In this episode of the podcast, we sit down with Dr. Joel Kahn, an integrative cardiologist with a practice in both Detroit and Atlanta. Dr. Kahn was in New York attending the Plant World Expo and we convinced him to come to Habitas for a recording session. Dr. Kahn has gained notoriety in the medical and nutrition worlds as an advocate of a plant based diet as a tool for preventing and reversing heart disease. He has appeared in documentaries like What the Health as well as the Joe Rogan podcast and the Doctors, a nationally syndicated television show dedicated to health and wellness topics. In addition to his medical practice, Dr. Kahn has become a restauranteur as well, opening plant based restaurants in both Austin and the Detroit area. Dr. Kahn is a rare “famous” doctor who also maintains an active clinical practice and he was one of the highest rated cardiology fellows ever at the University of Michigan Medical School.
This Episode Covers:
- Current plant based thinking on oil and fat as well as new studies [4:20];
- Dr. Kahn’s take on testing for sterol absorption as a proxy for cholesterol absorption [7:00];
- Defense of Dr. Ansel Keys and elevated LDL-P danger [12:40];
- Is the vegan movement really low fat? [20:00];
- Arachidonic acid, omega-3 supplements, industrial meat – an issue to take note of? [25:14];
- Calcium score and mast cell mediated IL-16 “stable plaque” [30:00];
- The Widow Maker Movie and gauging heart attack risk [35:00];
- The next big Vegan documentary Game Changers and Vegan diet impact on sexual health [39:00];
- Vegan YouTube and Bodybuilders [44:00];
- Lectin and the Plant Paradox [50:00];
- Ex-vegans and nutrient deficiency / FADS1 [55:00];
Show Notes and Discussion:
Right off the bat, Dr. Kahn references an NYU study which compared a whole foods plant based diet to the American Heart Association recommended diet. You can view that study here.
I asked Dr. Kahn about sterol absorption and whether he believes sterol absorption is an accurate predictor of cholesterol absorption, as labs like Boston Heart Diagnostics seem to believe. I wrote a post about sterol absorption in the context of the carnivore diet which may be of interest.
Dr. Ansel Keys published the much maligned 7 country study, which can be viewed here. The study has been criticized for cherry picked data and conflict of interest that shifted the blame for heart disease from sugar to fat at the behest of the sugar industry.
Here is a link to the study Dr. Kahn mentions that was performed by Ronald Krauss.
I bring up IL-16 as a marker associated with mast cell mediated “stable” plaques. Here is one the panels that uses IL-16 as a measure of arterial age. Interestingly, and perhaps a bit ironically based on our conversation on lectins, Dr. Gundry published this abstract discussing the role of elevated IL-16 in autoimmunity and the correlation between lectin sensitivity and IL-16 numbers. I am going to do either a blog or a podcast on this issue.
Dr. Kahn mentions chlorella as a travel hack designed to reduce radiation exposure. I add that chlorella is also effective as a binding agent for mycotoxin.
Here is a link to the Game Changers site.
Valter Longo’s work on amino acids and mTOR is outlined in his book, The Longevity Diet. Here is a link to Derek Simmet’s as well as John Venus’ YouTube channels, both Vegan bodybuilders. Here is a link to a post I wrote on Vegan bodybuilders.
Link to the Cronometer app.
And we close the show with lectin and Dr. Gundry. I wrote a blog post titled “In defense of lectin sensitivity and Dr. Gundry’s the Plant Paradox.” Here is a spoof video Dr. Kahn made poking some fun at lectin sensitivity.
Link to a good conversation on variations in FADS1 and ability to convert ALA to DHA.
John: Welcome to “The GeneFood Podcast.” I’m your host, John O’Connor. Hey everybody. Today we have a really exciting episode for you. We have an integrative cardiologist by the name of Dr. Joel Kahn, who you’ve probably heard of. Dr. Kahn has gained quite a bit of notoriety in the nutrition, in medical world as somebody who’s been featured on documentaries like, “What the Health.” He’s been on the “Joe Rogan Podcast,” he’s been on “The Doctors” several times. He writes for “mindbodygreen,” he’s really one of the leading commentators on integrative cardiology and how to use nutrition as a means for staving off heart disease and helping people live better and healthier lives. Of course, if you are familiar with Dr. Kahn’s work, you know that he is an advocate of plant-based diets. And we get into a lot of that today. We talked to Dr. Kahn about a whole host of different things. It was a great episode. There were some technical parts that I think some of our audience will really like. And then, we also got into some fun stuff like lectins and the YouTube culture for veganism, vegan bodybuilding and some of the new vegan documentaries that are coming out, when we can expect those documentaries to come out. I also wanna say to the audience prior to the episode beginning that a lot of doctors who have gained fame in the medical and nutrition world they tend to leave their clinical practices behind and Dr. Kahn is actually just the opposite. We come from the same community in Metro Detroit. And he’s somebody who not only is known and respected nationally as an advocate of plant-based diets, but he’s very well respected and very well liked in his local community, which I think speaks volumes. And a fun fact, Dr. Kahn was actually one of the highest rated cardiology fellows ever at the University of Michigan Medical School. He’s the real deal. He’s a lot of fun. We’re really excited to have him on the show. And here’s the episode.
John: Okay. So, Dr. Kahn, so you are here for, what’s the Expo?
Dr. Kahn: It’s The Plant World Expo. This is…or Plant-Based World Expo. It’s the first time that some entrepreneurs, a whole lot of vendors, a CME program, are trying to do and I’ll say, kind of like, Paleo f(x) does in Austin. Get a large group of people, get an energy…This is probably more academic because I was at Paleo f(x) a couple of months ago, if you don’t know it’s based…people that are in the Paleo movement, you know, love each other enough for two, three days, they can get along and they have vendors. And so, the plant world has so much energy, but we don’t have the best marketing and sex appeal. So, this is an attempt to kind of merge all that and I gave a talk this morning and got some other sordid activities. There’s people here from all over the world. It’s pretty cool.
John: So what did you talk about this morning?
Dr. Kahn: I give a talk about the future of cardiology is nutrition intervention. And I am trained and practiced for 30 years as an interventional cardiologist, I intervene with stents and balloons and very aggressive, very mechanical, maybe as sexy as an open heart surgeon, maybe sexier, or maybe they win the day for cracking open the chest and handling the heart and all the blood and guts. You know, we like that stuff, I loved…crazy. I loved putting needles in people and blood was flowing and opening and healing and all but, you know, none of those modalities get to the root cause of where disease comes from, but they can be very therapeutic and important and even lifesaving. So, nutrition is one foundation, it’s not the only foundation, stress management, fitness, sleep, love, addressing genetics, addressing biotoxicity and all nowadays to really address the root cause of cardiovascular disease. And that’s what I focus on now in practice. So, I’m intervening, I joke, with sprouts, not stents, nowadays.
John: For sure. Is this…because I know when we’ve spoken in the past, it seems as though you have basically said that the plant-based movement has moved a little bit off of this whole Esselstyn protocol of zero sterol, zero oil, you know, just very, very, very conservative on fats. Has that evolved? Like, what does that look like right now in terms of the protocol for this interventional nutritional cardiology?
Dr. Kahn: Right. So, if we talk about food industry it clearly isn’t focusing, the vast majority of it, isn’t focusing on, you know, if you ate nothing but plants, you’d have generally, a relatively low fat content to your calories, you could alter that by eating largely avocados and nuts and jack it up maybe to 30% to 40% of your calories. Again, leaving oil out you can make yourself 90% of calories from fat with a plant-based diet and can mimic a and actually create a keto plant-based diet if you want to really go jack those things up. The food industry isn’t paying attention. Not that there aren’t a few food delivery services and products out there that are whole food plant-based vegan and either naturally or purposely low in calories from fat or absent oil. The food industry is just providing all kinds of things that look like what the public’s used to, but no animals are involved. And some are probably pretty healthy and some are questionably probably not very healthy. But it’s moving. It’s growing, it’s exploding. In the science it’s still staying mainly, not that there’s a lot of new studies. In October 2018, New York University published formally 100 patient randomized study of people with coronary artery disease on the whole food plant-based no added oil Esselstyn style approach versus an American Heart Association diet which will be probably 20% to 30% calories from fat, maybe 35%. And the end point was inflammation. The endpoint was specifically measuring high sensitivity c-reactive protein. There was a drop with the whole food plant based diet of the Ornish-Esselstyn style. There was a flat line in terms of what happened on the American Heart Association diet. Of course, if you did this study with a standard American Western jacked up processed diet, you’d see c-reactive protein go up. So, as research comes out, it’s largely staying true. New diabetic research in 2018 was a whole food plant-based no added oil research, but it’s not what the public is largely doing. It’s not what the majority of patients are doing, but some should. The serious heart patient, the serious diabetic looking to reverse insulin resistance should probably omit oils from their diet.
John: When you’re looking at a blood panel, I mean, I’ve had blood work done with you, very advanced panel. You’ve looked at some genetic markers EPA, DHA. What is your take on sterol absorption, specifically, like sitosterol levels, these different desmosterol, these different…sterol absorption in terms of synthesis and absorption? Do you pay attention to that in terms of your patients? Like, you see elevated sitosterol, do you think, oh my God, this is dangerous? Or do you tend to just say, “Hey, you know what, I don’t care if you have a fairly elevated sitosterol count.”
Dr. Kahn: Yeah. So, you know, you can only react to what you measure and of those clinicians, cardiologists, that are doing advanced blood work. And I’ll just say, there’s a cost factor to the patient potentially of doing advanced blood work depending on, you know, how they’re reimbursed. There is the complexity of understanding the reports. And there’s a time factor trying to explain it to the patients. And finally, there are certain advanced tests that there just isn’t any remedy for if I find out that you have a genetic marker called 9p21 homozygous, I can tell you your risk of developing coronary disease on a genetic basis is higher than if you didn’t get that gene. But I can’t do anything specifically about it. So, the issue of getting advanced labs or not is difficult. The two providers in my field of heart disease, Boston Heart, and Cleveland HeartLabs overlap a lot. But your question, only Boston Heart provides that marker…
John: The sitosterol, yeah…
Dr. Kahn: I think Health Diagnostic Labs, I believe I gave the right name to the lab because it’s changed, does it too. So I predominantly use Cleveland HeartLabs. I’m familiar certainly with what you’re talking about. Theoretically, if you can identify that somebody is “a hyper-absorber” of sterols versus another person who is a hyper-producer of cholesterol. And then, there are people that have both aspects. But it might allow you to say, “I’m going to put you on either oat bran rich in beta-glucan, that might slow down absorption of cholesterol if you’re a hyper-absorber, or put you on a pharmacologic drug ezetimibe, Zetia that inhibits a receptor called the Niemann-Pick 1 receptor that’s involved in reabsorbing in your small intestine cholesterol.” And the hyper-producer to give a statin to, or you use a natural product like bergamot that has a statin-like effect or berberine that may have a statin-like effect. That is a great concept, but it hasn’t been studied. Are we going to improve patient outcome to classify people, hyper-absorber, hyper-producer, or a mixture and tailor their therapy or their diet to that measure? So, I don’t know if I’m missing out by not adding that to my panel, I’d have to send blood to two different labs and it just gets complex, very honestly.
John: No, I hear that. See, that’s what you think when you see the Esselstyn diet, he clearly has a view that there is some problem with sterol absorption for his really truly sick patients. And that’s why he’s saying, like, “Hey, it’s not only animal protein, but it’s also like, you know, avocado, nuts, and seeds.” I mean, he cuts out a ton of foods. It’s a very restrictive diet.
Dr. Kahn: Well, you know, it’s really those three and I did talk about that this morning. There are a couple of pioneers in the nutrition heart world that are not well known. One is Walter Kempner, MD, who developed the Duke Rice Diet, which in its day, the ’70s and ’80s, Hollywood stars would go to Duke and spend two, three weeks eating white rice, sugar, fruit, scraps of chicken, a very low-fat diet that nobody would call attractive or reasonable nowadays, but he published all kinds of weight loss, reversal of diabetes, reversal of diabetic eye disease, reversal of enlarged hearts, reversal of kidney disease. Insane data that’s actually respected but never followed anymore. He omitted avocados, olives, and nuts, and he was followed by a internist in Los Angeles in the late ’40s, Lester Morrison MD, whose name inscribes the auditorium at Cedars Sinai Hospital in Los Angeles, who developed a diet mimicking the deprivation of World War II. It’s very interesting.
And had a diet sheet for heart patients in 1948 in Los Angeles that specifically said, follow my diet, don’t eat nuts, avocados, and olives. I believe that is why those studies that were done subsequently by Dr. Dean Ornish, by Dr. Caldwell Esselstyn, by Dr. Neal Barnard, follow that pattern not that each one was tested. You can find a single study and find walnuts beneficial, rarely will you find a study that walnuts are harmful. You can find studies that avocados are beneficial to your cholesterol and your artery function. I don’t think you’re gonna be able to find a study that says they’re harmful. But people have not gone back to ask, why are these diets omitting these whole foods that have lots of, you know, nutrient-rich qualities? I think it’s a mistake, and the one loud voice in the plant-based nutrition world is Dr. Joel Fuhrman who will physically get almost violent about, what do you mean you’re not adding in nuts, avocados, and walnuts and, you know, olives to your diet? You need those “whole healthy fats” to absorb your vitamin, fat soluble components and such. So, there is a little split there yet both diets seem to work very well. And it may be we’re arguing about, you know, the tip of a pin.
John: Sure. Yeah. Dr. Fuhrman’s interesting. He’s been one of these guys that’s taken some flak in the plant-based world. I hear you with this sugar diet. That’s kind of your mechanistic entry point to the defense of Ancel Keys, because I was taking a look in preparation for the podcast, I saw some of your Joe Rogan notes and you had on this sort of like, “Hey, I know Ancel Keys has taken all this crap but hey, let’s not totally throw the baby out with the bathwater.” I mean, you’re somebody who…And I think it’s cool because it’s such an echo chamber out there, people are like, Ancel Keys was paid off. Ancel Keys was paid off. And you’re kind of like, “Hey, I’m not gonna totally dismiss Ancel Keys, he had some stuff that was valid about his work and…”
Dr. Kahn: Well, you know, specifically, it’s a blog, but there’s a blog out there you can read, you say echo chamber it’s interesting, or if anybody remembers the game operator, as somebody whispers in somebody’s ear, and the thing at the end of 20 Kids isn’t what it started with, that Gary Taubes, the famous Gary Taubes of “Good calories, Bad calories,” or good fats, bad fats and other books. A journalist who has also partially changed his tune recently, but we can talk about that. He wrote in 2007 in his book, Ancel Keys, you know, falsified data, picked 6 countries out of 22, hid the data that would have shown that diets higher in fat are not related to heart disease and he cherry-picked. Then another blogger, then another blogger, then another blogger. You can see they cut and paste into serial blogs to Nina Teicholz or Teicholz, however you want to say…Twenty-two different bloggers, I think it was, and it just became widespread that esteemed Professor with two PhDs with 350 publications, who has awards named after him all over the world, became known as a cherry-picking, you know, #FakeNewsScientist. It was the game the operator and the problem is the first quote was patently wrong. We can go into that for a second if you really want to. It’s a little bit of nutrition history, but it’s been so distorted, you know?
John: Well, I just I think what’s interesting is just taking…What we’re trying to do with this podcast and with our site, we’re trying to take unique positions on some of these issues. And I feel like in both, in my view in the vegan community, there’s a little bit of groupthink sometimes surrounding certain issues. If somebody is having problems on a vegan diet, and this is one of the things we want to get into, there’s a lot of things but you’re limited on time, but it kind of segues nicely into ex-vegans. And I think to give equal time, you know, you go to Paleo f(x) and you go to the plant-based conferences. To give equal time, you have Paleo bloggers and the Paleo community is, like, all saturated fat is fine, going keto. Nobody knows their LDL particle count it’s just kind of like keto, keto, keto, fat, fat, fat. The issue that I have with the vegan community is you have people like, you know, it’s sort of ridiculous but these vloggers like, Rawvana, she’s six years vegan, she gets caught eating one piece of fish and people attack her, and the reason why I have an issue with that is because I think there’s good science out there that some people on a vegan diet are gonna have a really difficult time getting DHA, getting the omega-3 fatty acids that they need to feel good. So, what say you?
Dr. Kahn: Let me just make one quick comment on Paleo f(x), keto and I will remember, we’ll come back around Rawvana. It is interesting, there is a scientist physician in Oakland, California, Ronald Krauss, K-R-A-U-S-S, MD, who earned the label from John McDougall, MD, a kind of wild and crazy plant-based doctor for 40 years, has written, very popular New York Times bestselling books on starch and weight loss. Ronald Krauss was the senior author in a paper in 2010, but lead author was Patricia Siri-Tarino, that was a meta-analysis that was the first loud voice that we could not confirm that saturated fat related to increased risk of cardiovascular disease. Paper did not say therefore add back eggs, butter and coconut oil. But it became a rallying point for the movement in the last decade that, you know, eating 80% of your calories from fat might have a reasonable basis because it’s not related to heart disease. Ronald Krauss was there, so Dr. McDougall gave him the title Dr. Lard he said, “Dr. Krauss is Dr. Lard,” and many people in the plant-based community refer to that. Dr. Krauss has had three stunning exceptions in the last two years. He did publish a paper that all LDL particle subtypes are atherogenic. There has been this idea that with a higher fat animal based diet you may shift small LDL particles to large LDL particles, that they’re not atherogenic. He published a fairly definitive metabolic ward study, the kind of best human science you can do.
John: Sorry to interrupt. That’s the Dave Feldman protocol correct? That you’re referring to basically or
Dr. Kahn: Dave would jack it up even further, Ronald Krauss didn’t, you know, this was a short-term human volunteer study done in a metabolic ward. Then Ronald Krauss published a paper in 2018 with Walter Willett, the head of nutrition at Harvard and some other people that he actually gave homage to Ancel Keys who you think he would be in the group of cherry-picking. Actually, Gary Taubes was one of the authors of the same article. They didn’t capitulate. But they did say until further data is out diets that jack up saturated fat are of concern and shouldn’t be recommended. They actually said that specifically about coconut oil. And just recently, you’ve seen the headlines, your audience, white meat raises cholesterol as much as red meat in a very carefully done study, and Ronald Krauss was the proponent and the senior author. So anyways, you know, it may not be as easy to support the enthusiasm behind the keto diet, behind the carnivore diet, behind the Paleo diet in terms of, we have our shaman, our Guru, Ronald Krauss, senior lipid expert in Oakland and part of Berkeley, California. Now, he seems to be, you know, moderating his stance a bit. To get to Rawvana, you know…
John: Just before you do that, because I want to make clear, I’m totally with you there. I think that if you listen to some of the lipid experts out there that are commenting in addition to yourself. I mean, Tom Dayspring is one of them. He’s very clear in his opinion, even Peter Attia who is somebody who’s much more in favor of high-fat diets than certain people. He’s as a student of lab work. And they say, look, you wanna talk about lectins being inflammatory which we’ll get to in a minute. You know what’s inflammatory? ApoB is inflammatory, LDL particle’s inflammatory. And nobody’s here to say, like, “Hey, we…” Aaron, our head of research is totally in your camp. If you have elevated LDL particle, the best science and it’s overwhelming, tends to show that you are at a much higher risk for heart disease. The problem is, is that certain people like PCSK9 variants, or people with very good genetics, or very robust LDL receptor activity, they might not have elevated LDL particle on a high-fat diet. And that’s something that I think has to be acknowledged more by the vegan community to gain more credibility and convert more hearts and minds, as opposed to just being like, “Well, you know, low-fat plant-based for everybody, right?” Because some people don’t have that reaction.
Dr. Kahn: I actually just, you know, I think the vegan movement has been labeled a low-fat movement in the press. But, you know, I don’t think that’s completely representative. And I think it’s somewhat unfair. I mean, when you have serious heart disease, and you research literature, and you’ll come across Nathan Pritikin and Dean Ornish, MD, and Caldwell Esselstyn, MD, you’ll find diets because…and you know, they’re whole food, plant-based without added nuts, avocados, and olives, so they’ll be about 10% to 15% of calories from fat. Those are very therapeutic diets for a very small slice of, actually, patients. They’re not necessarily, and if you read the books, Dr. Ornish will make it much more obvious than Dr. Esselstyn, but that they represent the end of a spectrum. And if you’re a sick patient, you might choose the end of the spectrum. But for the general public, there are a lot of places along that ruler that you can pick that’ll still be very favorable. If you even go back to Ancel Keys. Just to say, the classic statement that he did is when he did the Seven Countries Study, the percent of calories from fat in the diet in Crete was 40% of calories from fat, not as high as some current, you know, ketogenic diets but high.
John: That’s pretty high, though. Yeah. That’s pretty high.
Dr. Kahn: In Finland, it was 40%. Where was the highest heart attack rate throughout Europe in 1968, ’69? Finland. What had the lowest heart attack rate in the Mediterranean basin in 1968 and 1969? Crete. They both had 40% of calories. It was almost all very pure monounsaturated fat, olive oil, calories in Crete and it was butter and stuffed sausage in Finland, and they’re very different, you know, fatty acid constitutions. So, a plant-based diet that’s either added fats or just naturally high in fat because of avocados, nuts, and olives and other foods like that, is not in any way to be taken as an unhealthy vegan or plant-based diet.
John: Well, let me throw you a softball here for Rawvana and tie it into Dr. Ornish, because Dr. Ornish, Dr. Ornish is great. I love listening to his interviews. I love his work. I think it makes sense. He’s got a lot of great data. I’m a fan of Dr. Ornish, Dr. Ornish, though, he has fish oil in his protocols.
Dr. Kahn: Right.
John: So, he’s, you know, he’s using fish oil and if you look at his recipes, he has some dairy in his recipes as well, he does on his website.
Dr. Kahn: That goes back and he’ll explain one part of it but I’m explaining the other part I think, you know, he actually…his first research protocol was published in 1979. He was like 23 years old. And then he got it fully published in a very prominent journal called JAMA when he was 25 years old. So, he’s designing plant-based diets for serious heart patients at a time there’s no Whole Foods. There’s no Thrive Market online, you know, there’s no plant based algae oil capsules out there. His professor at Harvard, and he did his residency at Harvard is Alexander Leaf, MD, at the time the world expert on omega-3 and health, who advised him, you know, you’re going to be feeding these people, you know, rice, and beans, and grains and greens and vegetables, and fruits. Where are they getting their omega-3, I don’t know if the content of flaxseed, chia seed, hemp seed or even the availability of those natural sources of ALA were known, but he advised Dr. Ornish put them on fish oil to be sure during this…one of the studies was five years long, that you’re supporting their omega-3 content and remembering, although there’s some controversy now about fish based omega-3 capsules as a health benefit or not in certain disease states. In the ’80s it was pretty well accepted. So, there wasn’t any pushback. You’re absolutely right, 4 grams a day of omega-3 from fish oil were part of Ornish’s lifestyle heart disease reversal trial, and subsequently his prostate cancer study he did at UCSF. I don’t know why he did allow patients egg whites and non-fat dairy, I never asked him. I believe, again, if you look back and you say 1986, I’m gonna feed you nothing but, you know, lettuce and brown rice and some black beans, and some apples and oranges. It gets to be a pretty bland diet. So, it might have been a concern about protein, might have been concerned about calcium. It’s probably not fair to call the research that we attributed to Ornish of which really there’s no brand new research. The last publication I know of was 2013, really a vegan program. It’s a highly whole food plant-based program with some option for the patient to add some foods in.
John: Yeah. I mean, I’ve heard Dr. Ornish on Rich Roll and he’s kind of done a victory lap talking about his diet war days with, you know, the Atkins diet and saying, “Look, you know, it’s kind of clear that…”
Dr. Kahn: He debated and Molly debated Atkins, he debated Taubes, but, you know, these are out there on YouTube. But it’s just the nature of the world nowadays. There was like 2,000 views for a very contentious discussion. Now you get on Joe Rogan and, you know, you get 10 million views. It’s just world has changed.
John: It’s amazing. Why aren’t these doctors talking more about arachidonic acid because when I see this, I’m thinking, people say, “Well, I don’t eat industrial meat.” If you eat chicken, you eat industrial meat. I mean, chicken is by…it’s like 96% of chicken is industrial, it’s super high in…it’s fed corn. It’s super high in arachidonic acid. It hits the immune system wrong, you know, some people are predisposed to converting more omega-6 into arachidonic acid to begin with. To me that’s like the unassailable piece of veganism, like, poultry. It is inflammatory in the immune system. Not the fish as much, though, but I think, the, you know…
Dr. Kahn: Well, and it’s exact same statistic for red meat. Ninety-six percent of red meat bought in the United States is factory farm KFO red meat, it’s not grass-fed, you know, what’s his name, Saletan, the wonderful proponent of really beautiful husbandry of animals, which he should be, you know, congratulated and celebrated for, 96% is the worst of circumstances and same thing, it’s corn-fed and it’s pro-inflammatory. It’s pro-insulinogenic. It’s probably a pro-atherogenic, pro-cancerogenic. So, why aren’t doctors talking arachidonic acid? Number one, if you took a survey of…go to a good institution. I don’t think 1 doctor in a 100 measures omega-3 blood levels. They are available, Quest lab, I’m not involved, LabCorp. You know, most labs will draw a patient’s omega-3 and they’ll break it down into, you know, your EPA, your DHA, your arachidonic acid, various ratios. We’re not taught a lot about it. I don’t remember the last time I’ve encountered an article either in a good journal or even in a blog by a physician for a physician that, you know, let me train you what this means and how it can help your patient care. In general, omega-3 supplementation seems to have fallen out of favor. There was this recent, what is it called? The VITAL Study where they used 1,000 milligrams of omega-3 and I think it was 2,000 milligrams of vitamin D. And neither of those arms at a prospective Harvard study proved to be very effective.
I can’t verify this. But the organization in Fort Lauderdale, Life Extension which is a supplement company, but they’ve done research, they have a Research Institute, and they seem to at times have picked up trends before medicine has, like vitamin D might be an important supplement, COQ10 might have some benefit, omega-3. They’ve always claimed if you design a study with less than 1.8 grams of omega-3 supplementation, you’re not going to find benefit, it has to be from that level up. And so, this large Harvard study was 1,000 milligrams. They wrote an article in their, you know, lay journal that it would be predictable that at that dose you’re not going to see benefits. So, there’s that confusion and when there’s confusion, why are doctors going to even jump in and measure it and discuss it. It just seems to have fallen out of favor. In reality and it, you know, I believe in with all humility, you probably could go deep on omega-3 and arachidonic acid longer than I could. I can remember sitting in medical school, University of Michigan, God, 1982, and it was just when a guy named I think John Vale, I don’t even know how I remember that, was researching arachidonic acid and thromboxane and prostaglandins. And we were just starting to learn. There was so much excitement, just don’t feel that energy anymore. But what I can share. And then what I want to get back to is I do draw omega-3 levels on my patients through one of these specialty labs. And the frequency of low blood levels, sometimes strikingly low blood levels in the lab panel, I get 5.5%, or greater of omega-3 fatty acids is the normal range. And then, there’s the breakdown into various other components. The number of people that it’s 1.5%, 1.8%, 2%, I mean, 60%, 70% lower than this bare minimum, there are experts out there that say optimal health is 8%, 12%, omega-3 fatty acid levels for inflammation and maybe, optimize longevity.
It’s so freaky, I mean, it’s omnivores, it’s plantivores, it’s crap eaters, it’s quality eaters. And then I’m challenged, do I ignore that data, or do I throw all this anti omega-3 supplementation backlash the last 10 years away and say, none of those studies measure blood levels, what am I going to do with a patient who’s got inflammation, has some joint pain, c-reactive protein’s up, lipids aren’t optimal, they got, you know, their pattern on their lipids is type B with a lot of small LDL and such. And, you know, you supplement them with either food-based sources of omega-3 or algae-based sources of omega-3 or fish oil, high quality based sources. And you see their lab panel, you know, really change dramatically and I didn’t have to use a drug. So, I think there’s a real, real undiscussed and unmet need to measure and supplement. But do we have the database that’s gonna allow that to happen, and pharmaceutical industry all the sudden is really stoked up again about omega-3 because of a drug called Vascepa, pretty expensive, pure EPA play that if your triglycerides are up, they have an outcome study now. If your triglycerides, I think it was 250 to 500 with coronary artery disease, then you were put on, I think it’s 4 grams of EPA, they saw significant improvement in outcome in the study published about a year and a half ago. So, that’s a commercially available drug. Now, there’s drug reps out there teaching docs again, about omega-3, omega-3, but it’s not based on measuring it. It’s just routine use after a standard lipid panel with high triglycerides.
John: Yeah. I mean, the panels that you’re doing, that I ran through your office turned me on to, reignited my passion for making sure that the EPA and DHA levels are where they need to be. And also, another thing that’s cool that I think you’re bringing out there, message-wise is the importance of calcium scores. Just people out there who are listening, just going and getting what their baseline levels are. And I want to throw you a super nerdy curveball because we have a super nerdy audience. Interleukin 16, IL16, that is a marker that comes up in arterial age scores. And the research that I’ve been able to find shows that its mast cell-mediated what is the deal with that? And I think some of those plaques are more stable, is that like a good type of plaque to have?
Dr. Kahn: Stable plaque, you know, that’s a generic term, but, you know, it’s an interesting, just to go back a little bit there was a paper study published in 1995 by a Danish scientist of great renown, Dr. Falk, F-A-L-K, it’s really cool, and it just leads to hypothesis, you’re having a heart attack today, we rush you to the Cath lab, we inject dye down your arteries, we find that the middle of your left anterior descending artery is 100% blocked with a clot, then, presumably you put a wire, a balloon, and a stent, and you fix it. But we happen to find that you had a heart catheterization four months ago. So, this was the study design. People that had a…today a big heart attack, but we happen to find the old heart cath, what severity was that artery four months, five months, six months ago? Well, this Dr. Falk was able to find about 250, 300 people. It’s not a really good study as retrospective. Two-thirds of the time, the site that is now 100% blocked was less than 50% blocked the month or two or three or four before.
John: Wait, say that again. Hold on, say that…
Dr. Kahn: Two-thirds of that. It wasn’t a 90% blockage that two months later became 100%. That was one-third of the time. But the majority of…if you’re having a heart attack today. You’re Kevin Smith, the actor-producer and you’re having a big heart attack. If we did a heart cath on you two months before we wouldn’t find it a 90% blockage. We’d find a 30% blockage leading to the idea that unstable plaque, like a volcano, like Mount Etna in Sicily. It’s quiet for a while then it starts erupting. So, that’s where mast cell and white cell and the…it’s called the fibrous cap becomes thin just like maybe the top of a volcano starts to thin out a bit because of some heat and activity underneath. That has been the theme of cardiology now since 1995, that inflammation, inflammation, inflammation. It led ultimately to a prospective study that was published in 2017, called CANTOS that took heart patients with a HSCRP of 2.0 or greater. And this is kind of getting close. They found a drug, an orphan drug, that’s an interleukin 1 B inhibitor which is even upstream to interleukin 16. And they gave it sub-q every three months to 10,000 people, it’s amazing prospective study or placebo. The drug does only one thing, it lowers your c-reactive protein. It doesn’t lower your lipids.
So this Paul Ridker, a genius at Harvard said let’s construct a study that isolates lipid-lowering from inflammation lowering and see if it matters. And low and behold, the patients that were randomized to the interleukin 1 B, which is a way to lower c-reactive protein without lifestyle change, experience less events over the course of four or five years. It proved the inflammation hypothesis of coronary disease plaque rupture events, that drug is like $200,000 a year and it has a side effect called sepsis. So, it will never come to market in that role. It was followed quickly by another immune modulating trial similar with a drug called methotrexate, used to treat rheumatoid arthritis, psoriasis, that’s very inexpensive, that trial wasn’t positive. It was a big disappointment. So unfortunately, going back to really what we started with, you wanna lower inflammation, we’re talking lifestyle, we’re talking, you know, we’re talking sleep, we’re talking weight loss, we’re talking, you know, jacking up antioxidants and whole foods, and getting rid of metabolic endotoxemia and hyper-processed high fat foods. So, interleukin 16, yeah, it is an interleukin, as I recall, that is not associated with inflammation, it’s associated with plaques.
John: But it’s still gonna show up on a calcium score though?
Dr. Kahn: The end result. So, you know, just in case, there’s an amazing documentary I urge everybody to watch called “The Widowmaker” movie on Netflix, which goes through the history of why is there a test that costs $75 at a local hospital, takes under a minute, you lie down, hold your breath, and you go home, you get a report your heart arteries are free of calcification and calcification is known in the pathophysiology of atherosclerosis to be about 20% to 30% of the burden of plaque but very easily identified on X-ray studies, or you get a calcium score that’s 50, or 100, or 400, or 1200, or 1600, which is a software algorithm that tells you how many pixels and how dense the calcium is in each pixel. And there’s 2,000 studies that say calcium scores of zero are nearly risk-free for 5 to 10 years from heart attack because you basically have no calcific plaque and calcium scores that go up and up, escalate risk and identify sudden atherosclerosis. Why is that test not being promoted like colonoscopy and mammography, and thermography and cologuard and all the other things out there? Watch the documentary, I mean, it’s sort of a…
John: What’s it called again, “The Widowmaker?”
Dr. Kahn: “The Widowmaker” movie. Yeah, it’s sort of a conspiracy theory. It’s very dramatic, because actually, in the state of Texas, every citizen gets a free heart CT scan at age 50. Because one legislator got so pissed off when he had a heart attack and found out he could have had a test a year before that could’ve clued him in that he had a silent problem. So, I’ve been very aggressive, you know, test, not guess, is my kind of constant statement, you’re 40 or 45, or 48, you got some risk factors, or you’re just interested, go spend $75, go get the amount of radiation that a mammogram is which is considered low, and just get checked for the most serious and sudden life-altering or life-ending disease that still exists till we get our hands around it. So, that’s the calcium score, will that represent the whole inflammatory cascade, the lipid hypothesis, other genetic markers? Yeah. Lipoprotein A, you can’t measure it individually, but it’s the end result of all those factors, smoking, diet, blood sugar, the whole gamut.
John: Yeah. I think that is a great message for people out there, might as well get your calcium score, there is some radiation but it gives you a big clue into the health of your arteries.
Dr. Kahn: Take a big handful of chlorella about an hour before your x-ray exposure, Fukushima exploded and other things like that. There’s some good data that the incredibly high phytonutrient, chlorophyll, vitamin C, omega-3 content of organic, I would do organic chlorophyll, three, four, five, six grams of chlorophyll…Excuse me, chlorella, which is rich and chlorophyll, may actually prevent DNA breakage from radiation. So like, when I fly, I take three, four grams of chlorella, I have some in my bag right here. And, you know, if I’m having an x-ray procedure, which is pretty rare, I would do the same. It sounds hokey, but one, there’s no risk, two, it’s actually a food and an extremely high nutrient food. So, the only side effect is you’re actually getting a bolus of vitamin K2 and omega-3 and, and chlorophyll, antioxidant, you know, power I think it’s…the future of algae-based foods are…we haven’t scratched the surface.
John: Big for the omega-3s for the plant based community and also, you know, the mold doc’s love chlorella, because they use it as a binding agent for mycotoxin. Like, a lot of those guys, like, I don’t know if it’s part of the Shoemaker protocol, but some of these docs they love it because they think it can sort of help to detox some of this stuff that people get when they…
Dr. Kahn: Mercury too. Mercury it’s been shown to bind and exit mercury from the body and now you got to separate the woo from the science but there’s pretty good science to heavy metal toxicity, the prevention or extraction from the body with just you know, eating chlorella.
John: That’s a great point. So, getting the supplement game going can be beneficial. We had a big episode on that last episode. I want to take a brief tour through a topic that’s maybe a little less technical and a little more fun, which is vegan YouTube land. We touched on Rawvana we can kind of dive back into that but I want to kind of pair that up with “The Game Changers” movie that’s coming out I love these plant based movies. I think they’re, you know, I think there is a little bit of the whole kind of Fox News, MSNBC thing, you know, with some of these movies but I think that they’re good for people to watch because the overall message I think is positive. You know, “What the Health,” you were in “What the Health.” Do you know what the deal is with game changers?
Dr. Kahn: Oh man, you know, it’s a year overdue because of an incredible executive producer James Wilks, lightning Wilks, UFC fighter, plant-based but I think he’s a perfectionist and if he’s listening, I love you, James, but let’s get that movie out. I saw it a year ago and apparently it was like version seven. And you know, they wanted to get Lewis Hamilton, Formula…F1 and they want to get the Tennessee Titans in. So, they cut some people out and put some people in but yeah, it will be I would imagine it’s the best-funded plant-based documentary ever. It’s certainly the best produced because it’s James Cameron, who did Avatar and Titanic and, you know, I think the highest grossing producer alive. Or maybe Spielberg is, but between the two of them. They’re neck and neck. So I’ve seen it. It’s gorgeous. It’s well done. And basically, it goes through stories about plant-based athletes and their prowess, and the improvement they had either in performance, recovery, strength. But as you point out, there is a hilarious seven or eight minutes where they recruited three University of Southern California athletes. I think they’re basketball kids, tall, good looking kids. They put them in a lab with a urologist from LA, Aaron Spitz, who, he will become the world’s most popular urologist when the movie finally comes out. As he said he wishes his name was swallow not Spitz, he’s a urologist, I know that’s really gross.
John: Oh, God, that’s terrible.
Dr. Kahn: Yeah, Aaron, he’s actually…his claim to fame for now is…
John: That’s not good.
Dr. Kahn: He’s written a book called the “Penis book: How to manage your tool” by Aaron Spitz, MD.
John: You have a book that’s right up there, it was book came out before that I believe called “Vegan Sex” right?
Dr. Kahn: “Vegan Sex” was largely a product of a well-known plant-based athlete, Ellen Jaffe Jones who has competed in like 160 road races, and she’s a warrior at age 62, or 63. And has written many books, she approached me, I want to write the woman’s perspective of finding a plant-based man, and how joyful that is to find a plant-based tool to be very blunt. And she said, “Can you write some science chapters.” So, I contributed, and then there’s some great recipes, it actually, it’s a very inexpensive book, the recipes are worth the price of the book. But anyways, these three athletes, they find an old fashioned urology tool called the rigid scan, but it’s basically it’s a ring you put around your male member and go to sleep and every time…
John: It’s like the Oura Ring for your junk?
Dr. Kahn: Yeah, it’s like the Oura Ring for your, yeah, for your nozzle. And, you know, your deep sleep, and your stiff sleep, and your hard sleep, and your wide sleep, and all the rest. So, every time you have a nocturnal erection, it records it and it can tell all kinds of parameters. It’s an old machine, they found it. And they fed these athletes a meal, two different days about a week apart. One was a very meat-heavy meal and one was a…on the second day a whole food plant-based, probably low in oil diet. I haven’t seen the recipe. And the movie shows when they show the results to the athletes because they were asleep. I mean, this stuff happens at night, particularly when you’re 20, 21 years old and all. And the difference was like 300%, 400%, 500% more erections, length of erections, duration of erections, width of erections. And when they showed the graphs, these guys just, you know, they just broke up in laughter and embarrassment. But it, you know, it’s three patients is not the world’s biggest scientific study. Apparently, most of the crew and the movie when plant-based when those results came out. I’m pretty sure those three guys probably at least before a date went plant-based. So you know, if we ever get that movie out, Lewis Hamilton is, you know, you think about how his brain has to function second to second and he says, “I’ve never been sharper, better, stronger,” you know, in a car going 180 miles an hour around, you know, hairpin curves, pretty convincing stuff. I mean, you’re not gonna get a placebo effect at that level of precision.
John: Now, that’s fascinating, I mean, that’s one of the things I had heard previous interviews with…I think it was Dean Ornish, who talked about that. But that seems to be where the plant-based community wants to go. They wanna go into this thing of, hey, this is what causes erectile dysfunction. Don’t eat your chicken, you’re screwed if you do and then also this whole idea of vegan bodybuilders. And I think the vegan bodybuilders, in particular, is a little bit ironic because of the fact…And I love some of these vegan bodybuilders. They’re hilarious. I follow some of their YouTube channels like Derek Simnett and Jon Venus and some of these guys.
Dr. Kahn: A few guys here, Nimai Delgado…
John: I’ve seen his stuff, he’s…
Dr. Kahn: Just left him a minute ago.
John: Yeah. They’re cool guys and they’re…they seem to…I don’t know them personally but I’ve seen their YouTube channels. The thing I think is sort of ironic about that is that and I’ve heard you talk about this with Valter Longo and mTOR. And basically, this whole idea that Valter Longo is telling us the inflammatory amino acids in these animal proteins cause a problem because they’re anabolic and they stimulate mTOR. How can you have your cake and eat it too there? How can you be a bodybuilder and not stimulate mTOR? Like, how does that work?
Dr. Kahn: Well, I’m just pausing for a minute because I don’t think anybody who talks a lot about mTOR and certainly you mentioned Peter Attia will bring it up commonly in his discussion and he had David Sabatini, MD, on who’s often considered next to Valter Longo, you know, some of the top experts. You know, you don’t want your mTOR abnormally high consistently, which you might be able to achieve with a diet high in the amino acids that are largely found in meat. And when I say isoleucine, valine, and leucine, methionine and might be there. There’s other pathways I think that diets high in methionine, which tend to be animal based meat diets, accelerate aging, I don’t actually know if that’s true of the mTOR pathway, but you don’t necessarily want to low all…I mean, when you’re a child you want it jacked up because you’re growing but then…so during the adult phase, do you want to create a lifestyle or diet that you’re always low in mTOR activation and insulin-like growth factor 1. So there is this talk about cycling it, you know, bring it down low for a while, which will turn off some pathways associated with disease and cell damage and senescence and activate autophagy, and then go back and cycle it.
So, that is certainly the model that Longo has created in his five-day fasting mimicking ProLon diet, you know, that it may be enough to turn off as…if we can’t measure it. We measured IGF1 in his clinical studies, you can drop IGF1 for a week on his program. And then when you return to your diet, you’re probably going to allow it to drift back up and you could do it again a month later. It may be of value to do that in terms of autophagy and cell repair and senescence prevention. You know, there’s so much we have to learn about that. So, are these guys, you know, are they activating mTOR? I mean, the amino acid component of plant-based meals is not identical to the amino acid component of meat-based meals. And I don’t know a study, but I haven’t searched it, of plant-based athletes, weightlifters, and IGF1 levels. You know, most of these guys say they are not on anabolic steroids, they’re not taking supplements. They’re just eating large quantities of whole foods. Certainly, I follow Nimai Delgado and he shows his diet, he’s a very authentic human being and I’m absolutely certain he’s a clean bodybuilder.
John: He seems very cool. I’ve heard interviews he’s done. I think he’s the guy who grew up basically in like a Harry Krishna community. He’s never even eaten meat in his life. He seems great.
Dr. Kahn: A vegetarian his whole life and vegan for about a year. I think he’s really authentic. And the other thing is, this is careers for these people. It’s their passion. And they absolutely love it. They’re not necessarily, you know, longevity scientists. I hope it works out for all of them long term. You know, truly the real scary is the other side, the Paleo, keto world of weightlifters and you know, you had Harlequin, I’m blanking on his first name. Very well-known…
Dr. Kahn: Oh, is it Poliquin? Fifty-six…
John: We’ve probably mispronounced, yeah. I saw that.
Dr. Kahn: It was September 2018, it was two days before I went on the Joe Rogan show and he drops dead of a heart attack at age 56. You know, kind of the guru that they were following I’d be concerned there about accelerating atherosclerosis or creating unstable plaques or variety of, you know, dietary and maybe supplement based I don’t know what he was using.
John: Yeah, as a layperson, I’m just kind of waiting for somebody to come out and give me what they think the new thinking on IGF1 is, it seems like it’s evolving. My job here I feel like is just to play a little bit of devil’s advocate. I think those guys are healthy. I think they’re fine. The concern I would have for them if I were to identify one is that they’re getting enough DHA into the brain on a plant-based diet. I’ve learned a lot from following Derek Simnett, who’s a vegan bodybuilder, he turned me on to this app called Cronometer. I don’t know if you use Cronometer? I love that now. That is amazing.
Dr. Kahn: I’m familiar with it, I have not used it, but yeah, there are a number of people talking, it really helps them track their nutrient composition and such.
John: Yeah, for sure. So, I guess we can close off with a little bit on Dr. Gundry. I know you’ve been very outspoken against the Plant Paradox Diet. I mean, what’s your take? We in the…being…running a nutrition website, we do get people who seem to have sensitivity to lectin, and I have heard some people that have had some favor, some good stuff happened to them. I have a yoga teacher, very high integrity guy who’s a…I did a yoga teacher training under in San Diego a few years ago. He claims that without some of the lectin avoidance protocols in that diet, again, this is very…talk about the Aaron Spitz study, this is very N equals one, I get that. But he says, “Look, this helped me maintain my yoga practice. I mean, avoiding the lectins, it was very helpful for me.”
Dr. Kahn: Right. So you know, a blogger can write blogs they want and an athlete can talk about their nutrition. But you know, Dr. Steven Gundry was head of cardiac surgery at Loma Linda University for about 20 years. He was until 2004, I think he was an active cardiac surgeon. He did some amazing transplant research, if you remember baboon hearts being put in some infants…
John: Brilliant guy, yeah.
Dr. Kahn: What’s the guy’s name? I think Leonard Bailey who just passed away in the last few weeks, immune research. I mean, the guy has a reputation of being a scientist. Now he shifted 15 years ago to become an anti-aging doc in Palm Springs and, you know, massive practice. And that’s okay, too. But he carries that, that respect and title of being an established scientist, and here comes “The Plant Paradox,” because his patient Big Ed that couldn’t lose weight and his joints hurt and I forget the whole, you know, N of 1. Just every doc in the world couldn’t deal with it. And Dr. Gundry himself was some sort of vegan-vegetarian and running yet he was overweight. And between the two of them, they identified a theory that nobody else in the world has identified except maybe Tom Brady during the season, and his avoidance of deadly nightshades.
And now another well-known scientist, Tom Brady, but you know, it’s an N of 1 you gotta respect. But Gundry takes the MD degree and his Loma Linda experience and says, you know, I’ve done research that shows that the anti-nutrients in many foods, but are concentrated in legumes, are driving inflammation, and by eliminating them, I have cured many, many people and I’ve published the data and I wrote my book, “The Plant Paradox” to help so many people. Now, I don’t know because there is so little science. I’m not in any way denigrating anybody who says I either follow “The Plant Paradox” or on my own I just cut back on either deadly nightshades, Tom Brady, or legumes and says they feel better, great, I mean, I’m a doctor you feel better I’m happy but do you make it a public policy for most people to follow? Do you write a book that has what foods to eat and, you know, on the foods not to eat is pretty much every legume when almost all nutritional studies would identify, peas, beans, and lentils as a public policy statement, you know, a core inexpensive, microbiome friendly, cholesterol-lowering, protein rich, fiber rich, group of foods. In reality, he’s never published a paper on any of this stuff. He says he has, he hasn’t. He published one abstract that’s riddled with typographical errors, which is just absolutely embarrassing. It actually calls his protocol the pant paradox in a scientific abstract that he references as a conclusive data.
John: Which you have a great YouTube video on, which people can check out.
Dr. Kahn: I made little fun of it. Yeah. Because you know, it’s just embarrassing that with his capacity and his business and everything else, nobody noticed that there was a pretty comical typographical error. But finally, you know, I identified Dr. Colin Campbell of “The China Study” and his nutrition program identified that there were…This is what’s inexcusable, the book “The Plant Paradox,” it’s sold millions of copies New York Times bestseller for dozens a week, translated into 34 languages. If you open Chapter 1, read the first paragraph, go to the reference 1, go to PubMed. It’s not the right reference. It’s a reference about cows and he’s talking about rats. And you go to Chapter 2 and reference 4 and you do this, and then you go through the book, you realize, you know, the biggest paradox here is the science here is either the sloppiest science, intentionally fraudulent, or just incredibly sloppy and more recently, and I encourage people to look up a scientist, PhD, Stephan Guyenet, G-U-Y-E-N-E-T, he’s on Twitter. He’s got a website called Red Pen Reviews. They’re taking books like this, and they’re doing very detailed statistical and science analysis.
John: Oh, cool. Very cool.
Dr. Kahn: So, they judge that the references in “The Plant Paradox” were right, 26% of the time and 74% of the time they were just made up nonsense.
John: So, Red Pen Reviews, is that a website?
Dr. Kahn: Red Pen Reviews. It’s a website. There’s about 10 books so far, including “Grain brain,” including “Wheat Belly.”
John: What did they say about “Grain Brain?”
Dr. Kahn: Oh, God, D minus scientific support. They actually have “The Longevity Diet” by Longo there, and I haven’t read that whole review. It’s like about 90% scientifically accurate. I’m surprised it’s not higher than that, but it’s completely different ball of wax than you see in “The Plant Paradox,” I will tell you his new book Gundry, “Longevity Paradox”, which all of a sudden, eating beans is on the approved food list like, okay, I guess you changed your viewpoint even though you didn’t announce it to the public. Basically says never eat fruit…
John: Fruit to fructose thing?
Dr. Kahn: In fact, it specifically says never eat apples, apples will shorten your lifespan. And if you look for the reference, five pages on the role of fruit and longevity as a life-shortening habit, there’s not a reference in those five…It looks like his habits haven’t really improved. I actually talked to him personally. I mean, why don’t you just get somebody to clean up your references and rerelease the book? Because he said it was a mistake. I had a Harvard student that did my references. Well, if that Harvard student screwed up, you have a responsibility to put out credible stuff, so. The thing is, though, he’s a steamroller. You can’t stop Gundry right now. He’s huge.
John: He’s killing it, yeah.
Dr. Kahn: He’s well-funded. He’s making, you know, more money than Johnson & Johnson out of this whole enterprise. And a few people feel better. Is he hurting anybody? I don’t know. I don’t know. You know, nobody follows these diets long term. I mean, if you don’t eat legumes for three months, and then you give up, you probably didn’t hurt yourself, but it’s not authentic and honest.
John: I hear you. I know you’re pressed for time. I do want to close out in the last couple of minutes that we have here. And I want to just to speak to the ex-vegan thing, the ex-vegan YouTube thing because my sense of things is you have these people. we touched on it a few minutes ago. You these people, they go on a plant-based diet for six years, you’ve talked about this, they’re cutting back on water consumption, they’re helping the environment that doing all the things that the vegan community wanted them to do. And then they’re caught…and I get it. It’s a betrayal of trust, I get that. I do. But look, these people are like part of the tribe and they’re cast out so quickly. And I feel like there needs to be a way for the vegan community to continue to embrace these people because they’re basically like 99.9% plant-based. So, what do we do about the ex-vegan, what’s your take on the ex-vegan thing?
Dr. Kahn: Well, number one, you’re not seeing vegan physicians and other and scientists. And again, if you’re a scientist, it’s what Dr. Garth Davis, I mean, you may know him from the book “Proteinaholic,” and he’s pretty out there on social media, a bariatric surgeon, [inaudible 00:55:59] he goes, “I’m not pro-vegan to only show the science that supports pro-vegan,” he goes, “I picked a vegan diet because I read the science. And I studied the science as a bariatric surgeon concerned about nutrition. And it took me to age 45, but I adopted a whole food plant-based diet because of the science. I don’t have an axe to grind.” I feel similarly. And I’d say this, I mean, when data comes out, that a grass-fed beef and butter diet will reverse coronary disease and prevent disability and death, I will present to my patients that an option could be, you know, a new but I’m making up a hypothetical statement here because there is no such data at the present time and I doubt that ever will be, you know, you have to be authentic and honest with your patients, or if you’re a scientist with the science. All were…so I haven’t seen any plant-based scientist, plant-based physician, plant-based, you know, academician announce, “I’ve given up.” I mean, I’m frustrated, I tried it and I’m going back to either studying the benefits of meat or adopting meat, all you see are clickbait YouTubers. And I don’t know that all of this, you know, if I were Rawvana, all of a sudden I got 10 billion more views. I’m not saying it was authentic or…I think some of that…
John: A real politic kind of thinking there.
Dr. Kahn: I mean, she broke out of the pack and got more followers and probably sold more food guides, now she can sell food guides to vegans and non-vegans, I think it’s all a waste of energy and time, it sure provides fodder for other YouTubers and other bloggers and, you know, it causes…Some people have commented that there was a more recent YouTuber that in the last two weeks also bailed out of the system. And somebody counted, there’s been like, 25 of them this year that have pretty big numbers on YouTube and have announced they’ve given up. Is it authentic? Is it not authentic? But, you know, some have said, like, you know, and I’m not at all trying to be gender specific, but some of these were probably dysmorphic body shaming diet followers, that are very low calorie, you know…
John: The water fasting and all that…
Dr. Kahn: …Water fasting and salads and not, you know, nobody was counselling them on what’s a whole food plant-based, you know, food plate that the Physician Committee Responsible Medicine might talk about, let alone being sure they got enough omega-3 precursors or B12. I mean, who knows what these people are doing? Is it a big teaching point? I will say nobody on the planet knows, if you took 1,000 people put them on a really healthy whole food plant-based diet would 1,000 of 1,000 have optimal labs and health? Or is somebody going to seem to do better with, you know, some wild caught salmon or some grass-fed beef or some, you know, Kerry Gold butter out of Ireland or something? We don’t know the answer to that. I suspect most of those thousand would thrive. And, you know, if you just provided them meals that were beautiful and organic and well-constructed, but you know, is it 900 of 1,000? Is it 998 of 1,000? Is your microbiome or your genetic influence? You know, your specialty? If you’re, you know, ApoE3, do you need more, you know, fat content in your diet than the ApoE4, and you have to create a little different diet for people based on their genetics. That’s again, I know you’re going down that path. And I actually think we will tailor diets for sure to genetic profiling for sure.
John: What we’re seeing is that there are certain variants in some of these genes that make it more difficult to convert alpha linoleic acid, which is the plant-based omega-3 fat into EPA and DHA. When I see people, and you can look at the studies, a lot of the blogs out there and some of the more partisan vegan YouTube channels will tell you well, it’s like 3% conversion of ALA to EPA and DHA. I think the conversion from ALA to EPA is pretty robust in most people. But the conversion from ALA to DHA is actually…and some studies show it’s, like, miniscule or non-existent. So my concern for some of these people that go on these vegan diets you have people like you, you guys are…and the doctors that, you know, that are at these conferences, you guys are just a wealth of knowledge. You know this stuff inside and out, you know the micronutrients inside and out. You’re taking chlorella before flights, but you have these other…these kids who are out there, and they might not know they need to be taking algae oil, and they might be massively deficient in DHA, and they might feel anxious or depressed as a result. So, that’s when I see the fish.
Dr. Kahn: Right, and they might have vitamin D levels of 10. I mean, the whole thing. It’s very possible. You know, on that topic, I’ll just tell you some of your listeners might enjoy finding an online Dr. Brooke Goldner, G-O-L-D-N-E-R, MD, a psychiatrist in Houston. A woman contracted lupus at age 15. And a rather severe form of lupus at age 25, was on the verge of dialysis, adopted a whole food plant-based diet and modified it so that she jacked up precursors to omega-3, I mean, literally, you know, a pound of hemp hearts and flaxseed and chia seeds, eliminated all oils, big giant green smoothies, lots of hydration, and such and was cured of lupus, all her labs have been published and now counsels people on autoimmune disease. But she makes the point you will convert more ALA to omega-3 fatty acids if your oil and omega-6 content from oils is kept very low or minimal because they compete for the same pathways, so. That may be why that plant-based diet rich in oils, processed oils, particularly, which is going to be what most people are eating, kind of junky available plant-based foods that are out there right now, may leave you particularly apt to be deficient in omega-3 fatty acids.
John: Yeah. And Aaron, our geneticist has told me that the studies that were done on, to your point, linoleic acid converting to arachidonic acid in people, they used to think that it was like 2% to 3% of the of the linoleic acid omega-6 count that you ate would convert to arachidonic acid downstream. Those were all studies that were done in Caucasians. Now, what the research is showing is that…I actually carry one of these variants that hyper converts linoleic acid to arachidonic acid, but it’s more common in African American and Mexican populations. And so, the point you just made is very, very well taken for certain populations who might not know that when you’re eating the vegetable oil, it’s getting into this inflammatory stuff at a higher rate than what…the arachidonic acid, some of the bad stuff we talked about. So it’s a…
Dr. Kahn: Yeah, you know, and I’ll just say one more thing, there is a split amongst those plant-based doctors that are on the web or doing blogs or in YouTube’s, articles, there are some that firmly believe the only supplement you might consider is vitamin B12, and you’re done. And then there are those that will extend the list to perhaps vitamin D to algae coil or omega-3 algae capsules. Some will include a little bit of iodine either from sea vegetables or as a supplement, some taurine. So there are now some commercially available MultiVites, you know, by vegans for vegans. Sounds like Irish Spring. But nonetheless that are trying to in one-stop-shop supplementation fill a few holes that could exist in some people, could explain some of the YouTubers, you know, would Rawvana feel better with her diet and something called Complement Plus, which is a multivitamin for vegans, it’s out now from Matt Frazier, pretty well-known athlete. Unknown answer, but it makes sense to me to say take the best of the whole food plant-based diet, recognize the science says there still could be some nutritional deficiencies. But God knows you could point your finger the other way at a heavy meat diet and come up with the same deficiencies. But we’ve got, you know, one-stop-shop to plug it. Here’s a couple of simple capsules a day and you’re done. And that’s what I teach in my practice. You know, plants plus I call it, you know, best diet with intelligent supplementation, either just shotgun approach or do lab work and tailor it based on the lab work.
John: Awesome. Well, Dr. Kahn, this has been a very fun conversation. We really appreciate you coming down to this part of the city. It’s a real honor to have you on the podcast.
Dr. Kahn: Dude, you’re like Detroit’s brightest brain moved to New York.
John: I don’t know about that.
Dr. Kahn: Thank you. I really appreciate it.
John: We’ll see you at home.
Dr. Kahn: Absolutely.
John: Thank you, sir. Bye-bye.
“The GeneFood Podcast” is our attempt to synthesize the latest developments in the fields of genetics, nutrition and medicine, and offer you practical tips and stories you can use in your own unique health journey. If you enjoy this podcast, you can find more information online at mygenefood.com.
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