Podcast Summary: The Dylan Gemelli Podcast
Episode #70 Featuring Dr. Philip Ovadia – "STAY OFF THE OPERATING TABLE! A Masterclass on Heart Health"
Release Date: December 4, 2025
Host: Dylan Gemelli
Guest: Dr. Philip Ovadia, board-certified cardiac surgeon, founder of Ovadia Heart Health, author of Stay Off My Operating Table
Episode Overview
This episode is a deep-dive, no-nonsense masterclass on heart health with Dr. Philip Ovadia, a renowned cardiac surgeon and advocate for metabolic health optimization. Dylan and Dr. Ovadia tackle pervasive myths in cardiology—especially around cholesterol, fats, and heart-healthy diets—shedding light on outdated dogmas, the failings of the conventional medical system, and practical strategies to prevent heart disease. The conversation is personal, practical, evidence-driven, and empowering, focusing on actionable truth and patient empowerment.
Key Discussion Points & Insights
1. Dr. Ovadia’s Journey and Mission
[07:16]–[09:51]
- Dr. Ovadia shares how, despite being a heart surgeon, he struggled with his own health: morbid obesity and prediabetes.
- Realizes traditional advice (low-fat, low-cholesterol) was ineffective for himself and patients.
- Loses 100 lbs, reverses prediabetes, and is motivated to help others avoid heart surgery through metabolic health.
- "No matter how good a surgeon I might be... you’re never as good after you had the heart surgery as you would have been if you didn’t need the surgery in the first place." – Dr. Ovadia [09:51]
2. The Demonization of Dietary Fat
[11:28]–[17:30]
- Explains the historical rivalry between "sugar causation" and "fat causation" theories for heart disease.
- Low-fat diets took off based on flawed science and political pressure in the 1970s–80s.
- Dismantles the myth: Despite 70 years of low-fat advocacy and declining animal fat intake, heart disease worsens.
- Animal fats (especially saturated) are essential for human health and evolution.
- Notable quote: "Fats are essential, right? And especially animal fats, which have been the most demonized, but are actually the most important component of our diet." – Dr. Ovadia [11:28]
3. The Real Drivers of Heart Disease: Inflammation & Insulin Resistance
[19:49]–[22:11]
- Major contributors are NOT cholesterol, but insulin resistance and inflammation.
- Primary dietary dangers: Processed carbohydrates and seed oils, not saturated fats.
- Recommends focusing on foods that lower inflammation/insulin resistance: animal proteins, animal fats, and (optionally) non-processed carbs/vegetables.
- "The real kind of first principles... are to avoid the foods that are causing insulin resistance and inflammation." – Dr. Ovadia [21:49]
4. Essential Foods for Heart Health
[22:11]–[24:35]
- Dylan’s essentials: avocados, eggs (whole), grass-fed beef/pork, salmon, grass-fed butter/olive oil.
- Dr. Ovadia’s list: Primarily beef, seafood (salmon, tuna), eggs, dairy (butter, cheeses, yogurt), avocados.
- "It’s literally the exact opposite of what I was taught in school." – Dr. Ovadia [24:19]
5. Understanding Blood Panels
[25:00]–[26:05]
- Standard cholesterol (LDL/HDL/triglycerides) is insufficient; advanced panels (ApoB, LP(a), particle size) reveal the real risk.
- Quality of LDL particles is key: large, fluffy particles are benign (and essential); small, oxidized particles are dangerous.
- Root cause of harmful particle shift: insulin resistance, inflammation.
6. Particle Size, Statins, and the Cholesterol Controversy
[30:17]–[38:47]
- Small LDL particles are "damaged"; more likely to cause arterial plaque.
- Statins lower total LDL but disproportionately lower large, benign particles—leaving small, harmful ones behind.
- "The patients that are on my table have been on statins for decades, and they still got the heart disease and still ended up on my operating table." – Dr. Ovadia [38:14]
7. Lipoprotein(a) [LP(a)], Plaque Types, and Testing
[32:46]–[41:03]
- LP(a) explained: genetically determined, increases clotting risk, not directly treatable with diet/exercise.
- Statins do not lower LP(a); focus should be on reducing inflammation and clotting risk (nattokinase, baby aspirin).
- Calcium scoring: Best non-invasive test for calcified (hard) plaque; less predictive for soft plaque.
- "You can have a couple thousand of calcium [score] spread throughout the blood vessels and no one spot might be problematic." – Dr. Ovadia [40:46]
8. Soft vs. Hard Plaque Dangers
[42:45]–[45:46]
- Soft plaque is unstable, prone to rupture and sudden blockages (heart attack).
- Calcified (hard) plaque narrows vessels over time—can constrain blood flow but is less rupture-prone.
- Statins increase plaque calcification, but the implication for safety is still debated.
9. Reversing Plaque and Hope for Patients
[46:14]–[47:33]
- Plaque reversal is possible, though modest (10–20% reductions). Main goal: stop progression.
- "The body has an amazing capacity to heal... if you just stop doing the damage and let the body do its thing." – Dr. Ovadia [47:19]
10. Heart Function, Failure, and Ejection Fraction
[50:52]–[57:42]
- Echocardiograms evaluate heart muscle and valve function; ejection fraction (EF) of 55–70% is normal.
- Heart failure can be due to blockages, drugs (including steroids/chemo), viruses (COVID, flu), toxins, etc.
- EF can improve and patients can recover if causes are addressed.
- "If we can identify a root cause and we can correct that, we should expect that the heart function will improve." – Dr. Ovadia [58:52]
11. The "Idiopathic" Diagnosis and Underlying Causes
[55:21]–[57:00]
- "Idiopathic" heart failure means the doctor doesn’t know the cause—often due to lack of thorough investigation.
- Hidden contributors like heavy metals, mold, Lyme disease, chronic toxins can be missed.
12. Mental Health, Stress, and Patient Empowerment
[59:19]–[60:52]
- Psychological stress and hopelessness worsen heart health and outcomes through inflammation/oxidative stress.
- "If you can say... you can improve yourself... you have the power... it’s much more empowering. And patients react well to that." – Dr. Ovadia [60:17]
13. COVID-19, Spike Proteins, and Heart Risk
[61:05]–[62:36]
- COVID infection and (for some) the vaccine’s spike protein can damage hearts.
- Discussing these facts openly is essential for patient care and proper risk assessment.
Notable Quotes & Memorable Moments
-
On the failed "low-fat" experiment:
"Here we are 70 years later, this low-fat experiment has clearly failed, and we can't change our ways... our health has just continued to worsen." – Dr. Ovadia [15:57] -
On medical empowerment:
"If you change the way you eat... you can improve yourself. You don't need the medications to do this. You have the power." – Dr. Ovadia [60:16] -
On cholesterol particle sizes:
"If you have a lot of large LDL particles, those are not atherogenic, they are not plaque forming, and in fact they play so many vital roles in our bodies." – Dr. Ovadia [26:05] -
On statins and heart disease:
"That’s why people are still at risk. That’s why I see it routinely as a heart surgeon, that the patients that are on my table have been on statins for decades, and they still got the heart disease..." – Dr. Ovadia [38:14]
Timestamps for Important Segments
- [03:16] – Dr. Ovadia introduction and personal mission
- [07:16] – His personal health transformation and paradigm shift
- [11:28] – Why fat is essential and its wrongful demonization
- [17:30] – Impact of diet (low-fat to high-fat) on Dylan's health
- [19:49] – Insulin resistance/inflammation as true heart risks
- [22:11] – Top 5 essential foods for heart health (both guest and host)
- [25:00] – Blood panel essentials: going beyond basic cholesterol
- [30:17] – Particle size, statins, and what doctors miss
- [32:46] – LP(a), soft/hard plaque, calcium scoring explained
- [42:45] – The real dangers: soft vs. hard plaque
- [46:14] – Can you reverse plaque? (Yes, to some degree)
- [50:52] – Ejection fraction, echo, and heart failure causes
- [55:21] – Idiopathic diagnoses & missing underlying causes
- [59:19] – Mindset, stress, and patient empowerment
- [61:05] – COVID and heart health discussion
Conclusion & Free Resource
- Dr. Ovadia offers listeners a free digital copy of his book Stay Off My Operating Table at ifixhearts.com/dylan [63:24].
- Final message: Take charge of understanding and protecting your heart health—knowledge and empowerment are key.
Tone Note: The discussion is candid, compassionate, and straightforward, blending expert insight with personal experience and a drive to cut through medical dogma. Both men are committed to practical solutions and patient autonomy.