you want to try and hack your way to a little better deep sleep. I'm still learning how to do that in my own body. I sleep well, but it's not a lot of deep sleep according to my ordering. But finally, you know, so seven to eight solid versus 10 scattered. I mean, at the end of the day, if you're not tired, I mean, what does poor sleep cause besides cognitive impairment? I mean, is your weight optimal, is your blood sugar optimal? You know, even cholesterol can respond to improve sleep. So if your biometrics that you can do are good, if your blood pressure is good, I wouldn't be too worried about, you know, that napping up. There's a lot of things you can do. You take, you know, 0.3 milligram melatonin before bed. You can take some full spectrum hemp oil before bed. You can try magnesium before bed. There's a lot of herbal preparations, you know, you can try with valerian and other roots that are non-addictive and safe. And figure out maybe one of them's gonna, you know, maybe all of them, because you can stack them up, but one of them's gonna work for you. I like to rotate them. I have my own little mixture and some nights I don't take anything and it's never prescription drugs. But I am a, I really like full spectrum hemp oils. The kind that has all the chemicals found in the cannabis plant with the exception of THC, they're non-addictive and they're bought over the counter but, whoa, they're sleep bombs. They're good. Dr. Kahn, thank you so much. You're one of Rocky Swannies for the final minute. Let's do that. Let's bring them on. And this one is shut up and it's not a commercial thing. I've had these for about three years now. I actually have one in my living room, one in my bedroom, one in my office. I just need to get the daytime readers and then I'll be rocking them around the clock. Yeah, beautiful. And for those who don't know what the view looks like, there you go. That's very cool. You know, and I'll give you a shout out to, you know, there are other companies out there. I love that you also make clear glass and readers as a 61 year old guy, you know, having readers without having to wear glasses and glasses and looking like a freak of some kind. But if that's what you gotta do, it's what you gotta do. This is just a great, you know, innovation. Thank you, Dr. Kahn. And thank you so much for your expertise. Thank you so much for taking the time. Thank you to everyone on Facebook and YouTube who asked questions today. And thank you for those who will be commenting on the replay of this. Dr. Kahn, I appreciate your time. Happy Father's Day, sir. You stay well and good health to you. And we can follow up a bug out. We gotta get rid of that. Thank you, appreciate it, sir.