The Real Wizard of Oz

 A Conversation Between Mehmet Oz, M.D., and David Steinman

Is a doctor’s job to write prescriptions and do surgeries? To simply diagnose and    treat? To make judgments about how each patient should get well, without much regard to how that person might stay well? In a recent conversation, celebrated heart surgeon and author Mehmet Oz, M.D., set me straight about the real role of a physician: to educate and guide patients as they seek to live their most healthful lives.

Dr. Oz has devoted much of his seemingly boundless energy to educating the public about ways to promote and maintain optimal health through diet, exercise, and a solid understanding of the inner workings of the body. He is best known for his books, the most recent of which is You: On A Diet: The Owner’s Manual for Waist Management (Free Press, 2006), which he wrote with frequent co-author Michael Roizen, M.D., of the Cleveland Clinic. Their other collaborations are You: The Smart Patient: An Insider’s Guide for Getting the Best Treatment (Collins, 2006), and You: The Owner’s Manual: An Insider’s Guide to the Body That Will Make You Healthier and Younger (Collins, 2005). The books are light, even a bit on the irreverent side, taking topics that have generally been addressed in what he calls “sour, dour, downbeat” ways and injecting humor and fun. The cartoon illustrations are especially entertaining.

Dr. Oz has appeared on many television programs, including the Oprah Winfrey Show, where he now appears once every month on a Tuesday as the program’s official health correspondent. He helped to found the complementary medicine program at New York Presbyterian Medical Center, where yoga, aromatherapy, hypnosis, energy healing, acupuncture, music therapy, and visual imagery are combined with conventional medical approaches. He is also Professor of Surgery, director of the Cardiovascular Institute, and an attending surgeon at Columbia University College of Physicians and Surgeons in New York City.

Even with this incredibly busy schedule, Dr. Oz gave me the feeling that he had all the time in the world to talk to me.

What is your message?

It’s that you’re the world’s best expert on your own body. Don’t delegate that responsibility to anyone else! Your health team are there as teachers. The word “doctor” is from the Latin doctore, which means teacher. If I’m teaching you how to take great care of yourself, be a good pupil. Do your homework. Be prepared to follow my advice.

If you walk into a doctor’s office without knowing anything about your body and without well-thought-out questions, and if you expect to just be given a diagnosis and a medication or a surgery, your doctor won’t teach you. If you show up with a pad and a recording device and good questions, your doctor will teach you. That’s what we’re taught to do when we train to become doctors. In my practice, on any given day, I have patients who show up with thick Web printouts about their disease; I’ll spend lots of time with them, further educating them. Other patients…one showed up one day who sat down and said, “I’m told I need my valve fixed. When can you do it?” He didn’t want to get taught. He was scared and just wanted to get it over with.

What does a heart-health nutrition program look like?

I’m Turkish-American, and the traditional Turkish diet is the Mediterranean diet, and that’s how I like to eat. This is a diet that’s very rich in vegetables, fruit, nuts, and healthy oils. This also happens to be an extremely heart-healthy diet. It’s rich in fish and garlic, lots of spinach-low on the food chain, with lots of omega-3 oils from seafood, walnut oil and flax, and plenty of antioxidants and fiber, all of which are very good for the cardiovascular system.

You have said that fat isn’t the enemy. Is it the kind of fat? Which are good fats and which are the bad ones? How do flaxseed and fish oil play into this, and are they critical to weight loss even if they are fats?

That’s right…you’re supposed to have fat! Your body needs it to build neurotransmitters, cell membranes…What I recommend is that you push the saturated fats and trans-fatty acids out and incorporate more polyunsaturated omega-3 oils and, of course, olive oil, which contains healthy monounsaturated fats and all kinds of great antioxidants.

The omega-3s counter inflammation, which is known to harm the arteries and raise heart disease risk. They help reduce the “stickiness” of blood, reducing the likelihood of clots. And they seem to directly affect the ability of the heart to beat regularly and strongly. Flax contains short-chain omega-3s and fish oil contains long-chain omega-3s, which have slightly different roles in the body. The body can build the long-chain omega-3s from short-chain omega-3s, but the research strongly suggests that you’re best off getting both of them in your diet.

So I eat plenty of safe seafood and I also love flaxseed oil and flaxseed. I add the oil to my oatmeal in the morning, and throw some walnuts in there too for extra omega-3 fats.

I also suggest 2,000 mg a day of omega-3s from fish oil. I like to put some cod liver oil in a little glass of orange juice in the mornings. Choose a brand that’s molecularly distilled to remove toxins and that contains an antioxidant like vitamin E. And store all omega-3-rich oils in the refrigerator. I keep flax meal and walnuts in the fridge too, because those oils can go bad easily if exposed to heat or sunshine.

What other nutritional supplements do you recommend to your patients?

I recommend a B-complex, which helps protect against the damage stress can do. Also, for bone health, a supplement that provides vitamin D, calcium, and magnesium.

What is the role of health food stores and natural food markets for health?

Foods are drugs and act with the same power. If the owner of the store is knowledgeable, the store where you shop for food can be a huge help to you in choosing the best combination of foods and in giving you tips on how to prepare them. That’s probably one of the most creative ways. I love stores that combine organic foods with great nutritional support displays. And with supplements, there’s a lot to choose from out there, so if you have a store owner with a staff that knows its stuff, you’ll spend a lot less time wondering which ones are best for your needs.

What are your own special favorite foods?

Nuts. All nuts, but almonds in particular. Hazelnuts, walnuts. They’re rich in healthy oils, have some fiber and lots of energy. I also like raw vegetables: carrots, radishes, beets. Power foods like apples. Foods that can be transported easily, like citrus fruits.

Today I had melon for breakfast, some cut-up carrots, whole-grain rice with chickpeas for lunch, and a yam. I eat almost every other hour-except when I’m in the operating room-and I weigh less than I did in college. A half-hour before dinner, I’ll throw some nuts in my mouth to drive my ghrelin levels down. Ghrelin is the body chemical that makes your stomach churn, and by toning that down you can avoid being famished at dinner and overeating.

And how about eating out? Any tips for keeping it healthy?

The first and last 10 minutes of meals out are what really get people in trouble. In the first 10, the bread and butter come out; and in the last 10, there’s dessert. I send back the butter and ask for olive oil, and I only have a small serving of bread. And I have wine for dessert. Everyone else starts with the wine before the meal, which revs up your appetite and can get you tipsy if your stomach is empty. My wine comes in the middle of the meal, and I’m still nursing it when everyone else is looking over the dessert menu.

What do you think about organics?

There are a lot of very good reasons to eat organic, especially environmental reasons. Try to buy organic dairy, because it’s better for you and the environment. And some vegetables and fruits have small crevices that pesticides can get into: berries, broccoli, and lettuces. It makes sense to buy these foods organic if you can. If it’s a vegetable or fruit that can be peeled before eating, buying organic is less important. Don’t feel guilty if you can’t afford organic; you’re better off buying conventional produce than no produce.

What about dieting or weight management?

The overarching issue is this: You cannot diet hard; it doesn’t work. You have to diet smart. Appreciate the biology of blubber! Your biology is designed to go to your playing weight if you let it. You: On A Diet is all about this.

For example, let’s look at what happens when a person yo-yo diets-that’s dieting hard. You can lose the weight, but with the fat, you lose muscle; when you gain it all back, it’s proportionally less muscle and more fat. Your metabolism falls so that the same amount of food you ate before your diet will cause you to gain weight. So, if you set out to lose weight, you have to walk every day for at least 30 minutes and lift weights three times a week to preserve, maybe build, lean muscle as you lose fat.

At RealAge.com, Michael and I have supplied some free workouts. You can go there for information and inspiration.

What role does stress play in heart disease, and what lifestyle interventions do you usually recommend?

The “type A” person who’s always bothered, annoyed, frustrated, driven, and rushed is going to have higher risk of heart attack. The mind is so powerful; it can make blood vessels clamp down, it can make blood become more “sticky” and able to clot, and it can change the hormonal environment within the body in ways that contribute to elevated risk of heart disease. We also know that stress is a major driver of aging overall.

Yoga and meditation are ideal tools for management. I do yoga every morning. Yoga isn’t just about stretching or getting more flexible; it’s a practice that incorporates breathing and relaxation. It helps you to separate yourself from the chatter and emotional mayhem that go on in your mind and stress you out-instead of letting it control you, you can see it and still be relaxed, calm, and centered. A few classes at a yoga studio are all you need to get started with your own practice.

Do you believe in detox?

First, I do believe that fasting is healthy. A day of fasting helps us to remember how beautiful food is and how cool the body is! Extreme fasts aren’t really necessary, though. What I recommend is a day-long fast, followed by a couple of days where you limit foods like dairy products and bread, which contain the common allergens casein and gluten. Many people have mild food allergies where they feel sluggish or headachy but they don’t link it back to any reaction to the foods they eat; if they don’t eat these foods for a couple of days and find that they feel better, they can reduce their overall consumption of those foods or eliminate them and have a great impact on their health and well-being.

Who are your literary and health heroes?

In college, I discovered Ernest Hemingway. I loved how he would talk about coming of age and dwelling with realities…his style wasn’t “foo-foo” or overly sophisticated.

As far as health heroes go, I’d have to say it’s my father-in-law, Jerry Lemol. He’s a very famous heart surgeon. In the 1960s he became known as Rock-a-Doc, because he started playing rock-and-roll music in the operating room.

Jerry has always been willing to challenge orthodoxy…to re-examine what he has always thought to be right, and challenge his own core beliefs. I think that is a great characteristic for a doctor to have. To be a good teacher, one must always be willing to learn.

Be sure to listen to David Steinman’s radio program here at Ecology Radio or at WebTalk Radio. To learn more about becoming a Green Patriot visit www.greenpatriot.us. You can also subscribe to this column via RSS.