**EP323: Interview With Dr. Kaplan Part 2: A Day in the Life of a Cardiologist**
**Dr. Auric Bishop:** Welcome, my name's Dr. Auric Bishop. I'm a cardiologist, an author, and a keynote speaker. I'm CEO of the Healthy Heart Network. I'm all about trying to help people live as well as possible for as long as possible. Heart disease is huge in Australia. Every 20 minutes someone suffers a heart attack. Most of these could probably have been avoided if only we knew what to do. This podcast is all about helping you understand blood pressure, weight, and cholesterol for better health. If you enjoy this podcast, I would be honoured for a five-star review. You can share it with your family and friends. It may well save someone you love.
**Dr. Warwick Bishop:** Hi, my name's Dr. Warwick Bishop, and welcome to my podcast and videocast station. I'm delighted to have with me today Dr. Jason Kaplan, a cardiologist who will be sharing. Hi, Jason.
**Dr. Jason Kaplan:** Hi, Warwick. Thank you for having me, and great to be here.
**Dr. Warwick Bishop:** Look, for anyone who missed the first podcast I did with Jason, shame on you. I suggest you go back and have a listen to it. We were going to start off with this very topic that we're going to talk about on this podcast, which was about what we do on a daily basis for our own lifestyle routine. But we ended up heading down the road of plant-based diets and cardiovascular disease. It's absolutely fascinating. Jason is right at the forefront of that, shared his own experience, talked about some of the research in the space. And if you've missed it, please go back and check it out. You will find it informative.
Having said all that, Jason, today we're going to talk a little bit about what you and I do on a daily basis as part of our routine to try and keep well and healthy and share that with the people listening or watching. I'll let you kick off. How do you wake up? Tell me how you wake up.
**Dr. Jason Kaplan:** So thank you. Thank you, Warwick. I think it's important that I'd like to preface some of this by saying that, you know, we do our best as doctors to be both models for our patients, but there are times when we can't do exactly all of this, and there are times when we're busy and other demands come up. But listeners, not to be too hard on themselves if you can't do everything absolutely every day, but rather think about the bigger long-term picture and the cumulative effects. When we talk about habits for cardiovascular health and longevity, we aren't just talking about the effects in weeks that people may feel; we're really measuring the effects over years.
In fact, what I might add to that, which is super important for those listening, is some of the stuff we'll talk about not only will offer dividends in the long term because we are looking to reduce cardiovascular disease, but some of these things will actually make you feel better on a daily basis as well. And that's so important because your quality of life on a day-to-day basis—what else have we got? So there's a bit of a small investment.
**Dr. Warwick Bishop:** That's a great point, Warwick. Absolutely. There's a small investment for now, which will probably make you feel better. But we also want to see you live as well as possible for as long as possible. Over to you, Jason.
**Dr. Jason Kaplan:** Warwick, so as we might have touched upon just before, we were talking off camera about intermittent fasting. I think this is something that is really interesting. At least a few mornings a week, I tend not to eat breakfast in the mornings. I think that there is still a lot of research moving forward in time-restricted eating. We don't yet know what is perhaps the best way to do it yet. But for most people, it's eating during a limited time window. So for a few mornings a week, I will wake up. I do my best to wake up close to 6 a.m., both because that's when the house is quiet, and I have a few minutes—like sitting outside and having a cup of black coffee. When I talk about intermittent fasting, I think it's important to know that generally, I think it's reasonable to have either some green tea or some black coffee or some water so that is not breaking the fast. I just think about my plans for the day.
I think one of the really important things that has actually been shown to be of benefit, and as you said, provide an immediate benefit, is some form of meditative or contemplative practice. That generally provides not only a benefit today in how I'm feeling, but also it gives us the tools for vacuum cleaning our minds going forward. At least one morning a week, I will do a 6 a.m. yoga class. I do a Hatha flow yoga class, which is a fantastic way to start the morning. It sets me up for the rest of the day, if not for a few days. Generally, in my exercise, I will try to combine either a movement-based exercise such as yoga with higher aerobic activity. I always like to be able to tell my patients about where I think the evidence lies for some of the daily routines, but generally, 75 minutes of a higher intensity exercise program once or twice a week is beneficial, or more sustained moderate exercise done half an hour, five times a week. So depending on the week, I'll try and mix it up as well. Generally, we go to work most of the days. As mentioned in the last podcast, my dietary program is mostly plant-based. So lunch is often a salad, and then dinner is often a legume-based meal.
**Dr. Warwick Bishop:** Before we get too far through the day, Jason, I might just share how I...
**Dr. Jason Kaplan:** Oh, absolutely. Yeah. No, that's cool.
**Dr. Warwick Bishop:** I hate the alarm clock. So for anyone listening who hates the alarm clock, we can share that. I found there's a little option on my iPhone to wake up to the sound of birds twittering. It's super gentle, and so it no longer shakes me out of my sleep, which is a really nice way to wake up. I try and wake up as gently as possible. On the workday mornings, I set the alarm early and for the last couple of years have been doing a gratitude meditation, which is completely in keeping with your comments about clearing your mind and realigning and defragging to a degree. So I get that. It's a beautiful way to start the day. I jump in the shower after the shave and all the other bits and pieces. I try and finish the shower with a bit of a cold shower for about a minute to two afterwards. Now in Tassie in the middle of winter, that's pretty challenging. Part of the rationale is these bits of information that sort of point to activation of brown fat, changing your metabolism, and so forth. We can speak about that on another occasion.
I'll then walk to work unless the weather is inclement, in which case I'll drive. But I try and make sure I get that little bit of time walking to work. It's lovely, actually, because I will often plug in my audiobook. If I've got something that I'm listening to, I try and listen to stuff that's, I guess, better to say it's positive stuff rather than negative stuff. I tend to be looking for things that will give me something interesting or help me grow and develop. I get to work, have my first cup of coffee, second cup of coffee, and then I've pretty well caught up with you at about lunchtime where I may have something to eat or I may push a little bit longer. But you were talking about what you'd have for lunch—a light meal, or would you sometimes miss lunch and go a bit further? Where would you be with that, Jason?
**Dr. Jason Kaplan:** Look, generally it's a light meal for lunch, nothing too heavy to help me get through the day. In the afternoon, probably just some nuts—often some nuts and fruit before dinner.
**Dr. Warwick Bishop:** What more can I say? I love the idea of a podcast when exercising or when walking. And, you know, some of you may be listening to us when you're exercising. That would be lovely.
**Dr. Jason Kaplan:** That would be lovely. But I also love the idea of an audiobook. I would encourage people—there's so much great stuff out there. There is just so much to learn. I often also listen to some cardiology talks. One of my favourites is John Mandrola's podcast.
**Dr. Warwick Bishop:** Very good, very good. I reckon we could do at least several podcasts on what do you listen to when you're exercising. We could easily do that.
So your day wraps up. I love the cold shower. I think that is something that I think is really interesting, and we're starting to see it much more in both, you know, in the wellness space, but also the healthy living space as well. It's not just something in exclusive health clubs. When I look, I live fairly near the ocean here in Sydney, and I see about the people diving in early, you know, in all seasons. I think we're seeing a lot, as you said, positive benefits and brown fat, but also I think in the longevity space, positive effects on DNA methylation and telomerase activity as well.
**Dr. Jason Kaplan:** Yeah. Look, it certainly leaves you quite refreshed when you jump out of the shower in the morning and ready for the day. I sort of started to do it as a follow-up to saunas. So I'd do a sauna and follow that up with a cold shower, and I just tried to incorporate that into the mornings. But I think it's an interesting space—the challenge to the body leading to the sort of changes that you're alluding to at a cellular level, which is remarkable.
**Dr. Warwick Bishop:** So you'll get home. I mean, I walk home, so I've got another little bit of exercise as I get home. What's the rest of the evening look like for you there, Jason?
**Dr. Jason Kaplan:** So look, Warwick, I'll be honest. Some days in the clinic or in the hospital, often, you know, home is getting a little bit later. But I have three young children and often will do my best to try to spend some time with them before they go to bed and then spend some time with my wife. I think one of the really key things is that when we, as you know, perhaps in future conversations when we talk about longevity and cardiovascular health and when we recommend a lifestyle program, we have to include the relationships of the people around us—our family and close friends—about how much of an impact that has on our general health, but also on cardiovascular health. It's no good spending all that time in the gym or exercising and being very strict with the eating patterns if those aspects of our lives are not addressed as well.
So we'll spend some time with family, my wife. Often we have a dog, so often taking the dog for another walk around—a slow walk around the block. I do sort of most of our dinners are, well, just all of our dinners are plant-based. So it would be either salad or some oven-roasted vegetables with tofu, tempeh, legumes, or some sort of legume dish. I love green tea, so we'll have some green tea in the evenings. Depending on what's going on work-wise and family-wise, you know, I try to get somewhere about seven hours of sleep, but sometimes not always successful. But I think generally we know that lack of sleep is associated with worse cardiovascular prognosis. So at a minimum, six hours should be the absolute minimum. I also like that quiet time when everyone's gone to bed to catch up on my reading as well.
**Dr. Warwick Bishop:** What about you, Warwick? What are your feelings about sleep?
**Dr. Auric Bishop:** Oh, look, there's no question sleep's critical. We may even dedicate a whole podcast to that of its own because it is super important. I was going to say that as well—when I get home, I completely agree. If you don't spend time with those people in your life, you're really rowing the wrong boat. The Harvard longitudinal lifestyle or lifespan study showed us a multi-generational data that confirms that the two things that really drive longevity and quality of life are relationships and health. When they drilled down on that, health was most impacted by relationships.
**Dr. Jason Kaplan:** Absolutely. That study, that is just—and there's a great book about that too. There's an audiobook about it. They've got it, and I just can't remember the name now, but that Harvard longitudinal study where they looked at Harvard graduates and then followed them up for 30 years and then saw what were the positive impacts on their health and the relationship quality in marriage were so important. In actual fact, men live longer when they stay married. I think that part of our lives is really important.
**Dr. Auric Bishop:** Yeah, absolutely. So I just wanted to underline that because you're exactly right, flagging that. You know, I get home, I spend a bit of time with my other half. My kids have flown the coop, so I don't have that responsibility anymore, but I know what it was like. My evening meal is generally a salad with some protein cut in. I'm not vegetarian, as we talked about off camera, if you like. But I'll have a salad pretty well every night, and I'm pretty focused on fibre. We'll make sure that I'm getting fibre either through that salad or even supplementing with a fibre supplement if need be. That's a talk for another time too.
I think we could talk for a long time. I do have a glass of wine pretty well every night, and I'll often pour one generous glass, and that'll last me the night. I'm cognizant of current recommendations for alcohol consumption, but for me, alcohol is a component of my day-to-day, and I so enjoy food with a glass of wine and not as much without a glass of wine. So I make a choice that I enjoy it, and I'll not drink too much, but I do indulge. We go to bed early, and about 9, 9:30, 9:30, 10 o'clock latest, we're in bed generally. I really prioritize that healthy sleeping environment. We run an essential oil burner up in the corner because I read some fascinating research on essential oils and aging brains and dementia and memory and so forth. We put some calming oils in. We've got a red light in the bedroom. So as we go into the bedroom, it's not a bright white light; it's a red light which starts to allow your brain to calm down. My partner and I will actually listen to a nighttime delta breathwork meditation to help us get off to sleep.
Completely endorsing what you were saying before, Jason, the importance of sleep is huge. If you can ease into it, clear some of those thoughts from the day, and get deep restful sleep, you can face the next day. Whatever those problems may be that we all deal with in this modern crazy world, the better you can deal with those issues.
**Dr. Jason Kaplan:** Interesting. I love the idea about, you know, the changing of the light to a red light and the strong bright light. I guess I think should emphasize that, you know, there's a lot of data now about healthy sleeping habits associated with taking away screen time. Disconnect from our devices, from our phone. I love this. I've got this app called Do Not Disturb app, and it turns on at 10 o'clock. So I can't do anything, and it's a reminder to myself that I can't access any of those non-essential functions.
Look, I will add, I also wear an eye mask when I go to sleep at night to just make sure that any of the light that gets through the blinds or outside, if you like, is kept away from that extraneous light and that it doesn't cause any disruption at all. I've been sleeping with an eye mask for a good period of time and find that really just adds to the darkness and my quality of sleep as well. So it depends where you live; if you've got blackout blinds, all power to you, but our blinds are not perfect. This is a really nice way to make sure you have that darkness.
I'd love to speak to you more about, you know, alcohol because it's so important in a lot of our patients' lives and day-to-day lives. But it's really interesting to me about the data emerging about, I guess, both on—I used to, you know, routinely be able to happily recommend to patients that a glass of alcohol, you know, daily would lead to beneficial cardiovascular outcomes. In certain cultures and in certain lifestyles, I think it does, especially in the Mediterranean—importantly knowing that it's a different type of wine and much higher antioxidant wine compared to what we might consume. But I think more and more I'm starting to see more things coming through about the lack—mostly probably the negative effects of alcohol on multiple different health parameters. For many of our patients, it can be, you know, one is fine, but more than two probably can lead to more as well.
**Dr. Warwick Bishop:** Look, I think we should make a time to talk about alcohol. It certainly impacts quality of non-REM sleep as well. So there are lots of aspects to it, as well as the social aspect. But we have to keep an eye on the time. We're pretty close to the end of our time. But are there any final things in your day that you'd like to share or any major points?
**Dr. Jason Kaplan:** We touched on exercise, which is really a topic of its own. Both you and I incorporate it. I try and get a little bit of not just cardiovascular; I try and get a little bit of weight-related training in as well. But I think we can cover that another time. Jason, is there anything else that you want to mention to fill out your day in terms of what you do or any final points you'd like to raise as we wrap this one up?
**Dr. Jason Kaplan:** Look, one thing that I want to acknowledge you for is, I guess, the gratitude. It's about, you know, thinking about what am I grateful for today? What have I got to look forward to? Those are really good questions to ask ourselves. So what went right? What went right today as well? You know, often things that go wrong, but what went right today and what worked well? I think these are good questions that I try sometimes to ask or talk with my wife about towards the end of the day. But I think we do live in a lucky country in Australia, and we are fortunate compared to everything else that's going on in the world at the moment.
One other last thing, and I think thinking about, I guess, periodontal and oral health as well is important as well.
**Dr. Warwick Bishop:** Good one, yeah.
**Dr. Jason Kaplan:** I floss twice a week. My dentist told me last week they're using those incidental brushes. They're just as good as flossing. I love those Plixtas or something similar. So use them in your daily routine.
**Dr. Warwick Bishop:** Perfect, perfect. That's so good. Jason, absolute pleasure. In fact, I'm full of gratitude having the chance to share with you. I'm really grateful for anyone who's been listening this far, and I'm sure you've got something that you can take from this. If you have any queries or questions, drop us a note. I would love you to subscribe and please share this podcast so that others can get the information. Jason, thank you once more for joining me.
**Dr. Jason Kaplan:** Thank you very much, Warwick. And for everyone else, I hope you live as well as possible for as long as possible. Take care and bye for now.
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