In this episode of Prevention Over Prescription with Dr. K, we're joined by Dr. Behn Banihashemi to explore the shortcomings of traditional healthcare and the importance of primary prevention. Dr. Banihashemi shares insights from his Cardiac Longevity Clinic, which provides personalized assessments and treatment plans to improve overall health and longevity. The conversation covers transformative patient stories, the role of nutrition and exercise in metabolic health, key diagnostics for longevity, and the need for advocacy in preventative medicine.
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Speaker 1 (00:00):
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Speaker 2 (00:18):
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KWA Dcast. Welcome to Prevention over Description, the podcast where
we focus on what truly matters, taking control of your
health before it takes control of you. I'm doctor Quadio
Karen Mantang. I see you, physician, health advocate and your
(03:11):
guide to living stronger, healthier and longer. In each episode,
we'll explore how you can prevent illness and thrive through
practical advice on nutrition, movement, stress management, and building a
supportive community. Because prevention isn't just better than prescription, it's
the key to showing up as your best self. Let's
(03:32):
get started coorgasination. We got a special guest on pop
Prevention over Prescription where doctor k We got doctor.
Speaker 3 (03:40):
Ben in the mix, doctor Ben.
Speaker 2 (03:43):
Banahashimi, Cardiology, founder of the Cardiac Longevity Clinic, and we're
going to get into all things longevity today, folks. How
we're going to address this, How we're going to get
people to live longer, healthier lives, increase their health span,
not just their lifespan, their health span. Son, this is
(04:03):
what it's all about. And Ben, I've known him for years,
a few years behind me in medical training with this
man's a beast. He lives a lifestyle, he lives and
breeds healthy living, and he's trying to bring that to
our community locally and through his advocacy online. You are
going to love doctor Ben. I've been waiting for this
(04:25):
podcast for so long because you guys have asked for
doctor Ben, and now you are receiving Doctor Ben. We
are going to be talking about all things longevity. His
resumes insane, as you heard about in the intro, but
he is a trendsetter, he's an innovator, he's an entrepreneur.
He's a bit I must say, I'm a bit jealous
(04:49):
of all the things you're accomplishing, my friend.
Speaker 3 (04:51):
But welcome to the Welcome to the show.
Speaker 4 (04:53):
Thanks, thanks for having me man, It's a pleasure. It's
a long awaited conversation for me as well. You're looking
forward to chatting with you is always a pleasure.
Speaker 2 (05:02):
Oh, thank you, brother. I want to just get right
to it. You started a cardiac longevity clinic just recently.
I'm wondering what was the driver.
Speaker 4 (05:13):
Yeah, thanks for asking that, you know, I think it
comes from a couple of different routes. So number one,
as you know, I run a cardiology clinic in the
West End of Ottawa and have now been a cardiologist
for over ten years. And one of the frustrations that
I know you shared to some extent as well, is
(05:34):
just a frustration with a way of deliver healthcare in
our country. We are very much focused on band aid
solutions and kind of dealing just with complications of disease
rather than addressing the fundamental underlying issue of why these conditions,
these metabolic diseases happened in the first place. So as
(05:56):
a cardiologist, you know, for over ten years, I've kind
of dealt with these patients, these clients coming in with
cardiac disease, major complication, major cost to healthcare, major costs
for them personally and financially, and all we do in
cardiology is managing the kind of the end stage of
(06:18):
the disease, managing the complications of the disease, which is
a very inefficient, unintuitive way of managing conditions. You know,
they're coming with a heart attack. Rather than focusing our
attention as to why they had the heart attack in
the first place, we put them on pharmaceuticals. We put
stents in their hearts, we replace their valves, We do
all these very expensive, very complicated procedures that you know,
(06:43):
expose these patients with a kind of different side effects.
If it's a pharmaceutical complication, it's a surgery and procedure.
But then they come back again to me a year
or two later because we're not addressing the fundamental issues,
which is, you know, their lifestyle, the risk factors that
they're exposed to, the lifestyle choices that they're making, the
metabolic disease that is underlying their problem. We never address that. Unfortunately,
(07:06):
there's no focus, there's no money or funding or spending
in that part of healthcare. And frankly, even in our education,
as you know, we get such a limited exposure to
the actual science. Now there's tons of science for all
of these primary prevention strategies, these lifestyle strategies that would
have a massive impact in reducing cardiovascular complications and improving
(07:28):
people's longevity. But we don't learn it in school. You know,
I spend one month in my entire training, you know,
I have twelve plus years of medical training, spend only
a month in cardiac rehabilitation, And what I learned in
that rotation was so limited compared to the available science,
you know, So all of our effort, even in our
(07:50):
medical education, and definitely when it comes to healthcare, spending
and our time in the clinic goes towards managing complications
rather than addressing the underlying problems, the fundamentals of why
people developed these diseases, the cardiovascua disease, heart attack and
stroke and heart failure in the first place. So that
frustration is what led me to really start this clinic.
(08:12):
And of course I'm also personally very passionate about it.
This is, you know, wellness and health is something that
I am myself a practitioner of super passionate about, have
been doing it for a long time. So really the
idea was kind of to bring these two things together
and kind of create a practice that is personally meaningful
(08:32):
to me, personally enjoyable and rewarding to me, and I
think would make a massive impact in my patient population
as well.
Speaker 3 (08:39):
We're listening to Prevention over Prescription for doctor k h Be.
Speaker 5 (08:45):
Today is a shizu Mayezu used to drive down NBA's
turning them at a home and a survice that a
RB cheap for them, paus the day would show cheese
that would work with them, or in we got rid
of at tern for them, wasn't bon us a lust
I was perfect?
Speaker 1 (09:00):
Stream us Live at SAGA nine sixty am dot co.
Speaker 2 (09:12):
Welcome back to Prevention over Prescription with doctor k. You
don't hear many of us talk this way, Ben, like
many of us talk about You're right like there is
a significant amount of data out there about primary prevention
that we just don't highlight enough or get educated on
in during medical school, during residency, during fellowship. So I
(09:36):
do feel like your instincts of trying to push this
is going to be to have a significant impact. And
I think what I love about it too, Ben, is
that people will follow, The kids will follow the young trainees,
They'll be attracted to this because in my opinion, it's
going to make a significant difference in people's lives, which
is what we want to see.
Speaker 3 (09:58):
So how does this look when I.
Speaker 2 (10:01):
See that, you know, doctor Brent's got this new clinic,
Do I just go to a website sign up?
Speaker 3 (10:07):
Like? What what can I expect walking through the door.
Speaker 4 (10:11):
So it's very much a kind of an allur card
menu that we offer clients with regards to what they
want to have, because everybody, I think, you know, again,
one of the downsides of our healthcare system, which I'm
sure you've experienced, is that we have very cookie cutter.
We don't have any customized plans for people. You know,
what is good for me, what works for me, what
(10:32):
I need to be able to get healthy, is different
than what you need. So this whole idea that anybody
that comes through the door, we offer them exact same treatment.
It is so counterintuitive, but that's how we do ninety
nine percent of medicine. You know, I give the same
drug to one hundred people. I give the same exact prescription,
(10:53):
same exact lifestyle plan to one hundred different people. But
obviously that's not going to work. You know, obviously compliance
is going to be low when you're offering exact same
thing to every person. So ours is very much personalized
and customized plans. So when you come in through the door,
we do a very comprehensive assessment on you to determine
(11:14):
in the first place of what you need. You know,
what are your needs, what is lacking based on your
clinical profile, and then we offer you basically a many
of things that you can do. But in general is
divided into kind of three different category of services that
we offer in the cardiac longevity clinics. So number one
is cardiovascular assessment, which is obviously my wheelhouse. So we
(11:35):
can do obviously a full cardiovascular diagnostics on the clients,
from getting their view to max and do a schemeicry
stratification to look for coordinatory disease or looking for blockage
in the arteries, to getting an ultrasound of the herd
echo cardiogram to do a comprehensive structural assessment of the heart,
to doing coroated ultrasounds to kind of get a sense
(11:56):
of their overall vascular risk factors and the risk of stroke,
to prefer ultrasounds looking for perifer vaspil disease. So that's
kind of the first component of the program. The second
component is really a comprehensive metabolic assessment, so we do
kind of a full blood work panel, kind of above
and beyond what somebody would get in their family doctor's office,
focusing more on markers of both metabolic disease as well
(12:19):
as inflammation as well as insulin resistance nutrient deficiencies. So
there's a bloodwork panel, and then we combine that data
with a DEXA scan, which will give us a pretty
good idea of body composition, basically the gold standard for
assessing body composition, looking at visceral fats and looking at
their muscle mass, and then we combine that data to
(12:40):
give them a pretty comprehensive picture of their metabolic health.
That's kind of the second component of the program. And
then the third component is really their lifestyle assessment or optimization.
So I work with multiple athletic therapists, strength coaches as
well as dietitian sleep specialists as well as I call
it just so we kind of basically go through those
(13:02):
four areas of lifestyle. So we do a full fitness assessment,
full nutrition assessment, a home sleep study to kind of
get all their sleep architecture data as well as assessing
for sleep apnea, and then we do a kind of
a mental health slash stress assessment and then based on
how you score in these four areas, then we actually
(13:22):
give the clients an actionable plan as to how to
optimize these four areas of their lifestyle to get more
metabolically healthy and improve their longevity.
Speaker 2 (13:32):
Brilliant, brilliant, So Ben, I mean, the thing that I
fully enjoy you mentioning is the idea that it's customized,
it's personalized, because I think we're not doing this enough
in medicine at all, frankly, and it's the future with
(13:54):
the amount of data that's available to us.
Speaker 3 (13:56):
But I think that approach.
Speaker 2 (13:59):
Like not that you need validation, but if I were
to personally have a longevity clinic set up, this is
exactly what I would want. You have some like diagnostic test,
blood and structural to be able to get an assessment
of body comp like all these things that are that
you can't get anywhere else. Really it's so valuable that
(14:23):
you could get this in one center. So because of
all this, I would imagine people have to see you
front center. There's not a virtual option.
Speaker 4 (14:34):
Is that correct, not yet, but I'm kind of in
the process of starting that as well to kind of
offer this kind of more widely in a virtual manner.
Speaker 3 (14:42):
When do we start the longevity clinic.
Speaker 4 (14:44):
So it's been about eight months now.
Speaker 2 (14:46):
Eight months, Yeah, it might be a little early to
throw this at you, but like, can you think of
some transformations that you've seen or has there been any
stories that come to mind where the the impact that
the Cardiac Longevity Clinic has had on a patient has
been significant in your mind.
Speaker 4 (15:09):
Yeah. So, actually, my very first client was one of
my good friends and neighbors, and he essentially he came
kind of through our clinic and he now wants to
be a kind of a business development person for my
Cardiac Longevity clinic because he saw such a massive impact.
(15:31):
So basically, I kind of briefly going through his history.
Basically a client, a neighbor, very nice guy, but not
really necessarily taking care of himself, very well, overweight, had
me autabolic syndrome, significantly elevated blood pressure as well as
pre diabetes, never really diagnosed. Most importantly because he was overweight.
(15:53):
He also had severe sleep apnia. So coming through our clinic,
first thing that happened. Obviously, we diagnosed him with severe
sleep apnea, put his seatpop on him. That itself completely
changed his life, right because I mean, this guy was
having almost ninety events an hour, So just kind of
putting the seat pap on him all of a sudden,
and he's a business owner, all of a sudden, his
(16:15):
energy goes ten x. So just that completely transformed his
life of being able to function at a whole different
new level. And his blood pressure dropped. You know, he
had this huge issue. His family doctor was pushing him
to start him on blood pressure bills. Just getting his
slip appy A treated his blood pressure completely normalized even
before we kind of do any other intervention, and then
(16:37):
we gave him a fitness plan. Through the fitness plan
and through his cardiovascar diagnosis, we actually found out that
he had by cust periotic valve, which is for your audience,
is basically this condition where your valve from has a
birth defect. The main valve out of your heart has
a birth defect where instead of three kind of little valves,
it has two, and because of that it degenerates faster.
(16:57):
But this guy was in his early forties. Valve should
still be fairly intact if you're healthy, but aotic valve
is very much affected by a metabolic disease. So when
you have high blood pressure, pre diabetes, all these factors
that cause after those crosis, they can also cause the
seriation of the ertic valve. So his eerotic valve was
already chewed up quite a bit for someone in their
early forties. It was already had moderate theotic regratutation, so
(17:19):
the valve was moderately leaky, all primarily driven by obviously genetics,
but also the fact that he had metabolic disas, so
discovering that was also huge for him. His order had
already dilated a bit because of his highpertension. So just
imagine what would have happened to this guy if he
hadn't walked through our clinic and he would have come
five years later to discover all of these things, right,
(17:41):
his valve would have probably completely been chewed up. He
would have needed an aertic valve replacement at the age
of forty five, which is a pretty catastrophic, you know,
complication for something that can be managed all the way
to your late sixties, probably without having any surgery. So
I'm hoping that now that he went through the clinic
and then through all of that, obviously he kind of
had this wake up call. So we put him on
(18:02):
a fitness program, on a diet program. He's already lost
about thirty pounds. His blood pressure is now normal, his
metabolic markers are all normalizing. So he actually is a
part of because we offer a kind of a long
at chuneral program as a part of our longevity program too,
so he is now kind of a part of our program.
So we are seeing him on a monthly basis through
our nurse practitioner program and I'm seeing every three months.
(18:22):
So he's made these massive changes in his lifestyle which
is probably going to be for him life saving. And
then through all of this, he also had all his
daughter's screen for by cospioity Clove and actually one of
his daughters now by cospioty Clove, which would have never
been discovered again till God knows when. So the amount
of impact that you know you can create and coming
through a clinic like this, particularly for you know, this
(18:45):
this client of mine, you know, it's just you know,
I mean, he kind of talks about it all the
time of how absolutely life changing for him right to
have all these things done. How he feels now and
also kind of moving forward for his future, how we
have impacted him in his face.
Speaker 2 (19:00):
Who are listening to Prevention over Prescription with Doctor K.
Speaker 1 (19:17):
From No Radio, No Problem stream is live on SAGA
ninety sixty AM dot C.
Speaker 2 (19:24):
A welcome back to Prevention over Prescription with Doctor K.
Speaker 3 (19:37):
Incredible.
Speaker 2 (19:38):
I love hearing these stories for several reasons. One, he's
he has a new lease on life. He's feeling better,
he is actually more functional, going to be a better dad,
going to be a better business person, all the other
things that you want. Second, big highlight lesson here too,
(19:59):
Ben is a lot of people they feel like these
diagnosis that they have, these chronic disease diagnosis are permanent.
Where you just illustrated in this case how he was
able to reverse his hypertension reversus risk of metabolic syndrome
because of the changes he made, lifestyle modifications that he's made,
(20:23):
like that that's not a pill that he's going to
take forever, Like that's huge. And then third, I think
what you see when you have a patient like that
in their circle, Like you made the example with the daughters,
but I can guarantee you in his network, there's going
to be people that see what he went through and
(20:46):
they're going to be motivated. He's going to be an
ambassador of health. This is the intangible that people don't
realize too about some of the stuff that we talk
about about prevention. It's contagious. When you got that mom
that came off or dive meds because of her whatever
lifestyle modifications that she took.
Speaker 3 (21:05):
There are going to be people that follow, I promise you.
Speaker 2 (21:08):
So it's scalable and it's sexy too when you see
people getting healthy literally and figuratively. So I love that story, Bend,
because that just exemplifies what the power is when we can.
Speaker 3 (21:24):
Focus on prevention. Absolutely.
Speaker 2 (21:29):
So I'm curious from your perspective where you think some
of the levers that are most impactful for patients. So
I want to focus on nutrition. First of all, you
get a lot of information out there in terms of
what approach makes most sense for people, and I know,
once again, this is a personalized approach for many of
(21:51):
our patients. But in your experience, in the stuff that
you've read or listened to on podcasts, what do you
think is some of the high level that the things
people could do that can move the needle when it
comes to the nutrition and their metal bolic health.
Speaker 4 (22:09):
I'm actually really curious to hear your thoughts about this too,
because obviously you have a lot of expertise in this,
and you've talked to a lot of experts on this.
But I think nutrition is probably one of the most
challenging ones, right because there's so much out there, right,
There's so many fat diets out there, there's so much
information that's constantly thrown at people. So I think nutrition
is tough for that. And then the other reason that,
(22:31):
as you probably know, nutrition is tough is because there
are really very few randomized control trials looking at nutrition interventions, right.
So I think that those are some of the things
that makes nutrition science very very difficult to look at.
It's a very difficult thing to do randomized trials in
because it's very difficult to isolate one particular ingredient within
(22:51):
your diet, one particular component within your diet, and kind
of do a randomized trials on it. And of course
in medicine, that's kind of the best type of evidence
we like. I think it's important to look at some
of the other evidence. When you have prospective data at least,
it could be very helpful to look at. So I
would say, out of the things that I've seen anecdotally
(23:11):
talking to experts and kind of looking at the literature myself,
I would say probably the number one thing that would
make the most massive impact for people is to look
at their diets somewhat in terms of their macros, right, Like,
you need to be somewhat aware of what is going
you're putting in your mouth with regards to what is
(23:33):
kind of the composition, right, So how much protein am
I taking and how much carbohydrates I'm taking and how
much fat I'm taking? It most importantly focused on how
much protein you're taking, right, So protein is probably massive
out of all of your macros. Your carbon fat might
be important if you're looking at a massive amount of
weight loss, but number one probably protein is huge. I
(23:55):
know you are a huge advocate of this. You have
your own brand of now kind of protein powder because
of that, because most people do not take enough amount
of protein. It's actually very very difficult. And when you
look at the data for muscle mass, which is a
huge determinant of your longevity, there's tons of good data
associating muscle mass with all sort of longevity metrics. One
(24:17):
of the most important things other than strength training would
be how much protein a day you're taking. And as
you get older, it becomes more and more difficult to
have adequate amount of daily protein intake to maintain that
muscle mass. So making sure that you're somewhere between, you know,
zero point eight to one gram per pound of protein
a day, which is extremely difficult, but at least trying
(24:38):
to get close to that is probably one of the
main challenges that most of my clients, Almost every client
that comes through, even the ones that are super healthy,
very aware of what they're eating and their longevity lifestyle
they're probably lacking and how much protein they're taking. That
we see that almost universal in everyone that comes through
our clinic. I think the other one about nutrition that
University applies is how much alcohol you taking. It. Again,
(25:00):
it's a very black and white idea. Any alcohol is
too much. Pretty much now, I don't tell people necessarily
to stop drinking altogether, because I also appreciate that there's
a balance between longevity and pleasure, but I emphasize and
that we can kind of delve into that of all
the available scientific data as to how alcohol would impact
(25:22):
your health via different ways where your sleep, while how
much calories you're taking in increasing your risk of all
sort of cancer, particularly GI track type of cancers. So
I think that's again a very black and white universal
idea that I can always, you know, advocate to people
to kind of cut back on. And I think the
other one that is super super important again universally, is
(25:42):
making sure you're taking enough fiber. You know, fiber has massive,
massive data that I'm sure you're aware of. There's a
lot of good cancer data when we look at, you know,
the risk of developing things like colon cancer. Improving your
gut microbiome has tons of good data of how fiber
has a massive map impact on that. And just making
your food also less calorie dense, which ultimately leads to
(26:06):
reducing your calorie intake, balancing your calories better that would
ultimately lead to better weight strategy, especially for people who
have metabolic syndrome. So I think those are probably the
three top things that I almost talk to every client
about that is almost universal and that people are not
(26:27):
necessarily abiding to very well and can make a huge,
huge impact.
Speaker 3 (26:32):
That list is tight.
Speaker 2 (26:34):
It really is the other levers that I add, and I.
Speaker 3 (26:39):
In terms of.
Speaker 2 (26:42):
That I think can have a significant impact in metabolic
health is elimination. So like the processed food side, like
if you stick with whole foods in general, you'll get
at least your fiber side. Usually you're more likely to
hit your fiber goals. The macros are going to be enhanced.
So for me, that one is a lever, and then
(27:02):
the other one I would add not with confidence, but
with UH as a as an option, as a like
a time restricted eating.
Speaker 3 (27:11):
It's not for everybody, but certainly.
Speaker 2 (27:14):
As a lever for folks that that I want to
put some version of a restriction to their to.
Speaker 3 (27:21):
Their diet, I find that that could be helpful for some.
Speaker 4 (27:27):
Yeah, one hundred per I mean those are very very
good points. Process food is massive.
Speaker 2 (27:33):
Like I and like when we look at a North
American diet, it's funny, we were in Europe and and
Ghana last summer and you do realize that there's a
significant amount of process food that we have routinely in
our household too, Like we were three kids, Like.
Speaker 4 (27:52):
You can't right like nowadays it's so difficult.
Speaker 3 (27:56):
Yeah, but yeah, that that for sure to me is
another lever. What about it.
Speaker 2 (28:02):
I'm curious in terms of exercise because I know you're
a beast, like I've seen you.
Speaker 3 (28:07):
Not like human.
Speaker 4 (28:08):
I try, but I'm trying to, you know, keep up
with you.
Speaker 2 (28:13):
I feel like you're like in terms of the cardiovascular side,
you really seem to be at the next level. So
I'm curious one either at a personal level what you
try and do, but also some of the levers that
you like to promote for your patients.
Speaker 4 (28:32):
Yeah, so it's interesting that you bring that up. So
for me personally, and I think actually for a lot
of my clients, coming up with a comprehensive fitness program
is probably the most challenging lever to try and optimize.
Because nutrition, once you know the principles, it's relatively easy,
you know what you're doing, it's relatively easy to get
to where you want to be. But the fitness is
(28:54):
so difficult because everything you do affects another lever. But
generally speaking, when I talked to clients about it, there
are really five areas that you need to have some
sort of an exposure to on a weekly basis, so
kind of a level one is your aerobic capacity. So
when you look at longevity data for fitness, probably the
number one with the most widely available and most frequently
(29:18):
available research and studies on longevity is really this concept
of view two max. Right, So your maximum aerobic capacity,
how many million liters of oxygen per kilogram your body
is able to consume permitted, So by far it has
the most available evidence, strongest evidence for longevity. So I
(29:38):
think if people want to start somewhere, I would say
the number one place to start is really to look
at their VIEO two max and the ways to optimize it.
Where are they at compared to their agent gender, what
percentile are they at, and how much they're able to
improve that. Now, the important thing about vieotwo max is
not only affects your life expectancy, it really affects also
what we call health span, right, much functionality you have
(30:01):
as you get older, right, Because your VEEO to max
drops by about ten percent per decade.
Speaker 3 (30:06):
So if you.
Speaker 4 (30:07):
Don't start at a very high level, if you don't
optimize it when you're younger, as you get older, that's
how you run into you know, shortness of breath when
you're doing your activities a daily living that you and
I commonly see. You know, VEEO to max a huge
determinant of your your risk of being able to get
discharged post hospitalization, how you recover from surgeries and procedures.
(30:28):
There's tans of data available across all different medical disciplines
of how important your view to max is to your
overall prosperity and longevity as you get older especially, so
I think you've got to do something every week to
try and work on that. And as you know, it
kind of basically goes into two categories. You do some
sort of an interval training, we can kind of go
(30:48):
into more into depth in that, and then we can
kind of zone two training, which is really the fundamental
of how you optimize your aerobic capacity and your VEEO
to max. So I think those two are probably should
be the first things that people kind of institute into
the daily lives of their fitness. Is really that then
you kind of go into the strength training is the
(31:09):
next pillar, which is extremely important. We talked quickly about
muscle math, but there's also a lot of evidence also
for strength itself, things like grip strength being a very
important metric in longevity. Is this very interesting data I
can share with you of how grip strength is associated
with your dementia risk. You know, things that you would
normally not associate with each other at all, but there
(31:32):
is actually pretty good data and it all goes back
to you cannot have grip strength without strength training. So
people have good grip strength are always physically active, always
engage in some form of exercise to be able to
maintain that grip strength, and then through that they're able
to improve all these metabolic metrics that would ultimately lead
them to having lower risk of things like dementia, which
(31:52):
as you know, is metabolically driven to a huge extent.
So definitely strength training and another component and the two
last opponents that I always tell patients about them, most
people actually ignore. Once you want to want to get
from the ninetieth percentile to one hundred percentile of fitness
is really mobility and stability. So I think those are
two huge metrics that a lot of us, especially younger
(32:15):
people ignore, but as you get older and older, it
becomes extremely more important. Both of those metrics are very important,
not so much for your longevity per se directly, but
more for preventing injuries. So once you're more stable and
once you're more mobile in your joints, and if you
have a good comprehensive program that you can do on
(32:35):
a weekly basis, it really reduces your risk of injury.
It reduces your risk of fall as you get older.
Of course, the strength is a part of it, but
strength without stability will not prevent falls and will not
help you to prevent injuries. So really kind of those
two are I would say, the ones that most people
kind of often ignore but are very important to do
(32:56):
it that at least once a week to have some
sort of a mobility and stability routine.
Speaker 3 (33:01):
I love it. I love it.
Speaker 2 (33:03):
It's it's like Peter A Ta says, like you want
to be able to be eighty and put your your
suitcase above like in the in the airport, to be
able to put it.
Speaker 4 (33:14):
On the right or just pick up your grandchild on
the floor right.
Speaker 3 (33:17):
Who are listening to Prevention over Prescription with Doctor k.
Speaker 6 (33:21):
Live where the street ends in the basement, partner with
one of your friends and the tampschips all night, water
torture and sink. The furnace is burning.
Speaker 1 (33:37):
But still stream us live at Soga nine sixty am
Dot c a.
Speaker 2 (33:52):
Welcome back to prevention over prescription with doctor k absolutely
and I could guarantee almost all of us can use
more more ability and stability and uh, but yeah, to
reinforce the grip strength too, because I think a lot
of people sometimes they think things literally. My personal opinion
from that is, as doctor Ben mentioned, is that it's
(34:13):
directly strength. So I don't think if you just work
on your grip strength you're going to become you're going
to live longer. But mind you, there's a good data
out there to show that if you improve your grip
strength you will get stronger in your lists. So if
you are looking to uh improve your whatever whatever lift
you're trying to improve on, that's, uh, that's something to enhance.
(34:39):
But yeah, this is uh there's some gold here in
terms of gold nuggets here, Ben, what about you hear
a lot about blood work differing blood work, like, for example, uh,
if you go on X you'll see different opinions on
l d L in terms of its impact on LONGEM.
(35:00):
The different biomarkers you mentioned, the calcium score, like, what
in terms of diagnostics, in your opinion, are real significant
in terms of getting an assessment on longevity.
Speaker 4 (35:18):
Yeah, So I think at a very basic level, anybody
over the age of forty should have a full panel
of looking at their lipid profile, looking at their LPA,
looking at some markers of insulin resistance, at the very
least looking at their hemoglobin A one CE, but ideally
(35:41):
looking at their insulin levels. Looking at some sort of
an inflammatory marker, I think is very important. So you know,
we use kind of HSCRP. There's many different ones that
you can kind of use. I also look at uric
acid because uric acid, as you probably know, has an
indirect relationship with your metabolic health. So one of the
(36:02):
reasons that you develop high blood pressure in the context
of metabolic syndrome is usually because people have a higher
uric acid because it's a byproduct of breakdown of lipids
in your body, so usually has an association with your
triglys rides. It's a part of that pathway. So kind
of looking at those kind of markers or uric acid
and then uric acid itself is a market of information.
(36:23):
Obviously it can lead to gout, and you see this
all the time, this correlation between you know, obs people
developing out. A lot of it is related to that pathway.
But yeah, so some markers of your clear rippit profile,
markers of insulent resistance, markers of inflammation, and your LPA
because it's such a common undiagnosed condition for cardiovasca disease.
(36:44):
So we have a particular interest that a lot of
focus on LPA because through our clinic, even you know,
the patients that have already come through my clinic, we
have seen multiple people that we've caught with significantly elevated
LPA that they thought are quite healthy. They look healthy,
but because of this genetic predisposition to having what I
(37:05):
like to call sticky cholesterol particles, they have significant athoscrosis.
And then we do a calcium score on them and
you know, the calcium scores through the roof, despite the
fact that you know, everything else looks fine, if you know,
their family doctor would have looked at them. So those
are kind of some of the basic things that I
think everybody over the age of forty should get done,
you know, no question, and then you get to kind
(37:27):
of get through some of the weeds of you know
what else matters. You know, looking at the liver enzymes
for fatly livery disease. Again, you know naffold as you know,
an indirect marker of a lot of bad things, including
you know, your metabolic health. Those are kind of some
of the secondary things we look at. You know, calcium
score is interesting. So I'm hoping that at some point
we'll get to a place where we have very easy
(37:49):
access to private CTEs, because right now it's not really
readily available. It's very difficult to get a you know,
cardiac ct to kind of assess for calcium score. So
in my clients, I really reserve it for people who've
had a positive treadmill stress test and they are in
the kind of a law to intermediate risk of you know,
(38:09):
cardiovasca disease as to you whatever kind of risk score
that you use to assess the risk kind of an
in the law to intermediate risk with a positive treadmill
stress test, those are typically the people that we send
for calcium scoring. But I think it's a very very
in a private healthcare environment, is a very very useful
tool for anybody over the age of forty really to
(38:31):
kind of get a direct look at their vascular risk
and the risk of the risk of heart attack. And
there's tons of good data for it.
Speaker 2 (38:38):
This might be a bit of a challenging one bend,
But I respect your opinion. With a lot of this stuff,
What do you think we we got to do from
a advocacy, from a.
Speaker 3 (38:56):
Like, what do we got to do to get the
word out?
Speaker 2 (38:59):
Well, how do we get more buying in terms of
the preventative health side? Like what I appreciate about Ben
like he literally walks the walk in all aspects of life.
Guys like he he lives a healthy lifestyle. We occasionally
got a chat like text each other about some of
these approaches that in terms of healthy living, but he's
(39:22):
living it. And then he's also being part of the
solution which is opening up this clinic right which is
available to our local Ottawa folk. But what do you
think we got to do to amplify this, to scale this?
Because it's as many of my audience has heard, I
get sick of seeing patients and seeing themselves for seeing
(39:45):
their families suffer because of preventable disease. And if we
had more, we had more resources, more, if more more strategy,
being more strategic about it, I honestly think we could
put a dent in this. I have no actually I
have no doubt about it, But it's a long winded question,
But what are your thoughts around that?
Speaker 4 (40:06):
Yeah, so I think, you know, things like what you're
doing is super valuable, right like having this podcast, you know,
having this platform, you know, with all of your followers
on social media, to be able to spread this message
is very very important. And the important thing about you
know us, you and I is public trusts us, right,
(40:29):
So going through the through through our education, I think
you have we have the credibility to kind of talk
to people and hopefully a lot of people would listen
because I think for a lot of for a lot
of people, particularly on kind of a digital space and
social media, is really the credibility, right because there's so
many people, there's so much information out there, as you know,
(40:51):
a lot of it non necessarily the most accurate. So
I think credibility is a certain piece. So I think
we are definitely a privileged place to try and kind
of use our time and use that credibility to kind
of give people credible information that is available and backed
by science and kind of spread that message. But I
(41:14):
do think that kind of a digital space is by
far the biggest you know, what you do getting on
you know, TV, getting on radio. I think that has
a huge, huge impact, right, And a lot of it
is repetition, right, Like, once people see it once, maybe
they don't believe it. They see the second time from
a second Canadian doctor, they will kind of believe it more.
So I think that is a huge part of it.
(41:35):
I think the other thing that is super important is
how we communicate the message. You know, doctors sometimes tend
to be a little bit too too scientific. They don't
talk the common language that is easily understandable for most people.
So I think breaking it down and simplifying into easy,
actionable steps is very important. I mean, I can talk
(41:56):
all day about, you know, the metabolic pathways of arobolic
disease and how the you know, the physiological and bio
chemical pathways look like that means nothing to anybody, right
to most people. Really, what matters is, you know, break
it down, actionable, simple steps that people can follow to
make a difference. I don't know if you saw me,
I posted a video about, you know, a thirty minute
(42:18):
walk because I came across this steady yeah. Yeah, you know,
like something simple, something simple that anybody can connect to,
that has available evidence, is actionable for someone to start
somewhere because a lot of people. That's the other challenge
is if you're very sedentary and overweight and have all
these problems, it very difficult for you to start. That
(42:40):
first step is so difficult. If somebody is already fit,
making a little optimization is very easy for them. And
sometimes I'm afraid that maybe a lot of our audience
or those people that are already super fit. So the
question is how do you connect to the mass, to
the masses who are not necessarily anywhere yet. You know,
they haven't started even going to the gym, or they
(43:01):
have no idea about nutrition. How can you make it
as simple as possible, as actionable as possible for them
to make a small little step today that over time
I would have this massive impact. So I think those
are kind of some of the things we can do,
and you know I try to do in my communication
is to really make it simple and actionable for as
(43:21):
many people as possible.
Speaker 2 (43:24):
You do it well, And one thing I want to
I don't know if it's important or not, Ben, but
I think both of us, I feel both of us
do this, okay, is just being honest in terms of
our certainty it irks me when you're on the social
media feeds when people are like, this is the only approach,
(43:46):
this is the best approach.
Speaker 3 (43:49):
This is.
Speaker 2 (43:51):
Tons of evidence for this. When they're talking out of
their backside, I think. I think being humble and saying
is what I think. This is my suggestion. This is
based on the evidence that I see in front of me,
or the level of evidence we had. This is my suggestion,
or this is how I approach it. I think that's
under I think it's a it's it's more important than
(44:15):
we think, because what it comes down to is you
mentioned it before. It's trust, and we got we got
a certain level of trust because of our credentials. But
there's still the execution, like when you see I think
this is where the where the pandemic screwed some of
us up. Frankly, we were talking with absolute certainty about
(44:36):
certain things when we weren't one hundred percent certain.
Speaker 3 (44:39):
We thought it was the best action. But when you
come across that way, I think you lose. You can
lose the public.
Speaker 2 (44:45):
So yeah, I just want to command you to ben
like even when talking today, based on the evidence here,
this is where the standard when we were lacking some
systematic reviews or randomized control trials here.
Speaker 3 (45:00):
Like, I think that goes a long way.
Speaker 2 (45:03):
Even though I haven't heard this from people, this is
just something that intuitively I feel.
Speaker 4 (45:10):
No, you're correct about that. That's a very very good point. Yeah.
Like one of my main red flags that goes off
if I see somebody on social media is if they're
talking with too much certainty, then you know, as probably
all right, because we know even in things that we
think are certain, Like there are a lot of things
in medicine that we thought for a long time that
this is a certainty, and you have randomized trials even
(45:31):
and even those a lot of them end up becoming debunked,
you know, ten years later, So you don't forget about that,
even things that you don't have randomized trials for, you know.
So yeah, I think that's very important to always remember
that everything you hear you got to take it with
the creat assault and understand that nothing is one hundred
percent certain when it comes to lifestyle medicine and wellness space.
Speaker 2 (45:52):
One hundred percent. Yeah, Ben, this has been wicked. I
have been a long time coming. Actually kind of sad
we didn't get to do this before because I think
a lot of people are going to benefit it from this,
and we're releasing this obviously during Heart Health Month. So
but Ben, how do people track you down? Where can
(46:13):
they find you? Where do they learn more about the clinic?
Where do they sign up?
Speaker 3 (46:16):
Baby? Thanks? Man?
Speaker 4 (46:18):
Yeah, so our website is Cardiaclongevity Clinic dot com. So
all the information about the clinic and our services are
on there, or they can send us an email at
contact at Cardiac Longevity Clinic dot com. Our phone numbers
in there. There's a form they can fill out or
directly send us an email, so any of those would work.
Speaker 2 (46:41):
Amazing, Ben, Thank you for doing all that you do.
We definitely got to keep this momentum.
Speaker 3 (46:47):
Brother.
Speaker 2 (46:49):
In fact, we need to collaborate more now I think
about it, But stay tuned for some more action, my friend.
Speaker 3 (46:56):
Thanks for doing this.
Speaker 4 (46:57):
Thanks gaud and thank you for all the kind of
the awareness. You've always been my role model in this
kind of a digital space and how to spread awareness
for health and wellness. So thanks for doing everything that
you're doing.
Speaker 2 (47:11):
Man, that's kind of you to say, but thank you
and thanks for doing this. Thanks so much for listening
to doctor Ben on prevention over prescription.
Speaker 3 (47:20):
That episode was Gangster Baby.
Speaker 2 (47:23):
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(47:46):
these things that we're promoting, all these things that we're
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so that you show up as your best self, show
up guide as strong baby.
Speaker 3 (47:56):
Here we go.
Speaker 2 (47:57):
Let's do this all right, bo I, hope you're feeling
a little bit more jumping your step after that episode.
Thanks for listening. Talk Russell whose Yeah, it's like, if
you want to rhyme with me, you don't even know
what rod is looks.
Speaker 5 (48:12):
If you want to get clean, you want to get dirty,
you want to go left right.
Speaker 3 (48:15):
This is what we're doing.
Speaker 4 (48:16):
Wants to knock up.
Speaker 5 (48:17):
Let's just rock up forty one one, drinking my wine
as over through you think of beatif the strategies when
you battle.
Speaker 4 (48:23):
Since the national no reconsent
Speaker 1 (48:25):
People, no radio, no problem stream is live on Saga
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The views expressed in the following program are those of
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KWA Dcast. Welcome to Prevention over Description, the podcast where
we focus on what truly matters, taking control of your
health before it takes control of you. I'm doctor Quadio
Karen Mantang. I see you, physician, health advocate and your
(03:11):
guide to living stronger, healthier and longer. In each episode,
we'll explore how you can prevent illness and thrive through
practical advice on nutrition, movement, stress management, and building a
supportive community. Because prevention isn't just better than prescription, it's
the key to showing up as your best self. Let's
(03:32):
get started coorgasination. We got a special guest on pop
Prevention over Prescription where doctor k We got doctor.
Speaker 3 (03:40):
Ben in the mix, doctor Ben.
Speaker 2 (03:43):
Banahashimi, Cardiology, founder of the Cardiac Longevity Clinic, and we're
going to get into all things longevity today, folks. How
we're going to address this, How we're going to get
people to live longer, healthier lives, increase their health span,
not just their lifespan, their health span. Son, this is
(04:03):
what it's all about. And Ben, I've known him for years,
a few years behind me in medical training with this
man's a beast. He lives a lifestyle, he lives and
breeds healthy living, and he's trying to bring that to
our community locally and through his advocacy online. You are
going to love doctor Ben. I've been waiting for this
(04:25):
podcast for so long because you guys have asked for
doctor Ben, and now you are receiving Doctor Ben. We
are going to be talking about all things longevity. His
resumes insane, as you heard about in the intro, but
he is a trendsetter, he's an innovator, he's an entrepreneur.
He's a bit I must say, I'm a bit jealous
(04:49):
of all the things you're accomplishing, my friend.
Speaker 3 (04:51):
But welcome to the Welcome to the show.
Speaker 4 (04:53):
Thanks, thanks for having me man, It's a pleasure. It's
a long awaited conversation for me as well. You're looking
forward to chatting with you is always a pleasure.
Speaker 2 (05:02):
Oh, thank you, brother. I want to just get right
to it. You started a cardiac longevity clinic just recently.
I'm wondering what was the driver.
Speaker 4 (05:13):
Yeah, thanks for asking that, you know, I think it
comes from a couple of different routes. So number one,
as you know, I run a cardiology clinic in the
West End of Ottawa and have now been a cardiologist
for over ten years. And one of the frustrations that
I know you shared to some extent as well, is
(05:34):
just a frustration with a way of deliver healthcare in
our country. We are very much focused on band aid
solutions and kind of dealing just with complications of disease
rather than addressing the fundamental underlying issue of why these conditions,
these metabolic diseases happened in the first place. So as
(05:56):
a cardiologist, you know, for over ten years, I've kind
of dealt with these patients, these clients coming in with
cardiac disease, major complication, major cost to healthcare, major costs
for them personally and financially, and all we do in
cardiology is managing the kind of the end stage of
(06:18):
the disease, managing the complications of the disease, which is
a very inefficient, unintuitive way of managing conditions. You know,
they're coming with a heart attack. Rather than focusing our
attention as to why they had the heart attack in
the first place, we put them on pharmaceuticals. We put
stents in their hearts, we replace their valves, We do
all these very expensive, very complicated procedures that you know,
(06:43):
expose these patients with a kind of different side effects.
If it's a pharmaceutical complication, it's a surgery and procedure.
But then they come back again to me a year
or two later because we're not addressing the fundamental issues,
which is, you know, their lifestyle, the risk factors that
they're exposed to, the lifestyle choices that they're making, the
metabolic disease that is underlying their problem. We never address that. Unfortunately,
(07:06):
there's no focus, there's no money or funding or spending
in that part of healthcare. And frankly, even in our education,
as you know, we get such a limited exposure to
the actual science. Now there's tons of science for all
of these primary prevention strategies, these lifestyle strategies that would
have a massive impact in reducing cardiovascular complications and improving
(07:28):
people's longevity. But we don't learn it in school. You know,
I spend one month in my entire training, you know,
I have twelve plus years of medical training, spend only
a month in cardiac rehabilitation, And what I learned in
that rotation was so limited compared to the available science,
you know, So all of our effort, even in our
(07:50):
medical education, and definitely when it comes to healthcare, spending
and our time in the clinic goes towards managing complications
rather than addressing the underlying problems, the fundamentals of why
people developed these diseases, the cardiovascua disease, heart attack and
stroke and heart failure in the first place. So that
frustration is what led me to really start this clinic.
(08:12):
And of course I'm also personally very passionate about it.
This is, you know, wellness and health is something that
I am myself a practitioner of super passionate about, have
been doing it for a long time. So really the
idea was kind of to bring these two things together
and kind of create a practice that is personally meaningful
(08:32):
to me, personally enjoyable and rewarding to me, and I
think would make a massive impact in my patient population
as well.
Speaker 3 (08:39):
We're listening to Prevention over Prescription for doctor k h Be.
Speaker 5 (08:45):
Today is a shizu Mayezu used to drive down NBA's
turning them at a home and a survice that a
RB cheap for them, paus the day would show cheese
that would work with them, or in we got rid
of at tern for them, wasn't bon us a lust
I was perfect?
Speaker 1 (09:00):
Stream us Live at SAGA nine sixty am dot co.
Speaker 2 (09:12):
Welcome back to Prevention over Prescription with doctor k. You
don't hear many of us talk this way, Ben, like
many of us talk about You're right like there is
a significant amount of data out there about primary prevention
that we just don't highlight enough or get educated on
in during medical school, during residency, during fellowship. So I
(09:36):
do feel like your instincts of trying to push this
is going to be to have a significant impact. And
I think what I love about it too, Ben, is
that people will follow, The kids will follow the young trainees,
They'll be attracted to this because in my opinion, it's
going to make a significant difference in people's lives, which
is what we want to see.
Speaker 3 (09:58):
So how does this look when I.
Speaker 2 (10:01):
See that, you know, doctor Brent's got this new clinic,
Do I just go to a website sign up?
Speaker 3 (10:07):
Like? What what can I expect walking through the door.
Speaker 4 (10:11):
So it's very much a kind of an allur card
menu that we offer clients with regards to what they
want to have, because everybody, I think, you know, again,
one of the downsides of our healthcare system, which I'm
sure you've experienced, is that we have very cookie cutter.
We don't have any customized plans for people. You know,
what is good for me, what works for me, what
(10:32):
I need to be able to get healthy, is different
than what you need. So this whole idea that anybody
that comes through the door, we offer them exact same treatment.
It is so counterintuitive, but that's how we do ninety
nine percent of medicine. You know, I give the same
drug to one hundred people. I give the same exact prescription,
(10:53):
same exact lifestyle plan to one hundred different people. But
obviously that's not going to work. You know, obviously compliance
is going to be low when you're offering exact same
thing to every person. So ours is very much personalized
and customized plans. So when you come in through the door,
we do a very comprehensive assessment on you to determine
(11:14):
in the first place of what you need. You know,
what are your needs, what is lacking based on your
clinical profile, and then we offer you basically a many
of things that you can do. But in general is
divided into kind of three different category of services that
we offer in the cardiac longevity clinics. So number one
is cardiovascular assessment, which is obviously my wheelhouse. So we
(11:35):
can do obviously a full cardiovascular diagnostics on the clients,
from getting their view to max and do a schemeicry
stratification to look for coordinatory disease or looking for blockage
in the arteries, to getting an ultrasound of the herd
echo cardiogram to do a comprehensive structural assessment of the heart,
to doing coroated ultrasounds to kind of get a sense
(11:56):
of their overall vascular risk factors and the risk of stroke,
to prefer ultrasounds looking for perifer vaspil disease. So that's
kind of the first component of the program. The second
component is really a comprehensive metabolic assessment, so we do
kind of a full blood work panel, kind of above
and beyond what somebody would get in their family doctor's office,
focusing more on markers of both metabolic disease as well
(12:19):
as inflammation as well as insulin resistance nutrient deficiencies. So
there's a bloodwork panel, and then we combine that data
with a DEXA scan, which will give us a pretty
good idea of body composition, basically the gold standard for
assessing body composition, looking at visceral fats and looking at
their muscle mass, and then we combine that data to
(12:40):
give them a pretty comprehensive picture of their metabolic health.
That's kind of the second component of the program. And
then the third component is really their lifestyle assessment or optimization.
So I work with multiple athletic therapists, strength coaches as
well as dietitian sleep specialists as well as I call
it just so we kind of basically go through those
(13:02):
four areas of lifestyle. So we do a full fitness assessment,
full nutrition assessment, a home sleep study to kind of
get all their sleep architecture data as well as assessing
for sleep apnea, and then we do a kind of
a mental health slash stress assessment and then based on
how you score in these four areas, then we actually
(13:22):
give the clients an actionable plan as to how to
optimize these four areas of their lifestyle to get more
metabolically healthy and improve their longevity.
Speaker 2 (13:32):
Brilliant, brilliant, So Ben, I mean, the thing that I
fully enjoy you mentioning is the idea that it's customized,
it's personalized, because I think we're not doing this enough
in medicine at all, frankly, and it's the future with
(13:54):
the amount of data that's available to us.
Speaker 3 (13:56):
But I think that approach.
Speaker 2 (13:59):
Like not that you need validation, but if I were
to personally have a longevity clinic set up, this is
exactly what I would want. You have some like diagnostic test,
blood and structural to be able to get an assessment
of body comp like all these things that are that
you can't get anywhere else. Really it's so valuable that
(14:23):
you could get this in one center. So because of
all this, I would imagine people have to see you
front center. There's not a virtual option.
Speaker 4 (14:34):
Is that correct, not yet, but I'm kind of in
the process of starting that as well to kind of
offer this kind of more widely in a virtual manner.
Speaker 3 (14:42):
When do we start the longevity clinic.
Speaker 4 (14:44):
So it's been about eight months now.
Speaker 2 (14:46):
Eight months, Yeah, it might be a little early to
throw this at you, but like, can you think of
some transformations that you've seen or has there been any
stories that come to mind where the the impact that
the Cardiac Longevity Clinic has had on a patient has
been significant in your mind.
Speaker 4 (15:09):
Yeah. So, actually, my very first client was one of
my good friends and neighbors, and he essentially he came
kind of through our clinic and he now wants to
be a kind of a business development person for my
Cardiac Longevity clinic because he saw such a massive impact.
(15:31):
So basically, I kind of briefly going through his history.
Basically a client, a neighbor, very nice guy, but not
really necessarily taking care of himself, very well, overweight, had
me autabolic syndrome, significantly elevated blood pressure as well as
pre diabetes, never really diagnosed. Most importantly because he was overweight.
(15:53):
He also had severe sleep apnia. So coming through our clinic,
first thing that happened. Obviously, we diagnosed him with severe
sleep apnea, put his seatpop on him. That itself completely
changed his life, right because I mean, this guy was
having almost ninety events an hour, So just kind of
putting the seat pap on him all of a sudden,
and he's a business owner, all of a sudden, his
(16:15):
energy goes ten x. So just that completely transformed his
life of being able to function at a whole different
new level. And his blood pressure dropped. You know, he
had this huge issue. His family doctor was pushing him
to start him on blood pressure bills. Just getting his
slip appy A treated his blood pressure completely normalized even
before we kind of do any other intervention, and then
(16:37):
we gave him a fitness plan. Through the fitness plan
and through his cardiovascar diagnosis, we actually found out that
he had by cust periotic valve, which is for your audience,
is basically this condition where your valve from has a
birth defect. The main valve out of your heart has
a birth defect where instead of three kind of little valves,
it has two, and because of that it degenerates faster.
(16:57):
But this guy was in his early forties. Valve should
still be fairly intact if you're healthy, but aotic valve
is very much affected by a metabolic disease. So when
you have high blood pressure, pre diabetes, all these factors
that cause after those crosis, they can also cause the
seriation of the ertic valve. So his eerotic valve was
already chewed up quite a bit for someone in their
early forties. It was already had moderate theotic regratutation, so
(17:19):
the valve was moderately leaky, all primarily driven by obviously genetics,
but also the fact that he had metabolic disas, so
discovering that was also huge for him. His order had
already dilated a bit because of his highpertension. So just
imagine what would have happened to this guy if he
hadn't walked through our clinic and he would have come
five years later to discover all of these things, right,
(17:41):
his valve would have probably completely been chewed up. He
would have needed an aertic valve replacement at the age
of forty five, which is a pretty catastrophic, you know,
complication for something that can be managed all the way
to your late sixties, probably without having any surgery. So
I'm hoping that now that he went through the clinic
and then through all of that, obviously he kind of
had this wake up call. So we put him on
(18:02):
a fitness program, on a diet program. He's already lost
about thirty pounds. His blood pressure is now normal, his
metabolic markers are all normalizing. So he actually is a
part of because we offer a kind of a long
at chuneral program as a part of our longevity program too,
so he is now kind of a part of our program.
So we are seeing him on a monthly basis through
our nurse practitioner program and I'm seeing every three months.
(18:22):
So he's made these massive changes in his lifestyle which
is probably going to be for him life saving. And
then through all of this, he also had all his
daughter's screen for by cospioity Clove and actually one of
his daughters now by cospioty Clove, which would have never
been discovered again till God knows when. So the amount
of impact that you know you can create and coming
through a clinic like this, particularly for you know, this
(18:45):
this client of mine, you know, it's just you know,
I mean, he kind of talks about it all the
time of how absolutely life changing for him right to
have all these things done. How he feels now and
also kind of moving forward for his future, how we
have impacted him in his face.
Speaker 2 (19:00):
Who are listening to Prevention over Prescription with Doctor K.
Speaker 1 (19:17):
From No Radio, No Problem stream is live on SAGA
ninety sixty AM dot C.
Speaker 2 (19:24):
A welcome back to Prevention over Prescription with Doctor K.
Speaker 3 (19:37):
Incredible.
Speaker 2 (19:38):
I love hearing these stories for several reasons. One, he's
he has a new lease on life. He's feeling better,
he is actually more functional, going to be a better dad,
going to be a better business person, all the other
things that you want. Second, big highlight lesson here too,
(19:59):
Ben is a lot of people they feel like these
diagnosis that they have, these chronic disease diagnosis are permanent.
Where you just illustrated in this case how he was
able to reverse his hypertension reversus risk of metabolic syndrome
because of the changes he made, lifestyle modifications that he's made,
(20:23):
like that that's not a pill that he's going to
take forever, Like that's huge. And then third, I think
what you see when you have a patient like that
in their circle, Like you made the example with the daughters,
but I can guarantee you in his network, there's going
to be people that see what he went through and
(20:46):
they're going to be motivated. He's going to be an
ambassador of health. This is the intangible that people don't
realize too about some of the stuff that we talk
about about prevention. It's contagious. When you got that mom
that came off or dive meds because of her whatever
lifestyle modifications that she took.
Speaker 3 (21:05):
There are going to be people that follow, I promise you.
Speaker 2 (21:08):
So it's scalable and it's sexy too when you see
people getting healthy literally and figuratively. So I love that story, Bend,
because that just exemplifies what the power is when we can.
Speaker 3 (21:24):
Focus on prevention. Absolutely.
Speaker 2 (21:29):
So I'm curious from your perspective where you think some
of the levers that are most impactful for patients. So
I want to focus on nutrition. First of all, you
get a lot of information out there in terms of
what approach makes most sense for people, and I know,
once again, this is a personalized approach for many of
(21:51):
our patients. But in your experience, in the stuff that
you've read or listened to on podcasts, what do you
think is some of the high level that the things
people could do that can move the needle when it
comes to the nutrition and their metal bolic health.
Speaker 4 (22:09):
I'm actually really curious to hear your thoughts about this too,
because obviously you have a lot of expertise in this,
and you've talked to a lot of experts on this.
But I think nutrition is probably one of the most
challenging ones, right because there's so much out there, right,
There's so many fat diets out there, there's so much
information that's constantly thrown at people. So I think nutrition
is tough for that. And then the other reason that,
(22:31):
as you probably know, nutrition is tough is because there
are really very few randomized control trials looking at nutrition interventions, right.
So I think that those are some of the things
that makes nutrition science very very difficult to look at.
It's a very difficult thing to do randomized trials in
because it's very difficult to isolate one particular ingredient within
(22:51):
your diet, one particular component within your diet, and kind
of do a randomized trials on it. And of course
in medicine, that's kind of the best type of evidence
we like. I think it's important to look at some
of the other evidence. When you have prospective data at least,
it could be very helpful to look at. So I
would say, out of the things that I've seen anecdotally
(23:11):
talking to experts and kind of looking at the literature myself,
I would say probably the number one thing that would
make the most massive impact for people is to look
at their diets somewhat in terms of their macros, right, Like,
you need to be somewhat aware of what is going
you're putting in your mouth with regards to what is
(23:33):
kind of the composition, right, So how much protein am
I taking and how much carbohydrates I'm taking and how
much fat I'm taking? It most importantly focused on how
much protein you're taking, right, So protein is probably massive
out of all of your macros. Your carbon fat might
be important if you're looking at a massive amount of
weight loss, but number one probably protein is huge. I
(23:55):
know you are a huge advocate of this. You have
your own brand of now kind of protein powder because
of that, because most people do not take enough amount
of protein. It's actually very very difficult. And when you
look at the data for muscle mass, which is a
huge determinant of your longevity, there's tons of good data
associating muscle mass with all sort of longevity metrics. One
(24:17):
of the most important things other than strength training would
be how much protein a day you're taking. And as
you get older, it becomes more and more difficult to
have adequate amount of daily protein intake to maintain that
muscle mass. So making sure that you're somewhere between, you know,
zero point eight to one gram per pound of protein
a day, which is extremely difficult, but at least trying
(24:38):
to get close to that is probably one of the
main challenges that most of my clients, Almost every client
that comes through, even the ones that are super healthy,
very aware of what they're eating and their longevity lifestyle
they're probably lacking and how much protein they're taking. That
we see that almost universal in everyone that comes through
our clinic. I think the other one about nutrition that
University applies is how much alcohol you taking. It. Again,
(25:00):
it's a very black and white idea. Any alcohol is
too much. Pretty much now, I don't tell people necessarily
to stop drinking altogether, because I also appreciate that there's
a balance between longevity and pleasure, but I emphasize and
that we can kind of delve into that of all
the available scientific data as to how alcohol would impact
(25:22):
your health via different ways where your sleep, while how
much calories you're taking in increasing your risk of all
sort of cancer, particularly GI track type of cancers. So
I think that's again a very black and white universal
idea that I can always, you know, advocate to people
to kind of cut back on. And I think the
other one that is super super important again universally, is
(25:42):
making sure you're taking enough fiber. You know, fiber has massive,
massive data that I'm sure you're aware of. There's a
lot of good cancer data when we look at, you know,
the risk of developing things like colon cancer. Improving your
gut microbiome has tons of good data of how fiber
has a massive map impact on that. And just making
your food also less calorie dense, which ultimately leads to
(26:06):
reducing your calorie intake, balancing your calories better that would
ultimately lead to better weight strategy, especially for people who
have metabolic syndrome. So I think those are probably the
three top things that I almost talk to every client
about that is almost universal and that people are not
(26:27):
necessarily abiding to very well and can make a huge,
huge impact.
Speaker 3 (26:32):
That list is tight.
Speaker 2 (26:34):
It really is the other levers that I add, and I.
Speaker 3 (26:39):
In terms of.
Speaker 2 (26:42):
That I think can have a significant impact in metabolic
health is elimination. So like the processed food side, like
if you stick with whole foods in general, you'll get
at least your fiber side. Usually you're more likely to
hit your fiber goals. The macros are going to be enhanced.
So for me, that one is a lever, and then
(27:02):
the other one I would add not with confidence, but
with UH as a as an option, as a like
a time restricted eating.
Speaker 3 (27:11):
It's not for everybody, but certainly.
Speaker 2 (27:14):
As a lever for folks that that I want to
put some version of a restriction to their to.
Speaker 3 (27:21):
Their diet, I find that that could be helpful for some.
Speaker 4 (27:27):
Yeah, one hundred per I mean those are very very
good points. Process food is massive.
Speaker 2 (27:33):
Like I and like when we look at a North
American diet, it's funny, we were in Europe and and
Ghana last summer and you do realize that there's a
significant amount of process food that we have routinely in
our household too, Like we were three kids, Like.
Speaker 4 (27:52):
You can't right like nowadays it's so difficult.
Speaker 3 (27:56):
Yeah, but yeah, that that for sure to me is
another lever. What about it.
Speaker 2 (28:02):
I'm curious in terms of exercise because I know you're
a beast, like I've seen you.
Speaker 3 (28:07):
Not like human.
Speaker 4 (28:08):
I try, but I'm trying to, you know, keep up
with you.
Speaker 2 (28:13):
I feel like you're like in terms of the cardiovascular side,
you really seem to be at the next level. So
I'm curious one either at a personal level what you
try and do, but also some of the levers that
you like to promote for your patients.
Speaker 4 (28:32):
Yeah, so it's interesting that you bring that up. So
for me personally, and I think actually for a lot
of my clients, coming up with a comprehensive fitness program
is probably the most challenging lever to try and optimize.
Because nutrition, once you know the principles, it's relatively easy,
you know what you're doing, it's relatively easy to get
to where you want to be. But the fitness is
(28:54):
so difficult because everything you do affects another lever. But
generally speaking, when I talked to clients about it, there
are really five areas that you need to have some
sort of an exposure to on a weekly basis, so
kind of a level one is your aerobic capacity. So
when you look at longevity data for fitness, probably the
number one with the most widely available and most frequently
(29:18):
available research and studies on longevity is really this concept
of view two max. Right, So your maximum aerobic capacity,
how many million liters of oxygen per kilogram your body
is able to consume permitted, So by far it has
the most available evidence, strongest evidence for longevity. So I
(29:38):
think if people want to start somewhere, I would say
the number one place to start is really to look
at their VIEO two max and the ways to optimize it.
Where are they at compared to their agent gender, what
percentile are they at, and how much they're able to
improve that. Now, the important thing about vieotwo max is
not only affects your life expectancy, it really affects also
what we call health span, right, much functionality you have
(30:01):
as you get older, right, Because your VEEO to max
drops by about ten percent per decade.
Speaker 3 (30:06):
So if you.
Speaker 4 (30:07):
Don't start at a very high level, if you don't
optimize it when you're younger, as you get older, that's
how you run into you know, shortness of breath when
you're doing your activities a daily living that you and
I commonly see. You know, VEEO to max a huge
determinant of your your risk of being able to get
discharged post hospitalization, how you recover from surgeries and procedures.
(30:28):
There's tans of data available across all different medical disciplines
of how important your view to max is to your
overall prosperity and longevity as you get older especially, so
I think you've got to do something every week to
try and work on that. And as you know, it
kind of basically goes into two categories. You do some
sort of an interval training, we can kind of go
(30:48):
into more into depth in that, and then we can
kind of zone two training, which is really the fundamental
of how you optimize your aerobic capacity and your VEEO
to max. So I think those two are probably should
be the first things that people kind of institute into
the daily lives of their fitness. Is really that then
you kind of go into the strength training is the
(31:09):
next pillar, which is extremely important. We talked quickly about
muscle math, but there's also a lot of evidence also
for strength itself, things like grip strength being a very
important metric in longevity. Is this very interesting data I
can share with you of how grip strength is associated
with your dementia risk. You know, things that you would
normally not associate with each other at all, but there
(31:32):
is actually pretty good data and it all goes back
to you cannot have grip strength without strength training. So
people have good grip strength are always physically active, always
engage in some form of exercise to be able to
maintain that grip strength, and then through that they're able
to improve all these metabolic metrics that would ultimately lead
them to having lower risk of things like dementia, which
(31:52):
as you know, is metabolically driven to a huge extent.
So definitely strength training and another component and the two
last opponents that I always tell patients about them, most
people actually ignore. Once you want to want to get
from the ninetieth percentile to one hundred percentile of fitness
is really mobility and stability. So I think those are
two huge metrics that a lot of us, especially younger
(32:15):
people ignore, but as you get older and older, it
becomes extremely more important. Both of those metrics are very important,
not so much for your longevity per se directly, but
more for preventing injuries. So once you're more stable and
once you're more mobile in your joints, and if you
have a good comprehensive program that you can do on
(32:35):
a weekly basis, it really reduces your risk of injury.
It reduces your risk of fall as you get older.
Of course, the strength is a part of it, but
strength without stability will not prevent falls and will not
help you to prevent injuries. So really kind of those
two are I would say, the ones that most people
kind of often ignore but are very important to do
(32:56):
it that at least once a week to have some
sort of a mobility and stability routine.
Speaker 3 (33:01):
I love it. I love it.
Speaker 2 (33:03):
It's it's like Peter A Ta says, like you want
to be able to be eighty and put your your
suitcase above like in the in the airport, to be
able to put it.
Speaker 4 (33:14):
On the right or just pick up your grandchild on
the floor right.
Speaker 3 (33:17):
Who are listening to Prevention over Prescription with Doctor k.
Speaker 6 (33:21):
Live where the street ends in the basement, partner with
one of your friends and the tampschips all night, water
torture and sink. The furnace is burning.
Speaker 1 (33:37):
But still stream us live at Soga nine sixty am
Dot c a.
Speaker 2 (33:52):
Welcome back to prevention over prescription with doctor k absolutely
and I could guarantee almost all of us can use
more more ability and stability and uh, but yeah, to
reinforce the grip strength too, because I think a lot
of people sometimes they think things literally. My personal opinion
from that is, as doctor Ben mentioned, is that it's
(34:13):
directly strength. So I don't think if you just work
on your grip strength you're going to become you're going
to live longer. But mind you, there's a good data
out there to show that if you improve your grip
strength you will get stronger in your lists. So if
you are looking to uh improve your whatever whatever lift
you're trying to improve on, that's, uh, that's something to enhance.
(34:39):
But yeah, this is uh there's some gold here in
terms of gold nuggets here, Ben, what about you hear
a lot about blood work differing blood work, like, for example, uh,
if you go on X you'll see different opinions on
l d L in terms of its impact on LONGEM.
(35:00):
The different biomarkers you mentioned, the calcium score, like, what
in terms of diagnostics, in your opinion, are real significant
in terms of getting an assessment on longevity.
Speaker 4 (35:18):
Yeah, So I think at a very basic level, anybody
over the age of forty should have a full panel
of looking at their lipid profile, looking at their LPA,
looking at some markers of insulin resistance, at the very
least looking at their hemoglobin A one CE, but ideally
(35:41):
looking at their insulin levels. Looking at some sort of
an inflammatory marker, I think is very important. So you know,
we use kind of HSCRP. There's many different ones that
you can kind of use. I also look at uric
acid because uric acid, as you probably know, has an
indirect relationship with your metabolic health. So one of the
(36:02):
reasons that you develop high blood pressure in the context
of metabolic syndrome is usually because people have a higher
uric acid because it's a byproduct of breakdown of lipids
in your body, so usually has an association with your
triglys rides. It's a part of that pathway. So kind
of looking at those kind of markers or uric acid
and then uric acid itself is a market of information.
(36:23):
Obviously it can lead to gout, and you see this
all the time, this correlation between you know, obs people
developing out. A lot of it is related to that pathway.
But yeah, so some markers of your clear rippit profile,
markers of insulent resistance, markers of inflammation, and your LPA
because it's such a common undiagnosed condition for cardiovasca disease.
(36:44):
So we have a particular interest that a lot of
focus on LPA because through our clinic, even you know,
the patients that have already come through my clinic, we
have seen multiple people that we've caught with significantly elevated
LPA that they thought are quite healthy. They look healthy,
but because of this genetic predisposition to having what I
(37:05):
like to call sticky cholesterol particles, they have significant athoscrosis.
And then we do a calcium score on them and
you know, the calcium scores through the roof, despite the
fact that you know, everything else looks fine, if you know,
their family doctor would have looked at them. So those
are kind of some of the basic things that I
think everybody over the age of forty should get done,
you know, no question, and then you get to kind
(37:27):
of get through some of the weeds of you know
what else matters. You know, looking at the liver enzymes
for fatly livery disease. Again, you know naffold as you know,
an indirect marker of a lot of bad things, including
you know, your metabolic health. Those are kind of some
of the secondary things we look at. You know, calcium
score is interesting. So I'm hoping that at some point
we'll get to a place where we have very easy
(37:49):
access to private CTEs, because right now it's not really
readily available. It's very difficult to get a you know,
cardiac ct to kind of assess for calcium score. So
in my clients, I really reserve it for people who've
had a positive treadmill stress test and they are in
the kind of a law to intermediate risk of you know,
(38:09):
cardiovasca disease as to you whatever kind of risk score
that you use to assess the risk kind of an
in the law to intermediate risk with a positive treadmill
stress test, those are typically the people that we send
for calcium scoring. But I think it's a very very
in a private healthcare environment, is a very very useful
tool for anybody over the age of forty really to
(38:31):
kind of get a direct look at their vascular risk
and the risk of the risk of heart attack. And
there's tons of good data for it.
Speaker 2 (38:38):
This might be a bit of a challenging one bend,
But I respect your opinion. With a lot of this stuff,
What do you think we we got to do from
a advocacy, from a.
Speaker 3 (38:56):
Like, what do we got to do to get the
word out?
Speaker 2 (38:59):
Well, how do we get more buying in terms of
the preventative health side? Like what I appreciate about Ben
like he literally walks the walk in all aspects of life.
Guys like he he lives a healthy lifestyle. We occasionally
got a chat like text each other about some of
these approaches that in terms of healthy living, but he's
(39:22):
living it. And then he's also being part of the
solution which is opening up this clinic right which is
available to our local Ottawa folk. But what do you
think we got to do to amplify this, to scale this?
Because it's as many of my audience has heard, I
get sick of seeing patients and seeing themselves for seeing
(39:45):
their families suffer because of preventable disease. And if we
had more, we had more resources, more, if more more strategy,
being more strategic about it, I honestly think we could
put a dent in this. I have no actually I
have no doubt about it, But it's a long winded question,
But what are your thoughts around that?
Speaker 4 (40:06):
Yeah, so I think, you know, things like what you're
doing is super valuable, right like having this podcast, you know,
having this platform, you know, with all of your followers
on social media, to be able to spread this message
is very very important. And the important thing about you
know us, you and I is public trusts us, right,
(40:29):
So going through the through through our education, I think
you have we have the credibility to kind of talk
to people and hopefully a lot of people would listen
because I think for a lot of for a lot
of people, particularly on kind of a digital space and
social media, is really the credibility, right because there's so
many people, there's so much information out there, as you know,
(40:51):
a lot of it non necessarily the most accurate. So
I think credibility is a certain piece. So I think
we are definitely a privileged place to try and kind
of use our time and use that credibility to kind
of give people credible information that is available and backed
by science and kind of spread that message. But I
(41:14):
do think that kind of a digital space is by
far the biggest you know, what you do getting on
you know, TV, getting on radio. I think that has
a huge, huge impact, right, And a lot of it
is repetition, right, Like, once people see it once, maybe
they don't believe it. They see the second time from
a second Canadian doctor, they will kind of believe it more.
So I think that is a huge part of it.
(41:35):
I think the other thing that is super important is
how we communicate the message. You know, doctors sometimes tend
to be a little bit too too scientific. They don't
talk the common language that is easily understandable for most people.
So I think breaking it down and simplifying into easy,
actionable steps is very important. I mean, I can talk
(41:56):
all day about, you know, the metabolic pathways of arobolic
disease and how the you know, the physiological and bio
chemical pathways look like that means nothing to anybody, right
to most people. Really, what matters is, you know, break
it down, actionable, simple steps that people can follow to
make a difference. I don't know if you saw me,
I posted a video about, you know, a thirty minute
(42:18):
walk because I came across this steady yeah. Yeah, you know,
like something simple, something simple that anybody can connect to,
that has available evidence, is actionable for someone to start
somewhere because a lot of people. That's the other challenge
is if you're very sedentary and overweight and have all
these problems, it very difficult for you to start. That
(42:40):
first step is so difficult. If somebody is already fit,
making a little optimization is very easy for them. And
sometimes I'm afraid that maybe a lot of our audience
or those people that are already super fit. So the
question is how do you connect to the mass, to
the masses who are not necessarily anywhere yet. You know,
they haven't started even going to the gym, or they
(43:01):
have no idea about nutrition. How can you make it
as simple as possible, as actionable as possible for them
to make a small little step today that over time
I would have this massive impact. So I think those
are kind of some of the things we can do,
and you know I try to do in my communication
is to really make it simple and actionable for as
(43:21):
many people as possible.
Speaker 2 (43:24):
You do it well, And one thing I want to
I don't know if it's important or not, Ben, but
I think both of us, I feel both of us
do this, okay, is just being honest in terms of
our certainty it irks me when you're on the social
media feeds when people are like, this is the only approach,
(43:46):
this is the best approach.
Speaker 3 (43:49):
This is.
Speaker 2 (43:51):
Tons of evidence for this. When they're talking out of
their backside, I think. I think being humble and saying
is what I think. This is my suggestion. This is
based on the evidence that I see in front of me,
or the level of evidence we had. This is my suggestion,
or this is how I approach it. I think that's
under I think it's a it's it's more important than
(44:15):
we think, because what it comes down to is you
mentioned it before. It's trust, and we got we got
a certain level of trust because of our credentials. But
there's still the execution, like when you see I think
this is where the where the pandemic screwed some of
us up. Frankly, we were talking with absolute certainty about
(44:36):
certain things when we weren't one hundred percent certain.
Speaker 3 (44:39):
We thought it was the best action. But when you
come across that way, I think you lose. You can
lose the public.
Speaker 2 (44:45):
So yeah, I just want to command you to ben
like even when talking today, based on the evidence here,
this is where the standard when we were lacking some
systematic reviews or randomized control trials here.
Speaker 3 (45:00):
Like, I think that goes a long way.
Speaker 2 (45:03):
Even though I haven't heard this from people, this is
just something that intuitively I feel.
Speaker 4 (45:10):
No, you're correct about that. That's a very very good point. Yeah.
Like one of my main red flags that goes off
if I see somebody on social media is if they're
talking with too much certainty, then you know, as probably
all right, because we know even in things that we
think are certain, Like there are a lot of things
in medicine that we thought for a long time that
this is a certainty, and you have randomized trials even
(45:31):
and even those a lot of them end up becoming debunked,
you know, ten years later, So you don't forget about that,
even things that you don't have randomized trials for, you know.
So yeah, I think that's very important to always remember
that everything you hear you got to take it with
the creat assault and understand that nothing is one hundred
percent certain when it comes to lifestyle medicine and wellness space.
Speaker 2 (45:52):
One hundred percent. Yeah, Ben, this has been wicked. I
have been a long time coming. Actually kind of sad
we didn't get to do this before because I think
a lot of people are going to benefit it from this,
and we're releasing this obviously during Heart Health Month. So
but Ben, how do people track you down? Where can
(46:13):
they find you? Where do they learn more about the clinic?
Where do they sign up?
Speaker 3 (46:16):
Baby? Thanks? Man?
Speaker 4 (46:18):
Yeah, so our website is Cardiaclongevity Clinic dot com. So
all the information about the clinic and our services are
on there, or they can send us an email at
contact at Cardiac Longevity Clinic dot com. Our phone numbers
in there. There's a form they can fill out or
directly send us an email, so any of those would work.
Speaker 2 (46:41):
Amazing, Ben, Thank you for doing all that you do.
We definitely got to keep this momentum.
Speaker 3 (46:47):
Brother.
Speaker 2 (46:49):
In fact, we need to collaborate more now I think
about it, But stay tuned for some more action, my friend.
Speaker 3 (46:56):
Thanks for doing this.
Speaker 4 (46:57):
Thanks gaud and thank you for all the kind of
the awareness. You've always been my role model in this
kind of a digital space and how to spread awareness
for health and wellness. So thanks for doing everything that
you're doing.
Speaker 2 (47:11):
Man, that's kind of you to say, but thank you
and thanks for doing this. Thanks so much for listening
to doctor Ben on prevention over prescription.
Speaker 3 (47:20):
That episode was Gangster Baby.
Speaker 2 (47:23):
If you enjoyed that, please leave us any comments at
quodcast ninet nine at jmail dot com. Leave a five
star rating. Follow us on TikTok, Instagram, YouTube, Facebook, Twitter
at quodcast, Jump on our newsletter, jump on our community,
check out guide and nutrition put in podcasts fifteen for
your fifteen percent off, the bundles and the supplements. All
(47:46):
these things that we're promoting, all these things that we're
getting behind, is on that preventative side, on that proactive side,
so that you show up as your best self, show
up guide as strong baby.
Speaker 3 (47:56):
Here we go.
Speaker 2 (47:57):
Let's do this all right, bo I, hope you're feeling
a little bit more jumping your step after that episode.
Thanks for listening. Talk Russell whose Yeah, it's like, if
you want to rhyme with me, you don't even know
what rod is looks.
Speaker 5 (48:12):
If you want to get clean, you want to get dirty,
you want to go left right.
Speaker 3 (48:15):
This is what we're doing.
Speaker 4 (48:16):
Wants to knock up.
Speaker 5 (48:17):
Let's just rock up forty one one, drinking my wine
as over through you think of beatif the strategies when
you battle.
Speaker 4 (48:23):
Since the national no reconsent
Speaker 1 (48:25):
People, no radio, no problem stream is live on Saga
ninety sixty am dot c a
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