Participants: Don Mackintosh (Host), Hans Diehl
Series Code: HFAL
Program Code: HFAL000229
00:49 Hello, and welcome to Health for a Lifetime.
00:50 I'm your host Don Mackintosh. 00:52 Today we are going to be talking about deadly plaques. 00:56 This has something to do with heart disease. 00:58 Talking with us today is Dr. Hans Diehl. 01:02 He is from Loma Linda, California 01:04 He is a cardiovascular epidemiologist. 01:07 He is the founder and originator 01:10 of the Coronary Health Improvement Project. 01:15 Welcome, we're glad you're with us today. 01:17 Glad to see you again, Don. 01:18 The CHIP program, I'm kind of emotionally attached 01:23 to this program as well, aside from hosting here. 01:26 I've been a pastor in a local church in Wichita, Kansas 01:29 for the last 13 years, we've actually done 16 programs now. 01:33 I just want to thank you for that program. 01:37 It's turned the health around of my congregation and also 01:41 about a thousand people in my city. 01:43 I'm so glad that you embrace these concepts. 01:47 Today we are talking about deadly plaques. 01:50 What are you getting at here, deadly plaques? 01:55 Well, we want to talk about the number one killer 01:58 in our society today, which is heart disease. 02:01 It is responsible for every second death in our society. 02:05 People wonder why am I getting it? 02:09 Why is it hitting me? 02:11 It's just like a bolt of lightning out of a blue sky. 02:14 It really isn't. 02:15 I want to talk about heart disease 02:17 and the underlying disease process-deadly plaques. 02:21 Where do these plaques come from? 02:24 What are we really talking about? 02:27 We're talking about the heart 02:28 For instance, as you look at this heart here, 02:30 there is usually nothing wrong with the heart itself. 02:33 But the coronary arteries, you see those arteries, 02:36 these are the pipes that are being obstructed. 02:39 They're narrowed down with a plaque build-up. 02:42 I want to show you a roll-in that will illustrate the kind of 02:49 cause of heart disease these deadly plaques create. 02:52 Let's take a look. 02:55 ...woke up so to speak when I was working on the anesthesia 02:58 service learning how to put people to sleep. 03:00 I was seeing my patients for the next day's surgery 03:03 for coronary artery bypass surgery in order to bypass 03:06 clogged arteries in their heart. 03:08 Because it was late at night I drew the man's blood test 03:12 and when I took the blood to the laboratory and had it processed, 03:15 I couldn't believe my eyes. 03:16 Normally, this liquid layer floating on top 03:20 of the blood clot is quite transparent. 03:22 It's yellow but quite clear. 03:23 You can see right through it. 03:24 The blood in this patient's tube however, was anything but clear. 03:29 The serum floating on his clot was thick and greasy white. 03:32 It looked like glue, in fact, it stuck to the sides 03:35 of the blood tube when I shook the tube. 03:37 I went back to the patient. 03:39 I said, Mr. Phillips did you eat 03:40 before you came to the hospital tonight? 03:42 He said, Yes. 03:43 I said, What did you have? 03:44 He said, I had a cheeseburger and a milkshake. 03:47 When he said that I realized that what I was looking at 03:50 in his tube was all the fat in the beef burger, 03:54 all the butter fat in the cheese and the butter fat 03:56 in the ice cream and in the milkshake. 03:58 All this fat had oozed out into his blood and actually turned 04:02 his blood fatty. 04:03 Well, 30, 40, 50 years of keeping your blood very fatty 04:08 creates changes in the blood vessels that are very dangerous. 04:11 Over the years arteries can become clogged 04:15 with fatty material. 04:17 Then a blood clot can form blocking the blood flow 04:20 completely. 04:21 If the artery leads to the heart, the lack of oxygen 04:25 can cause heart muscle to die, that's a heart attack. 04:28 If the clogged artery leads to the brain, the patient 04:32 has a stroke. 04:33 The next morning we took Mr. Phillips to the 04:38 operating room and I put him to sleep and the surgeon 04:40 opened up his chest. 04:41 From these arteries he began pulling out yellow greasy 04:48 deposits of fatty material called atherosclerosis. 04:52 Can just 30 days bring a drastic change for the better 04:56 in your health? 04:58 That is incredible! 05:02 You know the first time I saw that clip in the first 05:06 CHIP program that we did, I couldn't believe it 05:09 and every single time I see it since that time, 05:12 it still is quite shocking. 05:13 All that stuff can build up, and he said that's the fat 05:18 in the cheeseburger and all the different things 05:20 that we are eating. 05:21 - Every time I see it, it really brings home a message too, 05:24 and that is what surgeons see every day who do 05:27 bypass surgeries. 05:28 These are the kind of things that cause obstruction 05:31 and narrowing and hardening of the arteries, 05:33 and that's of course what we call atherolosclerosis, 05:35 or hardening of the arteries. 05:37 - So when does this start, I mean, I don't have worry 05:39 about this until 40 or 50? 05:41 - Well that's what we thought, but we know differently now. 05:45 When it comes to Chinese peasants, they have to worry 05:51 about them when they are about 80. 05:52 - When they are 80. - Maybe 70! 05:55 - So I need to move to China. - That's right! 05:57 - So the Chinese, they don't struggle from this as much, 06:00 but when does this process start? 06:04 - This is basically a Western disease, and we find this today 06:08 in young people by the time they are teenagers 06:11 when some young people have been killed in car accidents, 06:16 autopsies are being done. It's absolutely shocking! 06:18 You see about 20% narrowing, look at the next roll in here: 06:22 You can see a graphic, by the time you are 20 years of age 06:26 you already have 20- 25% narrowing. 06:28 By the time you are 45 years of age, you have more like 06:31 50% narrowing, by the time you are 70 years of age 06:34 there is hardly anything left. 06:35 - Wow, so I am right in between the 20 and the 45 there so I 06:39 am right in the middle. 06:40 But that's a serious thing, so what does this lead to? 06:45 What does this cause? 06:46 - It's a very very serious thing because this is the 06:49 underlying disease process that leads to heart attacks, 06:51 to angina pectoris affecting the heart, it can lead to 06:56 the narrowing of the arteries to the ear, so you have 06:58 hearing loss, visual loss, memory loss, it can lead to 07:03 strokes, it can lead to gangrene, impotence. 07:07 These are all problems that are actually related to 07:10 this underlying disease process called atherolosclerosis, 07:13 that's what you saw there. 07:15 - So it's not something to take lightly, we have to really 07:19 take it seriously. 07:20 - Yes, we do, we do. You know these plaques, 07:23 and they come in two different forms as you see on the 07:26 next one, on the left side on the plaque you begin to see 07:30 a plaque that begins to increase to about 50, 60, 70, 80%. 07:37 By the time it is 80% narrowing the coronary diameter of the 07:42 artery, that's when you developed the first sign of 07:44 often what we call angina chest pain. 07:47 - Ok! - So this is a very common 07:49 plaque that grows in American arteries, 07:52 but there is another kind and that's the next one here 07:55 and this one is not quite as extensive, you can see... 07:58 - It's a smaller on the side there. 07:59 - Yeah, that's right, you can see on the left side there 08:02 it's smaller but it's much more devastating 08:06 because this is what we call a soft plaque. 08:09 It's a vulnerable plaque, it's squishy, and it is filled 08:13 with cholesterol on the inside and that can much easier, 08:16 what shall we say, break open. 08:19 When it breaks open, on the right hand side you'll see this 08:22 formation there of blood clot, when that opens up, 08:25 when that breaks it is usually quite often fatal consequence, 08:30 so that is responsible for 90% of all the heart attacks. 08:34 So the second kind of plaque that you saw is responsible 08:38 for heart attacks, the first one for angina pectoris. 08:42 - So the first one we saw filled up most of the artery 08:47 that's the one where when we looked at the other graphic, 08:49 it wasn't the person at birth or at 20 or 45 but it was 08:53 when they were very old. 08:54 - Correct! - And that is kind of more 08:56 stable and it's kind of calcified, it's kind of hard, 08:59 but the young ones, the little baby ones that we have to 09:04 worry about and so it's probably more dangerous 09:07 for someone younger. 09:08 - Yeah! These are the vulnerable plaques and often times 09:11 they don't even show up on our x-rays on angiograms. 09:16 These are very vulnerable, like you said, they are baby plaques 09:21 but they can break very easily, it depends on the amount of fat 09:25 and cholesterol and the inside, that is why it is so important 09:28 to bring the cholesterol level down in your blood stream, 09:30 because it also brings down the cholesterol inside the plaques. 09:32 - We hear a lot about this, it's on cereal boxes, 09:36 it's on the news, all different types of things, but it seems 09:40 like especially in America where I live, 09:42 everyone knows about it but they don't do to much about it. 09:45 - Yeah its tragic, we could avoid these plaques, 09:50 we could postpone them to be sure, we can even reverse them 09:55 but we haven't always know this, it took about 30 years 10:00 to do this large Framingham Study and here you see 10:05 there is over 1,000 research papers published, 10:08 it took the government about $43 million. 10:12 What they really found is that this disease doesn't just strike 10:16 blindly but there are certain risk factors, the factor 10:20 characteristics that we have that place us at a higher risk 10:24 for this disease. 10:25 - So what are some of those risk factors and how do they 10:27 discover them? 10:29 - Well they observed a whole town near Boston for 50 years 10:36 actually and they began to count the deaths, 10:40 they began to count the heart attacks, then they tried to 10:44 correlate this with certain characteristics, 10:45 and this is what they found, take a look. 10:48 You see this risk arch, and you look at the red and orange 10:53 colored risk factors. - Obesity and diabetes. 10:56 - That's right! That is smoking, cholesterol, 11:00 high blood pressure, triglycerides, inactive 11:02 life style, and stress. 11:03 These are factors that we can change but many of us don't, 11:08 if you go back to this arch you will notice here again 11:12 that the closer these factors are to the center the more 11:16 powerful they are in driving this disease. 11:18 - Ok, so cholesterol is the big thing. 11:21 - Cholesterol is the big thing followed by smoking and 11:23 triglycerides, so these are the big things, if you go back 11:26 one more time to the risk factors you will see something 11:29 very interesting. 11:30 In addition, most of these factors are under control 11:32 of our lips. - Our lifestyle, in other words 11:36 what we can do something about. - Take a look, cholesterol is 11:38 largely determined by what we eat, high blood pressure, 11:41 largely determined by what we eat. 11:43 Triglycerides, diabetes, obesity, so our food supply 11:49 is playing a major role in this kind of a disease 11:52 which is largely found in western society only. 11:55 - Ok, so this is probably your life work, I know it is because 11:59 we have seen in the Chip program that this is really what you 12:02 focus on, helping people understand this risk arch 12:04 and focus on, helping people understand this risk arch 12:06 then recognizing that they have some responsibility 12:09 - Yeah, actually opportunity don't they. 12:13 But you know when you look at the next graphic 12:14 you see on the left hand side, those people who have a high 12:20 cholesterol, take a look, that are suffering from 12:25 high blood pressure, they are smokers, diabetes, and they have 12:28 a positive general test. 12:29 These people in the red column they have 140 times higher 12:35 risk on the next one, as the one in the green column. 12:38 I mean you can determine your chance of a heart attack 12:42 in this extreme illustration by 140 times higher likelihood 12:47 by making some simple lifestyle changes. 12:49 - So in other words if you get your cholesterol down on the 12:52 one side it said it was 310, you get it down to 150 or below. 12:57 - Right! - And that decreases your risk 13:00 - Dramatically! - 140% you say. 13:02 - Well, - Or 100 times. 13:03 - Well if you add all these kind of things. 13:06 If you take the aggregate 140 times. 13:09 - So your blood pressure its 160, you get it down to 120 or 13:13 whatever less. - Yes! 13:14 - This is what happens as you help people through education 13:18 they start seeing these changes? 13:19 - Yes, we begin to realize that heart disease is not just 13:23 a random act, but rather it's something that comes to us 13:28 based on lifestyle habits that we adopt or accept 13:33 or practice. 13:34 For instance when you look at the next graphic you will see 13:37 that many of these risk factors are diet related. 13:40 Here you see a health column, this is a typical food column 13:43 in a developing country, you notice there that most 13:45 of the calories in this kind of a diet comes from starch. 13:50 These are usually corn, beans, grains, simpler foods, 13:55 you have some protein, and some fat, and some sugar. 13:58 - Well this is good, this is good then. 14:00 - This is very good. - This is what they would eat 14:03 in China, and in these countries where you don't see 14:06 heart disease. - That's correct! 14:07 So this is the more ideal diet a simpler diet. 14:11 - Ok, now we're talking with Dr. Hans Diehl, 14:13 when we come back we will look at what's bad, 14:15 you've seen what is good, we'll see what is bad, 14:18 and hopefully you will make the right choice 14:19 so you don't have to have these deadly plaques. 14:22 Join us when we come back. 14:26 Are you confused about the endless stream of new and often 14:29 contradictory health information, with companies 14:33 trying to sell new drugs, and special interest groups 14:35 studies that spin the facts, where can you find a 14:39 common sense approach to health? 14:40 One way is to ask for your free copy of: 14:46 Dr. Timothy Arnott and the Lifestyle Center of America 14:50 produced this helpful book of 24 short practical health tips 14:59 for example, did you know that: 15:13 If you are look for health not hype, then this book is for you 15:16 just log on to: 15:25 Welcome back, we are talking to Dr. Hans Diehl from Loma Linda 15:29 California, he is a cardiovascular epidemiologist, 15:32 which is a big way of saying that he deals with the heart 15:35 and looking at the studies in research to help people 15:40 first of all understand heart disease and hopefully avoid it. 15:43 I might say something else to our listeners as well, 15:48 chiphealth.com, isn't that right, that's your web page 15:53 and you can learn more about what we are talking about today 15:55 about the CHIP Program, about all of these different 15:58 risk factors... I have seen your web page 16:01 you have a lot of different little clips that can be played 16:04 and people can really get an education just by going through 16:07 that web page. You spent a lot of time 16:09 on that, we appreciate that. 16:10 We were talking about deadly plaques in our first half. 16:17 We talked about the fact that in America, or the western 16:21 countries, it's not a matter if whether or not they 16:25 most of them had these plaques because they are eating 16:27 this western diet. 16:30 But you've had good news for us, they don't necessarily 16:34 succumb to the risk factors, there are some diets and 16:39 there are some things they can do that can stop and perhaps 16:42 even reverse these things. 16:44 - Yeah, actually it's true Don, you can turn them on, 16:47 you can turn them off. 16:48 So it all depends on the choices that we make. 16:50 I want to maybe focus on the diet column once more. 16:55 - Ok, go back to what we were looking at. 16:56 Remember what we talked about, what is a good diet? 16:57 A good diet is probably a diet which is high in unrefined 17:01 starch such as corn, brown rice, beans, potatoes, simple foods, 17:07 right, now move to the next graphic and you see the 17:10 dramatic change over time as the income increases, 17:15 from the left to the right side. 17:18 You are no longer eating the corn and the brown rice 17:24 and the beans and the potatoes, but instead on the right hand 17:28 side now you are going to be - eating more sugar, more fat, 17:32 more vegetable fat, animal fat. 17:34 - Let's stay on that graph for just a minute here, 17:37 take a look, from the left side lots of potatoes, 17:40 now we eat Pringles, left side, lots of corn, now we eat Nachos, 17:46 left side, lots of beans, now we eat some steaks. 17:50 With affluent comes a change in our diet, 17:55 we are now engineering our food, we are now eating 17:58 more animal products, we are no longer eating a diet that's 18:01 high in starch, but now it's high in fats and sugar, 18:04 When ever you have this kind of a diet, within ten years 18:09 you find in that society that is adopting this kind of a 18:12 affluent dietary pattern, especially when you smoke 18:16 and you don't exercise, you will see within ten years 18:19 heart disease. 18:20 - So are you concerned about what they call globalization 18:23 about everybody kind of eating the same thing or hearing about 18:27 the same things because of the media. 18:29 - There was a time when heart disease was largely restricted 18:32 to 10% of the world's population, 18:35 that was fifty years ago, now it's probably at 45% 18:39 of the world's population, we see a globalization of 18:42 the western diet. 18:43 Everybody wants to eat like an American, people don't realize 18:47 they also die like Americans. 18:50 We didn't have heart disease 100 years ago, this is a new 18:53 disease, it has to do with not genetics so much, 18:56 as it has to do with our culture and what we are driven to do, 19:01 the choices we make in what we eat, and how we live and diet. 19:08 - So you said something interesting, 100 years ago this 19:10 wasn't anywhere except 10% an how do you know that? 19:14 - Oh, 100 years ago you couldn't find it in North America, 19:18 they've done autopsy studies that were recorded, 19:21 it was difficult to find this atherosclerotic plaque 19:24 in the arteries. 19:25 1950/1960, you began to see it everywhere, 19:28 after World War II major epidemic, 19:31 and today it has come down just a little 19:33 bit, but is still the number one killer in our society. 19:36 - People back then ate these foods that were not good 19:41 for them, what's the difference, the exercise? 19:43 - You mean 100 years ago? - Yea, 100 years ago. 19:46 - Oh no, people used to have some meat, 19:50 they had some of these specialty cakes perhaps 19:55 100 years ago, but it was a minority item. 19:58 You had a big steak probably on Sunday coming out of church, 20:01 today, every day is Sunday in our society. 20:04 - Umhum! - We didn't have those 20:07 candy bars, we didn't have those refined foods, 20:11 we didn't have potatoes coming in little chips, we didn't have 20:14 crinkly bags, this is a new invention. 20:18 This has increased the intake of fat, sugar, and salt 20:23 to the extent that it is now contributing to these 20:27 modern diseases. 20:28 - Ok, so this American diet, the western diet is toxic. 20:36 - That's a strong word but you are right. 20:41 - Ok, so what do you do to address these deadly plaques? 20:47 - Well, what we try to do through education is to help 20:53 people to move towards a simple diet, more foods as grown 20:58 maybe we need to get back to eating more potatoes, more corn, 21:05 more bean, fruits, and vegetables, there would be 21:09 less of these snacky items. Right! 21:12 There would be less of these crinkly bag items, 21:16 maybe we ought to cut back on cholesterol foods, 21:20 the animal products, and maybe use them occasionally 21:24 rather than every day. 21:25 Now in the CHIP program how do you go about doing this? 21:28 I kind of know, but I want our viewers to hear because this 21:32 is a powerful... it's actually, I don't know 21:37 you can probably update me but there are five or six 21:40 scientific studies now done on the CHIP program itself 21:43 that are showing that it is effective, so what exactly 21:47 is happening? 21:48 - Well we talked about these risk factors didn't we? 21:51 We talked about this risk arch. - Umhum 21:53 - So the CHIP program tries to help people through a 40 hour 21:58 education program to begin to make some simple lifestyle 22:02 changes so that your cholesterol drops on the average 15%. 22:06 So when you drop your cholesterol 15%, 22:08 you drop your risk of heart attack in half right there. 22:11 We help people to begin to eat more food of the right kind 22:15 and the weight comes down 6 to 10 pounds in 4 weeks 22:18 without even trying. 22:19 We help people to recognize that maybe we should cut back 22:23 on our salt consumption, and what you begin to see is 22:28 the blood pressures come down. 22:31 We get people into an exercise program and all of a sudden 22:34 they begin to feel muscles they haven't felt in years, 22:36 they began to become more energetic, 22:38 they feel we can do this, and some people that are still 22:42 smokers, we try to help them stop smoking. 22:44 We also do something about the diabetes by increasing 22:47 more of the fiber in the food intake. 22:51 - Now when you say we help them is it through education 22:54 primarily or through example? 22:57 - Yeah, we have groups of thirty people, groups of 500 people 23:03 that meet every night Monday thru Thursday 23:06 by in large, for 4 weeks and they learn the concepts 23:09 step by step looking at all the scientific studies 23:12 that we have out there. 23:13 We are all filling up libraries but how do really you make it 23:17 available to people and to translate this in such a way 23:23 that people can really take it in and then through 23:26 shopping tours and food demonstrations and 23:30 walking exercises, get them inspired. 23:33 As you know as time rolls on after two or three weeks 23:38 the people are popping up in the audience, 23:40 my daughter had to reduce my insulin, 23:43 my daughter had to reduce my blood pressure medication. 23:45 I lost 6 pounds by now, I am feeling great and so 23:49 it begins to spread and so as they come in to the 23:52 alumni program after the program is finished 23:55 there we have an opportunity to sustain these 23:59 lifestyle changes. 24:00 - So it's through education, I guess the big word for it 24:04 if you were a psychologist, or if you were someone that 24:07 is dealing with mental health would be cognitive 24:10 behavioral therapy. 24:12 - It sounds like a pretty big word but it is sort of a... 24:16 yes, you understand it is a rational approach to making 24:20 some simple instructions based on evidence, 24:22 not because of some emotion, or because you heard some body 24:26 talk about it on a talk show. No! No! 24:28 This is based on epidemiology, the study of epidemics. 24:33 - So that gets their attention, they say ok, it's not just me 24:36 it is not just my wife saying you shouldn't eat that 24:38 but there were thousands of people that ate this and 24:41 this is s what happened to them I don't want that 24:42 to happen to me. 24:44 They get their cognitions, their thoughts are changing let's say 24:48 boy, if my thoughts change then my behavior will change 24:53 and I won't have the same angina any more, 24:55 or I won't have what he says I will have. 24:58 - You see we take them through many of these large studies 25:02 for instance you can go to Japan 1950 Japan, difficult to find 25:07 heart disease in Japanese. 25:09 As a matter of fact the Japanese Medical School in Tokyo 25:13 imported coronary arteries from Johns Hopkins University 25:18 in Baltimore, we said we need to have some of these plaques, 25:22 some of these specimens so we can show our medical students 25:25 what kills every second American. 25:28 - Because they didn't have any of that. 25:29 - They didn't have any, can you imagine? 25:31 But you know all of this has changed, today Japan has become 25:34 westernized, today Japan enjoys fish. 25:36 - They don't have to import these any more, its gone. 25:39 This is exciting actually, where you have 40, 50, 60,000 people 25:45 that have now gone through the CHIP program, 25:47 and they all these same results. 25:50 You are a Christian clinician as well, how does the power 25:54 of God factor into this? 25:56 - Well I think we recognize that God is the creator 26:03 and He gave us a circulatory system of some 60,000 miles 26:09 per body. - Umhum! 26:11 - You think about this, I mean we are wonderfully, 26:14 fearfully made and as we recognize God is the owner 26:18 of our bodies, we can now respond to that gift 26:24 entrusted to us and say what can I do to return this gift 26:28 to you, how can I maintain the beauty of this organism? 26:34 So faith then comes in to empower for us to do that 26:38 which is not easy to do. - So this group activity 26:43 helps us but really the power of God must be available to us 26:47 personally to make these kind of lifestyle changes. 26:50 - If you can rely on God who empowers you, you can swim 26:54 against the current. 26:56 - Let's go back and look at one more, 26:59 there is a graphic back there, see if you can find that of that 27:02 optimal diet way back. This graphic is good too: 27:22 This is the Killer Diet and that is what we want to avoid. 27:25 Instead, getting back to the original diet that God had 27:29 planned for us fruits, nuts, grains, and vegetables. 27:32 - Simple foods, foods as grown, simply prepared. 27:35 - Well thank you so much for being with us, 27:37 the people that are watching can go chiphealth.com, right? 27:42 - That's right! - Learn more about the 27:43 CHIP Program, it's an exciting program, it's changed my life 27:47 and the life of others and many others across the country. 27:50 We hope that as a result of this program you'll have health 27:53 that lasts for a lifetime. |
Revised 2014-12-17