Naren: Hello everyone, welcome to our inaugural podcast for the podcast show, Let it Flow. This is Naren, your co-host and I’m super excited to be joined today by the author of let it flow Doctor Edmund Kwan. Doctor Kwan, welcome.
Dr. Kwan: thank you very much, Naren. I’m excited to be here and discussing this important subject.
Naren: I know you were born in Korea but I know you came to the U.S when you’re very young. Can you tell us a little bit about yourself Doctor Kwan. Who are you? Where did you come from and what got you interested in medicine?
Dr. Kwan: well our family immigrated to America when I was in my childhood and I came over here when I was eight years old and at that time America was a very different place and many of my parents friends are Physicians and so you know naturally, I kind of gravitated towards medicine and I think my parents really pushed me to becoming a doctor. They felt this is a stable profession and this is fairly Noble and we’re able to treat and take care of patients. So this took me on a journey. I went to medical school at Georgetown University at which point I decided to become a surgeon, and during my medical school, you go to various rotations and it started really excited me. It was the area of medicine where I felt like we could really cure patients right away. However I was really doing my medical stuff, I was literally never thinking about the other aspects of medicine like preventive medicine or Internal Medicine. So anyway, after medical school in my surgical training, I became a plastic surgeon which is an extension of surgery. I did my full full training in general surgery which means that the that I was able to do all sorts of surgery on the entire body and as a plastic surgeon, I as most people know it’s it feels as mainly the parents of the of the body and the faith. So this is what I have been dealing with over the last 20, 25 years, and then
Naren: Let me ask you a question, so you became a plastic surgeon in which year Doctor Kwan?
Dr. Kwan: I became a plastic surgeon in 1992 and then in 1994 a general surgeon in 1992 and plastic surgeon in 1994 and then really started my practice in 1995.
Naren: And I remember you telling me a story about this book one of your patients gave you about it’s called China Study. When did you get that book and tell me a little bit about the influence it had on you, Doctor Kwan
Dr. Kwan: that was probably about seven years ago, you know I was kind of happy in my practice, I’m in Manhattan New York City and doing just sort of what I do to improve patients or parents or reconstructing patients and and then Along Came this patient about seven years ago gave me this book you’re going to love this book. It’s about all about help and I said wow and I didn’t really think much about it and then I picked up the book. It’s a book written by a phd in nutrition his name is T, Doctor T Colin Campbell, and this book in this book Doctor Campbell goes over to China and does this huge epidemiological study involving hundreds of thousands of rural Chinese, and he looked at what kind of disease they had and realized that if the vast majority of Chinese in the world population did not get diabetes high blood pressure heart disease or cancer and in which Americans certainly get quite a bit of and, and, his conclusion of the study was that these Chinese were on a diet that’s mainly made up of plant-based diet meaning they didn’t eat much meat they couldn’t afford to and they ate basically Whole Food plant-based diet they didn’t eat processed food. Anyway they as a result they got very few disease and Doctor Campbell caused these disease of the affluence that the Americans and the Western cultures get.
Naren: so as a plastic surgeon blood flow is something that is very important to you right? The success of you know the work you do the surgery you do
Dr. Kwan: yes I started so I I read this book and then I started doing some research on my own because at the time they said oh cholesterol is a killer and I said cholesterol. So I started really I I stopped eating cholesterol and I I started doing a lot of research and I found out that was not the truth and I dug very deep read thousands of Articles and along with this, as a plastic surgeon we deal with how the blood flows in our body. What do I mean by this because outcome of our surgery is vitally dependent on whether the blood flow gets there or not, and if it doesn’t the surgery we do becomes a huge failure. In other words we cut tissues and rearrange it and rotate it around whether it’s a facelift whether it’s a local reconstruction or even breast reconstruction. So we’re cutting off certain blood vessels and hoping that the remaining blood vessels will carry the load and if the patient does not have good blood flow, then the whole surgery would be a disaster. So so this has always been on my mind this blood flow. So I’ve been thinking about this blood flow along with health and I realized that hmm, maybe blood flow impacts our health and impacts chronic disease so this is what’s taken me at this point
Naren: right and you dedicated like I mean I remember somebody telling me you read like thousands of articles on all kinds of subjects around medicine and health
Dr. Kwan: yes no I read thousands of Articles dealing with basically centering around basically blood flow but you know reading things on sugar cholesterol just a heart disease or diabetes and and all these other things so I and and how the blood flow can impact every aspect of our body yes so I and there are many many articles that are available these are research articles done by done at a really prestigious institutions like Duke University, Harvard, UCLA Colombia. So these are really and worldwide as well all around the world at prestigious universities. So these this these research articles and these research papers are out there. So I I read the pertinent ones and I continue to read it, read these articles and and this has sort of gotten me to writing this book.
Naren: right well what surprised you when you are doing all this research like is there anything that just I didn’t I mean that you saw that you didn’t expect to see?
Dr. Kwan: well you know at the beginning I thought that certain things like cholesterol for instance I thought cholesterol was a major problem with our blood flow and which I will talk about later cholesterol is the totally the opposite of what we think about. So, and and just our recommendation by both the our government and the nutritional sort of advice that we’re given is you know largely sort of not true in many respects. So I mean of course it’s influenced by many sort of third-party interest groups but those things that really surprised me. I mean the recommendation we get for the type of food we should be eating to even what really affects our health to how we should take care of our body, all those things surprise me. In fact and and and this is what I wrote in my book
Naren: I guess humans have survived on this planet for tens of thousands if not you know hundreds of thousands of years. So, so, nature kind of knows how to take care of us and I think what has happened over the last 100, 200 years especially in Western countries is you know everything has become a big business from you know Pharms, Pharma, Pharmaceuticals to the food industry to you name it so what we are told is the right way to do things perhaps is not necessarily the right way to do it
Dr. Kwan: Well, it’s funny though the way we eat in Korea when I was when I was a child was we pretty much ate what we call Whole Food, whole food, or or based on really a lot of plants because we couldn’t afford to eat a lot of meat but we did eat some meat but these are really not processed meat. They were either pork or chicken or beef, every once in a while but a lot of it was fresh fruits and vegetables and of course this is what we ate and I grew up partially in Korean country stuff and this is what sort of what Doctor Colin Campbell was talking about in his book. The rural Chinese sort of ate the same this kind of same diet and then we came to America and of course we traded in a lot of that for for eating you know mcdonald’s Burger King Kentucky fried chicken mac and cheese and a lot of processed food and then we added a lot more red meat into our diet. So we went from sort of plant-based hopefully diet to this processed diet filled with a lot of refined carbohydrates and and processed meat.
Naren: yeah I would love to go deep in one of our upcoming episodes on this topic. let’s talk about cholesterol I know we are told that cholesterol is a bad guy you know. Can you elaborate on this point. What did you discover in your research?
Dr. Kwan: well you know I think even before cholesterol which well when we talk about cholesterol we’re talking about what the cholesterol does to our body right?
Dr. Kwan: cholesterol causes plaques and causes blood of blood vessels to block be blocked and then of course the blood flow can’t go right that’s that’s the sort of the center of the argument against cholesterol, okay, that our body processed cholesterol and cholesterol floats around in our bloodstream and it causes a blockage because it deposits in the blood vessel wall and of course the blood vessel wall gets thicker and then the plaque rose and then blood flow cannot go through that’s the narrative that we’ve been told. The way our blood flows in our body is essential to the health of our body. What does that I mean that sounds very simplistic, but what blood does is it carries both oxygen and nutrients. So when we when we breathe oxygen goes into our lung and then it goes into our blood stream. When we eat the food is it goes into our stomach into the intestine, it gets absorbed and processed by a liver and goes into our bloodstream. So we have this oxygen nutrients and that needs to get to every cell in our body, right, and, and, and, and, it does this through blood flow it does through our circulatory system which is a major I call a super highway, I call it really super highway which which carries these substances and every cell needs it and depends on it and if the cells don’t get enough of it, then that’s when they get in trouble and this is where the the the Genesis or beginning of the disease process and our blood vessel, if you look at the blood vessel basically our blood vessel has the ability to expand and contract, okay. Again most people are not that familiar with this but it but but the blood vessels are not a static static structure meaning that our arteries, now Our arteries and veins Our arteries are able to expand means it kind of dilates out it could dilate up to about 50 larger than it’s it’s a resting diameter. So you could dilate out. Why does it do this well when we need more blood flow it has to do this, right. For instance when we exercise our muscles need a lot more blood because it needs a lot more oxygen and nutrients, right, maybe when you exercise so there’s a lot of demand for it. Therefore we must increase the blood flow. So our blood vessels dilate at the muscle level to deliver this. It dilates quite a bit so our muscles will get it but also our heart which has to pump a lot harder to deliver more more oxygen nutrients. Our heart has to pump harder, you know that when you run your heart is pounding right because
Dr. Kwan: heart has to pump harder and and our heart is made up but mostly muscle. It’s a it’s a muscular structure it’s a muscular pump really that’s what our heart is. So the muscle has to pump it because the muscle is the heart as well the heart itself needs oxygen and nutrients, when it’s working harder. So when we’re exercising our muscles in the body needs more oxygen and nutrients however our heart has to do that so when our heart is pumping to pump all that blood out to the body, it itself needs lots of oxygen and nutrients. How does it do that it does it? Through these small these blood vessels called coronary arteries people have heard of this it’s called coronary artery. These are the blood vessels that delivers oxygen nutrients to the heart muscle directly, okay. So, during exercise these coronary arteries will surely dilate just like it does at the muscle it dilates. When it dilates more oxygen and nutrients get fit and how important is this coronary dilation? Well just think about this if the blood vessel dilates by 50 percent, then I mean if the diameter dilates by 50 percent, it’ll deliver five times more blood. Just dilating 50 percent, it’ll deliver five times more that’s a huge difference so at rest versus when you’re exercising your blood flow to the heart can go up by five times and it needs that, it needs all that oxygen and nutrients, but then if you have a problem in the blood vessel like your plaque the position and the blood vessel now contracts down and it becomes stiff which is opposite of this sort of we’ll call flexibility and if the blood vessel now narrows by 50 percent which can happen when the blood when when the arteries get the get clogged from atherosclerosis or plaque now if you just reduce it by 50 it’ll slow the blood flow by 94 percent. So to reduce it by 94 percent that’s again a huge difference. By just narrowing it by half you now reduce the blood flow by 94 percent. So your cells are going to really suffer if you get that little oxygen and nutrients right.
Naren: right, I mean just to think back to you know I’m a big fan of you know watching war movies and stuff I know like even going back hundreds of years if you want to destroy the enemy you just you know their supply lines you know that’s kind of what keeps the army or the forces alive you know the supply is coming. In same thing here right the blood flow is what keeps all our cells healthy and functioning. So you’re saying, if that blood flow is impacted, then that’s at the heart of the problem that’s
Dr. Kwan: yeah so so all these process that happens. So these are blood vessel disease that can happen in our body, and it happens because it doesn’t happen accidentally, you know these the the injury to the blood vessel wall, we’re talking about blood vessel wall now because when we talk about blood vessels themselves, yes the blood flow is inside this is as you can imagine as you could just sort of picture it as a tube it’s a pipe so the pipe that and all the fluid is is flowing in that pipe including that’s all the blood carrying oxygen nutrients in all the other cells in our blood within the within the blood but the but the wall itself is what’s containing it, and that’s called the blood vessel wall and that in that in in class, that’s what happens. So the plaque deposits in these walls and then the walls kind of grow out and it impinges on the on the blood flow and so that’s what we call atherosclerosis but even before that happens, even before plaque happened it can get stiff. So if you just take away as that just described about vasodilation and vasocontraction which means blood vessel dilate up. Even if the blood vessel does not get all that plaque that that could impinge the blood flow, even if it becomes stiff, and it loses its ability to be flexible, then as I just described you’re going to lose a lot of flow, you’re going to reduce considerable amount of flow, right, just by not being able to expand. So maybe at rest. So for many people at rest they may be fine because they don’t their body does not require any more oxygen than what it is, just a at a resting level but this is when your blood vessel is stiff and it can’t expand out, when you’re exerting yourself then you’re going to get in trouble. That’s why many people have this chest pain, when they’re dirty you know that the traditional idea that when they’re shovelling snow then a lot of sort of that that heart attack or that sort of that chest pain angina occurs during that process because when they’re exerting themselves, at rest they’re fine because their body doesn’t need any extra blood flow but when they’re exerting, now they need a lot more blood flow and the heart is pumping harder, the hear itself needs a lot more blood flow. It doesn’t get it because the blood vessel is very stiff and unable to expand. So then patients develop chest pain and chest pain is basically telling us stop what you’re doing, right, it’s a signal it’s a
Dr. Kwan: Stop what you’re doing because you’re going to get in real big trouble
Naren: that makes sense. So, I know we’re going to go into more detail about the blood vessels and plot build-up and everything else in in our next episode. any other takeaways doctor that you want to leave our audience with?
Dr. Kwan: well you know there are so the plus as I just described this blood flow is very important for our health because every cell needs it and and really some of the good advice I want to give people advice on how to do this so some of the things that we can do. There are foods that are rich in nitrates, it’s such as it is nitrates and flavonoids and we’ll call L-Arginine these are foods such as nitrate rich foods are like spinach, beets, leaf lettuce. these things basically gets converted into Nitro you know nitrites and then it gets converted to nitric oxide and nitric oxide is really essential in causing the blood vessels to expand or vasodilate. So athletes know this very well so they consume a lot of this but just not athletes or any one of us or any one of us can have a diet full of these kind of food these sort of leafy leafy type of vegetables that are that contain tons of food that’s going to be converted to nitric oxide and relax our blood vessel. That’s why many nutritionists are advising that we eat these kind of food and flavonoids are also in berries and, and, so forth and these also are importantly in in causing vasodilation, in our blood vessel. So yes I’d like to there are things that we can eat dietary wise then we can eat that can actually help our blood vessel do a better job by dilating and there’s a whole list including spinach kale and wheat broccoli. We heard eat your broccoli When We Were Young right and this is very very reasoning is it’s going to keep you healthy because it’s going to have your blood vessels dilate up and and improve the blood flow.
Naren: Makes makes total sense. in terms of food most of these Foods typically like plant-based food is that what you’re finding?
Dr. Kwan: no no well yes a lot of plant-based foods contain these however L-Arginine I was talking about it’s an amino acid called L-Arginine, they’re found in red meat chicken fish cheese and even milk and eggs and nuts and almonds walnuts. So yes to even meat contain these kind of food that can help you with vasodilation. So it is not only plant-based food. Yes plant-based food have a lot of other rich in nutrients along with minerals and phytochemicals, however even Meats contain compounds that will essentially help you with vasodilation, but I’m talking about Whole Foods whole Meats not processed meats
Naren: right right the last question before we wrap up this episode, I’m sure this is a question that a lot of people have asked you before. What’s the most common misconception that people have about their health?
Dr. Kwan: well there’s a I think there’s a there are a lot of misconception about health. I think people feel that in general that this whole idea of preventing medicine or prevention is not that important or it’s still laughing on their mind. People think that they that the the body will take care of themselves and they don’t need to be proactive about their health. They believe that I think most people are very complacent when it comes to their health. They they think doctors will take care of them doctors will take care of their health. Doctors cannot take care of your health doctors will treat your diseases. So you go to doctor and you know honestly when we were in medical school, we were taught all about diseases we weren’t really taught about how to stay healthy or how to keep our patients healthy. That was not discussed or taught to us. We were taught how to diagnose the disease, what does the disease look like in the microscope. What does disease look like clinically and when patients develop disease what kind of medicine or surgery can we do to take care of that disease. So in there there’s nothing about how to keep patients healthy or so-called preventive medicine and for people, I think the biggest misconception is they think doctors are there to help them keep healthy. So they’ll say oh yeah I go to my doctor and doctor will keep me healthy, no doctor will not keep you healthy who’s going to keep you healthy you each individual person is going to keep themselves healthy or sick or diseased right. So what I’m saying is you need to know how your body works, in order to be healthy in order for you to be healthy you need to know how your body works and take care of your body every day. Your tasked, each one of us is tasked with 24/7. In taking care of our body right we want to and in order to take care of your body that means including what should I eat how should my physical activity look like. Should I smoke or not should I eat this kind of thing or should I do this or that, all those things you need to know if you know then you can take care of your body because no one is going to keep you healthy other than yourself. So certainly though obviously this this is learned. You could certainly learn some of this through your self-education. However sometimes internet could be sort of overwhelming and there’s some conflicting information out there, and doctors are not going to really tell you this either. So if you have some good friends or some peers or there are a few Physicians right now around who are doing this sort of what we call Integrated or just preventive medicine, when they will go over with you. Nutrition nutritional aspect and physical aspect of how to keep yourself healthy. So again I think the biggest misconception is people feel that they don’t need to keep them they don’t need to do anything. Remember what we do is when we’re young little we go to a paediatrician all of us go go for wellness visits right, Naren, we all go to doctor and paediatrician until we’re 18 years old. The doctors, the paediatrician will tell you do some of the blood work they’ll measure you they’ll do this and sort of measure what your progress is you know paediatricians are really at that point in most kids don’t have any kind of diseases right,
Dr. Kwan: because the paediatricians are already doing this when they’re young when we’re young but as soon as we turn 18 somehow we think and then of course we leave our home sort of the nest we leave our nest and then we go out there and we never go see a doctor I mean or we never even think about our health at all, until guess what until we become diseased right which will be in our 40s or 50s when that disease strikes then we go to the doctor and say what happened. Well for 25 to 30 years most people haven’t done anything anything to help their body and they’re not done any kind of preventive measures. They’ve just eaten sort of eating probably a lot of wrong food smoking and not doing enough physical activity and then of course the you know their their body gets worse and worse and finally it gets to a point where symptoms are now becoming very visible. When the symptoms strike for instance when your blood pressure goes up you’re not feeling when your blood pressure goes up or you’re feeling a little dizzy because your sugar levels are very high and then or you get this chest pain because you’re exerting yourself because you’re now diseased then you go to the doctor. By that point it’s already this disease has built up for many many years and it is not too late even at that point, but you know I believe you don’t have to do this and this is a largely misconception I think by the public, thinking that they’re okay they’re healthy when they’re not.
Naren: thank you so much doctor I think there’s a lot of interesting takeaways from this. I think you are kind of going to the heart of The Challenge which is around you know making blood flow you know happen better for us and trying to you know go into the details which we’ll cover in our upcoming episodes. You talked about some of the misconceptions that somehow doctors will keep you healthy, not really you you know only you are with you 24/7. So the person who can keep you healthy is you and a lot of that has to do with you know what we eat
Dr. Kwan: yeah and I want to really emphasize and I’ve been thinking away thinking about this now for a bunch of years. Your blood flow I mean it’s again I want to emphasize how important blood flow is. It’s just the fact that the blood sort of circulates in your body and go through these blood vessels, okay. It goes flows through these blood vessels it starts at the heart goes down to bigger blood vessel which Narrows down Narrows down and then Narrows down into the smallest of the blood vessels called the capillaries and capillaries is where all the oxygen and nutrient exchange occurs and this whole process is what keeps us healthy and really every chronic disease is defined by this by the way. Every chronic disease has its origin because of this, and so if you can improve just this mechanism then I assure you can become healthy and this is where I’ve been pushing towards every disease, I assure you even cancer, is based on this. It has its origin because our cells suffer and don’t get enough blood flow. Okay
Naren: that’s an amazing note to end our first episode with. Thank you so much Doctor Kwan, for taking the time and of course for writing the book and anyone who’s interested you can grab this book it’s called Let It Flow you can grab it on Amazon you can get a printed copy a kindle copy and you know so please read the book and and start sending us questions and of course also share this podcast with your friends you know forward it to them post it on social media, write a review for us on itunes. Thank you so much for listening and thank you so much for Doctor Kwan for what you’re doing for the for the people at large and of course you know people in the profession the healthcare providers so that we all can start thinking about you know really having this conversation with patients and really having this dialogue as a as a species thank you so much Doctor Kwan
Dr. Kwan: thank you I look forward to more episodes, thank you.
In this episode Dr. Kwan speaks about why and how he became a plastic surgeon, the importance of eating the right foods to help our blood vessels dilate and discusses the fascinating topic of blood flow and our health.