Naren: Hello everyone, welcome to another episode of Let it Flow. This is our second episode of this podcast show, and once again I’m excited to be joined today with Doctor Kwan. Doctor Kwan welcome

Dr. Kwan: thank you very much

Naren: in today’s episode, I want to kind of dig deeper in the second in the first chapter of your book you know you’re talking about blood vessels, blood flow, and plaque build-up. So let’s go through one by one. What do you mean when you write about flexible blood vessels?

Dr. Kwan: Just basically flexible blood vessel has the ability to expand and contract, and that’s vitally important because if it does that then the blood flow will be good and when we get diseases such as plaque buildup or stiffness the blood vessel, that’s the beginning process of this sort of the blood vessel disease then blood vessels will not have this loses ability to be flexible and not expand and then of course what that means is less oxygen and nutrients get delivered to the cell and that’s going to really impact every cell in our body and lead to all these diseases that we talk about.

Naren: so let’s go a little bit deeper on this so I have a follow-up question so when you say flexible blood vessels, so you’re saying when we are young and healthy so let’s say a two-year-old baby the blood vessels are very flexible, right, and can you give us some examples of you know a two-year-old baby versus maybe a 50 year old man and what happens

Dr. Kwan: yeah well for a younger person to have a flexible blood vessels now if you’re going to look at the flexibility of all this so you want to look at the blood vessel wall. Blood vessel wall in the previous episode I have not discussed this there is a in the middle layer of the blood vessel wall is called a vascular smooth muscle. The smooth muscle is tasked with basically contracting and relaxing. So our blood vessels are filled with with muscle. In fact the muscle is the majority part of our blood vessel wall by the way. The muscle it’s called the vascular smooth muscle and this vascular smooth muscle as you know it’s like muscles and anywhere in our body it can contract and expand right

Naren: yes

Dr. Kwan: if you contract basically it can contract them sorry it can contract like a muscle right so muscle we think of typically muscle we’re talking about like most on our legs or our biceps right when we contracts it tightens, right?

Naren: Right

Dr. Kwan: so that’s what that’s what the muscle of vascular smooth muscle is similarly, it tightens or it relaxes, okay. So when it tightens it’s called contraction. When it contracts sort of it tightens the blood of the wall and makes it narrower. So it’ll do that why does it need to do that why didn’t he just based on that why doesn’t it just expanding well it needs to do that if there’s a if if we need to increase blood flow some other part of the body because we only have about five to six liters of blood in our body. That’s total, for average person that’s all we have that’s it so we with that blood we need to circulate and perfuse our entire body with oxygen nutrients. So, so, we need you know when we’re working hard and our muscles needed it, we need to contract to somewhere else and shunt the blood to where we need it right?

Naren: right

Dr. Kwan: that’s why you need to contract that’s why contraction is important and then what’s another example when we go outside for instance when it’s cold outside if our blood vessels are expanded and dilated at the skin we’re going to lose a lot of heat. We don’t want to do that so our blood vessels contract with the skin so that’s why we become pale looking we become pale and so the heat can be preserved in our inner core of the muscle, and we’re not going to become hypothermic, right. So that’s important the flexibility of vasodilation, vasoconstriction. When we experience sustain an injury we get a cut you don’t want the blood vessels to stay expanded because then we’ll lose a lot of blood. It’ll contract down so we’ll lose less blood while, while, we develop a clotting there, right. So these are this is important, important, function. So our body needs to do expansion and contraction and and that is controlled by the vascular smooth muscle, which is which is made up of most of the blood vessel, the wall.

Naren: makes sense, so you’re saying the blood vessels, contracting and expanding is so important to our survival, you know, A because hey we have limited amount of blood so that blood has to be pushed to the right places and then like you talked about to

Dr. Kwan: We need, we need to shunt that blood where we need it, right? When we’re eating, when we eat we need to digest all that food and we need a lot of blood flow in our intestine, right?

Naren: right

Dr. Kwan: sort of taken away from the muscle, it’ll take you away from the muscle and by the way it’ll take away from some of the brain too, right, because we need it in the intestine, that’s why you become sleepy, right, you can become sleepy because now you’re taking away the blood flow from your brain. Also if you exercise right away while you’re eating after you eat you’re going to get stomach cramp right?

Naren: Right

Dr. Kwan: or you get so so because you you need the blood flow right there, and it’s taken away and if you get muscle cramps as well. So you don’t want to do that you don’t want to exercise right after you eat right,

Naren: right it’s like you know imagine having only a limited amount of electricity so you have to be very careful on how to use electricity

Dr. Kwan: yes we have only limited amount of blood and we planted all over the we need to put it where we need it we need to get it to where we need it and we do this through flexibility of blood vessels through vasoconstriction and vasodilates. That’s just everything is working properly

Naren: Right, right

Dr. Kwan: These can cause harm to these blood vessels and they become stiff and they don’t do this

Naren: this you know you’re explaining you’re making a lot of sense to me and I think most of us never really think about our health, and I’m guilty as charged and and when you explain it you know the way you’re explaining it Doctor in layman’s term, I totally get it, you know, like I think we live in a world where there’s infinite amount of energy in finite amount of stuff. So but a human body is not in finite there’s a limited amount of stuff and the body is smart enough to use it effectively and efficiently to kind of you know Keep Us Alive and Well for as long as possible. So thank you so much. I think the blood vessel the flexible blood vessel I think is a key point there am I I think correct doctor?

Dr. Kwan: and and just to go back to the initial question, younger people have this younger people have flexible blood vessels. As we get older our blood vessels become stiffer. It becomes stiff and we we lose its flexibility and of course of course, so when one study showed that when when when they exercise all their life and their athletic type of person their blood vessel was just as flexible as younger people. So your blood vessel does not have to lose flexibility as we get older. It loses flexibility because we get diseased blood vessels, not because it’s a natural process process of Aging. It’s a part of aging necessarily. It does it because we cause diseases. So when they looked at there was one study that was done at out of Canada mcmaster University where they looked at people, they and even that oh that even that study showed that people older people will have flexible blood vessels and it impacts the quality of their skin, you know and that’s important and there’s another study actually I was confusing with it another study done in Italy, which showed that the people who are older who have flexible blood vessels actually have blood vessels that are just as flexible as their useful counterpart in their 20s. So even people in the city 60s can have the same flexible blood vessel as a 20. Even athletic 20 year olds.

Naren: right

Dr. Kwan: This is important for us to learn and keep in mind

Naren: and we should talk about this in one of our episodes about how do you keep your blood vessels flexible you know as you get older

Dr. Kwan: so, we’ll talk about this in in the later in the later podcast

Naren: perfect my next question doctor what exactly is plaque buildup we all talk about plaque I think it’s one of the top keywords that we all know of I mean as an average you know people would think about health so what exactly is plot buildup

Dr. Kwan: plaque buildup is when when things like cholesterol and other material, fatty material basically deposits in our blood vessel wall. So you know deposits there and it’ll limit the ability of our blood vessels to be flexible and also it could impinge on the way the blood flows because it blocks the blood flow because it can literally impinge by ballooning out as the plaque grows the the blood can’t flow but if you look at what the whole process of what is plaque, how does that occur, I think there’s a big misconception and the what’s been sort of talked about in the by the by The Physicians and by by people and the understanding of lay people is that plaque is caused by cholesterol. That is absolutely not true

Naren: that’s what I thought

Dr. Kwan: that is not the original plaque. Plaque is due to injury of the blood vessel. Think about this your blood vessel wall the problem with the the whole problem that begins the plaque process is that your blood vessel wall gets injured. Why does it get injured well there are a lot of things that could injury. What what causes the biggest amount of injury well what causes injury bad food for instance processed food with chemicals that goes into our blood vessel because anything that we eat goes into our intestine goes into our blood vessel. So if now you have these chemicals in your bloodstream floating around and your body doesn’t know what it is and these chemicals start damaging the lining of the blood vessel wall called endothelium when you do that now you’ve got an injured blood vessel, your body has to respond. What else can cause blood vessel laundry any kind of toxins including smoke can cause or any other things that you can think of even pollution smoke bad food all these things can cause blood vessel wall injury. So really initial and even viruses and bacteria causing blood vessel wall injury. So you need it you start with an injury. Injury is what causes plaque. So again, cholesterol doesn’t cause plaque, injury causes plaque okay? So you have to think of this way. That only makes sense. Cholesterol is very abundant substance in our body which I’ll talk about in later session. I’ll go really deep dive into what really cholesterol is but cholesterol is one of the tools that our body uses to repair an injury. So you have this injury and this injury sets off a motion of of this process called inflammation, you know what inflammation is right? Inflammation is a an immune response. Who did not ask somebody what is inflammation most people are are puzzled. They don’t know what it means. Well inflammation is simply an immune response. What is what do you mean by immune response? Well it’s our body saying that something is there that shouldn’t be there and we need to fight against it because it’s going to damage us, right?

Naren: right

Dr. Kwan: classic example of an immune response is if a bacteria enters our body then the bacteria is going to destroy our body in order to fight that our body has to mount an immune response and this immune response is stop is carried out by white blood cell in our body and so white blood cell will neutralize this but this whole process doesn’t start. So usually when a vector enters our body it’s short lasting our body sort of mounts the amounts of an immune response gets rid of the bacteria and we’re fine right and those process usually last about 48 Hours 72 hours usually, and it goes back to normal but what happens is there’s another part of inflammation called chronic inflammation have you heard of chronic inflammation Naren?

Naren: I may have heard of it but I may not understand it

Dr. Kwan: again this chronic inflammation is really a, a, a, a, phrase and many people throw around without understanding really what it is okay. Chronic inflammation is an immune response again as soon as you see information you have to think immune response okay?

Naren: okay any new responses our body’s trying to protect itself okay that’s what a new response is all right we our body is built in with this beautiful immune response immune system that is capable of monitoring it because if something foreign Invaders come in you want to neutralize it right you don’t want it to take over your body right however if there’s also foreign substance not just Invader foreign substance like chemicals and things that enter your body you have to also respond to them and we do that through immune system and the problem with the chronic inflammation is when people, let’s say smoke I mean do they smoke one cigarette and they don’t smoke for the rest of their life

Naren: No

Dr. Kwan: no they’re going to smoke every day right?

Naren: right

Dr. Kwan: do they eat processed food today and say oh I’m not going to eat it tomorrow, right? Or are they going to be exposed to pollution today and that be exposed to tomorrow, no. It’s what happens is our body you pump in this Castle into your body so our body has to mount this immune response and that chronic immune response is called chronic inflammation. It has to do it. It has to do it. Otherwise it’s going to destroy us so a new response this inflammation is actually the best mechanism by our body that our body develops to to fight against this, and I think I want people to understand that could. Inflammation is built-in response that we our body uses to fight off and to defend ourselves, okay. So it is vital however in chronic inflammation unlike your normal acute inflammation, when a bacteria invades and you neutralize them goes away, chronic inflammation is if it lingers around. In other words our body is constantly attacked. It has it’s undergoing a Relentless attack, okay, and it’s pumping constantly this bad chemical or bad poison into our body and our body has to keep fighting and that’s chronic inflammation. When you have chronic inflammation, our bodies trying to Simply repair it. It’s trying to repair and so when you have chronic inflammation the destruction the blood that the wall sustain major damage, major damage, and I think uniformly now honestly in the medical literature among doctors they agree that chronic inflammation is a central figure in atherosclerosis and plaque deposition, okay, and they still State cholesterol though. Somehow they play that is cholesterol no. Cholesterol is a tool that our body uses to use it as a patch in fact cholesterol is in every cell in our body. Cholesterol is in every cell in our body. In order to in effect the cholesterol is anti-inflammatory. This is news for everyone. The cholesterol is anti-inflammatory it actually helps fight inflammation not pro-inflammatory. So the cholesterol is not causing a plaque. Cholesterol is used to repair a damage and when you repair damage, yeah you’re going to get a little plaster because that’s like a scar on the blood vessel wall, right. It’s a scare. So that’s what plaque is. So we use cholesterol not only do we use cholesterol, we use other other fatty acids as well like phospholipids, we use triglycerides, we use fatty acids we even use platelets we use other stuff, all part in trying to patch the wall up. So that’s all involved in in plaques. So plaque is again it’s an inflammatory with it’s an it’s it’s an it’s a result of inflammation. It’s an inflammatory response due to injury injury has to be there first. You get injury you get chronic inflammation you get inflammation and then you get plot deposition, but what’s really dangerous about this chronic inflammation is that not only does it lead to plaque but also when you have inflammation chronic inflammation, it I talked about this before in previous session, oxygen exchange occurs at the level of capillaries, right Naren? Capillaries

Naren: yes

Dr. Kwan: those are the smallest blood vessels where the oxygen nutrient exchange occurs. That’s one that’s that’s when the blood dumps off let our blood vessel dumps off oxygen nutrients the cell and then takes in waste product and carbon dioxide. What happens in chronic inflammation is your capillaries are destroyed. Many of the capillaries shut down and they stop functioning. That’s the real danger of chronic inflammation. So your blood vessel just seeks to function at the very important level, at the level of the capillary, and when they when the capillaries don’t function properly believe in your cells will not get enough oxygen nutrient and then they suffer and when the cells suffer that’s when all the diseases occur.

Naren: let me let me make sure I understand this. So when your cells get injured, right,

Dr. Kwan: when you’re yes

Naren: and it can get injured for all kinds of reasons like the chemicals the process

Dr. Kwan: When we’re talking about in the context of plaque, we’re talking about blood vessel walls those are the blood vessels walls

Naren: blood vessels walls, exactly, blood vessel walls when they get injured they can happen for all kinds of reasons. Mostly the kind of food we eat you know lack of exercise you said you know when you exercise your

Dr. Kwan: or even or even inflammatory cells. There are various things yes like cytokines that are that are that are expelled into our body because we’re overweight or because our insulin level goes up or sugar and I’m going to talk about this a lot, sugar is a major cause of damage to the blood vessel wall,

Naren: right. Even smoking or you know pollution all kinds of things right with inactivity, so all these things like you said oh wait I’m being overweight all these things can injure your blood vessels right? So when when they get injured then so that’s when inflammation starts happening meaning it’s the immune response?

Dr. Kwan: yes because injury means as soon as it’s injured also are we have to repair it, right, repair the injury

Naren: yeah

Dr. Kwan: inflammation is repair process is part of inflammation, yes, yes. Initially what inflammation does is inflammation has multiple arms. The first arm is to neutralize, neutralize, the, the, toxin or the Invader the foreign Invader, okay, that’s the number one task. Number two task is to repair it, okay. So inflammation once they neutralize it, it now it’s damaged the blood in this example blood vessel walls damaged now it must repair the blood vessel wall injury.

Naren: so what is it trying to neutralize so let’s say we eat a lot of chemicals and processed food is it trying to neutralize the chemicals?

Dr. Kwan: no it’s trying to neutralize the damage that the chemical has done

Naren: okay got it and and chronic inflammation meaning we keep damaging it I’m overweight for the last 10 years so I keep eating processed food every day. So so that’s why it’s chronic?

Dr. Kwan: you’re damaging your cells every day and the only way your body can take care of that damage is through your immune system and that immune system is chronic inflammation

Naren: right as opposed to thousand years ago we didn’t you know be very active you know we had to hunt or do whatever we need to do every day to eat

Dr. Kwan: yes

Naren: you know we have any chemicals or any processed food. So so there was less damage at least not chronic damage right, so

Dr. Kwan: there’s no and this goes very basic to The China Study where the rural Chinese don’t damage their blood vessels this way with inflammation

Naren: right

Dr. Kwan: they don’t eat all this kind of stuff and they’re fairly active

Naren: so the plaque is is so when when chronic inflammation happens, so it’s it’s a human I mean our immune system is trying to you know protect ourselves, then the plaque builds up as a byproduct of that. Is that what happens?

Dr. Kwan: yes, plaque is sort of a patch, you could look at plaque as a patch

Naren: okay

Dr. Kwan: plaque is a patch but it goes you know it goes even deeper than that. Plaque is a patch but also plaque is they’re they’re a deeper layer to plaque which I will go over in later because this is a little more sophisticated

Naren: yeah

Dr. Kwan: because our body is tasked with you know I talked about the vascular smooth muscle before. Even our vascular smooth muscle is involved in plaque formation because our because what our blood vessel is trying to do is he’s trying to keep itself healthy, right?

Naren: right

Dr. Kwan: that’s the job of the the blood vessel wall is trying to keep itself healthy because it has to keep itself healthy. So the blood will flow nice and smoothly through it wall through its lumen, right? Through the tube. So blood vessel wall is constantly trying to do that and we are constantly trying to destroy it. So what I have to constantly modify itself and and so when it does that when our blood vessel wall gets injured it undergoes different changes, including one of the one of the most important changes and what I was talking to you is called the endothelium. This is the lining every blood vessel in our body and the Heart Is lined with this one cell say, the tissue called endothelium, okay? And this endothelium is very vulnerable to injury and this this endothelium provides a nice smooth sort of wall, so our blood vessel blood flow will be nice and smooth, but this endothelium will get damaged because of all these toxins. That’s one of the mechanisms of blood vessel wall injury, probably one of the most common mechanism of blood vessel there are other mechanisms of injury including other chronic inflammation which will damage other parts of the blood vessel wall from the outside which will then also cause injury, as well. So all these what I want anyone to understand is, plaque starts with injury insult and injury okay not cholesterol. That’s what the takeaway is and it only makes sense right, it’s injured so it needs to repair itself. Why cholesterol is made in our liver and we’ll do a deep dive into cholesterol. We’re going to really that that it requires a whole session itself however cholesterol is a tool that our body uses and it’s made by the liver. It’s a it’s a tool that our body uses and we have plenty of cholesterol on our body. Our body makes thousand milligrams of cholesterol every single day. It just makes it. No matter how much you eat it still makes it makes a good amount to keep a nice level of cholesterol in your body. So this whole idea of trying to artificially lower your cholesterol to me it doesn’t make any sense then it’s dangerous. Your body needs cholesterol to heal. So blood the so the blood vessel and the plaque is due to injury, due to injury and injury and chronic inflammation and if you could think of it that way what can we do to prevent it. It is not to be on a low cholesterol diet or trying to take medication to lower the cholesterol but to stop the injury, right?

Naren: Right, you can’t keep breaking your leg every day and hoping that it’s going to heal I mean like when a sports person gets injured they make him rest for six months or three months till it heals

Dr. Kwan: You can’t keep eating toxins every day and then taking statins to lower your cholesterol level. You’re going to be okay? You’re not going to be okay. You’re going to be fine if you stop eating toxins

Naren: right right

Dr. Kwan: that’s all alone and are the narrative has been you lower your cholesterol you won’t get plaque

Naren: yeah I mean but we are told is continue doing whatever the heck you were doing before but take these pills at night during the day and everything will be fine

Dr. Kwan: Naren,

Naren: that’s not true

Dr. Kwan: Naren, think about how ridiculous that sounds

Naren: I know

Dr. Kwan: think about how ridiculous that sounds, you could do whatever you do to your body injure it, but just take medication to lower your cholesterol level

Naren: right

Dr. Kwan: that’s the narrative out there. Does that make sense to you

Naren: yeah I mean it doesn’t make any sense I mean it’s just stupid it’s like

Dr. Kwan: people don’t understand that plaques occur from injured blood vessel wall. Simple right take away the injury no more plaque

Naren: right you could actually even reverse plaque by doing this. You could reverse pakques.

Naren: that’s amazing. Last question doctor for this episode how does plaque impact blood flow I think I know the answer but I want you to explain it?

Dr. Kwan: how does plaque

Naren: impact blood flow

Dr. Kwan: well many ways obvious. I told you the plaque you know basically it’s a it’s an evolution just like everything else. It doesn’t you don’t just form a plaque overnight right?

Naren: yeah

Dr. Kwan: it’s a slow process initially you may have small little patches here and there which doesn’t impact the blood flow at all but initially, when your blood vessel gets injured your blood vessel becomes stiff, okay, and we talked about this it’s a it’s it loses its flexibility, that’s how it that’s how the biggest impact is when you lose flexibility of blood vessel wall, it no longer can expand and contract. It just it remains thick and then you add in a plaque on top of that then it’s going to you know decrease the flow radically, but the first process is it becomes stiff. When the blood vessel wall becomes stiff, your blood pressure starts going up. Now let me just explain that. When your blood vessel wall becomes stiff. So what is the origin of the high blood pressure well when your blood vessel wall becomes thick it can no longer expand during when the heart pumps the blood vessel sort of expands out to receive the blood. It’s very flexible. When the blood vessel wall becomes stiff when the heart pumps blood to the blood vessel it doesn’t expand anymore it becomes very stiff. So now the heart has to pump through a tighter tube, right? Does that make sense

Naren: yeah it makes sense

Dr. Kwan: yes now the blood the heart has to pump through the smaller smaller tube smaller pipe. So guess what the heart has to do it has to pump a lot harder, right, because it’s a tighter pipe. So

Naren: yeah

Dr. Kwan: so when it pumps a lot harder, what is the pressure going to do pressure is going to go up in the blood vessel wall. So the blood pressure goes up, that’s the sort of the sort of where the high blood pressure comes from not only does that happen, when the heart pumps harder, now it’s pumping with harder force when that force is harder now the blood vessel is feeling that higher the higher pressure and higher force on its walls. When the walls are faced with higher Force, it starts to thicken. It has to thicken, it sustains damage and it starts to thicken. So the higher the blood pressure the thicker the blood vessel wall becomes it’s a response the muscle in the blood vessel wall becomes thicker because now it’s on the higher pressure and also damage is done. So the blood vessel wall thickens the becomes thicker and thicker. You don’t want thick arteries, really thickened arteries, okay, because now it’s stiff thick now you’re going to get a lot more diseases there. Now the blood vessel was thicker and you have more any and when any tissue gets thicker guess what it means more up, it needs more oxygen nutrients, okay. Anytime any any tissues get bigger, it needs more oxygen. So when the blood vessel wall gets thicker, it needs more oxygen nutrient and it doesn’t get that and it’s going to become damaged now. Now, you get injured so high blood pressure damages the blood vessel walls too. That’s another form of injury. Another form, and the funny thing about plaques, plaques, do not occur in veins let me repeat that plaques only occurs in arteries not vein only the larger and medium arteries by the way not in the smaller arteries either. Just think about that plaques only occurs and medium and larger arteries not in the smaller arteries and not in the veins. Now if you believe this whole cholesterol Theory, why doesn’t it do that. Cholesterol is in the same amount in the arteries, in small arteries, and in the veins. So this whole narrative about that cholesterol causes plaques doesn’t make any sense, right, because it only if plaques only occur in larger and medium, medium, and large arteries and the reason why that’s for the lay people who don’t understand what vein is, arteries are the blood vessel that that comes right out of the heart and goes to the cells. Vein after the cells bring it back to the heart. So veins are typically very low pressure, okay, when you talk when we talk about blood pressure that’s being measured at the artery. Veins nearly have half a third of the pressure is the as the artery. So it’s very low low pressure system, okay. So the veins are when you look at the veins they’re very thin the walls are very thin and they do not develop plaques. Do you understand that Naren?

Naren: right right so I’m trying to, why doesn’t the vein develop plaque, why doesn’t the vein develop plaque?

Dr. Kwan: what if you think that this it’s a cholesterol problem well it’s in occur in the veins

Naren: right right it should because if it’s cholesterol should have happened

Dr. Kwan: to just make that even even more interesting when, we take a vein and we do this often in heart surgery. Heart surgery we have a black artery in our heart. So we get sometimes we get a blood vessel from the leg they call saphenous vein. They’re veins okay. That vein will never develop a plaque there okay in the leg, because it’s a vein

Naren: yeah

Dr. Kwan: vein and put it into heart now it has to do a job of an artery okay guess what that vein will develop plaque

Naren: huh

Dr. Kwan: it becomes thicker right away and it develops plaque

Naren: right, so let me understand, what’s what what what is it what is it about arteries that makes it you know a place for plaque, as opposed to

Dr. Kwan: higher pressure and more injury.

Naren: so why isn’t the injury happening in the veins

Dr. Kwan: injury doesn’t well there’s lower pressure too, lower pressure and although they’re subjected to the same toxins, it’s it’s it’s not injured like the blood and doesn’t get thicker. It doesn’t get thicker, like the like the like the arteries and I believe this is my sort of take on all this

Naren: yeah

Dr. Kwan: well being discussed and debated in the literature and among researchers, why doesn’t this occur right

Naren: yeah

Dr. Kwan: and some of the literatures point to this but the veins are very thin wall right as I told you right

Naren: yeah

Dr. Kwan: and it has to do with oxygen and nutrients because it’s very thin wall the veins in any situation get enough oxygen and nutrients okay but it’s in the arteries it’s much the artery is about eight to ten times thicker than the veins

Naren: right it has to be because it’s pumping right it’s pumping it out

Dr. Kwan: it has muscle there’s a lot of muscle

Naren: yeah

Dr. Kwan: and so arteries must have the the wall of the artery has to receive oxygen nutrients too. Although the the way it receives its oxygen nutrients is through vocal diffusion, the blood goes right through the walls but the artery is so thick that it can’t do it all, just by diffusing. Diffusing means it just goes through naturally, right. Diffusion

Naren: right

Dr. Kwan: so when the arteries are very thick especially the thicker the artery the harder time it has getting oxygen and nutrients. So Our arteries develop this another system called it it’s got its own blood vessel system. This is funny it’s called Vasa vasorum. I mean this is a next level for most I think people may not understand it but arteries themselves have arteries, blood vessels, because they need it right

Naren: right

Dr. Kwan: Vasa vasorum and the Vasa vasorum themselves get blocked. So I believe it occurs because there’s lack of oxygen and nutrients to the blood vessel wall. I believe that’s the, if you drill it down to the very fundamental the very essence of it, it’s due to lack of oxygen and nutrient, just like any other cells in our body when they don’t get enough oxygen nutrients they develop disease right, I told it at the get go

Naren: yeah

Dr. Kwan: yeah the blood vessel wall similarly when they don’t get enough oxygen nutrients, they get diseased as well. Where’s veins, that’s not a problem because the blood vessel wall is so thin oxygen nutrients is no problem

Naren: so again it comes back to blood flow when the blood flow is not happening to the arteries they get diseased

Dr. Kwan: yes everything, Naren, it has to do with blood flowing oxygen and nutrients to the cell, whether you use blood vessel whether you use liver cell or whether you’re a muscle, everything has to do with the blood flow because fundamentally, blood flow is the way our body delivers oxygen nutrients to every cell. Without it and we can talk about this without oxygen nutrients our body cannot produce energy. Cells cannot produce energy, and if you can’t produce energy Life as we know it seize. It has to produce energy for it to move

Naren: right right and blood flow combined with oxygen and nutrients is what

Dr. Kwan: what brings the oxygen nutrients

Naren: right right makes total sense. I think we had a wonderful discussion you know in our second episode doctor where we discussed chapter one of the book let it flow. I really want to thank you for your time and I also want to thank our listeners. Feel free to share this you know on social media please write a review for us if you love what you heard and of course go out and buy the book because it’s a pretty easy read and and it’s a short book. So you know I read it like in you know less than a day. So just get the book let it flow. Flow is the true foundation of Youth so get the book read it and you know let’s have some fun. Thank you, Doctor Kwan,

Dr. Kwan: thank you very much