#115 Dr. Columbus Batiste - Get SELFISH…Your Life Depends on It
Going to the Doctor is no fun, but when patients walk in to see Dr. Columbus Batiste, they are met with compassion, understanding, and genuine empathy.
Not only does he work with his patients with a team-based collaborative approach, but he also meets patients where they are at and explains health in a way that makes sense. As an Interventional Cardiologist (or “Plumber for the Heart” as he affectionately refers to himself), Doctor Batiste naturally treats disease with medicine and surgical interventions, but he also works with his patients from a mental and emotional standpoint - emphasizing nutrition, stress reduction, and overall well-being.
Today's episode includes a description of real-life patient case studies and Dr. Batiste provides his initial assessments and recommendations for treatment. Perhaps you recognize yourself or a loved one in one of the patient profiles. If so, appreciate the feedback and advice and, as he says, ask yourself, "What is your want and desire? What are you willing to do or not do in order to improve your health?
The key takeaway from Dr. Batiste? It's OK to be S.E.L.F.I.S.H. in your desire for good health. Ready to feel a little selfish? We hope so!
About Dr. Columbus Batiste, MD, FACC, FSCAI
Columbus Batiste, MD, FACC, FSCAI, is the Chief of Cardiology at Kaiser Permanente Riverside and Moreno Valley Medical Centers. He completed his residency in Internal Medicine and fellowship in Cardiovascular Disease at Loma Linda University Medical Center. He is also known as the “Healthy Heart Doc” and he endorses a holistic approach to health care, emphasizing nutrition, stress reduction, and exercise.
Episode Resources
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Full Transcript
Dr. Columbus Batiste:
And so the question that you have to ask yourself as listeners out there is, how reliable are you to you? Everything you do, every single moment is playing a role in the foundation for your future. And you're investing in your future health either way to poor health or the wellness. And we say illness versus wellness all the time. And so that's the dilemma.
Rip Esselstyn:
I'm Rip Esselstyn, and welcome to the PlantStrong Podcast. The mission at PlantStrong is to further the advancement of all things within the plant-based movement. We advocate for the scientifically proven benefits of plant-based living and envision a world that universally understands, promotes and prescribes plants as a solution to empowering your health, enhancing your performance, restoring the environment, and becoming better guardians to the animals we share this planet with. We welcome you wherever you are on your PlantStrong journey. And I hope that you enjoy the show.
Rip Esselstyn:
Hello my PlantStrong brothers and sisters. This is Rip Esselstyn. And I want to welcome you to another episode. Now that you guessed it, the PlantStrong Podcast. A trip to the doctor is never fun. And I get it. Especially when you know that you're not in the best of health. And no one wants to be told bad news about their health or hear about all the things that they're doing wrong. It's downright discouraging. But that's why it's so important to find medical professionals with compassion and those who are willing to work with you and meet you where you are.
Rip Esselstyn:
That's why I'm super jazzed about today's guest, Dr. Columbus Batiste, a board-certified interventional cardiologist with Kaiser Permanente. And a little side note here, Dr. Batiste actually did his training at Loma Linda, the only Blue Zones region in the United States. Now, not only does Dr. Batiste work with his patients using a team-based collaborative approach, but he also explains health in a way that makes sense to you and me.
Rip Esselstyn:
As an interventional cardiologist or plumber for the heart, as he affectionately refers to himself, Dr. Batiste naturally treats disease with medicine and interventions, but he also works with his patients from a mental and emotional standpoint, emphasizing nutrition, stress reduction, and overall wellbeing. I want to take advantage of the time that I had with this brilliant doctor.
Rip Esselstyn:
So today, we talk through a couple of real-life patient case studies, and he provides his initial assessments and recommendations. You may recognize yourself or a loved one as one of these patients. So I hope that you'll give it a listen, spread the word and take it to heart with me and Dr. Columbus Batiste. Before we hop into this conversation, I'd like to take half a minute and invite you to join our free PlantStrong community.
Rip Esselstyn:
This online portal is packed with people from around the globe who have come together to share recipes, ideas, and solutions to living a whole food plant-based lifestyle. We have tons of resources for you, free events and our ever-popular PlantStrong seven-day challenge. So grab a friend, commit to a week of a 100% PlantStrong living and join us at community.plantstrong.com. All right, let's get started. It is a pleasure to have you on the PlantStrong Podcast. Columbus, thank you.
Dr. Columbus Batiste:
Absolutely. It's always great to do these, but especially great to kind of finally meet you and speak of things. It's our first time speaking together.
Rip Esselstyn:
No, it totally is. And I've seen you obviously in a lot of different documentaries from Eating You Alive to The Game Changers. And love and admire your work from afar. So love to dive in a little bit today.
Dr. Columbus Batiste:
Yeah, absolutely. And the feelings are mutual. I like to say I take credit for some of the sales of your book, as I was constantly referring patients to your book, Engine 2.
Rip Esselstyn:
Well, and the Engine 2, it was, looking back, that came out in 2009. It was way ahead of the curve. And it's crazy how many books are out there now, isn't it?
Dr. Columbus Batiste:
Yes, it is. It is. But there's a different flavor for everyone. And things resonate with people at different times. So I think there's a value in that still.
Rip Esselstyn:
Absolutely. So and I'd love for our listeners to know a little bit of more about you, Columbus, and your background. So for starters, where did you grow up? Did you have brothers and sisters? What were your parents like? Can you tell me about your background.
Dr. Columbus Batiste:
Yeah. No, great. Thanks for asking. I always love talking about my family. They were tremendous. So I grew up in Los Angeles, in California. I was born and raised in Compton, California. Two parents who migrate over from Louisiana, part of that whole great migration that happened in the '30s and '40s and '50s and '60s and so forth. And I was the youngest of six kids. I am the youngest. I'm what you call the pleasant surprise. I'm not the mistake. I'm the pleasant surprise.
Dr. Columbus Batiste:
My dad was 40 at the time, and my mom was in her about 35 or so when they had me. And so I grew up with this emphasis on education. And I grew up where everyone had to go to college. Everyone had to go to private school and all of that whole bent like that, that happened with my parents. And I also grew up where watching my dad live with diabetes. I thought that was the norm because he had diabetes ever since I could remember. I remember seeing insulin inside of the refrigerator.
Dr. Columbus Batiste:
I remember seeing syringes there that he would discard and so forth. And that was the norm. I remember looking at his hands. And now I know it's from peripheral neuropathy, as I saw the atrophy in his hands. And just studying my dad's fingers and his hands, I remember as a kid playing basketball and watching him stumble. Recognizing he was a bit older ... By the way, today is my birthday.
Dr. Columbus Batiste:
And so I think about my dad around the same age I am right now, as he would stumble. We would go out and play games and basketball and things of that nature. It now makes sense about everything that he was dealing with as a result of this, diabetes and so forth. That's how I grew up.
Rip Esselstyn:
Is your father still alive today?
Dr. Columbus Batiste:
He is not. He passed away in 2010. August 12th of 2010. Interesting story, not interesting from a standpoint of like wonderful, but I remember he had been suffering for some time as diabetes had ravaged his body. And I was scheduled to actually fly out of town to go and visit for my brother-in-law's a wedding. And I stopped by my parents' house as I oftentimes would.
Dr. Columbus Batiste:
And I saw him and it just the look, and I just had this huge surge of emotion. I was like, "I can't go. I can't leave him." And it must have been in the God's will and the stars, whatever your belief system is. But all of my siblings converge on that house without communicating. And we all were there when my dad passed. Not an easy thing by any stretch of the imagination, but forever changed the trajectory of my life, my career, my passion, the way in which I approach things.
Rip Esselstyn:
Yeah. So if that informed your career path, it sounds like to become a physician?
Dr. Columbus Batiste:
No, I was actually already a physician. I was an interventional cardiologist at that point in time, and I actually was chief of the department. So I was doing all the standard stuff, pills and procedures, and doing more complex. I remember someone joked and they said that years ago, they said, "Man, I remember but this is way different now." I remember back in the day, he said, "The only way for cardiology and for healthcare is to do more procedures. And we need to build this out and do more things like that. And to see where he's at now and talking about green leafy vegetables and plants and eating is quite different."
Rip Esselstyn:
Also speaking of that, you obviously made a bit of a pivot in your practice, which I think says a lot about your character to be open-minded enough. What or who inspired you to give this plant-based thing a serious look over?
Dr. Columbus Batiste:
Yeah. I'll tell you. After my dad passed, I really had this introspection. I felt, to be honest with you, Rip, responsible for his passing in a sense. Not that I caused him to have diabetes, but for the information I did not provide to him. I asked him about his meds. I asked him about his lab. I never asked him about what he was eating. I remember. And then as a result, I even contributed as it relates to the shoes I purchased led to the fiddle, so that then led to him no longer walking.
Dr. Columbus Batiste:
And so it was a great deal of guilt. That combined with patients asking me, after I'd put stunts in and do procedures, "Hey doc, what should I eat?" All these things made me start to look and research. And we didn't have podcasts like this. We didn't have the books at nauseum like we have now.
Dr. Columbus Batiste:
And so as a result, I started searching and seeking and looking to get answers. And I finally, as I read your dad's book, I read many other books. I started looking at the research that was tied to the books in the old school pub med and so forth, and looking at it, it may clear sense to me. And at that point, the direction I needed to go, but I was still scared.
Dr. Columbus Batiste:
If you haven't noticed, I'm African-American interventional cardiologist. And so we're not a dime a dozen. So I was afraid that I was going to be stigmatized as that guy who, the weirdo, the guy who's practicing this plant-based vegan style approach with patients, and people will reprimand me. But I finally dived in and I did it. And what was so interesting was in that moment, I was encouraged by two people.
Rip Esselstyn:
And so what year is this?
Dr. Columbus Batiste:
This is actually 2010. I was encouraged by two people. Han Steel reached out to me to say, "Hey, listen, you know what? You're doing a great work." There's a great effort that you can do because other people in my med group mentioned me to them. And the other one was none other than your dad. And I'll be honest. I felt like a groupie because I read your dad's books.
Dr. Columbus Batiste:
I was just starting to look on YouTube and follow some things. And he called me and he said, "Columbus, this is us." And I paused, I was like, "Okay, who's playing a joke on me." And so he was like, "I just want to encourage you. You have such an opportunity here to be an agent of change."
Dr. Columbus Batiste:
And he went on, he invited me down there in Cleveland and down there to everything. And I actually went and spent like a little bit, and he said, very philanthropic and said, "Listen, whatever you need, I'll share with you." I took him up on it. And that was the beginning of everything. That was the launch pad right there, was after being with them.
Rip Esselstyn:
So it was probably one of his five-hour counseling sessions with 20 different people?
Dr. Columbus Batiste:
Absolutely. And your mom was there too as well. And then he invited me back to their home for dinner. And I met a few other folks. And your mom made a wonderful, incredible parfait. So I'm always a texture person. So I don't even do parfaits. That's not even in my vernacular. And I sat down and I said, "What am I going to do now? I have to eat this."
Dr. Columbus Batiste:
And I tasted it. And I was like, "That was really good." I was like, "This was really good." And the other person who came with me, I was telling her afterwards, I said, "This was incredible." And so I enjoyed it. I brought back all the materials. I crafted them and reworked them into my own version, but using him as a sounding board. And I've always appreciated your father. Incredible man.
Rip Esselstyn:
Well, this is all new to me. I had no idea that you've been to two Pepper Ridge, been to visit with him and all that stuff. That's great to hear. Okay. So tell me, let's go back just a little bit farther, and then I want to dive in with some questions for you. Why cardiology?
Dr. Columbus Batiste:
I'll tell you. Exactly. I wanted to be Lakers team doctor growing up. That was my dream. I'm a soul cowboy. I love the Lakers. Grew up watching Showtime. And that was that. But my second year in college, I went and I rotated through a cardiology for a summer internship. And I fell in love with the heart. It just made sense. It connected. Every single aspect, it breathed life in me. It breathed this level of excitement.
Dr. Columbus Batiste:
And so that was an easy, easy take for me as it relates to the heart. And as I began to learn more about it, I realized that, of course, the number one killer, I realized that it ravages homes continually. It's number one driver of healthcare expenditures. And so what greater place than to start is with the heart of the issue that can lend itself to everything else.
Rip Esselstyn:
Yeah. And you did all your medical training and your residency and fellowship at Loma Linda.
Dr. Columbus Batiste:
Yeah. Nearly.
Rip Esselstyn:
Okay. Nearly. And which to me is kind of ironic because it's one of the Blue Zones because of the Seventh Day Adventists. Are you Seventh Day Adventist?
Dr. Columbus Batiste:
I am actually.
Rip Esselstyn:
Wow, good for you. That's awesome.
Dr. Columbus Batiste:
Hopefully, the longevity will pay off from my habits and everything else like that. But what's interesting about that is that I never learned anything about Blue Zones. I never learned anything about nutrition.
Dr. Columbus Batiste:
And I don't say this in reprimand that the individual, but I actually rounded on rotation with one of the lead authors of the Adventist Health Study, the most quoted recited study and literature, as it relates to comparing vegans to non vegans, to vegetarians, et cetera, et cetera. And not one mention of the role of nutrition, the role of lifestyle in terms of intervening on chronic disease.
Rip Esselstyn:
Wow. So is your specialty within cardiology? Are you an interventional cardiologist? Is that the correct term?
Dr. Columbus Batiste:
That is. I'm a plumber. I get down and dirty. I'm a plumber. I was trained to go ahead and rim out the arteries and de clog them and go from there. I always say there's electricians of the heart, electrophysiologists. Plumbers of the heart, interventional cardiologists. And then you have body and fender guys, and these are for heart failure and so forth.
Rip Esselstyn:
So as a plumber of the heart who has now embraced this kind of more lifestyle medicine approach, this holistic approach, are you still doing a bunch of procedures, or has that kind of calmed down a little bit? And is your primary approach now, "Hey, this is what you got to be doing?" Or are you putting in the stents and doing the angioplasties and all those things?
Dr. Columbus Batiste:
So my fervor has shifted. So I still put in stents. I always kind of use the adage and I tell my kids this. My daughter is 16 and we teach her how the drive. So it's a great undertaking. And so I tell her, "If you have a flat tire, I have to replace that tire with a spare. But I need to now teach you not to drive over nails, not to roll backwards over the spikes. And that becomes essential. That's important.
Dr. Columbus Batiste:
Now, if the tire is a little bit low, I don't need to change the tire. I just need to go ahead and teach you methods on driving better." And so that's my approach. If a person's coming in with a massive heart attack, yes, they will get a stent. If a person's coming in with some nondescript symptoms and they've yet to really adopt lifestyle, they've yet to tend to go to the class one indicated therapy, oh, I pause at that moment.
Dr. Columbus Batiste:
So I'm known as that guy. Every staff member knows. I've given lectures to the staff. The patients know too as well. I'll tell you, ironically, just yesterday I was in the cath lab. And my colleague comes over to me sheepishly and he said, "Guess what?" He said, "Columbus. My patient just asked me, do you think that my symptoms can be changed by my lifestyle, the foods I eat?"
Dr. Columbus Batiste:
And he said, "Every doctor told me, no, it couldn't." And he laughed. And he said, "Well, my colleague, Dr. Batiste, if you were to talk to him, he'll tell you absolutely it can. And so I'll give you some of his paperwork." So I have all of my paperwork there that includes books like yours and others and documentaries on it, as well as pamphlets on how to eat plant-based approach with it.
Rip Esselstyn:
So I want to throw at you a couple of different personas. Some people they're going to come to you in your office. The first is a 35 year-old white male. He has a total cholesterol of 285 and his father died of a massive heart attack at age 49. What would you recommend that this guy do?
Dr. Columbus Batiste:
Well, the first thing that I'm going to do is I want to get a sense of what his symptoms are if he's having symptoms, or if his fear is over, the future events there. So first thing is to seek to understand what his concerns are, his level of understanding and level of concern. Next thing is I want to inquire where he's at in the space. What his diet is like, what his activity is like, what his blood pressure is like. Providing knowledge and information.
Dr. Columbus Batiste:
Next thing I want to do is I want to ascertain his risk. So inherently, he has some genetic risk predisposition, but what's his risk based upon these things there. And then begin at that point, ask him what his desire is. What's his why? What's his goal? And so what does he want? In other words. After I establish what he wants, the question then arises as to, what are you willing to do to get what you want? And what are you willing not to do to get what you want?
Dr. Columbus Batiste:
And so as we move down that paradigm, now I try and get a sense of his readiness for change, because not everyone is the same. And that may not happen in one visit. It may happen in sequential visits that are there. As I identify his readiness for change, now I intervene where he's at. Outlining the goal. If it's 26.2 miles of the marathon, that's our goal, but we may start at one mile today. And so identifying where he's at and then begin that process of leading him down that pathway towards improved health.
Rip Esselstyn:
Yeah. And that's remarkably similar to what happened with me and one of the guys at the Engine 2 firehouse. His great grandfather died before the age of 50 from massive heart attacks. His father had triple bypass at 51. At the age of 33, he had a cholesterol of 344. And he was a self-proclaimed third generation redneck. And every meal had to have a big piece of preferably fried meat on it.
Rip Esselstyn:
And it was after that 344 that he was like, "Damn, I got to do something. This is scary." And that's when I decided to chip in and start eating plants strong at the firehouse. So let me give you another one. And maybe the answer is always the same. So you got a 41 year-old Hispanic female. She's type 2 diabetic, hypertensive, 100 pounds overweight. And she's come to you because she's got angina, a little bit of chest pain.
Dr. Columbus Batiste:
Yeah. So first thing in that particular instance is knowing that her risk factors that she clearly has, what sounds like metabolic syndrome. She's obese, she's diabetic already, maybe a bit hypertensive. So she has all of the fertilizer for having bad coronary disease. So my first step is to address her need, which is, how bad is your angina? How severe? What's the risk level that's here? Are we talking about high risk features?
Dr. Columbus Batiste:
And so I'm probably going to undergo what I call risk stratification, either a stress test or either some imaging. A calcium score at that point. Once I identify that, now once again, it's still entails some of the same issues as before. I want to tap into her culture, because sometimes in different cultures, there's a fear of getting too small. The perception that, "Oh, I won't be as appealing." Or either the pressures in terms of her household, in terms of the foods.
Dr. Columbus Batiste:
It makes me remember a story. One time, a patient situation where I was. They were Hispanic. And unfortunately, they were not very affluent. And we were talking about the meals and eating. And I was going through my whole little pitch. I was giving the elevator pitch as quickly as I could there. And the guy stopped me and he's just like, "Doc, the apartment I live in has roaches." He was like, "I don't really have all of those things." And I had to come to screeching home and realize, "I need to meet you where you're at."
Dr. Columbus Batiste:
I started shifting the dialogue towards canned foods. I started shifting the dialogue to, "Okay. You know what? When you're out, here's what I want you to choose. When you're at certain places and beginning the process of meeting them where they're at." And I think that's the key when I hear about different ethnicities and cultures is trying to address and bring that into the equation of the approach of lifestyle.
Rip Esselstyn:
Yeah. All right. I'm liking it. So 55 year-old African-American, he's had three stents put in over the last five years, and he's about 60 pounds overweight. And he comes to you and he also is reticent to eat white food.
Dr. Columbus Batiste:
Absolutely.
Rip Esselstyn:
What do you say to him?
Dr. Columbus Batiste:
Yeah. So if I'm to dive straight in that the food, usually for men, I'll hit them where it hurts [laughter] I'll hit them where it hurts. And I usually try and tackle that upfront. And I'll talk to them about their sexual performance and talk about the relationship between that and their heart. That relationship, not only between longevity, about where they see their future self.
Dr. Columbus Batiste:
And oftentimes we put off on our future self. I'll speak to patients who are around that age and I'll speak to them who are looking to retire maybe five, 10 years. And I'll speak to them about how they had to put money aside for retirement. And what's the purpose of doing that? To live the life that you want to live when you retire. And so how you have to put aside, perhaps some of your pre prescribed likes and dislikes from early on to live the life you want to live from a health perspective. Adopting a dietary approach.
Dr. Columbus Batiste:
As I begin to kind of discuss all of those things and bring it home to the question, they don't want to eat white food. I will bring them back to really the core foundation of their foods as I will do anyone. And it's like, "Okay. Well, why don't we look at..." Since the African-Americans are diverse. It's not a uniform Eric. They may arise from the Caribbean or from the south.
Dr. Columbus Batiste:
And I'll speak to certain things. Callaloo, if they're from Jamaica. I'll speak to collard greens and mustards and kale. I'll reach in the cultural anchor, my bolts are from New Orleans. I'll speak to like red beans in the power of beans. I'll speak to the issue of okra that comprise of gumbo and how the beneficial effects of okra that are there. And even then from the immune function. I'll speak to all of the natural aspects of foods and the positive aspects and say, "Let's begin to go ahead and focus on those."
Dr. Columbus Batiste:
And it brings me back to the story when I was dating my wife. I decided to cook her a meal. I've been vegetarian my whole life. I've been PlantStrong, the user terminology for at least now the past 13 years. And so I brought my wife and I made these red beans.
Dr. Columbus Batiste:
There was a guy at her job who was from the south. And he said, You can't tell me there's no meat in these beans." I said, "There's not one. You don't have to use meat to make them creamy, to make them textured." And so when I do my cooking classes, that's when I love to bring out the points that we can bring your culture and incorporate that and eat well and thrive.
Rip Esselstyn:
So you just said something that piqued my interest. So you teach cooking classes?
Dr. Columbus Batiste:
Yes. I don't want to overstate that I'm a massive chef. I can cook a little bit. I've been cooking since I was a kid with my mom and so forth. But yeah, I do. So I'll talk about the health benefits. So for the past three years of pre COVID, we would put on a cooking class. And that was one of the iterations that I took from your dad.
Dr. Columbus Batiste:
And so every Thursday night, twice a month, we would put these on, and I would talk about the health benefits of the foods we eat, only plant rich foods, no oil, no salt, no sugar, and make them allow folks to taste them at that moment. And so we would tend to peak from a gathering of anywhere from 20 to about 60 people who would show up in attendance on regular basis.
Rip Esselstyn:
Wow. So with your patients that come in, like the ones that we just talked about. And let's say they're like, "Yeah, I'm curious in this plant based thing. What's my next step?" What do you, as an interventional cardiologist, where do you send them? What's their next step down the path?
Dr. Columbus Batiste:
Yeah. So when I was chief, what I did was I brought in a dietician. So when I was in training for internal medicine and at the BA hospital, what we would do is we would have a smoking cessation doctor that was there. So after you see someone, you'd send them right immediately over. So that way you capture them. I felt the same thing was needed from nutrition.
Dr. Columbus Batiste:
So I wanted to have a dietician right there that I can at least make a connection and then have a follow up with them. And so that's what I started. That's my normal spiel. I will give them information. I will encourage them. I give them the medical benefits of it. And I introduced them to the dietician. And I gave them simple tools to start this process. So I'm a big advocate of the bowl method. And that's usually how I encourage folks to begin the process.
Rip Esselstyn:
Wait, what did you say that method is called, the what method?
Dr. Columbus Batiste:
Bowl method.
Rip Esselstyn:
Bowl.
Dr. Columbus Batiste:
Bowl, yes
Rip Esselstyn:
B-O-W-L.
Dr. Columbus Batiste:
B-O-W-L. Not Manute Bol, the 7"6' former basketball player or anything else, but the bowl. So start with your grain, lagoon, your veggies. You can make it any ethnic cuisine that you want and choose, and you throw on there, the flavors of the earth. Your sausage, your spices, and you're good to go.
Rip Esselstyn:
Yeah. No, you're exactly right. What I love about the bowl method, I'll actually write about it extensively in my third book, The Engine 2 Seven-Day Rescue, is it's just like no recipe, recipes were exactly. You're taking the extra grain, the beans, the greens. I love what you just said. What did you say? The taste of the earth, something of the earth.
Dr. Columbus Batiste:
Yeah. The flavors of the earth.
Rip Esselstyn:
Flavors of the earth.
Dr. Columbus Batiste:
But you know Rip, the crazy part. So we were doing a cooking class, and my dietician, I told her, "Listen, I want to do a no cooking-cooking class." And she looked at me and she was like, "Nobody wants that. Nobody wants us to do that. They want to taste foods that we're preparing." I said, "Trust me. They want to know cooking-cooking class."
Dr. Columbus Batiste:
So every session I opened up with my spiel introduction before we go, and I said, "You know what? I want to see the hands." Because we have a debate right now going on. I said, "Do you guys want to No cooking-cooking class?" The hands went up like they were in the stadium. They were like, "Yes." I was like, "Yeah, for those of you who don't cook, you're too busy, they'll No cooking-cooking class." And so it was a huge success
Rip Esselstyn:
Yeah. That's like 32 second abs.
Dr. Columbus Batiste:
Absolutely. Exactly.
Rip Esselstyn:
All right [laughter] Well, we all know that abs are made in the kitchen, right?
Dr. Columbus Batiste:
That's right.
Rip Esselstyn:
Let me give you another persona. One or two, and then we'll move on. And this is just in case we have a listener that this resonates with. 62 year-old female, she's Indian. She moved to the United States 15 years ago, grew up vegetarian, but obviously consumed a lot of dairy and put ghee on everything. And she now has cholesterol above 250, LDL above 130. And is about pre-diabetic and is overweight by about 40 pounds. Same thing?
Dr. Columbus Batiste:
Nearly. Rip, I think at this point, I want to acknowledge her background. And I want to affirm her background in terms of the fact that she's been vegetarian. I want to affirm the background in terms of the rich flavors of the earth we used to have once again, the turmeric and the others, the anti-inflammatory. I want to affirm all those aspects. I want to affirm what she knows already, which is the large burden of disease inside the south Asian population, in terms of cardiovascular events and how this is common.
Dr. Columbus Batiste:
And at that point now, I want to query her in terms of knowing full knowledge of the food cuisine of the types of foods. The amount of unrefined and no fat added vegetables in grains and various aspects there. And begin the process of communicating with her step-by-step how she can still maintain her culture. The spices, the aromas, the flavors, without the fat.
Dr. Columbus Batiste:
And beginning that process of moving her through, I use different aspects. I talk about, really it's the same thing. And certainly doing the same thing over and over and expecting a different outcome. And so she's seeing many around her who are succumbing to disease as she herself is following along those footsteps. And so something has to change. And so the question isn't, whether or not changes that happen, it's what is she willing to do to bring about that change? And we go down that road.
Rip Esselstyn:
Yeah. So you mentioned fat there. And obviously, she's been overloading on the ghee, which is probably pushing her fat content up. I don't know. Well, over probably 30% of her total calories. With your patients that you're trying to help them. And I'm going to use a term that ... So I had Colin Campbell on the podcast a couple months ago. And he's like, "I wish that us and everybody where they would stop saying prevent and reverse.
Rip Esselstyn:
What you're doing is you're treating the disease." He's like, "You're treating heart disease." So I'm just going to use that. So for patients that want to treat their heart disease, is there a percentage of fat that you recommend they try and hit ballpark area?
Dr. Columbus Batiste:
I'll tell you, I simplify things. There is, but I'll be honest. The vast majority of people ... Well, first let me take a step back. When individuals come to me and if they're at the point of saying, "Doc, how much fat should I have?" There are a whole different level I'm playing. That's on the Gazi and Bill distribution. That's an outlier.
Dr. Columbus Batiste:
The vast majority of folks are getting into the standard American diet, whether or not. And I always say, standard American diet is vegan style, gluten-free style, whatever you want to call it, but it's highly refined process, over cooked and everything of that sort. And that's what we have to move away from. And so I get to them as it relates to frying.
Dr. Columbus Batiste:
And so my main thing, because there's been such huge amount of, I won't say arguments, but discussion as it pertains to different things, I focus on eating real food, whole food. And so as we begin that process of eating real food, whole food, that may contain if it's chia and flax seeds, if it's aspects of certain amounts of avocado, that's where I point them to as an initial.
Dr. Columbus Batiste:
And I will firmly move them away from refined fats and animal fats completely, and talk about from a caloric standpoint, talk about breaking it down to something tangible. The amount that, we play this game in terms of the food industry, in terms of ounces and grams and everything that isn't incomprehensible to people. And try to break it down at that point in that level to have them recognize what they're doing to their bodies. And they'll come back and, "Oh, well, it hasn't been shown that a little bit it's okay." I said, "Well, define a little bit. Define moderate."
Dr. Columbus Batiste:
I was saying this to just a colleague. He said, "Oh, moderate is okay. It's really okay." I said, "Let's talk about moderate." And that's what I loved about your dad's book. I'm not trying to be as cheerleader on this episode here, but for years, I will lecture and I will talk about his chapter in this book, which is moderation kills.
Dr. Columbus Batiste:
My wife hated when I would do that. She's like, "You're alienating people." I said, "It's true. What does moderation mean?" It means so many different things to different people. So I do. I hit him hard with the fat by trying to make it simple as a start and as they move because so it's not insurmountable.
Dr. Columbus Batiste:
And then once they get closer, now I began to refine and talk about driving that fat percentage down for them, as they've lost weight. And going from many of these people, 40, 50, 60% down to 20, 10% is where I'm trying to get them if possible, and looking at things from a caloric standpoint.
Rip Esselstyn:
Yeah. I think that's really, really smart. You're meeting them where they are so that they can hear the message. Kudos to you. All right. I got another one for you. And this just happened to me two days ago. So I got a guy I've been swimming with for probably 20 years with the Masters Swim program. And he had a heart attack. He's probably 65. He had his first heart attack when he was like 43.
Rip Esselstyn:
And after meeting me, he kind of started to embrace this. He's done better and better and better. So the other morning in the locker room, he said, "Rip, I'm not taking any stents right now. My total cholesterol is 131. My LDL is like 68. So my numbers are great, but I got my CT calcium score back the other day. And it was like ... And I can't remember what he said. Let's just say a hundred and points higher than it was the previous time. And I'm freaking out."
Rip Esselstyn:
And I've heard you talk about stabilizing those plaque formations. And I'm wondering if for our listeners that are following this whole food plant based lifestyle, all their numbers are looking gorgeous, but then they get a CT calcium scan it's elevated. Is that good? Bad? What does that mean?
Dr. Columbus Batiste:
Yeah. No, that's an important question. So what we know is that the calcium score is a marker of events, is what it's. It's just over the atherosclerotic process, the hardening of the vessels, the calcium deposits that are there from the atheroma. Now, taking a few steps backwards. One of the things that I do for patients just like that, and I have some like this.
Dr. Columbus Batiste:
And where they're in a dilemma, "Do I want to take something or do I not?" First thing I do is I'll say, "Well, let's check several other additional profiles. Let's check a small dense LDL", which I don't normally check if their cholesterol levels are through the roof high. "Let's check a C-reactive protein. Let's see what the inflammation is like in your body."
Dr. Columbus Batiste:
And now this will give us further inference to, is there some role or value or additional support given your prior cardiovascular event? Because still within the medical ledger, and we can discuss that at nauseum, but there still is a class one indication for that. So I'll discuss with them really about that role. After if I see their inflammatory markers are high, their C-reactive protein is high, their small dense LDL is high, now we have a dilemma at that point.
Dr. Columbus Batiste:
And now we're having a legitimate discussion of, "Once again, what's your goal? What are you willing to do? What are you willing not to do in order to achieve this?" And I've had some patients staunch in the plant-based movement, who's looked at me square in the face that, "I will not take anything." I say, "Okay." I say, "I understand." I bet others, they say, "I want max protection." And I say, "Okay, you have to continue." Because here's the thing.
Dr. Columbus Batiste:
I know if you don't take your medicine because the refills. Of course, you can just buy a medicine and never take it and just sit there, but chances are you're refilling it because you need it. I don't know if you cheat and go off the bandwagon for six months, three months a year between our visits. But you succumb. And so the question that you have to ask yourself as listeners out there is, how reliable are you to you?
Dr. Columbus Batiste:
Everything you do, every single moment is playing a role in the foundation for your future. And you're investing in your future health either way, to poor health or to wellness. And we say illness versus wellness all the time. And so that's the dilemma that I'm struck with when I hear a case like that.
Dr. Columbus Batiste:
And so in many instances, I am a bit concerned about, if I have sequential calcium scores and it's going up, it does make me a bit concerned. Now, I might take that another step and say, "Let's do a full coronary CT." But it just depends upon a patient. It depends on whether or not he's had a heart attack inside that area but the other areas all look fine, which may mean that it's a bit old. And it may change my perspective slightly.
Rip Esselstyn:
Yeah. Right. I like it. So you said a couple of things in that answer that made me want to ask you, what is your definition of health span? I've heard you talk about that in the past, and I liked the way that sounds.
Dr. Columbus Batiste:
Yeah. No, health span is more important than lifespan. I think just personally, once again, I look at my dad, he died at age 78, which people say, "Well, that's a robust life." Well, no, his health span probably ended when I was a teenager as his disease began to spiral. As I went to college and I came back and his ability to walk. My father-in-law. By the way, they both passed the same year.
Dr. Columbus Batiste:
My father-in-law, from hypertension and ill effects that led to kidney failure and so forth. But once again, his health span ended before he went on dialysis many years ago. So that meant like last 30 years of his life were not healthy. They were revolving around doctor's appointments. Revolving around pills schedules. Revolving around procedures schedules. And that's not a healthy way of living. It doesn't allow us to be vibrant. It doesn't allow us to live a life of purpose or enjoy our families.
Rip Esselstyn:
No. So it was revolving around basically being sick.
Dr. Columbus Batiste:
Yeah, absolutely.
Rip Esselstyn:
So speaking of which, you said you're the youngest of six. So you got five what? Brothers and sisters. What's the combination there?
Dr. Columbus Batiste:
Yeah. Two brothers. I have three sisters that are there. And so I fall right into my birth order when I'm around the family. I'm the little brother. So I may spur and poke and prod at them, or either I'm quiet and I let them answer. Even if it's medical things, all of a sudden, I'm not really saying much.
Rip Esselstyn:
Now, are they supportive of what you're doing? And if they like jumped on the bandwagon?
Dr. Columbus Batiste:
They are supportive of me as their brother. And every blue moon, they will tell me that they're making a concerted effort to be healthier and that they are working themselves towards that angle. It's quite interesting. As the old saying goes, a prophet is not necessarily respected in their own home. I definitely get more traction outside, but it's interesting.
Dr. Columbus Batiste:
I think that paradigm has allowed me to be much more empathetic, to empathize with people. The struggles when you're trying to lead a helpful life and your family isn't necessarily there. Or you're trying to lead a helpful life and your spouse wants to eat out all the time. How do you navigate that? And I think it's given me a unique perspective as it relates to that transition that, at the end of the day, it doesn't matter. You have to do what you have to do.
Rip Esselstyn:
Yeah. It's interesting, you made me think of a time when I was giving a talk at a whole foods store, because I did that for 10 years. I was a whole food market ambassador. And we were sitting there maybe 50 of us in a circle. And at the end, I asked just anybody that wanted to share a little story. And this one gentleman, he was 72 years old from Richardson, Texas.
Rip Esselstyn:
And he said that in 2005, he read the China study, and it totally changed the way he looked at food. He was one of 10 brothers and sisters. But he was the youngest. He shared it with everyone of his brothers and sisters. And he said they all put pudding, and they said they would rather die fat and happy than eat this rabbit food.
Rip Esselstyn:
And he said, "I'm here to tell every one of you sitting around this circle today, did not one of my brothers and sisters is alive today. So in that 10 year span, between 2005 and 2015, every one of them passed away. So it is remarkable to me, the lengths that people will go to, to dig in their heels and not have an open mind around this lifestyle. Truly is.
Dr. Columbus Batiste:
Absolutely. It definitely takes a commitment and a willingness to understand. And the problem is, is that in such a normalization of the norm has become eating the standard American diet, which is not the norm throughout the history of this country or the history of the world. And that now has become the norm. It's a failure when we call alternative medicine, lifestyle medicine.
Dr. Columbus Batiste:
When alternative medicine, lifestyle medicine should be the norm. Alternative medicine is conventional medicine, where this is now the secondary approach that should be taken. This should not be the first or primary source. You brought this up when you mentioned Colin Campbell. I always tell patients the same thing, which is just, "Listen. My goal as a provider is to help decrease your symptoms and help you live longer."
Dr. Columbus Batiste:
So as we go down this road, let's ask and answer the question, does a whole food plant-based diet help you feel better? Answer is, check the box, yes. Does a whole food plant-based diet, eating plant predominant foods help you live longer? Check the box. The answer is yes.
Dr. Columbus Batiste:
As you look down the plethora of research, the growing body of research, it continues to affirm the same process over and over, or same findings, which is the most important. So I don't have to use words like reverse. I don't have to use words like cure. I don't have to use words like remission. I'm using words like, this is a tool in your tool chest to treat that you have to start here first.
Rip Esselstyn:
So how long have you been with Kaiser Permanente?
Dr. Columbus Batiste:
Well, I was born at Kaiser Permanente. So that would be day one [laughter].
Rip Esselstyn:
Very loyal, aren't you?
Dr. Columbus Batiste:
I'm a loyal individual. Yes. Barely 23 years and with Kaiser now, 49. So I came out of training and joined Kaiser. I've been with Kaiser ever since.
Rip Esselstyn:
And Kaiser's got, if I'm not mistaken, they've got a very interesting model where they're very supportive of their physicians recommending a whole food plant based diet to their patients.
Dr. Columbus Batiste:
Absolutely.
Rip Esselstyn:
And that's kind of makes them a bit of an outlier, if I'm not mistaken, that preventative kind of lead with prevention approach.
Dr. Columbus Batiste:
Yes. That really truly was one of the most important aspects within Kaiser, is the fact that the origins of the organization were built off of prevention. And so even as providers, we're given bonuses. Our ability to be transitioning to partnership is based off of how we keep patients well. If we keep you well, we do better. And it makes sense. I'll tell you. It's a wonderful system.
Dr. Columbus Batiste:
The only problem with it is the fact that if patients leave us and go to another insurance, the other insurance gets to reap the benefits of all of our strong work in prevention, in screenings and so forth. But it's phenomenal, so that it lends itself to make sense why there's a support of us acknowledging lifestyle if we so choose.
Rip Esselstyn:
So I like that. So you are incentivized by Kaiser to keep people well, and then you will get bonuses based upon that. Brilliant.
Dr. Columbus Batiste:
Correct. Absolutely.
Rip Esselstyn:
Yeah. I love it. Let me ask you this. And we're wrapping up our time here. So just a couple closing questions for you, Columbus. Your kids, you've got, you've got two kids, right?
Dr. Columbus Batiste:
Yes.
Rip Esselstyn:
Two beautiful kids. Are they PlantStrong slash plant-based?
Dr. Columbus Batiste:
Once again, up and down. So I started them off. No doubt. They have to be plant based growing up. And as they've gotten older, I'll be honest, they've gone into the seesaw. But what's so interesting is my son at age 14, he'll be 15 in a month and a half. He's six feet, one inches tall. He says that, "I liked it better when you wouldn't let us make our own decisions. And we had to eat this food I felt better."
Dr. Columbus Batiste:
My daughter says it too as well. And so they understand. And I'll be honest, Rip, this is the part I don't know the right approach. I wish I did. I've chosen the approach of planting seeds and saying in example as they've gotten older, because I realized I'm not around them on a regular basis.
Dr. Columbus Batiste:
And so in that way, I'm living the message, and that they're seeing the effects of it. But trying not to be judgemental. And so in that process, I'm seeing them as they floundered for a bit, come right back full circle and begin that process. And that's the part that's so encouraging to me, because if the motivation comes from them and not external, that's the goal. And that's the key.
Rip Esselstyn:
Yeah. I think you're right on the money there. I really do. So winding down, do you have a hero in your life that's kind of inspires you along your path and your journey?
Dr. Columbus Batiste:
Yeah. I would say my greatest inspiration would probably have to be my family, to be honest with you. My dad, who passed. My mom, the disease burden that's there. And that was one of the main reasons why even within this whole plant-based movement, I decided to kind of really tailor some of my approaches to specific targeted communities of a message there. I almost like a Superhero movie. There's a good guy, there's a bad guy.
Dr. Columbus Batiste:
You have Wonder Woman, Batman, Superman, Black Panther. There's always a good guy versus a bad guy. That good guy wins in the end. But there are rapt. And so I have a different story that may be attractive to different segments of the population.
Dr. Columbus Batiste:
And so seeing what happens inside of my family, their disease burden, their level of receptiveness or non receptiveness, has really inspired me to take a slightly different trajectory along this plant-based journey, to really target individuals. And really try and loop them in and let them know that this isn't just for one segment. It's not for one financial strata. It's not for certain groups. It's for everyone.
Dr. Columbus Batiste:
And it applies to everyone once you dig beneath the surface. And showing that and demonstrating that. So that's been my passion. And so I'd say my family as a whole, for being my main driver for all of this.
Rip Esselstyn:
So it's your birthday today. How old are you?
Dr. Columbus Batiste:
Yes. I am 49 today. Crazy.
Rip Esselstyn:
Damn. You're not even 50. That's incredible. You're not even halfway done with this amazing life. That's so exciting.
Dr. Columbus Batiste:
Listen, I'll tell you it's a blood thing. I had someone ask me, how do I feel? And I said, feel kind of the same. I actually feel a little bit younger now as I've let go of some responsibilities. And I have a sense of comfort with who I am. That's kind of freeing in a sense. So I'm definitely blessed. And I definitely feel that that's really our goal is to give back, is to help people. That's the ultimate goal is to help people and deliver this message as best as we can to everyone out there.
Rip Esselstyn:
Here, here, here. You got a birthday party plan for you tonight?
Dr. Columbus Batiste:
No, I'm not into birthday parties like that. No, not too much. I usually keep on the down low and don't really mention much in terms of like birthdays. My wife will, and the family, the kids do, but the just going to hang out with the family. Enjoy.
Rip Esselstyn:
Are they going to have a plant-based cake for you?
Dr. Columbus Batiste:
They usually do, but I'll tell you, man, right now, I'm on this mission. Talk about 50 to just get in the best shape of my life -Yeah. So I'm really refining out the types of foods, the types of every ... I'll be honest, I never deal with macros, because of the fact that I think it's too complicated for, not that patients can't understand it, but let's make things as simple as possible.
Dr. Columbus Batiste:
But I'm really focusing on the character, the types of foods I eat that is going to refine in my exercise. It really doesn't matter how busy I am at work. I'm still coming. And I had long day in the lab yesterday, came home, play in my hour and a half. And so I'm on a mission to live the wellness journey and be selfish like I like to say.
Dr. Columbus Batiste:
I tell people it's about your spirituality, which is like meditation, gratitude, your exercise, your love, at the central component is your food, real food, whole food. Intimacy from intimate relationships, your sleep and laughing, humor. And you have to get selfish in order to kind of really live a life. And so I'm trying to adopt that every single day as I lead to the big 50 next year.
Rip Esselstyn:
Yeah. So everything you just said there, is there an acronym for it?
Dr. Columbus Batiste:
No, that's it. Selfish.
Rip Esselstyn:
So that's the acronym. Selfish.
Dr. Columbus Batiste:
Selfish is the acronym. Selfish is the acronym.
Rip Esselstyn:
Okay. Hit me with each one, one more time.
Dr. Columbus Batiste:
Okay. So selfish. S stands for spirituality. Now, that means different things to different people. Meditation, prayer, gratitude. I'm putting inside that area. Taking time just to reflect. That's S. The E stands for exercise. Doesn't have to mean cross marathoning. Doesn't have to mean swimming. It could just mean getting neat with it. Non-exercise activity, thermogenesis, walking around, doing different things.
Dr. Columbus Batiste:
The L stands for love. Choosing actively to love more than hate. We know the impact on the vessels. We know the impact on the heart. That's tremendous. The F is the central component, which is food, real food, whole food. Plant rich food, PlantStrong food. The I stands for intimacy. Not in a sexual way, but intimacy and relationships that you can communicate. I give the analogy with my mom and her dog.
Dr. Columbus Batiste:
My mom lives with me and she said, "Oh, my dog is my best friend." I was a little hurt. I was like, "How is your dog your best friend. I'm standing right here." But she love the dog. And so this dog knows when she's feeling sad, when she's having arthritic pains, whatever it may be that's there.
Dr. Columbus Batiste:
The second S stands for sleep. Something we all neglect to get our to-do list done. But getting real rich sleep, dream, full sleep that's there. And the last, the H stands for humor, for laugh. Finding something in life to laugh about. Not laugh at people but to laugh with people. And so whether it's a joke, whether or not it's a show. And so those things are validating science. And so that's one of the most important aspects, I believe, in order to achieve the goal.
Rip Esselstyn:
Yeah. So everybody out there, let's get selfish. Let's get selfish.
Dr. Columbus Batiste:
It's selfish.
Rip Esselstyn:
Every day, make it rich. Make it count. I love it.
Dr. Columbus Batiste:
That's right.
Rip Esselstyn:
So, Dr. Columbus Batiste, I want to thank you for joining me on the Plan Strong podcast. I want to thank you for being a trailblazer, and for all the work you're doing to help people see the power of a whole food, plant based diet to basically give them the heart they deserve. I love it.
Dr. Columbus Batiste:
I appreciate you. Thanks for having me on. Following your footstep.
Rip Esselstyn:
Hey, repeat after me. Peace.
Dr. Columbus Batiste:
That's right.
Rip Esselstyn:
Engine 2
Dr. Columbus Batiste:
I like that.
Rip Esselstyn:
PlantStrong.
Dr. Columbus Batiste:
Yes, sir. Got you.
Rip Esselstyn:
Your health span really is more valuable than your lifespan. Thank you, Dr. Columbus Batiste for dedicating your life to your patients and emphasizing the power of plants to add life to our days. You are a brilliant agent of change. For links to all of the resources in today's episode, visit planstrongpodcast.com. Thanks for listening. Please be sure to subscribe. And we'll see you next week.
Rip Esselstyn:
The PlantStrong Podcast team includes Carrie Barrett, Laurie Kortowich, Ami Mackey, Patrick Gavin, and Wade Clark. This season is dedicated to all of those courageous true seekers, who weren't afraid to look through the lens with clear vision and hold firm to a higher truth. Most notably my parents, Dr. Caldwell Esselstyn Jr and Anne Crile Esselstyn. Thank for listening.
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