True Health Revealed

Cambridge Professor and Obesity Geneticist, Giles Yeo (pronounced YO) PhD and I discuss the genetics and epigenetics of obesity and the influence of our food environment on our collective health, from a practical and actionable level. He makes a strong case why calorie counting is overrated, why BMI is a poor tool to assess metabolic health risk, why fat shaming is not helpful and why he, with all he knows, is a flexitarian. He adds a very interesting story of when he fully stopped meat, and then what happened when he restarted eating it. There’s more too but you’ll just have to listen to find out! #weightstigma

In this landmark interview (the first ever recorded interview of Drs. Appel and Sacks together!) we discuss the origins of the DASH Diet. DASH means Dietary Approaches to Stop Hypertension. It’s an eating plan, from before it was “low sodium” to variations with OmniHeart (comparing standard high carb DASH to reduced carb approaches emphasizing higher, largely plant based, proteins and monounsaturated fats) to OmniCarb (comparing two healthy versions of DASH: one low glycemic index and the other high glycemic index) to see what, if any impact, there would be in differing glycemic index in the most at risk subjects: those with insulin resistance. The answers to our questions may surprise you! And as always, Kathleen and I make sure that there are plenty of actionable nuggets to take away from each episode that will increase the odds of your adding not only years to your life, but life to your years!

The Guidelines may be relatively consistent but drinking patterns (especially during Covid-19 pandemic), and types of beverages have changed significantly.Harvard’s Dr. Eric Rimm, thought leader, alcohol researcher, and True Health Initiative Council member, joins Kathleen Zelman on the podcast for a spirited conversation into the prevailing wisdom and body of evidence on alcohol consumption.There is no recommendation to start drinking for health. So, if you don’t drink, don’t start. The rest applies to those who do drink alcohol. They discuss how, in the context of a healthy lifestyle that includes regular physical activity, not smoking, wholesome diet and healthy body weight, alcohol in moderation confers health benefits. Learn more about the risks; who should avoid alcohol; binge drinking and the importance of moderation.Key messages:The weight of the evidence continues to support moderate drinking defined as two drinks per day for men and one drink per day for women.Many variables play into these recommendations including genetics, so it is wise to discuss alcohol consumption with your physician.It doesn’t matter if you choose spirits, wine or beer.A drink (standard drink equivalent) is 1.5 ounces of 80-proof distilled spirits, OR 5 ounces of 12% alcohol wine, OR 12 ounces regular (not high gravity or craft) 5% alcohol beer.Beware of the calories! Drinking too much leads to weight gain. Most alcohol is 100-150 calories per serving but that does not include mixers.It’s best to enjoy alcohol with food and it’s not a bad idea to take off one day a week of alcohol consumption.

There is no disputing that diet is the single most important predictor of health – it is the leading cause of mortality in the US, causing more than half a million deaths per year. We are drowning in a food supply of high calorie, low nutrition foods and unhealthy diets.Today’s podcast is a thought provoking and enlightening discussion about sustainable diets that are good for your health and good for the planet. According to our experts David L. Katz, MD, MPH and Kate Geagan, MS, RDN, anything that is not sustainable and good for the planet should be off the menu.  They urged us to think of Mother Nature as a stock that we all own, and in doing so, we all have a role to play in choosing healthy sustainable foods for us and our planet.Key Messages:Sign up at NoBeefWeek.org for #nobeefweek, April 18-24, 2022.Americans eat twice as much meat as recommended by the Dietary Guidelines for Americans.Replacing some or all of the meat with protein rich legumes (beans, lentils, peas, soy) is an inexpensive and healthy way to meet your protein needs.Reduce the amount of highly processed foods and eat more plant foods such as whole fruits, vegetables, whole grains, legumes, nuts and seeds.Become a Flexitarian and enjoy a plant predominant diet with occasional animal based foods like fish, poultry or modest portions of other meats, keeping highly processed foods and beverages down to as realistically low an amount as possible.Embrace Meatless Mondays by eating more plant protein.Lower your carbon footprint by buying less food, wasting less, cooking more, eating fewer high calorie, low nutritional value foods and buying locally grown food.

In this episode of True Health Revealed, Dr. Tom Rifai interviewed two nationally prominent physicians, Dr. Jay Bhattacharya and Dr. David Katz, to discuss US and global lessons learned from the pandemic. Dr. Jay Bhattacharya is a Professor of Medicine at Stanford University and co-author of the Great Barrington Declaration that strongly advocated for focused population protection, particularly of the elderly, in order to avoid total population lockdown measures from harming the population, including strong advocacy for keeping schools open. Dr. Bhattacharya has been a prominent expert figure throughout the pandemic, often sacrificing his own personal interests in favor of his integrity and sincere concern for the welfare of the US and world population.Dr. David Katz, our hybrid guest/cohost was the founding director of the Yale Griffin Prevention Research Center and a past president of American College of Lifestyle Medicine. He is also the founding president of the non-profit True Health Initiative that supports the True Health Revealed podcast. Like Dr. Bhattacharya, Dr. Katz, from the beginning of the pandemic (March 13, 2020), recommended a public policy approach that would focus on total harm minimization, called DCISEV (pronounced decisive): Directing Crisis Intervention Services to the Especially Vulnerable, including intensive focus of protecting the elderly in nursing homes.In this episode they discuss:How the US and world may have looked if the Great Barrington Declaration and DCISEV were the basis of pandemic management policiesThe worldwide ramifications of the pandemic lockdown policies that did take place in lieu of the Great Barrington Declaration and DCISEV The mental and physical damage from fear-based media reportingWhat would’ve happened if nutrition and lifestyle based public policies (including produce trucks delivering healthy food into food deserts) were implemented from early on in the pandemic, as recommended in the American Journal of Health Promotion, June 2020The sad degradation of respect for the previously highly regarded US Centers for Disease Control and PreventionWhich countries Drs. Bhattacharya and Katz believe best managed the pandemicMisinterpretations of the vaccine adverse event reporting system (VAERS)How the Federal CARES Act played a role in hospitals’ recording COVID associated deathsFlorida’s governor Ron DeSantis’ call to Dr. Jay Bhattacharya in September 2020 to help the state guide pandemic management in FloridaDr. Rifai’s perspective on how history will judge public policies both for and against long term lockdowns, and risk-stratified protection of those at highest risk for severe COVID and death

Experts Elizabeth Ward and Hillary Wright, co-authors of newly-released The Menopause Diet Plan: A Natural Guide to Managing Hormones, Health and Happiness, offer valuable strategies how a nutrient rich diet plan and a healthy  lifestyle can not only mitigate and manage the symptoms of menopause and perimenopause, but also reduce weight gain, lower your risk for chronic diseases including cancer, and improve bone and brain health. Key messages:Focus on key nutrients such as calcium, omega 3 fatty acids and protein which is often lacking in the diets of menopausal women.Limit alcohol to one drink per day.The Menopause Diet Plan is similar to the Mediterranean and DASH diets, rich in protein, smart carbs, and healthy fats with a little room for splurge foods.Highly processed and refined foods are discouraged as they can worsen symptoms.Natural supplements to control hot flashes are not recommended as the evidence is limited.Exercise is essential to the plan, especially resistance training to maintain muscle mass.Dietary supplement recommendations are individualized where needed to fill in nutrient gaps.Resources: https://betteristhenewperfect.com/https://hillarywright.com/https://www.instagram.com/menopausedietplan/https://www.amazon.com/Menopause-Diet-Plan-Managing-Happiness/dp/0593135660

Season 1, Episode 11 Guest: Dr. Meeta SinghIn this episode we explore the science and the incredible power of sleep with international authority, Dr. Meeta Singh. Dr. Singh is also a performance consultant for professional sports including Major League Baseball, National Basketball Association, Pro Football Hall of Fame and many others. Tom and Meeta review the critical aspects of sleep including:the need for sleep,its impact on mental and physical performance,dementia, andthe value of naps.Key messages about the incredible power of sleep:Quality sleep promotes clearance of harmful toxins that build up through the day, reducing the risk for dementia.We can best cope with stressors when our bodies are well rested. Sleep is a reset button to help us face the stressors of the following day.You need 7-9 hours of sleep to function well.Naps can help meet the number of hours of sleep you need but it is not advisable too close to bedtime.When sleep deprived, caffeine can help with alertness and making decisions faster, but the quality of decisions may not improve (i.e., we may simply “make bad decisions faster”).You are less effective in general if you are sleep deprived.Less than 6 hours are likely to result in deficits in behavior.

You will be inspired and motivated to adopt her science-based philosophy of good health for your body and your mind through a commitment to self-care, self-love, regular physical activity and a whole food Mediterranean style dietary plan. Key Messages:Don’t eat after 8 pm.Strive to eat within a 12 hour or less window and give your body 12 hours to reset.Get moving, aim to accumulate 6-8000 steps per day. Use it or lose it – keep muscles strong by simple activities like pushups and planks. Fitness is energizing and critical to living healthfully and longevity. Eat whole foods, less processed foods and stay clear of the ‘hyper palatables:’ those sugary, salty, fatty foods that are addictive. Enjoy them as occasional treats. Make a plan and follow it regularly much like a yoga practice. Start with small steps that are sustainable in your commitment to a healthy lifestyle. Practice self-care, led with compassion and empathy. Be good to yourself. Self-love is an important part of being healthy. Don’t try to be perfect; aim to be better. Be mindful of the food you are eating by savoring the taste, smell, and pleasure. To achieve a health span, a long vibrant and robust life, you have to do the work. 

We know that nutrition, just like medicine, isn’t one-size-fits-all.  Kathleen chats with Stanford’s Dr. Christopher Gardner to better understand the hot topic of personalized nutrition, also called precision nutrition which assumes that each person may have a different response to specific foods and nutrients.  Precision nutrition asserts that the best diet for you may look very different than the best diet for another.But is it premature, does the evidence exist to define individual optimal diets or should we focus on eating according to the Dietary Guidelines? Christopher shares results of many of his research studies that have searched for the best diets.We also dive into the role of the relationship of diet and the microbiome (gut health).  Our diets determine which types of bacteria live in our digestive tracts, and according to precision nutrition the reverse is also true: the types of bacteria we house might determine how we break down certain foods, what types of foods are most beneficial for our bodies and how the microbiome impacts health and wellness.Key MessagesThere are so many variables, including genetics, gut microbes, lifestyle, biological, environmental, and social factors that affect an individual’s precision eating plan to improve overall health.The best diets start with healthy foods and weight loss can occur on a wide range of diet plans.One of the downfalls of weight loss diets is cutting calories but when you focus on feeling satisfied, it is much more sustainable long term and results in weight loss.Fiber rich diets feed the microbiome to produce healthy bacteria in the gut but it also depends on the existing bacteria.Prebiotics from fermented foods (yogurt, kefir, kombucha, kimchi, sauerkraut..) have the greatest impact on the microbiome that can boost immunity and reduce inflammation.

In this episode of True Health Revealed, we interviewed nationally renowned low carb advocate and author of the 2020 book “The Case for Keto,” Gary Taubes.Gary is known for being a passionate advocate for low carb approaches to nutrition, and by so doing, improving insulin sensitivity. From the perspective of many on “my side” (believers in plant rich eating patterns inclusive of legumes, whole fruits and whole grains), Gary is often thought of as someone that has an almost zero tolerance for all (even 100% whole) grains, root/tuberous (a.k.a. “starchy”) vegetables, legumes and most fruits that we consider strongly associated with vitality and longevity.Yet we had a very comfortable discussion reverting back and forth from personal experiences (including his addiction to smoking and my binge eating disorder) to discussing randomized controlled trials of nutrition (including the renowned DIETFITS trial of healthy low-carb versus healthy low-fat diets, led by Christopher Gardner at Stanford). I found Gary not to be “scary.” To me, our discussion revealed a humble, at times charmingly self-deprecating man who is, dare I say, flexible (e.g., pointing out correctly that the maintenance phase of Atkins diet phases has many similarities with plant predominant Flexitarian eating though most only focus on Atkins initial, ketosis inducing “induction phase”). He is also curious (for instance, about the nothing-but-meat “carnivore diet,” about which he’s curious more than anything). I heard no outright denial of the fact that a plant rich, flexitarian or even vegan approach (keeping in mind his wife, he makes clear, is close to plant pure) wasn’t appropriate and healthy for many.But he absolutely made clear his belief that controlling insulin via a low carb approach and titrating (adjusting) carbohydrate was key from his perspective to managing insulin resistance and weight control. Now, I don’t fully agree with that, obviously. Yet I saw no reason not to look at the mass majority of where we agreed… And yes, we could meet and “break bread” (minus the bread of course) over a fresh bed of vegetables and sustainable fish. In the spirit of the words he wrote to me in a personally signed copy of his newest book, “Here’s to Switzerland…!” Some of Gary’s summary points• Colorful low starch vegetables are healthy! He never ate more before going low carb.• Low-carb/keto is for metabolic correction in the insulin resistant and certainly is compatible with transitioning to a Flexitarian type eating pattern. But if weight gain/insulin resistance recurs…titrate back on carbohydrate, especially CRRAHP™ (calorie rich, refined and highly processed) carbs, but also whole grains, legumes, starch based vegetables and most whole fruits.• Foods containing CRRAHP™ carbs add addictive qualities and many people, though not necessarily all, may need to consider them like an addictive drug to be “dosed” carefully and with honest personal admission to susceptibility for drug like dependency.• Gary’s approach to low-carb and ketogenic diets is about personal experimentation and finding what works best to achieve metabolic health, unlike caricatures of him as someone who believes in absolutism. • Healthy populations such as Blue Zones and the Bolivian Tsimané tribes are different from westernized populations, particularly the United States with our insulin resistance and obesity epidemics. This is particularly in the sense that traditional (e.g., Blue Zones) and forager-horticulturalist based (for example, Tsimané) populations have never experienced the metabolic disruptions that drive our obesity epidemic, nor the epigenetic pressures that come from such, including those that occur in utero (e.g., upon unborn children to mothers who are insulin resistant). So while their eating patterns of high intakes of the legumes, root vegetables, whole grains, whole fruits and vegetables is quite justified considering the difference in their current and historical metabolic health (including lots of natural movement), the US population, which has been “raised” on the CRRAHP-SAD (SAD = Standard American Diet) is a different animal (no pun).• Social support is critical for any substantial transformational lifestyle change based on food behaviors, particularly in the inner circle of our lives such as life partners/spouses, is very important and otherwise makes any eating pattern that would be different than the CRRAHP saturated SAD (Standard American Diet) a struggle of a potentially insurmountable nature.• Gary is as human as anyone else when it comes to binge tendencies (like Dr. Rifai), and isn’t averse to the occasional slice of pizza or a dessert, although he probably fights the urges more so than most of us. 

You are what you eat and it all starts at birth. Give your baby a healthy start to help lay the groundwork for lifelong health. Dr. Stan Cohen, pediatric gastroenterologist, joins Kathleen to discuss the role of nutrition from infancy to childhood offering excellent guidance and advise on obesity, allergies, healthy meals, sugar, picky eaters, routine illnesses, the importance of gut health and more.  Parents of newborns to teenagers need to hear the wisdom from this seasoned expert who is the co-founder of www.Nutrition4Kids.com  and author of Healthy Babies, Happy Kids: A Common Sense Guide to Nutrition for Growing Years and What to Feed Your Baby: Cost-Conscious Nutrition for Your Infant.Key Messages:Get your children off to a healthy start.  Overweight babies and children often become overweight adults and are linked to health problems later in life, including persistent obesity and heart disease.Many of our children are overweight or obese: 13.4% among 2- to 5-year-olds, 20.3% among 6- to 11-year-olds, and 21.2% among 12- to 19-year-olds.Allergies are always to protein and usually occur immediately whereas intolerances show up several hours later. Feeding babies 4-6 months old whole eggs and peanut products can avert potential allergy development. Picky eaters usually grow out of the food jags.There is no other period of life when nutrition has a more profound impact than during the first 1,000 days of life (pregnancy – 2 years).  It is a critical time for human growth and development of the brain, body and immune system. Vegetables, beans and fiber are among the best foods to feed the healthy bacteria in the gut (microbiome) which in turn promotes immunity and brain health. After cereal, babies should be started on vegetables as first foods. 

As Physician Director of the Betty Ford Center, Dr. Haroutunian has contributed to the development of a variety of programs, including their Extended Care Program, the Licensed Professional Program and the Clinical Diagnostic Evaluation Program. He is the author of the renowned book, Being Sober, the foreword for which was written by Steven Tyler of Aerosmith (and to whom Dr. Harry is not only a friend, but his sobriety coach). Dr. Harry collaborated with Dr. Louis Teresi on Hijacking the Brain: How Drug and Alcohol Addiction Hijacks our Brains - The Science Behind Twelve-Step Recovery.Episode highlights: Dr. Harry and I discussed his perspectives from tens of thousands of hours of clinical (and personal) experience with alcohol abuse and recovery.First and foremost, he notes his strong family predilection for substance abuse disorder with alcohol.Dr. Harry believes childhood is where the roots of all substance abuse disorders are rooted.60% of alcohol abuse disorder is driven by genetics. But Dr. Harry emphasizes the importance of environmental/social pressures in aggravating genetic tendencies.The association of alcohol abuse recovery and sugar cravings is documented and strong. The C.A.G.E. questionnaire is a great screening for alcohol dependency.If anyone wants to reach out to Dr. Harry for gold standard support into substance abuse disorder recovery, call 760-972-7840.Notably, Dr. Harry is a big fan of Nathan Pritikin and the Pritikin Diet, having attended programs at the Pritikin Longevity Center when it was originally in Santa Monica, CA and run by Nathan himself.

A “bioengineered” (GMO) plant or animal has had a new gene inserted into it to give it a useful trait, like making it resistant to a pest or disease, ability to grow in drought conditions or enhancing its nutritional value.It has been estimated that upwards of 75% of processed foods on supermarket shelves – from soda to soup, crackers to condiments – contain bioengineered ingredients or GMOs for the past 20 years.Despite being around for so long, they are widely misunderstood, and have been vilified since they first hit the marketplace. They evoke fear and uncertainty to many, primarily because understanding genes is complicated. American consumers crave technology in every aspect of their lives except in food production.Dr. Alison Van Eenennaam, professor of Animal Genomics and Biotechnology at the University of California, Davis, joins me on the podcast to sort out the confusion and bring the scientific evidence to light along with the new USDA labeling rules.Key Messages about GMOs and Bioengineering*More than 20 years of data support the safety of foods made with bioengineered crops*Bioengineered crops enable farmers to use fewer chemicals and reduce their carbon footprint.*Globally, bioengineered crops are providing a lifesaving technology to feed a growing population, enable farmers to prosper in arid conditions, reduce malnutrition and blindness (golden rice).*Before a food is bioengineered, the protein is thoroughly evaluated to make sure it Is not an allergen or toxic compound.*Approval of a bioengineered food is highly analyzed and regulated with costs close to $136 million to bring a new bioengineered product to market.*Bioengineering is a tool in the agricultural toolbox that provides numerous benefits, especially in third world nations.

We discuss the benefits, risks and potential diminishing returns of marathons and triathlons. We review the effects of sudden intense levels of physical activity such as snow shoveling. We round up the interview by discussing relative risks for acute coronary events among those who follow different diets, and among smokers versus nonsmokers.Find out just where the “sweet spot” of physical activity is for true health. Spoiler alert: neither too little or too much physical activity is “sweet.” But you’ll want to hear the details in this excellent episode that is far more like a conversation among friends than “doctor talk!”Key Takeaways:What makes physical activity beneficial?Learn what “anti-effects” properties are (think blood clots, arrythmias, and clogged arteries)Every minute of exercise countsHow many minutes a week of physical activity the national guidelines suggestThe Copenhagen Study’s suprising results determining the “sweet spot” for sports activities“METS”What optimal resting heart rates are and how to achieve them naturallyHow to move from sedentary behavior to physical activity

Who should use CBD, how should you procure it and how much should you take? Learn all about the risks, benefits and scientific evidence that supports the role of CBD in health.Join Kathleen and RDN Janice Bissex, a holistic cannabis practitioner, and Program Director of Cannabinoid Medical Sciences at John Patrick University School of Integrative & Functional Medicine. Janice is also an author of Simple Guide to CBD: Fact, Fiction, and a Path ForwardWithout sufficient high-quality evidence in human studies, we can’t pinpoint effective doses, and because CBD currently is typically available as an unregulated supplement, it’s hard to know exactly what you are getting.Key Messages:CBD and THC are cousins but serve vastly different purposes.  CBD is not intoxicating.  Marijuana contains THC and is psychoactive.  Legally, CBD products can only contain .03% THC.If you decide to try CBD, talk with your doctor to make sure that it won’t affect any other medicines you take.In numerous studies, CBD was able to reduce or stop seizures. Epidiolex, which contains CBD, is the first cannabis-derived medicine approved by the FDA.Buyer beware, since CBD is not regulated so purchase from a reputable source and request a certificate of analysis. According to a report from the World Health Organization, "In humans, CBD exhibits no effects indicative of any abuse or dependence potential” and is considered safe. CBD is a plant that contains over 100 ingredients including health promoting terpines, cannabinoids, hemp, flavonoids and more. https://www.jannabiswellness.com