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Underground Wellness Radio

#337: Hacking Your Heart Health with Dr. Joel Kahn

Sean: Its episode 337 of Underground Wellness Radio. Heres whats coming up.
Dr. Kahn: Its not a $5,000 procedure. Hospitals arent getting rich on it. Physicians arent
getting rich on it. Sadly, sometimes things that are not big profit centers are not the things
that end up on the billboards and hospital radio ads. If you were to actually follow and eat in
the hospital cafeteria or room, your heart disease would get worse day by day. If youre
looking to reverse a potentially life-threatening problem with nutrition its not going to be
playing around with it. Youre not going to be sticking your toe in the water. I always tell
people if you dont like broccoli, it tastes better than chemotherapy.
Sean: Yo! Whats up yall. Welcome back to another episode of Underground Wellness Radio
brought to you by We are saving lives today. One topic I havent
covered in a really long time, I think its been years, is heart disease. There are so many
people right now with heart disease who dont eve know it because its silent for so many
people. Dr. Joel Kahn and I talk today about tests that you can get that are far more accurate
than the common standard tests that medical professionals are giving you these days.
The ECG, EKG, the exercise stress test, those tests while good, also have a lot of fans
positives, theyre not as accurate as we would like them to be. A lot of people are walking out
of the doctors office with a pat on the back from their doctor saying, Everything is fine. Your
heart is good, but really not. We talk about two tests that everyone needs to get a clear idea
of whats going on in your heart. We also talk about some lifestyle strategies as well as some
other stuff. Check it out. Heres Dr. Joel Kahn. Dr. Joel Kahn, welcome to the show, man.
Dr. Kahn: Hi. I am excited in the Motor City. The energy is high here. Thank you.
Sean: Thank you. I really appreciate you being here. I read your book the other day, Dead
Execs Dont Get Bonuses. Im really excited about this show because this show were about to
do is literally going to save peoples lives out there. Were going to talk about testing and
some of the testing people have never heard of before for heart disease. Heres the thing. You
talked about this in your book. When I go to a sporting event, usually its a San Diego State
basketball game. Im sitting there and theyll announce the attendance.
Every time they announce the attendance I look around and it will be like 20,000 people or
so. Theres 210,000 people on the Underground Wellness email list right now. I always go,
Wow. Every time I send an email I send it to ten times more people than are in this place
right now. Its crazy to me. Sometimes I dont even like to think about it because its kind of

intimidating to think about writing emails to that many people. You have a similar experience.
You went to the University of Michigan at Ann Arbor and youve been to the football games at
The Big House which holds
Dr. Kahn: The Big House and we watched the fab five when they were coming together. Jalen
Rose, Chris Webber.
Sean: Fab five was my favorite team ever. I had the black socks and everything. The thing
about The Big House is that is holds over 100,000 people. You wrote about this in your book.
When they announce the attendance what do you think when it comes to heart disease?
Dr. Kahn: Im thinking about every 25 seconds there is a heart attack in the United States.
Every 45 seconds somebody is dying. At least half the people in that stadium have
undiagnosed silent heart disease that I know how to find. I want to teach people how to find
it. I want to teach people how to stop it and reverse it. I have the same goal you have in
sprouting nutrition and fitness information all the time. I have a few more details with that
M.D. after my name.
Sean: Gotcha. Is it 700,000 people a year or something like that? Thats seven times more
people than are sitting in that stadium. Thats crazy.
Dr. Kahn: 700,000 people die of potentially preventable and reversible heart disease every
year. Thats seven stadiums packed to the roof, the Big House in Ann Arbor. It just blows your
mind when you think about what that means to a father, a son, a wife, a husband, children,
grandchildren, what weddings were missed, the whole cycle of life. Were going to do it.
Were going to educate people. Well talk about some of that today. Its like a big secret that
this silent killer has no way to jump in and prevent it. Were going to talk about it and show
people today that its done.
Sean: Like you said, its a silent killer. I feel like a lot of people dont understand exactly what it
is. I remember before I went to college where I studied nutrition and physiology and all of
that stuff, when I heard the term coronary heart disease I didnt really understand what that
meant. Lets give our audience some foundation as to what coronary heart disease is.
Dr. Kahn: Sure. The heart is amazing. I knew I wanted to be a heart doctor in middle school.
Im not sure why. Im not from a physician family. Ive never looked back. You have this
gorgeous pump that 100,000 times a day Were filling a swimming pool every day with all
of the blood our heart has to pump to keep ourselves going. We dont even have to think
about it. We have to think a little about moving our legs, certainly when we work out. The
heart is just there doing its job for hopefully 90 years.

Its all based on three very small arteries about the size of a BIC pen or number 2 pencil.
Thats about as big as the heart arteries get. They bend and they turn and carry that oxygen
rich blood down to this miraculous heart muscle. We have to keep the arteries clean. We have
to keep the muscles functioning with good nutrition and mitochondrial support, which I know
you know a lot about.
Coronary artery disease is the process of those beautiful arteries getting progressively
damaged, hardened, calcified and ultimately narrowed by plaque, which is a fancy word for
junk, and blood clots, a fancy word for pieces of jello, that define the years it takes to really
clog up an artery.
Sean: If I understand this correctly, what youre saying is the heart needs its own blood
supply to do what its supposed to do, correct?
Dr. Kahn: Its a miraculous and its a great lesson in life. The heart takes care of itself first. The
very first drop of blood full of oxygen and full of nutrients that the heart is going to pump out
goes right back into its own arteries. It has to pay itself first before it can pay others. Its a
wonderful system. Youre right. The take-off of the hard arteries is in the first pipe that gets
filled every day and every hour for years and years. Great system.
Sean: So if the arteries arent supplying the heart with the right amount of blood because
theyre clogged up, theyre obstructed, theyre blocked, its like unplugging the heart because
its not getting the energy it needs.
Dr. Kahn: Absolutely. You wont notice it at much at rest because you dont need as much, just
like your car going slow is not going to need as much gas as your car going fast. Youll notice
it in the gym. Youll notice it climbing stairs. Youll be winded. Youll be tired and you might
get that squeezing tightness. The message for the listeners is if youre over ten years old in
America, you have a little bit of it.
You have microscopic deposits already from the way we live our life in this wonderful country.
Nutrition and fitness has gone so off key. By the time youre in your twenties you have more.
Thirties, you might have a lot. Forties and fifties, were worried about your risk. In March of this
year three former NBA players died within three weeks of heart attacks, age 48-51.
Sean: Anthony Mason, Jerome Kersey, and who was the third one?
Dr. Kahn: I wrote a blog about it. If youre 48 years old and you die of a heart attack, that
means in your thirties and forties and probably even your twenties youre starting to lay down
some damage to your arteries. It doesnt need to be. Im always hopeful. I say those things not
to drag people down, but to say lets never let that happen again.

Sean: Yeah, lets figure this thing out. These arteries are progressively becoming more and
more obstructed over time for a lot of people and they dont feel the effects. Theyre not very
overt. It says in your book for 50% of the people the first sign of vascular disease is sudden
death. Your book is full of heartbreaking stories of CEOs who died all of a sudden. There is
one that really stands out. Its Imre Molner.
Dr. Kahn: Imre Molnar was a Hungarian immigrant that moved to the United States. He did
very well in the auto design area. He became the head of a college of car design in Detroit.
Fit guy, did yoga, ate healthy, big smile. He took a vacation with his wife and two young kids
two and a half years ago. He went out for a nice bike ride in the LA area and never came back.
He did not make it.
An autopsy proved a 90% blockage. He had been to his doctor two weeks before. This story
happens over and over whether youre seeing a doctor or not. If you dont know how to get
checked out and dont know the right questions to ask, the routine medical system is not
focused on this super aggressive, super early detection and lifestyle intervention. That is a
tragic story. It will put tears in your eyes when you see his kids.
Sean: Thats a story that Im never going to forget in my life. He left and kissed his wife
goodbye, just went on a bike ride. At some point the friend he was riding bikes with called
the wife and said, Youve got to come out here. Something is wrong. She goes out there and
hes having a heart attack. The ambulance comes and he dies. What really got me about the
story was the fact she said she just laid there on the ground with him for a while. I just kind of
put myself in her position.
Thats something I never want to have happen to me and I never want to have happen to
anyone in my family, to see me walk out of the door and never come back. It happens to way
too many people. In her story she mentioned that in hindsight there were things going on
with him she didnt think were a really big deal. There were signs and symptoms he was
having that she didnt and he didnt associate with heart disease. I want to go through a few
of those with you that a lot of people are dealing with right now that they might not associate
with heart disease. Number one, erectile dysfunction. Talk about that.
Dr. Kahn: Really important for your listeners. Its a growing problem that men are having
problems in the bedroom and sexual difficulties. Its an artery that fills up with blood and
blood rushes to create an erection. Its the same reaction in an artery in the heart that can
occur in the pelvis. Its a smaller artery so it actually may get damaged and clogged quicker
than a heart artery because of its size. A little bit of plaque can cause a problem. The number
one cause of erectile dysfunction is vascular, blood vessel problems.
Depression is a factor. Thyroid is a factor. Its blood vessel problems. Three to four years
before heart disease shows up bedroom problems may show up. Its a great clue to go to

your doctor and say Ive heard this might be an early sign of my arteries being damaged.
Whats my cholesterol? Whats my blood pressure? Whats my weight? What does my heart
scan show? Go for it. Find out. Dont wait.
Sean: A lot of guys think its psychological, or there is something going on in their
relationship when it could be something going on with the heart. Another one is cramping in
the thighs or calves called
Dr. Kahn: Thats a pretty far advanced sign. If anyone listening is a smoker they are particularly
at risk. That is leg arteries getting clogged up. When youre walking up a hill or youre on a
treadmill with a level incline you get this really uncomfortable cramping in your calves. We
joke that the reason the Marlboro man had to ride a horse was because his legs were so
clogged up and he couldnt walk. Its more than a joke because it really does affect smokers.
But they wont usually die of the leg problem. If the legs are clogged they have to go up
about three feet to the heart and make sure that its healthy and good.
Sean: You also mention a couple more. Excessive snoring and sleep apnea, baldness on top
of the head. The one I want to talk about with you is the diagonal deep crease in the earlobe.
That was kind of surprising to me.
Dr. Kahn: Were going to drive everybody crazy with this. If they look in my book or go on the
web you can look under earlobe crease heart disease to see pictures. Normally there is no
deep crease in the fleshy part of your lower ear lobe. This was described forty years ago that
this was a crazy sign of potential heart disease. Its by no means 100% perfect but it was
described and fell out of favor. I heard it about 30 years ago in medical school.
In the last couple years with new technology its been shown to be pretty accurate. Im an
earlobe evaluator. Ive had a bunch of people come into my office, Why are you here to see a
cardiologist? My earlobe has a crease. Its worth going through some basic questions and
testing. Everybody hit pause and go look in the mirror. If you have a deep crevice in your
earlobe you might want to get checked.
Sean: Lets say people go get checked. If those tests they do with their doctor come up fine
or positive it doesnt always mean everything is OK. There could still be stuff going on that
they didnt get tested for, correct?
Dr. Kahn: Absolutely. Im a big proponent of common sense. But common sense isnt being
used. If you want to know if there is a problem with the heart arteries, look at the heart
arteries. Just like if you want to know there is a polyp in the colon, youre going to need a
colonoscopy and look at the colon. If you want to know if your engine has a problem you
have to flip the hood and get under there. We do have that test. Its a CAT scan.

Its a simple 30 second imaging study where you lie on the table. Youre rolled in the scanner,
youre rolled out. No iodine, no IV, no risk of an allergic reaction. In about 30 seconds you
have truth serum. You know if your arteries are on the right side of the equation or theyre
getting degraded.
Sean: I want to get deeper with that in just a minute. Before we get to that I want to talk about
some of the problems with the current tests that people are getting. The ECG
electrocardiogram can measure peoples risk for heart disease. You say its only done in less
than 10% of medical exams. Whats the problem with the ECG? Whats the problem with the
exercise stress test?
Dr. Kahn: An ECG is a piece of paper with the wires. It represents the electrical activity of the
heart. If you have really bad blocked arteries or if youve had a heart attack 25% of the
people who have had a heart attack were not aware of it. It was a bad night of gas. It was
something they thought was the flu and they had a heart attack.
Those kinds of very advanced problems, unsuspected, can show up in an ECG. Lets turn the
equation a decade earlier and its of no value in picking up those earliest phases when the
arteries are getting worse and worse. Its worth doing, but you never want to stop with just a
normal EKG. Its not enough.
Sean: Exercise stress tests, I know a lot of people get. A stat from your book is if the heart
disease lesion is 40-60% narrowed, which is quite narrowed, its going to be missed.
Dr. Kahn: Its a shocking statistic for people to hear. I had a stress test, they told me it was
good. You just said you can still have arteries 40-60% blocked. You can even have a couple of
them in that range. The stress test is quite good at picking up the worst of the worst. There are
people walking around and playing handball and riding bikes that are all of the way to that
range without a clear cut warning.
But wouldnt you want to know if youre at a 40 or 60% blocked artery to clean up your
lifestyle and get proper therapy? Stress test will never show that. Its disappointing. Its an
indirect test. You never see the heart arteries on a stress test. If you want to know if the heart
arteries are blocked, get yourself a test that shows heart arteries.
Sean: Cardiolite. Is that the same as an exercise stress test?
Dr. Kahn: Thats where theres now nuclear medicine injected. It bumps the accuracy up. Youll
still regularly miss the 40-60% block. Plus youre getting a boatload of radiation. Ive become
less and less a fan of the stress test where they inject you with medication.

Sean: Lets do a review. ECG or EKG, that is going to find advanced heart disease. It may not
find it if its in early progressions. Exercise stress test, the same thing. Cardiolite, the nuclear
stress tests have radiation, and also as you say in the book, have great inaccuracies. You say
the nuclear test has 85% accuracy but still misses 15% of people.
You also get a lot of false positives that can cause undue stress and anxiety to people who
think theyre walking around with heart disease. I do want to get into some of the better
options for people. We want people to get these couple test were going to talk about. We
hear a lot about cholesterol but no one ever talks about the calcium and what that has to do
with anything. Tell us more about the calcium.
Dr. Kahn: If you talk to pathologists We can go back 80 or 90 years, youre a diabetic
patient and youve bumped your leg. They take you to a suite and they do an x-ray of your
leg, 60 years ago, 50 years ago. The radiologist would comment, The arteries in the legs look
calcified. Also, of course they would comment if there is a broken bone. Calcification or bone
like material in arteries should never be present.
It shows up extremely easy on x-rays, fortunately. It turns out almost all, I cant say 100%, but
99% or more of damaged arteries, plaque filled arteries will show. Its like concrete. Its a
mixture of stuff. Calcium is about 20% of that concrete like material. When you do some kind
of x-ray you may not see the cholesterol because that doesnt show up on x-ray, but youll see
that calcium mixed in it. Its kind of a blessing. Its so simple to image plaque in the arteries
because of this 20% calcification ingredient.
Sean: Youre saying we can use calcium as a marker of how much plaque is going on in there.
Is that the ECBT test scan?
Dr. Kahn: The original one was EBCT. The first machine that came out about 20 years ago
when CAT scanners were quite slow and crude. This was a breakthrough. Dr. Arthur Agatston
in Miami was one of the pioneers. Now, pretty much any hospital has third, fourth, fifth
generation CAT scanners that do this in a fraction of the time and radiation. EBCT is no longer
technology that is used.
Sean: We want the score to be what for these?
Dr. Kahn: Zero. The way you get a score is you lie down, get pushed in the CAT-scanner, hold
your breath and youre done. You go home. It took a minute. Nothing is injected in your body
and the arteries show up crystal clear on the scanner. Is there any calcium and if so, how
much? There is an algorithm. There is a formula. You want a zero. Maybe youll come back two
or six or ten. It can come back 300, 1200, 1800. The highest Ive ever seen is 6,000.
This was an asymptomatic man about two months ago. That means he had no chest pain, no
shortness of breath. His arteries were lead pipes full of garbage. I ended up having to do a

catheterization on him. Miraculously he was unclogged with medical therapy. You want to
know that number. It should be zero. I have 75 year old patients and 68 year old patients that
are zeros. God knows at your age, Sean, and Im in my mid-fifties, if we take wonderful care of
our bodies we should be running that zero score. Its a test you might only do once or once
every decade.
Sean: A quote from your book, Even patients with low calcium scores from 1-99 were 50%
more likely to die than patients with a calcium score of zero. That zero is incredibly important
for people. I need to get that done myself. You mentioned the radiation. Just to give our
audience some idea of a comparison between EBCT and something like Cardiolite, EBCT is 1
mSv which is fairly low, correct? The Cardiolite is 12 to 15. At the same time though, you dont
want people going out and getting these done quite frequently do you?
Dr. Kahn: No. We dont have a clear science how often it should be repeated. Im very
conservative on it. If youre a zero youre good for at least a decade for me. If youre abnormal
I dont even need to ever repeat it. I know I need to wrap you around an amazing prevention
lifestyle stress nutrition program, some nutraceuticals and aspirin. Thats going to do it for me.
You said the right thing. For years a person would go see their doctor who would order a
stress thallium or stress Cardiolite. Thats 15 times more radiation than this quick CAT scan
were talking about. Youd sure rather reduce your radiation. Its more accurate. Its 1/15th the
radiation and its available in every town in America.
Sean: Does it matter where the calcium is located on these tests?
Dr. Kahn: It probably does but its almost a predictable pattern. Some of you may have heard
the term the widow maker. Of those three heart arteries one of the three is the biggest,
baddest actor in town. If there is calcification and plaque, its beginning in one of the three
arteries. It takes the most beating. It takes the highest blood pressure hit and it reacts by
developing plaque.
As long as Ive mentioned that, if anyone wants to watch an unbelievably interesting
documentary about three months ago some docs in Ireland made a movie called The Widow
Maker. You can get it on the web. Its a fascinating story of this test, how its been resisted by
the medical community, and how in the state of Texas a couple of legislators got it through.
Its paid for in Texas but almost nowhere else in America. Fortunately, its become a very
inexpensive test.
Sean: Why is that? I mean, this test, the EBCT test, and the next test were going to talk about,
the CMIT test, sound like really good accurate tests. Why are they not covered by insurance?

Dr. Kahn: To be fair and scientifically sound, weve got hundreds and hundreds of scientific
studies. Nothing Im saying today is radical, outside the norm. The American College of
Cardiology, a conservative group of heart doctors, says these are good tests. What were
lacking is For example, lets take 1,000 fifty year old men. Lets find 1,000 of them that have
an abnormal calcium score. For 500 of them, lets put that away and ignore it. For 500 of
them, lets really wrap them around a good heart disease prevention treatment program.
Lets see if five years later fewer of the treatment group have heart attacks, strokes, are alive,
are spending money on bypass. That study hasnt been done. If youre highly skeptical you'll
say, Prove it to me that we should scan 1,000 people and make this uniform. But the rates of
heart attacks are so phenomenal and serious and the number one killer in every sector of the
American community over age 30. Are we going to wait? Because the study is probably not
going to be done.
The cynic is going to say its money. This is a test thats down to about $100 for the CAT scan
and maybe $150 for the other one we can talk about. Its not a $5,000 procedure. Hospitals
arent getting rich on it. Physicians arent getting rich on it. Sadly, sometimes things that are
not bigger profit centers are not the things that end up on the billboard and the hospital
radio ad.
It distresses me because it is a public service announcement that needs to be made by every
hospital system. Plus it actually does draw in business because you find out there is a lot of
heart patients out there. My clinic is always overloaded because Ive been aggressively
lecturing about this for years in Detroit. People come and if theyre abnormal I see them once
a year. If nothing else, well review their diet and their exercise and all the rest.
Sean: Right. Its definitely money well spent, $100. Get this done. Go for it. For the audience,
EBCT, get that done. Your result should be zero. Next one were going to talk about, carotid
intima-media thickness. Tell us what that one is about.
Dr. Kahn: Thats cool too because the problem with the heart arteries is theyre internal.
Theyre deep. Theyre small. Thats why we have to resort to the CAT scan. You have two big
arteries right in your neck. For guys, every time you shave you're rubbing on them. The
carotid arteries are bringing blood up to the brain. Women have them, too, of course. Theyre
right under the skin so all you have to do is put a little ultrasound microphone type device
and you see the arteries crystal clear.
You put a little gel, no radiation, its inexpensive. These machines are in every clinic in
America. If they have a special software you can look at the artery. You can measure how thick
the wall of the artery is. You have a normal chart. Youre 42 years old, your artery thickness is
.5 millimeters. Thats normal for a 42 year old. Or its too thick for a 42 year old. The thicker it
is the more plaque is developing. This is one of the earliest ways to know.

What age does your drivers license say, but what age are your arteries? Your arteries may be
younger than your drivers license. That would be a good thing. Im 54 years old. My arteries
are looking 35. You could be 40 years old and your arteries look 55 because of smoking and
lifestyle and all the rest.
The beauty of the ultrasound is you can start a program or a medicine or a lifestyle and you
can repeat it in six or twelve months, which I wouldnt do with a CAT scan. You can actually see
the number stabilize and even in some cases the number improves back toward the proper
artery age. Its a very aggressive approach. Its a very quantitative approach but again were
dealing with the number one killer in America. Lets not be passive about it.
Sean: Yeah. It says for the results here less than 25% percentile is low risk, 50-75 is average
thickness and if youre over the 75th percentile those are the thickest arteries and youre at
the highest risk. A middle aged person is .6-.7 micrometers, correct?
Dr. Kahn: You got it. Exactly.
Sean: Cool. For every .1 micrometer increase on your CIMT test the risk of heart disease
increases by 10-15% and the risk of stroke increases by 13-18%. There are lots of good stats
in your book. This one is also not covered by insurance but its like $200-250 bucks?
Dr. Kahn: In a few states its covered, a majority of the states its not. $150-250, it depends on
the clinic. Its not as widely available, sadly, as the calcium CAT scan. You have to find a clinic
that offers it.
Sean: If somebody were to ask you, Hey doc, which one is best if I can only get one?
Dr. Kahn: For the first time I see a patient I usually recommend the heart calcium CAT scan. As
you just said, Im looking at a neck artery and Im predicting whats going on in the heart. I still
want to know whats going on in the heart. Once Ive done that first scan then I can use the
carotid to follow them over time.
Sean: People go to the doctor. They get their lab tests done. You say here using standard risk
factors like cholesterol and blood pressure, at least 25% of people with heart artery disease
are completely missed. You also talk about the C-Suite lab test that people should get. I dont
want to cover all of them. They include MTHFR, LDL particle size and number, oxidized LDL,
CRP blood sugar, genetics, telomeres, stuff like that. What are the two most important ones
you want to tell our audience about today?
Dr. Kahn: Probably the most practical is to get an advances cholesterol test, not just the finger
poke you might get at a church screening or even in your doctors office. Theres value in that .
If that comes back 450 you dont need too much. You know youre in big trouble. Your

cholesterol is insane. There are people walking the streets with cholesterols of 450. They
need to be identified. We get better and better treatment all the time. Even just in the last
couple weeks there are new drugs out. For most of us cholesterol is 180, 220, 230. You frankly
have no idea what to do with it until you get an advanced cholesterol test that tells you the
number of cholesterol particles and the size of your cholesterol particles.
I like to test inflammation. The usual one you hear about that I order first line is high sensitivity
C-reactive protein. If youre not eating right, if youre overweight, if youre not sleeping well, if
youve got stress that youre not managing through meditation, yoga and other measures,
your body reacts. It gets inflamed. It gets fired up. Thats bad for arteries and it can be
measured in blood tests.
Sean: The c-reactive protein you talked about, you want that to be below 1, correct?
Dr. Kahn: Yes, that would be the normal range. With the obesity crisis in America, just that fat
around the belly creates inflammation. Under 1 is ideal. It does happen but we have a mass of
people walking around inflamed everyday. That is doing damage to their arteries while they
sleep and while they work and while they walk. It can be corrected. These are all reversible
Sean: Yeah. I want to talk about how to reverse them. We have all of these tests weve just
given to our audience. Im sure theyre thinking, What if my numbers dont come out right?
What am I supposed to do? You talk about lifestyle medicine in your book. Stop smoking.
Move your body 30 minutes a day. Each more vegetables and fruit. You also say grains as
well. Meditate, reduce stress, do yoga, 4-7-9 breathing, heart math. You mention all that stuff. I
want to cover a little bit of each of them. Lets start with nutrition. Youre a vegan. Are you
vegan because its going to protect you from heart disease or for other reasons?
Dr. Kahn: I am a vegan for about 30 years because of health issues, animal rights and the
environment. I care about all those. I am not a pushy in your face one. There is one group of
patients that I teach vegan medicine from the science, who are really advanced heart patients.
They need to know the publications and the work of Dr. Dean Ornish in San Fransisco and of
Dr. Caldwell Esselstyn at the Cleveland Clinic.
These doctors have taken some of the sickest heart patients in America and seen dramatic
improvements by eliminating all animal products and added oil from the diet. I lead a large
group of patients like that in Detroit with a website that connects people to allow us to
support others around the country. Im pretty darn adamant that they know the data. For the
rest of the world, the message is be a vegetable-arian.
Eat breakfast, lunch and dinner, fruits and vegetables, fresh as you can, cooked and raw. Every
health parameter says its got to be the core. After that I dont care. I dont like the words. Just

be a vegetable-arian and then add on whatever you need to make yourself happy the rest of
the day but you cant shortcut it.
Sean: Eat more vegetables. I think we can all use that advice. I want to get back to the Ornish
thing because Im curious. Im sure youre very well-versed in this. Ornish doesnt just change
the diet. They do meditation. They stop smoking. They do more walking. They do stress
reduction programs. It seems like when Ornish is spoken of its always about removing the
animal fats and animal meats.
Ill give you some statistics I found. For instance, he has his patients do meditation. A quote
from your book is, People who practice transcendental meditation regularly are 48% less
likely to suffer a heart attack, stroke or die than men and women with similar physical
conditions. You talk about sleep. Im sure he advises his patients to sleep more.
If you get seven or more hours of sleep at night you have an 85% reduction in heart disease.
He has them do all these different lifestyle modifications including the food part, eating more
vegetables and dropping the meat. Why do we just focus on the meats? Because there are
other things theyre doing, right?
Dr. Kahn: Right. If you were able to spend time with Dr. Ornish, and just recently Ive had the
chance to get to know him personally after 20 plus years of admiring his work on heart
disease, now prostate cancer, now anti-aging, hell tell you he believes the food is crucial, but
the love, the support, the emotional growth that his program recommends through
meditation and friendship is probably the strongest component. Youll hear him speak and
almost downplay the diet.
I think hes so passe with it because its been a part of the program since the early 1980s. He
hasnt really changed that. Theres no reason to. Every disease entity that he studies with his
original program seems to respond. Prostate cancer is probably the biggest victory in the last
ten years. His is a multifaceted program, as we should emphasize. A doctor a bit less well
known, but very well known to me at the Cleveland Clinic is a surgeon in his 80s, Dr. Caldwell
Esselstyn. He did essentially exactly the Ornish diet on heart patients starting in the 1980s.
He never applied the rest of the lifestyle and he got the same results. He had catheritization
proven reversal of serious heart blockage. People who are running to the emergency room
stop going for years and years at a time. People who are taking heart medicines and nitro pills
stop taking them. It was a 100% nutrition based program. Im sure he said, Do whatever
exercise youre capable of doing.
It was not a compound program like Ornish but he got the same results. I dont think anybody
really questions that. The diet is extremely important in the Ornish program and is the only
component of the Esselstyn program, or Dr. Bernard who had reversed diabetes. Everyone is

going to emphasize regular fitness but none of them like the complete program that Ornish
has. They all work. The food has to be the majority of the common bond.
Sean: When I ask you this Im not trying to debate you by any means. Im curious about
Ornish and Esselstyn. Are they researched studies that theyre doing or is it just a program
that they put people through?
Dr. Kahn: Ornish has some of the highest quality peer-reviewed research publications that
any cardiologist could ever hope to get. Some of his co-authors have won nobel prizes in
aging medicine, telomere research and such. Dr. Esselstyn has made many publications. He
never had quite the degree of funding that Dr. Ornish had and the collaboration with some
other large names. His work is in the medical literature which means it had to be subjected to
quality control. He just published a pretty big paper in 2014 updating his patient set from the
1980s. It was very favorable.
Sean: You know the research a lot better than I do. Ive heard there is no control group with
Esselstyn or Ornish. Is that true?
Dr. Kahn: Ornish had. His original study, called The Lifestyle Heart Trial first published in 1990
then updated in 1998, had a control group. It was such a dramatic difference that he just
ended up following those around his program. The control group was essentially the
American Heart Association diet. When a cardiologist gives a brochure to a patient and says,
I want you to follow this diet recommended by the American Heart Association, it will cause
your arteries to get worse year after year.
Thats the control group of the Ornish study. That alone should shock your boots but its never
said. If you were to actually follow the eating in the hospital cafeteria or room, your heart
disease would get worse day by day because that is some of the most awful food given to
humans anywhere. Thats my own little soap box. Esselstyn used those that didnt comply as
the control, those that fell out versus those that complied. He wasnt necessarily as strong in
study design.
As somebody said to me when the treatment for diphtheria came out, it took one patient who
got the treatment and survived a disease they never should have survived. Not every illness
requires a 5,000 patient study. When people were showing up over and over in emergency
rooms with sick heart events and within three months it stops, sometimes you have to use
experience based science.
Sean: In your experience, do you think Ornishs first study deserves repeating?
Dr. Kahn: We have technology now that wasnt available then. Weve been talking about CAT
scans for calcium scoring. Now we also have CAT scans where you get injected with die called

CAT scan angiograms. It would be absolutely fascinating to repeat his study or alter it in some
way using this new technology as the gold standard. But its a matter of funding. A
pharmaceutical company has no interest in doing that. A hospital has no interest in doing it
because its only going to lower their business by showing that diet reverses heart disease. Its
not good for hospital business to promote these programs. Its good for people. Its simply
unlikely to happen unless the American College of Cardiology gets behind it and they really
dont control the bucks.
Sean: Im sure people who are not so aware of this health space, when they find out there is
something going on with their heart their first inclination is to go to the American Heart
Association website and start following their diet. You just said that diet could make their
hearts even worse. Im sure the American Heart Association knows this, or maybe Im just
guessing. Why dont they change it?
Dr. Kahn: In defense, Im variously at times involve with American Heart or not. Its still a far far
better diet than the one that wasnt studied by Ornish, being what real Americans eat on
average days and what happens to their arteries. Im quite confident that would have been a
profoundly worse outcome if it was controlled. To their credit, theyre talking about reducing
processed food, adding more fruits and vegetables. There is that statement of moderation in
everything or moderation in your diet.
For some serious medical conditions, heart disease for sure, probably cancer, diabetes and
blood pressure, moderate approaches to diet give moderate complications not moderate
reversals or victories. My watch words that I created are extreme in diet, moderate in exercise
and abundant in love. If youre looking to reverse a potentially life-threatening problem with
nutrition, its not going to be playing around with it. Youre not going to be sticking your toe in
the water to see if the water is warm or not.
You may start gently but youre going to need to go full blown out with some program.
Whether its a juicing program in Florida called The Hipocrates Health Institute, whether its a
super clean paleo diet for weight loss and diabetes reversal or whether its a plant-based
heart disease, prostate, cancer reversal diet like has been shown by Dr. Ornish and others.
Dont hold back. Do it right and dont compromise. I always tell people if you dont like
broccoli, eat the damn stuff. It tastes better than chemotherapy. That may be what youre
facing. Dont wait until you have no choice.
Sean: Lets move on to exercise. You dont want to have sedentary people. At the same time
you dont want people turning into endurance athletes, correct?
Dr. Kahn: Exactly. Thats why I just said moderate in exercise. Its kind of the synthesis of
science right now.

Sean: What does that mean? What does moderate mean to you?
Dr. Kahn: Its fascinating and maybe your listeners already know this. In the last 5-8 years a
number of studies around the world raised the question, Can exercise be a dose that you
can overdose on and can repeated ultra-events like marathons and triathlons, can they cause
enough inflammation over and over to actually cause harm? There is at least some evidence
that at the end of a marathon you have released a whole bunch of enzymes in your blood. If it
werent for the fact you just finished a marathon we would diagnose it as a heart attack.
Or if you do an ultrasound or imaging of the heart, your heart looks beat up for a couple days.
The miracle of life is it does recover. But if you do that over and over, were finding in small
numbers in 10 or 15% or athletes to that degree, scars in the heart, arrhythmia problems in
the heart, maybe even some calcification of the heart arteries. There are some experts in the
field. I work out every day but Ive never strived to be an ultra athlete. There are some ultra
athlete cardiologists.
My friend James OKeefe in Kansas city has backed off and publicly speaks about it and has a
very popular YouTube. He will run shorter distances at slower paces interspersed with walking
and stretching and mind body fitness. He believes there is a solid body of data from
Copenhagen, particularly Denmark, that suggests there is a U-shaped curve. If youre working
out for longevity, not for a champion triathlete competition, there is a U-shaped curve and
you grab the middle of it. Dont sit around, get out there and move but it doesnt have to take
two hours a day in the gym to get there.
Sean: For the audience, I talked to Dr. Chip Lavie about this towards the end of our podcast.
Are you familiar with him?
Dr. Kahn: Yeah, he is a great friend. He is James OKeefes writing partner. They are one in the
same in that opinion.
Sean: His book was so good. The Obesity Paradox. That was a fantastic book.
Dr. Kahn: Dr. OKeefe is a little upset with Dr. Lavie. Theyre very close friends. Chip keeps
running and James keeps telling him, Slow down. Stop. Take a break. If you love it and it
gives you great joy you make your own decision, as is with most things in life.
Sean: Youre good friends with Rich Roll, right? Do you ever give him a nudge like, Rich,
might want to slow down a bit.
Dr. Kahn: Weve talked about it but thats his life. Thats his passion, thats his unique skill right
now, along with educating people about lifestyle. Ive never had a heart to heart with him.
Weve done two podcasts together and weve talked about it.

Its still the minority of people being identified with a problem. The perception that if a little is
good then a lot must be the answer is medically reasonable to question.
Sean: Rich and I talked about that during our podcast as well. He loves running. Thats what
he loves to do. He doesnt want to give it up and thats what hes passionate about. I want to
do a couple more topics with you. Meditation. I was watching one of your YouTube
presentations. You talked about something called Kirtan Kriya.
Dr. Kahn: Fascinating stuff. I was not raised in a house where parents were meditating.
Meditating was something new in my life in the last decade. You mentioned alreadyTo your
credit youre a very good reader and student. In a person who has had a heart attack, a pretty
well done study says, Teach a group of heart attack survivors to meditate and theyll have half
the risk of another heart attack in the next five years, compared to the group that just gets a
standard program and doesn't learn to meditate.
That is profound. Think about a drug that routinely dropped heart attack recurrence. Wed be
cashing in the bank with a multi billion dollar drug. Mind-body does the same thing. The
Kirtan Kriya is another set of data from a neurologist out of Tucson who has an Alzheimers
research institute. Hes of the Kundalini yoga tradition if people are familiar with that. Im a
practitioner of Kundalini yoga. He has a 12 minute meditation called the Kirtan Kriya. Its a
little bit of a recitation of words and sanskrit and a little bit of movement of the hands called
The power of it and the reason I teach it is he has combined with the UCLA School of
Medicine. He took really stressed out adults who were caring for sick kids or dying parents.
Half of them were taught this meditation 12 minutes a day. The other half didnt. UCLA
documented better brain function, better brain flow, longer telomeres, less aging, less
inflammation, better artery function in small numbers. These studies had 30, 40, 50, 60
people but when you take the whole body of data and you ask what is the power of mind
body practices like meditation or yoga or tai chi, they are profoundly supported in the
literature. Great thing to do.
Sean: Whats it going tot make to get that more accepted? Whats it going to take to get me
to walk into my cardiologist and he says to me, Meditate!
Dr. Kahn: Its going to take what I call re-om-bursement.
Sean: Re-om-bursement. I just got that.
Dr. Kahn: Re-om-bursement. Thank you. I made that up. It is sadlyI just wrote a little piece
for the Huntington post about what happens to interesting medical data that isnt mainstream.
I included the meditation data as one example. When theres one or two blockbuster studies

but they dont fit our paradigm, if theres not money behind it We are creatures of habit.
Theres no sales rep for meditation software knocking on the cardiologists door to bring them
up to date on the latest literature, to give them the Headspace app or something that is going
to get them and their patients on to mediation easily. Its going to be self-study or listen to
podcast or read my book. There are many great people out there. Mimi Guarneri is in your
town. If you have never met an integrative cardiologist in San Diego in La Jolla, she is a really
great teacher that practices.
Sean: Ive heard that name before. One more topic for you and Ill let you go. You mentioned
something that I hadnt heard about when it comes to heart disease that is kind of outside the
box, chelation therapy. Tell us more about that.
Dr. Kahn: Thats kind of that dream that we can turn the clock back. When we talk about Dr.
Ornish and nutrition its not called chelation therapy, but we are reversing established plaque
and thats medically proven. Chelation therapy came out of a really cool observation right in
Detroit, Michigan. People in car factories were getting occupational exposures to heavy
metals. They were getting lead exposure, mercury exposure, cadmium exposure. In the 50s,
we had a drug in the pharmacy, plugged in an IV, gave them this drug and you can reverse
that illness.
In the course of those treatments, some of these people had heart disease but reported they
actually felt better. They didnt have chest pain, they were breathing better. A couple astute
docs in Detroit said, Maybe this was some kind of therapy for the heart. Some studies were
done. The idea is that we live in a world where were acquiring toxicities, specifically heavy
metal. Mercury, lead, factories are spewing dirty air that were all breathing, buses. Even
though lead paints have been banned there is still lots of it coming in through toys and other
things from China, in our lipstick. Weve all heard these things and theyre true.
If we measure almost anyone in this country with a urinary or blood test or hair for these
toxins, we all have some of it. There is no healthy level in the body, only toxicity. Chelation
therapy now says were not waiting for the factory worker to get sick. Were going to find the
heart patient with clogged arteries. Give them, usually intravenous but theres also oral,
chelating agents that will bind and take out some of these toxins in the body. Its very
controversial. Very voodoo-like.
About a year and a half ago, our good government coughed up $30 million dollars to do a
study of 1700 heart disease patients. They werent heart attack survivors. Lo and behold when
the study was announced it actually did some good. If you were a diabetic heart patient you
were much better doing chelation than doing standard therapy alone. It just got swept under
the carpet after it was presented and published in very prestigious journals because we dont
have a reimbursement system. We dont have an education system. Youre still going to have
to find an integrative doctor who practices chelation.

But you could make case that its part of the program to go along with nutrition and fitness
and better sleep and weight control and the whole thing.
Sean: Ive interviewed a few experts about this. At least Ive asked them the question. Do you
need to properly screen patients for that? Can it be a little bit too aggressive for some
Dr. Kahn: There are side effects. You can drop your calcium level and get into problems. In
the study that was done they proved the point that it seems to have real ability and potential.
They didnt actually screen people. If you had heart disease and you consented and had the
routine blood work you were in the study. Most practitioners of chelation therapy will select
people that are proven to have toxic levels of these metals.
Theyll put them through the hair analysis or what is called stimulated urine tests and really
pick out those who were most likely to benefit. We dont know for sure if its necessary
because in the study that put chelation on the map it wasnt done that way. I think thats a
better plan. Its not a treatment for everybody. When you sit in a sauna, when you eat leafy
greens, when you include cilantro and parsley in your diet, youre chelating yourself too.
Everybody stay hydrated, poop regularly, pee regularly, eat your leafy greens and youre
doing the same process without the fancy name.
Sean: I dig it. Very good. Your book is called Dead Execs Dont Get Bonuses: The Ultimate
Guide to Surviving Your Career With a Healthy Heart. I thoroughly enjoyed it and Im not an
exec or anything like that. Somebody doesnt have to be an exec to get something out of this
book, right?
Dr. Kahn: Whos the CEO of Underground Wellness, sir?
Sean: I am but Im not your typical executive, putting on a suit, working 80 hours a week.
Dr. Kahn: The title was not intended to exclusive or offensive. I gave a short talk to a group of
execs in Phoenix about a year and a half ago. They got so excited about the topic an potential
to help their health and others. They said just self publish or put it on YouTube. It was on them
that I got the title. Its absolutely for anybody who cares about the best care of their body, the
real answer to the toughest questions which is that day that you wake up and youre not there
the next morning because heart disease got you, knowing that it could have been stopped or
reversed is the message. Dont delay. Get out there now. Find out how to get this testing in
your community and the whole lifestyle that is associated with it. 80% of heart disease can be
stopped right now if we do simple lifestyle measures that arent expensive or exotic.

Sean: Yessir. We saved some lives today. You also have another book called The Whole Heart
Solution and you have a newsletter on holistic heart health that our subscribers and listeners
can sign up for. Tell them about that and how they can get subscribed.
Dr. Kahn: On my website I have a newsletter that you can opt in and opt out.
Nobody is chasing you. I love to put out high quality holistic information from a credible
source. I teach at a medical school and I write papers. Im sticking to stuff that has a little more
support than the newest of the new age. Anybody is welcome to go over there an pop in for
the newsletter. It will show up next week. I hope you enjoy it. A lot of effort goes into it.
Sean: Fantastic. Thats Dr. Kahn, thanks so much.
Dr. Kahn: I have thoroughly enjoyed it. I look forward to meeting you the next time Im in San
Sean: Yes sir. Thank you. Alright, friends. We will see you next week with a brand new episode
with Jim Rendon who is the author of Upside: The New science of Post Traumatic Growth. Its
going to be a good one I am loving his book right now. If you get a chance to read it before
the show do it because its really awesome. If you want the transcript to this episode you can
go to and join the Transcribe Tribe. We have transcripts for
maybe the last 40 episodes or so as well as show notes. We will see you next time. Peace.