Stop Fearing Cholesterol: Alan Ogden on the Your Second Fifty Podcast

Welcome to the Your Second 50 podcast and today it's a real treat to have our friend Alan Ogden back with us. We are going to talk about a topic that's of interest for a lot of people who are either nearing 50 or over 50. It is the dreaded topic of cholesterol, which was such a big emphasis on cholesterol back in the 70s, 80s, and so on. The question is why and how has the field of knowledge around that dreaded topic evolved over the years? Alan is very knowledgeable about that space of cholesterol, so I'm excited to hear what he has to share with us, with our audience. Just to remember why Your Second 50, why this brand is important and what we wanted to achieve with the brand Your Second 50 is to inspire people to live the life that they've been dreaming of, to live their best life. But in order to do that, we have to first take care of the physical body. We have to have a strong foundation in order to live the life we dreamed of. Today, Alan is going to help us expanding our understanding around cholesterol and maybe taking care of some of the myths that have been basically propagated over decades around that topic. Alan, if you could introduce yourself briefly to our audience again. You have an impressive background. It's always a pleasure talking to you because I always learn a lot. Could you share a little bit about your background and what makes your background a little unique in a way? Absolutely. I was really fortunate. I went to university at the time when this whole controversy started and part of my university career. I have a Bachelor of Pharmaceutical Sciences. It's different than a Bachelor of Pharmacy. People go to school now. Well, now they get a Doctor of Pharmacy, which focuses on drug as a therapy, drug treatments. When I went to university, we had to learn pharmacognosy, which was the use of plants as medicine. So there were still doctors writing prescriptions and we would have to use plants to fulfill that prescription. And so I was right in the middle of this controversy and you might remember the start of this, Laurent, or I'm going to say the public face of this was all of a sudden we needed to get fat out of food. And unfortunately, we now know that the replacement was sugar, which had more devastating effect than actually the cholesterol or the fat in the food at the time. The original research, and I remember the day I was sitting with my professor in pharmacology and we were talking about this new information that on cholesterol and the guidelines that they were coming up with, LDL, HDL, the cholesterols that we check and triglycerides. And he was very suspect of the whole research because what he said to me was this doctor that was being elevated as the new expert in cholesterol had done a meta-analysis. In other words, his job was to look at all the information on research on cholesterol. And what he had done is he had cherry-picked just a few studies. He didn't look at all of the research, he just cherry-picked a few studies and then they came up with these guidelines that if you are over a certain level of LDL cholesterol, then you needed therapy. But his contention was the original application for the use of cholesterol was very specific. It was for people who were genetically subject to something called apolipoprotein A. So that's a type of cholesterol substrate that we make, which is very inflammatory. So if people do have high apolipoprotein A, it's very difficult to control through diet, exercise, and the things that most people would think of as controlling exercise. But the genetics was just forcing this. And actually, one of the doctors I worked with was one of these people where he could not get his LDL cholesterol anywhere close to the range. And then when they did a further examination here, he was genetically predisposed to this. And Alan, sorry to interrupt, but you're talking about genetically predisposed. You have knowledge in DNA testing, in genetics. Maybe you should mention that to our audience because that gives you the background information that you know where to look. You know how to interpret the data as well. Yeah. So we have genetics for our dietary cholesterol, saturated cholesterols, unsaturated cholesterols. We have a selection of genetics that we can look at that would indicate a predisposition and then we know what to go look for. You know, when you go to your doctor, they don't do genetic testing. They just do a blood test. They look at some results and then they make this decision on whether or not you should be on a cholesterol drug. And in the time that we've been doing this, the levels, allowable levels, pre sort of therapy have dropped. They continue to drop. So when I was, you know, 1978, 80s, there were certain levels, there was very few people that met them. And the statin drugs were approved for these people that had high apolipo-A protein from genetics. And then a very small study had been done on preventing secondary heart attacks in men. So there was no original research done on women with statin drugs. So the original approval for this drug, you had to be a male, you'd had to have already had a heart attack, they would start you on a statin drug, or you had to have genetically high cholesterol. And then this idea was propagated through this doctor and his selection of research that indicated that, wow, fat was bad. And I think if you would ask people, what do you think about cholesterol? They would just say, well, fat's bad, right? And we went through this whole process of removing fat from food. And if you look at those foods, what replaced it was sugar. And we now know that that, you know, is devastating. So what I did back in the day is we, with my professor, we looked at, okay, what is cholesterol? Why do we have it? We make cholesterol, like we, our liver is very good at making cholesterol. And why do we need cholesterol? And why are we stopping making cholesterol, if it's something that our body uses? So just for the audience, you know, you can't make, you make vitamin D from cholesterol. You make your hormones. So your insulin, your testosterone, your estrogen, your progesterone, all the hormones we depend on, have their root in cholesterol. So upstream from many of the activities in our body is something called cholesterol. And so when we start interrupting that pattern, then we are going to get downstream effects from cholesterol. So now where I work and the people I work with, first of all, we do a genetic testing. We see, you know, what are those genes that have the potential to increase these things. And then we do what's called, you know, there's a standard cholesterol panel, which I'll walk through for people. So when they go and get a blood test, they'll understand what the doctor's looking at and how he's making his decision. And then I'll add to that what we make, what we do as a test to really understand their need for cholesterol. So if you go have a blood test, generally it's a fasting blood test. So we want, we want your body to have flushed out anything that it possibly can. And if we still see high LDL cholesterol, our first response to that is not a statin drug. We look at their dietary pattern. How much saturated fat are they actually eating? Do they have some genetics that might indicate that they have an inability to use saturated fat? We look at all their liver enzymes because the liver is where cholesterol is produced. That's where it's modulated. That's where it's handled. That's where it's broken down into its component parts. And then we'll look at even kidney function. And finally, we'll look at their bowel function, because when we eat a lot of fat in our body, it goes through the liver. If we eat a whole bunch, it goes out into the bloodstream, comes back into the intestinal tract, and hopefully we have the bacteria in our intestinal tract to actually emulsify that fat and get rid of it. And so we look at all these different areas first before we would use medical intervention. Now there are some people, and I want to say this clearly, there are some people that statin therapy is a requirement for because of the genetics. Maybe even because they don't have the ability to change their diet too much or the desire to change their diet too much. So there is some. And the newer cholesterol drugs that are coming out are now not actually acting in the liver. They're actually acting in the intestinal tract, which is where the problems are coming from. So when we eat fat, our body has to emulsify this fat. It's going to make something called HDL cholesterol. Okay, so you can just take the H and remember heart. So HDL is cardioprotective cholesterol. And if we have high cardioprotective cholesterol, then from the very start we have to start minimizing the ultimate effect of LDL cholesterol. Then we do a further panel which is called a lipoprotein panel. So what that lipoprotein panel is looking at is the triglycerides. So we have this process, our body takes makes HDL cholesterol, LDL cholesterol, then there's triglycerides. Triglycerides get broken down in some called VDL, very low density lipoproteins. There's even smaller molecules that have another name. And we start looking at these. These are the ones that we've now identified that actually are doing the damage in our cardiovascular system. Remember that I said that all the original tests were done on males. And one of the things that why women were excluded at the time was it was pretty well known that as women go through menopause and they become postmenopausal, their LDL cholesterol naturally rises. Now, you know, we look at our grandparents, many who've lived into their 80s and 90s and never had cardiovascular disease. And yet they had this LDL cholesterol, which is another thing we looked at in our original studies with my professor when we were doing this is why are women not so subject to cardiovascular disease. Now remember, women are still subject to cardiovascular disease and cardiovascular disease can be a cause of fatality. Women usually have one heart attack where men might get away with, you know, one and another one and have this intervention. So there's some kind of cardioprotective mechanism when they have the cycle, the estrogen progesterone cycle, which they lose over time. But we just see this natural rise in LDL cholesterol, which has led us to then look deeper into what is in that. So I'm just going to give Donna, my wife, as an example. She's given me permission to do that. Her cholesterol was very high. Like she was just looking at those bare numbers that your doctor checked. So you check your HDL, you check your LDL, you check your triglycerides. That's basically as far as your doctor goes. And from that they make this decision about statin therapy. And she was very high. And so we went back and said, could we do a lipoprotein test? He did a lipoprotein test. A lipoprotein test came back very good. So what that means is even though the LDL is high, it's not damaging. It's not doing the damage that originally this research that was done in the 60s, 70s was indicating that it was doing because of this cherry picking of the information. And so then, now that we know this, what we did is we handled her LDL cholesterol through natural means. So we looked at how much saturated fat are you eating? We put on a natural product called Stericol. Health Canada allows us to say is a treatment for high cholesterol. Hypoglycemia is actually what it's called. Hyperlipidemia, hypertriglycemia. So all these things that are damaging. So there are ways that we can handle this. But the first thing we wanted to establish is how threatening is this? And the reason I like this is because we have really good information. And this gets downplayed, but it exists. So if you, you know, the other thing we have to remember is we're fighting a $35 billion a year industry right now in cholesterol, right? So there's a high degree of push to use cholesterol drugs. But when we break this down, and we look at what's actually going on, and what we were afraid of with my wife in particular, was a pattern that had happened with her mom. So her mom, you know, she goes to the doctor, she's about 77, 78 years old. Oh, my goodness, your cholesterol is really high, we have to get you on. And they put her on the maximum dose of a cholesterol drug. Within six months, she started having mini strokes. And this is a side effect of cholesterol that's not talked about. And it's actually downplayed. But it's very real. And it's particularly real in women. It can happen in men, the most usual side effect in men is an ability, it precludes their ability to maintain lean muscle mass strength. But in women, we have this further thing where we can have strokes. So is that the result of taking these drugs? Yes, it's a direct result. So what we're looking at, and now we know to look for this, when we put somebody in a high dose of statin therapy, remember that we make our hormones from cholesterol. Well, men are different than women, we're going to cycle testosterone every 24 hours for the rest of our life. So as soon as we put a statin drug in there, we've now interrupted the manufacturing of testosterone to a certain level. What keeps a man strong? Yeah, testosterone, right. So many men, you know, they go on a statin drug, then they're on a testosterone supplement. There's this cascade of intervention now, just because we did this, rather than looking at what could we do from a dietary source. Well, Alain, can I ask you, you mentioned one of the reasons, you were talking about the connection between cholesterol and the hormonal system. But you originally said that the body makes cholesterol. Yes, it does. So that would be one of the reasons why the body makes cholesterol. But I'm sure there are other reasons. And I'm interested in hearing your take on the role of cholesterol in somehow, sometimes maybe being needed to actually protect blood vessels, to have this coating that sometimes is necessary. My understanding of cholesterol is that if you've got too much, then it narrows the passage for the blood to go through, raises the blood pressure. So maybe we can talk about that. But first of all, why is it that the body makes cholesterol? Well, cholesterol, fat is a transport mechanism for many micronutrients in our body. If you think of all the elements that we take, zinc, magnesium, all these things that are essentially, some of them are water soluble, but many things that we need for just enzyme function, etc., are actually lipid soluble. When we look at the membrane, cellular membranes, and I'm just going to give neurons as an example, the cellular membrane of a neuron in our mind is about 40% made up of DHA, which is a substrate of cholesterol, right? So we can make these omega fatty acids, we can make hormones, we can make vitamin D. So vitamin D is a transport mechanism for calcium in our body. One of the things that we looked at, this is a study that was done during COVID, and we looked at vitamin D levels, just randomly throughout Canada, United States. And there's a range of vitamin D we should be in. I'm just going to give the number, it's like 75 to 250. There is another one that's zero to 60, but the most common one in Canada is 75 to 250. And the average Canadian was at 81. I think the US measurement is different, isn't it? Yeah, yeah. It's lower. It's like a zero to 60 measurement. But in the United States, to use that example, we found that the average was like 27, right? So it's very low. So we have very low vitamin D. So now this higher cholesterol becomes dangerous because we don't have enough vitamin D, right? If we put people on a statin drug, and we get this cholesterol reduced even further, then we compromise the transport of calcium. And what is atherosclerosis made of? Well, it's calcium, right? Calcium buildup. Yeah, calcium buildup. That doesn't move through freely. So we interrupt vitamin D production, then calcium doesn't move through. So there's many cascading effects. And I think that's one of the challenges that now research is looking at is, here was the original thought, we have to get LDL cholesterol down, because it's inflammatory. Well, LDL in itself isn't, it's actually the small molecules that are inflammatory, the lipoproteins, the very low density lipoproteins that are inflammatory. And if we're efficient at breaking those down in our body, which we can be, then it's not as great a threat. And there are natural ways that can help too, for example, curcumin or taking some supplements can help. A great microbiome is one of the best ways to help, right? So when we have a higher fat diet, we have great microbiome that those very low density lipoproteins can be broken down, they can be excreted. There's something that we now know there's a condition called skinny fat, right? So skinny fat is when we do a blood test on somebody, and they have reasonable cholesterol levels, we do a further test, we test their lipoprotein, and we find their lipoprotein B is high. So what does that mean? Well, that likely isn't a liver problem, it's more likely a digestive tract problem. So maybe, you know, we see this in people with Crohn's disease, or some other disease like that, where the fat that gets into their intestinal tract is not being broken down. And so, you know, we will give them something like lactobacillus plantarum, in an entero-coated capsule to get it down into there, because that can help break that down. Another thing we'll look at, and the reason we look at liver enzymes is because people can have a damaged liver, a non-functioning liver. And you know, fatty liver is one of the most common diseases on the planet right now, which means we're going to be really efficient at handling fats and sugars. You know, most people with diabetes have a fatty liver. We look at their liver, and we see that their liver enzymes are increased. Alcohol is one of the biggest things that can increase liver enzymes. And if you do that, then your body now can't handle the fat. So then your cholesterol is going to go up, right? And so there's just a whole bunch of things that now that we have to look at in order to make a decision, is medical therapy the right thing to do? Or are there other things that should be done first? And once again, I want to talk more in depth about these side effects, because when we interrupt liver metabolism and fat metabolism in the liver, there's so many downstream effects from that, right? Our hormones, well, all of our vitamins are basically, we have to have these fats to transport things around our body. One of the real big mistakes that was made was taking eggs out of people's diet, right? Because eggs have lecithin in them. Lecithin is a transport mechanism for vitamin D, vitamin K, vitamin A, vitamin E, all the things that are cardioprotective. And so when we took eggs out of people's diet, because there was an idea it had too much fat in them, or they had too much fat in the yolk, we just eliminated like four essential vitamins from people's diet without even thinking about it, right? No thought to that. And now, of course, Harvard has clinically proven that eggs have no bearing on dietary cholesterol at all. You know, you had some guy eating 30 eggs a day for a month doing that. So, but, you know, I think for what we need to understand, and this is about people at over 50. So, you know, the recommendations that I'm looking at now is that, first of all, we have to be very cautious about women and using statin drugs in women, particularly over 50. So once they're past their cycle, or getting past their cycle, we are going to see this sort of natural elevation in LDL cholesterol that hopefully will... That's normal, right? That's normal. That's normal. And that's where we really need to do some further investigation. See if we have those lipoproteins. See what the triglycerides are. And I tell people, when you go to the doctor now, and you get your blood panel done, the very first number you want to look at is your triglycerides. And if you can get a lipoprotein panel done, then if your lipoprotein is low, your triglycerides are under control, your LDL cholesterol can be higher, but your threat level for cardiovascular disease is much lower. So we really need to be cautious of women because that's where most of the cardiovascular side effects are coming in for stroke. Then we have to look at diabetes because there's a great relationship between fat metabolism, sugar metabolism, and diabetes is on the rise. So we look at the youth. I mean, this is where we're looking and we're seeing so many youth that are diabetic or pre-diabetic. Well, part of that problem is when we look at these kids, what's going on with their liver? I mean, it's overwhelmed. It's not mature enough to handle that much fat. And so now we're putting them at risk because their intestinal tract can't handle that fat. So they gain weight. They gain weight. Their hormones are all out of whack. But is statin the right therapy for that? And that's now being questioned. I think the good news for everybody is that there is a realization in the medical community that we need to look at statin therapy in an entirely different way. We need to look at what can we do in the intestinal tract? What can we do with the liver? What can we do for the things that are supportive of fat metabolism rather than just stopping the metabolism of fat? You're talking about supporting, helping support the liver and helping support the organs that are involved in processing fat. So could you share some thoughts about the connection between cholesterol, let's say, and high blood pressure? Because that's a connection I've seen, I've heard, the cardiovascular system and cholesterol. So could you share some thoughts around that? I sure can. Because high blood pressure, you know, is a greater, I think, is a greater risk factor for a cardiovascular event, even than cholesterol in most people, but they're not taking care of their blood pressure. So while we might see higher levels of cholesterol, the thing we need to take into account in people with high blood pressure, number one, is their kidney function, their hydration, are they being hydrated properly, right? So there's other things that would come into that formula before we would actually accuse cholesterol of being the cause of the high blood pressure. Why was cholesterol so closely associated, I'm talking decades ago, with high blood pressure and cardiovascular disease risk? Well, because the original research that was used to use statin drugs was, you know, preventing atherosclerosis. So atherosclerosis is the stiffening of your cardiovascular system, right? So the less flexibility you have in your cardiovascular system, the harder it is for the blood to go through. Your heart has to work harder in order to push it through. And your liver has to work, I'm sorry, your kidneys have to work harder. So it can be a cascading effect. It could be a result of long-term higher cholesterol where now you have your atherosclerotic plaque, you have calcium in places that it shouldn't be. There's tests we can do. We can do something called a CCT scan, which is we look at where the calcium actually is. You may have heard people talk about the widowmaker, right? Which is calcium accumulating, you know, in the large vein in your heart. And if we get that, I mean, if that closes off, there's not much we can do for that person. So, you know, my whole vision of this, and it really relates back to, and I have Dr. Knauss to thank for this. He's not on the planet any longer, but his ability to question the theory that was being presented at the time in the 70s, this is the late 70s when I was working with Dr. Knauss, saying, I think we're really not, we're missing the point. And then we see the result of what happened when we took fat out of food. We saw so many disastrous health conditions. And fat is needed for the brain too. I mean, there's so many, yes. And when somebody calls you a fathead, it's actually a compliment. I wanted to mention men though, because, you know, the original, that was the original reason for statin therapy, secondary, to prevent secondary heart attack in men. And, you know, there was a lot of things that went along with that. Like one was, if you were a man and you had a heart attack, they didn't want you to exercise, right? They were very cautious about exercise. They were afraid. They were afraid. Now we know that exercise is a primary component of that. We need that exercise. We need to get the blood moving. We need to increase the flexibility. The oxygen and all of the things. Yes. And the flexibility of the cardiovascular system. So, you know, if somebody has a heart attack now, we get them up and we get them walking. We get them, you know, doing 45 minutes of exercise right away. That's a great thing that has all been rethought. But the main side effect from statin therapy in men relates to a condition called sarcopenia. So that's the loss of lean muscle mass and strength. So we, you know, first of all, they have pain. They have muscle pain. And so it's inhibiting their contractile processes in their muscles. They get muscle pain. And this can be devastating. It can be very, very, and the thought is, well, it's going to go away in a couple of weeks. Well, maybe we lose our sensitivity, but what it's doing has not gone away in a couple of weeks. The problem with that as we age, we need muscle mass because one of the main causes of death is falls. And falls can be triggered, usually triggered by a loss of muscle mass. 100%. Yes. As a matter of fact, I just looked at a study last night. I wasn't looking at, because we're doing this today. It just happened to turn up. And they've just done a new evaluation. And even people in their 60s. So if you fall in your 60s, your chance of mortality in the next 10 years goes up by almost 70%. That's huge. Right. And with every decade of life, that chance of mortality increases. Right. So somebody like you and I, we're in our 70s. So a fall for us becomes chronologically. Yeah. Chronologically. That's correct. So the long-term effect of a fall is much greater as people get older. And that's one of the things that I've unfortunately seen in many patients that are on statin therapy. And they've been put on statin therapy when they were 50. Oh, we need to get you on a statin therapy. It's a long time. And then they fall when they're 60 or 65. And now we have a very complicated individual to work with. Right. Now we're trying to replace lean muscle mass. We're trying to get them functioning again. And this is the problem was in the movie was Dr. Kent Holtoff is talking about that. I mean, drugs are necessary and can be awesome. They can save lives at the same time. Drugs often carry so many side effects. So you might be trying to solve an issue, but you're actually generating cascade of potential side effects and additional problems. And Dr. Holtoff in the film is making the comparison with peptides, which peptide therapy you could stack them. You could have five, six, 10 peptides and no side effects and very effective to go to the root of the problem. So, I mean, the talk today is not about peptides, but I think I just wanted to mention that because you're talking about side effects and how devastating they can be. There are solutions. There are new options that were not available before and that people should actually research. There's an old option as well. There are old options. I'm sure you can talk about plants. Do you know that there's only one protein that has a Health Canada claim regarding reducing cholesterol? Which one? Soy protein. Oh, here you go. So I don't feel bad now that I'm eating my tofu. This is such a thing. This is another thing that I remember. Do you remember there was a book written by Barry Sears years ago called The Perfect Protein? I don't remember. Okay. He became very famous for the zone diet. If you remember back in the day, you could buy zone bars, the zone diet. Oh yeah. The 40-30-30 diet. And he became very famous because he wrote this book called The Perfect Protein. It was about soy protein. And Health Canada actually looked at the research that was being done. They gave a claim for 25 grams of soy protein consumed daily would lower cholesterol. But they destroyed, they tried to, I'm not talking about Health Canada, but you know, for a long time there has been this fantasy attached to soy protein that is supposed to be really bad for you from a hormonal standpoint, in particular for men, if I remember correctly. But I don't think there is a lot of, I don't know if there is a lot of truth to that. I wanted to mention, because we're talking about cholesterol and, of course, cholesterol and then statin drugs and effect on hormones. The reason I wanted to bring this up is the study, and I remember this very clearly, Men's Health Magazine ran this article, which was the one that killed Barry Sears' book. They ran this article. They found this individual who was drinking three and a half gallons of soy milk daily. That's a bit obsessive. Of course he was going to get something. I mean, three and a half gallons of soy milk. Yes. I mean, it was so ridiculous. But that's where all this, oh, it's got too much isoflavone, too much this, too much that. It's a fantasy. It's estrogenic, etc. Yes, that's right. And I've gone back to eating soy protein because it is actually, it's a perfect protein. But the key, you know, used to be that soy milk was so popular. And they said, oh, no, no, soy milk is bad. So now they are giving you oat milk. Yeah, oat milk, almond milk and oat milk, like the carrageenan and guar gum and all sorts of stuff. It's amazing. I'd like to bring something else that is typically attached with cholesterol. I remember, again, because my dad was always focused on his cholesterol. Every time he would go to the doctor, the cholesterol level, he was on drugs for cholesterol, probably because at the time they didn't know any better. He didn't have access to information like the information you're sharing with us. And the other thing that was really closely attached to that cholesterol kind of concern was salt. So maybe we can talk about salt as well, because I've been thinking about it. Instinctively, I am attracted to having some salt, good quality. So I'm talking salt. I grew up in Brittany on the West Coast. Some of my friends were actually harvesting salt. And I used to drive on these little roads close to the marshlands where salt was coming directly from the ocean and seeing these piles of salt, little mountains of white salt on the side of the road. And then it's packaged in bags and tourists can buy it. So we produced a lot of salt there, like natural salt from the Atlantic Ocean. And I am attracted to that because instinctively I feel that this must be packed with magnesium and iodine and so many things that are actually good for you. But a lot of people have been scared of using salt because of the connection with heart disease and cholesterol and all of that. So could you share some pearls of wisdom the way you look at it? Yeah, I agree with you. Salt is another thing that just got a really bad rap in this whole. So I just want to talk a study that was recently released and it's going to make your point. So they came up with a study and they said that cholesterol was saving so many lives. And so my question that I asked at the time was, how many people that you're testing that are on cholesterol drugs that you're saying they're saving their life, have made any dietary intervention? Well, nobody, right? So we're not comparing. So we take a group of people like myself, like Donna, my wife, people that have tracked cholesterol. As we've seen changes, we've made dietary changes. We've controlled it through diet. We've controlled it through exercise. And one of the very first things when I started exercising more intensely, I realized was I'm way too short of salt. I need more salt. I need it for energy. I need it to drive my hydration. You need it for everything. And so absolutely, it just fell into this category, unfortunately, of people that make no dietary intervention and they're eating food that is extremely high in salt. I'll just give you an example, Don. Yeah, bad salt. And just, yeah, not sea salt like you're eating. Don and I were out for dinner. We had an event and she said, oh, I just feel like a salad. And so I think she, I forget what it was, chicken and something. And I asked for the nutritional profile of her salad and it had 8,000 milligrams of salt in her salad. Well, they put salt because there's an addictive aspect, I think, where people want to keep eating more. Like we see that with potato chips. The salt somehow is addictive, I think, and people want to keep eating more. And we're short of it, right? We don't eat enough, so then we get something that's got salt, then you're going to eat more. But that's true too. You drink more, right? So yes, that's another thing that I've really been monitoring in my diet is increasing the amount of salt so that I can, I'm 73, I go to exercise, I lift weights, chronology. Yes, and I lift kettlebells, I do intense, I've run stairs. So just to go back on, I have to have salt to do all those things. You do. I have to have salt. Well, when is salt good? When is salt bad? I mean, I think salt is bad when it's added to food, like packaged food, but it can also be good. Can you share your thoughts around that? I think if we're using, do you remember back when we were kids and salt and pepper was on every table? Yes, of course. A meal was not complete without salt and pepper, right? Yes. And I'm glad we've got away from that because, you know, when we're cooking and we're using a little bit of salt in our cooking, or if we're, like me, taking creatine and you need, you know, 40, 50 milligrams of salt to help the absorption of the creatine, and we're not taking thousands of milligrams, we're taking it in reasonable amounts, it's very good for you. And if people find themselves in the daytime feeling woozy or feeling like they can't function, generally, they're dehydrated and they need some electrolytes and they need some salt, maybe some potassium and magnesium, but they need some salt. And that's what we're finding. So, if we're following a hydration program and, you know, we're adding 1,000 or 2,000 milligrams of salt into our diet a day, we're not going to get into any problems at all. It's just when people eat out all the time and they're getting 14, 15, 16,000 milligrams of salt, we're not meant to have that for sure. But we definitely need 2,000, 3,000 milligrams of salt a day. I've seen studies where they're saying 4,000 milligrams of salt. I think that's kind of size dependent as well. Okay, so maybe I was misguided when I brought up the topic, but so is there a connection between salt intake and cholesterol? No, there's more salt intake and high blood pressure. Okay. Right? Because you have to know, you have to flush that out. So, high blood pressure, you have the salt, you've got potentially cholesterol. Potentially, yes. But there's not a direct causation. It's just that the high blood pressure is there. And one of the reasons could be too much salt intake, sodium. And the other reason could be cholesterol not being managed properly or being, I don't know. What we're looking at, and you're bringing up good points, because what we're looking at is a population that doesn't control their diet. And we're trying to make conclusive statements about health on a population that has no guardrails, no idea. I tell people, first of all, you have to eat a protein-forward diet. Protein is the first thing you should... Sure. Start your meal with protein and build around protein, because we need our protein and we see... Especially as we age, because of muscle loss. Yes, we need protein. So, we build our meal around that. Then we add our vegetables and some carbohydrates and things around that. We're going to use a little salt in those things. But we're not... The guidelines and the rules are not made from those people, right? You and I are not to take care of ourselves. We're never put in a study. Never. Never put in a study to make a guideline for cholesterol or anything. It's the people that are... And then that's what the pharmaceutical industry uses. And you can't blame them because that's a high percentage of the population who are not going to take care of themselves. Well, it's just because if you go to a grocery store and you buy food, packaged food, packaged food... Sugar, salt. That's it. Sugar and salt. Those addictive things. That's it. And it's sad. It's really sad to see, because the cheapest food that people buy are the ones that are more loaded with salt and sugar and preservatives and all of that. And unfortunately, that is the food that people with low income, that's what they can afford. And then they land up being overweight and diabetes and all of that. And then they take drugs and their life is ruined. It's destroyed. Why? To enrich the shareholders of these food companies. I'm really glad you brought up the sugar, because there's another... Now we can't see observation as causation or whatever, but you see people that are eating a very high sugar diet, you often see high cholesterol. Now, my personal opinion about that is your liver, in an attempt to actually make... It's taking that sugar and it is converting it into alcohols like glycerols, et cetera, trying to make up for the lack of good food. So you do... There is a relationship between a high sugar diet and then... The production of cholesterol. Production of cholesterol. But once again, when we're a drug company, we're not looking at the population that's taking care of themselves. We're looking at the population that isn't. And the people that I think watch your Second Fifty are the people who are taking control. They want to know. And I would say the majority of them through diet, exercise, through lifestyle choices, are not going to need the medication that the average person needs. And that's one of the reasons why I'm here. I want to separate illness and age. Right now, if you go to your doctor, you and I go to our doctor and, okay, we're in our seventh decade, and they'll say, I've got an achy knee. Well, their first reaction is, you're 70. What do you expect? Exactly. Right? It's not, okay, let's sit down and see what you're doing. What's your activity level? Are you staying hydrated? Are you doing these things? That's not their questions. And so then we now have this idea in our collective that age and illness are intimately connected. And as you age, it's not, I had this actually say, somebody say this to me the other days, he's just 70 years old. And he said, well, it's, we're going to die somehow. It's just, we don't know how yet. We don't know what's going to get us. And I'm like, that's from this idea. That's from this idea, right? And I'm sure he's probably on a statin drug, you know, like all these things. Well, Alain, maybe in closing, it's a fascinating conversation, but it's coming to an end. In your career as a pharmacist, I'm thinking about you, you know, behind your counter and preparing, you know, cutting pills and preparing the medication. You have seen like tens of thousands of people coming to you. And they come to you with anxiety. They come to you with fears. They come to you with, you know, a script from their doctor. And so have you noticed patterns? Like when it comes to cholesterol, for example, all the cholesterol drugs you've been dispensing, have you noticed patterns on the people who are actually coming to you with these, let's say cholesterol issue, that's a, hmm. Yeah. And you could even see them coming to you and already, you know, it's probably going to be cholesterol. Have you noticed patterns that you've recognized of issues that people, and maybe it's connected to diet. I don't, obviously it is in a lot of ways, but can you talk about that a little bit? What I've seen when I first started in pharmacy, people come into the store and they'd say, do you have something for that? And they meant, do you have a pill, potion, lotion, something I can take, get me back to work. I don't want to think about this. Right. What we see recently, people coming into the pharmacy going, do you have something for that? And they mean, what's the alternative? I have this thing from my doctor, I have this white piece of paper and it's got three or four things written on it. Is there something besides this that I can take? And that's... That's hopeful. That's really hopeful for me. But you didn't really see that back in the 80s or 90s? Oh, no, no, no, no, no, never. This is recently, I would say within the last five, maybe seven years, we've seen this. We've also seen a little change in how cardiology is actually being practiced where people now they'll come in, they have a prescription for a statin drug. And then on the bottom of the doctor will have wrote in a note, please add some CoQ10, please add... Again, very interesting as well. Yes, because it's known that when you take a statin drug, it's going to reduce the amount of CoQ10 you have in your body. And for people make sure you get ubiquinol, not ubiquinone, ubiquinol. But yeah, so there is a change and it's a good change. And that's hopeful. And it's nice to finish on a hopeful note. It is, yes. Alan, it was very interesting. Thank you so much for being with us today on your Second 50 podcast. My pleasure. Thank you.