For most of my career, I believed what every heart surgeon is taught: heart disease is a cholesterol problem. Lower LDL, avoid saturated fat, prescribe the statin, and if all else fails, send them to the operating room.
Then I became the patient.
I was over 100 pounds overweight, metabolically unhealthy, and on the same path as many of the people whose chests I was opening every week. Losing the weight forced me to ask a question that changed my life: What if we’ve been treating the wrong disease all along?
I sat down with Mike Rowe to talk about why I no longer believe heart disease is simply a cholesterol problem, what actually changed my health, and why our healthcare system spends far more time treating heart disease than preventing it.
What we get into
- Why I believe metabolic health matters more than cholesterol alone.
- How becoming the patient changed the way I practice medicine.
- The biggest myth about saturated fat and red meat.
- Why bypass surgery treats heart disease, but doesn’t cure it.
- What people can do today to dramatically lower their risk of ever needing a heart surgeon.
Becoming the patient
Mike asked me what changed my mind.
The answer is simple. I finally looked in the mirror.
I was following the same advice I gave my patients. Eat less. Move more. Avoid fat. Count calories.
And it wasn’t working.
When I changed the way I ate, focused on improving my metabolic health, and stopped fearing natural fats, I lost over 100 pounds. More importantly, I realized much of what I had been taught about nutrition simply didn’t match what I was seeing in my patients or in myself.
We’ve spent decades fighting the wrong battle
We’ve convinced millions of people that cholesterol is the disease.
It isn’t.
Cholesterol may be involved in heart disease, but it doesn’t explain why so many people with “normal” cholesterol still have heart attacks. It doesn’t explain why rates of obesity, diabetes, and metabolic disease continue to climb despite decades of low-fat dietary advice.
If we only chase cholesterol numbers, we miss the bigger problem.
Surgery isn’t the finish line
People often think heart surgery fixes heart disease.
I wish it did.
A bypass can restore blood flow. A valve replacement can save your life. But neither one addresses the metabolic dysfunction that caused the disease in the first place.
That’s why prevention has become such a big part of my mission. I’d rather help someone avoid surgery than perform the best operation of my career.
Real food beats food marketing
One part of the conversation that always gets people’s attention is nutrition.
We’ve made eating far more complicated than it needs to be.
Forget the labels on the front of the package. Forget the latest health claims.
Ask a simpler question. Did this food come from nature, or did it come from a factory?
The closer your food is to its natural form, the better chance it has of supporting your metabolic health.
The future of heart care isn’t another medication
Modern medicine is incredible when you’re having a heart attack.
It is far less impressive at preventing the first one.
If we want to reverse the epidemic of cardiovascular disease, we have to stop waiting until people become patients. That means focusing on nutrition, metabolic health, movement, sleep, stress, and the habits that determine our health decades before symptoms appear.
That’s a much harder conversation than writing another prescription.
It’s also the one that has the greatest chance of changing lives.
If you’ve ever wondered whether we’ve been asking the wrong questions about heart disease, I think you’ll enjoy this conversation with Mike Rowe.
And if you want to dive deeper into the science behind metabolic health and preventing heart disease, my new book, Stay Off My Kitchen Table, is the next step.
Your heart disease didn’t begin the day you had a heart attack.
And preventing it doesn’t start in the operating room.