Hacking Your Heart & Preventing Diabetes – Dr. Rocky Patel Podcast Review

I’ve always been a fan of Dave Asprey’s Bulletproof Podcasts – he is probably the most famous biohacker that’s out there. On one of his earlier podcasts, his guest was Dr. Rocky Patel, a family physician who focuses on prevention and early detection and treatment of diabetes and heart attacks. He practices what he preaches and lost over 85 pounds following the program that he now advocates for his patients. Here are some of the highlights from the show:

• Current food recommendations are not based on science but on US policy – we’ve been vilifying saturated fats but science shows that saturated fats and cholesterol are not the culprits.
• Eating quality fats and saturated meat is actually good for you and will raise HDL cholesterol and make the brain work better.  There are now prescription drugs based on medium chain triglycerides (MCT) oils.
• Dr. Patel follows a Paleo-type diet with the right amount of quality protein and good fats to maintain his health and weight.
• Diabetes is a disease of insulin resistance. The pancreas needs to make more insulin to decrease blood sugar levels – with the excess sugar we eat, it works so hard that it gives up and then starts decreasing the production of insulin. Then the blood sugar goes up and this triggers the diabetes process.
• A fascinating fact I learned on this podcast is that the pancreas burn-out starts 20-25 years before you actually become a diabetic! In pre-diabetes, the current metric for fasting blood sugar is considered 100-125 and the post-grandial (after a meal) glucose is 140-200, but the actual disease process of insulin resistance is a spectrum.   
• In an interesting study published by a leading diabetologist in 2010 at the Baylor College of Medicine in Texas, a study on 8,000 patients showed that a one-hour post grandial glucose greater than 125 was consistent with insulin resistance. If the one-hour post grandial glucose was greater than 150, you are 13 times more likely to become a diabetic in the next eight years. In fact, the fasting sugar, two-hour post grandial glucose didn’t matter – ONLY the one-hour sugar number mattered. And you can do this test at home with a glucose meter.
• He also noted that 80% of the patients he sees are insulin resistant.
• Diabetes is correlated with heart attacks – LDL cholesterol did not make the top risk factor for heart attacks. The number one factor was the good to bad cholesterol ratio and number two was smoking. Taking your total cholesterol number and subtracting your HDL will give you the non-HDL cholesterol count which is a better marker.
• Inflammation is a cause of atherosclerosis. Lipoprotein-associated phospholipase A₂ (Lp-PLA₂) is an enzyme that plays a role in the inflammation of blood vessels. Measuring Lp- PLA₂ along with High-sensitivity C-Reaction Protein (Hs-CRP) will provide an indication of how inflamed your body is and your risk for heart attack.
• Heart attack is not necessarily a progressive blockage – it’s the inflammation of the arterial wall over the plaque that can burst and cause blockage in blood flow.
• Insulin resistance is the root cause of diabetes and inflammation is a cause of atherosclerosis. So if you are inflamed, your body will be laying down plaque and it won’t matter what your cholesterol is. You need to address the pro-inflammatory conditions of insulin resistance and diabetes.
• For long-term and mid-term risk patients, he uses a combination of diet and lifestyle to address inflammation. Low dose aspirin, supplements like resveratrol, pcynogenol, grapeseed and pomegranate extract with niacin (B3) and Omega 3 (fish or krill oil) are basic add-ons to the program.
• For near-term risk patients (those at the highest risk of heart attack), he will combine medications like statins and beta blockers/ace inhibitors to quickly squash inflammation to bring the risk level down so it can be managed over the long term by diet and lifestyle interventions.
• His belief is that we need to combine natural and allopathic medicines to get the best outcomes. We don’t live in a natural world anymore so we need to biohack with the right combination that is personalized to our needs. We need a targeted approach but the long-term goal is to eventually wean patients off their medications.
• One thing he absolutely recommends is getting dental check-ups every six months as periodontal disease will make inflammation go up and increase the risk factor.
• He emphasizes the need to optimize vitamin D levels as most people have sub optimal levels. Don’t just take vitamin D – get tested first and then determine how much you need.
• Managing stress and getting enough sleep is another must for optimal health – you need more than 6 hours of sleep per night.

The full podcast is posted below: