Heart disease was four times more deadly than it is today. In those days, we had no statins, no stents, and no bypass surgery. Food was the only weapon doctors had.

Pharmacies in Rome and Greece even stocked extra virgin olive oil for patients with “hardening of the arteries.” Doctors sent people to pick up bottles, almost like prescriptions. Olive oil wasn’t curing clogged arteries, but it showed an early recognition that diet mattered.

Then scientists noticed something bigger. In certain Mediterranean villages, people lived longer with far less heart disease. It wasn’t genetic. Relatives who moved to cities and switched to Western diets developed heart disease much earlier.

Researchers didn’t stop there. They followed men in villages across Europe and the Mediterranean for decades. Some communities ate diets heavy in saturated fats. They developed clogged arteries and heart disease quickly. Other communities ate diets rich in fruits, vegetables, legumes, fish, nuts, and olive oil. They had much lower rates of heart disease. This pattern became the foundation of what we now call the Mediterranean Diet.

At that time, diet gave us hope. But today, we know that food alone is not enough.

The Lyon Diet Heart Study proved how powerful diet could be. Conducted just as statins came onto the market, it showed that patients with heart attacks who switched to a Mediterranean-style diet had a 70% lower risk of another cardiac event. That meant fewer heart attacks and fewer deaths.

Later, the PREDIMED trial confirmed these results. In high-risk adults, the Mediterranean Diet reduced major cardiovascular events by about 30%. That’s impressive, but it also raises a question: can people sustain it? Adherence usually means sticking with the diet about 70 percent of the time. That’s not perfect.

Here’s a personal example. I have hypercholesterolemia and a strong family history of heart disease. I follow the Mediterranean Diet carefully. But even with strong adherence, my LDL cholesterol never dropped below 180. With two drugs — Zetia and Crestor — my LDL is now in the 40s. Food helps. Medicine saves.

The PESA Heart Study showed why this matters. Researchers in Spain followed adults who felt perfectly healthy. Using advanced imaging, they found more than 60 percent already had plaque in their arteries. Atherosclerosis begins silently, and often decades before symptoms appear.

The JUPITER trial with rosuvastatin (Crestor) proved what medicine can do. Statins reduced cardiovascular events by 44 percent, and the study had to stop early because the benefit was so strong.

And then there’s Dean Ornish. His program is often called the “diet that reverses heart disease.” But it was never just a diet. His patients quit smoking, took statins, took blood pressure medications, and practiced yoga. Ornish proved that lifestyle matters — but it was food and medicine together that made the difference.

Meanwhile, scammers still sell false hope. Barbara O’Neill, banned from giving health advice in Australia, charges thousands for seminars where she claims cayenne pepper “opens arteries.” That’s pure fiction. Cayenne is a spice, not a stent. She also claims cholesterol guidelines only exist to enrich drug companies. Yet my three-month supply of Crestor costs $2.36, while she profits thousands. The real con is clear.

So here’s the truth: salmon is healthy, but it isn’t a stent. Olive oil helps, but it isn’t a statin. Food prevents disease. Medicine treats it. Together, food and medicine are...

People love to believe that food can replace medicine. We talked about this in Episode One, where I explained that Hippocrates never said “let food be thy medicine.” Still, the myth endures.

Food does matter. The right eating pattern can lower blood pressure. One of the best-studied is the DASH Diet—short for Dietary Approaches to Stop Hypertension. It is often called America’s version of the Mediterranean Diet. While the Mediterranean Diet was being mapped out for overall health, the DASH researchers asked a sharper question: what foods can lower blood pressure directly?

Unlike most nutrition studies, the original DASH trial provided all the food to participants. That meant researchers knew exactly what people ate, meal after meal. This is rare and expensive, but it gave them confidence in the results.

The DASH diet emphasizes:

• Fruits and vegetables, especially potassium-rich foods like bananas, beans, and leafy greens
• Whole grains
• Lean proteins, like fish and poultry
• Low-fat dairy
• Less red meat, sweets, and sodium

Because it combined several food groups, DASH worked quickly. Within two weeks, blood pressure dropped.

The results were consistent. People following DASH lowered their systolic blood pressure (the top number) by 8–11 mmHg and their diastolic pressure by 5–6 mmHg. That is about the same as one standard blood pressure pill.

Even more important, DASH showed that sodium reduction matters. Those who cut sodium intake to 1,500–2,300 milligrams per day saw the greatest improvements. This shattered the myth that unlimited salt is safe. Too much sodium raises blood pressure, increases heart disease risk, and fuels strokes.

This is where things get messy. Electrolytes, especially sodium, are necessary during prolonged exercise—typically more than 1–2 hours, in hot weather, or when sweating heavily. Under those conditions, sodium helps prevent hyponatremia, a dangerous drop in blood sodium levels.

However, for most people exercising less than an hour, water is enough. Regular meals will replace lost sodium. Salty drinks or powders aren’t required. In fact, most commercial sports drinks don’t even contain enough sodium to match sweat losses in extreme events.

Here is where the grift appears. Shirtless salesmen on social media love to sell high-priced mango-flavored salt packets as “essential” electrolytes. They promise performance and recovery, but they may actually raise your blood pressure and put you at risk.

Science says otherwise. Electrolyte supplementation should be individualized and used with caution. People at highest risk from unnecessary sodium loading include:

• Those with hypertension, heart failure, or kidney disease
• Women, who are more prone to overhydration and hyponatremia due to smaller body size and lower sweat rates
• Older athletes or those with low body mass
• Recreational athletes who follow outdated advice to “drink as much as possible”

Even ultra-endurance athletes cannot rely on sodium supplements alone. If they drink more than they lose, sodium will not prevent hyponatremia and may make things worse. The best strategy is to drink to thirst and use salty foods or fluids only when truly needed.

How can you follow DASH in real life? Here’s one...

People love to say “food is medicine.” Some even claim Hippocrates himself said it. But here’s the thing: he didn’t. The phrase does not appear in any of his surviving writings. In fact, historians believe the line was created centuries later and then falsely attached to Hippocrates to give it weight.

Still, the idea persists. Even the current head of HHS, Robert F. Kennedy Jr., has repeated the myth. And when RFK Jr. is your fact-checker, you know you’re in trouble.

Now, as someone certified in Culinary Medicine, I believe food is incredibly powerful. Eating the right foods can prevent disease, improve health, and help you live longer. However, food alone rarely works as well as actual medicine. That is especially true when it comes to cholesterol.

In the early 2000s, Dr. David Jenkins and his team introduced what they called the Portfolio Diet. Instead of focusing on one “superfood,” the diet combines several cholesterol-lowering foods:

• Soy protein
• Nuts, like almonds
• Viscous fibers from oats, barley, or psyllium
• Plant sterols from fortified foods

Each one has a small effect. But when you put them together, the benefits add up.

Why does it work? Cholesterol gets secreted by your liver into bile, then travels into your gut. Normally, most of that cholesterol is reabsorbed into your bloodstream. But fiber and plant sterols bind to cholesterol and drag it out of your body. That’s why bowel movements are brown—bile is brown, and fiber helps carry it out. More fiber means you feed your gut bacteria and flush away cholesterol. It really is a win-win.

The Portfolio Diet has been tested in multiple clinical trials. In one JAMA study, people who followed the diet lowered their LDL cholesterol by about 13 to 14 percent over six months. That translated to a drop of about 24–26 mg/dL.

Other studies show that people who stick with it can lower their LDL by 17 percent on average. Some who were especially diligent saw drops of more than 20 percent at one year. The Portfolio Diet also improves non-HDL cholesterol, apolipoprotein B, and long-term risk for heart disease.

So yes—it works. In fact, the effect is similar to what you get from early statins like lovastatin.

The science sounds great. But how do you actually eat this way? Here’s one example day:

• Breakfast: Oatmeal made with soy milk
• Snack: A handful of almonds (about 25–30 grams)
• Lunch: Lentil soup with whole-grain bread
• Dinner: Tofu stir-fry with vegetables and barley
• Extra: Two grams of plant sterols, often from fortified margarine spreads

That daily pattern gives you soy protein, fiber, nuts, and plant sterols. But here’s the challenge: it takes careful planning to hit the right doses every day. It’s not impossible—but it is hard to sustain.

Many people confuse the Portfolio Diet with the Mediterranean Diet. Both are plant-forward, emphasize nuts, legumes, whole grains, and lower cardiovascular risk. However, the Mediterranean Diet is broader and easier to follow. It includes olive oil, fish, fruits, vegetables, and even moderate wine.

The Portfolio Diet, on the other hand, is very prescriptive. You must hit specific amounts of soy protein, fiber, and sterols daily. Think of the Mediterranean Diet as the entire restaurant, while the Portfolio Diet is just one corner of the menu—focused...