March 25

Dr Monica Aggarwal Driving Positive Change For RA Treatment And Public Health

In This Paddison Podcast Episode with Dr Monica Aggarwal:

Monica Aggawal Thumb

Dr Aggarwal joins the American College of Cardiology Nutrition Committee
How the goal is to influence doctors on the safe and powerful approach of nutrition
Monica’s book coming out soon!
Where disease comes from
The study is on hold but it will happen
Variations on Rheumatoid Arthritis results (triggers and responses)
Why we need clinical data on this plant based diet
29.00 Start with a plant-based diet
30:00 Gut can take at least 3 months to heal
31:00 Don’t introduce more than one thing at a time
32:00 How drugs can impact gut healing
33:00 Gluten sensitivity can be reversed
34:00 Gut flora of Africans study shows how it can change
36:00 Monica looks well: Sleep is important. Yoga. Avoid dairy!
39:00 Clint’s RA documentary in the pipelines
40:00 What’s next for Monica

This podcast does not constitute medical advice. All changes surrounding medications, diet and exercise should be made in consultation with a professional who can assist your unique health circumstances.

Listen to the episode here:

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Clint: Good day. It’s Clint here. Thanks for joining me again for another episode of The Paddison Podcast. We’re going to have fun today.

We’ve got Dr. Monica Aggarwal back on the show. She was in episode number 11. And you may recall, she’s a very highly regarded cardiologist based out of Baltimore. She herself went through a very, very challenging time with rheumatoid arthritis, and came to the same conclusion that I have several years ago, which is that a plant-based diet is the way to go for this disease. And using that approach, she now requires no medications to keep her inflammation at normal levels, and is doing all sorts of things, running and just lives a very active life, and isn’t burdened by the side effects of severe drugs.

So we were due for a catch-up, because last time I corresponded with Monica, we were trying to get a study published to show the powerful effects of a plant-based diet, with a collaboration effort, with all of the success stories and data that I’ve had come back to me through clients of The Paddison Program, and also through some of her other contacts including Dr. McDougall, who we had on the last episode.

She’s currently in Malaysia. So let’s pick up the conversation as Monica explains what she’s doing there, and what she’s got planned.

Dr. Aggarwal: What I would say is, I think I would start with this. I think in…I think what was happening to me in America was that I was losing a little bit of why I went into medicine, and I was just seeing patient after patient, and the demands and expectations from us, as physicians, and was involved in labour-intensive, and I felt like I was losing my…why I became a doctor. And I just needed to kind of re-centre and recalibrate.

And some of my good friends at Hopkins called me and let me know about an opportunity where they were part of a medical school in Kuala Lumpur, Malaysia. You know, frankly, I had to look up Malaysia on the map. I knew generally where Malaysia was, but we just…I was like, I know it’s near Thailand, but I don’t know exactly where.

So when he asked me to join the…join over and come over to K.L., I initially was…thought that’s impossible. You know, nobody does that. You don’t leave your track and do something different. I was the director of my Ecolab [SP], I was doing really well, things were going well. Who leaves that? But that’s sort of why I did need to leave that, isn’t it? Because I was just continuing every day, the same thing, running, running, running around all the time, moving from patient to patient and not really feeling I had enough time with each patient, and just the constant demands in balance.

And so when the Malaysia opportunity was…it was a teaching opportunity and I have always taught throughout my career, but I kind of was intrigued about an opportunity to go to another place and so teach the next generation. And I love Asia, and so I thought it would be a really neat experience, and it really has been. I mean, I see cases that I will never see in the U.S. I will never see. Because medical care is so good in the U.S., and not to say it’s bad here. I’m not making that distinction. It’s just that because people go to the physicians so regularly there, anytime there’s routine visits, yearly physicals, it’s just not…that’s not routine in Asia, and patients get further along before you see their illness. And so I have seen incredible things.

And I had…and the students are amazing. They are humble and they love learning from me, which is so cute. They ask me if they can buy me lunch so that I don’t have to take lunch, so that I can teach them through lunch.

Clint: That’s a great compliment, isn’t it?

Dr. Aggarwal: It’s so lovely, it’s so lovely.

Clint: So you’re trained as a cardiologist, for our listeners who will recall our earlier conversation. What are you teaching the students? Are you covering generic medical stuff or are you concentrating on your expertise?

Dr. Aggarwal: So every cardiologist is also trained in internal medicine. So you train in internal medicine which is general medicine, and then you subspecialize in cardiology. And so I always had an internal medicine background but I haven’t used it in years, and it’s been fun to re-learn stuff and I’m for sure a better doctor than I ever was a year ago. And it’s been interesting, it’s a year-long sabbatical that I’m taking. So I’m going back this summer. And when I go back, my desire is to really focus more on integrative cardiology, which is what I think all of this has come together to where I’m supposed to go.

You think about why life happens the way it does and you think about why you got sick and why I got sick and how things happen, and you think that they’re the worst moments in your life. And they are in so many ways for sure, but they just…but sometimes you have to go through those bad moments in order to see how to live, and what you were meant to do. And I definitely…I’m shaped and changed because I got sick. And in some ways, and it’s weird to say, but I’m thankful that I got sick. I don’t know if that makes any sense because I’m not really thankful, but…

Clint: It makes a lot of sense. I’ve said…I’ve actually written in the book that in some ways, it was the best thing that ever happened to me, and I actually came to the belief that I was given my particular disease because of my personal research background and because of all the spare time that I have as a stand-up comic. I only work one night a week or two nights a week. You know, I could spend the rest of my time getting well and then sharing that with other people, in the way that you’re doing it too.

So, look…but on the flip side, just as you made the comment there, I think if I could have it all back and have every joint perfectly healthy again, and have started my family earlier because I wouldn’t have been on all the drugs and I hadn’t put my wife through all the hell that we had to go through, honestly I probably would take it all back and just had been healthy. Because it’s shocking, isn’t it? I mean, let’s face it, it’s shocking.

Paddison Program

Dr. Aggarwal: For sure. I don’t think anybody ever wants to get sick. But…and there’s no question that we’ve all been through our share of trauma. And all the listeners have too. I mean, I get calls and emails and people referred from you and from other people who know that I have rheumatoid, and they send me comments and telling me their stories. And you know, there’s no question that we’re all sort of suffering from a crazy illness. And so there’s no question that I would want it on anybody. But now that we do have it, it really has changed me.

And so you know, I think when I go back in the summer, I will be truly integrated. I did do…it’s interesting, I did an integrated fellowship with Andrew Weil years ago, 10 years ago. And maybe I was a little bit more…this is when I was in training, so I did sort of multiple different fellowships. And I did an integrated fellowship and I thought, you know, this isn’t really for me. I’m not really…I don’t believe this, I don’t believe that, and it’s almost like I had to have that background because when I started using nutrition and learning about other alternative therapies, I had to look…I had to sort of lean on that knowledge and all that studying I had done back during that fellowship to say, what is going on? Maybe…let me make this more…make it more sense. And it’s interesting because sometimes you don’t know the value of something that you’re learning until now, and then I had a chance to really use it. It was so interesting. So I did that integrative fellowship, so I have a lot of experience with integrative medicine.

Then I’ve got this cardiology background and now I’m obsessed with nutrition. So in some ways, it’s all going to sort of like come together and be…

Clint: And it’s beautiful.

Dr. Aggarwal: …the new job.

Clint: So you mentioned just before we started recording I think about how you feel that you’ve changed since you’ve been here. I just want either…can you open up a little bit and share how…what it’s meant to you to be able to share with these students, and to be able to step outside of your career up until this point to take a new direction for you?

Dr. Aggarwal: Right. Yes. So I got a little tangential there I see.

So in medical…so when I’ve been here this year, besides seeing these incredible patients, which I have seen, working with the students, their humility, it’s almost like they’re humble in a way the American medical student isn’t, who may be just a bit more entitled. And the students here, they’re adjustable, take anything that I will give them, and they’re lovely. When I work with them, it takes a lot to teach. You give a lot of yourself. But their feedback has been so lovely. I’ll give you an example.

Two days ago…and everybody knows now that I’m leaving. There’s a lot of interesting emotion. So there’s two examples. One, two days ago my students said to me…they said that I had given them…they said that I was…you know, they were very flattering. But one of the things that they said was that I had given them…they made me look at medicine…I made them look at medicine in a new way, and then they actually realized that medicine…what medicine was because of the teaching. And I just…you know, that’s so warming, and to be able to give that to somebody is fabulous.

The other episode and example that happened to me is I was working with a patient who’s extremely sick and this happened yesterday. Actually it’s interesting that we’re having this call today. And he was very sick, he had congestive heart failure, which is a weakening of the heart, and he was in an abnormal heart rhythm, and he was building fluid in his lungs. And I was explaining to the patient what was going on, because unfortunately there’s a lot of, I’m the doctor, you’re the patient, don’t ask me questions kind of attitude, where I think we’ve shifted away from that in the States, where there’s a lot more communication. Unfortunately there’s still a lot more of the, “I’m the physician, you’re the patient.” So patients often go home and don’t really understand their illness.

And so I spent a lot of time with him, talking to him, and the student…he was asking me…asking the students about me and they were saying that I was leaving, and this one really hurt and made me feel very conflicted because he said to me, he said…and he grabbed my hand and he started crying, because he’s very sick and he’s dying. And he grabbed my hand and he started crying, he said, “Don’t leave.” He said, “Teach…please stay here and teach my Malaysian sons and daughters, and make them better. And give them what you have to give them and make them better.”

I’m definitely conflicted about that, but a warming moment for sure about sort of what…there’s so much to give here and they are so…they’re so eager to take, and it’s lovely.

So I loved it. I love being here and I love teaching, and I hope to continue to teach. I have a lot of new plans for when I go back, which I think will come to fruition. Because I think I have…I’m excited to go back to the U.S. and teach students…medical students about nutrition. And I did a survey with…so this year has been interesting and I’ll step back a little because I’ve become involved in a lot of different things. I’ve got this book coming out, which has been exciting and we can talk about that. And then I’ve also joined the American College of Cardiology Nutrition Committee which has been really interesting.

So the American College of Cardiology basically is sort of the cardiology national organization. Sets all the standards on how we all practice. One of the committees is the Nutrition Group, and there’s only 10 members on that group and I’m 1 of them.

Clint: Oh, congratulations.

Dr. Aggarwal: …thankful for that. I’m not sure I’m worthy of the talent in that group, but they are fabulous.

And we…part of it is that we’re writing or putting together national standards for hospitals and trying to figure out what’s…how doctors perceive their nutrition education. And one of the things…and I can’t give a lot of the data because it’s still sort of confidential, but I can say that we’re finding that doctors…you know, it’s sort of embarrassing how little of nutrition education they’re getting in school…medical school residency, fellowship, and beyond, and they just don’t feel equipped to teach their patients how to eat well.

And so it’s ironic, isn’t it? That the physician is supposed to be the person to teach lifestyle changes, and we do. We say…as doctors we say, well you need to change your diet. You need to exercise more. But we don’t actually give patients really concrete ways to make themselves better. And the reason is, is because most physicians actually don’t know how to. And that’s a sad reality, and that’s one that I would tell you that I have had to spend years teaching myself to learn nutrition and the benefits of nutrition and why, and read all the studies and try to understand. Because what I didn’t want to do is say, okay, nutrition is great, but I wanted to understand why and what has being studied and what are the trials and how does inflammation work? And that took a lot of time, but that is unfortunately not taught in medical school.

So that committee has been really interesting for me because I’m definitely around amazing people. But eventually, hopefully we’ll be affecting national standards in nutrition.

Clint: Let me ask you this, you mentioned a couple of the…your colleagues who are in that committee as well on an email to me before we organized this chat. One is Dr. Dean Ornish, another is Dr. Caldwell Esselstyn, both very, very famous doctors, and then yourself. All three of you sort of very heavily into the plant-based nutrition approach. Now, are all 10 of you sort of plant-based advocates, or is there conflict within the group over what’s right and what’s wrong?

Dr. Aggarwal: So you know, I’m the newest member, so I can’t…I don’t know a lot of the intricacies of the group. But no, everybody is definitely not plant-based, there’s…and deliberately so. Because the American College believes in plant-based diet, the Mediterranean diet, which is the diet that made big news a few years ago in the New England Journal, which was one of our biggest journals, which showed that the Mediterranean diet improves outcomes. So it was one of the big…it was a really big trial, but if you look at the Mediterranean diet, it’s primarily a diet that’s focused on plants. So it’s plants, whole grains, and nuts, and seeds, and yes, there’s a little bit of fish, and there’s a component of…there are other facets. But overall it’s a plant-based diet.

So a lot…there are some people that are strong believers in Mediterranean and then there’s variations in between, but yeah, I’m sure that there is dissension, but everybody respects each other and I just look forward to being part of a group with great people. Like I said, I’m the new member. I’m the new guy in the group and I just need to hear their energy. I mean, everybody is really excited about it and it’s really nice.

Clint: Yeah, that is…that’s a huge accolade and something that I can see you’re excited about, and that is great.

You also mentioned your book earlier. Let’s move across onto your book. I’m looking forward to reading your book, but I have to wait a little longer, don’t I?

Dr. Aggarwal: Yeah, we’ve had many hiccups along the way. It’s been done for some time, but you know, nuances of life and a couple of artists and dealing with other people’s schedules sometimes takes some time as you know. So I’m excited about this. So for me, this is…I wrote it with a friend of mine who’s an internal medicine doctor, and we really spent a lot of time going through our process. And for me, I wanted people to understand that some of the stuff that I was telling them doesn’t have a lot of clinical data, and I wanted to give them a real look at what I thought, what had data to support it, what I thought was anecdotal, so people could look at this as sort of a guide and say, look, this is the right…this is what we know for sure, this is what we think is okay, and this is what we definitely think is not good. And that’s what we did, and I think people have some big questions which I tried to answer in that book. And so I start out with a lot of my own history and explaining why I got into this, and sort of how my illness changed me, and then we go into sort of different things that we should be doing to sort of improve our balance.

So I think that most things are related to imbalance in the body between stress and rest. And when you have an imbalance in stress and rest, you develop inflammation. And that imbalance comes from many different things. It comes from the obvious, which is stress, but it comes from lack of sleep, poor nutrition, sedentary lifestyle, which creates an imbalance between your…what we call your parasympathetic and your sympathetic systems. And your parasympathetic being your rest and digest, and your sympathetic being your fight or flight.

Well, your fight or flight response is a great system, it’s responsible for when you have a tiger…when you see a tiger and you can run. So it has all your cortisol and all of your stress markers go up. And so when you’ve hurt yourself, you don’t feel pain and you can run. The problem is, is that all animals, including ourselves, also need to balance that with rest and digest, which allows us time to recover. And most of us in society now are not running that…are not balanced. I definitely was not when I got sick for sure. You know, postpartum my third child, working full time, trying to nurse, trying to do this, trying to do that, trying to be a good mother to three children.

But I think most people are…unfortunately everybody has that kind of story. Like we’re all running around, we’re not sleeping a lot, it’s become such a badge to sleep four hours or five hours and working hard. Working between 8 to 12 hours is sort of the standard, isn’t it? And so with that comes poor diet and sedentary lifestyle. And so what happens is we deplete our resources. And in that time, we have this hyper-stressed time, depletion of resources, it’s the substrate for illness.

And that’s what we talk about, and then we try to sort of explain to people why we think people get sick, and then why…we may bring up different illnesses, autism, we bring up Alzheimer’s disease, other sort of chronic illnesses, cardiovascular disease, of course autoimmune disease, of course because it’s near and dear to us. And so we talk about how all these illnesses have a lot of components of that lack of balance.

So then we step back and we say, okay, well this is the reality, this is why these things are happening to us, why illness is so common, so many different illnesses are common now. We’re seeing more cardiovascular disease, more autoimmune disease, more autism. And you could argue, oh well, we’re overdiagnosing or we’re more aware of…and there’s many things that I go through in the book to say, yeah, I know that. But still the reality is, is we’re seeing so much more of these illnesses, and so why is that? And we try to explain sort of why people are seeing more illness and why we’re seeing so much more autoimmune disease.

And then we take…we step back and we try to give you…give the things that work, that we think work and we try to support it with the data. And there’s a lot of data out there, loads of it, about nutrition and…so nutrition and exercise and yoga. So all these different facets. So it’s exciting, so it’s really fun.

Andrew Weil did the forward on the book, which is really nice, and he’s a kind man to write that forward, and it should be out this summer, and so we’re excited about it. You know, we are looking forward eagerly to it coming out.

Clint: Awesome, awesome. Well, I’m sure I’ll see notifications of it on the email…on Facebook or some other format and I’ll be the first person to get a copy. So that does sound really interesting. And I know a lot of our listeners will be really looking forward to getting a copy. So sounds like it’s about three or four months away.

Let’s talk about something that is a continuation of a topic that we spent a lot of time on, on our last call, which is the journal paper that we were sort of working on.

After our last podcast episode, I had about a dozen of the listeners email me and say, “Hey, I want to be part of this.” And just to recap what we were talking about, is just gathering a bunch of…sort of before and after results really of C-reactive protein or rheumatoid factor, any blood indicators, and any other quantitative indicators that showed that going through a plant-based diet improves the condition of people with a clinical diagnosis of rheumatoid arthritis. And so we were hoping to collate a bunch of these individuals’ data and then put it all together, and you were going to act as the coordinator to try and get this published, so that we could show the medical community what’s possible.

So where are we at with that?

Dr. Aggarwal: So I’m glad you brought that up because for sure that is…at this point, it’s really on hold. But it’s only on hold temporarily. There is a lot of excitement in the community about this trial, especially among plant-based people. A lot of people are talking about it. Like McDougall did a retrospective analysis of 10 patients and he likes that. So I talked to him about it and it definitely…and it’s powerful. But we really need a prospective trial, which basically means, okay, they start out and they come into the office with the illness and they can be on medications or not, depending on…we’re not going to withhold medication for sure. So people would get started on medications or if they refuse medication, then we could offer those people plant-based diet, or the medication patients would also be on plant-based diet. And then, the third arm could potentially be just medication.

And then you could compare all of those over…we would probably do a small pilot study just to see if it’s possible that people improve…do like six weeks or two months, and see if we can measure those inflammatory markers over time and see that there would be an improvement. And I think that’s the way the clinical study has to be done, and I know there’s excitement from your community and mine for sure. So it’s better if everybody can stay tuned and hang tight. It will happen, there’s no question. It’s just a matter of me getting back and getting back on track again, and I will get back to all of you on that.

There’s one thing I do want to say though. I did get a lot of feedback and comments after my last podcast with you. And a lot of comments that came from the community was things like, “I have this illness, I have rheumatoid, I want you to save me or I want you to cure me. What exactly do I have to do to cure this?” Or a lot of comments like, “If you cured yourself, then I can do the exact same thing. Please tell me exactly what you did.” Or there was the other side, which is, “I’ve tried these things and I’m not better yet. How long do I have to wait to get better?” And then the third is, “I don’t want to start medication, can I do this diet and will I get better?”

And so I gave people a lot of the same advice, and so I want to just kind of say this to the community. The thing about what we know about rheumatoid and about autoimmune disease in general, and I do think a lot of these autoimmune diseases are similar, but while they’re different in terms of what end organs are affected, the autoimmune process in the body is very similar.

However, each person is not the same. We’re all…this is not a homogeneous disease. In other words, it doesn’t affect each person the same way, and people are at different levels of inflammation, they present at different times, their antibodies are higher and some are lower. And then we have the person who…every person’s gut and inflammation level and autoimmune system works just a little bit differently, and each person will have a different trigger as well, and we don’t know all of the triggers, the food triggers and other triggers that could be causing this disease.

But I do…while I believe wholeheartedly in the diet that we all talk about, it’s never going to be the same answer for everybody, and it’s not…it’s a broad umbrella of what to start people, but sometimes you have to tweak it, and some people…when people say, can I come off medicine and try this diet, I say no. Because we have clinical data and clinical research to show that these DMARs, these disease-modifying anti-rheumatic drugs work. And there’s clinical outcomes that support them. And I don’t have that clinical data on diet. I hope to, but at this point, I don’t. So as a physician, I can only say, stay on your drugs and use diet as a supplement to that, and then hopefully when you’re feeling a lot better, you can wean yourself…with the help of a physician, wean yourself off the medication.

And I just want to say that because it’s really important to understand that everybody’s response is not going to be the same, and you have to kind of take the diet for what it is. It is a diet but everybody’s triggers are different. So some people say, “Well, can I take this off and will that make me better? Do I…should I eat fat? Should I not eat fat?” And so we will always give…we should give a framework as physicians with your book…with what…you give a framework of how to make people better, but some people will have triggers that are wheat-based, some people will have dairy-based. Some people say, “Well, do I have to be vegan and gluten-free?” The answer is not the same for everybody. You know, gluten is an interesting thing, it’s become a little bit trendy unfortunately now, and I don’t mean to make light of a real problem. However, gluten-free has become quite popular in a way it hadn’t been in the past.

If you talk to Dr. Fasano, Alessio Fasano at Mass General who does a lot of work on celiac disease, he says that only about 1% to 2% of the population actually has celiac disease, which is the true wheat-based allergy which causes a systemic inflammatory reaction. But he thinks that about 7% of the population is gluten-sensitive. And that’s a hard thing to measure, right? There’s no clear markers. You can check your celiac markers and they’ll be negative, but you can still be gluten-sensitive. So that’s an important thing.

So most of the population can tolerate gluten, and that’s an important thing to know. So…but there is like 7% of us that cannot. And so sometimes you have to try different things and see how they affect you, to know if they’re going to…that that’s one of your triggers. So I can’t tell anyone that they should do it or not. But what I can say is what I recommend in general is to start with…what I usually do is I like to go pretty strong at the beginning in terms of eliminations. But I usually pick one elimination, which I usually start with a total plant-based diet. So people say, “Well, what about fish? What about chicken? I can’t get rid of those things.” So everybody’s got to do what they think they can, but at least start with getting out…if you can’t do…if you need your fish and your chicken, at least start by eliminating all your red meats. Loads of data to support getting rid of red meat in terms of inflammation, cancer, hypertension, cardiovascular disease. So you eliminate your red meat. And then you start slowly and try to eliminate more and more.

If you can and you’re a drastic sort of person like I am, I’m the type of person who wants to do everything all at once, then do it. But you know, you’ve got to figure out who you are as a person and what you are willing to do, but it does take the gut about six weeks to almost three months to kind of heal. And so all of your changes that you make, you have to really give it a fair shake before you can say that it’s worked or it hasn’t worked.

And so often, I’ll recommend sort of going plant-based and adding in spices that I think are anti-inflammatory, and taking in anti-oxidants and we can talk about some of that if we want, but…that I think are really important and that’s what I usually start with. But I usually start with gluten as well, and then I don’t…also eliminate nightshades at the beginning. I just start there. And then I see how people do. And then, if we’re still not where we want to be in three months with the people who are meticulous about the diet, then I might try a different elimination or add another elimination.

That’s how I do it. I know we all do it a little differently, but that helps me because then I can understand. I feel like I have tried something…if I try…sometimes if I try too many things at once, I get confused because I don’t know what healed them. That sometimes works for me if I just start out with one big change, which is going plant-based, which is a big change for most people, and then maybe adding gluten if it needs to be or nightshades. Because for instance, I eat nightshades and a lot of people don’t believe that nightshades are…should be eaten by patients with autoimmune disease, but I don’t find nightshades to be a trigger for me.

Clint: Well, since I last spoke, you’ve covered a lot of territory, and I’m trying to take notes so that I can comment on the…on each of the…

Dr. Aggarwal: Isn’t a problem. I’ve learned so much. Every time, I’m just blown away with what’s out there and I just…I could go on and on about the leaky gut and inflammation because that is the meat of this.

Clint: I know, I know. Absolutely. Well, let me just complement quickly what you just said. Because everyone hears a lot from me, and we don’t get you very often. So let me not take up too much of this time.

But first of all, so well put, everything that you described about the people who vary with their results. Everything you said is exactly the way that I explain this as well, which is that, look, on top of all of those variables, people also have a different history of medications, and I find this extremely important. I find people who’ve taken lots of non-steroidal anti-inflammatory drugs, lots of antibiotics, and lots of Prednisone. Particularly Prednisone over a very long time, like three or four years. These folks are very more challenging to help than people who haven’t been on those three collection of drugs.

And then secondly, I used to have what I would self-diagnose as gluten sensitivity. Not celiac disease, but gluten used to cause for me the specific response of blocking of my nasal passage. So maybe slight inflammation through the nose, nasal passage. But I found that by avoiding it for a long period of time and staying plant-based, exercising a lot, that now has gone. So I can now enjoy all breads, cereals, no problem whatsoever. So I say to those people with not celiac disease, but with gluten sensitivity, that that is something that I do feel there’s a good chance of overcoming. And that’s just my opinion on that.

Paddison Program

Dr. Aggarwal: I agree with you, Clint. I mean, I think we need to remember that it’s all about healing the gut. And sometimes things that would cause a significant reaction…people often to say to me when they go plant-based that their body can’t handle it because they have massive diarrhoea, they can’t get off the toilet, too much gas since…that’s very…they feel uncomfortable all the time. Well, that’s because our gut’s like, wow, I’m totally not used to eating this way and it takes time for the gut to heal.

So there was this interesting study and I know you…I want to hear…this gets me so excited.

So if you look at people, and they eat the African-American diet versus the African diet, and this has been studied. And this was a trial that came out…there’s two. One came out like 10 years ago and one came out as a follow-up literally in the last year. So it basically said, okay, we have the African-American who…and I don’t mean to say that every African-American by any means eats poorly, but they took an inner city African-American population who would…sort of not the best diet, and then they took an African man in a village. Again, not to say that every African eats well and I know that these…I’m not trying to imply any stereotypes, but just this is what was done in the study.

And what they found was when they looked at the gut flora of the African…inner city sort of black patient versus the African rural village patient, they found that the gut flora in the inner city patient was…had more toxins and more bacteria, bad bacteria, versus the one from the rural village, which is more of a stronger, healthier gut flora. And then they said, okay, well that’s true, well fine, fine, fine. But let’s just bring this African from this village and put him into this inner city, and what happens. Well what happened…or rather, I think they did the reverse. Sorry. They took that inner city patient and gave him that rural village diet, and the gut flora changed and he got better.

And so we know that once you heal the gut flora, that certain sensitivities and reactions that you might have had in the past then become sort of…like yours perhaps, became things of the past.

Clint: Well, absolutely. And I don’t know if I…we went into too much again of my side of our stories when we spoke last because you are the guest. But…

Dr. Aggarwal: I like your stories.

Clint: But…I mean, I couldn’t eat anything without pain, except leafy greens. I mean, I couldn’t eat even the foods that are now the baseline or the elimination…first 12 days elimination of my program, which is just buckwheat, quinoa, and sweet potato. I couldn’t even eat those without inflammation. So, I mean, that’s how severe I was. And so to get to a point now where I can even eat foods that are high in fat like avocados and olives and things, like no problem. And even what you would consider junk food, which I only ever eat if I’m at a function and I have no food and I’m sitting at a table as a guest and they give me, I don’t know, a soda or something, these things don’t bother me.

But anyway, I wanted to ask you, are you still running? You look fantastic. This is the best I’ve ever seen you look.

Dr. Aggarwal: I do. You know, I sleep so well. I am meticulous about many things. And I don’t want people to think…and people say, you can’t…how do you lead this perfect life? First of all, I don’t. I have many treats [inaudible 00:36:50] problem, I love to drink mojitos. But I don’t drink them with sugar, alcohol, and I don’t drink often. So these are sort of in moderation. I have little treats. So we all have our things, but those are my two things. I like to have a mojito once in a while, and I like to have a piece of dark chocolate.

So never said that I do everything perfect, and after you get out of that sort of initial inflammatory period just like you said, you have the flexibility where your gut can tolerate some changes and some kind of…whatever you want to call them, little treats if you want, where it’s okay and your body will be fine and I don’t have a reaction if I eat…My mojitos are turmeric-infused though. You should see my turmeric-infused mojito, it’s fabulous. But anyway…so that’s the first thing.

But I do…I do a lot of yoga, I sleep well, and I really do eat fairly meticulously. Like I eat no dairy. My dairy is my trigger, I believe, and I eat absolutely zero dairy. If there’s even a suspicion that there could be dairy in the food, I won’t eat it. So for me that is my…well people say, well how can you be so…how can you do that? And I…for me, that’s not a question because I was so sick. I was so sick, I crawled up the stairs. I used to cry every day. For me, not eating the thing that I know for sure is inflammatory for me, it’s a non-issue. Because I will do what it takes to get better. So yes. So you know, I am running. I do a lot of…like I said, I do a lot of yoga and I sleep.

Clint: Well, it’s working. You look fabulous.

Dr. Aggarwal: Oh, thanks. So do you.

Clint: So our next baby due next month, which we’re house-hunting at the moment in one of the most hottest property markets on the planet that it’s so…it’s a challenge for us, it is. But we couldn’t be happier, and everything’s going really well.

In fact, I want to tell you something that could dovetail in somehow with your plans. And this is something that I’ve only sort of provided small snippets of information in the past.

We are trying to create a documentary about my story here with a very reputable production company in Australia, who are targeting not just Australian-based distribution, but maybe a worldwide audience, and I’ve spoken with Dr. Klaper and Dr. Goldhamer over at TrueNorth, and we could be looking at doing a clinical trial as part of that documentary. So this would involve something very similar to what you described earlier in the call, but taking people through the program that I encourage people to go through.

Dr. Aggarwal: Congratulations, that’s fabulous.

Clint: Thank you.

Dr. Aggarwal: Documentary, I mean, that will be awesome.

Clint: It is, and I…you know, all these things take a lot of money, and we’re trying to raise funds at the moment. But what we’re going to be looking to do is something similar. And now I think that…you know, I think both things can be done presumably. Let’s just hope that both can happen. But if there is an opportunity to collaborate, since we’re kind of covering similar territory, and ours is going to be funded by investors who want…

Dr. Aggarwal: Oh!

Clint: Yeah. Right?

Dr. Aggarwal: It’s awesome.

Clint: Right?

Dr. Aggarwal: I’d love to be part of it for sure, you know, depending on whatever level of comfort you have. I think we should all collaborate, like this doesn’t…I’m not somebody who believes that you grow by standing on top of each other, but you grow together and stand together. And so whatever you think, I would love to have you involved with, I continue to remember that, that you have people that are excited. I just have to sort of get back there and write this trial, write this IRB [SP] proposal and let’s try to do it, and if yours comes and you get all these investors, we’ll do it simultaneously or whatever we’ll do. We’ll figure it out.

Clint: Yeah. Well, that sounds good. I mean, it seems like everyone’s trying to achieve the same thing and you and I are sort of at the centre of it, and we both have the same desires for this, so it’s pretty exciting.

Dr. Aggarwal: It is, it is.

Clint: So let’s wrap this one up. Tell me what you’re going to be up to when you get back to the States. How are you going to spend your first couple of weeks when you get back?

Dr. Aggarwal: Yeah. So when I come back…I mean, I think it’s going to be…you know, in some ways I’m trying to enjoy every moment while I’m here because there’s so much to enjoy and I don’t want to…I really do love every day here. But there’s also sort of having to look forward at sort of where to go to…you know, I think at first when I get back, a lot of family to see, huge family, and I look forward to spending time with them when I get back for sure. But after that, I think that it’s going to be sort of…I hope to have sort of finalized my job prospects, or at least not finalized them but get close to sort of where I’m going to be before I get home. And so that it’s sort of just the details when I get back, and then, you know, I…we’ll see. We’ll see. You know, it’s hard to know, but there are some neat prospects out there and I’m excited about them, and I’m hoping…I’m looking forward to sort of the next year.

Clint: Are people still going to be able to come to your clinic and be able to seek your services and help if they have rheumatoid or other health conditions?

Dr. Aggarwal: Absolutely. So, I caution people…and my current clinic environment that I left was a cardiology practice, and so I wasn’t really equipped to take care of non-cardiac patients. Even though I’ve always managed their non-cardiac patients, but I…they had to have had a cardiology problem. In the new world order, that should be different, and the goal is to be more integrated medicine with a bend on integrated cardiology rather than to be just a cardiologist.

Because there’s so much more to all these illnesses than just…I find…it’s amazing. I mean, I can show you pictures of my patients who I change their diets and they say, “Well gosh, this doc put me on this medicine, this doc put me on this medicine, and I wish I’d known about the diet” and [inaudible 00:44:46] people…well, here’s a great story of a guy and he’s a wonderful fellow and he…so this is a fun story that I talk about in the book, but what it is, he’s a 70-year-old patient of mine who was having a stomach bleed and he was bleeding out of his bottom. And because he was bleeding out of his bottom, he became so significantly anaemic, which means that his blood counts were low and he started developing chest pain. He was admitted to a hospital. Not my hospital, he was admitted to a hospital, he was known to be so anaemic, and they gave him blood product, which was appropriate, and they decided that he needed to have endoscopy done, which is when they go down into the stomach to look for an ulcer or an abnormality, which he did have.

But then, at the same…then they also said during that same admission, because he had that abnormality and because he was having chest pain, that he should have a stress test. Well, you could argue that as a physician. I would say well gosh, he already had a stress test, didn’t he? He had chest pain when he was anaemic. That’s a stress test enough. But they did a stress test and it was very abnormal in multiple different areas, suggesting that there were multiple blockages in his heart.

So then they proceeded to recommend cardiac catheterization during the same admission, to be invasive, which would basically mean that they would go into his leg and go up to his heart, there’s blood loss. You have to then be on blood thinners once you get…so say you need a stent, then you would often need to be on blood thinners.

So if you think about that just for a moment, which I realize, most people don’t know a lot of these details, but if you get a cardiac stent or a heart stent, you have to be on a blood thinner. He already has a bleeding problem. So you fix his problem by giving him blood, then put a stent in him to give him a blood thinner so he can bleed again, which then he’ll have to come off his blood thinner and then his stent will close.

So it doesn’t make sense, yet that’s what was recommended. So he called me and he said, “I don’t know what to do. What do you think I should do?” And I said, “Look, I can’t…you know, I’m not seeing you right now, it’s hard for me to know what to do with you.” And I could only advise him to see…to do what the physicians there were recommending, but could only give some peripheral guidance.

He decided to leave the hospital against medical advice and he came to see me the next day. And I saw him and I said, look…and he said…he showed me his med list. He was going on three or four different drugs just to make him go to the bathroom, to poop, because he was so constipated intermittently and he was given…he was told to take three or four medicines just to make him have a bowel movement.

And I said, “Hey, look, let me give this a go, okay? Let me try to fix your diet.” And so I literally spent an hour with him, telling him what to eat. Because he was sort of a simpler fellow in a sense. He said, “Well, how do you get spinach? Isn’t it just in the freezer section?” And so unfortunately he didn’t really know, and that’s okay. So I spent time with him and showed him where he would get things and kind of really spent a lot of time with him. And he said, “Well, what about the catheterization?” I said, “Look, you’re not having chest pain right now, let’s just continue to watch you. I’ll see you every two weeks.”

So I saw him every two weeks, and by four weeks…by two weeks out, he said, “I’m pooping so much and I’m taking all these meds. Do I take all these meds while I’m eating all this food?” I said, “Absolutely not. Stop all those meds.”

By four weeks out, he had lost weight, he was walking, he was having no chest pain, and was feeling amazing. And then by six weeks out, I repeated the stress test, and it was normal. And so he had a normal stress test, and so…which means basically not that the blockages aren’t there, but that he has adequate blood flow around the blockages, so his heart is working fine. And I think that’s just an example to everybody to say, look, diet works, it’s so important. We have missed the boat in what…in terms of the way we’re treating and taking care of patients. We give them pills before we give them diet, and as a physician, I’m sorry for that. Because there’s so much that we have to offer just in our plates. And so that’s what I would say about it.

Clint: Yeah. Well, that’s a great story. And you can see why you’re so happy and why you’re glowing and why karma is delivering to you right now because you’re helping people in the way that so few are. And it’s really great to see. And it’s also wonderful to see your career trajectory, it’s just sensational at the moment. And all the people you’re associating with, I mean, it’s really exciting. It’s really great to observe and I’m really happy for you.

Dr. Aggarwal: Thank you. And like I said, these people around me are giants and I’m just sort of…I’m just hoping to get mentored by them. You know, I don’t…I am not in their class, but I hope to just learn. And I have told them that just mentor me. Teach me what you have to know and…but like I also said is that this is not a physician versus non-physician thing. We are all…you know, you and I, we’re doing the same thing and we have to work together. And you’ve been a patient, you’ve changed your life. You’ve changed your diet. You have so much to offer the community and the world. And so anybody who sort of feels otherwise I think is doing a disservice, because you don’t have to have an M.D. after your name to offer good advice.

Clint: Yes. Thank you.

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