332. The Revolutionary Approach to Health: Dr. Philip Ovadia’s Insights on Metabolic Surgery

Dr. Philip Ovadia:
As a concept people are always talking about they want to live longer. But the reality is, is when you say to someone, "Well, if you could live to 110, but you're going to spend the last 30 to 40 years of your life in nursing homes, and not able to do things for yourself and you're going to need all of this help," people kind of reconsider that and say, "Yeah. I don't really want to live longer necessarily. I want to live better."

Dr. Richard Shuster:
Hello, and welcome to the Daily Helping with Dr. Richard Shuster, food for the brain, knowledge from the experts, tools to win at life. I'm your host, Dr. Richard. Whoever you are, wherever you're from, and whatever you do, this is the show that is going to help you become the best version of yourself. Each episode you will hear from some of the most amazing, talented, and successful people on the planet who followed their passions and strived to help others. Join our movement to get a million people each day to commit acts of kindness for others. Together, we're going to make the world a better place. Are you ready? Because it's time for your Daily Helping.

Thanks for tuning in to this episode of the Daily Helping Podcast. I'm your host, Dr. Richard. And I am so excited to share with you our guest today, Dr. Philip Ovadia. He grew up in Long Island completing an accelerated pre-med and medical school program in Pennsylvania, and then went on to complete a residency in general surgery, followed by a fellowship in cardiothoracic surgery. He's been a practicing heart surgeon since 2005, and he is on a mission to help as many people as possible avoid the need for heart surgery.

We're going to talk about this and his book, Stay Off My Operating Table. I think everybody wants to stay off your operating table. Philip, welcome to the Daily Helping. It is awesome to have you here with us today.

Dr. Philip Ovadia:
Thank you, Dr. Richard. Great to be here with you. And, yes, I agree that everyone should want to stay off my operating table. But, unfortunately, that's becoming increasingly difficult to do in our environment today. And that's why we're going to have a conversation about what people can and should be doing to empower themselves to ensure that they don't end up on my operating table or anyone else's.

Dr. Richard Shuster:
Well, I love this. We've done health episodes. We've never really done a heart-centric episode, and we've certainly never done one with one of the most well-known heart doctors on the planet. So, there's a part of your bio that I skipped over intentionally because I want to hear your story. So, what I'd love to do with everybody is let's hop in your time machine. Let's go back and talk about what puts you on the journey you're on today.

Dr. Philip Ovadia:
Yeah. Sure thing. You know, ultimately what put me on this journey is that I was a very unhealthy heart surgeon that was destined for my own operating table, so to speak. I was morbidly obese. I was pre-diabetic. I have the family history. And I started asking myself, "If you can't figure this out for yourself, how are you helping other people?" And what I started to recognize was that, you know, the advice that I had learned to give in school, the advice that I would give people when they came to me with heart disease wasn't working. It wasn't working for me. It wasn't working for them. And I recognized that a different approach was needed.

And at that point, you know, I started to come across some different information. I started to ask some different questions. And I found some different answers, I guess you would say, about what really causes heart disease, which is the number one killer in the United States, and why heart disease remains the number one killer far and away for us, despite the fact that we're being told that if you eat a low fat diet and you take your medication, that is the way to avoid heart disease.

So, once I was able to fix my own health, lose over 100 pounds, reverse my pre-diabetes, I recognized what we should be doing to keep people off of the operating table and avoid heart disease. It has become my mission to spread that information far and wide and, like I said, to empower people to keep themselves off of my operating table.

Dr. Richard Shuster:
So, you know, I'm really excited to go down this path with you because, as you said, the traditional doctor will tell you, "Okay. Eat some Quaker Oats, take your statins. Get on whatever medication that fits to bring the blood pressure down." But you've got a bit of a different approach to health, so let's start there, and you discovered this on your own journey to lose 100 pounds, to not be pre-diabetic. So, somebody listening to this saying, "Okay. Well, my doctor told me to eat my oats and eat a low fat diet and take these meds." So, what should we be doing?

Dr. Philip Ovadia:
Yeah. So, first and foremost, we need to understand what the true root cause of heart disease is. And, again, the story that's been built and the way that your doctor likely has been educated is based on the understanding that cholesterol is the primary driver of heart disease. And that relates to the cholesterol that we're eating, and the foods, and the amount of cholesterol that ends up in our bloodstream, and the various approaches from a dietary and a pharmaceutical standpoint to lower your cholesterol as the primary means of preventing heart disease.

And what I would say is we have been trying that approach now for decades, really for over 50 years that cholesterol has been the focus when it comes to heart disease, and we're not seeing the impact from it. Like I said, heart disease remains far and away the number one killer. Every year in the United States, it kills over 650,000 people. And we're doing all of the things that we've been asked to do. When you look at how much dietary cholesterol, how much dietary fat we eat here in the United States, it has gone down significantly. More and more people are on medications to lower their cholesterol. Cholesterol lowering medications have become the most commonly prescribed class of medications for chronic disease. And yet, like I said, we're not seeing an impact on heart disease.

So, when we go back and we say maybe cholesterol isn't really the root cause, what we find is that there has always been sort of an alternative theory here. And it is that sugar, and specifically our body's response to excess sugar and carbohydrate intake, which is something we call insulin resistance, this is really the true root cause of heart disease. And so, we need to then step back and say how do we address insulin resistance because that is what is going to lead us to meaningful reductions in our risk of heart disease.

Dr. Richard Shuster:
So, there's been a lot of talk in recent years about the role that sugar has in terms of the body's inflammatory response. Talk to us a little bit more about insulin resistance. Give us insulin resistance 101 here.

Dr. Philip Ovadia:
Yeah. Sure thing. So, insulin is one of, what we call, master hormones. It's one of the substances in our body that, really, signals sort of the overall direction that our body is going in, the overall strategy that our body is using. And what insulin does, the main reason that people hear about insulin is in the context of sugar, and specifically diabetes.

And so, one of the roles that insulin plays in our body is when sugar comes in, when we eat carbohydrates and when we eat sugar, and that sugar is now in our bloodstream, sugar at excessive levels in our bloodstream is directly toxic. It damages our blood vessels. It damages our organs. So, the body wants to get it out of the bloodstream. And insulin comes along to get sugar out of the bloodstream. And there are a number of places that it can, you know, kind of put that sugar. Some of it can just be burned for energy, and then some of it gets put into the liver, some of it gets put into the muscle, and then the rest of it gets put into our fat cells to store when we can't use it right away.

And the problem is, is that as those storage areas start to get full, they stop responding to the insulin. So, you can picture sort of the train conductor trying to load people onto the train car. And that conductor is the insulin, and he's telling all these sugar molecules to go get on this car, which is destined for your fat cells. And at some point, the car starts to get full and people kind of stop listening to the conductor and can't get on the train anymore.

And that's basically what's happening with insulin resistance. Your fat cells, your liver, your muscle cells all say, "Well, we can't take any more sugar so we're going to stop listening to the insulin." And now the sugar starts to accumulate in our bloodstream, it starts to stay in our bloodstream and that's what starts to cause damage to the blood vessels that leads to heart disease, for instance.

Dr. Richard Shuster:
So, this isn't obviously something that happens overnight. And as a teenager, everything I ate with sugar, like most people. And, again, I know this is a really loaded question, for most people, when does the negative effects of this really start impacting them? Is this showing up in their 40s? When do we really start seeing this statistically?

Dr. Philip Ovadia:
Yeah. So, this is one of the other issues that we struggle with is that we fail to recognize this as an early stage. And this process really starts pretty early in life. And one of the unfortunate things that we see now is that it's starting earlier and earlier. So, when we look at something like the end product of insulin resistance, which is type 2 diabetes, we see that now showing up in teenagers, which is pretty scary because they are already far along this process. It turns out that if you're looking for the right things, you can detect this a lot earlier than when it gets to the point of diabetes.

So, one of the issues that we have around is that doctors pay attention to the amount of sugar in people's bloodstreams. We measure their blood glucose level. Almost every time you go and get blood work done as part of routine physicals, you're going to get either your glucose level checked or you're going to get something called a hemoglobin A1C test, which is a reflection of how much sugar has been in your bloodstream over about a three month period.

And the issue there is that for a period of time, probably a decade, maybe even longer, your body, the insulin is working correctly and it's keeping the sugar levels in your blood within the normal range. But it's taking more and more insulin to accomplish that because the cells aren't responding as much to the insulin, so the body's response is we'll just make more insulin to get the sugar out of the bloodstream, and we can do that for a while.

But because most doctors don't check your insulin level, and this is one of the key take homes that I want people to understand, is ask your doctor not only to check your glucose level, but to check your insulin level as well. Because if you detect early on that your insulin level is running high, you know you're in the early stages of this process, and that's when we have the best chance to intervene to change our habits and to start to then reverse the insulin resistance that's occurring.

Dr. Richard Shuster:
Once you get to a stage 2 diabetes, can it be reversed fully? It sounds like you were able to fully reverse yours.

Dr. Philip Ovadia:
Yes. Well, yeah, I wasn't personally full blown diabetes. I was kind of what they call prediabetes. I was in this insulin resistance stage. But I now do routinely work with people who do have the full blown type 2 diabetes. And the traditional approach to that, again, is just to manage it. We'll put you on medicines which help to keep your blood sugar under control. Over time, that usually leads to more and more medicine, higher and higher doses, and adding different medicines. And, ultimately, a lot of people with type 2 diabetes end up having to now inject insulin because their bodies can no longer make enough.

But it turns out that you can actually effectively reverse type 2 diabetes. And the way to do so is basically to minimize your intake of carbohydrates, sugar and carbohydrates. And now you're going to lower your body's need for insulin. Your body can actually become more responsive to the insulin over time.

And you can reverse type 2 diabetes, but most doctors aren't actually aware of that. They haven't seen it ever happen. They haven't done it with their patients. And, you know, not your doctor's fault. They just haven't been educated about this because we don't talk about it. But we now have plenty of evidence that it's possible. Myself and many other physicians out there have worked with many, many patients to do so, published scientific studies on it.

And, again, another key takeaway for your audience, if you have type 2 diabetes, ask your doctor what can I do to reverse this instead of just managing it with the medications.

Dr. Richard Shuster:
I love this. So, you've painted a very terrifying picture for a lot of us, because sugar is in so much that we eat. I wanted to ask you something as a curiosity first, before we move on to kind of the more practical application of healthy habits to stay off your operating table. So, why do you think now? Why is it showing up in younger and younger people now? Sugar has been in everything for decades, but why now is this becoming more of a problem?

Dr. Philip Ovadia:
Yeah. So, two things to understand here. One is it's not just sugar. Sugar is one of the components of our food supply, and specifically our processed food supply that is damaging our body's kind of metabolic machinery and leading to these problems. And I believe that the reason that we're seeing it more and more and earlier and earlier is because our food supply has become so toxic.

You know, when you walk into a supermarket these days, 95 percent of what's in there is really not what should be considered food. A good friend of mine came up with a term, he calls this stuff Near Food Objects, NFOs. But the real food is the stuff that your great grandparents would have recognized. It's the things that grow in the ground and the things that eat the things that grow in the ground. The produce and the animal products that are there in their minimally processed forms. And this is really what we were meant to eat. This is what we evolved eating as human beings. So, it's really only been within the past 50 to 100 years that we've introduced these near food objects into our food supply, and they have now become the dominant part of our food supply.

And this is why we are seeing these problems show up more prominently and earlier in life because, literally, for some people now from the day they are born, they start getting these processed foods. Even things like infant formula have large amounts of carbohydrates and sugar, have vegetable and seed oils. These fake oils that have been developed because we are so afraid, we've been told to fear eating the natural fats that occur in animal products and dairy, for instance. And so, we've now created this toxic food environment that is making people sicker and sicker.

Dr. Richard Shuster:
So, that was going to kind of lead me to some of the questions, What do we eat? I mean, obviously, don't eat Snickers and don't eat pizza every day, right? That takes care of the carbs and the sugar. But you kind of teased us, so we've been taught that some of these things are bad and there are some oils that we're using that are not so good. So, let's start with oils. What are the hard healthy oils that we should be eating and what kind of oils should we not be eating?

Dr. Philip Ovadia:
Yeah. So, unfortunately these days the advice that I have to give to people is if you're looking at a cooking oil and it has a heart healthy sticker on it, heart healthy label, it is not heart healthy. Really, any of these processed oils, these vegetable and seed oils we should be avoiding. And we should be getting back to what we evolved as human beings eating, what our grandparents and our great grandparents would use, and these are the animal fats that come from the environment around us. And then, there may be some room for the non-processed, what we call, fruit fats, which are things like coconut oil, avocado oil, and olive oil.

Now, one caveat there that I give people with those oils is you got to make sure it's the real stuff. Because a lot of what gets sold, particularly as olive oil here in the United States, is not real olive oil. It's cut with vegetable and seed oils because that's less expensive for the food manufacturer.

So, stick to the natural animal fats, and these include things like butter, lard which is going to be pork fat, tallow which is going to be beef fat. And then, you can also add olive oil, coconut oil, and avocado oil, the fruit oils. You want to avoid the vegetable and seed oils.

Dr. Richard Shuster:
Okay. Good stuff. Dairy, dairy is okay, dairy in moderation? What's your position on dairy?

Dr. Philip Ovadia:
Yeah. So, again, I believe that dairy can be part of a healthy diet. I believe that it should be minimally processed dairy, which means it should be the full fat dairy, not the skim milk that they've stripped the fat out of and put sugar into. And then, some people do need to pay attention to the fact that dairy can be a trigger for autoimmune type conditions, autoimmune type reactions, some people don't tolerate dairy.

But, again, dairy was villainized because it contained higher levels of saturated fat. And we were told that we need to get the fat out of our diet and take it out of your dairy products, and that's how we came up with all these low fat dairy products, which are just processed food in another form. So, if you're going to consume dairy, it should be the real stuff, kind of as close to how it comes out of the cow or the goat or the sheep as possible. And if you have certain autoimmune conditions or certain kind of allergies to some of the components, you might need to be careful about consuming dairy.

Dr. Richard Shuster:
Got it. And, obviously, if things like beef tallow and lard, ghee and butter, if those are okay, then clearly in some capacity the meat that they come from is okay.

Dr. Philip Ovadia:
Exactly.

Dr. Richard Shuster:
So, talk to us a little bit though about the meat to vegetable ratio, because I presume we're not canceling vegetables here, like vegetables are good.

Dr. Philip Ovadia:
Well, you know, I would tell you that vegetables don't have any unique nutritional advantages over animal products. Animal products are what we primarily evolved eating as human beings. Our digestive system, everything is designed for us to eat the animals. It's not necessarily optimized for us to eat the plants and the vegetables. And when you look at autoimmune conditions, which have become more and more common, we oftentimes see these things being triggered by plant proteins, by plant matter. So, we may need to avoid plants in certain situations.

And then, a lot of the fruit in particular more so than the vegetables, but some vegetables as well, are going to be very high in natural sugars. And people say, "Well, it's a natural sugar, it's okay to eat." And that may be true, but if you are already insulin resistant and metabolically broken, any sugars, whether they're natural sugars or the added sugar in the candy bar, your body doesn't differentiate them and won't be able to properly process them. So, for some people, the answer is, yeah, you may need to minimize especially certain fruits and vegetables as you're trying to recover from your insulin resistance.

Dr. Richard Shuster:
Very interesting. I can hear children all over the country celebrating their vegetables are going to go away from their parents who listen to this.

Dr. Philip Ovadia:
It is pretty interesting. And this whole story of vegetables being essential for our health has really been built around, yeah, if you're substituting the vegetable for a candy bar, definite improvement in your health. But I would put forth that they're not necessarily optimal for us. They're just better than some of the alternatives.

Dr. Richard Shuster:
I want to talk about a couple of other things to keep us off your operating table here, exercise and supplements like vitamins, things like that. So, let's start with exercise. Is it the high endurance cardiovascular type stuff that you recommend? Is it the heavyweights? What do you see as the the best kind of exercise for heart health?

Dr. Philip Ovadia:
I think the best exercise when it comes to heart health is going to be the resistance exercises that are going to help you to build and maintain muscle. And there's a couple of reasons for that. First of all, as I mentioned earlier, muscle is actually a place that our body can put excess glucose. And muscle is going to be more metabolically active to burn off some of that excess sugar that we might consume. So, from a metabolic standpoint, having more muscle becomes uniquely advantageous. We also have plenty of data showing us that the better you are at building and maintaining muscle as you get older, the longer you're going to live and the better quality of life you're going to have.

So, as a concept people are always talking about they want to live longer. But the reality is, is when you say to someone, "Well, if you could live to 110, but you're going to spend the last 30 to 40 years of your life in nursing homes, and not able to do things for yourself and you're going to need all of this help," people kind of reconsider that and say, "Yeah. I don't really want to live longer necessarily. I want to live better." And ideally we'll do both, but maintaining that quality of life becomes important and muscle is essential for doing that.

Now, that doesn't mean that the cardio exercise is bad for you or it shouldn't be done. It's just that if, like many of us, you have limited time and you're trying to figure out what to prioritize when it comes to your exercise, I would tell you to prioritize the resistance exercise first and foremost.

Dr. Richard Shuster:
Got it. And what are the top one or two supplements for heart health you would recommend somebody take over the counter?

Dr. Philip Ovadia:
Well, I would tell people that if you're eating a proper diet, there should be minimal need for supplements. So, I'm not a big fan of kind of blanket supplementation. Now, with that being said, there are some common deficiencies that we see, people, that is going to contribute to your metabolic problems.

And specifically when we look at heart disease, one nutrient in particular that is very important is vitamin K2. And vitamin K2 is uniquely found in animal products. So, this is where I go back to eat a lot of animal products and you'll get your vitamin K2. But if not, you may want to add that as a supplement. And a kind of a co-vitamin that works together with the vitamin K2 is vitamin D. And vitamin D is something that many of us are deficient in. So, vitamin D probably along with vitamin K2 becomes one of the most common supplements that I recommend.

Dr. Richard Shuster:
Perfect. Well, this has been fantastic. You've scared us all a little bit, but given us some really good information that, hopefully, people can use to rebuild their heart health if it's a problem for them. So, stay off those carbs. Stay off that sugar. So, Doctor Philip, I've loved our time together. As you know, I wrap up every episode by asking my guests a single question, and that is, what is your biggest helping? That one most important piece of information you'd like somebody to walk away with after hearing our conversation today.

Dr. Philip Ovadia:
Yeah. So, really, the biggest helping I want people to understand from this conversation is that they are in charge of their health, that they are empowered. And that they can make these changes to avoid my operating table and to really feel their best every day. Don't be sitting back waiting for your doctor to do this for you. Don't think that the government is going to do this for you. It is up to you to take charge of your health, empower yourself, educate yourself, and figure out how you can get yourself to optimal health.

Dr. Richard Shuster:
Well said. Tell us where people can learn more about you online and get their hands on your book.

Dr. Philip Ovadia:
Sure thing. So, I Fix Hearts is where to find me, ifixhearts.com is the website. Right on the front page, free quiz that people can take to assess their metabolic health and figure out if they might be struggling with insulin resistance. You can find all my resources link there as well. The book, Stay Off My Operating Table, widely available on all of the usual places. And I look forward to working with people to assist them in this. We have a number of ways that we do that. We have courses, we have coaching programs, and I have a private telemedicine practice that I see people throughout the United States to help them optimize their metabolic health and stay off my operating table.

Dr. Richard Shuster:
Perfect. Well, we will share all of those links in the show notes for your episode at drrichardshuster.com so many people can take advantage of that. Well, Dr. Philip, I loved our conversation today. Thank you so much for joining us on The Daily Helping.

Dr. Philip Ovadia:
Thank you, Dr. Richard.

Dr. Richard Shuster:
No, this was great. And I also want to thank each and every one of you as well who took time out of your day to hear this conversation. If you liked it, if you learned something, if you're inspired, if you're throwing out the carbs, go give us a five star review on your app of choice where you listen to podcasts, because this is what helps other people find the show. But most importantly, go out there today and do something nice for somebody else, even if you don't know who they are, and post it on your social media feeds using the hashtag #MyDailyHelping, because the happiest people are those that help others.