Tribute to Dr. Stephen Sinatra

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Dr. Ben Weitz, Dr. Howard Elkin, Dr. Jonny Bowden, and Dr. Drew Sinatra pay tribute to Dr. Stephen Sinatra, Integrative Cardiologist.

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Podcast Highlights

2:04 Dr. Stephen Sinatra was a conventionally trained cardiologist, but he discovered natural healing and became one of the great innovative integrative cardiologists integrating nutrition, mind-body medicine, and other alternative therapies. Dr. Sinatra wrote over 20 books, including The Coenzyme Q10 Phenomenon, L-Carnitine and the Heart, Lower Your Blood Pressure in Eight Weeks, Reverse Heart Disease Now, and The Great Cholesterol Myth.

Dr. Sinatra got us to think differently about cholesterol and its role in the atherosclerotic process. After the Lyon Diet Heart Study was published in 1994, which showed that a Mediterranean-style diet could reduce cardiovascular disease by 76% in high-risk patients without significantly changing their total or LDL cholesterol, this spurred Dr. Sinatra to question that saturated fat intake leads to elevated LDL cholesterol, which leads to atherosclerosis hypothesis. He also became more skeptical of the benefits of taking statins to reduce the risk of a heart attack. He observed that some of his patients with high cholesterol had clean arteries, while some patients with low cholesterol died from heart attacks. In The Great Cholesterol Myth by Bowden and Sinatra, they write that, “There is not evidence that supports a direct relationship between saturated fat and heart disease, and cholesterol is a relatively minor player in heart disease and a poor predictor of heart attacks, and the primary cause of heart disease is inflammation.”

Dr. Sinatra also observed patients who took statins had complained of memory and other cognitive problems, depression, muscle pain, and low libido due to the depletion of coenzyme Q10. Dr. Sinatra was one of the first to recognize and promote the importance of CoQ10 for heart health. He pioneered the use of specific nutritional supplements to help the heart to reverse heart failure, including using CoQ10, as I just mentioned, L-Carnitine, magnesium and D-ribose.

5:28 Dr. Mark Houston was unable to join us but he gave me this statement to read: “Steve was a dear friend and one of the best physicians that I have known. We loved working together at meetings and on our two books that we edited. He was a pioneer in cardiology and was never afraid to tell the truth about heart disease. He has been proven correct in many of his early ideas that were not initially accepted by the traditional cardiology community. He was admired by everyone who knew him. He was kind, compassionate and caring as a man and as a doctor. He was loved by his patients, friends, family, and all his associates. He was a mentor to me, and I learned enormous amounts of information from him. I will always remember our good times. I will miss him. I send my regards, love, and prayers to all of his family. Steve made a difference in the way we now practice cardiology and will be remembered as a master and one of the most influential of our time.” That’s from Dr. Mark Houston.

8:31 Jonny Bowden explained that Dr. Sinatra was “a gracious, kind, generous, spirited human being”. Jonny and Dr. Sinatra both stumbled on the Lyon Heart Study and both had an epiphany that the data on heart disease does not support what we’ve been told about the cholesterol hypothesis. When they wrote The Great Cholesterol Myth together they spent one third of the book talking about HeartMath and about community and relationships and sex life. They talked about the gut, walking in nature, getting sunshine, etc. Jonny had had some success with writing and had written The 150 Healthiest Foods on Earth and the publishers wanted a bunch of sequels, including 150 ways to lower your cholesterol and Jonny instead wanted to write a book questioning the cholesterol hypothesis. His publisher told Jonny, who is a nutritionist, that they would only publish it if he wrote the book with a cardiologist and it had to be a world-renowned cardiologist. So Jonny called up Dr. Sinatra and said, “Steve, you want to write a book that’ll blow the lid off the whole cholesterol thing?” He says, “I’m in.” That’s how that book got done, and it wouldn’t have gotten done if he hadn’t signed on as a co-author.

15:08 It is now in the news that the the results were falsified in the landmark study that showed that the cause of Alzheimer’s is a buildup of amyloid plaque. This concept is the basis for much drug development, including last year’s new drug approval for Aducanumab, which is a monoclonal antibody against beta amyloid, but it does not make anyone better. This is a good example of why we should question the status quo in medicine when things don’t all add up. Jonny explained that Alzheimer’s disease can be considered to be type III diabetes and we have an epidemic of a metabolic condition called insulin resistance, which predicts heart disease better than any other metric. Dr. Elkin pointed out that only 12% of adults in the US are metabolically healthy, meaning that 88% have some form of insulin resistance.

19:26 Dr. Stephen Sinatra changed our thinking about the role of cholesterol in heart disease and he emphasized that we have been measuring cholesterol incorrectly. Jonny explained that cholesterol is a fat that cannot float around in the bloodstream, so it must be contained in a lipoprotein like LDL or HDL. These lipoproteins are the boats and the cholesterol is the cargo. The problem with heart disease is that the containers, the LDLs that get caught in the endothelial wall and cause plaque and heart disease. When it comes to testing, we should not focus on the amount of cholesterol, but on the number of these boats, the LDL particle number that is part of an advanced lipid profile, and not just on the estimated LDL, which is what you get from standard lipid panels.

22:40 Dr. Sinatra was also big on measuring Lp(a) as part of the lipid panel. Lp(a) is a very atherogenic particle, but it is not easy to change it and there is not yet a specific drug to lower it. You can get about a 30% reduction with niacin and another 10% or so with L-carnitine.

25:31 Dr. Sinatra was a big believer in the value of the Mediterranean diet for preventing and reversing cardiovascular disease. It is the most studied diet for cardiovascular disease and the Lyon Heart Study and the PREDIMED study were two of the most important studies showing it’s value. Jonny prefers a lower carb approach to diet and he was always trying to get Dr. Sinatra to eat a higher fat/lower carb version of Mediterranean with less grains and more nuts, etc.. Drew related that his dad was paranoid about saturated fat in the 80s and for about 10 years his family ate not meat and they would eat a lot of grilled swordfish and his family was probably very mercury toxic.

Dr. Sinatra: Yeah, he loved Mediterranean diet. I think, for him, being Italian, it was probably hard to get off the pasta. That’s sort of like a staple of the Italian diet, or at least we think it is, and so my father always enjoyed a nice Italian meal with pasta. He did believe that olive oil was really like the secret sauce, and I do think that he was onto something with the olive oil. I do believe that olive oil can help drive a lot of these positive things that we see with Mediterranean diet, and agree with Jonny and all you about, in terms of reducing carbohydrates and that sort of thing.

Dr. Bowden: Let me tell you a story about the olive oil.

Dr. Sinatra: Mm-hmm.

Dr. Bowden: The particle test, this whole thing we’ve been talking about with the particle test, I have a personal story about that. Because my LDL, HDL numbers were perfect, perfect for decades. Any doctor would look at it and, “Your LDL’s ridiculous. You’re just doing fine.” Then when I became a functional nutritionist and learned about this, and saw that that was a bogus test and got the real test, I find that I’m in the high-risk zone for particles, and I’ve got the worst kind of size. I’ve got the pattern B which is, as somebody mentioned earlier, the little-

Dr. Weitz: Small, dense, yeah.

Dr. Bowden: Yeah, the Small dense ones. I’ve got this. I am an example of how the test … of being undertreated. In other words, I was a false negative. They said, “Oh, yeah, there’s no problem whatsoever,” and in fact, when you looked under the hood with the right test, I had very high particle size. I have all these wonderful, amazing functional cardiologists in my network, starting with Steve, and I asked their opinions, “Guys, what do you … I’ve got a serious particle problem. What should I do?” I’ll be honest. One of them said, “I know you’re not crazy about the statins. I think we should try, maybe, five milligrams of Crestor.” Others said, “At your age, it’s absolutely not necessary to do.”

I went to a cardiologist at Scripps who gave me certain supplements. I got a little stricter on my diet. Here’s what Steve’s advice was. Steve said, “Before you go on the statin, I want you to take a quarter cup of olive oil every day for three months, and then let’s remeasure,” so I did. He literally prescribed olive oil, and I do it to this day. If I had the bottle, I’d show you. I literally swig it from the bottle, as a medicine. Every day, it’s one of my supplements, and I did that. I can’t say it was just that, but that, the supplements that Dr. Triffon at Scripps Institute recommended, the stricter adherence to the higher fat, lower carb diet. My particles went from 2,200 to 1,600, and my particle size went from B to A.

Dr. Howard Elkin is an Integrative Cardiologist and he is the director of HeartWise Fitness and Longevity Center with offices in both Whittier and Santa Monica, California. Dr. Elkin has written a book, From Both Sides of the Table: When Doctor Becomes Patient, that will soon be published. He can be contacted at 562-945-3753 or through his website, HeartWise.com.

Dr. Jonny Bowden has a PhD in Nutrition, speaks around the world and has written a number of books, including Living Low Carb, Smart Fat with Dr. Steven Masley, The 150 Healthiest Foods on Earth, and The Great Cholesterol Myth with Dr. Stephen Sinatra. His website is JonnyBowden.com.

Dr. Drew Sinatra is a Board Certified and Licensed Naturopathic Doctor, addresses and treats the underlying causes of chronic disease. Specializing in gut support, lyme disease, mold illness, and autoimmune disease. His practice is in Mill Valley, California and he can be reached at 415-388-5520 and his website is DrDrewSinatra.com.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.

Podcast Transcript

Dr. Weitz: Hey. This is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates. To learn more, check out my website, drweitz.com. Thanks for joining me and let’s jump into the podcast.

Okay, great. Welcome everybody. We’re here today to honor one of the giants in the world of functional medicine, integrative cardiologist, Dr. Stephen Sinatra, who died on June 19th. I’m Dr. Ben Weitz, doctor of chiropractic and functional medicine practitioner, and the host of the Rational Wellness Podcast found on Apple Podcasts, Spotify, as well as on YouTube. I’m joined by Dr. Howard Elkin, integrative cardiologist at HeartWise in both Whittier and Santa Monica, California. Dr. Elkin participated with Dr. Sinatra on a study on the benefits of grounding for heart health, and they published a paper pertaining to that. We’re also joined by nutritionist and PhD, Dr. Jonny Bowden, who co-wrote the book, The Great Cholesterol Myth, with Dr. Sinatra. We’re also joined by Dr. Drew Sinatra, a naturopathic physician, and he’s also the son of Dr. Sinatra. They worked together on quite a number of projects. Unfortunately, Dr. Mark Houston, who was an associate of Dr. Sinatra and a close friend, was unable to make it because of some last minute scheduling problems.

While I did not know Dr. Sinatra personally and never had the honor to interview him, I certainly knew of him, listened to him speak, and read some of his books and articles. Dr. Stephen Sinatra was a conventionally trained cardiologist, and at one time, was the chief of cardiology at Manchester Memorial Hospital in Connecticut. He discovered natural healing and became one of the great innovative integrative cardiologists integrating nutrition, mind-body medicine, and other alternative therapies.

Dr. Sinatra was a great educator, lecturing frequently, and he wrote or contributed to over 20 books, some of which include The Coenzyme Q10 Phenomenon, L-Carnitine and the Heart, Lower Your Blood Pressure in Eight Weeks, Reverse Heart Disease Now, and The Great Cholesterol Myth. He also published over 45 peer-reviewed papers and wrote hundreds of blogs and other articles on various topics in natural approaches to cardiology.

As a bioenergetic psychotherapist, Dr. Sinatra used mind-body medicine to help his patients to heal, including looking at how unexpressed negative emotions such as anger and sadness could contribute to hypertension and heart disease. Dr. Sinatra got us to think differently about cholesterol and its role in the atherosclerotic process. After the Lyon Diet Heart Study was published in 1994, which showed that a Mediterranean-style diet could reduce cardiovascular disease by 76% in high-risk patients without significantly changing their total or LDL cholesterol, this spurred Dr. Sinatra to question that saturated fat intake leads to elevated LDL cholesterol, which leads to atherosclerosis hypothesis. He also became more skeptical of the benefits of taking statins to reduce the risk of a heart attack. He observed that some of his patients with high cholesterol had clean arteries, while some patients with low cholesterol died from heart attacks. In The Great Cholesterol Myth by Bowden and Sinatra, they write that, “There is not evidence that supports a direct relationship between saturated fat and heart disease, and cholesterol is a relatively minor player in heart disease and a poor predictor of heart attacks, and the primary cause of heart disease is inflammation.”

Dr. Bowden: You mean Dr. Houston.

Dr. Weitz: Dr. Houston. Dr. Houston, sorry. Dr. Houston was unable to make it, but he did give me a statement that I’d like to read now to get things started. “Steve was a dear friend and one of the best physicians that I have known. We loved working together at meetings and on our two books that we edited. He was a pioneer in cardiology and was never afraid to tell the truth about heart disease. He has been proven correct in many of his early ideas that were not initially accepted by the traditional cardiology community. He was admired by everyone who knew him. He was kind, compassionate and caring as a man and as a doctor. He was loved by his patients, friends, family, and all his associates. He was a mentor to me,” to Dr. Houston, “And I learned enormous amounts of information from him. I will always remember our good times. I will miss him. I send my regards, love, and prayers to all of his family. Steve made a difference in the way we now practice cardiology and will be remembered as a master and one of the most influential of our time.” That’s from Dr. Mark Houston.

I thought, before we get into the science of some of Dr Sinatra’s innovations, I’d like to go around and ask each of you to mention something that you recall that Dr. Sinatra said or did that would tell us something about who he was as a person. Howard, would you like to go first?

Dr. Elkin: I think, my first meeting with Sinatra was very memorable. This was maybe 12, 13 years. I was doing my A4M membership, American Academy of Anti-Aging Medicine. We had an afternoon of cardiology with Dr. Sinatra, so it was great. We had like three or four hours with him. I kept on asking questions, and I kept on raising my hand because I knew the answers. Finally, after about 45 minutes, he says, “May I ask you what your specialty is?” I said, “Cardiology.” Everybody laughed because I was the only cardiologist in the room other than me and him, so, “I want to see you afterwards,” so we met afterwards. I ended up participating in an infomercial that we did here in Los Angeles, where I met his wife, Jan. Then he got me interested in earthing, which is another great topic of his. I was extremely interested in it, and we did a study together on the effects of blood pressure.

He was a wonderful teacher and I’m most proud and honored that he wrote the forward to my book that’s coming out after Labor Day, so it’s precious to me that he wrote that forward and he did an excellent job. I’m indebted to Dr. Sinatra because I was always a thinker outside the box, but I finally found someone in my field who was successful in what he did, so I didn’t have to feel alone anymore. I owe a lot of … I have a lot of gratitude, and I honor him tremendously. I’m glad to be here tonight.

Dr. Weitz: Thank you, Howard. Jonny?

Dr. Bowden: Gee, I don’t even know where to start. I owe so much to Steve. He was such a gracious, kind, generous, spirited human being that infused every interaction you had with him. In no particular order, he and I both stumbled on that Lyon Diet Heart Study that you mentioned, completely independently, and had the same kind of epiphany. That data does not support what we’ve been told, and we both started wondering about it, and we had so many other things we found in common. We both did postdoctoral work in psychology. I have a master’s in psychology. He was trained as a bioenergetic psychologist. I think it really informed the way we looked at disease in general. We devoted, in the revised version of The Great Cholesterol Myth, we spent one-third of the book not talking about diet, exercise, supplements, or anything. We talked about HeartMath. We talked about community. We talked about relationships. We talked about sex life. We talked about the gut, all of these things. Walking in ecotherapy, walking in the greenery and getting sunshine and how all of these things had powerful, powerful effects on our physiology, on our hormones, on our immune system, on all of these things. He realized that so profoundly when no one was talking about mind and body.

Also, when you were listing his books, one that you didn’t mention was so influential, not just for me, and so prescient. It was Heart Disease for Women. He was one of the first people to shout out, “The emperor has no clothes,” when it comes to all the studies that have been done on heart disease that used only male patients. He was one of the first, even pre-woke, to say, “Heart disease presents differently in women. It’s different symptoms, it’s different … They’re different creatures. They respond differently to pain. You got to look at this as a whole other thing.” People, now they talk about that, but they forget that that was Steve, I don’t know how many years ago he wrote that book, Drew. It must have been 15 years ago. He was on to a lot of this stuff very, very early on.

I had some writing successes before I met Steve. I had a bunch of books, the food book and stuff, but if he hadn’t agreed to write that book with me, and I’ll tell you exact, if you’re interested. I had a book deal with Harper because I wrote The 150 Healthiest Foods on Earth, and they wanted a whole bunch of sequels to that because it was a hit, so Die Hard you want Die Hard 5, Die Hard … Well, that’s what they do, so we had 150 Best Ways to Promote Your Energy, and 150 Best Ways to Live Longer. They came to me with this idea. They said, “We think the next great book will be, how about The 150 Best Foods to Lower Your Cholesterol?” I said, “That’s a wonderful idea, but it’s certainly not for me.” They said, “Why?” I said, “Because I think that’s the wrong target for heart disease, and I think we’re just moving in the wrong direction.” They said, “What are you talking about?” It led to a discussion, and I presented my case. I sent them studies and they were afraid to publish a book that questioned the cholesterol hypothesis. Finally, after much debate, and I was very persistent, and I sent all the studies, they said, “Look, we can’t publish this by some cockamamie nutritionist who’s a …” I’m left-wing of things, anyway. Said, “We will publish this if you can find an MD to co-author it, but it can’t be just an MD. It’s got to be a cardiologist. It can’t be just a cardiologist. It has to be a world-renowned cardiologist. You got one who will endorse this, we’ll do it.” I call up Steve, I said, “Steve, you want to write a book that’ll blow the lid off the whole cholesterol thing?” He says, “I’m in.” That’s how that book got done, and it wouldn’t have gotten done if he hadn’t signed on as a co-author.

Dr. Weitz: What a great story.

Dr. Sinatra: I love that.

Dr. Weitz: Drew?

Dr. Sinatra: Gosh, I’m like Jonny here. I don’t even know where to begin with a story. I think seeing my father evolve from a conventional cardiologist into the man that he was two months ago was such a beautiful journey to see him move along with. This guy had a health food store that he opened in, I think it was like 1987. I was 10 years old then. Just, I remember all the food on the shelf. He had this thing called, something like the Roger Buffalo cookie, which was just like the first PowerBar ever out there. Maybe PowerBar was there at that point, but there was no other bars on the market.

Dr. Bowden: Tiger Milk bars.

Dr. Sinatra: What’s that?

Dr. Bowden: They had Tiger Milk bars.

Dr. Sinatra: Yeah, exactly. He was just a pioneer in the thinking ahead. It’s like, “People need food on the go. Let’s develop this bar that people are going to quickly eat.” Look at the bar market today. It’s massive.

Dr. Weitz: Right.

Dr. Sinatra: He was always a thinker. He was always ahead of his time. It was such a beauty watching him evolve and develop supplements that I started taking when I was a young teenager. My friends made fun of me because I took all these vitamins and such, but I’m so grateful that he got on that path because then it really put me on the path of becoming a naturopathic doctor.

Short story here with the cholesterol is I think I went to the Manchester Memorial Hospital, which you mentioned, Ben, where he was chief of cardiology. He gave a talk on statins, and it was just the coldest energy in the room. All the fluorescent lights were flickering. I looked out in the audience, and all the doctors just were unhappy. They just weren’t happy, and they were very angry that he was presenting another side of cholesterol, which was, “Hey, be a little cautious in your prescribing. You don’t want to just give this stuff out like candy like we’ve been doing for the last decade.”

I saw that and I really looked up to how much courage he had to stand up to these doctors and say, “Hey, we’re basing this on a theory right now. This is only a theory, and we should take it as that. Let’s have more evidence come in before we just willy-nilly put everyone on a statin.” Then the doctors were mad. They were furious. They said, “How can you do this? This is against standard of care.” The thing about my dad is he didn’t get angry. My dad never got angry. He just said, “Okay.” He’d walk away, and I could tell that he would think to himself, “Well, when these guys are ready, maybe they’ll join on and look into the theory of heart disease in terms of cholesterol.” I could go on and on, but I just had to share that story about the cholesterol and Manchester Memorial Hospital.

Dr. Weitz: That’s great. It’s interesting. You guys both brought up the idea of questioning conventional thinking. In the news, just in the last day or two, is this revelation that the landmark study that showed that the cause of Alzheimer’s is a buildup of amyloid plaque, it turns out that, according to this analysis, that study was falsified. Yeah, it’s a huge shock to the whole medical establishment, the research, and very, very interesting. They’ve been developing drugs for Alzheimer’s based on this concept, and of course, the drugs don’t do very much. That’s why we had this big controversy last year over that aducanumab, or I’m sure I didn’t pronounce it properly, but this new drug, this first new drug for-

Dr. Bowden: Oh, I know [inaudible 00:16:10]

Dr. Weitz: … Alzheimer’s. That was-

Dr. Bowden: Terrible drug.

Dr. Weitz: Exactly.

Dr. Bowden: Terrible.

Dr. Weitz: 30% of the patients get inflammation and swelling in their brain, and nobody gets better. They just get worse at a slower rate. Anyway, it’s all based on this concept of what the cause of Alzheimer’s is, and now that whole concept is now in question. There is a perfect example of wanting to question orthodoxy.

Dr. Bowden: Can I interject something here?

Dr. Weitz: Of course, go ahead, Jonny.

Dr. Bowden: Tie something in with Steve’s message and with what you just brought up. I think it’s so important, and he would kill me if I didn’t make sure that we all knew this. Because you had mentioned earlier that one of our theses is what really causes heart disease is inflammation and oxidation. Alzheimer’s, as you guys know, and maybe some of the people in the audience do, Alzheimer’s is now being referred to as type 3 diabetes.

Dr. Weitz: Right.

Dr. Bowden: The reason for that is that we have an epidemic of a metabolic condition, which underlies not just diabetes and pre-diabetes, and hypertension, and obesity, and heart disease, but also Alzheimer’s. It is the same metabolic condition and it is called insulin resistance. It also, coincidentally, underlies the three major comorbidities for COVID as well as the ones I mentioned, lung disease, kidney disease, and liver disease. We have this insulin resistance. This is epidemic. When Steve and I, we did The Great Cholesterol Myth, when we went back and did the revised edition and looked even more deeply into the research that had been done since 1970, we found that insulin resistance predicts heart disease better than any other metric, except possibly lung capacity and volume. It is a fantastic predictor for every chronic disease that we care about. It’s been my passion and my message, especially since Steve died, but really since the book came out, to get that message across to people that insulin resistance is where the action is. That’s what we should be looking at, and insulin resistance can be turned around, it can be prevented, it can be reversed by diet, fasting, and lifestyle. That was the message of our book, and Steve believed that. Since you brought up Alzheimer’s, I think it’s only appropriate to bring that up because that’s central to all of those kind-

Dr. Elkin: Problem is not gone by any stretch. In fact, a research study came out … I knew from a study about two and a half years ago that only 12% of the adult American population is metabolically healthy.

Dr. Bowden: That’s what I’m … What does that mean? What does that mean?

Dr. Elkin: [inaudible 00:18:42] 3% of the adult American population is metabolically healthy. More women than men. This just came out about a week and a half ago.

Dr. Bowden: Yeah, and that study, the one you were talking about, which came from the NH, NHANES data-

Dr. Elkin: Right, correct.

Dr. Bowden: … that says only 12% are metabolically healthy, they are talking about insulin resistance. 88% of us have some degree of this insulin resistance. Guys, if you don’t know what that is, it is an inability of the body to manage the carbohydrate load that you’re giving it. That leads to inflammation, oxidation and slowly but surely, heart disease. Alzheimer’s, pre-diabetes and the whole gamut of metabolic diseases, and Steve knew that.

Dr. Weitz: Right. What else should we say about the role of cholesterol and heart disease, and what other things did Dr. Sinatra revolutionize in terms of the way we think about LDL?

Dr. Bowden: I think that he was as passionate as I about saying that we are measuring cholesterol incorrectly, that we are still talking cholesterol. Can I just, two seconds of background for those who don’t-

Dr. Weitz: Absolutely. Go ahead, Jonny.

Dr. Bowden: Cholesterol is carried in a container, and the reason for that is the molecule itself is hydrophobic. It can’t live in water. It’s oil and water. It doesn’t mix, so it has to go in the bloodstream in a container. The container is the lipoprotein, the L in LDL.

Dr. Weitz: Right.

Dr. Bowden: Some lipoproteins are low density, which means that they float. Some are high density, which means that they’re heavy and they sink. These lipoproteins are the boat, the cholesterol is the cargo. Somewhere in 1963 or so, when they figured out that cholesterol travels in two basic kind of containers, and they gave them the idiotic names of good and bad, we got into this notion that there’s a different kind of cholesterol that travels. It’s all the same cholesterol. It travels in two containers. What we have realized in the last 20 years, that the mainstream profession does not get, is that the containers are what the problem is. It’s the containers, the LDLs that get caught in the endothelial wall and cause plaque, and heart disease, and all the rest of the stuff. The new tests for cholesterol look at the number of boats in the water.

Dr. Weitz: The LDL particle number.

Dr. Bowden: Yes. That is the test that we should be using. Any prescription that’s given based on the old test is about as valid as a prescription given on the Cosmopolitan horoscope of the day. It’s completely magical thinking. We need to know how many boats are in the water. That’s the message of the book, and it was Steve’s message. When people tell us, “My cholesterol’s high,” the first thing we always ask is, “By what test?” If they say, “Well, the LDL and HDL,” we stop talking. “Go back and get the real test. That’s a fake test.”

Dr. Weitz: Right. Because that LDL number is the estimated-

Dr. Elkin: [inaudible 00:21:45] happening in the real world right now. You’re absolutely-

Dr. Bowden: What?

Dr. Elkin: I’ve been doing specialized cardio lipid testing for 20 years. If you’re dealing with Medicare, Bluecross, Blueshield-

Dr. Bowden: Forget it.

Dr. Elkin: They do not like me. They do not like a doctor that orders specialized lipid testing.

Dr. Bowden: I’m with you. I understand.

Dr. Elkin: It is unbelievable what my staff has to go through just for the labs to get paid because we have to send records, why I ordered it. It’s crazy, so there’s so much work that needs to be done.

Dr. Bowden: So much work.

Dr. Elkin: The doctor’s ordering the right test. It’s getting these things to be paid because they just want us to do a simple lipid panel. That’s all they care about.

Dr. Bowden: I know.

Dr. Weitz: For my take, you’re never get to get anywhere with insurance companies. The key is, is maybe some point in time, we’ll stop insurance companies from running the healthcare system.

Dr. Bowden: Well, that would be very nice, wouldn’t it?

Dr. Weitz: Yeah.

Dr. Elkin: It’s expensive testing you’re talking about. It ain’t cheap.

Dr. Weitz: Yeah.

Dr. Sinatra: Well Jonny, correct me if I’m wrong here, but I know my dad was really big on Lp(a) lipoprotein (a), and making sure that was added on to any sort of lipid panel.

Dr. Bowden: Yeah.

Dr. Sinatra: That can be a more atherogenic lipid particle.

Dr. Bowden: The NASH use of the LDL particles. The thing about Lp(a) is that there’s really no way of changing it, and that’s kind of the dirty secret. I think Steve had a couple of supplements he thought might make a difference with that like nattokinase and stuff, but it’s a really hard number to change, so once you know your number … I don’t get it tested every year.

Dr. Sinatra: Yeah.

Dr. Bowden: I think that might be why it doesn’t get as much attention. There’s no drug that can bring it down. I mean-

Dr. Weitz: That’s exactly why. Yeah, yeah. By the way, there will be a drug in a couple of years and then everybody will be testing it.

Dr. Bowden: Right, exactly. Then they’ll tell you how important it is. Right now, it’s not important because [inaudible 00:23:32] paying for it.

Dr. Weitz: Niacin can move the number some. L-Carnitine can move the number some. There are some things that can move the needle.

Dr. Bowden: Oh, good to know. Okay.

Dr. Weitz: Yeah. You can get about a 30% reduction with niacin.

Dr. Sinatra: Yeah, that’s the biggest mover, but nattokinase, Boluoke, all those, I haven’t had great success with those.

Dr. Elkin: Neither have I. Neither have-

Dr. Bowden: It’s like raising HDL. I mean, they tell you, “Exercise.” No, it doesn’t. Come on. Nothing gets HDL higher, in my experience, and I’m not even sure it matters that much.

Dr. Weitz: Right. Then we not only had the LDL particle number, but the particle size. The fact that the small, dense LDL is much more atherogenic than just the amount of LDL.

Dr. Bowden: The size is also a very good stand-in for insulin resistance. If you’ve got a small particle size, and you got a high triglyceride to HDL ratio, you almost don’t even need to be tested for insulin resistance because that’s a great surrogate right there.

Dr. Weitz: By the way, that’s one of the unfortunate problems with statins is they don’t do anything to improve LDL particle size.

Dr. Bowden: Nothing, nothing.

Dr. Elkin: Well, they have an anti-inflammatory effect, which we were not aware of when they came out in the ’80s when I was a fellow. We just thought, “Oh, it lowers LDL cholesterol. It does it quite nicely.” We later learned, years later, 15, 20 years later, that it actually does have an antiinflammatory effect.

Dr. Bowden: It also, as Steve used to point out all the time, it tends to thin the blood slightly, so it turns, what he called, ketchup into red wine. Those are important values of statins. As Uffe argues, statins would probably be better medicines if they didn’t lower cholesterol and they just did that. I would argue that though they may have a slight benefit as being antiinflammatory and slightly thinning the blood, you can do both of those things with zero side effects with ginkgo, Vitamin E, or fish oil.

Dr. Sinatra: Mm-hmm. Well said.

Dr. Weitz: Okay. Next topic is Dr. Sinatra’s contribution to the importance of a healthy diet for preventing and reversing cardiovascular disease. Howard, do you want to maybe start us off?

Dr. Elkin: Yeah. The whole thing with, already been mentioned is the Mediterranean diet, and it started with Lyon Heart Study in the ’90s. Then the PREDIMED Study came out in 2013, which was actually primary prevention. The Lyon Heart Study was really based on secondary prevention. It showed whether you combine olive oil or nuts, whatever, that Mediterranean diet actually with … It’s no other diet’s been shown thus far to be as effective in decreasing heart disease, so it put that on the map. That’s my take, and I know that Sinatra and I have had many talks about the Mediterranean diet. There are lots of different aspects to it. Some people think it’s too much carbs, too many … I don’t imbibe on cereals. I don’t think there’s a healthy cereal out there, but I think the basic premise behind Mediterranean diet is quite good and we have research behind it.

Dr. Sinatra: [inaudible 00:26:41]

Dr. Bowden: Yeah. I don’t think Steve and I 100% agreed on the Mediterranean diet thing. I was always trying to get him to eat a higher fat version of it with less grains. The thing is, he came from that world where the Mediterranean diet was the dietary answer, and epidemiologically, there’s great evidence that it’s associated with all kinds of great things. I’ve always been much more of a skeptic. There are 22 countries in the Mediterranean. They don’t all eat the same diet. There’s Turkey, there’s North African countries. They don’t. When I was writing Living Low Carb and looking into the Mediterranean diet as a thing, I looked at menus that are currently available at all of those countries in the best restaurants, and every one of them has meat on it.

I think that there’s a variety of ways to eat Mediterranean style, I think, and Steve and I agreed on this. It’s not just the diet, it’s the lifestyle. They spend time in the sun. They take naps, they talk to each other, the men express their feelings. There’s a lot of differences between the way they live in the Mediterranean and the way we live here, so it’s not really just this one thing. Definitely, that style of eating, if you will, or the things that has in common. The higher amounts of nuts, and the good fats, and all of that stuff is a very good place to start. I would tweak it a little with less grains and a little more fat, but that still, that doesn’t make it any less Mediterranean.

Dr. Sinatra: Right. Well, let me lead into this with a story, and that my dad was paranoid about saturated fat in the ’80s, and so guess what we did for 10 years? We had no meat. Okay. He just didn’t buy meat, and instead, we had swordfish steaks on the grill all the time. I can’t even tell you how mercury toxic my whole family probably is, but that’s how, at the time, he was thinking to himself, “Hey, I’m giving my family fish. There’s omega-3s in there. It’s got to be good for you.” Then, all of a sudden, we learn about tuna, and swordfish, and all the other different larger fish in the sea that are mercury toxic, and so I thought that was kind of funny because I can still taste what swordfish is like.

Dr. Bowden: Wow.

Dr. Bowden: Let me tell you a story about the olive oil.

Dr. Sinatra: Mm-hmm.

Dr. Weitz: Small, dense, yeah.

Dr. Sinatra: Wow.

Dr. Bowden: I think the olive oil … It may not have been the whole story, but that’s the way Steve was. He’s, “Hold the medicine. Try the olive oil. Let’s see what that does.”

Dr. Sinatra: That’s great.

Dr. Weitz: Yeah. I know Dr. Houston’s very big on olive oil too.

Dr. Bowden: It’s a great food. It’s a medicinal food. There’s no doubt.

Dr. Weitz: Yeah. You got to get the right olive oil.

Dr. Bowden: Yes.

Dr. Weitz: Yeah. It’s got to be extra virgin, organic. It should all come from one country. You should name the specific type of olive that’s there. If it has a bitter taste, that means it’s going to be higher in the polyphenols.

Dr. Sinatra: There you go.

Dr. Bowden: Yeah. By the way, I don’t know if anybody knows this, a little trivia. There was a book written not too long ago by the food writer and expert, and he said the four most faked foods in the world, Kobe beef, Parmesan cheese. I forgot the third, and the fourth was extra virgin olive oil. It is so … They lie about that on the label consistently, so you got to be really, really careful. Steve had his own olive oil company.

Dr. Weitz: Yeah, be honest with you, most olive oils don’t even say on the label what type of olive, where they’re from.

Dr. Bowden: A lot of them are mixed and compounded with other oils, and-

Dr. Weitz: Right.

Dr. Elkin: They’re tainted, they’re tainted.

Dr. Bowden: They’re tainted.

Dr. Weitz: Yeah, yeah. I had an olive oil expert on the podcast, and one of the things he emphasized is it should say what country and it should name the specific type of olive, like koroneiki olives from Greece.

Dr. Bowden: Yep, yep, yeah.

Dr. Weitz: Next topic. Let’s talk about the importance of some of these nutraceuticals that Dr. Sinatra pioneered like coenzyme Q10, L-Carnitine, magnesium, D-ribose.

Dr. Bowden: He called them the awesome foursome. Drew could probably talk about it just as eloquently. I mean, he-

Dr. Sinatra: No, you go ahead first, Jonny. Go ahead.

Dr. Weitz: Yeah.

Dr. Bowden: Well, these were the four nutrients that he felt were really powerful for heart disease. Carnitine because it transports fat into the mitochondria, so it can be burned for energy. Magnesium, because it’s just needed for 300 different biochemical operations and it lowers blood sugar and it lowers blood pressure. Coenzyme Q10, he was one of the biggest proponents of coenzyme Q10, which basically is a nutrient that helps your heart make more ATP. It helps everything make more ATP, but the heart never takes a vacation, so it was a very, very heart-healthy nutrient. D-ribose is something we’re using to this day.

It’s so funny, because he was prescient about that one as well. D-ribose is a naturally occurring sugar, which has a number of incredible properties that he realized, way before the rest of us did, number one, it helps the cells to make ATP. It does this by turbocharging an enzyme called AMPK, which is a master metabolic controller. It’s like the air traffic controller of the cell. It is responsible for making the cellular bitcoin, which is ATP. That’s the stuff you need to do absolutely everything from talking, to waving your hands, to dancing the Mambo, to blinking your eyes, you need ATP, and coenzyme Q10 helps you make that. I’m sorry. D-ribose helps you make that.

What we have found recently about D-ribose … I use it in my coffee because it’s just such a great way, at the cellular level, to help make energy. I wondered myself. I thought, “This is awfully sweet-tasting.” It’s really fantastic if you like stevia, or monk fruit, any of that stuff in your coffee. This is just as good, but it’s got to raise your blood sugar, right? No. The miraculous thing about this naturally occurring sugar that’s good for energy is it actually has been used in diabetes treatment, and it actually helps lower your-

Dr. Elkin: It’s a five-carbon sugar versus a six-carbon sugar like glucose and sucrose.

Dr. Bowden: Exactly.

Dr. Elkin: That’s the difference.

Dr. Bowden: Exactly. That was one of his awesome foursome and to this day, I use … I would never be without magnesium. It’s one of my three basic supplements for everybody, and D-ribose is right on my counter, right now to this day, and coenzyme-

Dr. Weitz: That’s great.

Dr. Bowden: [inaudible 00:36:02] my vitamins.

Dr. Sinatra: Yeah. I’ll add to this that I think my dad pioneered it with cardiovascular disease and supporting heart, circulatory system, and all that. He wrote his book, Metabolic Cardiology, which was all about using these supplements, and talked about heart failure, helping with hypertension. I believe now that, just with things, we’re going, we’ve learned that, hey, you could use this protocol in someone with migraines. You could use this protocol in someone with chronic fatigue, or fibromyalgia, or someone that’s suffered with a long, chronic illness like Lyme disease, for example. It’s multifactorial in what we can use it for, which is beautiful because it’s not just for the heart, but it’s for the whole body, charging up every cell, like you were saying, Jonny.

Dr. Bowden: Yes.

Dr. Sinatra: I just feel like my dad really … Especially CoQ10. I really feel like CoQ10 was like his baby. He really nourished that baby and brought it to life. I believe it was 1986 that he had that on formulary at Manchester Memorial Hospital.

Dr. Bowden: Wow.

Dr. Sinatra: Think about that. 1986. I think I was around six years old when that happened. That just blows me away that he was just so advanced in his thinking back then of CoQ10, and then all these others were brought onboard. It was sort of, CoQ10 was really the beginning. Then I think it was magnesium next, and then it was L-Carnitine, and the last one was really the addition of D-ribose. It was really just so beautiful to see the evolution of the awesome foursome over time, and how it can not only support the heart, but the rest of the body as well.

Dr. Bowden: Getting CoQ10 into the formulary, I can’t emphasize how important that is. My mother died of congestive heart failure in the late 1900s. I went there and I said, “Can we put her on a couple hundred milligrams of coenzyme Q10?” They said, “What is that?” I said, “It is an enzyme that is used to make energy for the heart. It’s used in Japan as a prescription medicine for congestive heart failure. There’s major research on it.” We didn’t have the internet then. I printed out pages and pages of stuff. I brought it to them. Didn’t matter. Wasn’t in the hospital formulary. They never heard of it. Do you realize-

Dr. Elkin: It is still not in the formulary.

Dr. Bowden: … what Steve did-

Dr. Elkin: It’s still not in the formulary.

Dr. Bowden: Huh?

Dr. Elkin: It’s still not in the formulary.

Dr. Bowden: Getting it in the formulary in Manchester General was, people-

Dr. Sinatra: It was huge.

Dr. Bowden: Hats off, man. That’s just incredible.

Dr. Weitz: Well, one of the things that not everybody may realize is that the heart, unlike all the other organs, is the most dense with mitochondria-

Dr. Bowden: Of course.

Dr. Weitz: … which is what produces the energy, and coenzyme Q10 is so crucial for mitochondrial function, so it makes a huge amount of sense. I know, Dr. Elkin, you use those nutrients in your practice as well.

Dr. Elkin: Well, I have a very active practice, and a lot of patients with cardiomyopathies. They all, everyone with cardiomyopathy gets all four of those. I do CoQ10 levels. People that have cardiomyopathies and congestive heart failure really should have levels of four or five, and so I go by levels. Usually, they go on at least 400 milligrams a day. It’s also been used for Parkinson’s patients, for Parkinson’s as well. The L-Carnitine, and the D-ribose, I’ve used it in chronic fatigue. I’ve used in other states like that. It’s funny. Now, I do have patients on statins because I have a lot of patients with confirmed coronary disease that have stents and bypasses, so I don’t just have preventative. I mean, I have primary prevention, and I have secondary prevention. People need to know that in secondary prevention, it hasn’t really changed. Still, the standards are pretty strict because patients that are on statins generally do better. Anyway, anyone that goes on a statin in my practice automatically goes on CoQ10. It’s a must. I tell them right and then there.

Dr. Bowden: Where do you stand, just as a side, on the ubiquinol versus the standard-

Dr. Weitz: Ubiquinone, yeah.

Dr. Bowden: Ubiquinone.

Dr. Elkin: That’s funny. Because I asked that question more than once to Steve, and he didn’t think it made a difference.

Dr. Bowden: I did too.

Dr. Elkin: I specifically said that patients are saying ubiquinol because they see it in the Life Extension Foundation, right?

Dr. Bowden: Yeah.

Dr. Elkin: Well, I asked Steve about it. Do you know anything, Drew, about that?

Dr. Sinatra: No, the same thing. I kept asking him over and again, and he basically would say that they’re equal, and that there was a big marketing push out there to get-

Dr. Bowden: Huge.

Dr. Sinatra: … ubiquinol a better product, but it really was the same.

Dr. Bowden: Yeah.

Dr. Elkin: Right.

Dr. Bowden: Yeah. He told me that there may be cases in which, for some reason, the person doesn’t absorb the standard one as well, and there may be an advantage in those cases, but he was very squishy on it. He thought, basically, that as he pointed out once, there’s like 18,000 studies using ubiquinone before ubiquinol even came out and we had pretty good results, so it was …

Dr. Elkin: Checking levels do help. Cleveland does it. Labcorp does it. Boston Heart does it. They will do CoQ10 levels.

Dr. Sinatra: Well, Howard, thanks for doing that because I know my dad measured levels way back in the day, and thank goodness you’re carrying the torch there and continuing with that, because just a reminder, I don’t do that with my patients and I probably should.

Dr. Elkin: Thanks.

Dr. Sinatra: Yeah.

Dr. Bowden: I’ve never had my levels measured. I may come to you and get them measured. That’d be an interesting metric to know about.

Dr. Weitz: Yeah, yeah. It’s also included in the Micronutrient test from Vibrant.

Dr. Bowden: Ah, good.

Dr. Weitz: Which is-

Dr. Sinatra: Oh, okay.

Dr. Weitz: Yeah. They’ve done the old SpectraCell Micronutrient test quite a bit better. Let’s talk about the role of emotions in heart health, which is something that Dr. Sinatra was probably one of the few cardiologists ever to talk about.

Dr. Elkin: Stephen gave me his book.

Dr. Bowden: Heartbreak. I’m so glad you brought that.

Dr. Elkin: I started reading it. I said, “Steve, this is amazing.” He said, “Howard, that book was written 20 years ago.” I thought it was … I said, “Are you kidding me?” Because I related to it so much, because I’m a body-mind kind of doctor. I believe, whether it’s cancer or heart disease, they’re correlates.

Dr. Sinatra: Yeah.

Dr. Elkin: Yeah, so I totally support his work in this. This book was [inaudible 00:42:21]

Dr. Weitz: Are there certain insights you got from Dr. Sinatra’s thinking about this that have helped you with some of your patients?

Dr. Elkin: Yeah. Specifically, it’s interesting. My cancer patients are a little different than heart patients. Because heart patients, they have a type A personality, which has changed over the years. Competitive, and blah, blah, blah. I’m type A, but I’m not cynical and I’m not angry. Those are the two, those are bad characteristics. Cancer patients are a little different. They tend to repress a lot of their feelings.

He talked about that in this book, and I see that a lot. I do talk a lot … In my practice, I teach patients how to breathe. Meditation is an important part of what I do. I teach it, and about getting emotions out. I talk about it in my book and I practice it every day with my patients. They have to get it out. I think this book was just revolutionary for me, and I’ve said it to my patients as well.

Dr. Weitz: How about yourself, Jonny?

Dr. Bowden: Well, I was just thinking about, as I mentioned earlier, we had both had training in psychotherapy, and we’d both been patients of psychotherapy, so we both really felt this way about the connection and the bimodal communication between heart and mind, and brain and body. What’s striking to me is how much the research has supported his intuition. They’re writing now about, we all know, maybe people who are listening might not know, there’s this major thing in the body called the vagus nerve, and its job is to do communication from the back of the brain all the way through. It has outposts in the heart, in the immune system, in the gut. There’s really no more debate about body and mind, and separation in the vagus. That’s why all that, gut feeling and stuff like that, where so much, 80% of your serotonin is made in the gut, and all of that information flows back and forth, and the science is supporting that.

Dr. Bowden: There’s a new book that just came out by a professor of medicine at Harvard, who also has a divinity degree from Princeton, and it’s called Cured. They looked into some of these cases, remarkable cases of remission that are not medically explained, but are documented and stuff. It seems that the thing that all of them have in common is that these patients somehow figured a way to tap into their parasympathetic nervous system and calm themselves down.

Dr. Bowden: A lot of them got stage 4 diagnoses. They quit their job. They moved to Costa Rica, and miraculous … Without thinking that was going to happen, they did what Steve always talked about, which is to tap into that natural healing that the parasympathetic system does, the rest and digest system, and to be able to get off that treadmill a little bit. That’s all about emotion. It’s all about stress and anxiety, and about finding stillness, and finding calm, and taking off-

Dr. Elkin: Drew, I think you see a lot of this as a naturopath. My last YouTube Live was on this very thing, the parasympathetic nervous system, and using the vagal maneuvers, and so forth, but we are so sympathetically overdriven.

Dr. Bowden: Overdriven.

Dr. Elkin: Look what’s happening in the world right now. Besides our health issues, just look at the world, how divided we are in this country. Everybody’s tense. I’ve never seen such a tense world before. No wonder disease is rampant right now. It’s terrible, so we need to really calm and do these vagal … That was one of the things that’s interested me about earthing and being grounded is it actually helped get back to your normal circadian rhythm and increase the parasympathetic tone. Very fascinating. Stephen taught me that.

Dr. Sinatra: Yeah. I’m guessing, I’m feeling called to share these stories tonight.

Dr. Weitz: That’s great. We appreciate it.

Dr. Sinatra: My dad was a storyteller. When I used to shadow him when I was a teenager, and I think in my early 20s, I did a lot of shadowing of him, which I’m so grateful for at this point now. What I loved about the way my dad handled his patients was that he listened. He let them tell their story, and a lot of emotions would come up. Sometimes, the patients felt rushed, but he’d always give them the time and the space to allow them to tell their story. That in itself was the medicine, listening to the story. Because a typical doctor’s visit is what, six minutes, when you go see a conventional doctor? What do you do? You just go in, you got hypertension. You come back with an ACE inhibitor, whatever it is, but my dad was different. He had a little bit of a longer visit, and he allowed that space for transformation and for storytelling of the patient, which they needed.

Dr. Sinatra: That’s primarily why I became a naturopathic doctor, because I was so interested in counseling. Really, he was doing counseling the whole time, the psychoenergetic training that he did. That blew me away with his patients because he sometimes wouldn’t even have to recommend something. He would listen to them, and, all of a sudden, they’d give him a hug at the end, and ah, that was the medicine they needed at the time. I think my dad just had that uncanny ability to be present and to listen with compassion, and open ears. Patients really, they came to see him for that.

Dr. Elkin: I think, now with large medical groups and HMOs, the medical world is so corporate. I still have my own individual, solo practice. I’m a dinosaur, I guess, but patients really appreciate this. The number one complaint, if you look at surveys with patients, they feel they are not being heard by their doctor. They don’t feel heard. My mother, who’s 96, said, “Yeah. They got one foot out the door, one foot in the door.” It’s a complaint. People, they don’t feel heard.

Dr. Sinatra: Yeah.

Dr. Weitz: Yeah. Unfortunately, it’s the system. It’s hard to blame doctors because they’re part of the system. I know on the West Side, there aren’t too many physicians who are independent. Most of them have become part of a group, and the group’s been bought out by a hospital. The hospitals come in and run the show. They prescribe to them how many people they need to see, and so they’re caught in the system.

Dr. Sinatra: Yean.

Dr. Weitz: Let’s talk a little bit about earthing. I know that that’s something that Dr. Sinatra pioneered. I know you worked with him on that earthing study, Howard. What is earthing and what role can this play in heart health? I think this is the remarkable. It’s basically using the negative electrons from the Earth’s surface. First of all, if you look at free radicals, they’re positive though. How do you squelch them? Well, free radicals, it’s the Earth’s surface, and I did this. I’m not doing it as regularly now as I used to. When I would do earthing every single day, grounding in my front yard, and so forth, I would literally feel tingling from the ground within. I really felt that sense.

Dr. Elkin: Stephen and I did it. We wanted to see the effects on blood pressure. We know it helps to decrease viscosity. We know it’s antiinflammatory, antiaging, but hinted, it also had an effect on blood pressure. We did a small study. Unfortunately it was a grassroots study, so we didn’t have a lot of patients. It was just me and a nurse that did this, but we did find a very positive correlate. You had to make sure the patients were grounded for at least 10 hours, which is hard to do.

Dr. Bowden: How did you ground? How did you do-

Dr. Elkin: We had grounding mats. We had grounded sheets. We encouraged … They had to report it, and they came in once a month. I set this up with Stephen and Guyton Chevalier, I think, and we had a whole protocol set. It wasn’t easy to do, believe me, it wasn’t, because you’re dependent on people. It was difficult, but patients loved it and they felt more calm, and they got … Here was the best thing. They felt they got more rested sleep. In some of these patients, we weren’t testing for this, the C-reactive protein, which is a marker for inflammation, came down-

Dr. Bowden: Wow.

Dr. Elkin: … in several of these patients, which is a marker of inflammation, so it’s fascinating. I wanted to, we talked about doing a bigger study and more studies, and we talked to Clint Ober. We never got around to it. I think that the reports on earthing, being grounded are significant. They’re phenomenal, but for the medical world to appreciate this, we need to have more studies. That’s just it.

Dr. Sinatra: Yeah, no, agreed. My dad was really big into understanding when this started to occur when we weren’t grounding anymore, and it was really when we started to wear these shoes that were rubber-soled, which connected you from the Earth. If you ever met my dad at any point, he probably came walking through the door in these radical cowboy boots. He had ostrich cowboy boots, and all these snakeskin ones, crazy ones. Those cowboy boots were grounded. They had a leather sole, and he, I think, maybe unconsciously, was moving towards the realm of grounding, even though he didn’t really know it.

When he stumbled upon this, I believe it was like 2007-2008, as I remember we were first talking about this idea, concept of grounding and earthing. It really blew his mind. I believe too, that it was great, because I saw him bring the science of it into effect, meaning like you were saying Howard, this free flow of electrons into the body helps with free radical stress, et cetera. I saw him finally connect to the Earth, and that was one thing that made me really happy, because my dad was always such this busy guy. He’s like go, go, go, go, go. Always there for someone. Traveling a lot, working a lot.

It was so good to see him ground out, as we called it, and connect to the Earth, and not only get the physical benefit of this free flow of electrons into your body, but also this connection with Mother Earth that I saw him evolve with over time, and it was great. It was great to see that. He’s such a strong believer in grounding, I can’t tell you. Every time we’d do something or go somewhere, he’d say, “Son, ground out.” We’d fly in an airplane, “Go ground out.” Every time, just, “Go ground out.” It’s imprinted in my mind, and now I do it with my kids too. I’ll be like, “Kids, take off your shoes. Go ground out.”

Dr. Elkin: He’s right.

Dr. Sinatra: Yeah.

Dr. Weitz: That’s great. Maybe, Jonny, do you want to add anything about the grounding?

Dr. Bowden: No. There were times when we were doing the cholesterol book tour, and we were doing appearances and stuff, and he was really into it. I had the crisis of conscience that I felt it was outside the Overton window for our audience. We were already taking on the medical establishment with such outrageous claims, “Saturated fat doesn’t cause heart disease, and cholesterol is being measured wrong, and it’s not the …” It was already a little bit outside, and when he started talking about grounding, I was just worried. The Overton window, it’s like, “Dude, it’s a little too much. Maybe just don’t talk about it on the Dr. Oz show, because I don’t think that they’re going to quite get it.” I was always trying … I thought he was on to something, but I was fearful that because it was such a radical, new concept and so easy to characterize … You know how conventional medicine would … You know what they … I wanted, not to silence him, but I wanted him to keep it private because I was afraid it would dilute or make it easier for people to dismiss our message about heart disease and the stuff we’ve been talking about for the last hour.

Dr. Elkin: The thing I remember about Steve is that he was so passionate and energetic. He could have sold me on anything. When we had this luncheon and talked about grounding, would I be interested? I jumped at the chance because I felt somewhat protected by him because I wasn’t paving the way. He’d already done it, or was doing it. I was just riding on his dovetail, you know?

Dr. Bowden: Mm-hmm.

Dr. Elkin: I was honored to be able to participate. It was great.

Dr. Weitz: Maybe we could wrap up by saying something about what we should all focus on to help carry on Dr. Sinatra’s legacy in the world.

Dr. Elkin: Gosh.

Dr. Weitz: Howard?

Dr. Elkin: I think we’ve all said it, but I think, because I’m in an active practice, I am living it every day. I give him a lot of credit for how I practice, really, because I don’t think I’m a maverick. I learned from him and I gleaned from him, and so it just seems natural to me, because I’m a thinker too. I don’t just pass out pills. His memory remains indelibly within me, and as long as I practice, as long as I live, I’ll always remember the role that he played and how he helped me. I’m very grateful, having known him.

Dr. Sinatra: Yeah. I want to say that my dad was a phenomenal cardiologist, no questions about it. He was also an amazing heart doctor. There’s a difference there and that is-

Dr. Bowden: Good. Good one.

Dr. Sinatra: … he had such a high level of compassion and unconditional love for himself, his patients. He had dogs, guys. He had two or three dogs, sometimes in the office, come in with him. What doctor does that? What doctor does that? That, in a way, protected him, actually, energetically, from some things that would go down with patients. Also, gosh, he just had such an open heart, and he shared that love with everyone, and that’s what attracted people to him. Just his level of compassion is just, it’s infinite. That’s the message I want to go out to people, is that we live in a very difficult time now. There’s a lot of stress, and it’s very easy to be judgemental of others, but maybe open your heart more and allow love to come into your heart so that we can live more in peace in this world and not so much anger.

Dr. Elkin: Beautifully stated.

Dr. Weitz: That’s great. How about you, Jonny?

Dr. Bowden: I’m reminded of a parable I heard, something I heard once to describe the difference between Eastern and Western medicine. I think it describes the way Steve practiced. It said that in Western medicine, we look at the symptom that the patient has in front of us. In Eastern medicine, they ask, “Who is this person in front of me?” Steve didn’t practice by lab tests. He practiced by treating patients, not numbers, not metrics. I think that’s probably the biggest message, the biggest tribute I can give him. He saw the person, the whole person, their story, everything about them. The lab tests and the symptoms were just part of that. They weren’t what he treated.

Dr. Weitz: Awesome.

Dr. Sinatra: Well said.

Dr. Weitz: Yeah, I don’t think I have much to add, other than to say that some of the most important messages I’ve heard from you guys is the importance of questioning orthodoxy and thinking outside the box. Even though medicine is a science, there’s also an art to it, and listening to your patient, which is just so sorely needed, and to have compassion for your patients, and do everything with a passion for what you do.

Dr. Elkin: I want to thank you, Ben, for bringing us all together.

Dr. Bowden: Yeah. Thank you, Ben.

Dr. Elkin: This was Ben’s idea, and I jumped at the chance.

Dr. Bowden: Thank you, Ben, and thank you, Howard, and thank you, Drew.

Dr. Elkin: It was really a pleasure.

Dr. Weitz: Okay. Well, thank you, Howard, Jonny, Drew. Thank you for everybody who’s watching it live, and who’s going to watch it on the recorded version.

Dr. Elkin: All right.

Dr. Bowden: Goodnight.

Dr. Weitz: Okay, goodnight.

Dr. Elkin: Bye, guys. Bless you.

Dr. Sinatra: Thank you.

Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast. If you enjoyed this podcast, please go to Apple Podcasts and give us a five-star ratings and review. That way, more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts. I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica Weitz Sports Chiropractic and Nutrition Clinic. If you’re interested, please call my office, 310-395-3111, and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz. Thank you, and see you next week.

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