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发现心脏病真正原因的外科医生Dwight Lundell，做客电台的对话
德怀特·伦德尔博士——心脏病的真正和令人惊讶的病因
Dr Dwight Lundell The Real and Surprising Cause of Heart Disease·
心脏病的治疗方法:真理将拯救一个国家
The Cure for Heart Disease: Truth Will Save a Nation
摘要
1. “心脏病”是指动脉粥样硬化或斑块积聚在心肌的动脉中，出现各种症状。当血管完全闭合并导致心肌死亡时，心脏病和死亡就会发生，这通常会导致致命的心律不齐。当我们谈论心脏病时，指向心肌供血的动脉被堵塞了，以及它们被堵塞的后果；
2. 血管是整个心血管系统的控制器。血管基本上是由血管的单层内皮层控制的，这被称为内皮。它确实是控制血液循环的关键层，最终控制了我们的大部分新陈代谢；
3. 动脉粥样硬化就是血管内皮损伤导致的动脉炎症性疾病；内皮细胞损伤导致炎症，炎症导致心脏病；
4. 超过半数的心脏病患者的胆固醇水平正常；
5. 如果没有炎症，胆固醇永远不会沉积在血管壁上；
6. 高血糖直接引起血管内皮细胞的氧化损伤；
7. 健康人的血液中大约只有5克的糖 （而一瓶超大杯可乐含有200克的糖）；
8. 过渡摄取含糖食物必然导致肥胖胰岛素抵抗和血管内皮损伤；
9. 预防和治疗心脏病，控制血糖非常重要；
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2013年10月6日/在播客/by Elance。
奖金:德怀特·伦德尔博士[45分钟，37秒]
本周我们有幸听到德怀特·伦德尔的报道。用他自己的话说:
The Cure for Heart Disease: Truth Will Save a Nation
工作经历
”Lundell博士在过去的25年在心血管和胸外科手术方面的经历包括美国外科委员会、美国胸科外科协会和胸外科医生协会的认证。伦德尔博士是“体外循环”心脏手术的先驱，减少手术并发症和恢复时间。他在《跳动的心脏名人堂》中被列入《凤凰杂志》的顶级医生10年。
他被同行公认为领袖，曾担任亚利桑那大学和耶鲁大学医院的首席住院医师，后来担任过参谋长和外科主任。
他是路德教会心脏医院的创始合伙人之一，该医院成为美国第二大心脏医院，现在由BANNER HEALTH公司拥有。
作为他领域内公认的领导者，Lundell博士已经咨询并建议了许多领先的医疗设备制造商，如Cardio胸科系统，Inc.之前和之后由贵公司收购。他建议圣·裘德医用组织瓣膜植入和市场营销。他咨询了A-Med公司，并发表了第一个心脏支持微型泵的临床研究。他与人合写了一项临床研究，验证了合并手术的关键技术，该技术后来被Medtronic公司收购。
出版物和报告
心脏病的治疗方法The Cure for Heart Disease: 2007年7月。
一种微型右心支持系统可改善心脏后/侧冠状动脉旁路移植术中心脏输出和脑卒中的体积，心脏外科论坛，2003;6(5):302-6。
临床和6个月的冠状动脉血管造影评价采用自闭夹子装置:多中心前瞻性临床试验，J. Thorac心血管疾病，2003年7月;126(1):168 - 77,177 - 8的讨论。
控制心脏输出的因素的相互关系，医学假说，1983年1月;10(1):77 - 95。
主动脉内气囊泵的临床应用，Ariz Med, 1981年1月;38(1):19-21。
随机对照改良的线导和标准内主动脉球囊导管，J. Thorac心血管系统，1981年2月;81(2):297-301。
联合主动脉瓣置换术和心肌血管重建，康涅狄格州医学，1980年6月;44(6):363-6。
联合主动脉瓣置换术和心肌血管重建的心肌保护的重要性。Thorac杂志,1979;12月28(6):501 - 8。
食道平滑肌瘤，康涅狄格州，1979年8月;43(8):483-5。
1979年5月，新英格兰外科学会的冷化学心脏麻痹。
1978年12月，在康涅狄格的外科医生协会，胸廓出口综合征的多普勒超声诊断。
10月27日(10):993-995。
肺癌的管理指南，Ariz Med, 1977年3月34(3):176-82。
教育经历
耶鲁大学医学院。
首席住院医师，心胸外科，1978-1979年。
耶鲁大学医学院。
心胸外科居民,1977 - 1978
亚利桑那大学，亚利桑那健康科学中心。
总住院医师，一般外科，1976-1977年。
亚利桑那大学，亚利桑那健康科学中心。
手术居民,1971 - 1973,1975 - 1977
亚利桑那大学，亚利桑那健康科学中心。
普通外科实习生,1971 - 1972
亚利桑那大学
1971年《医学博士，宪章》
乔纳森委托人
http://www.facebook.com/TheSmarterScienceOfSlim
http://twitter.com/ # ! / jonathanbailor
“瘦身”是“Simple.org”的非盈利营养教育项目。
完整的录音稿
乔纳森·贝洛:大家好，乔纳森·贝洛(Jonathan Bailor)带着另一份更聪明的《超能科学》播客回来。今天的节目让我很兴奋。我想给大家一个快速的免责声明，因为我们将在今天的播客上稍微深入一点，但是我们会故意这样做。今天的嘉宾很能深入了解当我们患心脏病的时候会发生什么。到底发生了什么事? 我们有一位外科医生，他做过大约5000次冠状动脉搭桥手术，大约2500个心脏手术，1000个肺癌手术和普通外科手术，还有5000个普通的血管外科手术。一个和患病的心脏和病变的动脉有成千上万个小时的经验的医生。有谁能比这位出色的外科医生、神奇的人以及《治愈心脏病的医生》的作者德怀特·伦戴尔博士更能说明这一问题在生物学层面的真正意义。Lundell 博士，欢迎您参加我们的节目。
Dwight Lundell:谢谢你，乔纳森，能和你在一起真是太好了。
Jonathan Bailor:伦戴尔医生，非常感谢你加入我们。很高兴能在低碳水化合物饮食巡回推广中见到你。有一件事引起了我的共鸣关于你关于低糖水化合物饮食的演讲。感觉就像回到了大学，这很好，因为它很学术。你做得很好，没有太多的评论，过于个人化，或者利用你的个人喜好，在什么味道好，什么是什么，什么是什么，并不是道德的，你说的很简单，“这里是生物学，从血管和心血管的角度，描述当你的身体崩溃的时候会发生什么。”我希望我们能坚持事实。让我们把注意力集中在生物学上的事实，谈谈什么会真正导致心脏病。
德怀特·伦德尔:那太好了。这是我30年来的激情。
Jonathan Bailor:从最上面，我们通常听到的，Lundell医生，当然最近我们的共同朋友Jimmy Moore参与了一场关于什么导致心脏病的精彩讨论，它看起来并不是很像你的个人经历或者大部分的科学文献。我们从第一个开始。当我们“得了”心脏病时，会发生什么呢?
德怀特·伦德尔: 让我们来定义一下心脏疾病，为听众澄清一下。当我们说“心脏病”时，我们说的是动脉粥样硬化或斑块积聚在心脏肌肉的动脉中。出现各种症状。当血管完全闭合并导致心肌死亡时，心脏病和死亡就会发生，这通常会导致致命的心律不齐。当我们谈论心脏病时，我们谈论的是给心脏肌肉供血的动脉被堵塞了，以及它们被堵塞的后果。
乔纳森·贝洛:很好，这很有意义。让我们继续。
Dwight Lundell: 血管真的是整个心血管系统的控制器。我们把许多东西跟心连在一起。情感，勇敢，等等。“他的心”。心显然是一件美妙的事。它每小时泵出数百上千加仑的血，而且没有抱怨。实际上，控制一切的系统的大脑把血液输送到应该去的地方并保持它的流动，防止它凝结，携带我们的营养物质，把我们的废物带回来; 所以真正能控制血液往那里流动，什么时候流动，血流的大小的是血管。血管基本上是由血管的单层内皮层控制的，这被称为内皮。这些细胞，再一次强调，是单细胞层的厚度，必须停下来思考它。我们从空气到食物到水的所有东西，等等，都必须沿着这条管道穿过这个微小的单层，到达我们的细胞的其他部分。我们从新陈代谢中产生的所有废物，它们通过这些细胞回到血管系统，从肺中被排出，或排出尿液或汗水，或其他任何可能的东西。它确实是控制血液循环的关键层，最终控制了我们的大部分新陈代谢。
Jonathan Bailor:当这一层开始崩溃时，就是当我们开始看到心脏病和心血管疾病的第一个征兆吗?
Dwight Lundell: 是的，这是关键。如果没有不好的事情发生在那一层，我们根本就不会得心脏病。
乔纳森·贝洛: 你在体内的成千上万小时里看到了什么? 是什么原因导致了内皮的损伤?
德怀特·伦德尔:那天我告诉某人，我看到的裸体比色情电影制作人还要多。不幸的是，他们中的大多数人都在生病中，在绝望中。这样，一点都不好笑。这是悲伤和悲惨的，但幸运的是，我们有一些简单的机械方法来避免代谢对血管的影响。很令人沮丧的是，我们意识到这些人赢得了战役，但最终我们输掉对心脏病的战争，因为我们没有注意到基本面，原因是我们没有注意到这个叫做内皮细胞的微小层发生了什么。
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Jonathan Bailor: 什么误会? 作为一种文化，为什么我们不关注它，我们在做什么，因为没有更好的条件，我们在不断地激怒它?
德怀特·伦德尔:我们在过去的四年里一直专注于胆固醇和控制胆固醇的药物，以及通过食物控制我们血液中的胆固醇水平。这是我们谈论健康时最大的话题。“我们是如何做的?“ 哦，我的胆固醇很好。”这不是问题所在。为什么这不是问题所在: 超过半数的心脏病患者的胆固醇水平正常。胆固醇是我们在自己体内制造的物质。它不是一种有毒物质，无论那个方面，形状，或形式，我们有一个简单的想法“只要我们能降低胆固醇，我们就能治疗心脏病”。有趣的是，一旦确诊，我们就会停止思考这个问题。这就是心脏病发生的情况。我们不再考虑血管里发生了什么。我们只是在看一些我们能用药物来衡量和改变的东西。这是胆固醇水平。当我们从冠状动脉搭桥手术开始时，我们从腿上取下静脉，绕过堵塞，我们进入了血管成形术，我们在里面放了一个小的气球，并将它充气，试图将空斑移开。然后我们退后一步，再看看这里到底发生了什么。这发生在20世纪80年代末和90年代。最后，所有的小步骤都被阐明，我们了解到动脉粥样硬化的基本机制是胆固醇和细胞碎片的基本机制，导致血管中有斑块，最终导致心脏病发作，中风等，是低度炎症。当你说到“发炎的动脉”时，你会发现它，因为它表明它的低度炎症是斑块的基本机制，使斑块生长，最终导致斑块破裂，这是导致心脏病的灾难性后果的原因。
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Jonathan Bailor: Lundell医生，请快速总结一下，确保我理解正确;几个事情。最根本的原因是，如果我们要测量任何东西并说“这是你需要注意的东西”，如果有任何一件事，最接近该问题的是炎症。这与我们被告知要考虑的，即胆固醇的情况形成了鲜明的对比。我们都很熟悉和脂肪恐惧症，以及整个胆固醇是如何开始的。我想和大家分享的一个故事——我很好奇你对它的想法，Dwight-是这个小故事，你说的是如此专注于胆固醇，因为它是我们可以测量的东西。故事有点像这样:一个女人出去慢跑，她的隐形眼镜掉了出来。她开始四处寻找，但没有成功。另一个女人坐在长椅上，她看到第一个女人在寻找她的隐形眼镜，她想帮助她。她看到正在寻找隐形眼镜的女人正站在附近的路灯下。她走过去，在路灯下找她的隐形眼镜，说:“你在抓着你的眼睛，我注意到你停止了慢跑，你失去了隐形眼镜，我能帮你找吗?”失去了隐形眼镜的那个女人非常非常高兴，她说:“当然，它从十英尺高的地方掉了出来。”第二个女人看着她说:“对不起，你说你的隐形眼镜掉到十英尺外了?”那个拿着眼球的女人说:“是的，它从十英尺远的地方掉了下来，指着离她十英尺远的地方。”第二个女人说:“如果它掉在后面，你为什么要看这里?”那个拿着她眼球的女人说:“这里的光线更好。”
德怀特·伦德尔:这是个好故事。
Jonathan Bailor: 看起来这有点像动脉粥样硬化，心脏病和胆固醇。这公平吗?
德怀特·伦德尔:这是公平的，如果我们能测量和改变一些东西，我们认为我们在做某事，事实上，我们什么都没有做。因为有一半的心脏病患者的胆固醇水平是正常的。让我们把注意力集中在炎症上，我没有说这是原因，我说这是机制。引起炎症的原因是损伤。当我们受伤时，生物反应就是炎症。这是一系列复杂的事件，我们不需要深入进去，只需要说炎症是对损伤的反应。经典的标志——如果你还记得你什么时候有了划痕，或者是什么，肿胀，温暖和疼痛。经典的符号，calor, dolor, rhubo, rhubor，对吧?
乔纳森·委托人:是有意义的。
德怀特·伦德尔:不管怎样，发生的是化学物质被细胞分泌出来，用来释放我们的白细胞，这是我们的防御机制。他们来战斗，杀死细菌或者带走泥土，或者开始给伤口带来营养，蛋白质和胶原蛋白。这是一个复杂的过程，从一个急性的，积极的反应开始。如果我们没有这样的反应，我们会死于每一次愚蠢的感染，所以要感谢它。正常情况下，炎症会进入一个分解阶段，所以我们就像你皮肤上的一个条子一样愈合伤口。它是红色的，它是温暖的，它是疼痛的，肿胀的，然后它开始愈合一天左右。可能会有一个很小很小的伤疤，但它已经消失了。真的，这是对我们内皮细胞的一种基本损伤。对我们的内皮细胞重复的小的损伤不允许炎症的愈合。这就是心脏病的起因。这个已经很清楚了。最好的研究报告1999年由罗斯博士发表在《新英格兰医学杂志》上。标题是“动脉粥样硬化是一种炎症性疾病”。所有这些的细胞机制，如果有人感兴趣的话，可以看看那篇文章。对我来说，真正的问题是，我再次赢得了战役，但输了战争，所以我退了回去，说:“是什么导致了内皮细胞的损伤?”有很多事情可以做到。吸烟可以做到这一点。多种化学物质会损伤内皮。这些细胞是相对较长的活细胞，因此它们很难繁殖。当他们受伤的时候，他们的功能就不能正常地扩张和收缩我们的血管，控制血流并确保它不会堵塞并在正确的时间把营养物质送到正确的地方。这叫做内皮功能障碍。不是我们在电视广告中看到的ED，而是内皮功能障碍。在现代社会，我们看到的是我们不像以前那样吸烟，我们的空气污染在大多数地方都比过去好，但是我们仍然接触到了很多东西。你不会抽香烟，也不会把你的鼻子塞进正在驶过的柴油卡车的排气管里，你不会故意伤害自己，所以有些事情是我们无法避免的，但有些事情是可以做到的。我们来看看到底是什么导致了我的内皮细胞不断的损伤并引起慢性炎症并堵塞我的动脉并让我心脏病发作? 最好的答案是看一个加速的例子。让我们来看看糖尿病患者。几乎所有人都死于心脏病。他们失去了视力，失去了肾脏，我们切除了他们的腿，但他们仍然患有严重的心脏病。这是加速内皮损伤导致这种疾病的一个例子。很多人都说糖尿病是加速衰老的一个例子，人们说，这是一个很好的例子。糖尿病患者可能会损伤内皮，导致肝脏衰竭、失明、截肢和心脏病等问题。答案是高葡萄糖。这是糖尿病患者的特点。他们的血糖经常处于高的水平。大多数细胞都有所谓的胰岛素受体。他们对胰岛素有反应。当胰岛素从胰腺中分泌出来，作为对我们摄入碳水化合物的反应时，葡萄糖被推入细胞。当细胞满时，他们说“不，我不需要了”，胰岛素受体被关闭，糖泵关闭。细胞可以控制内部发生的事情。内皮细胞和其他一些细胞没有相同类型的胰岛素受体，它们没有相同类型的葡萄糖泵; 所以它们就在我们血液里的葡萄糖的支配下。所有这些葡萄糖进入线粒体，我们创造能量产生大量的自由基，这些自由基超过了我们压制它们的能力。从根本上说，这就是损伤内皮细胞的原因。高血糖。开始这个伤害过程并不需要很高的血糖。当我们研究糖尿病时，我们发现这是一个很好的例子。当我看到一篇关于高血糖对所有这些器官以及所有这些组织和内皮细胞的损伤的论文，然后有人想要开始制造一种药物来阻止这种内皮细胞的损伤并停止氧化应激时，它使我疯狂。阅读这样的文章我开始用头撞桌子。我们为什么不少吃一点糖呢?
Jonathan Bailor: Lundell医生，我真的很欣赏你刚才做的事情，希望你能继续在这个节目中做些什么——我们在这里讨论医学科学。我们讨论的是细胞机制，你通过非常客观的方式说服我们，比如“发生了什么?”你有炎症，你有细胞机制，你对内皮细胞损伤导致炎症，炎症导致心脏病。什么会对内皮细胞造成重复伤害? 好的，那么损伤发生的机制是什么? 好吧，我们能把什么放在我们的身体里呢?在那里没有任何与环境有关的事情——并不是那些没有价值的东西值得思考——但这并不是这次谈话的内容。如果我们讨论的是医疗条件的原因，这是一个生物学机制的问题，它可以被研究和论证。如果我们想要“争论”，让我们以一种非常具体的方式来论证这些机制。如果有人不同意你的观点，我想他们会说:你刚刚列出了八个步骤。第四步是错误的，这就是为什么。不攻击任何东西。在某些方面，我认为你是正确的，因为如果你错了，为什么不直接说“科学是错误的，这就是为什么，而她的论文证明了这一点”。听众们，当你在网上浏览时，我强烈建议你去看——如果有人不同意你的观点，那就是——如果有人不同意Lundell博士或任何好医生的意见——他们会基于分散注意力的政治观点而产生分歧。在某些方面，这是一个迹象表明他们攻击的人实际上是在做某件事。他们不同意这个论点，他们说"哦，废话。这个论点是正确的，所以我必须为其他事情争论。如果你在学术环境中学习逻辑或辩论，当你开始看到一个人攻击一个人而不是他的论点本身的时候，你就会发现这个论点是正确的。当我们谈论生物学和人们的生活时，科学的正确性是很重要的，是吗，德怀特?
Dwight Lundell: 哦，绝对重要的乔纳森。其他一切都是政治或宗教的讨论。我所说的机制，都是可以测量的, 已经很清楚的机制，他们没有争议。不是在推销一种药物或其他，也不是激动的在说我是在吃土豆还是牛排，还是在拯救世界，或者杀死植物之类的。这是生物学。这里发生的就是生物学。
乔纳森·贝洛:我一直在说这个。这是我们在智慧科学上的口号之一:生物学不是意见的问题。我们当然可以辩论，讨论我们是否应该吃这个或那个，因为它对经济或农业有好处，或者因为它使美国农业部高兴，但这些都是单独的对话。每个人都请,如果你开始向任何人谈论这个或者你读医生Lundell的《治疗心脏病和你开始与人们分享科学或查看医生Lundell提到新英格兰医学杂志》上的论文或任何教科书都将会解释说,这是这是如何工作的,请让他们知道“嘿,我不认为生物机制。如果你想和我“意见不一致”，请在我所说的同一层面上与我意见相左。告诉我为什么我的生物机械论论点是错误的。在我所讲的生物过程中识别出链条是错误的。直到你真正做到这一点，你实际上是在支持我所说的，因为你在向我证明你不能反驳它。这让我有点兴奋，Lundell医生，因为看起来如果我们能把科学带回这个，很多困惑就会消失。让我给你一个很简单的例子。纽约大学的Murium Nestle博士是一位杰出的研究人员。当然，她和我对一些事情有不同的看法，但她继续说，她对美国农业部食品指南金字塔的批评之一是，它没有认识到淀粉和糖在体内的生物相等性。我不在乎你是否吃土豆，糙米，高果糖玉米糖浆; 当它离开你的胃，你的葡萄糖从另一端出来。这是葡萄糖。你的身体不像“哦，蜜蜂做了这个，它是蜂蜜，我在乎”。不。身体只是说“是葡萄糖”。如果我们知道葡萄糖在身体中起作用，我们知道某些食物会转化成葡萄糖，我们争论的是什么?我遗漏了什么东西?
德怀特·伦德尔: 这很有趣，因为它都变成了葡萄糖。都分解成C6H12O6。这是葡萄糖。葡萄糖并不是邪恶的。让我们不要陷入那种愚蠢的事情。我们需要一些，我们可以制造一些。实际上，我们需要的是零，因为我们可以从蛋白质和脂肪中生成某些细胞需要的葡萄糖。这就是身体的实际情况。让我们回到我所说的损伤内皮细胞。当我们把血糖升高到160以上时，内皮细胞开始损伤，或多或少。胰腺在这个水平开始损伤。许多其他细胞无法抵御高血糖。如果我们想要测量一些东西，看看我们是否健康，我们肯定会测量我们应该吃什么，以及我们应该在30分钟、1小时和90分钟后吃一些食物后的血糖。我在祈祷我们拥有的时间。测量的工具已经有了，但它还没有被批准，我们有葡萄糖，我们有葡萄糖标记仪器，在智能手机上显示我们的血糖值。该设备已经有啦。那将是有史以来最伟大的健康工具。
Jonathan Bailor: Lundell医生，我很感谢你说我们没有在这里说“好，坏，坏，政治”就像如果你喝了2万卡路里的脂肪酸，那就不好了;太多了。如果你吃了氨基酸补充剂，吃了一袋的氨基酸，那对你也不好。我们都承认，做任何事情过度都是不好的，我想我们所说的是“发现葡萄糖的水平——当然，我们的饮食尤其是在西方文化中，会分解为葡萄糖——那种不会对心血管系统、炎症或心脏病造成重复伤害的水平。”把注意力放在这一点上。不要把注意力放在讨论政治或意识形态问题上。你怎么认为?
德怀特Lundell:当然。这就是基本原理。每当我看到一个标题“xyz是与此相关”或“红肉引起心脏病”或“鸡蛋是健康的鸡蛋是坏的”或“维生素E是好的”或“维生素E是坏的”,你可以看到所有的这些标题和我们必须从根本上记得当我们读这些东西甚至如果我们读医学文学协会不是因果关系。这就是我们堆积在胆固醇上的废话。如果不是炎症，胆固醇永远不会沉积在血管壁上。时期。这是纯生物学。胆固醇水平相对来说是不相关的。如果没有验证它不会到达那里。许多事情可以导致动脉发炎,不仅仅是葡萄糖,虽然在现代的环境，我们已经清理了其他因素，当我们看一下这两个-最大的杀手心脏病和肥胖和糖尿病时 葡萄糖是最容易控制和最重要的事情。所有这些的原因都是间歇性的高血糖-高血糖来自于消耗的碳水化合物。你不会从蛋白质或脂肪中获得低血糖，但你会从碳水化合物中获得。你知道，你看到人们在便利市场上行走，其中有一件东西——它有200克葡萄糖。我们做葡萄糖耐量测试，看看你是否有糖尿病仅用50或75克的葡萄糖。
乔纳森·贝洛:要说清楚，你在做测试时让人呆在办公室里，因为葡萄糖的“高水平”——如果你在服药后没有被监控，可能会给病人带来问题，对吧?
德怀特·伦德尔: 是的，这是可能的，但是人们每天都要进行六次超大的糖耐量测试。
乔纳森·贝洛:我认为他们应该把它放在大的Gulp容器上。“只在医生的眼皮底下吃。”你应该能够买到那一大口，但前提是你有一个医生来监督你。
德怀特·伦德尔:这是个好主意。看到母亲带着大苏打水，然后是一袋薯片，就很痛苦。再一次,如果你喜欢苏打水,你喜欢苏打水,和你不会死于喝苏打水,但是那些孩子们会得到高血糖因为当你停下来思考, 在血糖在100的水平时，我们大约一茶匙糖溶解在血液中——你想象超大杯（GULP）的可乐相当于30或更多茶匙的糖。
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乔纳森·贝洛:伙计们，我真的希望你们能接受。当你在听这个节目的时候，你很容易就能听到这里的节目——这是你的第二次演讲——你刚刚提到的是什么，你的身体里有一茶匙的葡萄糖在你体内循环。这相当于5克。如果你坐着吃了200克的葡萄糖，那么至少有195克的葡萄糖需要去别的地方。你去哪儿了，伦德尔医生?
德怀特·伦德尔: 一定要去某个地方。除非我们真的有非常非常健康的胰腺和对胰岛素有反应的非常健康的细胞，否则我们的血糖会很高，会损伤我们的内皮并导致心脏病。它唯一可以去的地方是肝脏，肌肉和脂肪细胞。当肝脏和肌肉“饱和”时，只有一个地方可以去，那就是脂肪。
Jonathan Bailor:从生物机制的角度来看，当我们用疯狂的碳水化合物来做的时候，我们要非常清楚，如果你吃的是不含淀粉的蔬菜，你就不会摄入200克的葡萄糖。你的胃会在那之前爆炸。我们并不是说反任何形式的碳水化合物。我们说的是反浓缩的，非天然的葡萄糖来源，只有在你通过处理过的垃圾食品或真正含淀粉的物质的情况下才可能发生。如果你这样做，你会使你的组织发炎，因为你有超高的血糖，然后在那之后，再加上侮辱，它进入你的脂肪细胞。它就像在脸上打你的身体，然后让你变胖。这并不是一个有趣的经历。
德怀特·伦德尔: 就是这么简单。我喜欢你的座右铭“让它简单”。我们所有的东西都卷起来了。“嗯，你不能喝一小口牛奶或半块奶酪，或者吃点奶酪。”我们所有的东西都是这样的。这就是我们所接受的关键。我最近听说过一些被挖掘出来的木乃伊，他们说“这证明他们是肉食者”或者“他们是食草动物”或者“这证明了什么”。木乃伊有心脏病。嗯你猜怎么着?即使是木乃伊也有可能会破坏他们的内皮细胞，比如住在山洞里或者整天吸着烟。有不良的口腔卫生，有不愈合的伤口，有慢性感染——诸如此类的事情。对我来说，这些都是愚蠢的论点。就像你说的，让我们坚持生物学。如果我们想要了解事实并快乐起来，我们来谈谈生物学。如果我们想自娱自乐，忘掉争吵，我们来谈谈其他的事情。
Jonathan Bailor: Dwight，我认为，对我来说，这是这次谈话的真正意义。它是如此重要，听众，有道德，政治，娱乐，体育，生活方式，数学，机械工程。还有生物学。这是一门科学，如果有人想说一些生物学上的东西，比如“动物的蛋白质会导致癌症，但是植物的蛋白质不会。”我建议你不要对那个人大喊大叫——但你要问他们“从生物学角度来说，植物蛋白的作用机制是什么，而不是基于动物的蛋白质?”“难道它们都不能分解成氨基酸吗?”你真的认为一些重要的氨基酸-等等，什么?如果他们不能回答这个问题，他们就不会争论生物学。他们巧妙地提出了一种道德观或意识形态的争论，并将其伪装成一种生物学上的争论。德怀特，你怎么看?
德怀特·伦德尔:我认为这很好。
Jonathan Bailor:我很感激。这只会让我感到沮丧，因为我认为它比它所需要的要复杂得多。显然，生物学是复杂的，但是把所有这些不必要的编辑化，就会变得非常复杂。就像你说的，Lundell医生，人们都快死了，所以我们需要退一步。我认为我们有些人需要把我们的自我放在架子上，即使我们在某个时间点说了一些东西，而生物学可能会反驳，让我们把注意力放在生物学上。让我们专注于拯救生命，而不是让任何东西云。如果我们是，让我们很清楚地说“我认为这个道德问题实际上比没有心脏病更重要”。这可能是一个很好的论点，让我们讨论而不是争论过去。我把肥皂盒放在这里，所以我要安静下来。好了，Lundell医生，如果你要留给我们的听众任何一种今天您给我们分享的智慧——那会是什么呢?
Dwight Lundell: 控制你的血糖。
乔纳森·贝洛:我喜欢。
德怀特·伦德尔:为了获得细节，你可以从艾伯特实验室得到一个血糖仪，然后再点这些脚本。很发人深省。如果我们要谈论未来，医学的未来将会更好地照顾我们自己。对我来说，医学的未来是复杂的。有些事情真的很糟糕，让我对我热爱的职业感到不高兴。其他的事情让我感到骄傲。我想我们最终会用自己的方法来做，这真的很简单。你不会每天都出去刻意地割伤自己，那你为什么要每天去做六次高血糖呢? 很容易解决。血糖仪。测试带相对便宜。测试你的空腹血糖，吃完后一个小时测试一下自己。如果你的血糖过高，你吃了太多不该吃的东西。由于很多原因，医生不能再告诉你真相了。这是一个完整的播客，但即使是他们想要的，他们也不得不告诉你降低你的胆固醇。高血糖的治疗方案与适当的饮食无关。它们都和药物有关，还有这个，那个，还有那个。在我们使用胰岛素之前，我们用低碳水化合物饮食治疗糖尿病患者。有些让我抓狂。我正在看一个关于胰岛素的大型节目。胰岛素与这种疾病和癌症有关，我说，哇!是什么导致了高胰岛素水平?“它不是从天而降的。”胰岛素水平高是一件事的结果。用碳水化合物刺激胰腺。但是你不能说这个词。
Jonathan Bailor: Lundell医生，如果我不得不离开我的听众，那就是你所说的看到所有这些头条新闻。你看到一个标题，你看到有人在说什么。表现得像个五岁的孩子。不断地问为什么。如果一项新的研究结果表明“素食者活得更长”。如果你真的读过这个研究，实际上是说吃蔬菜的人寿命更长，这是完全不同的。如果有人对你说，“好吧，你为什么这么说?”因为一组吃的蔬菜比另一组多。这和吃素没有关系。这和多吃蔬菜有关系。好吧，为什么多吃蔬菜会这样呢?哦，好吧，那是因为你认为它有这些生物机制。如果人们不能跟着你走那条“为什么”的链条，就停下来。这不是生物学上的争论。不断问“为什么”。你觉得呢，德怀特?
德怀特Lundell:完全正确。我最好的教授总是说“证据是什么?”“询问证据是什么，它是如何工作的，为什么会发生?”就在那张纸条上，你听到人们引用了这项研究和这项研究，99%的人只阅读了摘要或摘要的摘要。当你意识到今天发表的医学研究中可能有90%是错误的或偏颇的，仅仅因为它被发表在医学杂志上并不能使它成为神圣的真理。它使我们需要看的东西，当你说xyz与abc相关联时，这并不意味着因果关系，意思是“有问题吗?”为什么?是因果关系还是别的什么?一个愚蠢的例子是，阅读理解与增加鞋子的大小直接相关。这是一个真正的声明。
Jonathan Bailor:这似乎不是我们问题的核心来源。
德怀特·伦德尔:不断增加的节目规模与成长、变老以及学习如何阅读有关。它不是鞋子的尺寸，而是随着年龄的增长，学会了如何阅读。也许这不是一个很好的例子。
乔纳森·贝洛:不，这是完全合理的。我认为关键是，德怀特，大众不能让其他人迷惑自己。显然，相关性不会导致因果关系。我甚至不认为我们需要走那么远。每当你听到什么标题或看到什么，只要问“为什么?”我觉得你说得很对，Lundell医生。在底线，注意你的血糖，过更健康的生活并不一定那么难。你怎么认为?
德怀特Lundell: 很简单。
乔纳森·贝洛:我喜欢。伦戴尔医生，非常感谢你今天能加入我们并分享你的所有见解。各位，如果你想了解更多关于Lundell医生的信息，请查阅他的《治疗心脏病的书》。Lundell医生，再次感谢您今天与我们分享这个生物学。生物学并不是一种观点的问题。我很感激你能让我们从底层的过程中走出来。
Dwight Lundell:非常感谢，Jonathan。
Jonathan Bailor:谢谢你，Lundell医生。听众们，我希望你们像我一样喜欢今天的节目，并且记住;本周和之后的每一个星期，吃得更聪明，运动更聪明，生活得更好。很快跟你说话。
Bonus Dr Dwight Lundell The Real and Surprising Cause of Heart Disease
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This week we have the pleasure of hearing from Dwight Lundell. In his own words:
The Cure for Heart Disease: Truth Will Save a Nation
“Dr. Lundell’s experience in Cardiovascular & Thoracic Surgery over the last 25 years includes certification by the American Board of Surgery, the American Board of Thoracic Surgery, and the Society of Thoracic Surgeons. Dr. Lundell was a pioneer in “Off-Pump” heart surgery reducing surgical complications and recovery times. He’s in the Beating Heart Hall of Fame and has been listed in Phoenix Magazine’s Top Doctors for 10 years.
He has been recognized by his peers as a leader and has served as Chief resident at the University of Arizona and Yale University Hospitals and later served as Chief of Staff and Chief of Surgery.
He was one of the founding partners of the Lutheran Heart Hospital which became the second largest Heart hospital in U.S. and is now owned by Banner Health
As a recognized leader in his field, Dr. Lundell has consulted and advised for a variety of leading medical device manufacturers such as Cardio Thoracic Systems, Inc. before and after it’s acquisition by Guidant Corporation. He advised St. Jude Medical on tissue valve implantation and marketing. For A-Med, Inc., he consulted on, conducted, and published the first clinical study on miniature pumps for heart support. He co-authored a clinical study validating key technology for Coalescent Surgical, which was subsequently acquired by Medtronic, Inc.
Publications & Presentations
The Cure for Heart Disease: July 2007
A Miniature Right Heart Support System Improves Cardiac Output and Stroke Volume During Beating Heart Posterior/Lateral Coronary Artery Bypass Grafting, Heart Surgery Forum, 2003;6(5):302-6.
Clinical and Six-Month Angiographic Evaluation of Coronary Arterial Graft Interrupted Anastomoses by Use of a Self-Closing Clip Device: a Multi-center Prospective Clinical Trial, J. Thorac Cardiovasc Surg, 2003 Jul; 126(a):168-77, discussion 177-8.
The Interrelationship of Factors Controlling Cardiac Output, Med Hypothesis, 1983 Jan; 10(1):77-95.
Clinical Applications of the Intra-aortic Balloon Pump, Ariz Med, 1981 Jan;38(1):19-21.
Randomized Comparisons of the Modified Wire-Guided and Standard Intra-aortic Balloon Catheters, J. Thorac Cardiovasc Surg, 1981 Feb;81(2):297-301.
Combined Aortic Valve Replacement and Myocardial Revascularization, Connecticut Medicine, 1980 Jun;44(6):363-6.
The Importance of Myocardial Protection in Combined Aortic Valve Replacement and Myocardial Revascularization, Annual. Thorac Surg, 1979 Dec;28(6):501-8.
Leiomyoma of the Esophagus, Conn Med, 1979 Aug;43(8):483-5
Cold Chemical Cardioplegia, Presentation at the New England Surgical Society, May, 1979.
Doppler Ultrasound Diagnosis of Thoracic Outlet Syndrome, Presented at Connecticut Society of Board Surgeons, December 1978.
Hypoliquorreic Headache and Pneumoncephalus Caused by Thoracosub Arachnoid Fistula, Neurology 1977 Oct;27(10):993-995.
Guidelines for the Management of Lung Cancer, Ariz Med, 1977 Mar;34(3):176-82.
Education
Yale University School of Medicine
Chief Resident, Cardiothoracic Surgery, 1978-1979
Yale University School of Medicine
Cardiothoracic Surgery Resident, 1977-1978
University of Arizona, Arizona Health Sciences Center
Chief Resident, General Surgery, 1976-1977
University of Arizona, Arizona Health Sciences Center
Surgery Resident, 1971-1973, 1975-1977
University of Arizona, Arizona Health Sciences Center
General Surgery Intern, 1971-1972
University of Arizona
Doctor of Medicine, Charter Class of 1971″
Jonathan Bailor
http://www.facebook.com/TheSmarterScienceOfSlim
http://twitter.com/#!/jonathanbailor
The Slim Is Simple.org Non-Profit Nutrition Education Effort
Full Transcription
Jonathan Bailor: Hey everyone, Jonathan Bailor back with another bonus Smarter Science of Slim podcast. I am really excited about today’s show. I want to give a quick disclaimer, because we’re going to go a little bit deep on today’s podcast, but we’re going to do that intentionally. Today’s guest is very much able to go deep on what really happens when we come down with heart disease. What’s actually going on behiHeart nd the scenes? We have a surgeon with us who has performed about 5,000 coronary bypass surgeries, about 2,500 other heart surgeries, 1,000 lung cancer surgeries and general surgeries, and 5,000 plus general vascular surgeries. An individual who has literally thousands of hours of hands on experience with diseased hearts and diseased arteries. Who better to tell about what truly is causing this at a biological level than the wonderful surgeon, wonderful man, and author of The Cure For Heart Disease, Doctor Dwight Lundell, welcome to the show.
Dwight Lundell: Thank you Jonathan, it is wonderful to be on with you.
Jonathan Bailor: Again, Doctor Lundell, thank you so much for joining us. It was truly a pleasure meeting you on the low carb cruise. One thing that really resonated with me about your talk on the low carb cruise. It felt like I was back in University, which was alright because it quite academic. What you did so well was-without editorializing too much, getting too personal, or leveraging your personal preferences on what tastes good and what is and isn’t moral to eat-you stated very simply “here is the biology of what happens when your body breaks down from a vascular and cardiovascular perspective”. What I am hoping is that we can stick to just the facts. Let’s focus on the biological facts and talk about what really causes heart disease.
Dwight Lundell:That would be great. It’s been my passion for thirty years.
Jonathan Bailor: From the top, what we generally hear, Doctor Lundell, and certainly very recently our mutual friend Jimmy Moore was engaged in a wonderful discussion on what cause heart disease, and it didn’t really seem like it reflected much of your person experience or much of the scientific literatue. Let’s just start from square one. What happens when we “get” heart disease, and what leads up to that?
Dwight Lundell: Let’s define heart disease for a minute to clarify that for the listeners. When we say “heart disease”, we are talking about atherosclerosis or plaque build up in the arteries that feed the heart muscle. Symptoms occur. Heart attacks and death occur when that blood vessel gets completely closed and causes heart muscle to die which generally leads to a fatal irregular heartbeat. When we talk heart disease, we’re talking about the arteries that feed the heart muscle getting plugged up, and the consequences of them getting plugged up.
Jonathan Bailor: Excellent, that makes perfect sense. Let’s keep going.
Dwight Lundell: Well, the blood vessels really are the brains of the whole cardiovascular system. We attach lots of things to the heart. Emotion, bravery, and all of those kinds of things. “He’s got a heart”. The heart obviously is a wonderful thing. It pumps gallons and gallons of blood every hour and doesn’t complain. Really, the brains of the system that control everything and send the blood where it’s supposed to go and keep it flowing, keep it from clotting, carry our nutrients around, carry our waste products back; so the thing that really controls where things go, when they go, or how much goes are the blood vessels. The blood vessels are basically controlled by the single cell layer thick lining of the blood vessel, which is called the endothelium. These cells, once again, single cell layer thick, must stop and think about it. Everything that we take in from air to food to water, etc. Has got to go down this pipe and through this little single layer to get to the rest of our cells. All of the waste products that we generate from metabolism, they go through these cells to get back into the vascular system to be expelled as C02 from the lungs or passed out as urine or sweat or whatever it might be. It’s really the critical layer that controls the circulation and ultimately, it controls most of our metabolism.
Jonathan Bailor: When that layer starts to break down, is that when we start to see the first signs of heart disease and cardiovascular disease?
Dwight Lundell: Yes, that’s the key. Without something bad happening to that single layer, we would never get heart disease at all.
Jonathan Bailor: What have you seen in your ten plus thousand hours inside the body? What is causing this?
Dwight Lundell: I was telling someone the other day that I’ve seen more naked bodies than a pornography producer. Unfortunately, most of them were sick and in desperate circumstances. In that way, it’s not funny at all. It’s sad and tragic, but luckily we have some sort of simple mechanical ways to stave off the effects of metabolic consequences on those blood vessels. It was pretty frustrating to realize that there were winning battles with these people, but ultimately we were losing the war on heart disease because we weren’t paying attention to the fundamentals because we weren’t paying attention to what was going on with this tiny layer called the endothelium.
Jonathan Bailor: What is the misunderstanding? Why are we, as a culture, not paying attention to that and what are we doing to continuously inflame it, for lack of better terms?
Dwight Lundell: Well we were focused for the last four years on cholesterol and controlling cholesterol with medication, and cholesterol levels in our blood with diet. It’s the biggest conversation when we talk about health. “How are we doing?” “Oh, my cholesterol is great”. That just isn’t the problem. Here’s why it isn’t the problem: over half the people with a heart attack have normal cholesterol levels. Cholesterol is a substance we make in our own body. It’s not a toxic substance in any way, shape, or form, and we had sort of a simplified idea about “as long as we can lower the cholesterol, then we can cure heart disease”. The interesting thing is that once the diagnosis is made, we stop thinking about the problem. This is what happened with heart disease. We stopped thinking about what was going on with this blood vessel. We were just looking at something we could measure and change with medication. That is cholesterol levels. As we moved on from coronary bypass surgery where we take a vein from the leg and detour around the blockage, we moved on to angioplasties, where we put a little tiny balloon inside there and inflate it to try to move the plaque out of the way. Then was a time we stepped back and took another look at what really was going on in here. This happened in the late 1980s and throughout the 1990s. Finally, all the little steps along the way were elucidated and we understood that the fundamental mechanism of atherosclerosis that is the fundamental mechanism of cholesterol and cellular debris, etc. causing a plaque in the blood vessel which ultimately had consequences of heart attack, stroke, etc. was low grade inflammation. You hit it on the said when you said “inflame the artery”, because it turns out that it low grade inflammation that is the fundamental mechanism of the plaque, makes the plaque grow, and ultimately makes the plaque rupture, which is what results in the disastrous consequences of heart disease.
Jonathan Bailor: So Doctor Lundell, just to pause really quick and summarize to make sure I’m understanding this correctly; a couple things. The fundamental cause, it appears, if we’re going to measure anything and say “this is the thing that you need to watch out for”, if there is any one thing, the closest thing to fitting that bill is inflammation. That is in sharp contrast to what we’ve been told to think about, which is cholesterol. We’re all pretty familiar with (?) and fat phobia and how the whole cholesterol thing got started. One story I want to share with folks-I’m curious about your thoughts on it, Dwight-is this little story where you talked about being so focused on cholesterol because it’s something that we can measure. The story goes a little bit like this: A woman is out for a jog and her contact lens falls out. She starts looking around for it, not having any success. This other woman is sitting on a bench, and she sees the first woman looking around for her contact lens and she wants to help her. She sees that the woman who is looking for her contact lenses is standing under a near streetlight. She walks over to the woman looking for her contact lens under the streetlight and says “you’re holding your eye, I noticed you stopped jogging, did you lose your contact lens and can I help you look for it?” and the woman who lost her contact lens is very very happy and she says “absolutely, it fell out about ten feet back”. The second woman looks at her and says “I’m sorry, you said your contact lens fell out about ten feet back?” and the woman holding her eyeball says “yea, it fell out about ten feet back, pointing ten feet away from her”. The second woman says “why are you looking here if it fell out back there?” and the woman who is holding her eyeball says “well the light is better over here”.
Dwight Lundell: That’s a good story.
Jonathan Bailor: So it seems like that’s a little bit what’s happening here with atherosclerosis and heart disease and cholesterol. Is that fair?
Dwight Lundell: That is fair, if we can measure something and change something, we think we’re doing something, when as a matter of fact, we’re not doing anything. This is illustrated by the fact that half of the people that have heart attacks have a normal cholesterol level. Let’s focus back on inflammation and I didn’t say it was the cause, I said it was the mechanism. What causes inflammation is injury. Whenever we get injured, the biological response is inflammation. It’s a complicated cascade of events which we don’t need to go into just to say that inflammation is the response to injury. The classic signs are-if you remember when you got a scratch or whatever-redness, swelling, warmth, and pain. The classic signs, calor, dolor, rhubo, rhubor, right?
Jonathan Bailor: Makes sense.
Dwight Lundell: Anyway, what happens is that chemicals are secreted by cells to call out our white blood cells, which are our defense mechanism. They come to fight the battle and kill the bacteria or carry away the dirt or begin to bring nutrients and proteins and collagen in to heal the wounds. It’s a complicated process that starts with an acute, aggressive response. If we didn’t have this response, we’d die from every silly infection that came along, so be thankful for it. Normally, inflammation goes into a resolution phase so we heal the wound like a sliver in your skin. It was red, it was warm, it was painful, and swollen and then it started to heal a day or so later. There might be a tiny, miniscule scar, but it was gone. Really, it’s a fundamental injury to our endothelium. Repeated small injuries to our endothelium don’t allow resolution of the inflammation. That’s the cause of heart disease. This is well worked out. The best paper was published in the New England journal of medicine by Doctor Ross in 1999. The title was “Atherosclerosis is an Inflammatory Disease”. The cellular mechanisms in all of that, if anybody is interested, can look that article up. The real question for me, then, was once again I was winning battles but losing wars, so I stepped back and said “what’s causing the injury to the endothelium?”. There are many things that can do that. Cigarette smoking can do that. Chemicals of a variety of times can injure endothelium. These cells are relatively long lived cells, so it is hard for them to reproduce. When they get injured, they don’t do their function properly of dilating and contracting our blood vessels and controlling the flow and making sure it doesn’t clog and delivering the nutrients to the right places at the right time. This is called endothelial dysfunction. Not the ED that we see in the T.V. Commercials, but ED: endothelial dysfunction. In our modern society, we see that we don’t smoke as much as we did, our air pollution in most places is better than it was, but we’re still exposed to a lot of things. You wouldn’t necessarily smoke cigarettes and you wouldn’t stick your nose in the exhaust pipe of the diesel truck that is going by, and you wouldn’t intentionally injure yourself, so there are some things we can’t avoid, but there are some things we can. We take a look at what it is that could injure my endothelium repeatedly and cause this chronic inflammation and clog up my arteries and give me a heart attack? The best answer is to look at an accelerated example. That it to look at patients with diabetes. Almost all of them die of heart disease. They lose their vision, they lose their kidneys, we amputate their legs, but they still have severe heart disease. This would be an example of accelerated endothelial injury leading to this kind of disease. Lots of people have said that diabetes is an example of accelerated aging, etc. People have said “well, this is a great example. What is it about a diabetic that might injure the endothelium and cause these problems of liver failure, blindness, amputation, and heart disease?”. The answer is high glucose. That is the characteristic of diabetics. Their blood sugar is repeatedly high. Most cells have what is called an insulin receptor. They are responsive to insulin. When insulin is secreted from the pancreas in response to us eating carbohydrates, glucose is pushed into cells. When the cells are full, they say “no, I don’t need any more” and the insulin receptor is closed off. The sugar pump shuts down. The cell can control what goes on inside. The endothelial cell and a few other cells don’t have that same kind of insulin receptor, and they don’t have that same kind of glucose pump; so they are at the mercy of the glucose we have in our blood. What happens is that all of this glucose goes into the mitochondria, where we create energy creates lots of free radicals, which overwhelm our ability to neutralize them. That, fundamentally, is what injures the endothelial cell. High blood sugar. It doesn’t have to be very high to start this injury process. When we look at diabetes, we see that is a perfect example. It drives me crazy when I see a paper on hyperglycemic injury to all of these organs and all of these tissues and the endothelium and then somebody wants to start create a medicine to stop this endothelial injury and stop the oxidative stress. I start beating my head against the desk here reading an article. Why don’t we just eat a little less sugar?
Jonathan Bailor: Doctor Lundell, what I really appreciate about what you just did and hopefully what you will continue to do in this show-we’re talking about medical science here. We’re talking about cellular mechanisms and you talked us through very objectively, like “here is what happens. You have inflammation, you have cellular mechanisms, you have injury to the endothelial cells that cause inflammation, inflammation leads to heart disease. What can cause repeated injury to the endothelial cells? Okay, well what is the mechanism by which the injury can happen? Okay, what can we put in our body that can lead-” nothing in there was a moral statement. Nothing in there was tied to environmental concerns-not that those aren’t valuable things to think about-but that’s not what this conversation is about. If we’re talking about the cause of a medical condition, that is a question of biological mechanisms, which can be studied and demonstrated. If we want to “argue”, let’s argue those mechanisms in a very specific way. Like if someone were to disagree with you, I would expect them to say :you just outlined an eight step process. Step four is wrong, and here’s why”. Not attacking anything else. Anything else is, in some ways, I perceive as an admission that you’re correct, because if you were wrong why not just say “the science is wrong, and here’s why, and her’s a paper that proves it”. Listeners, as you’re out there just perusing the internet, I would urge you to see-if someone’s going to disagree with Doctor Lundell or any good doctor out there-they’re disagree based on distracting political type arguments. In some ways to me that that is an indication that the person that they are attacking is actually on to something. They are not agreeing with the argument, they are saying “oh, crap. The argument is sound, so I have to argue bout something else”. If you study logic or debate in an academic setting, when you start to see a person attacking a person for things other than the argument itself, ofte n times that is an indication that the argument is sound. When we’re talking about biology and people’s lives, getting the science correct is pretty important, isn’t it, Dwight?
Dwight Lundell: Oh, absolutely important Jonathan. Everything else is sort of a political or religious discussion if you will. What I’ve said about the mechanisms, those can all be measured. They’re worked out. They’re not controversial, it’s not promoting one medication or another or getting emotional about whether I’m eating a potato or a steak or saving the world or killing a plant or whatever. It’s biology. That’s where it happens is biology.
Jonathan Bailor: I’ve been saying this. This is sort of one of our slogans at Smarter Science of Slim: Biology isn’t a matter of opinion. We can certainly debate and have wonderful debates about whether or not we should eat this or that because it is good for the economy or agriculture, or because it makes the USDA happy, but those are all separate conversations. Everyone please, if you ever start talking to anyone about this or you read Doctor Lundell’s book The Cure For Heart Disease and you start to share the science with people or check out the New England journal of medicine paper that Doctor Lundell mentioned or any textbook which will explain that this is how this works, please just let them know “hey, I’m not arguing anything other than biological mechanisms. If you want to “disagree” with me, please disagree with me on the same level of what I’m talking about. Tell me why the biological mechanistic argument I’m making is wrong. Identify the chain in the biologic process that I’m talking about that is wrong. Until you actually do that, you’re actually arguing in support of what I’m saying because you are showing me that you can not disprove it”. This gets me a little bit amped up, Doctor Lundell, because it seems like if we could just bring the science back into this, a lot of the confusion just goes away. Let me give you a very simple example. Doctor Murium Nestle over at NYU is a brilliant researcher. Certainly she and I have some different opinions on some things, but she went on record stating one of her critiques of the USDA food guide pyramid is that it failed to recognize the biologic equivalency of starches and sugars in the body. I don’t care if you eat a potato, brown rice, a high fructose corn syrup; when it leaves your stomach, you’ve got glucose coming out the other end. It’s glucose. Your body isn’t like “oh, bees made this, it’s honey, I care”. No. The body just says “it’s glucose”. If we know glucose does certain things in the body, and we know certain foods turn into glucose, what are we arguing about? Am I missing something?
Dwight Lundell: That was actually funny because it all turns into glucose. It’s all broken down to that C6H12O6. It’s glucose. Glucose is not evil. Let’s not get drawn into that silly thing. We need some, and we can make some. Actually, to be absolute about it, we need zero because we can make-from protein and fat-the glucose that we need for certain cells that require glucose. It’s what happens. Let’s go back to what I said about injuring the endothelium. The endothelium starts to get injured when we raise the blood sugar above 160. Maybe less, maybe more. The pancreas begins to injure at those levels. Lots of other cells can’t defend themselves against high sugars. If we wanted to measure something to see if we are healthy, we sure measure-to see what we should eat and how much we should eat-our blood sugars at thirty minutes, one hour, and ninety minutes after we eat some food. I’m praying for the time that we have. It’s out there, but it’s not approved yet, that we have glucose that we have glucose markers that show our blood glucose onto our smartphones. The device is available. That would be the greatest health tool ever.
Jonathan Bailor: Doctor Lundell, I appreciate that you said that we’re not over here saying “good, bad, evil, political” just like if you drank 20,000 calories of fatty acids, that wouldn’t be good; an abundance of that. If you took amino acid supplements and just ate a found pound bag of amino acids, that wouldn’t be good for you either. We all acknowledge that over doing anything is bad and I think all we’re saying is “find the level of glucose-and certainly so much of our diet especially in Western culture breaks down into glucose-that will not cause repeated injury to your cardiovascular system or inflammation or heart disease. Focus on that. Don’t focus on arguing about politics or about ideological issues. What do you think?
Dwight Lundell: Absolutely. Once again, that’s the fundamentals. Whenever I see a headline “xyz is associated with this” or “red meat causes heart disease” or “eggs are healthy or eggs are bad” or “vitamin E is good” or “vitamin E is bad”, you see all of these headlines and we must fundamentally remember as we read these things-even if we read the medical literature-association is not causation. That’s where we got piled up on the cholesterol nonsense. Cholesterol would never ever be deposited in the wall of our blood vessel if it wasn’t for inflammation. Period. That’s plain biology. The levels of cholesterol are relatively irrelevant. It wouldn’t get there without inflammation, and many things can inflame the arteries, not just glucose, although in our modern environment-since we’ve cleaned up other things-glucose is the easiest to control and the most important as we look at both heart disease-which remains the largest killer in the USA-and obesity and diabetes. The cause of all of those is intermittent hyperglycemia-high blood sugar-from over consuming carbohydrates. You don’t get hypoglycemic from protein or fat, but you do from carbohydrates. A Big Gulp-you know, you see people walking about of the convenience market with one of these things-it’s got 200 grams of glucose. We do a glucose tolerance test to see if you are diabetic with 50 or 75 grams.
Jonathan Bailor: To be clear, you keep people in the office while you’re doing that because that “high level” of glucose-if you’re not monitored after administering that could cause problems to the patient, right?
Dwight Lundell: Yes, it could, and yet people are doing a super max glucose tolerance test six times a day.
Jonathan Bailor: I think they should have to put that on the Big Gulp container. “Only consume this under the watch of a physician”. You should be able to buy that Big Gulp, but only if you have a physician with you to monitor you.
Dwight Lundell: That would be a great idea. It just pains to see mothers bringing their babies out with big sodas followed by a bag of chips. Once again, if you like soda, you like soda, and you won’t die from drinking a soda, but those kids are going to get hyperglycemia because when you stop and think that we have about one teaspoon of sugar dissolved in our blood at any time-even at a level of 100-and you look at the Big Gulp and that’s 30 or more teaspoons of sugar.
Jonathan Bailor: Folks, I really want you to let that sink in. It is pretty easy when multitasking when listening to the show here-for one second here-what Doctor Lundell just mentioned which is born out of all sorts of research is that any point in time you’ve got about a teaspoon of glucose circulating in your body. That is five grams. If you eat 200 grams of glucose in a sitting, at least 195 of those have to go somewhere else. Where is that somewhere else, Doctor Lundell?
Dwight Lundell: It’s gotta go somewhere. Unless we really have very very healthy insulin and very healthy cells that respond to insulin, our blood sugar is going to be high, and it is going to injure our endothelium and lead to heart disease. The only place it can go is basically to the liver, the muscle, and fat cells. When the liver and muscle get full, there’s only one place it can go, and that is to fat.
Jonathan Bailor: So when we look at it from the biological mechanism’s perspective, when we overdo it in terms of insane carbohydrate-and let’s be very clear-you aren’t going to eat 200 grams of glucose if you’re eating non-starchy vegetables. Your stomach would explode before that would happen. We’re not saying anti-carbohydrate by any means. We’re saying anti-concentrated, unnatural sources of glucose which is only physically possible if you’re doing it through processed garbage or really starchy substances. If you do that, you inflame your tissues because you’ve got super high blood sugar, and then after that’s done-to add insult to injury-it goes into your fat cells. It’s like it punches your body in the face and then makes you fat. That doesn’t really seem like a fun experience.
Dwight Lundell: It’s just that simple. I love your mottos of “make it simple”. We get all wound up in all of this stuff. “Well, you can’t drink a sip of milk or half a piece of cheese or have some cheese with your dinner”. We get all wound up in this kind of stuff. It’s what happens to what we take in that is critical. I’ve heard references lately to some of the mummies that have been dug up that says “that proves that they were meat eaters” or “they were vegetable eaters” or “that proves something”. Mummies had heart disease. Well guess what? Even mummies had things that could damage their endothelium like living in a cave or breathing smoke all day long. Having poor dental hygiene, having wounds that don’t heal, having chronic infections-all of those kinds of things. To me, once again, those are silly arguments. As you say, let’s stick to some biology. If we want to get down to facts and be happy, let’s talk about biology. If we want to entertain ourselves, forget arguments, let’s talk about those other things.
Jonathan Bailor: Dwight, I think that, to me, is really the take home message of this conversation. It’s so important, listeners, that there is morality, politics, entertainment, sports, lifestyle, mathematics, mechanical engineering. There’s also biology. It’s a science, and if anyone is going to say something biological in nature, for example “protein from animals causes cancer, but protein from plant’s doesn’t”. I would urge you-don’t yell at that person-but just ask them “biologically, what is the mechanism by which plant based protein does not cause cancer yet animal based protein does?” Don’t they both just break down to amino acids? Are you really arguing that some of the essential amino acids-wait, what? If they can’t answer that, they are not arguing about biology. They are subtly making a moralistic or ideological argument and disguising it as a biological argument. What do you think about that, Dwight?
Dwight Lundell: I think that’s very very well said.
Jonathan Bailor: I appreciate that. It just frustrates me because I think it is made out to be more complicated than it needs to be. Obviously the biology is complicated, but layering all this other unnecessary editorialization, that’s when it gets really complicated. As you said, Doctor Lundell, people are dying, so we need to take a step back. I think some of us need to put our egos on the shelves and even though we said something at one point in time and the biology may contradict that, lets focus on the biology. Let’s focus on saving lives and not let anything cloud that. If we are, let’s say very clearly “I think this moral issue is actually more important than not getting heart disease”. That could be a very good argument, and let’s have that discussion rather than arguing past each other. I get on my soap box here, so I’ll quiet down. Well Doctor Lundell, if you have to leave our listeners with any one piece of wisdom-you’ve shared so much wisdom with us so far today-what would that be?
Dwight Lundell: Control your blood sugar.
Jonathan Bailor: I love it.
Dwight Lundell: To get the details, you can actually get a glucose meter for free from Albert Laboratiories and then order the scripts. It is quite revealing. If we’re going to talk about the future, the future of medicine is really taking better care of ourselves. The future of medicine for me is mixed. Some things are really really bad and make me unhappy about my beloved profession. Other things make me proud. I think we’re going to end up with do it yourself medicine and it’s really quite simple. You wouldn’t go out and purposefully cut yourself every day, so why are you going to go out and be hyperglycemic six times a day? It’s easy to solve. Get a glucose meter. The testing strips are relatively cheap. Test your fasting blood sugar, and test yourself an hour after you eat. If your blood sugar is high, you ate too much of the wrong thing. For lots of reasons, doctor’s can’t really tell you the truth anymore. That’s a whole ‘nother podcast, but even they they might want to, they’re literally forced to tell you to lower your cholesterol. The treatment protocols for hyperglycemia have nothing to do with the proper diet. They have all to do with medicines and this, that, and the other. Before we had insulin, we treated diabetics with a low carbohydrate diet. Duh. Some of it drives me crazy. I was watching a big broadcast about insulin levels. Insulin is associated with this disease and cancer, and I’m saying “whoa! What is it that makes high insulin levels?” it doesn’t come out of the sky. High insulin levels are the result of one thing. Stimulating the pancreas with carbohydrates. Yet you couldn’t say the word.
Jonathan Bailor: Doctor Lundell, if I have to leave my listeners with one thing, it is what you said about seeing all of these headlines. You see a headline, you see anyone saying anything. Act like a five year old. Keep asking why. If a new study comes out that says “vegetarians live longer”. If you actually read this study, it’s actually saying that people that eat vegetables live longer, which is completely different. If someone were to say that to you, ask “well, okay, why are you saying that? Oh, it’s because one group ate more vegetables than the other group. It has nothing to do with being a vegetarian. It has more to do with eating more vegetables. Okay, well why is it that eating more vegetables does that? Oh, okay, it’s because you think it has these biological mechanisms”. If people cannot follow you on that chain of “why”, stop. Then it’s not a biological argument. Just keep asking “why”. What do you think, Dwight?
Dwight Lundell: Absolutely correct. My best professor always said “what is the evidence?” ask what the evidence is and how does it work and why does it happen? Just on that note, you hear people quoting this study and that study, well 99% of them have read nothing but the abstract or a excerpt from the abstract. When you realize that probably 90% of the medical research that’s published today is wrong or skewed for one reason or another-just because it is published in a medical journal does not make it sacred truth. It makes it something that we need to look at, and when you say xyz is associated with abc, that does not mean causation, that means “is there a question? Why? Is it causation or something else?” Sort of a silly example is that reading comprehension is directly correlated with increasing shoe size. That’s a true statement.
Jonathan Bailor: That seems like that’s not the core source of our issues here.
Dwight Lundell: Increasing show size is associated with growing up and getting older and learning how to read. It wasn’t shoe size, it was learning how to read as we got older. Maybe that wasn’t a good example.
Jonathan Bailor: No, it makes total sense. I think the key here, Dwight, is that folks can’t let people confuse you. Obviously correlation does not result in causation. I don’t even think we need to go that far. Every time you hear any headline or see anything, just ask “why?”. I think you hit the nail on the head here, Doctor Lundell. At the bottom line, watch your blood sugar and living a healthier life doesn’t have to be that hard. What do you think?
Dwight Lundell: It’s simple.
Jonathan Bailor: I love it. Well Doctor Lundell, thank you so much for joining us today and sharing all of your insights. Folks, if you want to learn more about Doctor Lundell, please check out his book The Cure For Heart Disease. Doctor Lundell, thank you again for sharing this biology with us today. Biology really isn’t a matter of opinion. I appreciate you stepping us through the underlying process.
Dwight Lundell: Thank you so much, Jonathan.
Jonathan Bailor: Thank you Doctor Lundell. Listeners, I hope you enjoyed today’s show as much as I did, and remember; this week and every week after, eat smarter, exercise smarter, and live better. Talk with you soon.
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