Dr. Ovadia: Heart disease has been the number one killer in the United
States now for essentially a hundred years. And what I have seen throughout my
career as a heart surgeon is it's not getting better. By most metrics we look
at, it's getting worse. The only thing we've really gotten better at is the
surgery — we can keep people with heart disease alive longer, but they're still
dying of heart disease. No matter how good I am as a heart surgeon, no matter
how good all the heart surgeons out there are, the patient is never as good
after they have the surgery as they would have been if they didn't need the
surgery in the first place.

Karen:
Today's guest changed my life. He shifted how I think about my own
health, and I'm excited to have him on the show. Dr. Philip Ovadia is a
board-certified heart surgeon who has performed over 3,000 heart surgeries.
He's also the founder of Ovadia Heart Health, and he's the New York Times
bestselling author of Stay Off My Kitchen Table and the author of Stay Off My
Operating Table. Dr. Ovadia, I am so glad you're here.

I'm Karen Norheim, and this is
Always Lifting.

Dr. Ovadia: It's great to be here with you, Karen. Really excited to
have this conversation with you and your audience. This one, from my
perspective, might be a little different than some of the podcasts I usually
do, but I think we're going to make it a great conversation.

Karen:
Absolutely. I'm thinking the best place to get started is what
brought you to want to become a heart surgeon — a cardiac surgeon, a
cardiothoracic surgeon. Explain that to me as someone who doesn't really know
anything about being a heart surgeon.

Dr. Ovadia: All the fancy different names for it. The honest answer is,
I have no idea — and I'll tell you why that's actually very revealing. My
parents swear that from about five years old, whenever anyone asked what I
wanted to do, I always said I wanted to be a surgeon. Not a doctor — a surgeon.
I have no idea why. Somehow I had this idea, and it just persisted all through
my early academic career. I knew I was going into medicine, and from the first
time I was in a hospital — volunteering in a local emergency room — I
immediately gravitated toward the procedures.

Heart surgery grabbed me from
the first exposure — the balance of technical skill and physiology, literally
holding the heart in your hands, stopping it, starting it. I loved it right
away. The ironic thing, looking back, is that when I told my mentors I wanted
to go into cardiac surgery, they begged me not to — this was the early 2000s,
statins were everywhere, and they said heart disease had basically been figured
out. Here we are, 25, 30 years later, and heart disease is still far and away
the number one killer. There's actually a shortage of heart surgeons in this
country right now.

Dr. Ovadia: My journey really started with me. About 15 years ago, I was
a morbidly obese, pre-diabetic heart surgeon. I came to the realization that I
was headed for my own operating table — and the other important realization was
that I had no idea what to do about it. The advice I'd been taught to give my
patients — eat less, move more, eat low-fat — wasn't working for me.

I was at a conference where the
guest speaker was investigative journalist Gary Taubes, who'd just written The
Case Against Sugar. That was the first time I heard about low-carbohydrate
diets, insulin resistance, and metabolic health. I went on a low-carb diet, cut
out sugar, and ultimately lost 100 pounds and reversed my pre-diabetes. Along
the way, I came to understand that the cholesterol-centered narrative I'd been
taught was an incomplete picture of what actually causes heart disease.

Dr.Ovadia: When we're metabolically healthy, our bodies are properly
utilizing the inputs we give them — and food is the primary input. When we get
into the biochemistry, we find something called insulin resistance, which means
the body can no longer properly utilize the carbohydrates, fat, and protein we
eat. Sugar, in all its forms, is toxic to our body when it accumulates. Insulin
resistance and metabolic health are actually a root-cause factor in nine of the
top ten leading causes of death in the U.S. and the world — cancer, chronic
kidney disease, diabetes, and we're increasingly aware of its role in
neuropsychiatric conditions too.

93% of adults in the United States are metabolically unhealthy. Only 7% are metabolically healthy.

Dr. Ovadia: One piece of evidence I see every day is the noticeable
shift in the age of patients I operate on. Twenty-five, thirty years ago, my
patients were in their 70s and 80s. Today, I'm routinely operating on
40-year-olds, and I've even had some 30-year-olds end up on my operating table.
If you think back to 2020 and 2021, every news channel had a daily ticker for
COVID deaths. At its peak, COVID was still only the number two killer — it
never even got close to heart disease, which has been the number one killer for
a hundred years. Why don't we have a daily ticker showing that every 33 seconds
in this country, someone has a heart attack? That's really the ticker that
should have been up — and should still be up — until we fix this problem.

Dr. Ovadia: Two related terms we focus on in the book are nutrient
density and bioavailability. Our bodies don't actually sense calories — that's
a construct the food industry came up with. What our bodies are looking for is
nutrients, and it's not enough to just put nutrients in your mouth — your body
needs to be able to extract and use them, and that's bioavailability. When you
look at food through that lens, you quickly understand that the most
nutrient-dense, most bioavailable food for human beings is ruminant animal meat
— red meat.

It's only in the past hundred
years or so that we shifted away from it, and our health has only worsened
during that time. That's become my theme — meat is medicine — and it's the
central message I wanted to come out of this book.

Dr. Ovadia: I think the most important first step for everyone is asking
why. Why do you want to be healthy? It seems like a silly question, but you
really need to understand why, because the concepts I teach are simple to
understand but hard to put into practice in our modern environment. The thing
that gets you through those hard moments — walking past 95% of the supermarket,
constructing your order at dinner — is understanding why you're doing it in the
first place, at a really fundamental level.

Karen:
Dr. Ovadia's story is a powerful reminder that even after thousands
of surgeries, the most important discovery of his career was realizing how many
of them never had to happen. His work on metabolic health shows us that real
change starts with small, deliberate steps, and that it's never too late to
begin your journey toward better health. For more info on Dr. Ovadia and his
work, see the show notes below. If you haven't already, give us a subscribe,
and don't forget to always lift.