>> Dr. Terry Simpson: Long before statins, long before stents, when

heart disease was the number one killer, it was four

times more deadly than it is today.

Part of that is because we had no real treatments. No

statins, no stents, no bypass

surgery. And so food was the best

medicine we had. In the

pharmacies of Rome and Greece, they even kept

extra virgin cold pressed olive oil on the

shelves for patients with what they called hardening of the

arteries. Doctors would send people down to pick

up a bottle almost like it was a prescription.

And then research began to notice something else.

In certain parts of the world, small towns

and villages around the Mediterranean, for example,

people seemed to live longer with far

less heart disease. It wasn't genetics,

because their cousins who moved into the cities

eating a westernized diet developed heart

disease much earlier. Those scientists didn't

stop there. They followed not just

Mediterranean villages, but other small

villages around the world where people ate

traditional foods, often those same patterns

for generations. From Finland to Japan,

they tracked adult men for decades

and saw a striking difference. In places

where diets were rich in saturated fats, arteries

clogged early, and heart disease was common in

places where diets look like what we now call the Mediterranean

diet. High in fruits, vegetables, olive oil, legumes, and

fish, heart disease was rare

at the time. Diet was our only

weapon. It gave us a clue and it

gave us hope. I know this

literature well, and while you won't often hear it

promoted on social media because saying eat this

way doesn't sell a lot of supplements, the

evidence is solid. Eating this

way decreases your risk. But it

is nothing like the therapy we have

today. Food is important. It's

empowering. It's the thing you as a patient

can do every day to change your health.

And we cannot ignore it, because here's one.

Bad diet filled with ultra processed food and

saturated fat accelerates

atherosclerosis, drives heart disease, and raises

the risk of cancers. And that's

what today's episode is about.

Why it's not food as medicine, but food

and medicine together. And why

salmon is. No matter how good it tastes,

salmon is in a stent.

Today we're going to make sense of the madness of diet and

heart disease.

I am your Chief Medical Explanationist, Dr. Terry Simpson,

and this is Fork U Fork University,

where we bust a few myths, make sense of the madness,

and teach you a little bit about food and medicine.

The Mediterranean diet, if you've been following my podcast for a

while, isn't one single thing. It is not

from one single area. It's a pattern Lots of

fruits, vegetables, legumes, nuts, olive oil, whole grains,

fish, little red meat, modest dairy

and wine in exceeding moderation.

It's not a fad, it's based on real

populations. And we have decades of data showing it

improved cardiovascular outcomes.

One of the most famous studies was the Lyon Heart Study.

This randomized secondary prevention trial took

patients who already had their first heart attack and

randomized either to the Mediterranean style

diet or or what the French called

a prudent cardiac diet.

And here's the timing. This study took place just as

statins were coming onto the market. So while doctors were

beginning to prescribe cholesterol lowering drugs,

Lyon showed that diet itself could also

have a dramatic effect. And the results were

stunning. Over about four years, the Mediterranean

diet group had a 70% reduction in recurrent

heart attacks or recurrent cardiac

events. This wasn't just better

cholesterol numbers, it was fewer heart attacks

and fewer deaths. It was a combination of lower

cholesterol and less inflammation. But let's be clear,

those patients were highly motivated and this was

carefully constructed study. They weren't just

eating salmon once a week. Their entire

dietary pattern changed. And you can

imagine Lyon, France changing

from butter to olive oil wasn't always

an easy sell. Later,

in larger studies, like what we call the predimed

trial in Spain, confirmed the benefits in

high risk but otherwise healthy individuals. The Mediterranean

diet lowered rates of heart attacks, strokes and cardiovascular

deaths by 30%. That's

impressive. It proves food matters, but it's

not magic. While those relative

risk reductions are large, the absolute numbers are

still smaller than what we see with medications in high risk

groups. And here's the can you

sustain it? When we talk about dietary adherence,

we usually mean people are able to stick with it 70% of the

time or more. That's good. It's not

perfect because we're not perfect. I'll give you a

personal example. I follow the Mediterranean diet with

pretty strong adherence. But I also have

hypercholesterolemia with a strong family

history of heart disease. Even with my diet, I could

not get my low density lipoprotein, my

LDL or below 180. But with

two drugs, Xedia and Crestor, my

LDL is now in the 40s. That's the difference.

The Mediterranean diet is powerful, but for some of us,

especially those with genetic risk, food

alone isn't enough.

Let's talk about the PISA Heart Study, which stands for

progression of early subclinical

Atherosclerosis. It adds another layer of our

understanding. This was a long term project

launched in 2010 by the Spanish national

center for Cardiovascular Research and Santander

Bank. They followed middle aged adults who

felt perfectly healthy. Using advanced imaging,

researchers found that more than 60%

already had measurable plaque in at least

one artery. The lesson

Atherosclerosis begins silently.

Decades before symptoms, it tracks

directly with APOB and LDL cholesterol. The

Mediterranean diet can slow that progression and

statins can dramatically reduce it. But by

the time you're waiting for the stent, the disease has

been smoldering for years. When you

see these young men on the Internet

claiming that they can eat whatever they want because they're

metabolically healthy, they are slowly

layering atherosclerotic plaque down

into all of their arteries and you won't manifest it

for years to come. Now let's compare that to

medicine, and we're going to start using what's called the Jupiter

trial, which looked at Rosuvastatin Crestor, the

medicine I take, and it looked in people with

normal LDL cholesterol but elevated

C reactive protein, which is a marker of inflammation.

The trial had to be stopped early because the benefit

was so strong. Rosuvastatin reduced major

cardiovascular events by 40.

And unlike a diet study where adherence is hit or miss,

all you had to do was take a pill.

So while the Mediterranean diet lowered events by 30%,

statins cut that nearly in half. And it did it

in people who didn't even have high

cholesterol. And then there's the

Dean Ornish program. You probably heard people say that

the Ornish diet reversed heart disease, but here's

the nuance. It wasn't just a diet.

Yes, it was very restrictive, very low fat,

vegetarian style diet. But participants also

quit smoking, took statins, took blood pressure pills

and did something I love yoga. So was

it the food? Some of it, sure. Was it the medicine?

Absolutely. Was it the stress reduction and lifestyle

change? Without a doubt, Ornish deserves

credit for showing that lifestyle matters. But let's not

pretend his diet alone

unclogged arteries. It was food and

medicine, not food as

medicine.

Which brings me to the scam portion of my

podcast, because I have to have that.

Barbara o' Neill from Australia has no medical

education and has been banned from giving health advice

in her country and yet travels around the world

charging thousands of dollars for her seminars.

One of the things she claims is that cayenne pepper can open your

arteries and stop a heart attack in its tracks.

This is complete fiction.

There is zero evidence that cayenne pepper

prevents treats or Reverses heart attacks. None.

Cayenne is a spice. It makes chili taste better.

It might make your nose run, but it will not

reopen blocked coronary arteries.

My God, if it did, we would be using it in

every hospital in the nation. She claims that the cholesterol

guidelines were lowered just to make money for drug companies.

Really? Because my three month supply of

rosubastatin cost me $2.36.

Meanwhile, Barbara O' Neill charges thousands for her seminars.

Tell me again who's profiting here? And

here's the kicker. She denies that APOB and LDL

cholesterol are the primary drivers of atherosclerosis,

which every major cardiologist society in the world, from

the American Heart association to the European Society of

Cardiology, agrees that APOB is

the causal agent of atherosclerosis.

Barbara o' Neill's denial isn't science, it's

salesmanship. And Barbara o' Neill belongs in the same

category as the shirtless salesman hawking mango

flavored salt packets. She isn't offering help.

She's selling false hope dressed up as empowerment

and charging dearly to do it.

Now let's make this real. If you're in the middle of a heart attack,

grilled salmon is not going to open your artery either. That's what

stents and bypass surgery do. Food

prevents disease greatly, but not

completely. Medicine and procedures treat it

and can help sometimes reverse it. The tragedy is when

people confuse the two. Thinking olive oil replaces a

statin or nuts replace a stent. They don't.

The Mediterranean diet is the most evidence based

eating program we have for cardiovascular and many other

types of health. It reduces events, improves survival

and it tastes good. But it does not replace

medicine. The Lyon and Predimed studies

show us that food can lower risk by 30 to 70%.

The Pisa study showed us that plaque forms silently long

before symptoms. The Jupiter study showed us that statin

lowers events by nearly half. And Ornish showed us that

lifestyle works, but only with medicine alongside

it. And when a heart attack hits, only

stent and surgeries save lives.

The truth is simple. Food is the foundation.

Medicine is the reinforcement. Together

they're unbeatable.

This has been episode three of Food is in a Prescription

Pad. Next time, when beans aren't metformin. How

legumes lower blood sugar and not like medicine.

I'm Dr. Terry Simpson, your chief medical explanationist.

Remember, salmon is delicious, but it is

not a stem. Forku is

produced by producer Girl Productions and

it is advertised out through the world and all

things audio from Simpler Media and my good friend the paw

God, Mr. Evo Terra. For references and

more, please visit your doctor's orders and

forku.com and don't forget to

check out my newsletter on Substack, where I dive into

deeper times with these topics. And here's the

disclaimer. I am a board certified physician,

but I am not your physician. This

podcast is for education, not for personal

medical advice. Please talk to your Western trained

board certified doctor and a dietitian before making any

changes that will affect your health or your diet. Because

we want you to be around because we have a lot more

episodes to go.

All right, everybody, have a good week.

Enjoy your salmon. I like mine baked.

Hey, Evo, you know these people who think if

you put enough olive oil on a salad, you'll avoid a

statin or stent? That's like thinking sunscreen

protects you after you've been burned. Food helps prevent the

fire, but medicine turns that out. And as for cayenne

pepper, that's seasoning, not surgery. Anyone

charging thousands otherwise is a scam artist. I'm going

to stick with the salmon. Maybe I'll put some cayenne pepper and olive oil on

it. And my $2.36 statin.

Anyway, hey, buddy, I'm kind of wondering what food

you're up to these days because, hey, we got about

900 more episodes of fork you to go before, uh,

you know, we have to get a stent.

Wait, wait, wait, wait, wait. You put crestor

on your salmon? Man,

physicians are

weird,

Sam.