Heart Surgeon: The Real Cause of Arterial Plaque — and How to Reverse It | Dr. Philip Ovadia

**Jesse Chappus** (0:00)
Coming up on today's show.

**Philip Ovadia** (0:02)
Early on in my career as a heart surgeon, I learned there was a link between oral health and heart health. People that have periodontal disease, those people are at higher risk of having heart disease. It turns out that insulin resistance is the primary driver of heart disease. Dr. Joseph Kraft, he looked at all the patients with heart disease. And what he found was 90 to 95 percent of them were insulin resistant. There's a couple of different pathways that connect the insulin resistance to the plaque and the damage in the blood vessels. The first one is the sugar problem. Insulin resistance lowers production of nitric oxide, a essential chemical that our body uses to help protect our blood vessels. I typically recommend starting with coronary artery calcium scan. All men by the time you're 40, women by the time you're 50, get your first scan. I have 30-year-olds ending up on my operating table. That means that that disease started in their 20s, and so screening earlier can be helpful in certain situations.

**Jesse Chappus** (1:08)
How often are you scanning somebody middle-aged and finding no plaque?

**Philip Ovadia** (1:12)
The statistics are...

**Jesse Chappus** (1:13)
When it comes to hard plaque, soft plaque, is there any chance there for a reversal?

**Philip Ovadia** (1:18)
I think for both, the answer is yes.

**Jesse Chappus** (1:20)
The million-dollar question, somebody that gets a reversal, what are you having them do? Dr. Ovadia, when somebody goes low-carb, keto, carnivore, somewhere on that continuum, and they don't get the health results they're expecting, what do you find is at the root of that?

**Philip Ovadia** (1:42)
Yeah, we need to understand that the human system is quite complex. And I never like to over-simplify things. Right, so when we say go keto, carnivore, low-carb, there's a lot of nuance that goes into that. And one of the things I think that has become most apparent to me now, doing this with patients in my practice for the past six years, is it's not just enough to focus on the food you put in your mouth. We have to really get into how your body reacts to that, how our body is processing that food. And this gets into issues like gut health and bioavailability and nutrient density of those foods, to help us understand why some people react in certain ways and others don't react in a different way.
And that's what I've really come to learn over this time is the approach, you know, we have sort of the general rules, eat real food, for instance, right? That can be applied to everyone, but there's nuance within, you know, how your body is going to react and maybe some other aspects that we need to look at so that we ultimately can get the results that we're trying to achieve with that patient.

**Jesse Chappus** (3:14)
Okay, so say a hypothetical patient comes to you. We know we've got the check on the proper quote unquote diet. And again, there's variability, there's different diets that can work for different people.
But say they're still not getting those results, you named a few different variables there. How do you begin to uncover for that person what's at the root of that?

**Philip Ovadia** (3:37)
More and more, like I said, one of our focuses becomes your gut health. And simple questions like, how do you feel after you eat? Do you feel bloated? Are you getting heartburn?
Do you feel energized? Or do you feel tired after you eat? These are some indicators that we can use to determine if they have a problem with their gut health broadly. And what I really mean by gut health is, you've put the food in your mouth, right? You got the input, the information that's in that food, the nutrients, right? That's what our bodies are looking for from food. And now we have to figure out, is your body able to properly utilize that? Is your digestive system working in a manner that we can extract those nutrients, and we can then use them for all the things that we need to use them for within our bodies? So starting with simple questions of, how do you feel after you eat?
Looking at the quality of your bowel movements is another good indicator of what's going on with your gut. There is some testing that we can get into, but honestly, when it comes to gut health, the clinical scenario, right? How the patient feels and the signs and symptoms that they're experiencing actually go a lot further in informing us what's going on there than the testing does.