Dr Rob Cywes: #1 Cause Of Heart Attacks & Strokes (AVOID THIS)

Dr. Robert Cywes, a double board-certified surgeon and metabolic disease expert, discusses the primary causes of heart attacks and strokes, emphasizing that sugar, not fat or cholesterol, is the main culprit. He critiques the common medical focus on LDL cholesterol, arguing that it misrepresents the true risk factors. Cywes advocates for a high-fat, low-carbohydrate diet, highlighting the importance of natural fats and the dangers of processed foods and sugars. He also discusses the adverse effects of statins and suggests alternative treatments like aspirin and colchicine for cardiovascular health, while stressing the need for personalized dietary approaches.

• Heart attacks and strokes are the leading causes of death in first-world countries.
• The problem is often misattributed to fat and cholesterol rather than elevated sugar levels.
• Nicotine and high blood sugar are primary causes of arterial plaque and heart disease.

"The commonest cause of death is heart attacks and strokes. The problem is not fat; the problem is not cholesterol; the problem is elevated sugar."

• Elevated sugar levels are a significant risk factor for heart disease, more so than fat and cholesterol.

"By the time you're sitting in the emergency room clutching your chest because you've had a heart attack or your face is drooping because you've had a stroke, it's too late."

• Early screening for cardiovascular diseases is crucial but often neglected.

• Nicotine causes significant damage to blood vessels, leading to plaque formation.
• Elevated blood sugar levels cause chronic inflammation in blood vessels, contributing to heart disease.

"The starting pivotal point was nicotine... industry diverted our attention away from nicotine being the causative agent that created the plaque in our blood vessels toward what the plaque was made of."

• Industry misdirection has led to a focus on fat and cholesterol instead of the true culprits.

"The problem is not fat; the problem is not cholesterol; the problem is elevated sugar."

• Elevated sugar levels are the primary concern in heart disease, not fat or cholesterol.

• LDL (Low-Density Lipoprotein) is often blamed for heart disease, but it is part of the body's healing response to inflammation.
• Statins, used to lower LDL levels, can be harmful and are not addressing the root cause of heart disease.

"The LDL molecule, the one that everybody's concerned about... it's not causing the problem; it's responding to the problem."

• LDL is wrongly blamed for heart disease; it actually helps in the healing process.

"The medications that they use to decrease the LDL are very, very toxic to other parts of the human system."

• Statins can be harmful and do not address the underlying issue of inflammation.

• Early screening for cardiovascular diseases can prevent severe outcomes like heart attacks and strokes.
• Many people are unaware of their risk until it's too late.

"There are great screening tools to detect early development of cardiovascular disease... I start to screen at around 40 years of age."

• Early screening can help in early detection and prevention of heart disease.

• Genetic factors determine whether a person is more likely to suffer from heart disease or lung disease due to nicotine.
• Similarly, genetic factors influence how effectively a person's body can manage blood sugar levels.

"There are people like myself who genetically our bodies are very, very good at clearing the sugar from the bloodstream... then there are other people who cannot produce enough insulin."

• Genetic factors play a significant role in how the body manages blood sugar and its susceptibility to heart disease.

• Chronic inflammation caused by elevated blood sugar levels leads to the swelling of endothelial cells in blood vessels.
• This swelling narrows the blood vessels, increasing blood pressure and contributing to heart disease.

"When sugar comes along down that blood vessel, the first thing that sugar does is it goes into the cell... you get this instant flooding of extra water inside of the endothelial cell."

• Elevated sugar levels cause endothelial cells to swell, leading to increased blood pressure and inflammation.

"Hypertension is caused directly by sugar at the initial inflammation but it's separate and apart from the plaque."

• High blood pressure is directly linked to elevated sugar levels and inflammation, not just plaque formation.

• The tobacco and sugar industries have historically misled the public about the true causes of heart disease.
• Vaping and "natural" sugars are often marketed as safe, despite their harmful effects.

"The narrative is driven by industry... smoking folks now say, 'Oh, smoking is bad but vaping is fine.'"

• Industry narratives often mislead the public about the safety of certain products, contributing to ongoing health issues.

"There is very, very few sources of sugar that we currently eat that existed in their current form when I was born."

• Modern diets are filled with manufactured and hybridized foods that contribute to elevated sugar levels and heart disease.

• Avoiding sugar and nicotine is crucial for preventing heart disease.
• A diet high in healthy fats and low in sugars can help protect the heart.

"One of the biggest causes of heart attacks and strokes is sugar, and so we need to avoid it."

• Reducing sugar intake is essential for preventing heart disease.

"The problem is not fat; the problem is not cholesterol; the problem is elevated sugar."

• Emphasizing the importance of dietary changes focused on reducing sugar and increasing healthy fats.

• Low-fat diets deprive the body of essential fats needed for cellular functions.
• Healthy fats are crucial for maintaining overall health and preventing heart disease.

"Every single cell in your body is made of two layers of fat, and if you're on a low-fat diet, you're depriving your cells of healthy forms of fat."

• Healthy fats are essential for cellular health and should not be eliminated from the diet.

"A high-fat diet will actually protect your heart."

• A diet high in healthy fats can help protect against heart disease.

• Plaque Disease (Plumbing Problem):
  • Plaque disease involves the clogging of arteries.
  • It is primarily a problem of clotted blood vessels.

"Plaque disease is a plumbing problem. It's where the plum is getting clotted."

• Hypertension (Swelling and Narrowing Problem):
  • Hypertension involves swelling, narrowing, and some inflammation.
  • It affects the endothelial cells and the interstitial space.

"Hypertension is a swelling and a narrowing problem as well as a bit of inflammation."

• Interstitial Space and Sugar:
  • The interstitial layer is active, consisting of tubules and canaliculi.
  • Elevated sugar in the interstitial area damages nerves, endothelial cells, ligaments, and tendons.

"When the sugar level elevates in that interstitial area and is not cleared by the cells, you're also getting elevated sugar damages nerves, that changes the cellular nature of the endothelial cells and damages ligaments and tendons."

• Electrical Malfunctions (Atrial Fibrillation):
  • Elevated sugar can cause electrical malfunctions in the heart.
  • This leads to conditions like atrial fibrillation, an irregular heartbeat.

"One of the commonest bad aymas that we starting to see which is electrical malfunction of the heart also caused by elevated sugar is called atrial fibrillation and various forms of irregular heartbeat."

• Three Cardiovascular Diseases:
  • Elevated sugar levels can cause plaque disease, hypertension, and electrical issues in the heart.

"We've got a plumbing problem, we've got a swelling problem which is hypertension, and we've got an electrical problem or electrification of the cells particularly at the pulm veins where they come into the heart."

• Misleading Health Advice:
  • Many health beliefs, such as the dangers of cholesterol and the necessity of a low-fat diet, are influenced by industry marketing rather than science.
  • Historical slogans like "breakfast is the most important meal of the day" were created by companies like Kellogg's.

"If you trust the tobacco companies, if you trust Kraft Foods, if you trust Nestlé, I can't help you, because that is their messaging and it is marketing messaging."

• Misinterpretation of Salt and Sugar:
  • Salt is essential for regulating water distribution, retention, and removal in the body.
  • Sugar, in contrast, is toxic at elevated levels and the body works hard to eliminate it.

"Salt regulates our water distribution and our water retention and our water removal. The human body has a great resource for dealing with salt. Sugar, on the other hand, is toxic to the human body at elevated levels."

• Evolutionary Perspective on Diet:
  • Historically, humans have consumed natural fats and limited sugar.
  • The modern high-carbohydrate diet is a recent development in human history.

"The Europeans only really discovered significant sources of sugar in the 15-1600s after Columbus discovered sugar cane or brought sugar cane back from the Americas back to Europe."

• Natural vs. Manufactured Fats:
  • Natural fats come from animals and plants, while manufactured fats are processed and extracted from seeds.
  • Natural fats are essential for human health, while manufactured fats are less beneficial.

"Natural fat is the fat that occurs naturally in animals, naturally in plants or is just squeezed out of the plant like olive oil or coconut oil or avocado oil."

• Misconceptions about Saturated Fat:
  • Saturated fat is not dominant in most animal products except milk, which is essential for mammalian development.
  • The fear of saturated fat is based on outdated information.

"There is nothing that we eat certainly on the Animal product side except for one thing that is dominant in saturated fat and that's the only thing that is dominant in saturated fat is milk."

• Role of Fat in the Body:
  • Fat is crucial for the structure and function of cells.
  • The body needs fat for energy and cell construction, and it cannot function properly without it.

"Every single cell in your body is made up of two layers of fat. Your body's turning those cells over very rapidly. If you look at the brain, it looks like this white gelatinous material. Why? 65% of it is fat."

• Essential vs. Non-Essential Nutrients:
  • Essential fatty acids are crucial for survival, while sugar is not essential.
  • The liver can produce sugar as needed, but essential fats must be consumed through the diet.

"If you never ever ate sugar again in your life, your liver is so good at making sugar that nothing bad would happen. That's an important consideration. Sugar is not essential in the diet; fat is."

• Carnivore and Ketogenic Diets:
  • These diets can help improve both physical and mental health.
  • They emphasize the importance of consuming natural fats and proteins.

"We need fat and adequate protein especially if we want to heal inflammation and heart disease. A very easy way to do this is to try a carnivore diet."

• Community Support:
  • Support from doctors and a community can be crucial when starting a new diet.
  • Access to medical advice and meal plans can help ease the transition.

"If you're thinking about trying a carnivore diet, I would love to invite you to join our Go Carnivore Community. We have board-certified carnivore and keto doctors to help support you and answer your most common medical questions."

• Natural Fats:
  • These include fats from animals and plants that are naturally occurring or simply pressed out, such as olive oil and coconut oil.
  • Natural fats are a part of human history and essential for health.

"Natural fat is the fat that occurs naturally in animals, naturally in plants or is just squeezed out of the plant like olive oil or coconut oil or avocado oil."

• Manufactured Fats:
  • These are fats that are processed and extracted from seeds, often involving heating and chemical processes.
  • Examples include canola oil and Crisco, which are less beneficial for health.

"Manufactured fat are the fats that are hydrolized and produced in factories. We have to heat seeds up, we have to extract fat."

• Polyunsaturated Fats:
  • These fats are often misunderstood and can be both naturally occurring and present in seed oils.
  • The key is to focus on the source of these fats, whether natural or manufactured.

"The fat in an animal, whether it's a salmon that you're eating, whether it is a chicken skin that you're eating, whether it is a steak, whether it's bacon that you're eating, the fat in there is predominantly polyunsaturated."

• Dietary Balance:
  • A balanced diet should include natural fats and avoid manufactured fats.
  • The goal is to nourish the body with essential nutrients while avoiding harmful substances.

"We as a species have been eating and chasing natural fat for our entire existence. They didn't slaughter the skinniest, leanest little goat or lamb or sheep in the Bible; it was the fattest one."

By focusing on these key themes and understanding the nuances of how sugar and fat affect the body, individuals can make more informed dietary choices that promote better health and well-being.

• The carnivore diet is preferred for its simplicity and ease of adherence.
• Transitioning directly to a carnivore diet is not recommended due to its rigidity.
• The diet should be approached gradually, similar to how an alcoholic avoids alcohol.
• The focus should be on understanding personal dietary needs and avoiding societal influences on diet.

"It's very simple. It's got nothing to do with science. It's simpler and easier, and my dog doesn't eat leftover salad."

• The speaker prefers the carnivore diet for its simplicity, not necessarily for scientific reasons.

"Nobody should start on a Carnival diet. It's too rigid, it's too strict, and the body can't go from this to this right away."

• A direct switch to a carnivore diet is not advisable due to its strict nature.

"Carbohydrates are not the problem. Our relationship with them is."

• The issue lies not with carbohydrates themselves but with how individuals interact with them.

• Individuals should establish rigid dietary boundaries based on their health and metabolic conditions.
• For those with metabolic health issues, carbohydrates should be eliminated.
• Vegetables are an exception to the carbohydrate elimination rule.
• Personal dietary boundaries should be maintained for life.

"The first thing is, look at your diet and get rid of the carbohydrates, but then within that, everything is fine."

• Carbohydrates should be eliminated first in the diet, but other foods can be consumed within this boundary.

"I stay away from fruit because they're all manufactured or they're all hybridized and full of sugar."

• The speaker avoids fruits due to their high sugar content and hybridization.

"You can then create for yourself a narrower spectrum of what we eat, and you start with a broader spectrum and slowly you refine that."

• The diet should start broad and be refined over time based on individual preferences and health.

• Dietary approaches should be individualized based on cultural practices and health conditions.
• For vegetarians, a higher fat, green vegetable diet is recommended.
• Certain diseases, like Crohn's disease, benefit from a pure carnivore diet.
• Personal convenience and simplicity are reasons for choosing a carnivore-based diet.

"I'm not going to fight that. I'm going to work with them to help them be on a higher fat, more green vegetarian diet rather than white vegetarian diet."

• The speaker adapts dietary recommendations to fit cultural practices like vegetarianism.

"I've chosen to be carnivore or carnivore-based because it's easier and simpler for me to exist that way."

• The choice of a carnivore diet is based on personal convenience and simplicity.

• The key to a successful diet is sustainability over a long period.
• Occasional consumption of vegetables is acceptable to avoid extreme rigidity.
• Essential dietary components include fat, salt, and micronutrients from specific sources.
• Supplements are generally unnecessary if the diet includes nutrient-rich foods.

"The key thing here is not what you do for a little while; it's the sustainability."

• Long-term sustainability is crucial for dietary success.

"Making sure that you are getting three essential things in: number one, fat; number two, salt; and number three, a source of micronutrients."

• Essential dietary components include fat, salt, and micronutrients.

"I don't take any supplements except fish oil because I've got a history of dementia."

• Supplements are generally unnecessary if the diet is nutrient-rich, except for specific health conditions.

• Knowing oneself and being honest about dietary needs is crucial.
• Avoiding foods that trigger unhealthy behaviors is important.
• Carbohydrates and sugars are viewed as addictive substances, similar to drugs.
• Fat is emphasized for its satiating and hormonal benefits.

"The first thing you want to do is get to know who you are, be honest with yourself, and know who you are."

• Self-awareness and honesty about dietary needs are essential.

"I look at sugar and starch not as a food source because we don't need it. I look at it as a drug that we become dependent on."

• Carbohydrates and sugars are viewed as addictive substances.

"Fat for me and fat for many people is very satiating. It's very good for your hormones, very good for your brain, very good for your heart."

• Fat is beneficial for satiety, hormonal balance, brain, and heart health.

• The three macronutrients are fat, protein, and carbohydrates.
• Protein needs are generally stable, while fat should be emphasized.
• Excess protein is converted into sugar, which can be problematic.
• The body regulates fat consumption but not lean protein consumption.

"The narrative should not be protein, protein, protein in the modern era; it should be fat, fat, fat."

• The focus should be on fat rather than protein in the diet.

"The liver will take excess protein and turn it into sugar. There is no store in the human body for protein."

• Excess protein is converted into sugar by the liver.

"The body will regulate fat consumption; it doesn't regulate lean protein consumption."

• The body naturally regulates fat consumption but not lean protein.

• The body has three phases of energy utilization: storage, glycogen release, and fat utilization.
• The liver plays a central role in energy storage and distribution.
• Excessive carbohydrate intake overwhelms the liver, leading to metabolic issues.
• Fat utilization is the healthiest state, regulated by hormones like glucagon.

"The liver then becomes part of the Distribution Center, sending that creating and sending that energy out to the cells under the influence of glucagon."

• The liver distributes energy under the influence of glucagon during the fat utilization phase.

"The healthiest state of being is called the fat utilization phase, governed by a low level of insulin and a higher level of glucagon."

• The fat utilization phase is the healthiest state, regulated by low insulin and high glucagon.

"Consumption of food should only be rare and occasional and should be the food that your body mostly needs."

• Food consumption should be infrequent and based on the body's needs.

• Transitioning from a sugar-burning to a fat-burning state should be gradual.
• Initial high insulin levels block fat utilization, so dietary fat is needed.
• Saturated and polyunsaturated fats bypass the liver and are readily utilized.
• The goal is to convert cells to primarily burn fat instead of sugar.

"You want to slowly convert your body to being a primary sugar burner to being a primary fat burner."

• The transition from sugar to fat burning should be gradual.

"If your insulin levels are high, it's blocking utilization of your own fat, so you want to be eating fat in the diet so it's available to you."

• High insulin levels block fat utilization, so dietary fat is necessary.

"You're slowly converting your cells under the hormonal changing environment to changing from being dominantly sugar burners to being fat burners."

• The goal is to convert cells to primarily burn fat through hormonal changes.

• Chronic high insulin levels lead to various health issues, including cancer.
• Insulin regulates cell division and can prevent proper cell regulation.
• Elevated insulin is linked to the prevalence of diseases like breast cancer.
• The focus should be on reducing insulin levels to improve overall health.

"Cancer is a disease that is common in my genetic pattern because insulin regulates cancer transformation."

• Chronic high insulin levels are linked to an increased risk of cancer.

"Insulin prevents the regulation of cell division, leading to cancer."

• Elevated insulin disrupts cell regulation, contributing to cancer development.

"The healthiest state of being is where the body is healing itself, with low insulin and high glucagon levels."

• The ideal state of health involves low insulin and high glucagon levels, allowing the body to heal itself.

• Insulin regulates sugar in the brain, and optimal brain function requires more fat than sugar.
• Obesogenic individuals, who produce a lot of insulin, are at risk for heart disease, cancer, Alzheimer's, polycystic ovarian syndrome (in women), low testosterone (in men), autoimmune diseases, and thyroid diseases.
• Diabetogenic individuals, who cannot produce enough insulin, suffer from cardiovascular disease, stroke, and neuropathy due to chronically elevated sugar levels.
• Managing insulin levels through diet, particularly by reducing carbohydrate intake, is crucial for both groups.

"Insulin regulates the sugar in the brain, and you want fat in the brain, not sugar. A little bit of sugar but mostly fat."

• Insulin management is essential for brain health, favoring fat over sugar.

"Obesogenic people like myself are at risk for heart disease, cancer, Alzheimer's, polycystic ovarian syndrome in women because now you're getting higher testosterone, lower estrogen that's regulated by insulin."

• High insulin levels in obesogenic individuals lead to various health risks, including hormonal imbalances and chronic diseases.

"Diabetogenic people who cannot produce a lot of insulin, their damage is being caused by chronically elevated levels of sugar because they don't have enough insulin to clear that sugar."

• Diabetogenic individuals face health issues due to insufficient insulin to manage blood sugar.

• Reducing insulin levels through diet, particularly by avoiding carbohydrates, is a gradual process that can take up to two years.
• Immediate results are not typical; significant hormonal regulation changes take time.
• The analogy of switching a car's fuel from petrol to diesel illustrates the need for gradual dietary changes to avoid adverse effects.

"You want to bring my insulin levels down by not triggering it with carbohydrates in the diabetic situation they want to bring their blood sugar levels down."

• Lowering insulin and blood sugar levels requires dietary changes, primarily reducing carbohydrate intake.

"The conversion takes about two years to occur, but the question then is how long are you going to do this for?"

• Significant dietary changes and their effects on insulin take time, often up to two years.

"If you suddenly go from fueling your body with sugar to fat, your body's going to reject that; it's miserable."

• Gradual dietary changes are necessary to avoid adverse reactions from the body.

• Statins are commonly prescribed to lower LDL cholesterol, but their effectiveness in preventing heart disease and strokes is debatable.
• A better measure of heart disease risk is the Coronary Artery Calcium (CAC) score, which detects plaque in blood vessels.
• Statins have significant side effects, including muscle pain, diabetes risk, and cognitive issues due to their impact on cholesterol levels in the brain.

"Doctors should be appropriately worried about your heart attack and stroke risk. The problem is that they associate elevated LDL, elevated cholesterol with that risk, and that's a false association."

• Elevated LDL cholesterol is not a direct indicator of heart attack and stroke risk.

"The screening test is called a CAC, a Coronary Artery Calcium score. It's a simple CT scan, very low radiation, very low risk."

• CAC scores are a more accurate measure of heart disease risk than cholesterol levels.

"The harm of statins is about 42% of people are going to have significant clinical harm from statins, and there is no benefit."

• Statins have significant side effects with questionable benefits in preventing heart disease.

• Aspirin and colchicine are more effective than statins in preventing heart disease by blocking platelet activation and white cell activation, respectively.
• New drugs like GLP-1 agonists address insulin resistance and sugar management more effectively than statins.
• Lifestyle changes, particularly dietary modifications, are crucial for long-term heart health.

"Aspirin blocks platelet activation, and a new drug called colchicine blocks the activation of white cells."

• Aspirin and colchicine are effective in preventing heart disease by targeting different aspects of the clotting process.

"The GLP-1s and that class of drugs directly address the problem of sugar."

• GLP-1 agonists are effective in managing insulin resistance and sugar levels.

"Preventing this disease with a healthy diet, we cause the problem, we can reverse it or we can stop it by changing our diet."

• Dietary changes are fundamental in preventing and managing heart disease.

• Many people eat carbohydrates not for nutritional value but for emotional management.
• Recognizing and changing the relationship with food is essential for long-term health.
• Healthy emotional management includes physical activity, human connections, and creative outlets.

"The overwhelming number of us are going to get sick and die of metabolic disease caused by our diet."

• Metabolic diseases, primarily caused by poor dietary habits, are a leading cause of death.

"A snack is always an emotional event; it is never a nutritionally based event."

• Snacking often serves as an emotional coping mechanism rather than a nutritional need.

"Establishing healthy human connections, establishing creative outlets, establishing physically active outlets for our emotional needs."

• Healthy emotional management involves physical activity, social connections, and creative pursuits.

• Dr. Rob Cywes emphasizes the importance of understanding the role of insulin in various health conditions and the need for gradual dietary changes to manage insulin levels effectively.
• Statins are questioned for their effectiveness in preventing heart disease, with alternative treatments and lifestyle changes being more effective.
• The relationship with food, particularly carbohydrates, needs to be re-evaluated for better emotional and physical health.
• Dr. Cywes provides resources and consultations to help individuals understand and manage their metabolic health.