It’s not about being perfect. It’s about being better. Our trial proved this. We demonstrated that you can achieve highly meaningful — even medication level — cholesterol reductions with a tiny dietary change!
As a part of my series about the women in wellness, I had the pleasure of interviewing Elizabeth Klodas, cardiologist and founder of Step One Foods.
Dr. Klodas has dedicated her career to preventive cardiology and to helping her patients reduce their reliance on prescription medications by achieving long-lasting health improvements through dietary change.
Dr. Klodas trained at Mayo Clinic and Johns Hopkins, and founded Preventive Cardiology Clinic, where she continues to see patients. She is author of the book Slay The Giant: The Power of Prevention in Treating Heart Disease, and Founding Editor of www.cardiosmart.org, the patient education website of the American College of Cardiology. She founded Step One Foods out of a conviction that changing diet could be as easy — and as effective — as taking a pill, so long as the food formulations were science based, practical and rigorously validated.
Thank you so much for doing this with us! Our readers would love to “get to know you” better. Can you share your “backstory” with us?
If someone had told me in medical school that one day I would start a food company I would have laughed in their face and told them they were crazy! And yet 20 years into cardiology practice that’s exactly what I’ve done.
As I look back on the path that drove me to become Step One’s founder, which is truly the first “Food as Medicine” food company out there, I would have to point to my upbringing. My father was a dedicated physician, my mother a bakery owner deeply involved in food and food manufacturing. So perhaps I was always destined to marry the passions of my parents. But it’s really my patients that drove me to start this company.
As a physician, all I was ever taught to do was to prescribe drugs — as many drugs as are needed to get people to “goal”. The result? Waiting rooms full of people with perfect “numbers” who still look sick and feel awful. No cures. Just a never ending revolving door of follow-up visits. This is not why I went to medical school! What’s worse, many of my patients were telling me that all the drugs I had put them on had made them feel worse.
So I started asking my patients what they ate. And what they told me was shocking — for two reasons. One was that it became instantly clear that there is no amount of medication I can put them on to make up for what they were actually eating. And two — without exception my patients were telling me I was the first physician to even ask!
What I had discovered was a giant gap in care. The truth is that the vast majority of what cardiologists treat — like high cholesterol, high blood pressure and diabetes — is driven in part or in whole by diet. And to me, if a health condition is caused in part or in whole by food, Step One should be to change the food.
At that point I went on a nutrition crusade. I handed out pamphlets, suggested cookbooks, pointed people to websites. I even did one on one counselling with my patients educating them about what they should be eating. And every patient left my office grateful for the information and excited to be able to finally take a more active role to improve their own health.
And the ones that did it? That followed my advice? It was transformational. Medication lists shrank, diagnoses melted away. Patients were literally becoming non-patients. It was the first time I was effecting cures. The problem? I could count the successes on one hand. Most people came back deflated. “I couldn’t do it.” “It was too hard.” “I don’t have time.” “I’m so busy!”
But I refused to give up on my patients because it was so clear to me — the solution is correct — change the food — it’s the tools that are wrong.
Can you share the most interesting story that happened to you since you started your career? What were the main lessons or takeaways from that story?
What was most interesting to me was that no one else was willing to take this on. I took the “food as medicine” idea to big food companies, but they told me the ingredients we needed to use were too expensive and they wouldn’t be able to make enough money. Investors wanted me to get patents (which are not possible with food) so they could charge drug-level prices. Food manufacturers wanted to substitute out real food components for flavors and fillers so the products could be made on their equipment. The U.S. Small Business Innovation Research (SBIR) program wasn’t interested in a nutrition approach that could help more than 70 million Americans reduce their reliance on prescription medications. I would have never imagined that the odds against Step One Foods would be stacked so high from the get go!
But perhaps what was most surprising was that my peers were highly skeptical whether it could even work! So I had to complete a randomized controlled clinical trial (the type of study typically reserved for evaluating whether a drug is effective). And I proved that our products could yield highly significant cholesterol reductions in just 30 days. By simply trading out two snacks per day and changing NOTHING ELSE.
Fortunately, as I was fighting the big fight and proving the “experts” wrong, I found intense interest in my approach among consumers and the Canadian government — which provided the majority of the financial support for the research study. Their collective belief in the premise behind Step One Foods and their support of our efforts sustained our company, even in the early days when our very survival was in question. My big takeaway is that if you do the right thing, press on with conviction and always act with integrity, you will prevail.
Can you share a story about the biggest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
Where to begin? If you were judging what I did through a traditional food manufacturer lens, you’d say that when I did this I did everything wrong! I used expensive ingredients. Because that’s what the research told me to do. Not just one kind of nut but all three. Real chocolate. No extra sugars, added binders or flavor enhancers. Every ingredient in every product chosen for its health promoting properties. My goal was to make sure that every serving of every product delivered at least 5 g of whole food fiber, 1 gram of omega 3 fatty acids, 1 g of plant sterols and abundant antioxidants. Why these nutrients? Because they’re vital for heart health and almost universally missing from people’s diets. So I took no shortcuts and cut no corners because what was guiding me was health — nothing else.
Unfortunately, that meant I gave no thought to scaling production — and this turned out to be a big deal. It never occurred to me that equipment to make the foods as I designed them is not easy to find. So I had to figure that out too!
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?
I’ve been blessed to be surrounded by great people all my life. I was truly born beneath a lucky star. My parents were an example, my patients an inspiration, and my husband and family a cheering section that propelled and supported me all the way along. But I do have to tip my hat to Bill Alldredge, my business partner, who helped me take a concept and turn it into a business. I went to medical school — not business school — and had no idea how to manage a manufacturing concern. I met Bill when I needed to write a business plan (something I’d never done before). Bill loved the concept, invested in the company, and became a founding partner. I’m the dreamer and he’s the realist. It’s a really effective balance and a pretty great business relationship.
Ok perfect. Now let’s jump to our main focus. When it comes to health and wellness, how is the work you are doing helping to make a bigger impact in the world?
Heart disease affects all of us. Everyone reading this article either has or knows someone who has high cholesterol, high blood pressure, high blood sugar, a stent, a bypass graft, a heart attack, a stroke. Today, the treatment of heart disease eats up over 300 billion dollars each year. In 15 years, at our current trajectory, the care of heart disease will consume nearly 800 billion dollars. It’s completely unsustainable. Especially since 80% of heart disease need not exist! That’s not a wish. It’s a FACT. We know because there are communities around the globe where heart disease is almost unheard of. The biggest difference between them and us? It’s what they eat. Which makes complete sense — the main risk factors for heart disease (high cholesterol, high blood pressure, high blood sugar/diabetes, excess weight and poor diet) are caused in part or in whole by food.
Step One is pioneering the “Food as Medicine” category. Everyone has heard of the concept and understands it — after all it’s been around for over 2000 years since the time of Hippocrates — but, believe it or not, no one has taken this concept to its logical extreme to create a line of real, whole foods that serve a defined therapeutic purpose. Never mind subjecting that line to the rigors of a randomized controlled clinical trial to prove that, in many people, food can be as effective as drugs in lowering cholesterol! When I embarked upon this journey, I was frankly shocked that there had been no leaders before us. So I take our role extremely seriously. We are not only pioneering a new food category — we are also setting the standard for those who come after us. There is no end to the chronic health conditions that couldn’t benefit from a targeted nutrition intervention. We hope we are the beginning of a food revolution. Because it only takes a look around a waiting room or a hospital ward or shopping mall to know that, when it comes to nutrition, what we’re doing now is not working.
Can you share your top five “lifestyle tweaks” that you believe will help support people’s journey towards better wellbeing? Please give an example or story for each.
- It’s not about being perfect. It’s about being better. Our trial proved this. We demonstrated that you can achieve highly meaningful — even medication level — cholesterol reductions with a tiny dietary change!
- Small changes add up to big health results over time. We eat multiple times per day every day. So even seemingly minor changes in what we eat can add up quickly. One can of soda per day might not seem like a lot, but that adds up to 30 CASES of soda in a year. So eliminating one can of soda per day, is actually a health transformation. Adding something good has the same giant effect — an apple a day is 3 BUSHELS of apples over the course of a year. That’s a lot of beneficial antioxidants, fiber, micronutrients you’re putting into your body. And if the apple is an exchange for your regular cookie, that’s a double impact!
- The most impactful thing you can do for your health is change what you eat. — Most people look to exercise as a great way to lose weight, but changing what you eat is far more efficient. Eliminating 100 calories per day (the equivalent of a piece of bread or small cookie) will lead to a 10 lb weight loss over the course of a year. To burn off 10 lbs through exercise alone, you’d have to walk from Minneapolis to Chicago!
- Unless you do your part, medical treatments will be far less effective. It’s not enough just to be on medications to protect yourself against devastating health events like a heart attack or stroke. For example, studies have shown that people who have one of these events are much more likely to have subsequent cardiovascular problems if their diet remains poor (irrespective of all the drugs they’re on).
- Increase fruit and vegetable intake while lowering sodium intake if you want to avoid or moderate hypertension. Sodium is a major contributor to high blood pressure and most of us consume far too much salt. Keeping sodium consumption below 2300 mg/day while increasing fruit and vegetable intake can be as effective as a drug in lowering blood pressure readings.
If you could start a movement that would bring the most amount of wellness to the most amount of people, what would that be?
Stop giving all the advantages to drugs. Drug costs are covered by insurance, they hold patents that prevent others from democratizing their benefits, and their use is encouraged during medical training. If we are ever to change this paradigm, the playing field needs to be leveled for food.
What are your “5 Things I Wish Someone Told Me Before I Started” and why?
- It will take longer than you think
- It will be harder than you think
- It will test your convictions more than you think
- It will take more people helping you than you think
- It will be far more rewarding than you think
Starting a business is not easy — especially if you have no training to run one! But if you understand the problem you are trying to solve, are convinced that your idea is correct, and that you know you can help, never take “no” for an answer. If I listened to every “no” I heard along the way I would have abandoned this effort a long time ago. Instead, I’m rewarded daily by emails from customers who are grateful that we exist. As a physician, I can tell you that this is what it’s all about and what keeps me going. Making a difference in someone’s health is an amazing thing to be able to accomplish.
Sustainability, veganism, mental health and environmental changes are big topics at the moment. Which one of these causes is dearest to you, and why?
For me, food is where it’s at. What we eat has direct, nearly immediate effects on our health and when it comes to nutrition the answer is always pretty much the same — a whole food plant-based diet. The science is voluminous and consistent that our diets should be predominantly composed of beans, greens, nuts, seed, fruits, vegetables and whole grains — all in their most whole and unprocessed forms. That means steel cut oats not Cheerios. Apples, not applesauce or apple juice. As close to the original form as possible. The way nature created it. The more I’ve read and studied nutrition, the more I’ve learned there are no major controversies as to what an optimal diet is. The truth is we know what to eat — we just don’t.
What is the best way our readers can follow you on social media?
They can go directly to our website at www.steponefoods.com, and check out the blog section. I contribute blog content that I hope is useful and actionable on a weekly basis. You know, I didn’t start Step One to sell a bunch of food! I started Step One to help change how we approach health and healing. To prove that there’s way more to it than just drugs and that food should have a central role. And that the most powerful weapon anyone can have is knowledge. My goal is to empower people to be the best possible stewards of their own health. We have a lot more control over it than we are being led to believe.
Thank you for these fantastic insights!