Initialize sequence coming to you live from Houston, Texas, home to the world's
largest medical center, in a bunch of days on the day, Rocket Coty,
this is Your Health First, the most beneficial health program on radio with
doctor Joe Bellotti. During the next hour you'll learn about health, wellness and
the provention of disease. Now here's your host, doctor Joe Bellotti. Well,
it is another outstanding Sunday evening in Houston or wherever you are tuning in
from the name of the program is Your Health First. We're here every Sunday
between seven and eight pm. And as I've been saying now for twenty one
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I would say, wherever you are if you're in your car, if you're
at home, grab a drink, hopefully a non alcoholic drink for the topic
tonight and settle in. This is going to be a packed packed radio program
tonight. Now you know, we not that we go out of our way
to talk about fatty liver. That's that's a condition that that we talk about
a lot and something that I see every day as a liver specialist. But
we have in the studio tonight two experts, Doctor ran Deep Sunisia, a
cardiologist. Ran Deep has been here before. And somebody new to the Your
Health First Family, doctor Mason Neuridine, who is new to Houston within the
last year and a half and he is a hepatologist similar to me. And
we're going to really talk about the interplay of heart disease and fatty liver.
Fatty liver and heart disease and really what you all need to know. So
I'm going to start off with doctor Sunesia, Welcome back to the program.
It's been a few months, but every February one you send me a text
to say it's American Heart Month. We have to talk. So here you
are. I'm honored and privileged to be here. Once again. Thank you.
Well it's it's I'm gay and Mason. You're here talking about liver disease.
Welcome to the program. It's an honor to be here. Joe.
I wanted to be on this show. I heard about it and I'm glad
to be here today and here you are live all right, So to get
let's just start off, since that is American Heart Month, doctric in Asia.
In a nutshell, explain to everybody how big of a problem heart disease
is, because really, at the end of the day, half the people
are going to die from heart disease. Well, absolutely, it is the
number one killer of people, not only just in the US, but all
over the world. A total of twenty four percent of the deaths occurred because
of cardiovascar illness. There is a cardioscar death that occurs every thirty four seconds
and an acute heart that occurs every forty seconds in the US. So it's
a staggering statistics. And the fact is that this statistics not just holds true
for the US, this is literally all over the world, including the Third
World and developing nations. In Asia, the incidence of heart disease and heart
text is rising. Because of the increasing incidence of obesity and other risk factors.
Right, So, as a cardiologist, if you could say the most
common thing that you say typically in a day, what is more? High
blood pressure? Is it? People? And heart failure, people having heart
attacks? What do you think it is? I would say hypertension hypilipidemia probably
are the commonness because I see patients you know, from all ages, you
know, below sixty five, above sixty five and hypertension hyperlipidemia probably is the
commoness. And then along with that, Cordneouder disease comes, you know,
asymptomatic, symptomatic, and especially in the elderly population, conust to heart failure,
as you know, is the number one diagnosis for patients above the age
of sixty five, both in the offices and in the hospital admissions. Yeah.
Now, when you see patients, say a new patient sixty five,
sixty eight years old with high blood pressure, some cholesterol issues, and you
bring up all of the risk factors, but you mentioned obesity as a risk.
How do they react to that? Well, you know, that's a
stark reality. You know, based on the statistics, forty two percent of
the US population currently is obese and they're talking about we will be crossing to
fifty one percent by the end of the decade. Unfortunately, because of the
pandemic. In my practice, at least the way I see it, approximately
seventy five percent of the patient population has gained between ten to twenty to thirty
plus pounds. So in the last three years, this pandemic has not done
us any favors. We have been less active, eating more and as a
result we have packed one pounds. Yeah. Now Amazon as a liver specialist
and we're talking about obese here fatty liver. I mean, it doesn't get
any more clear what the problem is. Now. You were involved in the
changing of the name of fatty liver. We've sort of gone away from using
the word fat. So explain that everybody what fatty liver is and and how
the name changed. Sure, and it's good to be here with a cardiologist.
What I tell my patients, this disease is a cousin of the others,
Yes, the obesity, the type two diabetes, the hyperlipidemium, hypertension.
Indeed, some people say it should be part of the metabolic syndrome right
under the umbrella and where it ends up heart disease, right, and for
the liver also crosis. So faty liver is as it sounds. When fat
goes into the liver, deliver usually says, well, this is fat.
I can handle it, like medications. I should handle all of those.
But then when there's excessive eating or there's excessive fat coming from the tissue of
contaneous tissue under the skin to the liver and the liver gets tired, he
says, well, I can't handle that much fat. And then the fat
sits there, right, And that's at the beginning of fatty liver, and
then inflammation and scarring and as you know cruses are then yeah, and you
mentioned how we you know, cardiology is holding hands with livid disease, liver
diseases, holding hands with cardiolsgy. It really is. Fatty liver is a
manifestation of obesity. Hypertension a manifestation of obesity. Cardinary artery disease manifestation of
obesity. So in a perfect world we could almost cohabitate and work under the
same tent in a way managing these patients. And many of your patients come
to see me. My patients go back and they have heart disease that we
discover, so it really I think it is a crisis. Now in the
last minute, I at least ask each of you how big of a public
health threat is the whole fatty liver scene with obesity amazing you, Yes,
it's the estimator is around thirty percent of the population in the United States they
have fatty liver. Now in Texas it's forty percent, right, and a
lot of states is more than thirty percent. Luckily, that's not causing problems
on everyone is just like the subpopulation, but still a lot of them goes
to the advanced stages about ten twenty percent of thirty percent, that's millions of
people. So it's kind of just increased with the obesity. As mentioned earlier,
from a public health standpoint, obesity and heart disease they go hand in
hand, and that the fatty liver. So it's the epidemic of obesity.
As we talked about forty two percent, and especially in African Americans and in
Hispanics, the obesity factor is more than almost prevalence is more than forty five
to forty eight percent currently in twenty twenty one data which is supposed to exceed
beyond fifty three to fifty four percent. So obesity, hypertension, hyperlipidemia,
pre diabetes, diabetes, they are all going hand in hand and with all
that, corneoder disease is a silent killer that comes along with that, right,
Yeah. And the truth of the matter is which Mason, you'll get
into the people with fatty liver, the dying of heart disease. Absolutely,
you know. We like to think, and it's a sad thought to say
that, well, everybody's needing a liver transplant and they're dying of liver failure.
But the truth is most are dying of heart disease. It's the number
one cause. Yeah, and death and deathn't these patients. So we tell
them, like, make sure your cardiologist is looking at your heart. Yeah,
yeah, you know. One one question is we see so many patients
and they may be seeing a cardiologist because they're on a stat and they have
high cholesterol, and be it the primary care physician. Some cardiologists they're stopping
their statins thinking that it's going to harm the liver. What's your take on
that as a cardiologist. No, I absolutely recommend that they must continue to
stating. However, I do want them to see you a liver specialist and
any other liver specialists, so that they know that what is the degree of
fatty liver, what extent of fatty liberate it is? And there Mason and
yourself will come in and tell us the degree of fibrusis the their music to
my ear, yes's exactly it. So, Joe, you and I see
patients every day coming to us and they say it's the lipid or or another
stat in that causes elevated liver enzymes. So as my callinggue mentions that we
need to keep them mine because they get a heart attack, and then we
go there fatty liver and what on deepshit is exactly the point is how bad
it is, because it could be a simple problem. It's just fat.
But also, on the other hand, you want to know if they're going
to souss or they just a step away from cervices. So that's our job.
Yeah, and again we'll get into this and the next break. But
a lot of people and there are millions of people out there, many listening
tonight that have a fatty liver, and it's like, oh, it's not
that big of a deal. We'll worry about it later, all right,
We're going to take a quick break. Come down to Joe Galotti. This
is your hell first. Every Sunday between seven and eight pm, we're talking
fatty liver and heart to disease. Stay tuned, don't move, raising your
health IQ, one listener at a time. Doctor Joe Galotti, this is
your health first. Thanks very much for tuning in on this Sunday evening.
We've been discussing heart disease. We've been discussing liver disease, fatty liver and
in the studio to friends, colleagues and experts. I would say Maison new
Adine, founder of Euston Liver Institute Houstonliverinstitute dot com. And doctor Randeepsunasia,
founder of Houston the Cardiology Center of Houston. Their website is Houston Cardiology dot
com. Welcome back to you both, Doctor Neurdean, I'm gonna I'm gonna
get to you talking about fatty liver as the the uh colver expert here tonight.
So many people are walking around with fatty liver, very nonchalant, sort
of there head in the sand. Oh I got a fatty liver, but
it's not a big deal. What do you say to everybody tonight. That's
listening tonight about the reason to get a bit serious about this. That's a
key question. The last thing that you want to end up is having soross
out of the blue. You end up in deliver doctor's office. You don't
drink alcohol and you're being told you have seruces and you and I see that
every single dage. All right. So now, the American Association for the
Study Liver Disease, the American Gastroentology Association, since twenty twenty one, they
made it really clear that we should not put our head in the sand,
that we should look for those that they have advanced disease. And it's easy
if you have type two diabetes or like Crandeep mentioned earlier, hypertension to slipidemia
and these risk factors they make fatty liver warse. So you got to ask
your primary care or your doctor to look deeper into your liver. If they
say don't worry about it, as them actually for additional tests because they have
risk factors. And we can talk about this, h but you know,
I feel fine. I feel fine, doctor Nourrodine. What are you bugging
me about this for? And it's an asymptomatic disease. You don't feel symptoms,
you don't feel nothing, and all of a sudden they're showing up in
your office. Joe, you see that with fluid in the abdomens called assietys
or complication from serviuce right, So we gotta tell them. You really have
to pay attention. Elevated liver enzymes could be okay, but it could be
a problem. There's certain tests. I mean, there's something called FIP for.
If you google it, you'll find what's a FIP for. It's a
numbers an age and some blood test. And your doctor need to know about
this. If they don't know about this, to ask them what is my
FIP for? Gool it? If I be for google it and you know,
I would say, well, tomorrow's a holiday, some people might not
be working, but Tuesday or Monday for those that have to work. Call
you doctor if you know you have fancy liver. I really we're going to
start a movement here, Dotter neurody. Call your doctor say hey, what
is my FIB for? Why not? And I think we need to do
that. And I've got some of my staff, some PA's of mine in
the studio here what do we say to our patients deliver suffers in silence,
and so don't be put off that I feel good, I look good.
Now the difference with heart disease, many patients could be silent, but a
lot of people have chest paining, their short of bread, they've got palpitations.
How do you how do you try to instill in your patients? And
you are a great communicator, I would say, without a doubt, instill
on them the need to take this seriously, their heart disease or their risk
factors. You know, good communication and education of the patients is critically important,
as you know. And you know I say announce of prevention worth a
pound of cure. So you know, I am a very big believer of
coordinaty calsium scores, and we have so many patients walking in with a high
pretention hypperlipidemia, obesity, any risk factor. I am a very big and
strong believer of corodinary calcium score. And it's like you know Phipps four score.
Here, every patient needs to know the cordinary calcium score. They really
need to know where they stand. And once you know your coronarty calsium score,
the beauty of that is FO one hundred and forty dollars probably the best
one hundred and forty dollars you'll ever spend. And Houston method system across the
entire city does this. It's a three minute test, totally non invasive,
gives me an aus a wealth of information and you know where you stand,
what your coordinaty calsium score is not the entire story, but yet it's a
phenomenal start where you stand. And the key is once you know your cornerity
cassium score and you know where your persentile is. Because the cornity custium score,
we are able to see that individual, standardize them against the Meser registry,
calculate the personile based on age and gender, and we are able to
say, hey, you know what you are in the nineteenth percent time when
I've had these patients. Sixty year patient comes in the score of three hundred
four hundred, you're already in the ninety fifth percentile and one meaning trouble,
meaning trouble because one risk potential trouble. So because you know the Carney cultium
score, as you know the classification as I follows, zero is none,
one to ten is minimal, eleven two hundred mile one hundred and one to
four hundred is multi monit four and severe over one thousand very severe. So
once you know your score and where you stand here persontile, it's a stark
reality and that increases compliance of using aspirint statin as a very big thing.
Right, same thing for what we're I think they're ahead of us in a
way in doing that and we're only now sort of lagging. We've got these
millions of people with fatty liver. They're head up where the sundown shine.
And this is what you're trying to do. Yeah, and deep, you'll
be proud of me. I'm in my forties and I have got my calcium
score or they multiple times auso. Yes. So indeed, like one of
the things I was attending one of the leadership meetings in the American Association for
Steady Delivered Disease and they said, we wish that we have this FIP for
sign on a billboard. Yeah, in the city, if you have type
two diabetes or metabocrist factors, get your FIP four. Yeah, so get
that. Yeah, all right, So two things learned. Get your calcium
score and your FIB four FIB number four everybody during the break, look it
up and you can calculate your fIF four. All right, I am doctor
Joe Galotti. This is your health first. Every Sunday we are here.
You are our best to educate the public. Stay tuned news, weather and
traffic. Well right back, Welcome back everybody, doctor Galati. I hope
you have had a great weekend. A little time to recharge your batteries.
I went out today on sort of a leisurely walk and my wife and I
get a little nutty trying to track our steps and our activity on our watch,
and we came up a little short. We didn't get to ten thousand,
but then we went to Costco and I'm proud to say I hit my
ten thousand mark. Another three thousand steps in Costco today, So another two
or three thousand steps and two hundred dollars. That's what it costs these days.
So I'm in the studio with doctor Amazon Nouridine, a hepatologist and researcher
here in Houston at the Houston Liver Institute. In Doctor n Deep Sunasia,
former chief of Cardiology at Houston Methodist Hospital West and he is with Cardiology Center
of Houston Mason with regard to fatty liver. We were talking about the FIB
four. Another tool which is almost equivalent to the one hundred and forty dollars
for the calcium scores is fiber scan. How does that fit in? And
again, if people have fatty liver that they're listening tonight, or they have
a loved one, they can get the FIB four. But I would say
maybe up a higher level of accuracy, maybe with the fiber scan. In
a nutshell, tell everybody about that, right on, Joe. So someone
is googling it. It's labs and age and they're like, they see the
score in's high. What do we do next? So you have that in
office or liver offices. It's ultrasound like machine. You think you're doing regular
ultrasound. It's different. People start getting ultrasound, that's not it. This
one is kind of like vibrating like machine like ultrasound. We put it on
the right side of the body, which the liver is, and within five
six minutes it tells you exactly how much fat you have in your liver and
more importantly, if there is corning in deliver, which is the problem because
cerosis everyone heard about cerrousis right, it's complete scarning of deliver. So this
one tells you if you are on the road to that from zero, one,
two, three four, it tells you exactly what it is in less
than them ten minutes. Yeah. The other thing is and at every opportunity
to mention this corosis does not mean you are an alcoholic. And a day
doesn't go by where you tell somebody, hey, you have cirrhosis or we
believe you're close to cirrhosis, and they get insulted saying, how dare you
call me an alcoholic? Absolutely, so this is the old man used to
be non alcoholic fat you living disease. And that's where sort of the name
change came in. Yeah, and the people it was like a process,
voting process, and people patients said, when you say non alcoholic, even
if I go to my neighbor and I say I have no alcoholic fatty liver
disease, first thing, they just like omit that word none and they think
I'm alcoholic. And then they hear the word fatty and I think of myself
fat. So we changed that to call something mazzled. It's a long name,
but basically this disease is actually the most common cause of cirrhosis right without
drinking right, and it's related to food and overweight right excess. Speaking of
that cholesterol again, many people have elevated cholesterol and what makes me, I
don't wan say laugh, but I sort of giggle inside. I just have
a touch, just a touch elevated. It's not that bad. My doctor
wants to watch it, even though I have five years of high cholesterol and
treglis rides. So they come to you, and let's say you start them
on a statin or some drug to lower therapy lower the cholesterol. What are
the options, both drug wise and non drug wise to treat high cholesterol.
Yeah, I think we have to manage the cholesterol based on the risk factors.
And here the calroinety calcium score plays a very big role. If they
have lipids which are mildly elevated and your score is zero, you know,
then the management would be different. But if they have premature corgnatory disease with
high calcium scores, then you become very obsessive about managing their ldeal much more
better. Bringing down below seventy and now the newest recommendations from May of twenty
twenty three are bring them down LDL below fifty five one. So the options
we have are obviously the cornerstone statins. We have a fair number of statin
lipid soluble non lipe is soluble. We have to figure out what works for
the patients starting low go to high intensity status, which are travel status and
reserver statin. If non cogina disease, we tend to start with those.
Key is that you have to monitor the patients carefully because TATAN associated muscle symptoms
which is present in up to twenty five percent of the population. It has
happened if you ask the patients they're having these non specific militias. You have
to monitor the patients because if that affects the quality of life, then you
have to reduce the dose. Add non statin in the form of zittamite can
be added. And now we have phenomenal other therapies in the form of pskin
and inhibitors that can be added on to the most well toiled dose of statin.
We have two of three of those in the market. And then we
have also now of the new inclyas round which is lequio, which can be
given once every six months. The first dose so there are other options there,
but statin still remain the corner store. How because with fatty lever,
we talk about losing five percent of their body weight, ten percent of their
body weight, which in someone that is hundred pounds overweight, that's not that
much. I mean, it's a decent amount of weight. Do you ever
feel that losing twenty pounds is enough to lower their cholesterol and their risk?
Absolutely, lifestyle modification plays a key role. It helps you reduce your degrees
of inflammation, reduces the LDL, reduces your A and C, will reduce
your overall degree of inflammation everything. So lifestyle modification will contribute anywhere from ten
to twenty percent. And you know those are important because you just cannot just
write prescription to the patient. Lifestyle modification is critically important, and I say
weight loss is the best medicine. There is no doubt about it, right.
I just want to make a comment for the people who are listening.
We're blessed to have these medications that run the mentioned, but I just want
to make sure people also know that fatty liver cannot be treated with these status
and UNTI fat They're important to be on it to protect heart disease, but
tatty liver unpartocularly has shown not to be solved by statins or psks. There
are other medications for them, but we put these. We asked ran Deep
and the cordiologists to help us managing the slipidemia bad closure on these patients so
they don't get the heart attack right, So maybe we'll jump to research.
Doctor Nurdine is a national and international expert within research, especially in fatty liver
disease. Where are we at with these new drugs? What is the hope
for the future? And thank you for asking this question and asking me to
be here today, and joy your show is always timely and this is a
very timely time for factory liver. Why so in New England Journal paper this
is the top medical journal that we know of as doctors, we just published
the paper on therapy for or faty liver or its advanced forms called MASH.
The paper came out two weeks ago. But also there is an expected therapy
to be hopefully approved by the FDA next month in March twenty twenty four.
We're watching for this news. So rismitero is probably gonna be the first drug
approval for MASH, which is the advanced form of fatty liver. So we
used to be told, Okay, we send these patients to you guys,
you do fiber scan and then what is just weight loss and exercise. So
the answer is no. Now we have medications that they're gonna be hopefully in
the market next month. But you know, when people come to your office,
you have these options. They are in clinical trials, they are in
research, and importantly, some people say, well, I don't want anyone
to experiment on me, and I'm just gonna wait. But guess what some
of these medications are actually if they approved for other indications such as wait longe
and type two diabetes, but the FDA is requiring them to do it on
fatty liver patients and NESH and many of them are weight loss medications. So
patients when they come to our offices like you office, Joe, I'm sure
when you put them on clinical trial for fatty liver and they start losing the
weight and we're seeing fatty liver also helping they get early benefits. With FDA
approve medications for other indications that they are safe. So we used to be
accused that we don't have enough tools. We actually have a lot of tools
and deliver off right now. Once this new medicine is FDA approved within the
next few weeks, I would almost anticipate that there's going to be a lot
of patients that are going to be infused into the system to be evaluated for
these medications. But since we have doctor Sinasia here, we're going to see
these patients and see they have high cholesterol, they have hypertension. So I
think everybody involved this, with this influx of patients are going to have to
carefully look at them. If they're not coming from a cardiologist, we're going
to have to act on their behalf, stratify what risks they have, and
get them into the right people for that sort of global care. What do
you think of that? Absolutely, because anybody who's got fatty liver probably has
coordinary disease. Also, yes, I'm working out today asking I'm going to
ask my patients to do the calcium score. I used to shy away from
recommending it test, and I just I emphasize. I tell them I had
a patient with chest pain and he's like, oh, my doctor just that
stressed as and was normal. I'm like, no, no, no quot
to cardiologists. It's and he ended up with corllioism and had a stint right
at the end of the day. But I think these patients, once we
start caring for them, it's important to prevent the number one cause of this
death in them, which is cornogy disease hard heart attacks. Now, I
think and it really reinforces this connectivity and brotherhood and sisterhood or personhood whatever we're
gonna call it, between cardiology and livid disease. We cannot under understate that.
All right, final segment coming up. I do hope all of you
are enjoying this conversation with doctor Neuridean and doctor Sunasia. I'm doctor Joe Galotti.
Don't forget doctor Joe Galotti dot com. Stay tuned. Final segment coming
right up. Josh's playing one of my favorite songs here. Well, final
segment here, we have a little under ten minutes. And for those that
may be just joining, we have doctor ran Deep Sunasia, acclaim cardiologist here
in Houston. Houston Cardiology dot Com is his website. And then Mason Neuridean
leading the charge in livid disease research with Houston Liver Institute dot com here in
Houston and around the world. So we've been talking about liver disease, fatty
liver, heart disease, the interplay with cholesterol and obesity. Now alcohol.
Now this is not necessarily a discussion of alcoholism or addiction, but for those
of us in liver disease, we get very sensitive with alcohol, even small
amounts. If you have fatty liver or hepatitis B or hepatitis C, that
can make the liver disease worse. So what's your position. What do you
tell everybody tonight if you have fatty liver and what to do about alcohol?
Yeah, so I'll just go buy the guidelines by our society. First of
all, if you have cerusis, you got to stop, Julian, you
know that. I know that. It's not just because like we want to
punish you. Because serus is and alcohol is badness. It's going to go
to the bat side. The liver is going to limp further. And more
importantly, you are more prone to developed livery cancer if you drink alco oni.
Right, not good. So the data on fatty liver, if it's
in early stages, the data is kind of all over the place, and
some people say minimum amount are okay, especially if it's a wine, that
that's okay. But by time you start getting scoring stiffness in the liver,
especially like the one you do with fibers, can you see them preserces or
have some scarring, it's probably better, especially in the pre sources stage,
to stop and focus on a healthy lifestyle. But earlier stages in moderation,
in the right amount, it's probably allowed for now right now on the flip
side, patients come up to us and again we're on the liver side,
we're taking a detailed alcohol intake history and we'll red flag it and we'll say,
you know that three glasses of wine or you know, at lunch or
in the evening is a little too much, or it is too much in
the setting of fatty liver. And the classic response is, well, I'm
doing it for my heart, and you sort of want to throw the flag
out and say foul ten yards you're out. So from you, doctor Sunasia,
no, I think what do you say? Very important that you know,
we need to make people aware of the amount of alcohol they're drinking.
For women, as you know, it is one drink per day and total
more than seven drinks per week is considered excess. For men, it is
two drinks a day. And you have to also understand when you ask a
patient, so I drink a glass of wine and one serving is four ounces,
so you know they're saying, oh, you know what, dark You
know, I had like this big glass, and he's just showing me a
big before. That's that's three to four servings in one sitting, right,
and that's excessive. And obviously we tell them that that ultimately has number one
negative cund deliver with fatty liver because they are obese already, excess calories,
and then you have excessive alcohol as negative impact on alcoholic card in myopathy also,
so those are things, and then excesscalories. Every one ounce of wine
has twenty five calories. And I just this last week had a patient.
I mathematically calculated him and I said, you know what, in order to
lose one pound, you have to have a negative balance of thirty five hundred
calories, right, And if you do five hundred calori less per day,
and every day of the week, you loss a pound. And that five
hundred I divide into two parts two fifty two fifty two fifty less caloric intate
primarily affecting carbs, bread, pasta, dessert, snacks, potatoes, rice,
alcohol, And he said what, Yes, I said alcohol part of
carbs. He said, yeah, carbs. Yes, I said, that's
all part of cars. And if you reduce two and fifty calories per day
and two and fifty calories of increasing utilization meaning burning mode does half of a
brisk walking, jogging, running, whatever you may do, and very important
part in this, in these lifestyle modifications, as long as you don't have
any history of co ind to heart failure, sixty to seventy ounces of water,
that stimulation of metabolism reduces uppetite critically important right now, you know,
back Amazon, back to you with lifestyle changes. We you know if you
is it true to say if we didn't have obesity, there'd be no fatty
liver. That's a little bit of a stretch. But what do you what
do you think? Yeah? I mean it. I want to point to
lean fatt lean fatty liver here. Yes, if we solve obesity, the
problem will decrease significantly. Nevertheless, there are some people unblessed with the lean
fatty liver. Usually they have something called insulin resistance meaning this is their body
doesn't handle insulin well. And if you actually want to know each patients are
those those are the patients that look fine, and then you look under their
shirt and they have this small belly there that's coming from insult resistant. Asian
people, yes, a lot they have lean, faty liver people from India
actually as well. Faty liver is a big problem there and they have it
on the lean side. So it goes back to the right amount of eating
as well as the type of eating. So you actually you were talking like
hepatogeously, the slow carb, the slow carb, you were talking about a
lot of people that are they look fine, they not overweight, They eat
all of those a lot of sugars and they get this insult resistant and they
get fat over pretty amazing. So doctor Senesa, we're going to get you
back on next week to finish up American Heart Month. We'll get off the
liver, but you're holding your own here, I must say last fifteen seconds.
Message for tonight on heart disease messages, lifestyle modification plays the critical weight
loss is the best medicine and get your coordinatory cut some score done. Critically
important if you combind lifestyle modification, got a good cardiologies, good evaluation,
got a coordinator, cut some school and obviously work on diet, exercise,
weight loss and get your lips looked at Nordy in fifteen seconds. Even if
you drawn drink a lot. If you have time two diabetes, you're overweight,
or have I LOO pressure cholesterol, know if you have FATI liver and
how bad it is, and there's a test called FIP four as your primary
care for it, we have options for you. Perfect all right, the
two of you have been outstanding for everybody. If you want to hear this
again, this will be posted probably in a three or four days as a
podcast. You could re listen to it, share it with your loved ones,
but until then, get your FIP four calcium score, take coke Q
ten, if you're on a statin and be well, love one another out
there. I'm doctor Joe Galotti and we will see you next Sunday. You've
been listening to Your Health First with Doctor Joe Bilotti. For more information on
this program or the content of this program, go to your Health First dot
com. M