Lifestyle Intervention- with Dr. David Katz
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Lifestyle Intervention- with Dr. David Katz

Nick: I’m with Dr. David Katz. This is a very important interview because
we’re going to talk about the intervention of lifestyle medicine and its impact on you. Dr. Katz, you gave an amazing talk this morning
and your credentials were impeccable. Tell me what brought you into this field of
lifestyle medicine? David: I think we all just sort of gravitate
toward the things that seem to matter. For some people the obvious thing to do is
go to Wall Street, for some it’s to go to the operating room. I went into medicine partly because my dad’s
a doctor and had a great example right at home, partly because I wanted that kind of
opportunity to make a tangible difference in the world. And then within medicine I wasn’t sure where
I was going to wind up but I’m sort of a big picture person, that’s just my native tendency. So others may not see the forest for the trees,
I’ll see the forest and maybe not want to be quite so focused on the details, the trees. Well, frankly, the forest right now is lifestyle
medicine. You look around the world, you look at the
epidemiologic literature and what we’re seeing is this explosion in rates of chronic diseases
that have long been taking years from lives and life from years here in the US and developed
countries but the same problems are taking over the world, they really are. And so you got cultural transitions in China
and India, rates of chronic diseases are just exploding and you see this all around the
world. And so frankly we used to look at infectious
diseases and things where we were a little less in control as the major scourges at the
population level. The major scourges at the population level
right now is stuff we’re totally in control of so that’s the issue. Essentially the root causes of all of this
preventable misery is lifestyle. It’s eating badly, not being active, smoking
too much, not sleeping enough, stressing out. I describe the six-cylinder engine of lifestyle
as medicine is feet, forks, fingers, so physical activity, dietary pattern, not smoking, sleep,
stress, and love, strong social bond. And we have incontrovertible evidence, as
you know, in expanding decades and the peer-reviewed literature showing that if we eat well, are
active, don’t smoke, sleep enough, manage stress, and cultivate important relationships,
80% of all chronic disease could go away. Heart disease, cancer, stroke, diabetes, dementia. So once you know that, the question isn’t
why do you do lifestyle medicine but how could you do anything else? Nick: Right. I think there’s a common misperception that
maybe coming back from infectious disease and the drug model of dealing with say, infections
and so forth, that somehow there’s a pill for each chronic disease and that’s somehow
going to be superior or work faster than lifestyle medicine. But we have quite a bit of evidence, epigenetics,
fitness, diet, supplements, these things including the power of the mind have a profound and
rapid change in the body and potentially, as in your book, which is a wonderful book,
Disease-Proof, slash your risk of heart disease, cancer, diabetes and more by 80%. David: What you’re saying is absolutely true. We have this disease care model and we have
‘there’s a problem-here’s a drug’ approach that prevails. But actually drugs have pretty much never
been shown to do some of the stuff that lifestyle does. For example the best study showing that you
can take gummed-up coronary arteries and shrink the plaque away, lifestyle intervention. Plant-based eating, physical activity, lifestyle
intervention. Lifestyle intervention has been shown to change
gene expression in a way that will lower cancer risk over time. We really have nothing in pharmacology, no
nutrient supplement that’s been shown to exert that same influence. The other thing about lifestyle is you can
pay it forward. If you’re living well as a parent you’re going
to share that with your kids, you’re not going to put your kids on a drug. The other thing about it is potentially it’s
free, we could actually lower cost for society as opposed to raise them by having everybody
on drugs or surgery. So the power of it is greater, the rapidity
of action, as you say, unbelievable. To completely transform your lifestyle may
take some time but we have evidence that what you eat for a given meal actually changes
the behavior of your vasculature. We do in my shop endothelial function testing
which is this very dynamic measure of blood vessel health and we could show that if you
eat this meal which is good or this meal which is bad within hours, the behavior of your
blood vessels night and day. So immediate effects, long-term effects, cost-reduction
as opposed to raising cost, the ability to embrace this as families as opposed to “I’m
on a pill, good luck to you,” everything about it is better. Now, it doesn’t foreclose on the opportunity
to use drugs appropriately. I’m an internist, I prescribe medication,
and I’m an integrated medicine practitioner, I use nutraceuticals and supplements, but
they are supplemental to, never substitutes for what lifestyle as medicine can do. [0:05:05] And finally, if you look beyond the quick
effects and the peer-reviewed literature to the real world, we’ve got these populations
around the world called blue zones where people use lifestyle as their medicine accidentally,
it’s just their culture just gives it to them. What’s the result? They live longer than anybody else, they live
better than anybody else, they live to be a hundred pretty routinely, go to sleep one
night and just don’t wake up, they die better than the rest of us, they’re happier, and
frankly they don’t have to take any medication because the way they live is the medicine. Why wouldn’t you want that? So it’s better. And again, they can be complementary. We have a lot of people in our culture who
already have serious chronic diseases that has to be treated, diabetes has to be treated,
heart disease has to be treated. But as we look ahead, I think about my children
and the next generation, we could give them a future where they don’t need all these medications. Nick: Right, right. [0:06:11] End of Audio

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