Transcription
We think about an athlete, correct me if I'm wrong with this perception, in shape, top of their game, fit as a fiddle, healthy as an ox, whatever, you know, euphemism you want to use. But what we're finding is, even if you are a really, quote/unquote, healthy athlete, you're still at risk for heart disease. Dr. Loomis, am I off base on that?
That's correct, Chuck. You know, it's interesting that, you know, cardiovascular disease is the number one killer in the Western world. And you have to remember too, that many athletes, you know, decide to start engaging in athletics even as they get older. You decide you want to run your first marathon, your first half marathon, so you might be 30, 40 years old when you start. And in those, and, and there's, you know, even though they're not professionals, they're still athletes. And in fact, everyone is an athlete in their own way. I'd like to think so. You know, if you can carry laundry up from the basement, you're being athletic. If you give your kid medal, yeah. If you give your kids a piggyback ride, you're being athletic. So, and, and, and the risk for cardiovascular starts at a very young age. We know from autopsy studies that even, you know, kids in their 10, 20, 10, 12 years old, teenagers already show, are starting to show the very early signs of athos neuroses, you know, the beginnings of atherosclerosis. So it really is a fairly ubiquitous disease in the United States. And, and but, but on the other hand, we know that that regular physical activity markedly reduces your risk for dying from heart disease over the long run.
Interesting. And Susan, I want to ask you, not just from your position as a co-author on this paper, but as a parent, here's something like that that's that's got to be alarming for you.
Well, it is. And we've even had guests in our conference talk about how looking at the arterial plaque of fetuses, which is talked about, mind-boggling. Then you're, you're so responsible for the health of that child's heart from, from the get-go. And yeah, you've got to make sure there is no pass. There is no pass for a young person's metabolism, right? Which is what people think you can kind of eat whatever you want as long as you look slim. And it goes into adulthood too, talking about athletes who run marathons, but their arteries can be clogged, and you don't even know it, 'cause you look at them and you think there's perfect health. You don't know what that person eats, and you don't know what's going on inside, right? So we hear a lot about, well, if I'm an athlete, I need protein. And that, of course, means, you know, let's, let's just get the healthy meat, you know, the chicken breast, that's your medal to athlete.
Well, what's interesting about health in general, you know, chronic disease and health and heart disease, it, at the core of all of these, most of these chronic diseases, everything from heart disease, diabetes, cancer, at the core lies inflammation. And the Western diet is highly inflammatory. And even when we eat things we perceive as healthy, low-fat milk, or lean chicken, or, you know, low-fat beef, or whatever, those things are still highly inflammatory. And, and, and, and it's this inflammation that's created that it really puts us at risk for heart, not only heart disease, but many other chronic diseases. And, and it's also interesting that exercise, intense exercise, and I'm talking about marathon and beyond, is also highly inflammatory because it creates a lot of oxidative stress. We burn oxygen for fuel, and one of the byproducts of that are oxygen free radicals. And those oxygen for your adocus can can interact with our blood vessel walls and creating the feeling of dysfunction. And they oxidize the LDL or bad cholesterol particles, which increase our risk for atherosclerosis. And that people on the other, or the extreme end of exercise may have as much heart disease risk with someone at leads a sedentary lifestyle. And then again, a lot of that we can offset that oxidative stress by the food that we eat.
Mm-hmm. And the only source of antioxidants or plants. You know, the impetus for this paper, I think, was how popular vegan diets are with professional athletes. So people who maybe they came to that because they care about the environment or compassionate about animals, but I'm guessing the majority of the, the, the line on the Tennessee Titans NFL team are actually more concerned about their performance. So they know when they eat plants and avoid animal products that they are going to be combating the inflammation that we all face, and maybe even more so as kind of an endurance athlete. But yeah, there are their performance reasons for eating this way, and it does help to be eating an anti-inflammatory diet and avoiding all those pro-inflammatory foods.
Dr. Lomas, in your career, you've had the opportunity to work with scores of professional athletes. You were the team internist, I believe, for the St. Louis Rams before they moved to Los Angeles, as well as the baseball team, the Cardinals there. Give me an idea of how the players were, stay specific to football here, week 15, 16, late in the season, how were their bodies holding up at that point?
They were sore. No, I mean, you know, that football is a very taxing on the body for a variety of reasons, not only the physical effort, but the physical contact. And now I was taking care of the team before I went plant-based ER. And, you know, I can tell you that that the perceived proper nutrition, you would go, you know, we would go on an away game and games were at noon, and we would have a breakfast spread. And, you know, it would be steak and chicken breast and pasta. Those are the three, you know, because you got to get your protein in, your carbs. And, and, and then, you know, fast forward, and you, I had the opportunity to meet some of the Tennessee Titan players through the, the upcoming documentary, The Game Changers, switch, which I'm proud to be in. And you talk to them, and, you know, the thing they noticed the most was their ability to recover week after week after week. And, and, and in fact, it's interesting when, when 20 of Morgan first went plant-based, you know, he had teammates that literally almost made fun of him. And pretty soon they notice he's having the best season of his career, he's not in the training room every week, you know, he sees he's recovering faster. And pretty soon they're coming up to him, you know, on the sly and saying, hey, now, what? Tell me again, what you're doing, because it does work. And when you talk to professional athletes, no matter what the sport, Olympic cyclists, will implicate lifters, professional boxers, long-distance runners like Scott Jurek, every single one of them says that that the performance aspect, the recovery, and the ability to show up the next day and the next day and the next day and perform at a high level and recover from that stress every day is by far the biggest change they've noticed. I remember Brendan Brazier, who does I am Iron Man triathlete professional, saying this years ago, saying, I can train seven days a week, whereas my competitors train six, because they have to take that day of rest to recover. I don't have to do that because my diet kind of does that for me. And that's why I have that competitive edge. One extra day a week over the course of year, a year, years makes you a better athlete. And I mean, I can speak to that personally. I'm celebrating my 60th birthday by trying to kill myself in July. Yeah, yeah. I'm training for my first full Ironman triathlon. And I can tell you that that my training today is more intense, and my recovery is better than it was when I was running marathons in med school, 35 years ago. Wow. And it's pretty amazing, really.
Susan, my question to you is this, is this rapid recovery time, is it more based off of the fact that the athlete is not eating meat, or is it that these plant-based foods are actually inhibiting that inflammation?
I mean, I, I see it as both. I don't, I can't imagine that you could do one without the other. You need, for the reasons we started with, you are experiencing all this stress, the oxidation, and you see need these antioxidants and the inflammation, you need those anti-inflammatory foods to support your routine. And if you don't have, yes, the absence is key, but, but you, but it's, it's a, it's, you know, you got to have. By the way, I think about this, you know, exercise in and of itself is an inflammatory condition. Okay? So imagine we eat an inflammatory diet, right? We have this low-grade fire burning in our bodies all the time. And then we go exercise, we're putting gas on the fire, right? All right. When you, we eat an anti-inflammatory diet, a plant-based diet, you, you've already got some water there. And so when you try to light the fire, it, you can't, right? Because you've already got the water there to put the fire out. And so I think that's the kind of the best way to understand it. So you've got the, the, the difference between the low-grade fire from the inflammatory foods like meat, and the water, which is the anti-inflammatory foods from plants. And that's a fairly simplistic way, but I think that's, I think that's that's the way I visualize what's happening in our bodies when we think about exercise and the relationship it has to diet.
I want to ask you another big takeaway from this paper is the increased blood flow, the boosted blood flow, I believe is how it's been termed. Just a lay question here for you, Dr. Loomis, that is important to an athlete because why?
Well, because our muscles burn. We need oxygen to make our muscles work. That oxygen comes from our blood and from our red blood cells specifically. So the more oxygen, the more blood we can deliver to our working muscles, the more oxygen we can extract, and the higher performance. And, and so a couple of things that happen when you move toward a plant-based diet. So one, the actual viscosity or the thickness of the blood is less, so the blood flows more easily. And probably just as important is the endothelial, the into the endothelium, which is the lining of the heart and controls the blood vessel dilating and constricting appropriately, becomes much more reactive, especially the under under the influence of foods that are high in nitric oxide. And foods like beets and kale and things like that. And it's been shown, there's clinical studies that have shown that for endurance athletes, if you ingest beets or beet extract, for example, before you exercise, you can see up to a 10% improvement in endurance performance. And it's probably related to the increased blood flow through an improvement in endothelial function that the beets and the nitric oxide causes.
Susan, do you know of any other food that can matter? I mean, that 10%, that's that's a big boost from beets, but what other foods would you be recommending?
Well, I think anything that has the kind of that dark color, like cherries would have the same kind of effect. And I'm sure they would just need the, the other fruit lobbyists to do more tests to see what what their foods do. But I do think that that conversation about viscosity is so relevant to even people who don't exercise, because they've done studies over and over and over again, feeding people things like, here, eat this, drink this milkshake, and eat this McMuffin, and let's see what happens. And the rear body's reaction to that immediately, and for hours on following eating that kind of food, it just gets thicker and thicker and thicker. And all your lab values start to go horribly wrong. And that's one meal. And you're talking about an American diet where we eat like that constantly, at least three meals a day plus snacks. Our blood viscosity just constantly being thickened. And I just kind of picture that as manifesting in these very lethargic people. And of course, you are like, your blood can't even move because of your diet. And it's not that study with that one high-fat meal, look what it does. And people like, oh no, it's like we have one high-fat life. Here that's how we're operating all the time. There's a great scene in The Game Changers where they take so Griff Whale, and it was an FFL wide receiver is plant-based. And so they take him and two of his teammates, and they feed him burritos. And Griff has a plant-based burrito, and his teammates have, you know, beef or chicken burritos. And they draw their blood. And then they feed them all plant-based burritos. And when they show the players the blood, the two that ate the meat-based burritos, their blood was literally milky cloudy from the fat. Wow. And so imagine, you know, that sludgy blood trying to get through your blood vessels. Griff's blood was clear. Wow. On the repeat blood work, after they all three had a plant, you know, all three of their blood was clear, right? So there was, I mean, the, the visual representation to actually see that fat so suspended in the blood was pretty eye-opening to those players.
Would that blood appear similar, that that dark and cloudy nature, would there still be that viscosity say if that that fat was coming from a plant-based source like an avocado, high in fat?
I would imagine if you ate enough avocados. But if I recall from the scene, there was avocados on the plant-based on the plant-based burritos. So not, you know, obviously you do have to be careful with the overconsumption of oils. There has been some evidence that even Hollywood small doses with transiently causing endothelial dysfunction. So so there are, you know, being vegan or plant-based, still trying to focus primarily on unprocessed foods. So in trying to avoid the edible, highly processed edible oils, highly processed sugars, highly processed grains, which are all plant-based, but but also can play a role, you know, I have to have an adverse effect on, you know, not only viscosity but also inflammation, especially with sugar.
I wanted to ask you this, Susan, before we wrap up. So we've talked a lot about ultra-endurance, we've talked about football. You've really had a chance to look at athletes from all sports. And I'm wondering like, is there one sport in particular where an athlete will really see a benefit, or is this like really across the board? You know, plant-based diet is is really going to be in their best interest, considering it's in the best interests of someone who doesn't do anything and just sits on the couch?
Yeah, across the board, it is beneficial. But I think to Dr. Loomis's point of the, the pro-inflammatory nature of really ultra-endurance exercise, those people who are doing something that feels really great and and seems like, oh, this should, this should combat perhaps even a bad diet, or it doesn't, but it actually could be dangerous if you're not eating well. I think they probably would see the most benefit, or hopefully not see the adverse effects of not eating well and of doing ultra sports. But, but again, I always, you know, most Americans don't do this stuff. They go to the gym three days a week and they, you know, they, they too need to eat well. So I just try to underscore that.
I mean, I would agree with that. And in fact, I think the ultra endurance community is the one that's most been has embraced plant-based nutrition most. It's it's a very easy sell. And, and, you know, when you got guys like Scott Jurek, or I had the pleasure mania Abby Mitchell, who's up and coming, Intel, Safley in Boulder, and I mean, on the list was Brendan Brazier, I mean, list goes on and on, Rich Roll. I mean, these guys that have, because it does lend itself not only performance, because you know, in those long races, we use carbohydrates, for example, for fuel, with primarily glycogen. And the, the, the nature of a plant-based diet is about 75 to 80% unprocessed carbohydrate. So you, you know, your gat, you, it ensures that your gas tank is full all the time. And then the recovery piece. So I think I would agree, the alter endurance folks probably benefit not only from a performance aspects but also the risk aversion, if you will, because of the oxidative, the oxidative stress they create with these very long bouts of physical activity.
With this paper, with the study, what is your big takeaway? We've talked a lot about inflammation today, but if there's one key piece that you want people to take away from this, what would it be?
Gosh, I guess because, you know, I see patients in the clinic and talk about diet all the time. And I know that half of us, half of all adults are going to succumb to heart disease. I'm always struck by the benefit of eating a plant-based diet for heart health. And there were so many components of this that led to that, whether it was, um, you know, the arterial integrity, or if it was blood flow, or just getting the plaques out of your arteries, all those benefits for your heart, they're so important to, to the non-athlete as well. To me, that's the takeaway is, is how important it is for your heart.
Yeah, I mean, I would agree. I think what's interesting is if you, if you think about the reasons that people come to plant-based nutrition or vegan diets, you know, historically, it initially was a lot of it for a lot of ethical reasons. And as the body of research built, now more and more people come through it for health reasons, and then for the environment. But, but raising awareness that there's a fourth way into plant-based nutrition through performance is real. And, and I think especially for younger, you know, athletes who maybe put, you know, may still be bathed in this bro science around protein and meat, I think showing, you know, giving them that the scientific kind of backing or permission to an understanding of how a plant-based diet can improve their performance over the long run, you know, what else does it do? Well, it's, it's ethical for the animals, it keeps them from getting heart disease, and it's good for the environment. So, so I think my takeaway is it's really about about opening up another door or avenue for people to come to plant-based nutrition that that transcends the traditional ways that we think about it. Again, if you know climate, their environment, and ethics, and health, that that performance is another pillar. And, and again, the ankle bones connected to the knee bone, right? So they're the great, beautiful thing about is not only do you perform better, but you're healthier, and you make the world a better place to live. It's such a great point.