The WORST Food Destroying Your Heart: Dr. Philip Ovadia (Transcript)

And thankfully, I started to come across some different information that led me to ask some different questions, to really start to understand the root cause of heart disease, which I had been treating for my entire career, obesity, diabetes, these chronic conditions that were leading patients to my operating table.

Ultimately, you know, I was able to overcome my own health challenges, you know, lost nearly 100 pounds, have maintained that weight loss now for many years. And I was able to come to a true understanding of what the cause, what the root cause of heart disease is, so that now I can help people to prevent it. And that has really refocused me and given me a mission in life, I would say, to keep as many people as possible off of my operating table.

Rethinking Medical Advice

Because the reality is, is the vast majority of what I do as a heart surgeon shouldn’t need to be done. Heart disease should be preventable and is preventable in the vast majority of cases with the right, you know, diet and lifestyle interventions. And we do a very lousy job at that in medicine. I would say in mainstream medicine, but I realize how important it is. Because ultimately, no matter how good a surgeon I might be, no matter how good all the heart surgeons out there might be, you’re never going to be as good after the surgery as you would have been if you didn’t need the surgery in the first place.

RINA AHLUWALIA: So I’m curious for people watching out there, what was the advice that you were told that you followed that made you sick and morbidly obese as well? What was that advice?

DR. PHILIP OVADIA: Yeah, I think it’s, you know, the dietary advice that we’ve all heard, you know, here, it’s the US dietary guidelines, it’s the food pyramid. But I think the fatal flaw within that food pyramid is this concept that we should be eating low fat diets. I think we can clearly now go back and say, the science that led to that recommendation was flawed, maybe fraudulent. And the outcomes of following that diet are disastrous.

They’re all around us. They’re the, you know, skyrocketing rates of obesity and diabetes that we see. There are the 88% of adults in the United States that are not metabolically healthy. And it’s the fact that heart disease, the very condition that that was designed to impact, remains far and away the number one killer. And really, there’s very little to no evidence that low fat diets have had any benefit on the incidence of heart disease. And I would say that it’s made it worse because they do promote obesity and diabetes, which are major risk factors for heart disease.

RINA AHLUWALIA: And I know that many people watching as well, they come across a turning point. There’s going to be something that happens in their life where they make that change. What was it for you that made you change the course of what you’re actually doing?

DR. PHILIP OVADIA: Yeah, so, you know, and I think that really comes down to a mindset issue. You have to know why you want your health to improve. For me, the primary driver was I had young children who, you know, I wanted to be around for. And like I said, I knew where I was headed. I’ve seen it in my patients. I have the family history of heart disease. And I knew where I was headed.

Finding Your ‘Why’

And I knew if I wanted to be here for my children, and my grandchildren, and my great-grandchildren, I was going to need to change my course. And that is what led me down the pathway that I then travel down.

RINA AHLUWALIA: Absolutely. And I think for many people, it’s about the children. It’s about the family. It’s about wanting to live a strong and healthy life. And I’d love to know for those watching, what is your why? Why do you want to get healthy, lose weight? What is your big why to help you stay on track? Because I think that if we know that, it helps us with all the challenges. Because we’re going to talk about carnivore, because I know that you’re carnivore. That’s a challenge to stay on for a lot of people.

So understanding the why is so important. And I’m curious to know, now that you know everything that you know from all the experts, from all the history that you have in your own experience, what do you think now is the cause of heart disease?

DR. PHILIP OVADIA: Yeah. And you’re exactly right about needing that why. And that’s why in my book, I talk about the principles, the seven principles of metabolic health. And the first principle is really that mindset issue. Because knowing all the facts, reading all the studies, all of that is great. But at the end of the day, it’s not going to be enough to sustain you if you don’t know why you’re making changes.

So, a very important point to reemphasize. And ultimately, my why had two components to it. It had my family and my children and my wife that I want to be there for. But it also had being there for my patients and being a better doctor. And that meant truly understanding and getting to the root cause of heart disease, the disease, like I said, that I spend every day fighting against with my patients.

Misconceptions in Medical Understanding

And, you know, again, this is an area where we have had many, I would say, misunderstandings and physicians have been misled to believe that cholesterol and dietary cholesterol and dietary saturated fat are the primary drivers of heart disease. We now know that not to be true. That hypothesis has been, I would say, thoroughly disproven on many levels. And when we really want to look at the root cause of heart disease, it comes down to damage to the blood vessel walls from inflammation and primarily from insulin resistance.

There are some other things that contribute like smoking that can cause damage to the blood vessel walls, heavy metal toxicities, you know, other things. But the primary driver of heart disease is insulin resistance and poor metabolic health. And I know that if we were to focus on that to the same degree that we focused on lowering cholesterol, we would have a major impact on the incidence of heart disease.

Addressing Insulin Resistance

RINA AHLUWALIA: Well, the big question, how do you fix insulin resistance?

DR. PHILIP OVADIA: Yeah, it really starts with the food that you eat and, you know, the other lifestyle components that are going to help as well. But, you know, I tell people to start with the food that you’re eating because that is the major influencer. That is what leads us to become insulin resistant. And ultimately, you know, as that progresses, we then get to diabetes.

And that’s the major way that we can undo it. And this is another important concept for people to understand. Diabetes is a reversible disease. Type 2 diabetes is a reversible disease. And people don’t get told that. They get told it’s a lifelong condition. You got to take your medications. We have to manage it as well as possible. And we now have ample evidence that type 2 diabetes can be reversed. And in doing so, you are reversing the insulin resistance as well.

The Impact of Metabolic Health

And again, this is the common root cause that not only heart disease and diabetes share, but the majority of the chronic disease that plagues our society. Things like cancer, many forms of cancer, Alzheimer’s disease. You know, you can keep going down and down the list. And it seems like almost every chronic disease that, you know, is so prominent in society today has its roots in metabolic health and insulin resistance.

RINA AHLUWALIA: So talking about the foods that we eat, because I know many people watching, they’re all about what food should I be eating? What food should I be eating? Tell me the list. Let’s first talk about the foods that we should not be eating. The most dangerous foods that are going to cause heart disease, cancer, diabetes, and all the rest of it. In your opinion as a heart surgeon, what are those foods?

DR. PHILIP OVADIA: Yeah, so I think we first have to look at the processed foods. These are the things that come in the packages, in the boxes, in the bags. These are the things that have these long ingredient lists. And in particular, they have two components that are problematic. The first is highly processed carbohydrates, the flours and the sugars that aren’t really anywhere close to their natural form. And then we have the vegetable and the seed oils. These are adulterated, manufactured fats that, again, our bodies did not see these things until our very recent history.

They do not exist in nature. And they have some unique and problematic effects when we consume them that I believe are major contributors to these chronic diseases that we’re seeing.

RINA AHLUWALIA: So processed foods, anything in a box or package, sugar?

DR. PHILIP OVADIA: Yeah, I think sugar needs to be very carefully consumed, if at all. And if you are metabolically broken, if you’re insulin resistant, that means that your body is intolerant of sugar and carbohydrates. And the best way to manage that is to eliminate it.

You know, you certainly need to lower it. And in most cases, the answer is just eliminate it. It is not essential for life. We don’t need to be eating it. So if you want to have the greatest impact, elimination of sugar is going to be the way to go.

RINA AHLUWALIA: Okay. And here’s another question. What about these natural sugars like fruit? What do you think about fruit?

The Role of Sugar in Metabolic Health

DR. PHILIP OVADIA: Well, again, you know, our body doesn’t really differentiate much between, if at all, between natural sugars that are in fruit and, you know, the processed sugars. It’s all sugar. It all goes through the same metabolic pathways. So whether or not you can eat fruit is going to depend on your personal situation. If you are metabolically healthy, if you are not insulin resistant, if you are active and you have a good amount of muscle mass, then yes, your body is going to be able to tolerate some sugar.

And, you know, there are various things that we can do to figure out how much is too much for you. But if you’re not, all of those things, and if you’re like most adults, certainly here in the United States, and really I would say worldwide at this point, and you are insulin resistant, or you’re obese, or, you know, you have diabetes, your body is going to be intolerant of that. It can’t process it well. And so any amount is going to be harmful, whether it’s coming from the piece of fruit or the candy bar.

RINA AHLUWALIA: I’m so glad that you said that, because do you know how many doctors say, oh, have the fruit, have the vegetables, have all the different things, and then that’s healthy for you. And I think many people get confused because we hear so many different opinions from different doctors. That’s why I like to speak to doctors like you, Dr. Ovadia, because you say it how it is, you know the general thing of different diets and what works. And I know when it comes to the best diet out there, because there is no one best diet for every single person.

And I think that many people, they’re wondering, what should I be following if I want to lower my insulin resistance, if I don’t want to have a heart attack, if I want to live until I’m 100 and feeling amazing? So the loaded question is, what is something that’s going to work for most people?

Principles of Healthy Eating

DR. PHILIP OVADIA: Yeah, so the first principle that people need to be following when they’re thinking about what to eat is to eat whole, real food. I tell people, eat the things that grow in the ground and eat the things that eat the things that grow in the ground. Now, as we’re making these dietary changes, I want people to focus on metabolic health and insulin resistance. That should be your guidepost.

If what you’re eating is improving your metabolic health or helping you to maintain your metabolic health, then I am all in favor of it. And that is a good dietary strategy for you. And you’re right. I can’t sit here and say everyone should be eating X diet. It’s why in the book, I didn’t give you Dr. Ovadia 21-day diet plan, like so many of these books do. I give you a framework to work within, and I give you a lot of options of things that can work if done in the right way.

And I also give you the pitfalls of all of these dietary strategies that will prevent them from improving your metabolic health and helping you ultimately achieve the success you’re looking for. So what I lead people back to is our focus is on improving and optimizing your metabolic health. You’re going to figure out the strategy within the ‘eat whole real food’ rule that gets you to success. And you’re going to recognize that that may even change over time.

Because not only is there not one right diet for everyone, but even for each individual at different times, at different points in your life, depending on where you are in terms of that metabolic health, the dietary strategy may need to change some. And, you know, we talked about fruit earlier and how if you’re not metabolically healthy, fruit should be off your menu. But if you are metabolically healthy and you want to incorporate it, not that it’s mandatory, but you want to incorporate it some, there are ways to do that while still maintaining your metabolic health. And I have no problems with those.

Choosing the Carnivore Lifestyle

RINA AHLUWALIA: Okay. And I know that you follow a carnivore lifestyle, as do I. So why did you choose that lifestyle over, for example, keto or paleo?

DR. PHILIP OVADIA: Yeah. So ultimately, and, you know, I tried all of the above, ultimately carnivore is what I settled on for two reasons. The first reason is that’s what helps me to feel my best. There are improvements that I noticed on carnivore that while I had lots of improvements on keto, low carb, paleo, all of that stuff, carnivore really got me to what I feel is my best point.

And the second reason I maintain my carnivore lifestyle is because I find it easiest to do. It’s just, it’s pretty simple. You know, don’t have to track, don’t have to think about it. I just eat animal-based products. And, you know, when I’m hungry, eat till I’m full. It fits very well into my busy life. And that’s what has kept me with it now for over four years.

Debunking Myths about Red Meat and Saturated Fat

RINA AHLUWALIA: Well, I can tell from the smile on your face that it’s working very, very well and you’re very happy with it. So when it comes to the carnivore lifestyle, I’m sure that you’ve heard this thing about red meat. Red meat is not healthy for you. Red meat has high amounts of saturated fat. Do you think that saturated fat leads to heart disease?

DR. PHILIP OVADIA: Absolutely not. And at this point, we have more than enough evidence that that is not true. The many, you know, people don’t realize that many of the societies, many of the guidelines that initially had limitations on saturated fat have actually removed those limitations because the science simply just doesn’t support it. And when we look at, you know, how we came to believe that to be true, we can look back and see where the errors in the science were made and how that narrative really got pushed more by a sort of socio-political agenda than people’s health. So I am absolutely confident in saying that dietary saturated fat is not causing heart disease, and there is no reason that we should fear it as part of our diet.

Understanding Cholesterol and Heart Disease

RINA AHLUWALIA: And when it comes to when you eat more saturated fat, a lot of people, they’re going to get their blood work done and they’re going to see their cholesterol increasing. They’re going to see also the LDL increasing, not for everybody, but for some people. I think they’re going to be a bit worried. How would you advise people when they speak to their doctor, because their doctor is probably going to be worried as well, how would you tell people to understand or help them understand the mechanism of LDL? Is LDL important to look at for heart disease as a measure?

DR. PHILIP OVADIA: Yeah, so what I ask people to understand and focus on, and I do a lot of work around this, helping people to understand this and educating them, working with my patients to understand this, is it’s not the amount of your cholesterol that we should be concerned about. It’s the quality of your cholesterol that we need to be concerned about, and it’s the environment that that cholesterol is functioning in. And again, this is where we circle back to things like insulin resistance.

Because ultimately, if you have a lot of non-damaged, healthy cholesterol particles around, and your blood vessel walls are not being damaged on a constant basis, there is no evidence that LDL cholesterol, elevated LDL cholesterol is harmful to us. Most doctors don’t understand this. They don’t get educated on that nuance. The approach that has been taken is that all LDL cholesterol is bad, and we need to lower all LDL cholesterol.

And again, I go back to what has the outcome of that been? Because that has been the approach now for essentially 40 years. Cholesterol-lowering medications are the most widely prescribed class of medications. Our LDL cholesterol levels on a societal basis have lowered, and yet we’re not seeing a noticeable impact on the incidence of heart disease. And what I see as a heart surgeon is that, you know, at least half, probably more at this point, of the patients that end up on my operating table, have been following that strategy.

They’re on the medications, they’ve changed the diet, they’ve lowered their LDL cholesterol, and they’re still ending up on my operating table. So that is another thing that has led me to step back and say, something can’t be right here. It can’t be simultaneously true that LDL is the most important factor when it comes to heart disease. And more and more people are on these medications and doing these diets to lower their LDL cholesterol, and they’re still developing heart disease.

So again, I think that cholesterol, it’s not that it’s unimportant. It’s not that it’s, you know, we can just completely ignore it. It’s that we need to understand the nuance around cholesterol, and that it’s the quality of the cholesterol, and the environment that your cholesterol is functioning in, that we should be focused on.

RINA AHLUWALIA: Okay, so if it’s the environment that the cholesterol should be functioning on, let’s say that you have somebody going to get their blood work done, what should they ask for?

Assessing Metabolic Health

DR. PHILIP OVADIA: So ultimately, you need to be able to assess whether or not you’re insulin resistant, and whether or not you’re metabolically healthy. Depending on your capacity to get blood work, and your ability to find a practitioner who understands this, and can guide you through this, or, you know, you’ve educated yourself enough on this. There are a couple of different levels, I guess, that I point people to. The very basic — five basic metrics that I want people to start with.

Because if we can get these five metrics in line, that’s going to get us most of the way to the finish line without getting very complicated. So I want you to focus on your waist circumference. And again, very easy, measure that at home. I want you to focus on your blood pressure. Again, you can measure it at home. And then when it comes to labs, there are three basic labs to be looking at. Your fasting blood glucose level, your HDL cholesterol level, and your triglyceride level. And, you know, you can go to the book and get the numbers.

You can go to my website, ifixhearts.com, right on the front page. Free quiz that will lead you through those metrics, and help you determine if you’re metabolically healthy or not. And if you get those five metrics all into the healthy range, pretty good chance that you’re going to be insulin sensitive and, you know, in a good place. There are some more advanced metrics that, you know, I oftentimes will be looking at with patients. Things like your insulin level, various ways to determine whether or not you are insulin resistant. And, you know, again, there’s lots of different options there. And there are some complex tests that we can get into. But ultimately, start with the basics, get those right.

And then, you know, as you’re working with a skilled practitioner on this, as you’re educating yourself, you can get more into the weeds. And we can, you know, figure out if you’re truly optimized or not.

Prioritizing Muscle Building Over Cardio

RINA AHLUWALIA: I love how you make it so simple, because some people make it so complex, but you make it so simple. And another thing that people find, it’s simple, but they find it complex, is weight loss. And from your perspective, being a heart surgeon, do you think that cardio or exercise is a good way for people to lose weight?

DR. PHILIP OVADIA: So I think it can be an adjunct, but I don’t think that cardio is effective in and of itself in weight loss. And we have multiple studies that show this. So, you know, it’s not that cardio is bad. It’s just that it’s not really effective for weight loss. And when I’m talking to people about their activities and their exercise, I ask them to prioritize building muscle first and foremost, before you’re doing the cardio. And there’s many reasons for that. But, you know, ultimately muscle is more metabolically active, will help us lose fat, and will help us to maintain our metabolic health.

If after you’ve put proper time and energy into building and maintaining your muscle mass, if you want to add some cardio, great. But understand that it’s not necessary. I know plenty of people that have optimized their metabolic health without ever stepping on a treadmill or, you know, running long distances. Maintaining muscle mass is a much more important factor as we’re looking to improve our metabolic health. And as we look at things like predictors of longevity and health span.

RINA AHLUWALIA: So resistance training not only helps with the weight loss, along with the diet, it also predicts longevity, reversing disease, and helping you maintain a healthy lifestyle. So when it comes to doing cardio, is there any, because people are saying that, you know, but cardio is healthy for you. We should be doing cardio because it’s good for your cardiovascular system.

But you’re saying that you should prioritize resistance training first. And then if you have extra time, do cardio. Is that right?

DR. PHILIP OVADIA: Yes, that’s exactly what I’m saying. And again, I’m not saying that cardio is bad for you, or cardio isn’t good for your health. It’s just that it shouldn’t be our priority. And the reality is, is that most people have limited resources to put to this. And I want them to be putting that towards building and maintaining muscle mass, which is ultimately going to have a greater impact on what we’re trying to fix.

RINA AHLUWALIA: Absolutely. And also when it comes to weight loss, I think a lot of people, some people think that they should be counting calories for weight loss, and also to achieve optimal health, reverse disease. Do you think that counting at all is useful in your experience?

DR. PHILIP OVADIA: No, I really don’t think that counting calories is a useful strategy. When we look at the whole concept of calories in, calories out, what we see is that there are problems on both sides of that equation. When looking at the calories in, the reality is, is that we do a very lousy job of counting calories when we try. Um, you know, if your food has a label on it, which for the most part it shouldn’t, there’s a good chance that there is a 10 to 20% error in the label as to the amount of calories that that food actually contains. And we also, need to understand that, you know, again, not all calories are the same.

Understanding Caloric Intake and Metabolism

Uh, and there are things like the thermogenic effects of food that don’t get accounted for when we are calculating these calories. On the other side of the equation, we have no good way of determining how many calories we burn. You know, outside of a laboratory setting, this is notoriously difficult to estimate. And these formulas that we use to try and estimate it are inaccurate.

And again, the amount of calories that we’re burning are going to be influenced by the types of calories, the types of food that we’re eating. Uh, and then things like activity, muscle mass, all of these complex things. Uh, so calories in, calories out just does not work as a model for weight loss. I know I certainly try to use it many times and it just doesn’t work.

You know, I would have some short-term success because yes, when you eat less food in general, that’s going to cause you to lose some weight. Uh, but it wouldn’t maintain over the long run and numerous studies have shown that.

RINA AHLUWALIA: And I am absolutely the same way. Prior to studying carnivore, I used to count calories. I used to diet, doing all these different things. But it’s interesting that when I started carnivore, I let go of all of that. I’m actually eating more than I did previously and maintaining a healthy weight. And I’m sure that many people are curious, what does a carnivore heart surgeon eat in a day?

A Day in the Life of a Carnivore Heart Surgeon

DR. PHILIP OVADIA: Yeah. So, my dietary pattern for most days is pretty simple. I usually eat once or twice a day and that’s going to be animal-based foods. Uh, so, you know, the way that my days tend to run is that I fast in the morning. You know, I typically won’t have breakfast. I’ll have some coffee, usually black coffee. And, so I typically won’t eat in the morning and sometime around mid-afternoon when I — my schedule slows down enough and I might start getting hungry. I’ll typically eat one meal.

And then, again, depending on the day, a few hours later in the early evening, I might have a second meal or, I might just have the one meal in the evening, depending on how my day is running. I focus on the amount of protein that I get in, in a day. I want to make sure I get adequate protein. And so, for me, that means on most days eating, somewhere between a pound and two pounds of meat.

Variety and Simplicity in Diet

And, oftentimes I’ll mix in a few eggs or maybe some yogurt, with that. Uh, it ends up being pretty simple. You know, I do like eating a variety of meats. So red meats, ruminant animals, uh, I’ll mix in seafood as well. I minimize the non-ruminant animals because of some of the issues that can come up with how they’re being fed. And that kind of covers it for me. You know, like I said, I like the simplicity, the ease of doing a carnivore diet.

RINA AHLUWALIA: And do you think that people that are following carnivore or on their lifestyle, do you think that they have to do fasting? Because I know that you do one or two meals a day. I get so many questions. Should I fast? Not fast? Three meals a day? How many meals a day if they want to lose weight and reverse disease?

Fasting and Its Role in a Carnivore Diet

DR. PHILIP OVADIA: Yeah, so I don’t think fasting is essential, but I think it can be a great tool, especially if you’re looking to lose weight. There are a number of people that come at this situation that they’re not necessarily overweight, uh, but they are insulin resistant. And, in that situation, fasting might not be the best tool for them or might be more difficult. People who are chronically undernourished have been dieting chronically, like many of us have at first fasting might not be the right tool.

So I really guide people, you know, this is where you follow your hunger. When we get the processed foods out of our system, we can now trust our hunger signals and we can eat when we’re hungry and eat until we’re full. Now, until you get to that point, like I said, it’s going to depend on your situation in general. If you’re overweight and obese, if you’re insulin resistant, probably, integrating some component of fasting is going to be useful for you. But I don’t like to force the issue. I don’t like people, doing the fast because they think they have to do the fast.

I like them getting to the point where they’re just hungry less often and then fasting kind of naturally becomes part of your plan. And that’s what I love about you because Dr. Ovadia is so, he’s so of the people, if I can say that. It’s more about giving people a general understanding about, okay, you can try this and try this and people really understand what’s going to work for them to lose weight.

Personalized Approach to Health and Wellness

RINA AHLUWALIA: It’s not that you have to follow this or follow this. It’s kind of a general principle that you can follow to achieve your best health. But I just want to say thank you so much, Dr. Ovadia for taking the time out to speak to us about heart disease, about weight loss, about how to achieve our optimal health. How can people find you?

DR. PHILIP OVADIA: Yeah, so iFixHearts is really the way to find me everywhere. So the website, iFixHearts.com, you can find out there about all the ways that my team and I work with people to implement these processes and to improve their health. I do have a private telemedicine practice.

So I see people in consultation and work with them on an ongoing basis. We also have great coaching programs, courses, the book, everything is there. Over on social media, again, iFixHearts at Twitter is where I’m most active. You can also find me on Instagram over at Ovadia Heart Health.

And then we have the iFixHearts YouTube channel where I host the Stay Off My Operating Table podcast, and we have lots of great conversations every week.

RINA AHLUWALIA: You are such a busy heart surgeon. Along with your job, you’re doing all that social media work. That’s amazing. Thank you so much, Dr. Ovadia, and I’m sure we’re going to see you very soon.

You might like to watch this video next with Dr. Elizabeth Bright. Especially if you’re starting a carnivore diet to heal and to lose weight, you might need to know how to start a high-fat carnivore lifestyle the right way. You might also like to watch this video by Dr. Ken Berry discussing the ultimate beginner guide to start the carnivore diet. I’ll see you guys next week.

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