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Dr. Mike Confronts Dr. Gundry's Controversial Health Views

— A closer look at surgeon's claims on vitamin C and smoking risk, leaky gut, and more

MedpageToday

In this video, Mikhail Varshavski, DO -- who goes by "Dr. Mike" on social media -- sits down with cardiothoracic surgeon Steven Gundry, MD, to discuss his controversial health claims.

Following is a partial transcript of the video (note that errors are possible):

Varshavski: I have 25 million subscribers of people who listen to every word I say and correct every mistake I make. I could tell you how your information, very confidently, lands with them and it doesn't land in the way you intend it to. I just urge that in your upcoming books and the speeches that you make, just take that into consideration. Because when you make statements like "Apples are horrible," "The worst thing you could do for your mitochondria is a fruit smoothie," it's not just taking a little bit of liberty with the information, it's truly misleading people to make bad decisions for their health. That's all I'll say.

Dr. Steven Gundry is a cardiothoracic surgeon who found success leaving the operating room and shifting his focus to prevention along with writing several bestselling books, including "The Plant Paradox" and his upcoming book titled "Gut Check." You may have seen his content across social media highlighting his very controversial claim that certain healthy foods are actually bad for you.

His most popular claim is that foods like beans, tomatoes, whole grains, and bell peppers are actually unhealthy because they contain proteins called lectins and therefore are destroying your gut. This has drawn sharp criticism from the medical and nutrition community at large, given the great amount of evidence showing that those who eat those foods are significantly healthier, have lower risk factors, and do not require the removal of such foods.

Being fully honest here, I was one of those critics. When Dr. Gundry's team reached out for him to come on The Checkup, I made sure that we stated early and openly that if he were to come on it would likely be a critical conversation. To his credit, he welcomed the debate. I also mentioned, given that he is a cardiac specialist and I'm a family medicine doc, I would like to bring in Dr. Danielle Belardo, who is a cardiologist heavily focused on research surrounding disease prevention. In fact, she is on the committee that puts forth new guidelines aiming to decrease the number one killer of all of us: heart disease. Dr. Gundry again agreed, so here we go, The Checkup podcast.

Well, we're talking about heart disease prevention and it's great to have two people who are passionate about heart disease prevention because for myself, as a primary care provider, so many of my patients come in too late, already with heart disease. Then we're focusing on trying to reverse that and reverse that, not just through medication methods, but also giving them some lifestyle modifications. That takes a lot of work because currently the American Standard Diet is an absolute disaster. The things my patients are consuming, high ultra-processed foods -- very, very problematic.

But Dr. Gundry, I'd like to start with you because part of, I would say, your success on social media and with your books, "The Plant Paradox," has been that the advice doctors, the medical system, gives to patients when it comes to diets, including what we call healthy foods, are actually unhealthy. Tell us about that.

Gundry: Yeah. I think that's certainly my observation over the last 50 odd years that I have been doing this. As a heart surgeon, we knew that if we put a stent in someone or did a bypass, we'd probably see them for their next procedure in 5 to 7 years in general. And we were taught that this was inevitable and there is not much we could do to slow down the process -- statins, blood pressure medications, lifestyle modifications, exercise more, but in fact, those were really piddly little things in the scheme of things.

When I, 28 years ago, watched a gentleman from Miami, Florida -- Big Ed in all my books -- reverse 50% of the blockages in his coronary arteries, which were basically totally occluded, in 6 months time with a diet and taking a bunch of supplements willy-nilly from a health food store, I knew that he was onto something and spent the last 28 years figuring out how he did it.

Varshavski: That's interesting to me because in medicine we always look at anecdotal situations as perhaps not the strongest level of evidence, so why did this one case... because I have patients that come to me, follow all sorts of unique diets. I have patients who have been smoking for 45 years and they are living a healthy life and they say, "It's 'cause I smoke." Obviously, we laugh about it because we all agree that it's not true -- so why did this one case move you so?

Gundry: Actually, let me stop you right there. Probably it's because he smoked that he is doing so well.

Varshavski: OK, we need to back up. How do we get there?

Gundry: Well, I have a whole chapter in "Gut Check" looking at the healthiest, longest-living people and one of the unique features of most of the Blue Zones is that, particularly the men, are heavy smokers. And the smoking, actually the nicotine in cigarettes, is one of the best mitochondrial uncouplers that's ever been discovered. We have looked at this through the wrong lens. We said, "Wow, what other healthy lifestyle things are these guys doing that's preventing smoking from harming them?" In fact, we should have looked at it the other way. What is it about these people who are smokers that allows them to live to 105 to 110 years old? When you do that, then you say, "OK, smoking was good for them. Why don't we see the oxidative stress that smoking, we all know occurs -- why don't we see the cancers in these people?" It's because the rest of their diet facilitates the absorption of the oxidative stress in these guys.

Varshavski: So your state is that if you smoke, but eat in this specific way, you can negate the negative effects of smoking?

Gundry: Yeah. What's fascinating, as a heart surgeon, way back in the good old days most of our patients were smokers and they had specific proximal lesions in their coronary arteries. The rest of their blood vessels were absolutely gorgeous and they were skinny for the most part.

Varshavski: How did you gauge that? Did you...?

Gundry: What do you mean? We operated on 'em.

Varshavski: But you operate on what other vessels that you saw? Like you would do peripheral arterial disease screenings on those patients?

Gundry: Sure. Yeah.

Varshavski: And you would find...?

Gundry: I used to operate on...

Varshavski: Because one of the number one risk factors for peripheral arterial disease is smoking.

Gundry: Correct, because the smoking, the oxidative stress, isn't stopped by our current diet. Let me give you an example.

Varshavski: OK.

Gundry: We're one of the few animals that don't make vitamin C, and vitamin C -- and I've written about this. Normally, unfortunately collagen breaks as blood vessels flex and contract, and it breaks primarily at bends. When that collagen breaks, vitamin C normally rebuilds that collagen. In smokers, they don't have vitamin C because the vitamin C has been used up in handling the oxidative stress. They have basically raw collagen that sits out and then we start the process of an inflammatory attack and cholesterol is basically a spackling compound, and just keeps spackling that area.

The great news about smoking is that it always happens at these bends where flexion occurs. If, like these people in the Blue Zones who live a very long time as smokers, if you have huge amounts of vitamin C-containing foods in your diet -- and incidentally olive oil doubles our own vitamin C production, which is kind of cool -- then you mitigate those effects and you don't see the negative effects of smoking. You actually see the positive effects of nicotine.

Varshavski: Is there research that backs up where if you change someone's diet to have high vitamin C content that there negates their risk of smoking? Because I have never seen that.

Gundry: Yeah. That's all been done in the Blue Zones.

Varshavski: Well, Blue Zones are not research studies. In fact, you've been quite critical of Blue Zones, even in your book.

Gundry: Yeah. For instance, let's take Sardinia, for example, one of the Blue Zones. Only the people who live up in the mountains actually have longevity. The people who live down by the water don't. What's different about those people is that they are sheepherders and goat herders. What they eat is a large amount of fermented sheep cheese, sheep yogurt, and what makes them have longevity is the men, 95% of the men, smoke and only 25% of the women don't. What's unique is, as we all know, women live about 7 years longer than men. The men in Sardinia have a 7-year longer lifespan than the women because they are smokers. That's what brings them up.

Varshavski: But that's an incredible conclusion to come to.

Gundry: The same with the Kitavans.

Varshavski: But I'm saying there are so many variables that influence one's life. How are you isolating the one? We have trouble isolating anything in research.

Gundry: Look at the Kitavans. Staffan Lindeberg spent his lifetime studying the Kitavans in Papua New Guinea. They smoke like fiends. They have never had a documented case of a stroke or coronary artery disease. Never had a documented case of lung cancer.

Varshavski: I'm confused how in this scenario we're using Blue Zones as an example for this, but then in your book you point out that in Okinawa you feel that the Blue Zone is untrue because they may be trying to collect pensions and their family members are not reporting their deaths appropriately. How on the one hand are you using Blue Zones as a form of backing up what you're saying versus other times saying it's actually... the whole thing is a sham?

Gundry: I'm talking about coronary artery disease and longevity.

Varshavski: Right.

Gundry: These people don't have coronary artery disease despite the fact that they are smoking. I'm saying we should actually look at this backwards and say, "Wait a minute, all these people are smokers. Is there a benefit to smoking, to nicotine?" I'm not saying... don't get me wrong; I never had a cigarette in my life. But we negate the fact that maybe we're missing a positive benefit.

, is a board-certified family physician and social media influencer with more than 11 million subscribers.