Health Longevity Secrets

Heart Surgeon: It's Not Cholesterol — It's Metabolic Health | Philip Ovadia MD

• Robert Lufkin MD

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0:00 | 47:17

A cardiac surgeon who's performed thousands of open-heart operations says most of his patients didn't have to be there — and the culprit isn't cholesterol, it's metabolic health.

In this episode of Health Longevity Secrets, Robert Lufkin MD sits down with Dr. Philip Ovadia, board-certified cardiac surgeon and author of the new book "Stay Off My Kitchen Table." Once morbidly obese and prediabetic himself, Ovadia lost nearly 100 pounds and rethought everything he was taught about heart disease. He explains why "meat is medicine," how red meat got vilified by bad science, what really drives heart disease, and how his nationwide telehealth practice is rebuilding primary care around metabolic health.

Chapters:

  • 00:00 — Introduction
  • 01:34 — Why a Heart Surgeon Wrote "Stay Off My Kitchen Table"
  • 04:54 — Do You Need to Eat Meat? Nutrient Density and Bioavailability
  • 07:30 — Meat Is Medicine: Why Red Meat Was Vilified
  • 09:38 — How Bad Epidemiology Made Meat the Villain
  • 12:43 — Red Meat Down 40%, Heart Disease Worse: What That Tells Us
  • 14:23 — Ovadia's Own Journey: Obese, Prediabetic, and Gary Taubes
  • 15:54 — Why Medical Schools Resist This (and What's Changing)
  • 19:01 — RFK Jr, Trump, the New Food Pyramid and realfood.gov
  • 21:38 — Leaving Employed Surgery for a Telehealth Practice
  • 25:24 — Metabolic Care Beyond the Heart: Building Primary Care
  • 31:38 — What Telemedicine Patients Actually Experience
  • 37:01 — It's Not Just What You Eat — It's What You Absorb
  • 38:50 — Gut Health, Anti-Nutrients, and the NAD Supplement Problem
  • 42:37 — Best Wearables: Why the CGM Tops the List
  • 44:11 — Empowering Patients to Take Back Control

Key takeaways:

  • Metabolic health — not cholesterol — is the primary driver of heart disease, and most heart surgery is preventable through diet and lifestyle.
  • "Meat is medicine": red meat was vilified largely by poorly done epidemiologic science layered with political and economic interests.
  • U.S. red meat consumption has fallen ~40% since the 1950s–60s, yet heart disease has gotten worse — strong evidence meat isn't the cause.
  • It's not just what you eat, it's what you absorb: gut health, bioavailability, and plant anti-nutrients all shape your results.
  • The continuous glucose monitor (CGM) is the single most powerful wearable for understanding how food and lifestyle affect your metabolic health.

Studies & sources:

Dr. Lufkin's book "Lies I Taught in Medical School": robertlufkinmd.com/lies

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Your Daily Choices Shape Health

SPEAKER_03

But the reality is that we as human beings, we have the ultimate power over our health. And the decisions we make every day about what we eat and what we do, those are the most empower, those are the most important determinants of our health.

SPEAKER_00

Welcome back to the Health Longevity Secrets Show, where we push the limits of human potential and unlock the secrets to our health and longevity with your host, Dr. Robert Lovkin.

SPEAKER_02

My guest today is someone who spends his days doing something most of us hope will never need. Open heart surgery. Dr. Philip Ovadia is a board-certified cardiac surgeon who's performed thousands of operations. And after all those hours on the operating table, he came to a conclusion that should stop every one of us in our tracks. Most of the patients he operates on didn't have to be there. Phil's own story is part of what makes this so powerful. He was once morbidly obese and pre-diabetic himself, heading, in his own words, towards his own operating table before he lost nearly 100 pounds and completely rethought what actually drives heart disease. The answer wasn't cholesterol, and it wasn't a prescription, it was metabolic health. He's the author of a new book we're talking about today: Stay Off My Kitchen Table. In it, he defunks 12 myths mainstream medicine still clings to, lays out five markers that you can measure right now, and gives you seven principles to take back control of your health. So whether you've already been handed a diagnosis or you simply never want to meet a heart surgeon professionally, this conversation is for you.

SPEAKER_00

And now please enjoy this week's episode.

SPEAKER_02

Hey Phil, welcome to the program. Great to be uh back with you again, Rob. It's so it's so good. You and I go go way back, brother, uh, on this on this journey. It's it's fun to connect with you, and I'm so excited to to talk about the the new book

A Preventable Death And A Vow

SPEAKER_02

and kind of drill down on it, which is which is coming out literally today. So perfect, perfect timing. But yeah, I I I noticed you you open the book with Corinne, uh, this 39-year-old mother that you lost on the table to an aortic dissection that you call basically 100% preventable. Can you walk us through that night and the in the moment you realize that you wanted to, you know, quote, write yourself out of a career?

SPEAKER_03

Yeah, so you know, that was the opening of Stay Off My Operating Table. And, you know, that's really what uh was one of the defining moments when I really understood that I had to go from just treating heart disease, you know, as a heart surgeon, to doing everything I can to prevent heart disease and keep people off the operating table. And, you know, that was a powerful opening to my first book, Stay Off My Operating Table. And now this new book, Stay Off My Kitchen Table, is the logical follow-up uh to that book. And, you know, Stay Off My Operating Table has had an amazing impact. And I am grateful every day for everyone that has read that. And, you know, I get all the stories and the emails and you know, see the reviews on Amazon about the impact that it had on people's lives. Uh, but what I realized and what really, you know, spurred me to write this new book, Stay Off My Kitchen Table, is the need to really go deeper, right? In a lot of ways, in Stay Off My Operating Table, I gave people a framework that was going to help them prevent chronic disease, reverse things like heart disease and obesity and diabetes. Uh, in stay off my kitchen table, I really wanted to go deeper. I wanted to help people to understand, you know, why the recommendations that we make in Stay Off My Operating Table are so important. And we start talking about concepts like nutrient density and bioavailability. And uh I really wanted to get one of the underlying messages, right, that has evolved over the past few years out there that meat is medicine and meat is essential to good human health, and

Can You Thrive Without Meat

SPEAKER_03

to help people understand why that is.

SPEAKER_02

Yeah, and and uh if for people who is this do people need to eat meat to be healthy, or can people read this book and let's say they're on a vegan or vegetarian diet? What can they can they find value in this, or is meat the the only way to do it, in your opinion?

SPEAKER_03

Well, I think people will find value in that, and actually it became a central theme in the book when we talk about my co-author, Joshua Lysick, and his journey. He spent a long time on a vegan diet and like many people got initial, you know, great results and went, you know, years uh for what he thought was being in good health. But then things started to unravel and he started to recognize that there may be some issues. And ultimately, you know, he talks about the factors that led him to decide that veganism was no longer the right option for him. You know, again, I I try not to be too dogmatic with people, right? I I understand fundamentally, right, that we can't and shouldn't be telling people that there is only one correct diet for all human beings. But it is important for us to understand the basic framework of what health is and what our bodies need to get there. And when you start understanding concepts like nutrient density and bioavailability, it really shows you how, you know, diets that are devoid of meat are going to be problematic because there are essential nutrients that we can only get from meat. And the nutrients that are in plants oftentimes are not very bioavailable to us. And um, the nutrient density of plants is not very good. So you have to eat a lot of them ultimately. And, you know, these are the types of things that are going to ultimately lead, steer people in the directions that are going to help them accomplish better health. I mean, in the end, I am in favor of any dietary approach that's going to help people to avoid and reverse chronic diseases, help people stay off the operating table, so to speak, and not have to, you know, suffer from these chronic diseases that have become so ubiquitous. And ultimately, if you're on a dietary plan that is doing that and you're monitoring it and you're getting good results, great. But if you're not, you need to be, you need to be honest and you need to understand why. And then we can start to talk about what are the changes that need to be made so that we can get you to a place of better health and ultimately optimal health.

SPEAKER_02

Yeah, and I I really appreciate Joshua Lysick. You introduced me to him. He was the co-author of my book also. He's a he's a great resource. And and Joshua and I both were on a vegan diet for almost a decade, I think. I was too. And so to summarize what you're saying, then you can be healthy on any of these diets, but it's much, much more difficult if you're on a vegetarian or vegan. You've got to watch things, you've got to, you know, just it's much more challenging. Whereas a meat or nutrient-dense diet, you just eat and automatically you're healthy, right?

SPEAKER_03

Yeah, I think that's what most people experience. You know, it's just simpler because quite, you know, the uh a meat-heavy diet is the diet we evolved on as human beings. And so our, you know, intestinal, you know, digestive system is optimized towards eating meat. And we're really not optimized to eating plants. And I think a lot of people experience, you know, what you experienced, what Josh will experience, and we have so many more, and we we give a few, you know, we we have a few other people's stories in the book that, you know, when they first go on these diets, vegan and vegetarian diets, they do experience improvement in their health because they're generally coming from kind of a standard Western diet, right? And they're eliminating a lot of processed food and perhaps eliminating a lot of, you know, the high sugar foods. And so they do see initial improvement. But after a period of time, they come to recognize that they're not able to accomplish and maintain optimal health because of the challenges of getting the right nutrients, getting the essential nutrients that our bodies need. And um, you know, ultimately, like I said earlier, I have now firmly come to believe that meat is medicine. Meat is essential to human health. And we need to change the narrative around this, right? Because especially when it comes to heart disease, red meat has been made the, you know, the demon, the devil. And uh the opposite is true, right? Red meat is not harmful for our heart health. It is not harmful for our health overall. And as I said, you know, I have now come to believe, and of course, this has been a major shift in my thinking because I've been immersed in the world of treating heart disease for the past 30 years. And the overall messaging has always been that meat is bad for our health. And now here I am as a heart surgeon telling people that meat is actually essential for health.

SPEAKER_02

So, so you're literally the ultimate expert, a heart surgeon who, you know, literally you deal with the

Why Red Meat Was Vilified

SPEAKER_02

heart as the focus of your practice. So, why, how did we get to a point where meat was so vilified? What what got us here? You you you know, uh tell walk us through that a little bit.

SPEAKER_03

Yeah, so you know, if we really go back and do an honest assessment of how we got here, right, we see a combination of poorly done science, and we also see the influence of um, you know, things like politics and economics, right? Financial concerns that started to creep into the way that we interpreted the science. But, you know, to go back to the beginning, right? Most of the science that underpins the concept that meat is bad for our health is poorly done epidemiologic science. And I know this is something, you know, that you've probably talked about on this show before, right? But epidemiologic science is designed to help us generate hypotheses, right? It's not designed to prove something as true or something as causative when we're looking at disease processes. So, you know, the problem is you look at a large group of people, right? And you look at what they're eating and you're trying to correlate something to, let's say, the heart disease, you know, outcome. And uh so you go back and you get a bunch of people that that developed heart disease and a bunch of people that didn't develop heart disease, and you try and ask them what they ate, right? Now, this in and of itself becomes problematic because most people are not very good at recalling what they eat. But even if you're, you know, kind of doing it contemporaneously, right, and then looking years later, you know, that's one challenge around epidemiology. But the other challenge is, you know, and and this is really the probably the primary underlying thing that caused such a problem with meat as it relates to heart disease, is because we have been told that meat is bad for our health, right? The people that eat more meat tend to do other unhealthy things as well, things like smoking, things like not exercising. And so it becomes impossible to really isolate meat as the cause of the bad health outcomes. But again, because of the sort of political and financial interests that came into play, we overinterpreted the epidemiological science ultimately. And when, you know, the better science came out, right? You know, interventional trials that don't demonstrate the harms of red meat. And again, some of them actually demonstrate benefits of red meat, those now just kind of get ignored because they don't fit in with what was accepted as the widespread belief. And that's how we ended up where we are today. But, you know, in the end, I just look at where we are today, right? And I say, okay, for the past 50 years, we've been giving people this message of eat less meat. And in fact, we do eat less meat. You know, consumption of red meat has gone down something like 40% compared, you know, here in the US when you compare uh the 1950s and the 1960s to today. And yet heart disease has gotten worse. So that in and of itself, right, should tell us that obviously it can't be the red meat that's causing the heart disease problem. If we've cut back on it, people listen to the advice, they eat less red meat, and their

His Turning Point With Weight

SPEAKER_03

heart disease is not getting any better, it's actually getting worse.

SPEAKER_02

The other thing I I really appreciate about your background, Phil, is not only are you a domain expert on the heart and cardiovascular disease, but also on a personal side, you've walked the walk and and had the journey. Uh, you you know, you talked about you were before you were morbidly obese, pre-diabetic, you know, over a hundred pounds, overweight. So I'm I'm wondering what what finally clicked for you after so many years of eat less, move more, and and following the food pyramid, doing everything right? What changed for you?

SPEAKER_03

Yeah, what really changed for me was, you know, that realization of where I was headed, right? That, you know, I was traveling down that same path that all of these patients that were ending up on my operating table had traveled down. And, you know, I also came to the realization that I didn't know what to do about it. Um, because that same advice that you just mentioned, right, it wasn't working for me. It wasn't working for them. And so that kind of led me to start thinking about things differently, asking different questions. And, you know, thankfully I came across the work of Gary Tobbs, who I know you know well, and you know, um has been a major influence in both of our lives uh now. And that really started to open my eyes to what I needed to do personally, but also to what I didn't know, right? What I the information that had been shielded from me as a heart surgeon, as someone you know, emerged in the world of heart disease, I came to realize that there was a lot of contrary information out there that we as physicians just simply don't get exposed to. And, you know, seeking out more and more of that information is what really has helped me change my personal path and now be able to change the path of so many of the people that uh I work with and I influence.

Why Medicine Resists New Data

SPEAKER_03

Why isn't this information getting out more?

SPEAKER_02

I mean, it's it's it it's obvious when you look at the data. Why why aren't our medical schools and other physicians embracing this? Uh what what are what are the impediments to it? And do you think it's changing since since we last talked and since your first book?

SPEAKER_03

Yeah, it's a great question. And obviously, you know, major focus of your book, you know, lies I taught in medical school, right? And, you know, the reality is I do think it's spy it it is changing. I am starting to see progress, right? And we see it on many different levels. We see it now in the national conversation, right? And we see, you know, how uh uh the chronic disease epidemic, right, is has risen to, you know, uh risen and has become a focus of the national conversation. We have new food guidelines now that very much incorporate a lot of what we both uh talk about and have espoused for many years. And so I am starting to see some hope. I also see hope just by talking to younger doctors, people and you know, students that are currently in medical school, you know, young doctors that have recently graduated medical school and are going through their training, right? And I'm starting to see them understand that simply focusing on treating the disease is no longer enough. It's not acceptable. We need to be talking about what are the steps that are needed for preventing these diseases, for reversing these diseases. And that brings us every time right back to diet and lifestyle. And, you know, yes, there may still be some disagreement about what the optimal diet is, right? But at least if people are discussing that diet and lifestyle are key factors in this, that's how we are moving forward. And that is what makes me optimistic. Um, you know, again, that's why I think, you know, it was a good time for me to write this second book now, because it is part of the national conversation, and more and more people are seeking out this information. You know, they're following you, they're watching your podcast, they read your book, right? And all the others in the space that uh are doing the same. And the more that we can amplify and and discuss, you know, the more that we get that out there. And each day, right, new people are being exposed to these concepts and these inf this information. And that's what we have to just keep doing.

SPEAKER_02

Yeah, at the risk of losing either half of my audience, who I love dearly, both of them, this is not a political podcast. Uh, but certainly it is it is amazing that the national conversation with our government, you know, and hopefully it'll be whichever party's in there in the future, but we're now hearing words like, you know, lifestyle and seed oils and insulin resistance spoken by government leaders in the space.

What Government Could Fix Next

SPEAKER_02

And and like you say, they there have been changes, you know, the food pyramid and you know, and new legislations. What moving forward, what are the things that haven't changed that you that you'd like to see our government do right now that they could, that are some what's what are the next low-hanging fruit things, if you could major wave a magic wand that could be accomplished at a government kind of regulatory level?

SPEAKER_03

Yeah, I think the big one at the government regulatory level is going to be setting up the structure so that doctors are incentivized and you know reimbursed for for doing this work and and talking about these things. You know, right now, again, our you know, the whole structure around the healthcare payment system is based on doing things to treat disease. And it is still very deficient in opportunities to prevent disease or reverse disease. And that is really, I think, the major structural thing that is going to need to be addressed at the governmental level. And again, we're starting to see some aspects of this. It's either under consideration or it may have already been passed, new codes that doctors can use when they deprescribe medicines. And I think this was initially targeted towards the mental health area, but you know, that's okay. That's a good start, right? And then it can start to broaden out from there. So we are starting to see these things happen, but that's I think what we really need more of. Um, the fact that we got the new food pyramid is amazing. The fact that we have a government website called realfood.gov, right? Wherever the new food pyramid lives and where, you know, a lot of this information lives is amazing. And uh, you know, like you said, this isn't this isn't about one party or the uh or the other, you know, and in reality, right, this all came out of the cross-party coalition between Robert F. Kennedy Jr. and and President Trump. And so, you know, this is about improving our nation and improving our world ultimately, right? Because just as unfortunately our lousy, the original version of the food guidelines spread from the U.S. throughout the world and have had negative impacts on the world health, I am optimistic that the new food guidelines will start to undo that. And the US will continue to be the leader. And ultimately, more and more countries are going to start to make changes away from the old old guidelines towards these new

Breaking Free From Employed Medicine

SPEAKER_03

ones.

SPEAKER_02

Yeah, and and you you're right in the thick of it. You've you've Uh you're transitioning from an from an employed surgical position now as a locum surgeon to to run a growing telehealth practice that we're we're gonna dive into in more detail later. But how did what did walking away from this the conventional path teach you about how the medical system actually works? And this this new practice, by the way, uh is tele telehealth, and it's not just cardiovascular care and heart health, but it's also primary care. So people will be able to do that for all of their primary uh care health. Anyway, sorry.

SPEAKER_03

Yeah, you know, ultimately, again, it uh I had spent my career, right, up until you know, five years ago uh when I sort of uh made this change six years ago, actually now. I had spent my career just as an employee heart surgeon. And um I I mean I had a very good life, right? I can't uh I can't complain about you know the the blessing that I had to be able to become a heart surgeon, right? And I got paid very well to be a heart surgeon, and I the easier path for my life, and I know you, you know, went through similar things, would have been just you know keep doing what I was doing. And uh unfortunately, right, there is a endless supply of people who need heart surgery. There is incredible demand for heart surgery, and there is actually a shortage of heart surgeons in this country. So, you know, the demand for my services were very high. But when I realized that I could have much more impact, you know, keeping people off the operating table, and I launched Ovadia Heart Health, my nationwide telemedicine practice. And, you know, and at the same time I shifted how I worked as a heart surgeon. I left my employed position, I became an independent contractor, and I started traveling around to different places where, because of that shortage of heart surgeons that I mentioned, you know, they were in need of surgical services, and I was able to provide that for them. And, you know, what that really opened my eyes to was what a uh sort of bubble we get forced into as employed physicians, right? Because we ultimately are beholden to the policies that whoever is employing us, whether it might be a, you know, hospital or it might be an insurance organization, but whoever's employing you ultimately gets to tell you, you know, how you're going to practice medicine. And, you know, that might not be overt because there are laws that kind of protect, you know, doctors' independent practice. But what you realize is you just get a very filtered view of the world. And things like we talked about earlier, right? The information that comes to you, you know, in terms of ways of managing these diseases, um, that you end up in a very filtered situation. And uh ultimately getting out and being independent, being able to, you know, seek out my own information, uh, being able to then talk freely to my patients about, you know, what I think the best approaches are here that may run very much counter to the mainstream narrative that had the potential for getting me in trouble, you know, when I was an employed physician. Now I have the freedom to do that. And the other thing that's been, I think, different about, you know, the journey now is I have a much more direct relationship with the patients, right? We don't have insurance companies in between. We don't have hospital policies, right, in between us. You know, if together with the patient we decide on a path forward, you know, then we can go ahead and do that without outside influence. And you, you know, you don't recognize it maybe while you're in the system, but now that we're out of the system, you know, I do recognize what the limitations were. And I think this is a much better way for both the patient and the doctor. And again, the patients that I'm working with respond very well, and I think they recognize it as well.

SPEAKER_02

And and you're one of, as we've

Metabolic Care Beyond The Heart

SPEAKER_02

talked about, you're also moving into primary care, sort of providing that service. So I'd be curious, what's your take on what's happening with primary care? Because we have we have sort of a national uh growing presence in primary care with you know, our friend Mark Hyman's uh function health or Peter Diamond's Fountain Life or Jacob Peters' Superpower or Him's and Hers, even, or even the Aura Ring people are sort of uh pivoting into a primary care function where they provide prescriptions, they uh they do blood tests, they you know, uh provide wearables, and then and then the the you know, sort of the overall AI effect on all that on automating it and you know transforming primary care forever as we know it. What what what do you think is going on? What do you what are you experiencing on that end?

SPEAKER_03

Yeah, so the first kind of impetus for all this from my standpoint was, you know, we we tend to, you know, what has evolved in medicine is we've become very siloed, right? And the heart disease doctor, the heart doctor is just supposed to treat the heart. And what's interesting is when, you know, I shifted my approach to this metabolic focused care, right? And I started telling people, you know, we started focusing on diet and lifestyle changes to try and best address their heart disease, right? And we start to see the impact on all the other things that were going on with that patient, right? Because when I tell a patient, okay, eliminate processed food and eat less carbohydrates, all of a sudden their diabetes is getting better, right? And now they, you know, and they need someone to manage that for them, right? And we started to get some conflict when they would go back to their primary care doctor, and their primary care doctor who isn't metabolic focused and doesn't think this way, you know, who is still largely under the dogma of, well, you know, low-carb diets are bad for you, and this and that is going to happen, and so you shouldn't be doing that. And so patients more and more started requesting of me, well, can't you just manage my diabetes? Can't you just manage my thyroid problem? Because what you're doing to help my heart is making all that stuff better as well. And so that's sort of been the evolution of my practice. And, you know, my practice has now reached a point where, you know, I am licensed in all 50 states. We have patients in all 50 states and, you know, internationally. And this is really a demand that came out of my patients, right? That they wanted my team not just to be focused on their heart health, but they wanted us to be able to address all of their other things. And that's what we've, you know, been able to expand into. So, you know, it becomes very holistic care because the underlying concepts, right? Insulin resistance, metabolic health, right, gut health, these things end up touching all of the various disease processes, all of the various organ systems. You really can't just limit it to one. When you take this approach, I could no longer say, well, I'm only a heart doctor, because the real, you know, realistically, I'm not. Like I said earlier, I'm treating and I'm improving things like diabetes, things like their autoimmune conditions and their gut problems. And so that has now led me to start to build out my practice in a different way, right? That it's not, you know, the heart doctors are over here and the diabetes doctors are over here, and the primary care doctors are over here. It really is just a team-based approach of we are addressing your metabolic health, and that's going to address all of these various organ systems and disease areas.

SPEAKER_02

Yeah, that's that's certainly a theme that that we're hearing more and more. That it's not like, well, I have diabetes and I have heart disease and I have gout. No, you you don't have three diseases, you have three symptoms of one disease, and that disease is metabolic health. And it it makes perfect sense what you're saying, is that if the silos really don't aren't for the best of the patients, you know, to to just treat one aspect of that disease and then send them to someone else for the other aspect who may not even agree, agree with that. So that primary care is it's it makes perfect sense and it sounds like it's gonna help a lot of patients uh get a unifying preventative functional metabolic health theme for their for their practice. So that's uh that yeah, super, super good. And then to be clear, as you say, people can people can sign up.

What Telehealth Looks Like Day To Day

SPEAKER_02

Uh it's telemedicine. So anywhere in the US, and you mentioned internationally too, then what what do patients experience? What like what what what do they do for labs or you know, people have an impression in their head of you know going to their primary care doctor. How does that how does that differ doing it with telemedicine as opposed to if they were seeing someone locally?

SPEAKER_03

Yeah, so uh the first difference is that it is a very team-based approach, right? When people first sign up to join our practice, they're not just signing up to see me for one appointment. They're gonna work with my health coaches and they're gonna have multiple appointments. They're gonna work with my nurse practitioner. The the testing, you know, the resources we still do locally, right? You don't have to travel to wherever I am to get your blood work done, to get things like imaging done, right? Um, that can all be done locally, and we help our patients find the local resources. And then, you know, the visits are just more convenient, quite frankly, for both uh patient and doctor. You know, you don't have to come to an office, you don't have to sit in a waiting room and, you know, go through all the rigmarole that it has become, it seems, to see a doctor anymore. You just get on your computer at the time that we agreed upon, and you know, wherever I am and wherever you are, we can meet. And, you know, people worry about the limitations, right? You know, aren't there things that the doctor needs to be right there, you know, to listen to my heart, for instance? And in reality, again, the technology that is evolving is amazing. If I want to listen to a patient's heart, I can send them a device that they hold over their chest, it records their heart sounds, it uploads to the cloud, and I can listen to their heart, right? I can do all sorts of things with remote monitoring tools these days. So that, you know, the reality is that there's very little outside of actual procedures that need to be done on patients. Most of the stuff that we really do in terms of uh medical care can be done remotely and is probably better done remotely. So patients, like I said, have been responding very well to it. It's a very different experience. And, you know, the other intentional decision I made when setting up this practice was that it is a direct relationship between the patient and myself and the practice, right? We don't have an insurance company in between. And so, you know, again, circling back to things like testing and lab testing, it turns out that in many cases it can be done more cost-effectively and certainly more efficiently when you don't have an insurance company, you know, deciding what tests need to be done and you know how much they're gonna pay for it. So that's been very eye-opening, like I said, both to me and the patient. You know, all of these things that quite frankly I worried about as well as a doctor when I was first setting this up, you know, that is this gonna work via telemedicine? You know, are patients gonna respond? Can I do what I need to do? Uh and more and more, I, you know, I think this is the way that the medical system is going to be evolving. And I think we are going to be seeing less and less of the need for inpatient, in-person care, especially when you're talking about, you know, diet and lifestyle interventions to help someone become more healthy and prevent the need for, you know, those procedures that maybe, you know, need to be done in person.

SPEAKER_02

Yeah, this this truly is is medicine 2026. And and it's, you know, like like you say, rather than having an average local doctor who will then send you out to the local lab and the imaging center and wherever to get things done, have a superior doctor through telemedicine who really knows what they're doing. They'll send you to the same labs and the same imaging center. So that that part of the experience won't be any different. It's just you'll have this uh telepresence. And increasingly, I'm seeing that more and more, even from conventional medicines. A good friend of mine's an endocrinologist at UCLA, and she has full-time clinical practice in endocrinology, and she hasn't seen a patient since 2019. Every single consult is telemedicine over Zoom or you know, the equivalent uh, you know, take your pick of uh video conferencing, because that's that's the way that it can be done now. And I'm I'm so happy you're doing this because I I get people question all the time from you know from XYZ small town in America or even here in LA, and they'll say, hey, where can I get a good functional metabolically oriented primary care doctor to take care of me? And oftentimes it's not the answer is I don't know. Well, now I know, and so we'll we'll be sending those to you when you get set up. How soon will the will the primary care aspect uh be going, Phil, do you think?

SPEAKER_03

Yeah, so you know, that's something that's evolving. Again, you know, we we uh are doing it sort of de facto, you know, as of today. And, you know, it's gonna be about a six-week gap between when we're recording this and when we're ready right, you know, onboarding a primary care physician into my practice. And we may be, you know, done by the time this releases, but again, you know, even absent of that, this is something that we're already doing within the practice. And so the practice continues to evolve, and uh people can, you know, come check out what we're doing. Uh, you know, I'm sure we'll give the links at the end, but uh just come see what we're doing, and there's a good chance we can help you with whatever problems you're looking to be helped with.

SPEAKER_02

Yeah, we'll definitely have the the links in the

Nutrient Absorption And Gut Clues

SPEAKER_02

show notes, but I I I want to talk just a little bit about Stay Off My Kitchen Table. The first book was Stay Off My Operating Table, which I still love and recommend to everyone to read, but this one is even better. And one one of the things you you talk about um on what you you focus on a point about what your body absorbs, not just what you eat. Could you speak to that a little bit?

SPEAKER_03

Yeah, you know, this is uh something that I again increasingly came to recognize as I was taking care of people and you know, we were doing this metabolic approach. And some people, you know, quite frankly, weren't getting the results that we wanted for them and they wanted for themselves. And that was a big question of why. You know, why can you put two patients on the same dietary approach and one responds phenomenally and uh and the other one doesn't? And what I came to recognize was, you know, it's not just putting the food in your mouth ultimately, it's what your body is able to do with that, and you know, how your gut is functioning to be able to absorb that food, be able to extract the nutrients that are in the food. And so that really led me to learn a lot about gut health, and we talk about this in Stay Off My Kitchen Table, what an impact that has. And then, you know, that also leads you to understand how some of these foods might interact, how some things like plant foods can actually block the absorption of nutrients. They have what are called anti-nutrients that we talk about in the book as well. So ultimately, you know, understanding that it's not just what you eat, it's what your body then does with what you eat that is going to determine the outcomes that you get from that. And that has been, you know, an ongoing shift and evolution in the way that we are now able to uh help patients and evaluate patients.

SPEAKER_02

Yeah, there we there was a uh interesting article that just came out on um NAD supplementation, and it's a popular supplement that many people take. And you know, no question, and NAD you know helps mitochondrial function. It's you know, it's key in ATP synthesis and everything. But the the study, after years and years of dozens, hundreds of companies selling NAD oral supplements, the study showed that oral supplements doesn't have any effect on blood levels in this large meta-analysis. So it's gonna, you know, that now that doesn't mean that it doesn't affect the local delivery to individual organs or individual cells. That's yet to be determined. But at least from this one marker through blood levels, they uh weren't able to tell anything. So this whole the whole point of bioavailability and absorption and interactions with with our gut is is just fascinating. Now, do you do do you do gut microbiome analysis or anything like that with your practice? I know that's an area that's that some of people are beginning to look at, although it it it's still very challenging, it seems.

SPEAKER_03

Yeah, it is. You know, it it's an area of uh ongoing evolution in my practice, I'll say. There's lots of different testing that can be done around, you know, gut health and the microbiome, and we still don't quite know what the right things to test are and and you know how to evaluate that. Uh honestly, we take a uh uh a much more basic approach, you know, just focusing on patients' symptoms as it comes to their gut, looking at things like, you know, and we talk about in the book, right, just the quality of your stool, the characteristics of your stool can be an indicator of your gut health. And, you know, having symptoms like bloating and things like that. There can also be some indirect measurements of, you know, your gut health. And, you know, you mentioned about the NAD, right? But lots of other supplements and nutrients, right? That if we have someone, for instance, that's, you know, we know is eating a diet that's high in vitamin B, right, but their vitamin B blood levels are low, right? That's an indicator to us that they are not absorbing what they're eating. And so we can start to look for subtle clues like that in the testing as well. There is some testing that I think has promise to this to give us maybe a little bit more direction and detail regarding these things. But uh just understanding the concepts, again, helps direct you towards certain choices about your diet and your lifestyle that can even if we can't measure it, we can see the effects of the improvement in how well you're absorbing nutrients, for instance, when we see other health metrics improving. So that's kind of the approach that we take in the book and in my practice as to assessing the, you know, assessing how

The Wearable That Changes Everything

SPEAKER_03

well our bodies are absorbing these nutrients.

SPEAKER_02

One other question we get with a lot of people have emailed in when they knew you were going to be on the program was to ask you about wearables and what your favorite wearables are for your for your practice that that you can monitor remotely or for telemedicine. What what do you what do you recommend or what do you wish more people would use or would hope would be developed even?

SPEAKER_03

Yeah, so the number one wearable for us is the continuous glucose monitor. Uh, you know, seeing in real time what your blood sugar is doing in reaction to the food that you're eating, uh, and also in reaction to other things that are going on in your life, how well you're sleeping, you know, what kind of activity you're getting or not getting, you know, stress, right? And being able to see that impact in real time, I think the continuous glucose monitor is the one wearable that really has the potential to shift our whole understanding and our whole conversation around diet and lifestyle. So that that one is at the top of my list, and we we really recommend it to everyone in our practice. It may not be the type of thing that you need to do all the time. It's something maybe that you do intermittently, you know, and you help use it intermittently to help evaluate the changes that you're making. But that is probably the most powerful wearable. Again, when it comes specifically to heart health, and when we broaden out to general health, uh, the CGM is the big one for me.

SPEAKER_02

And and to be clear for our listeners, the CGM can be monitored remotely. So Phil and his team can monitor it no matter where you're located. So it's perfect for a telehealth practice like this. Do

Empowerment Mindset And Final Takeaways

SPEAKER_02

you have any closing thoughts for our audience before we go?

SPEAKER_03

Yeah, I mean, really, you know, again, and and we had talked about it previously, but I think it's worth re-emphasizing. This is all about empowering patients to take back control of their health. I think, again, that has really been a uh driving force for me as I think about, you know, how I wanted to build a practice and structure a practice and really just how I do everything, right? Is all about empowering people to take back control of their health. The real unfortunate, you know, message that is baked within our healthcare system is that you, the patient, are kind of powerless, right? You can only take the medicines or you can only have the procedures done, you know, to try and improve your situation. But the reality is that we as human beings, we have the ultimate power over our health. And the decisions we make every day about what we eat and what we do, those are the most empowered, those are the most important determinants of our health. So I am all about empowering people to take back control of their health.

SPEAKER_02

We've been speaking with Dr. Philip Ovedia, and the book is Stay Off My Kitchen Table. It's coming out today. You need to get it to buy it today. I can't recommend it highly enough. Thank you so much, Phil. This has been a wonderful conversation. Thanks, Rob. Great seeing you as always. Likewise. If you are enjoying this program, please hit that subscribe button or even better, leave a review. Your support makes it possible for us to create the quality programming that we're continually striving for.

SPEAKER_01

Can I start? Is it recording?

SPEAKER_02

It's already recorded.

SPEAKER_01

Oh sorry. This is for general information and educational purposes only. It is not intended to constitute a substitute for medical bike or council. The practice of medicine and the healthcare.