Transcription
Hi Jeff Nelson. In this video, I'm gonna talk about how there is a small group of somewhat newer plant-based doctors who push the idea that healthy fats like olive oil, avocados, and nuts have nothing to do with promoting heart disease or other diseases.
Now, these doctors are not giving evidence-based advice. Though, they aren't using common sense in my opinion. They're offering speculation, and it's important that people recognize that.
Now, as an aside, I like guacamole and nuts as much as the next guy, and I eat them from time to time. I'm not saying that everyone should follow Dr. Ornish's or Esselstyn's program guidelines about fat, although I would recommend it if you have heart problems or want to be sure you don't develop any.
But what I want to show is that the fat-pushing plant-based doctors don't have any good science to back up their claims about these fat-rich foods. This is the first of two videos. In this video, I'm going to look at some of the science cited by three plant-based doctors who push olive oil and/or healthy fats, and I'm going to show how this is weak, commercial research studies done by people paid by the industry whose products they're studying, and it's biased, and sometimes even corrupt.
I'm going to show how easy it is to poke holes in it, and why you should do what the majority of the steam plant-based doctors do when it comes to commercial research: ignore it. I'm also going to show that the same researchers who do commercial research get themselves on two panels and committees at places like the American College of Cardiology, and then they push like hell to get the foods of their employers into guidelines so that these companies can make big money in sales as a result.
Now, let's look at some of the newer studies being touted by the olive oil promoting doctors. Who are they? One is cardiologist in training, Dr. Danielle Bilardo, who promotes keto diets. Next, cardiologist Joel Kahn, who, while he says he recommends the low-fat vegan diets of Ornish and Esselstyn to his patients with heart disease, he himself follows a keto diet. "I do plant-based keto because I know my calcium score and carotids are perfectly clean, my labs are optimal. Most don't know that, but should."
First, he's acknowledging as a cardiologist that eating a higher fat diet can be dangerous, so you'd better be sure your labs are optimal. Also, Dr. Kahn has written articles saying olive oil should be avoided. I don't know if he's changed his position, but as I'll discuss in a moment, he shows a lot of confusion on the topic.
The final doctor I'm looking at who promotes olive oil consumption is Dr. David Katz. Dr. Katz doesn't actually promote a vegan or even a vegetarian diet. He believes the Mediterranean diet is the best, and that by using moderation, you can accomplish the same results that Esselstyn and Ornish have accomplished. But to make his points, he misrepresents research, as I'll show in a moment.
So here's an example of the kind of study Dr. Bilardo uses: "Higher olive oil intake was associated with lower risk of CHD and total CVD in two large prospective cohorts of US men and women." Here's the study. The conclusion says, "The substitution of margarine, butter, mayonnaise, and dairy fat with olive oil could lead to lower risk of CHD and CVD."
So this study found that substituting margarine, butter, mayonnaise, or dairy fat with the same amount of olive oil appeared to lower heart disease risk by about 5%. Butter is 63% saturated fat, while olive oil is 14% saturated fat. So this result shouldn't surprise anyone. The average American consumes 11% of calories from saturated fat. The AHA and the ACC both recommend consuming no more than 5 or 6% saturated fat.
It turns out Americans are eating twice as much saturated fat as they should be. It says, "Current average intakes of saturated fat are 11% of calories." How can people get their saturated fat intake from 11% to 5 or 6%? Well, lose the butter, lose the margarine, lose the mayo, lose the dairy, and lose the olive oil. You can't reduce your saturated fat intake from 11 to 5% by eating a product that is 14% saturated fat, like olive oil.
Now, this olive oil study really has nothing to do with anyone eating a healthy plant-based diet. Maybe Dr. Bilardo has a lot of non-vegans following her, which is why she would host it, but it's not relevant to vegans. We don't eat butter or mayo or animal products, like the people being studied. They got some very small benefit by giving up unhealthy foods for a less unhealthy one.
It's worth mentioning. See the researchers on this study? You may recognize them if you watch my videos on nuts and oil. These are many of the same guys that I've named before who've done study after study for the olive oil and nut industries. This is a who's who of corporate research. It's the Harvard team of researchers for hire. And Dr. Frank Hu, he's the nut and olive oil researcher whose lab assistants are paid for by Unilever, the big food and beverage corporation. He does a lot of work for them.
There was an uproar in the British Medical Journal about this because the potential for bias is enormous when a big food company is paying for overhead. But this is just how corporate science works. Dr. Frank Hu recently said in the Washington Post that researchers should be looking at dietary patterns rather than single foods or nutrients. So he basically admits in this article that studies of just one food don't really give us very useful or even necessarily accurate information. He says dietary patterns are what actually counts.
But even though he acknowledges this, the majority of the research that Dr. Frank Hu does is on just one food, paid for by the company that sells that food. Commercial science isn't real science. And to learn more about this, I recommend you watch my one-hour interview with Marion Nestle called "Food Companies Can Buy Research Results."
Now, here's Dr. Kahn. He's promoting another high-fat keto food: "Avocados a whole avocado every day helps cut cholesterol and could be the secret to a healthy heart, study claims." So this study showed that people eating an avocado a day lowered their LDL cholesterol levels by around 10%.
When you look at the study, it was paid for by a grant from the Hass Avocado Board, and the senior researcher who designed and managed the study is Penny Kris-Etherton, a member of the Hass Avocado Nutrition Science Advisory Board. A lot of these researchers are on staff for the nut and olive oil and other industries. And even if some of them don't get paid for serving on a committee, they get flown round to resorts for meetings, getting these all-expense-paid vacations in addition to being paid to do studies.
So this is commercial research. This avocado study was a randomized crossover controlled trial of 45 overweight and obese people. They tested three diets: a so-called low-fat diet (24% fat), a medium-fat diet (34% fat), and a medium-fat diet with an avocado. These three diets were all compared against an average American controlled diet. The medium-fat diet that didn't contain avocado had sunflower oil and canola oil instead to try and equalize the fat and calories.
So right off, methodologically, this study is highly flawed. Looking at Figure 1, it shows researchers took the baseline blood samples for analysis here at the start of the trial. Then they randomized people into the three diets. Then they took blood samples for analysis at the end of each diet period. Between each diet, they took a two-week break and followed what they called a compliance break diet. They don't tell us what participants were eating in the compliance diet. We have no way to know what they ate and how it might have affected the results.
But what they did was to compare the values from this one initial blood test at the start with each of the results at the end of the three diets. At the end of five weeks, again, there's no way to know for sure how the compliance break diet they went on before each five of the five weeks diet was influencing these numbers. What was the actual cholesterol at the start of each diet period? We don't know. So that introduces a huge amount of bias. We don't really know what the change was from the start of the diet to the end. They didn't measure before starting each diet.
And answer that, we know soluble fiber lowers LDL cholesterol. For example, the National Lipid Association says eating 5 to 10 grams of soluble fiber a day can help lower total and LDL cholesterol by 5 to 11 points, and sometimes more. There's a lot of research showing this. And look at the difference in fiber in each group. The control diet had 17 grams of fiber, while the avocado diet contained 35 grams of fiber. That's more than twice as much fiber as the control diet. The avocado diet had lots more fiber than the other three diets.
Looking at Table 5, LDL cholesterol decreased from the control down to the avocado diet, and the amount of extra fiber in the avocado diet could explain the entire lowering of cholesterol. So this study is a joke. They didn't control for fiber. Plus, the control group consumed 13% saturated fat, while the avocado group had only 6%. So that could also help lower the avocado group's LDL by comparison.
But this is a typical commercial study trying to isolate one food and then setting up a study to get a specific outcome for marketing purposes. You could do this same study but substitute broccoli or oatmeal instead of avocados. Put one of those foods in versus canola and sunflower oil, and you get an even better cholesterol-lowering effect without all the extra calories or fat from the avocado.
Now, the final doctor, Dr. David Katz. He's a doctor at Yale who runs an organization called the True Health Initiative. I'm going to give full disclosure: Yale gets a lot of money from the olive oil industry. They put on symposiums, they get a lot of money to plug olive oil. So let's take a look at Dr. Katz's recommendations.
This is a very recent article by Dr. Katz: "How much fat should we have in our diet?" Dr. Katz starts out by citing the programs of Ornish and Pritikin. Then he writes, "The most restrictive diet, whole food predominant, plant exclusives, low in total fat (less than 10% of calories), and thus exclusive of both high-fat whole foods and nuts, seeds, olives, avocados, and extracted oil, can do great things for health. Such a diet has been shown to cause regression of atherosclerosis plaque."
Then he goes on to say that we don't really know for sure what role olive oil might have when it comes to reversing heart disease. He admits there's not much evidence showing that it helps. But then he writes, "Absence of evidence is not evidence of absence." That's pretty much the state of the science regarding dietary fat content and coronary plaque.
"Studies using higher fat diets, notably a Mediterranean diet in the Lyon Diet Heart Study, have shown much the same reduction in heart attacks and death." So Dr. Katz is claiming that the Lyon Diet Heart Study showed "much the same reduction in heart attack and death" as the Ornish and Esselstyn diets. Is he correct? No, he's not.
Now, this is sort of comparing apples to oranges when Dr. Katz is comparing one type of study, the Lyon, to studies like Dr. Esselstyn's and Dr. Ornish's. In the Lyon, they took 600 people who had had a heart attack. Half got the American Heart Association Step One Prudent Diet, the other got the Mediterranean diet. The Mediterranean diet had better outcomes for heart disease versus those on the AHA diet.
Here's Figure 3 from the Lyon study. This experimental group is the Mediterranean diet, and this is the control. It's the standard AHA diet. And this line represents how many people in each group had no major cardiac events as time went forward. How many were free of having a heart attack or a stroke and China trips to the emergency room and so on. By year 5, the control group here, it looks like about 58% of people in the control group didn't have any further heart problem. So that means 42% of the control group did have a recurrence of heart problems.
People eating the Mediterranean diet, they did better, and by year 5, about 75% had not had any major cardiac problem. So about 25% of the people following the Mediterranean diet did have a recurrence of heart problems within 5 years. So obviously, the Mediterranean diet was better than the AHA diet.
Now, let's compare this to Dr. Esselstyn's diet. This study is where Dr. Esselstyn's team followed 198 consecutive patients who went on his low-fat, no-oil diet. 177 of the participants were adherent, meaning they followed the diet. And at the end of almost four years, there was only a 0.6% rate of heart attack, stroke, or death. There was one person out of 177 following Dr. Esselstyn's diet who had a problem, an individual who had a small stroke.
So the Lyon study, we know people were following the Mediterranean diet had a 25% recurrence of cardiac problems. One in four people experienced a serious problem. But the low-fat plant-based diet, less than 1%, less than one in a hundred people had a problem. So that's 25% of people eating a Mediterranean diet had a serious heart event, but less than 1% of the people eating the low-fat plant-based diet had a problem.
How many major cardiovascular events (death, heart attack, and stroke)? Here is the Mediterranean Lyon Diet Heart Study: 25%. Look over here. Treating the causation. Here we are: six tenths of a percent. Over a 30-fold difference. What is the difference? Why can't everybody do that? All we're doing that's different, we're treating the causation of the illness. Okay. The Esselstyn diet is more than 25 times lower in serious heart recurrence compared to the Lyon.
So when Dr. Katz wrote, "Higher fat diets like the Mediterranean diet in the Lyon Diet Heart Study have shown much the same reduction in heart attacks and death as the 10% fat Esselstyn diet," that's completely false. The low-fat plant-based diet has much, much better outcomes for preventing heart attacks, death, stroke, and China trips to the hospital, and every other cardiovascular measure than the Mediterranean diet, any way you cut it. And there are a number of ways you can try to compare the results of these two studies since they're different methodology and different end points. For example, 5% of people following the Mediterranean diet died during the study. No one following the Esselstyn diet died. Esselstyn had a 93% reduction in angina. The Mediterranean diet had a much smaller reduction, and so on.
But anyway you run the numbers, Dr. Esselstyn's diet kicks butt over the Lyon. So there's really no comparison. Dr. Katz is mistaken and misinforming his readers when he asserts that they're comparable.
And here, it might be relevant to mention that Dr. Katz receives money from two olive oil marketing associations. It's shown on his website: the North American Olive Oil Association and the Olive Wellness Institute. His partners in the venture receive millions of dollars from the oil and nut industries. A recent article published in the Journal of the American Medical Association discussed Dr. Katz's financial ties to the food industry. Basically, Dr. Katz had been observing that some pro-meat research was done by researchers with financial ties to the meat industry, and I agree that's a very relevant point to make.
And this article pointed out that Dr. Katz was basically the pot calling the kettle black. But what has for the most part been overlooked is that Katz and THI (that's Katz's organization) and many of its council members have numerous industry ties themselves. The difference is that their ties are primarily with companies and organizations that stand to profit if people eat less red meat and more plant-based diet. Unlike the beef industry, these entities are surrounded by an aura of health and wellness, although that isn't necessarily evidence-based.
So I basically agree with this. It's one group of hired hands for the meat industry up against a group of hired hands for the olive oil and nut industries, among others. And they're both, to varying degrees, you know, being selectively cherry-picking and using weak data because that's what food companies expect. So buyer beware with these kinds of outlets.
An article just last week mentioned Dr. Katz's links to big industry. He was once paid $3,500 an hour as an expert witness in a Chobani legal case to defend the sugar contained in yogurts, and he apparently got a $731,000 grant from Hershey's to study diabetes, and a whole lot of other money from the food industry. He's a very intelligent, articulate, and charismatic person who's carved out a lucrative niche in being a paid expert for food companies.
Also, the Lyon Mediterranean diet used canola oil as a substitute, by the way, not olive oil, in many things. We look at this study. It notes, "Because the participants would not accept olive oil, traditional to the Mediterranean diet, as the only fat, a rapeseed canola oil-based margarine was supplied free for the whole family to all experimental subjects." So study participants received a canola oil-based substitute rather than olive oil.
Canola oil isn't healthy, but it's certainly better for your heart than olive oil. It's much lower in saturated fat. It has a much better omega-6 to 3 ratio. In fact, Ornish has written extensively about how canola oil is healthier than olive oil. In this article, he wrote, "Studies comparing the effects of canola oil versus olive oil show the canola oil consumption results in lower LDL cholesterol levels." This is not surprising, since olive oil contains approximately 14% saturated fat, whereas canola oil has much less. It's clear that olive oil is a healthier fat than many others, but not as healthy as canola or fish oil.
Dr. Ornish goes on to cite research. A study by Dr. Robert Vogel in the Journal of the American College of Cardiology found that olive oil significantly reduces blood flow to different parts of your body, whereas canola oil and salmon do not. This measure of blood flow, called flow-mediated vascular dilation, is a standard, well-accepted test by the American Heart Association and others. In this study, blood flow was reduced by 31% after an olive oil meal, but was not reduced by a meal with a similar amount of fat from canola oil or salmon, probably due to the higher content of the protective omega-3 fatty acids in canola oil and salmon.
So you can see Dr. Katz is grasping in his attempt to defend olive oil and a higher fat diet. He misstates the results of the Lyon to make them sound as good as Dr. Esselstyn, and he pushes the Lyon as an example of olive oil when it's the healthier, or less unhealthy, canola oil being used for a replacement effect. He also ignores these well-accepted flow-mediated dilation tests which document how olive oil harms your arteries.
Oil-pushing doctors often invoke the PREDIMED study. The PREDIMED was a study paid for by the nut and olive oil industries, and it was done by many of the same group of olive oil and nut industry-funded researchers who do a lot of this research. Several researchers who did the olive oil study that Dr. Bilardo was tweeting about also did the PREDIMED. And this is how it works, according to research from Professor Marion Nestle: Any researcher who gets money from the food industry to do a study, and then the study fails to get the results that the food company wanted, that researcher will never be hired to do a study again for that company.
The three researchers who want to be hired again and again and again, they just have to be sure the company gets the positive results every time that they want. So this is just science for advertising purposes.
So the PREDIMED study was actually retracted by the New England Journal of Medicine a couple years after it was published because it was a mess. They couldn't actually fix all the errors when they republished it, but it's a commentary on the poor level of peer review here that none of the peer reviewers caught the many problems that led to retraction. I've come to believe that peer review can be totally meaningless.
PREDIMED, in a nutshell. The researchers designed the study with three diets: the Mediterranean diet as a control. It was between 37 and 39% of calories from fat, and they called it the low-fat diet. Now, the fact that the olive oil researchers got away with calling a 39% of calories from fat diet a low-fat diet, again, it shows the extremely low quality of the peer review of this study. The second diet was the same diet but with more olive oil added, and the third was the same diet but with more nuts added.
They recruited about 7,000 participants, and the main requirement to be in the PREDIMED study was that you couldn't have any signs of heart disease. So they took people with no heart disease, put them on these three diets, and then followed them for about five years. The major finding at the end was that all three diets caused enormous heart disease and death.
Here's a table showing the three diet groups, and it shows that the number of heart attacks was statistically the same between the three groups. The number of deaths from cardiovascular causes was statistically the same. The number of deaths from any cause was statistically the same. The only difference was in the rate of strokes, and in the nut and olive oil group, there were a few less strokes each year per 1,000 people. But remember, between all three groups, the number of deaths from cardiovascular disease was statistically the same.
There are some important takeaways from PREDIMED. These are diets no one should be following who's concerned about heart disease. These diets don't prevent heart disease. They took people who were well and had no heart disease and made many of them very sick and very dead with heart disease. The other takeaway message is how do the nut or olive oil industry-funded researchers, who have been entrusted with this study, how do they interpret it? And they claim that PREDIMED is a huge success. They say, "Hey, even though all three of these diets caused hundreds of deaths from heart disease in people who didn't have heart disease, there were slightly fewer strokes in the high nut and high olive oil diets compared to the control diet, and that means olive oil is heart-healthy."
Okay, but don't be fooled by this. For people interested in using a plant-based diet to prevent or reverse heart disease, the PREDIMED is completely irrelevant. Adding more nuts or olive oil to a Mediterranean diet that is already causing heart disease in healthy people is like rearranging the deck chairs on the Titanic.
The other point: PREDIMED researchers work to get themselves onto government committees and expert panels and medical organizations, and then lobby like hell to get their commercial research accepted. There. We know this happens. On recommendation committees for statins, for example, in 2013, when the AHA and the ACC released new guidelines, those guidelines dramatically enlarged the number of people recommended to take statins. Who benefited by this advice? The drug companies that sell statins, of course. Lipitor is the most profitable drug ever sold.
Rather than use a cholesterol number to determine if you need statins, the panel came up with a formula for risk that includes things like age, blood pressure, diabetes, and so on. And they decided that if you had a risk of 7.5% or greater of vascular disease in the next 10 years, you should be prescribed a statin. And that meant overnight, millions more Americans would be recommended to take statins based on no new research, just based on the opinions of the panelists.
Now, in the UK, you need a 20% or higher risk to be prescribed statins. Everyone is looking at the same data. Why did the US Heart Association's do this? It turns out more than half the doctors on the panel who came up with this new recommendation had current direct ties with the statin manufacturers. That is, they did research, worked as consultants, and/or received money for personal research from these statin companies. And some had ties in the recent past, which they didn't have to technically disclose. But if you watch my interview with Marion Nestle, she describes the research that shows that 30 to 40% of researchers don't disclose money they receive from corporations. My feeling is that once a researcher has been tainted with a conflict of interest, they can't really be trusted to be free of conflict, even if it's been a year or more since they got the money.
Dr. John Ioannidis, a well-known Stanford physician-scientist and writer who has made contributions to evidence-based medicine, epidemiology, and clinical research, wrote an article in JAMA when the new statin guidelines came out, calling them "the statinization of the planet." Statin studies are often funded by statin companies, and they use commercial research gimmicks. For example, here's one that was called the Heart Protection Study, where, without going into too much detail, they recruited 32,000 people for the study. Before it started, they gave everyone a 40-milligram statin dose every day for four to six weeks. A lot of participants had bad reactions to the statin, so they kicked them out. 12,000 people removed during this run-in period, and then they started the actual study with just 20,000 people.
And this is why we see wildly different rates of side effects when people are on statin treatment in real life than we do in studies like this. They've removed 36% of the participants before they randomized and started the study. 36% of people couldn't tolerate the statin, but in the study, they show a much lower side effect rate. This helps explain why 50% of people prescribed statins have stopped taking them within a year. And many cardiologists aren't even aware of how this research is done, especially young ones with little experience who just accept what the medical industrial complex puts out.
Obviously, there are times when statins are appropriate and should be prescribed, but the drug companies are basically put in charge of these panels because the people on the panels work for them. You get recommendations geared for Big Pharma's bottom line, not based on solid, unbiased research. And we see the exact same thing in nutrition recommendations.
The oil pushers love to cite a 2017 paper with nutrition recommendations that was published in the Journal of the American College of Cardiology. The ACC. A number of plant-based doctors were able to participate in this paper to help make better nutrition recommendations, which is terrific. Doctors like Neal Barnard, Caldwell Esselstyn, Dean Ornish, and Kim Williams. Also on the ACC nutrition panel were people like Emilio Ruse. Mr. Ruse is key researcher responsible for the PREDIMED study and countless other paid for by the nut and the olive oil industry. Here, he was on the steering committee and was a principal investigator of PREDIMED, and he gets money from the International Nut Council and the California Walnut Commission, where he serves on their scientific advisory committee.
Here's Penny Kris-Etherton on the same paper. She did the avocado study that we just looked at, where they used fiber to lower LDL and make it look like it was the avocados. They list some of her conflicts: California Walnut Commission, Hass Avocado Advisors, Seafood Nutrition Advisory Council, McDonald's Global Advisory Council, Tara Via Board, Canola Oil Council, McCormick Spice Institute, National Cattlemen's Beef Association. She's done what looks like an enormous amount of commercial studies, like Amelia Ruse, and is getting money from these food companies. And conflicts matter.
And although Doctors Esselstyn, Bernard, and Ornish all are opposed to oils, including olive oil, for heart disease, they weren't able to get that recommendation excluded. Did Amelia Ruse and Penny Kris-Etherton recuse themselves and say they wouldn't participate in decisions where they had a clear financial conflict, or did they press to have their employers' foods included? What do you think?
One thing I'm certain of: the olive oil industry knows what it's doing and gets its money's worth when it hires these researchers. One thing that Dr. Kahn has done repeatedly is to take the nutrition guidelines from the ACC and try to make a big deal out of the fact that Esselstyn, Nutrition, Bernard's names were on these recommendations, which included recommending olive oil as heart-healthy. Here we can see a recent tweet: "Doctors Esselstyn, Ornish, and Bernard authored this recent... it is what all cardiologists read and are taught. They see the recommendations and they often follow them." And he highlights the part that says, "Extra virgin olive oil reduces some CVS outcomes when consumed in moderate quantities." He wants people to think that Esselstyn, Ornish, and Bernard endorsed that particular statement.
Now, Dr. Kahn knows very well that these doctors are clear that they are opposed to olive oil, and that on a big committee, you can't get your way on everything, and they don't endorse this part. Despite knowing that, Dr. Kahn continues to invoke their names as if they support it. The intent by Kahn, I believe, is to sow confusion. Otherwise, if he actually believes oils are unhealthy, he would be using this knowledge to explain to Bilardo and any others who could be misguided that these well-known doctors do not agree with this part of those guidelines, and that he doesn't either. Unless he does.
But the point is, you can't rely on ACC nutrition recommendations. They've improved over the years, but still have a ways to go due to a commercial bias. Research that isn't profit-driven is what counts. A lot of these medical organizations have panelists relying on studies designed to increase some food company's bottom line. And it's not like the research of someone like Dr. Dean Ornish, for example.
Consider following the example of someone like Dr. Kim Williams, who was president of the American College of Cardiac Cardiac and guidelines. He himself said he was eating the ACC heart-healthy diet of no red meat, skinless chicken breasts, and so on, but his LDL was still very high at 170. Dr. Williams had a very sick patient, he says, who came in for an appointment, and he was surprised to see that her scan that day was normal without her having had any intervention. And he realized that she had reversed her heart disease. Dr. Williams found out the patient had gone on Dr. Ornish's diet, and ultimately, he changed his own diet.
So obviously, the ACC guidelines are not actually the final word on heart health. At least they weren't for its president, who is impressed by Dr. Ornish. Dr. Ornish even put his diet against the American Heart Association diet in a study. The AHA diet was the controlled diet, and Ornish proved that his low-fat plant-based diet is better.
So be careful where you get your information. If you want to know what the leading plant-based physicians feel about oil, I recommend reading Dr. Esselstyn's paper. A paper he didn't co-author with anyone else and didn't have to compromise on with some food industry-funded researchers. It's called "Is Oil Healthy?" Dr. Esselstyn reviews human and animal studies and explodes the myths around olive oil. This table, for example, summarizes studies on animals and humans showing atherosclerosis can be created by olive oil. The last four are studies on humans, all showing impairment of arteries by oils, and especially olive oil.
The bottom line: Don't look to organizations like the ACC or the AHA to be some kind of final word or even have the best advice. They don't. Some doctor telling you that, "Oh, I follow all the ACC recommendations to the letter," that should probably be a warning that you have a cardiologist who may not be good at critical thinking. Look for a plant-based doctor, if possible, with wisdom and experience, who follows true evidence-based medicine, which isn't only trying to identify the best research evidence to take into account, but also assessing the doctor's clinical expertise and the patient's values, preferences, beliefs, circumstances, the patient's needs, and expectations. It's about making a shared decision between doctor and patient on the appropriate treatment pathway to maximize that patient's health outcomes. But stay away from doctors who want you to believe that they're God and throw around the word "science" as if they know everything, and that everything in the guidelines is the law.
Okay, that's it for today. In my next video, I'm going to talk about the long history of research on plant-based diets, and you're going to see that there are a multitude of studies that have looked at giving people higher fat diets comprised of healthy plant fats, not animal fat or saturated fat, and you're going to see that these diets caused heart disease in the same way animal fats do. Thanks for watching. Please share your comments and give this a like if it's the kind of content you like. I'll see ya on the next one.