Transcription
Well, of course, we want to stay healthy, and we want to stay alive. Now, in the past, people have largely died through warfare, famine, drought, infectious diseases, plague, and various lifestyle factors associated with poverty. And that's still the case in many places in the world. But in the Western World, the main cause of death now is metabolic ill health. So what is metabolic ill health? Why aren't more people talking about it? What the heck can we do about it? Because we want to stay alive and spend more healthy time with those that we love. We don't want to die prematurely. Let's learn about that now from Dr. Rim Motra. Obviously, this is purely for educational purposes and in no way constitutes medical advice.
Welcome to this talk, and it's amazing that senior doctors and scientists and consultants around the world come to talk to us. And one of them is the pioneering cardiologist, Dr. Asim Motra. Asim, welcome back, and thank you for coming on, John.
Always great to speak to you, mate. Thank you. Now, there's a basically a pandemic, I think we could say a pandemic or certainly an epidemic of metabolic ill health around the world. What is meant by this term, metabolic ill health?
In essence, um, it's an imbalance between using fat for energy and storing it. And and it and it translates, John, into a number of different markers that are very, very strongly associated with the development of disease. In fact, I would argue it is the major issue, the elephant in the room, behind the chronic disease pandemic, is poor metabolic health. Um, and to give some perspective, and the and the figures in the UK are not too far off, is only 93—well, 93% of American adults have suboptimal metabolic health. I suspect in the UK it'll be over 80%. In Australia, um, we know that in New Zealand it's very similar figures. And most people don't know it because it's not the forefront of conversations that doctors have with their patients because it's not something we're really taught about in medical school. It's very much a term that most doctors won't be able to define if you ask them. But it but what the the good news is, through lifestyle measures, you can improve these markers of metabolic health. And there were five in particular; there were five measures, if you like, safe, simple to do.
Waist circumference—okay, so you want it to be less than 102 cm if you're a Caucasian man and less than 90 cm if you're a female. Blood triglycerides—you want them to be less than 1.7 mmol per liter. HDL, so-called good cholesterol—wants to be above one mmol per liter. You want an HbA1c, a measurement of your average blood glucose, to be less than 5.7%, as in not being pre-diabetic. And your blood pressure to be less than 120 over 80, as in not in the prehypertensive, obviously in the hypertensive range. This is all, by the way, defined without the use of medications.
And this sounds a bit inconvenient, uh, seem. I mean, why why should I bother? What diseases will I get if I if I don't do these things?
Well, listen, everything under the sun, mate, to be honest with you. I mean, the first and foremost, insulin resistance, which is the abnormal biological process going on in the body, um, is actually at the root of, you know, what gives you a, you know, um, suboptimal metabolic health. It is the primary driver of heart disease. It is the precursor to type two diabetes. It is responsible for, at least, of explaining what causes high blood pressure. It's linked to non-alcoholic fatty liver disease. It's linked to more and more evidence now linking it to anxiety and depression. Um, almost certainly the second most common cause of cancer after smoking. So if you get your metabolic health right, you're in a much better position for your lifespan and quality of life.
I want to make this real. Um, if we can assume, um, heart disease, if if you're if your coronary arteries that supplying your heart are gummed up, if they're atheromatous, just give me one example of why that matters. Tell us, tell us what a myocardial infarction is.
A myocardial infarction, also known as a heart attack, is a very specific definition, which is necrosis, damage to death of the cells of the heart muscle because of a restriction in blood supply for a prolonged period of time, at least 2 minutes. And that's when you have a heart attack. And it can be small, a small, you know, um, uh, relatively, uh, minor heart attack with less damage of of cells of the heart muscle to very large. If it's very large, that can then impair the ability of the heart muscle to perform its functions as pumping blood around the body and gives people fatigue and breathlessness. So that's what a heart attack is. It can lead to a cardiac arrest. A cardiac arrest just means the heart stopping. Some people mistake a heart attack for cardiac arrest. Ultimately, we all die of a cardiac arrest because the last organ, you know, to to that that indicates that we have got like signs of life or, you know, for for tissues to function, that that um, stops functioning is the heart. And that ultimately is a cardiac arrest. But one of the primary causes of a cardiac arrest, not the only cause, is a heart attack. A heart attack's painful; then they can be very, very painful. Um, I mean, I've managed thousands in my career, you know, the front line doing emergency cure heart surgery, you know, primary angioplasty if you like for these patients, seeing them in the acute setting, diagnosing it in the acute setting. Um, the typical symptom of a heart attack, what is described, is a feeling like an elephant is sitting on your chest.
That sounds quite painful.
So basically, it's a central heaviness. And one of the telltale signs when you see a patient or someone is if they make a fist and say, "I can feel something here." This can also present in a milder form, which is angina, which is something that's brought on with exertion and relieved by rest. And that is because of a—likely because of a severe blockage, not enough to cause a heart attack, but enough to reduce blood supply enough to cause discomfort or pain in the chest with exertion. And that blockage, and you said atheroma, usually needs to be at least at least 70% blocked to to induce symptoms in a patient with exertion. So when the demands of the body exceed the ability of the heart muscle to to meet those demands in terms of the artery flow to the heart muscle, and that's when you get so-called angina. But here's the catch, here's the caveat, if you like, or the um, something that that throws people quite often: 86% of heart attacks, John, happen at areas of the of the heart artery that are not severely narrowed. So a heart attack often happens acutely when one of these plaques, these deposits, damage to the arteries, build up over time, suddenly blocks because they expose their inner contents to the blood supply, like a ticking bomb, like a—I describe it like a pimple bursting. It's like a pimple that's there, not doing any harm on its in its own right, suddenly bursts; the contents are exposed to the blood, and then the the the body responds by forming a clot around there, thinking it's responding to a damaged vessel. And that then that clot then completely blocks the blood supply and causes a heart attack. And 86% of the heart attacks happen at areas or narrowings or lesions that are not severely narrowed. That's why it's described or well-known itself, you know, within the medical literature, if you like, there there's a—we learned this in cardiology: 50% of heart attacks happen with no prior warning, no angina preceding it.
Weird, isn't it?
So it's just a low-grade pathology that suddenly results in an elephant sitting on your chest.
Absolutely. But the key thing is, what are the risk factors that lead to the build-up in the first place? And the same risk factors also drive the acute problem or the occlusion. And the traditional ones are type two diabetes, smoking, high blood pressure, and high cholesterol. However, and that means high total cholesterol or LDL cholesterol, so-called bad cholesterol. However, my independent research with other scientists over over a decade has concluded, with many different bits of data, look, uh, leaving no stone unturned, that in my view it's quite clear: at best, high cholesterol is a minor or weak risk factor of heart disease, and at worst is not a risk factor whatsoever. Either way, it should not be our primary approach to managing heart disease. And I think the evidence for that is overwhelming.
I'm actually totally convinced by this. Actually, I don't want all of a sudden an elephant to be sitting on my chest. So um, I'm convinced that these things are important now. And to to be serious, you know, the patients that I've looked after, many patients after MI, and they say, John, "I can't describe the pain," you know, they can't describe how bad it was. This is the worst thing they've ever experienced in their entire life, you know, that they're white as a sheet, they're in absolute agony, they're terrified, they feel they're about to die. Horrible, horrible, horrible condition.
Yeah. And the pain is so bad, John, people, some people can appreciate this who may not have um, you know, ever had a heart attack, it's so bad that it induces, you know, the autonomic system is is so in um, sort of uh, fight-or-flight shock—100%, fight-or-flight. They start vomiting, you know, so that's the other thing you can tell that very, you know…
Yeah, yeah. People that I mean, you know, the patients that have described the worst pain is is the myocardial pain, and then the renal and the bolics, they just tell me that this pain is just off the scale.
Yeah. So if you're a nurse or a doctor, have compassion on these patients because the pain is unimaginable. So I I need to reduce my waist circumference, I need to reduce my triglycerides, I need to get my HDL up, I need to keep my blood sugar down, and I need to keep my blood pressure under control. Can we go through each of those briefly? How do—I mean, my waist does tend to expand a bit sometimes, seil—what do I do about that?
Listen, I'm in the same boat in the sense that I am quite sensitive to waist circumference going up, and it's—I called you seil, then a—sorry, I've just been doing gigs with with—I've just been doing doing some talks with um, with Cil Dandon, blood pressure on the very same thing.
So yeah, yeah, yeah. I mean, essentially, for for for a large proportion of the population, if not most of them, the insulin resistance is very common now. Yeah. And the the one approach, the one trigger, and the one solution is all linked to our consumption of starchy carbohydrates and sugar. And the reason for that, John, is anything that causes a rapid intake of blood glucose, yeah, into the bloodstream, yeah, is going to drive insulin to go up. Why? And insulin is also the fat, one of the fat-storing hormones. But the primary place that stores fat is your belly, yeah. So that so so especially, especially if you're a man, absolutely. So one of the primary ways of getting the waist circumference down quickly is really cutting out, eliminating all the starchy carbs and sugar and focusing on protein, fiber, you know, um, so-called healthy fats in the form of extra virgin olive oil, for example, but even including things like butter and cheese and stuff which are not harmful. All of these together, through a dietary approach, can actually get the waist circumference better. And on top of that, and this is what we're finding as well—I've been finding with my patients and also with the program which we'll talk about as well that I've set up uh, with a nutritionist—is that the, you know, these conditions, so the metabolic health markers get better, but that also means the blood pressure gets better; the type 2 diabetes can even go into remission. I find it with patients, in not a small minority of patients, within just a few weeks of dietary changes alone, doing nothing else, since in the gym, you know, not you know…it's interesting; exercise, I'm a big fan of exercise for mental, for your body, there's all these, but it's never really been shown in any clinical trial on its own to really improve the metabolic health markers by much at all. But what has rapidly shown that on its own is diet, dietary changes. Yeah. And and particularly the refined foods, particularly the the refined carbohydrates.
Yes. And since our last talk, I have managed to cut down on carbs quite a bit. I'm eating more fruit and veggies. Al o—was did—but I've become a bit of a connoisseur on olive oils because olive oils, extra virgin olive oil, is good for you. So when I go around to friends' houses now, I ask for a slug of their olive oil, just take a hit. I I think I think olive oil is like a medicine; it's like nature's medicine, really, anti-inflammatory, you know, so many good properties of it. Um, the the most researched, I think, food, if you like, um, or source of energy that has shown through different trials to be likely very strongly beneficial for people with heart disease, to prevent heart disease, prevent strokes, even cancer. So I'm a huge fan of of of extra virgin olive oil, and probably one of the secrets of the so-called Mediterranean lifestyle, yeah, you know, in quotes, diet that made them much less risk of heart disease and cancer during the period of the the 40s, 50s, and 60s when heart disease was rocketing in the in places like the UK and the US, even though interestingly they still smoked, they didn't smoke as heavily as we did. I think their average cigarette consumption was five a day. But even though they were still smoking, they're out in the sun as well. That's the other thing: vitamin D is so so important. I think that's another missing link in all of this is the the massive importance of vitamin D for one's overall health, for the immune system, and and severe vitamin D deficiency, um, on that note, John, has been linked to a six-fold increase of heart disease as well.
Wow.
So we should really add that as a sixth one, shouldn't we? But we'll come on to that. So so trying all these different olive oils, you get that you just take a hit, and you get that peppery taste at the back of your throat. So I, you know, it's good quality if you feel that little tickle, then you know it's a good quality.
Yeah. That's the polyphenols going, you know…
Yeah. And you do learn to tell the different ones, so it's quite interesting to try that. And my friends find it quite amusing as well that I go around and say, "I'd like to sample your extra virgin olive oil, if you don't mind, please."
Right, that's good. I'm going to really work on the carbs. I don't want this elephant sitting on my chest.
Definitely not. Triglycerides, yeah, just the, you know, produced by the liver, part of the cholesterol profile, um, they are a marker of insulin resistance. They are also linked to what we call small, dense LDL, so LDL cholesterol, which in its own right is not an issue, but the subfractions of the LDL, there are two types of particles, type A and type B. The type B are the small, dense ones, which are more likely to cause damage to the inner lining of the heart arteries, and type A are the large, fluffy ones, which are less likely. They are linked to the triglycerides as well. So um, it all kind of—it's a pattern, if you like. But my view on this as well is probably that if you if you sort the insulin resistance out, they may well just be markers of the insulin resistance, which is really the primary pathway to the damaging of the arteries because insulin itself, in excess, is directly toxic to the inner lining of the arteries. It interferes with the endothelial cells, the the the the um, outermost layer, if you like, of the arteries that have contact with the blood, which, you know, also have control on what enters within the artery wall, um, the elasticity of the vessel, etc., etc. You know, they they cause endothelial dysfunction, and that's the first step, if you like, to heart disease developing is endothelial dysfunction. So getting my triglycerides down, it's it's reducing sugar, reducing carbohydrates, and and unfortunately reducing alcohol a think as well.
Yes, absolutely right. Alcohol is another big one. Um, I think alcohol in moderation probably doesn't have much impact on triglycerides, but certainly when you're getting into excess, when you get into the 30, 40, 50 units a week, depending on your, you know, your body size and your ethnic background as well, that plays a role, you're going to then have a problem with the triglycerides as well.
How important is Omega-3s in keeping triglycerides under control?
Omega-3 has a big role to play. Um, I mean, in fact, they've even developed drugs, um, you know, around people with very, very high triglycerides, which can be genetic as well, to bring it down. Um, interestingly, the data on Omega-3 supplements is very mixed, and overall the data at the moment doesn't suggest a benefit when it comes to heart disease. It maybe other benefits for the brain, etc. I'm not denying that, but when it comes to heart disease, really the only data, best data we have, is probably through consumption of two portions of oily fish a week should bring your triglycerides down somewhat. It will probably do that as well, but the the bigger impact is going to be the sugar and refined carbs. I've not, in my clinical experience, that has the the strongest impact on getting triglycerides down.
Why?
So HDL stands for uh, high-density lipoprotein, but I I remember H for healthy.
Yes. So I want I want those up. How do I get those up?
Well, interestingly, when you do the low-carb diet, the HDL naturally goes up itself anyway. Not quite fully understand the mechanism of that. Other things that raise HDL, interestingly, are saturated fat. So it's basically—I want to be eating my butter. Can can I have cheese on my toast and eggs for my breakfast?
Well, well, well, as long as the toast is keto toast, yeah, that's fine.
Oh, I forgot about that.
Yeah, yeah, yeah. If I stin slice of toast and a nice thick slice of cheese with a fried egg on in extra virgin olive oil—extra ol—also can raise HDL, and also there's some evidence, mechanistic evidence, showing that it improves the function of HDL. And one of the, you know, I don't theory is probably undermining the the the the role, but one of the mechanisms we believe that HDL is beneficial, so—al good cholesterol—is it maybe removing some of the deposits of the, you know, the develop within the heart arteries and taking it out from the heart arteries back into the liver, and then it just, you know, gets broken down there. Um, and actually, on that point, John, my understanding now is evolved, and I've been pushing this as much as I can through different um, media, is that heart disease is not fixed. We used to think that you develop these blockages; they're fixed, and they gradually increase over time. It's a dynamic process; it's a dynamic, dynamic chronic inflammatory process worsened by insulin resistance. And therefore, if it's dynamic, it means it can—you can reduce these plaques. And of course, you know, we talked about it before briefly, but on in my movie, First Do No Harm, we went to India, and we found this cardiologist, and he's published research on this showing that meditation actually was the only independent factor that reduced the blockage, the severity of the heart heart artery blockages, which has a plausible biological mechanism now because chronic stress itself increases chronic inflammation; chronic inflammation is bad for all sorts of diseases, including heart disease. Or or I'm sure if you look at other religious traditions, you know, I mean, prayer probably does the same thing, you know, it's um…
Yes, it's it's that which allows peace in the mind. It does. And also, you know, external stresses are some are unavoidable and inevitable in life at different stages, but having a good, strong sense of community, good relationships, friends, family, that almost protects us from the effects of external stress. There's even these amazing studies done over 20 years ago, the the the original the coronavirus—it's just, you know, because coronavirus has got this bad um, connotation now, but any cold is a coronavirus, as you know—and they found that those people were—they actually inoculated people with the with the with the common cold, if you like, with the cold viruses, they inoculated them with them, and they they correlated their risk of developing symptoms and actually having a cold, which was very strongly related to loneliness and not having good quality relationships or sense of community. On the other on the other end, the ones that had all the aspects of sense of community and not being lonely and being social had um, only one in three of those people developed colds who were inoculated versus two out of three of the ones the other at the other end of the spectrum. So it's fascinating, impressive.
Yeah. But so olive oil, just to clarify, olive oil should raise my HDL?
Some, yes, absolutely, yeah. That's good. Um, HbA1c is is that something…well, it's average glucose, again the same thing, and it's really important because of course, you know, type two diabetes is is a condition associated with a reduction in life expectancy by 5 to 15 years. 70 to 80% of people with type two diabetes will develop some form of dementia. It it increases, you know, um, uh, 80% of people with type 2 diabetes will die with thrombotic complication, heart attack or stroke. It's really the one condition you want to avoid as much as possible. And again, it's related to—or certainly you can definitely send it to remission and even get out of the pre-diabetic stage by cutting out the starchy carbs on the sugar. And of course, the Hb there stands for hemoglobin; it's looking at how much sugar goes into the red blood cells, which are just there for a while. So it's it's an active marker of the past sort of six six weeks.
Trigger control.
Yeah, absolutely. So we want we want that to be low. Uh, what's what's the optimum blood pressure? Interesting one. Um, I'm against overmedication; we can talk about this as well briefly with the meds because it's important. Um, what? Ideally, less than 120 over—so for every 20 mm of mercury increase in your blood pressure over 115 systolic, there is a doubling of your risk of stroke.
Say that again.
Every every 20 mm, every 20 Mercury above 115 systolic, there's a doubling the risk of stroke.
Now, blood pressure was 115, I've got a particular risk. If it was 135, my risk of stroke is doubled?
Yes. Wow. It is, and over about a 10-year period. But what's um, interesting with the blood pressure stuff, and this applies to many medications, is that when you look at the trials, so what is considering mildly raised blood pressure, so you've got the prehypertension, which is your 120 to 140 and your 80 to 90 diastolic, all right? Then you've got hypertension, high blood pressure, mildly raised blood pressure, which goes which is above 140 over 90 up to over 160 over 100, all right? And then 160 to 180 is moderately raised; 90 to 100 is, you know, moderately raised diastolic. And then 180 over 100 is severely raised. Now, most people in this country are on pills, John, for mildly raised blood pressure, but guess what? No benefit. So the randomized control trials looked at this; Cochran did a review; you can look at this up on the NNT numbers, street.com. If you're on blood pressure pills for mildly raised blood pressure with no other very high-risk factors, okay, which is most people, they followed those people up with random control trials; it did not prevent heart attack, stroke, or death. So the question is, why? And my theory is insulin resistance is responsible or the root cause of high blood pressure to a large degree, and if you're just sorting out one issue with a pill but not sorting the insulin resistance out then you, of course, which is the main driver, then of course you're not going to get much benefit. And the more extreme levels, the very, very high blood pressure, probably is having on its own right a much damaging effect on on the blood vessels, and therefore lowering it will have some benefit, but at the milder levels, it's not going to do anything. So it is in everyone's interest to try and—and we can do this through lowering blood pressure um, with lifestyle, and I've got people coming off their pills, I mean, all the time.
So what what you're actually saying is that what what we diagnose as high blood pressure is probably just symptomatic of underlying insulin resistance?
Yes, which is largely caused by too many refined sugars, ultra-processed foods, carbohydrates. But this is really important as well: insulin resistance, there are two things going on here. One is the hyperinsulinemia, over time, excess insulin in your blood because of these starchy carbohydrate diets, kind of thing. But the other side is the cells becoming resistant to insulin. Now, that can be because of the high insulin on its own over time because, you know, anything that's over-stimulated becomes resistant, right? But there's probably separate mechanisms of the cells becoming resistant to insulin independent of the high insulin. And I think the missing linkage on is chronic stress. Interesting. So we know independently, people with chronic stress lifestyles independently are more likely to develop type two diabetes. So when you eat sugar, the pancreas is obliged to produce insulin, and that means your blood insulin levels are high, and that might be doing some damage in itself.
Yes.
But in a sense, the insulin, although it's stimulating the natural insulin receptors, over time, if they're overused, it's kind of beating them up a bit. It so you get beat-up insulin receptors; that means you can't respond to the insulin; that means your pancreas has to produce even more insulin.
Yeah, absolutely. And of course, over time, your p—and insulin itself at high levels is directly toxic to cells anyway. So the other reason why we know I think high insulin, independent of glucose, is separately harmful is if you look at the best-controlled type 1 diabetics, yeah, whose HbA1c will be the perfect levels, but need insulin because these are the ones that don't produce insulin because their pancreas stops working; they have a life expectancy 10 years shorter than average.
Yeah. So so people with t type 1 diabetes, they're not going to be insulin resistant though, are they?
No, not necessarily. So so so what we're saying is the ins—even though the glucose is well controlled—so the glucose itself is thought to be the damaging aspect of type…
That's correct. But even well-controlled type ones where the the glucose HbA1c is essentially in the normal range, yeah, they will have 10 years less life expectancy, probably because insulin itself…
So that isn't all doom and gloom, and there is—and I'm, you know, we're not obviously we're giving information here; we're not we're not advising people to do…oh heck, no, no, this is…but we find—I do find with some patients, for example, that I've managed that where who've gone on low-carb diets, they they've reduced their requirement for insulin.
Got it, right.
Which is great. So there's less insulin circulating that controls the blood glucose because they reduced the carbohydrates. So we don't have obviously long-term data on them, but it's entirely likely and plausible that it is going to be beneficial for them in the long term.
Got it. So I can increase my insulin levels because I'm not diabetic by going and eating more carbohydrates; that will increase my insulin levels.
Yeah. But someone who is type 1 diabetic who can't produce the insulin, the only way they increase their insulin levels is to inject more insulin. So if they want to lower their insulin levels long term, they have to balance that with lower carbohydrates and sugars.
Absolutely. So so if if someone with type 1 diabetes—if you're watching with type 1 diabetes—go to your doctor and and say, "Doctor, would would it help me if I lowered my total amount of insulin requirement that I have to inject? Less in. So I inject less insulin, and how do I do that, and is that going to help me long term?" That would be—and, in fact, interestingly, um, you know, there's one there's a GP in this country that's done more more clinical work and had more clinical experience in this because he's a type 1 diabetic himself, and his name is Dr. Ian Lake. So you can look him up on on the internet, Ian Lake, and uh, you know, see what he's been doing. But he's a type one who's been also managing other type ones and himself with a low-carbohydrate diet very effectively.
Interesting.
Yeah. So insulin is kind of the—I mean, if you think about it, hunter-gatherers, they're eating mostly sort of animal products and foraging for roots that are very low sugar; their insulin levels would be low.
Yeah. Well, also in our diet, John, the predominant way that we get these high glycemic index carbohydrates into our into our guts is actually through ultra-processed food, which is, you know, more than half the calorie consumption in this country comes from ultra-processed food, which are these industrial formulations, five or more ingredients, modified starches, sugar, unhealthy oils, you know, protein isolates, lack fiber, lack essential nutrients, drive overconsumption, right? Dopamine here, hyper-palatable, etc., etc. So if you get rid of those, you're already half, at least halfway there from your—it's cutting down on the other carbs as well because, I mean, I I've been looking at bread ingredients, and you know, virtually all of the bread contains emulsifiers, you know, why? You know, it makes it an ultra product; it makes it ultra-processed. Our bodies weren't designed to deal with these additives, preservatives, these thickeners, etc., which our body will treat as a toxin. And how do we treat things as a toxin in a body? We have an activated immune system; a chronically overactivated immune system is not good for autoimmune disease and for collateral damage of that overactive immune system to other cells and tissues. So we've got more than enough plausible mechanisms to—now I would say—treat ultra-processed food like the new tobacco.
Absolutely.
So um, last week, uh, Dr. Cil Dandon and me did a video on uh, flax seeds, and we found out that people that took flax seeds that they had actually a reduction of about 10 mm systolic and about four or five millim diastolic blood pressure, probably due to the omega-3 mechanisms.
Interesting.
Yeah. I know I've written about this a while back, and I do prescribe that to all my patients as well.
Oh, excellent. I'm glad…oh, that's very…in…yeah, yeah. I think the three the three foods that have had some study data on that um that are beneficial for blood pressure: flax seed, blueberries…
Yep.
And beetroot.
Yes. But blueberries are cheap in America but expensive in the UK. I think blackes—I think blackberries are probably the British equivalent of blueberries.
Right. Okay. That's because they've got the same black polyphenols in them, which of course…I know that I have I have blackberries and blueberries every day. So yeah. But of course, the fl—the flax is one thing, but the the blackberries, blueberries, and uh, beetroot, of course, they're all the blue—sorry, the blueberries, blackberries, and beetroot are all much the same color.
Yeah, yeah. So they've got the the same polyphenol in them.
Excellent. Right. What what is your um, metabolic health…you you're collaborating with Kim D…
Yeah, Kim Pent. So she's a nutritionist who's for almost two decades of clinical experience off Harley Street, you know, managing p with with their health and their weight. We've come together and created a a plan based upon my original, you know, diet plan that I've written about and published on, combined with her clinical experience. So it's been adapted and and refined, if you like, to really over help people's overall health, get their metabolic health better, get their mentally feeling better, get their sleep and energy levels better. Not just diet programs—is obviously we're advising people on other things, including stress, etc., and also providing educational content on things like cholesterol and statins. And tomorrow, John, actually, uh, I'm doing a a webinar, live Q&A, for people that join up to Metabolic Reset on statins and cholesterol because, as you may have known, a few days ago, there were headlines in multiple media outlets saying that everybody over 50 should be taking a statin, which for me, my first response is, "Are you—I'm not going to swear—kidding me?" And uh, it's a family show, so we need to we need to try and let people know the whole truth. I'm for all for informed consent. I'm not going to go there and say, "Don't take statins," and I'm going to say, "What does the independent analysis of the data tell us?" And also, John, as well, I'll explain expl why not having, you know, lowering cholesterol is probably not necessarily a good idea; in fact, could be harmful. Yeah. So I'm going to put all of this, and people can interact through the Q&A. So if people want to obviously join and and and they can cancel immediately, you know, it's it's a joining fee, whatever, you know, to start with £55 for the first month and then £5 afterwards. It's it's a community group, like kind of um, program uh, where we are in once a month doing Q&As and lives and adding educational content as well, and things like blood pressure and, you know, diabetes and lots of other, you know, we're going to have experts on sugar, etc., lots of different things going on there. Um, they can cancel straight away; they just want to come for the webinar and hear everything they want to be educated, that recorded, then they can do that and then cancel straight away. But yeah, we'll put the link for that of course at the top of the description.
Yeah, so that's great. But but you, in the meantime, you've given us all this completely for free, I seem. So thank you very much for that.
Yeah. You've got pretty much most there already, my my squiggles that I write down as as we're talking, uh, but those important words: weight, CC, comfor, tricer, waist circumference down, triglycerides down, HDL, high-density lipoprotein up, HbA1c down—we want that down, blood pressure down into the low the lower ranges of normal would be absolutely brilliant. And I I I actually think uh, that the exercise is the one that's probably good for blood pressure, particularly, I think.
Yeah, it it is. I think again, uh, there's a bliss point with exercise; you don't have to overdo it, you know