Interviewer: Let's talk about diet a little bit. Is the diet that we've grown up hearing about still the one that's considered heart healthy or there are some changes?
Dr. Bradley Bale: Probably the best recently published data looking at diet was with the Mediterranean diet, and you probably saw the announcement on the well done trial. And they looked at two different variations of the Mediterranean diet. One was supplemented with extra virgin olive oil. The other was supplemented with more nuts. And they compared it to a diet that was less concentrated in fat. And what they showed was the Mediterranean diet significantly reduced the risk of stroke. The headlines actually read, well the Mediterranean diet reduced the risk of heart attack. When you look at the actually study in detail, there was a trend toward reducing the heart attack risk with the Mediterranean diet, but it was stroke. That's where it was very significant. When you lump the stroke together with the heart attack and with cardiovascular mortality, it was significant. But that significance was driven by the stroke reduction. And the variation of the Mediterranean diet that reduced the stroke almost 50 percent was the arm that had the extra nuts. Now the extra virgin olive oil also reduced stroke risk but not as much. It was significant, but not as much as the one with nuts. But in that study it's very interesting that there is no caloric restriction in any of the three dietary arms. So what also really didn't make the news, which we find extremely interesting, is none of the three diets varied in terms of their significance of keeping you alive. So all causes of death, it didn't matter. None of these diets reduced longevity. And we would argue the reason they didn't reduce longevity is to do that, you have to throw in caloric restriction. You know, the data really is pretty solid out there. If you've got a BMI between 20 and 25, you're going to live longer. If it goes above 25 or below 20, you're not going to live as long. So, it's an interesting distinction, because what we concentrate on and what we feel like we're experts in is what we call arteriology. Keeping the artery wall healthy. And certainly if you want to live a long time, that's a requirement. You have to keep an excellent highway of nutrition going to all of your cells and all of your organs. If you don't, you're not going to live very long. But, living long requires more than just keeping the arteries healthy. So you can have very healthy arteries and still of course die at a very young age. So diet, if you want to throw in longevity, you need to throw in caloric restriction. If your only concern is stroke and heart attack, the Mediterranean diet even without caloric restriction has a significant impact on that risk. But again, we fine tune even that with the [unknown] gene. So, all of our dietary advice is very individualized based on that gene. Like the Mediterranean diet of course does contain alcohol. Well if we have a patient who's [unknown] four, we tell them it may not be in your best interest to actually drink the alcohol. And again if they're female, certainly they need to be aware of extra cancer risk from drinking the alcohol. But overall, Mediterranean diet is pretty hard to beat. If you want to live a long time, you'd better restrict the calories too.