Welcome to the Stay Off My Operating Table podcast with Dr. Philip Ovadi a. I'm your co host, Jack Heald. This is the last show of 2021. Doctor O, it's been quite a launch. And a great year for you?
Yes, I think so I think a lot of exciting things have happened in 2021. For me on the professional side, been a good year personally as well. And I think the podcast, you know, now a few months into it has been going exceedingly well. And we thought this would be a good opportunity just to sort of wrap up the year and sort of what we're going to call Season One of the podcast.
Well, let's see, season one will have 23 episodes, which, if I recall correctly, is how many that old time TV shows used to get in a season: 23 episodes. So we'll call this a full TV season without any kind of video at all.
Perfect.
I'm looking at our statistics from from season one. And it looks like the things that people really are flocking to hear more about basically all falls under the category of metabolic health. So let's start with a quick review of what you called the Seven Principles of Metabolic Health, just give us the quick and dirty on that
Sure thing. So again, the seven principles of metabolic health, the first principle was that you need to view your health as a system, not as a goal. The second principle was to eat real whole food. The third principle was to make one sustainable change at a time. The fourth principle was to move. Principle number five was to sleep enough. Principle number six was to relieve stress. And principle number seven is to get a doctor who gets it.
to get a doctor who gets it. We're going to talk about this in a lot more detail in next year when we when we do season two, but real quickly, I just want to remind our listeners that Dr. Ovadia has a telemedicine practice for many of the states in the United States. So you can certainly contact him online at Ovadia Heart Health and get more information if you need a doctor who gets it. Good stuff. All right, I'm looking a little
deeper here. Another thing that that seems to be drawing a tremendous amount of attention was the relationship between metabolic health and two of what I believe are the three biggest killers in the United States. One is heart disease, and the other is diabetes. Talk real quickly - just give us the summary again, about the relationship between metabolic health, (or the lack thereof), and those two diseases, which are two of the three biggest killers.
Certainly, so we know that diabetes, you know, and again, kind of specifically talking about type two diabetes, although this basically applies to type one diabetes as well. You know, diabetes is essentially a problem of metabolic health. And, you know, when the body is no longer able to handle the carbohydrate load that is being presented to it in the form of the food that we eat, that is essentially what diabetes is.
And we know that people with diabetes are at significantly increased risk for heart disease. And again, that applies to both type one and type two diabetics. And we know that even without developing overt diabetes, most of the people that develop heart disease, specifically, you know, atherosclerotic heart disease, build up a plaque in the arteries have evidence of poor metabolic health or insulin
resistance. Many of them have overt diabetes, but even those ones that don't have overt diabetes, if you test properly for it, you can find that they are insulin resistant and not metabolically healthy.
You know, I don't think I heard that the first time you said that in - I think that was probably in - Episode 18 or 19? That most people who have heart disease, show signs of, even if they don't have overt diabetes, they're headed in that direction? I don't think I heard that. And I try to listen.
Well, and I think that's really, you know, something that most doctors don't understand either. You know, unfortunately, what tends to happen is we don't do the proper tests to look for that, in patients that have heart disease, but there were studies, you know, many of which were done in the 1970s. In the 1980s.
Again, before we had such a focus on cholesterol, there were studies done looking at insulin resistance and there're tests called glucose tolerance tests, or there's something called the Kraft test that shows how your body responds to a load of
sugar. And what we find is that people who present with heart disease, one particular study that it can think I've looked at people who came in with a heart attack, and over 90% of them showed an abnormal response on a glucose tolerance test, meaning that they had insulin resistance and poor metabolic health. And like I said, many doctors today don't realize that, because we have become so focused on cholesterol, and we only look at the cholesterol issue, and the patient isn't overtly diabetic.
We don't test further, we don't look at insulin levels, for instance, routinely, to really see that that's what's going on under the surface.
Trying to figure out how to phrase a question that's, it's bouncing around inside my fairly empty noggin. So bear with me as I stumble through this. Are there signs that people listening can identify in themselves that they might be insulin resistant, without doing blood tests? Are there symptoms of this kind of thing that people can say, "hey, I have these symptoms, these occur. Maybe that's what's going on." Or do you need a blood test in order to determine it?
There really aren't symptoms, especially early on in the process of insulin resistance. But what I point to is those markers of metabolic health that we've talked so many times about, specifically, the waist circumference, which is something that people can measure at home, and blood pressure, which is something that is commonly measured. And it's typically one of the earliest, I guess you could call it a symptom, one of the earliest manifestations of poor metabolic health is high blood
pressure. But again, oftentimes the medical system doesn't recognize it as such. It's just, it's what we call essential hypertension, which means that we don't have an explanation for it. But the reality is that the explanation is usually for metabolic health and insulin resistance. In terms of people at home, what they can do, I would tell you that measuring your waist circumference is the first thing
to be paying attention to. And if your waist circumference is more than half of your height, that is an indicator that you might not be metabolically healthy. And that should prompt you to find a doctor who understands this, and go get the blood work done. And the other testing done to determine if in fact, you do have insulin resistance and poor metabolic health. Because as I think I said, you know, in a few of the prior episodes, that can show up 10 years before the other stuff
starts showing up. Before diabetes shows up, before heart disease shows up, even before even high blood pressure shows up. There's a period of time when if we're looking at the right blood testing, we can figure out that someone is on this path, and we can intervene and change that path. So that's why it's important to get this checked early. And quite frankly, I tell everyone, ask your doctor as part of the routine physical exam, the routine blood work that you get done, ask them to add on an
insulin level. Not something we commonly check, but it's an inexpensive test. And if your fasting insulin level is more than 10, that's a warning sign, but you got to check it to know about it.
The other sort of shortcut that can be used is on your typical cholesterol panel, instead of just looking at that LDL cholesterol, that bad cholesterol number that all the doctors focus on, ask them what the other numbers are: the triglyceride level and the HDL cholesterol level, because again, those are two of the five markers of poor metabolic
health. And if your triglyceride levels are high, and your HDL cholesterol levels are low, that is another indicator that you might have insulin resistance and poor metabolic health.
So let's assume there are, there's a man or a woman in their mid to late 30s or early 40s. And they're academically interested in this conversation that we're having. But when they look at themselves, they think, "hey, you know, I am a little thicker around the middle, but I feel great. I'm sure this doesn't apply to me."
Or are you saying - and I think this is what what I heard, but I want to make sure - that you can have insulin resistance, which leads to all these other bad outcomes, and not really have any other noticeable symptoms yourself?
Yes, definitely. And I would tell that person who's in their mid 30s, or early 40s, who's, as you said, just a little thick around the middle, that this does apply to them. And it is essential that they investigate this further. You may be one of the small percentage of people who is kind of especially what we call central obesity, and not metabolically unhealthy. But that is an exceedingly small percentage of people, and more than likely, you are
metabolically unhealthy. And like I said, the good news is the earlier you detect this, the better chance you have of stopping it before it gets to the point of significant damage being done.
I want to circle back around and get back to the genesis of this whole thing. Because not everybody who's listening started with with season one, episode one. You were obese all of your life until you figured out what was going on almost six years ago. So you had all those metabolic, all those markers for being metabolically unhealthy? And then you changed how you ate, you changed how you moved. You made a lot of changes. The question now is what are those metabolic markers look like when
you do these blood tests? Has it been reversed in the blood tests as well?
Yes. So you know, I would say at the time that I started this journey I had four of those five abnormal. My waist circumference was certainly above 40 inches. My HDL cholesterol level was low. My triglyceride levels were high, and my fasting blood glucose, at one point was over 100. So you know, those are four of the five metrics. I never had high blood pressure,
You said over 10 is too high on the fasting glucose?
Over 100 for the fasting blood glucose.
No, I mean, the number that is considered too high.
Yeah, 100. The 10 is for fasting insulin level fasting. A high fasting glucose is what we look at for the metabolic health parameters and over 100 is the cut off there. So I had four the five abnormal. Today, I am one of the 12% or less of adults in the United States that has all five measures in in perfect range, in good range.
So how old were you when you started fixing it?
So I was 40 to 41 years old when I started fixing it. And when I was at my worst, and I started fixing it, I was 41. Today I am 47. And as I said, I have all five of those metrics in good range. And I plan on staying that way for the next 47 or more years.
To me, that is one of the most hopeful, optimistic pieces of information that we could give anybody who's listening. You were in your early 40s, and had been obese your entire life. You were on a trajectory that was going to end and a heart attack, and or diabetes, and at least a terrible decline in their quality of life due to poor health or an early death. And you got a hold of it, you turned it around.
Yeah, and I think, as we kind of wrap up this year, that is the message that I try and get across to people. That if you look at this, if you measure it, you can always improve it, it's never too late. Even the patients that I ended up performing heart surgery on afterwards, I tell them, you can still change your course, you can still, there might be some damage that you might not that we can't undo. But we can stop more damage from being done as we move forward.
And you're never too old, you're never too sick really to start this. I know people in their 70s and 80s, who have started this and had great success. And they feel like they're in their 40s and 50s again.
That is fantastic.
I can tell you this, here I am in my late 40s, and I am in better shape, better health and I feel better than I did when I was in my 20s. And I think there is always hope. There is always room to improve this. You just got to commit to it. And you got to start and take it from there.
I think that is a fantastic way to wrap it up for season one. It's never too late. You can do it. Alright, well, I think it's a good time to remind listeners that they can follow you on Twitter at "@Ifixhearts." And Dr. O is a good follow. I've been following him for a while and I just love the hope and the optimism that he brings to - not just the subject of health - but the subject of how to live a
life. So I if you're a Twitter person, I recommend that you follow Dr. O. Then of course his website at Ovadia Heart Health dot com you get all the information you need about engaging Dr. O as your own guide for metabolic health. Anything you want to add as we wrap up
Just wanna wish everyone out there happy new year and make 2022 the year that you address your metabolic health.
Thanks so much, Doctor O. You've been an inspiration to me already this year. And I appreciate it. Thanks so much.
Thank you, Jack.
All right. For Dr. Phillip Ovadia. I'm Jack Heald. This is the Stay Off My Operating Table podcast and we will talk to you - believe it or not - next year.