Episode 52: Heart Health with Dr. Jack Wolfson

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Q&A with a Paleo Cardiologist

While my podcast usually focuses on autoimmune disease, I frequently get questions from people new to the paleo lifestyle, who are concerned about the effect of the paleo diet on their heart health. We’ve been taught in our lifetimes to fear fat, cholesterol and red meat, all of which are part of the paleo diet. And if we’re not afraid of these foods ourselves, our families often are. So, I thought it would be great to have an expert on the show to separate fact from fiction.

Dr. Jack Wolfson is a cardiologist who follow the paleo diet and lifestyle himself, and recommends it to his patients. He’s also the author of the book, The Paleo Cardiologist: The Natural Way to Heart Health.

Listen to the Show

Show Notes

  • Intro (0:00)
  • Announcement (1:47)
  • Thank You to our Podcast Sponsor – Paleo on the Go (2:35)
    • A frozen meal delivery service, they have a large menu of items for the paleo autoimmune protocol (AIP).
    • Use the code PHOENIX for 10% off your first order.
  • Meet Dr. Jack Wolfson (4:36)
    • He is an osteopath and board-certified cardiologist who follows the paleo diet himself and recommends it for his patients.
    • His father was also a cardiologist and died at age 63 from progressive supranuclear palsy. Conventional medicine couldn’t help him, and it left Jack searching for answers. He met his future wife Heather in 2004. She challenged his ideas about diet and medicine, which led to a complete shift in the way he viewed health and treated illness.
    • He now specializes in treating heart problems through natural means, through his medical practice: Wolfson Integrative Cardiology.
  • Cholesterol 101 (10:05)
    • We’ve been taught to fear cholesterol, but our body actually needs it to survive. It’s a component of every cell membrane in our body, and it’s a building block of every hormone, from sex hormones to vitamin D.  There’s a reason our bodies make it, and also crave it in certain foods.
    • A review of 40 studies published between 1979 and 2013 showed that dietary cholesterol was not statistically associated with any coronary artery disease or stroke.
    • Cholesterol testing: Dr. Wolfson recommends the Advanced Lipid Analysis. This includes not only LDL & HDL but also particle size. Regular LDL & HDL testing is unhelpful. It’s the particle size that relates to cardiovascular risk. The large, fluffy particles can be beneficial. The small, dense particles can stick to artery walls and cause atherosclerosis.
    • Instead of statins, if someone’s tests show cardiovascular risk, Dr. Wolfson prescribes the paleo diet and lifestlye alongside a holistic protocol and re-tests in 3-6 months. He has seen cholesterol levels improve for hundreds of patients.
  • Dr. Wolfson’s Testing Protocol (22:48)
  • Heart Medications (24:55)
    • Dr. Wolfson’s goal as a physician is to help people eliminate their need for medication. Depending on the person’s health and commitment to the protocol, this can happen quickly or slowly over time.
    • NNT = Number Needed to Treat. How many people need to take a medication before 1 person benefits. You can search Pubmed by medication name + NNT, to find this statistic in clinical trials.
    • Statins are the first drug Dr. Wolfson recommends eliminating. Statins do  lower cholesterol numbers, but since cholesterol isn’t the cause of heart disease, it has minimal impact on heart attack risk or life expectancy. NNT’s vary from study to study between 39 and 154. Dr. Wolfson finds that unhealthy cholesterol numbers also lower through the paleo diet and lifestyle, but simultaneously inflammation lowers and overall health improves, without side effect risk.
    • Dr. Wolfson has also helped his patients eliminate blood pressure medication, but he tapers that medication slowly and carefully, as the individuals blood pressure starts to stabilize on its own.
    • Caution: always work with a doctor when making medication decisions. Dr. Wolfson himself is accepting new patients. You can also find like-minded physicians through functional medicine practitioner directories.
  • Diagnostic Testing (33:54)
    • The  tests Dr. Wolfson believes are helpful:
      • Basic Treadmill Stress Test – but only when someone is experiencing symptoms. Routine stress tests are unnecessary.
      • Echocardiogram – This is cardiac ultrasound and a very safe procedure.
      • Comprehensive Blood Tests – this provides direct information regarding cardiac risk and the effects of diet and lifestyle interventions.
    • Tests he thinks are unnecessary:
      • Coronary CT Scan – Almost everyone over the age of 50 will have some evidence of coronary artery disease, so he believes the test is redundant. The CT scan also exposes the body to high amounts of radiation that in turn damages the heart and arteries.
      • Nuclear Stress Test – Very rarely necessary but now performed routinely. This test also exposes the body to radiation and is very costly.
  • Cardiac Procedures (38:57)
    • Angiograms, Angioplasty, Stents, Bypass Surgery – Dr. Wolfson believes these are all overdone and often preventable. If a doctor tells you that you need one of these interventions immediately, that’s a good indication it’s truly necessary. However, if a doctor wants to send you home and schedule this procedure a week or a month out, that’s an indication you might not need this procedure. Use that time to get a second opinion and try another treatment path with an functional medicine practitioner.
  • Diet and Heart Disease (41:22 and discussed intermittently throughout podcast)
    • Research has proven that saturated fat intake doesn’t lead to heart disease. That’s another myth, similar to the cholesterol myth, that science over time has proven wrong.
    • As long as you eat plenty of vegetables (the foundation of the paleo food pyramid), meat consumption isn’t linked to health problems either. Resource: Research Analysis by The Paleo Mom.
    • Dr. Wolfson’s Paleo Food Pyramid prioritizes nutrient-dense foods: vegetables are the foundation, high-quality meat and seafood comes next, followed by healthy fats and then fruit in-season. He also prioritizes organic, grass-fed and wild-caught, because chemicals like pesticides have been shown to directly impact heart health.
    • He’s a big fan of herbs and spices as a way to get lots of medicinal foods in your diet. He calls them “natural pharmaceuticals.” If you’re following the paleo autoimmune protocol, here’s a list of spices allowed on the AIP.
    • Some of his favorite foods are sardines (rich in omega 3’s for cardiovascular and brain health) and avocados (rich in healthy fat, fiber and vitamins/minerals).
    • He doesn’t recommend dairy. It’s a modern food, not an ancestral food, and isn’t a natural part of the diet after infancy. This includes raw, grass-fed dairy. Dr. Wolfson thinks it’s fine as an occasional treat (if tolerated), but doesn’t recommend it as a regular part of the diet.
    • Dr. Wolfson is a fan of bacon. The natural nitrates are vasodilators and can be good for hearth health, provided it’s high-quality bacon that’s additive-free. He doesn’t recommend it daily, but once or twice a week is fine.
    • Dr. Wolfson believes that heart disease is actually autoimmune in nature, and linked to gluten and grain consumption.
    • While vitamin D levels are related to heart health, supplementation doesn’t change heart health risk. Instead, vitamin D from the sun (the natural way that our body makes is) is the only D supplement that Dr. Wolfson recommends, and he believes it’s essential.
    • Recommended books: Death By Food Pyramid and Good Calories Bad Calories.
  • Case Studies (53:36)
  • Outro (57:17)

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