- Hey everybody I'm Doctor - (mic distorts)
I'm at the Heart Rhythm Society conference.
And I have the pleasure of talking
with Doctor John Day who's an electrophysiologist
at Intermountain Health in Salt Lake City, Utah.
Doctor Day thank you for being here.
- Oh, thank you so much for,
talking with me today. - Thank you for taking a few,
yeah, I really appreciate you taking a few minutes
out of your time to talk with us and be interviewed
for the website.
- Absolutely.
- So, I wanted to talk to you about how you approach
new patients when you see them, okay?
When you get a new consultation for a patient who has AFib,
how do you counsel them, how do you know
when people are better for, you know,
life style modifications versus diet,
or when is a procedure like an ablation
really a next best option for them.
You know I, in your approach, the first thing and probably
the most important thing is life style optimization.
Optimizing their bio markers, optimizing life style.
By that we mean, you know, focusing on nutrition,
getting the weight down, exercising daily,
embracing the stress, optimizing sleep.
And I find that if people can do that,
and you've probably seen the same thing in your practice,
a large percentage of them can put their AFib into
remission, or at least significantly decrease that burden.
So that's the, that's the best goal.
And the good news is, even if it doesn't work,
then whatever therapy we may offer, whether it be ablation,
etc, we get tremendous success from it.
And so, that's really where it's at,
and not only does the AFib go away,
but the diabetes, the hypertension.
- Yes, exactly.
- Their acid reflux, the anxiety, whatever else,
they seem to go away as well.
- And with the last guideline update for AFib
there's a lot of emphasis on weight loss
and how weight loss can really help AFib symptoms,
but patients a lot of times want a guide,
they want to know what can they eat, what can they not eat,
what diets are good.
Is keto diet good? Is paleo diet good?
You know, they want a nice guide of what to do.
And so how do you counsel the patient, are there certain,
would you say, just weight loss is important?
Are there certain foods that are important?
Food to avoid that are important?
- Absolutely. Unfortunately, I wish we had more data in it.
- Yes, yes.
- There are some data that a mediterranean diet
can be helpful for atrial fibrillation.
And as you know the mediterranean diet isn't
an all you can eat pizza and pasta,
but rather focused plant based, some fish, olive oil, etc.
But I think the main thing with my patients
is try to focus on the basics.
One, I try to tell them,
whatever vegetables you're eating, triple.
Just triple.
And hopefully it's not zero,
hopefully they've got something there to triple.
Sugar, processed carbohydrates, flour.
And it's not because of the gluten,
it's because flour really acts, behaves like sugar
in the body.
And, as everyone, at least most people
who are more health conscientious know
that flour will bump your, even whole wheat,
bread will bump your glucose more than a Snickers bar.
Not that I'm advocating Snickers bars.
But, triple the vegetables.
Get rid of sugar, processed carbohydrates, flour.
If they can just do that, usually the weight
takes care of itself.
- Right. Now when it comes to life style modifications
and changing diet, it's a bit of a long term strategy.
I mean, obviously weight doesn't come off
in the next week or two, you know?
- No.
- But when it comes to AFib symptoms.
Let's say you have a patient, and they say,
"You know what, I'm gonna change my life.
I'm avoiding sugar," all the things you just talked about.
Have you seen any cases where,
really the AFib stopped right away,
or does it still take a couple of months
to see any benefit from the AFib standpoint.
- Right, well usually they start feeling better immediately.
Now they may go through a sugar withdrawal,
a sugar detox, but once they get through that detox phase,
generally they start feeling better, the weight comes off,
their knees stop hurting,
they find their blood pressure now
is under much better control, they're not snoring at night,
and the AFib, just day by day, gets better.
It's not immediately overnight, but it does get better.
- Do you ever find that in the short term
until that process kind of takes place that you have to be
more aggressive with medical therapy,
like antiarrhythmic or other types of medications,
or even procedures just as a quick short term solution,
you know, for people who are in and out of the hospital,
and life style modifications might take a little while
to see it reflected.
- It may, and sometimes we do have to use
a short term antiarrhythmic,
but given the toxicities of that, and most people
who are willing to make life style changes
are usually not the same people who want
to take drugs for the rest of their lives.
But, for short term periods, sometimes we need it.
- Yeah.
- And, then, as we talked about,
sometimes they don't get that cured,
or maybe it puts it into remission for five years,
ten years, and then at a future date we do that ablation.
- Yeah.
- But if they're maintaining that life style,
those are the people that our ablations
we get tremendous success with.
- And obviously we just talked about life style,
I always tell people, my patients,
there's short term plans and there's long term plans.
And the diet, the food you eat, weight management,
whole morbidity about weight management,
is essential for your long term success,
whether that be just purely life style modification,
medication, procedures, everything works better
with better life style.
- It does.
- Now you're busy in the internet world.
You've got your own website, and your previous book,
do you want tell people who a little bit about yourself?
- Yeah, it's called 'The Longevity Plan',
and that really came about
with my own health transformation.
You know I hit my mid-40s, and one by one
I'm getting all these medical problems,
auto-immune disease, eosinophilic esophagitis,
hypertensive, overweight, and I really struggled,
and for me it was difficult even getting through the day,
doing procedures, wondering if I'm going to have to take a,
go on disability, or early retirement.
And so for me it was really a search.
For people who follow me know that I speak fluent Chinese,
and through one of these trips to China,
speaking on behalf of a medical society,
introduced to this village in China,
in the Longevity Belt, where they have
some of the longest life expectancies in the world,
more centenarians than anywhere else,
and they don't have all these chronic medical problems
that we have in the West.
- Yeah.
- And, in hearing that, at first I didn't believe it,
but it's like, I've gotta see. And through that experience,
and seeing, and being in this village in this part of China
with the highest percentage of centenarians in the world.
Deconstructing, what is their secret sauce,
doing genetic studies, and all these others.
We came to realize, it wasn't the genes,
it wasn't something in the water,
it was adherence to this healthy life style.
And through this, sharing it with my patients,
so many of my atrial fibrillation patients,
we were able to get them off drugs,
or perhaps a previous ablation wasn't effective,
we're able to then find relief for them
by coupling life style optimization with ablation.
And so, really, this book really represents what we found,
kind of the secret sauce.
It did well, it briefly hit best seller status,
we won a bunch of book awards, but it's something
that I recommend for my patients,
because, if you wanna beat AFib,
everything you need to know is there in that book.
- Well, please check it out,
'The Longevity Plan' by Dr. John Day.
Dr. Day, thank you for taking a few minutes of your time
to interview I appreciate it a lot.
- Oh thank you so much, happy to.