Vital Discourse

Dr. Ben Cilento and Dr. Lee Mandel
  • 5.0 (2)
  • ALTERNATIVE HEALTH
  • SERIES

On Vital Discourse, two surgeons and friends—Dr. Ben Cilento, M.D. and Dr. Lee Mandel, M.D., J.D., F.A.C.S., F.A.R.S.—help you stop guessing and start making sense of your health. Tune in every week for the inside scoop on health, policy, and law, for advice, interviews, debates, and straight talk you won’t find anywhere else. With backgrounds in military and law, Dr. Ben and Dr. Lee cut through the noise and bring you the guidance you need. In each episode, they help listeners navigate the healthcare system, find answers to their most pressing questions, and take steps to start feeling great, with lots of laughs along the way. No appointment necessary—the doctors are in.

Episodes

  1. EPISODE 1

    Snoring, Sleep Apnea, and the Truth About Quick Fixes

    Snoring and sleep apnea remain among the most misunderstood health problems in modern medicine. They are not harmless habits but airway disorders linked to cardiovascular risk, cognitive decline, and chronic fatigue. In this first episode of Vital Discourse, Dr. Ben Cilento and Dr. Lee Mandel explain how modern medicine approaches snoring, why anatomy matters more than gadgets, and how real treatment plans are built through clinical data and patient-specific design. Listeners will gain clarity on nasal airflow, home sleep testing, CPAP therapy, oral appliances, and hypoglossal nerve stimulation while learning how to protect their own sleep and overall health.  Chapters:  00:00 Intro – Why Vital Discourse Exists 08:14 Dr Lee’s Journey Through Medicine and Law 17:02 The Medical and Legal Disclaimer – Framing the Conversation 20:01 What ENTs Actually Do and Why the Airway Matters 35:21 Why “Quick Fix” Culture Misleads Patients 55:33 Launching Episode 1 – Why Start with Snoring and Sleep Apnea 58:41 Understanding the Three Levels of the Airway 1:01:57 What Sleep Apnea Really Is and Why It Matters 1:03:39 Home Sleep Tests vs Lab Studies – Measuring Real Sleep 1:11:55 From CPAP to Surgery – Matching Treatment to Anatomy 1:18:14 The Power of Nasal Airflow and Why It Shapes Every Outcome 1:24:57 Inspire and Genio Implants – The Future of Sleep-Apnea Therapy 1:39:15 Inside an ENT Evaluation – What Patients Can Expect 1:45:16 The Hidden Costs of Ignoring Sleep Apnea 1:56:19 Final Takeaways – Clear Steps Toward Better Breathing and Sleep If you enjoyed this episode, make sure to subscribe, rate, and review it on Apple Podcasts, Spotify, and YouTube Podcasts. Instructions on how to do this are here.

    42 min

  2. EPISODE 2

    Obesity, Hormones, and the Vicious Cycle of Sleep Apnea

    Obesity and sleep apnea create a loop that reshapes metabolism, hormones, and airway function long before most patients notice the signs. In this episode of Vital Discourse, Dr. Ben Cilento and Dr. Lee Mandel explain how fragmented REM sleep disrupts growth hormone, leptin, and ghrelin, lowers metabolic rate, and drives weight gain that feels impossible to reverse. They break down how fat in the tongue, neck, and belly changes airway physics, how inflammation and insulin resistance add strain, and how GLP-1 medications, testosterone, CPAP, surgery, and weight programs fit into a coordinated plan designed to restore both breathing and metabolic health. Chapters: 00:00 - Introduction 00:00 - Welcome & Episode Overview 00:36 - Understanding Sleep Apnea 00:36 - What is Sleep Apnea? 01:14 - The Paper Straw Analogy 02:23 - Recognizing Sleep Apnea Symptoms 03:14 - Snoring vs. Obstruction 04:30 - Sleep Study Diagnostics & Severity Levels 05:57 - The Sleep Apnea-Obesity Connection 05:57 - Common Medical Advice About Weight Loss 06:39 - The Truth About Correlation 07:24 - Why Weight Gain Comes First 07:48 - How Sleep Apnea Prevents Weight Loss 07:48 - Sleep Disruption & REM Sleep 08:11 - Understanding REM Sleep & Muscle Relaxation 09:30 - Growth Hormone & Metabolic Changes 10:29 - Leptin & Ghrelin: The Hunger Hormones 11:49 - The Vicious Cycle Explained 12:20 - How Obesity Worsens Sleep Apnea 12:20 - Anatomical & Mechanical Effects 12:43 - Fat Deposits in the Tongue & Throat Muscles 13:32 - Critical Closing Pressure & Airway Physics 14:40 - Impact on Lung Function & Oxygen Saturation 16:27 - Heart Health Complications 16:52 - Neuromuscular & Inflammatory Effects 16:52 - Fat's Impact on Muscle Control 18:04 - Inflammation & Sleep Apnea 19:23 - Why Weight Makes Treatment Harder 19:51 - Treatment Approaches 19:51 - The Multi-Pronged Approach to Weight Loss 21:03 - GLP-1s: Benefits & Risks 22:00 - The Testosterone Trap 24:06 - Comprehensive Treatment Strategy 25:26 - Key Takeaways 25:26 - Vital Point: Weight Doesn't Define Sleep Apnea Risk 26:32 - Importance of Professional Help 27:33 - Closing Thoughts & Call to Action

    29 min

  3. EPISODE 3

    The Nose, The Valve, and The Collapse: How Nasal Obstruction Drives Sleep Apnea

    Nasal obstruction is one of the most overlooked forces behind sleep apnea. In this episode of Vital Discourse, Dr. Ben Cilento and Dr. Lee Mandel explain how nasal resistance, negative pressure, childhood mouth breathing, turbinates, and the nasal valve all influence airway collapse at night. Listeners learn how to recognize hidden nasal issues, why dry mouth signals nocturnal obstruction, and how procedures like septoplasty, turbinate reduction, valve reconstruction, and laser-based reshaping improve sleep-apnea treatment across CPAP, oral appliances, and Inspire.

    30 min

  4. EPISODE 4

    Chronic Sinusitis vs Allergy: Why So Many Patients Receive the Wrong Diagnosis

    Chronic sinusitis and allergies share overlapping symptoms, which leaves many patients misdiagnosed and stuck in cycles of antihistamines, decongestants, and steroids without lasting relief. In this episode of Vital Discourse, Dr. Ben Cilento and Dr. Lee Mandel explain how to distinguish persistent bacterial or structural sinus disease from allergic inflammation and why treatment depends on identifying airflow obstruction, duration, CT scan patterns, and response to medical therapy. They break down the 12-week definition of chronic sinusitis, why CT scans often under-call real disease, and how structural issues like deviated septums and narrowed sinus openings trap fluid and fuel infection. The doctors walk through allergy testing, immunotherapy, minimally-invasive sinus surgery, balloon dilation, and the real role of medications.

    46 min

  5. EPISODE 5

    The New Food Pyramid: Why America's Dietary Guidelines Just Flipped Upside Down

    The 2025-2030 Dietary Guidelines represent the biggest shift in American nutrition policy in 35 years. In this episode of Vital Discourse, Dr. Ben Cilento and Dr. Lee Mandel sit down with nutrition expert Brandon Ward to break down what changed, why it matters, and how to actually apply these guidelines to everyday eating. The new food pyramid inverts decades of grain-heavy recommendations, prioritizing animal protein (1.2-1.6 grams per kilogram of body weight), healthy fats, and fibrous vegetables while significantly reducing refined carbohydrates. Listeners will learn what a "serving" actually means, how to navigate grocery stores that were designed around the old pyramid, why the 1992 guidelines contributed to America's obesity crisis, and how schools, food manufacturers, and families can adapt. The doctors and Brandon also address common criticisms around saturated fat, sustainability concerns, and implementation challenges. Chapters: 00:00 Intro – Why the New Food Pyramid Is a Game-Changer 11:04 Introducing Brandon Ward – Nutrition Expert and Performance Coach 12:30 What Is the New Food Pyramid and How Does It Compare? 16:40 Understanding Servings – What Does "One Serving" Actually Mean? 18:41 The Mediterranean Diet Connection – Why Experts Have Known This for Years 20:08 How Brandon and His Clients Have Been Eating This Way All Along 21:16 How the Old Food Pyramid Created the Obesity Crisis 22:20 The Fat-Carb Relationship – Why Low-Fat Diets Failed 23:18 What Happens When You Eat Carbohydrates Without Fat 24:26 The Grocery Store Problem – How Food Aisles Reflect the Old Pyramid 25:46 Fruits Aren't All Created Equal – Why Berries Beat Bananas 27:31 The Avocado Exception – Why This Fruit Breaks the Rules 29:08 Fish and Omega-3s – The Benefits of Wild-Caught vs. Farm-Raised 32:40 Do You Need to Eat Vegetables Every Single Meal? 38:18 Why Variety in Vegetables Matters More Than You Think 41:00 Protein Timing – Does It Matter When You Eat Your Protein? 46:14 Balance, Moderation, and the Takeaway Message 47:15 Addressing the Criticisms of the New Food Pyramid 48:08 Saturated Fat and Cardiovascular Health – Debunking the Myth 49:04 Animal Protein vs. Plant Protein – What the Evidence Actually Says 51:18 Sustainability Concerns – Can We Produce Enough Animal Protein? 53:47 Environmental Impact – The Methane Argument and Real Solutions 56:04 Implementation in Schools – Why This Is Actually a Benefit, Not a Burden 57:51 Final Thoughts – Building Lifelong Healthy Habits If you enjoyed this episode, make sure to subscribe, rate, and review it on Apple Podcasts, Spotify, and YouTube Podcasts.

    47 min

  6. EPISODE 6

    Fasting 101: Why It Works & What to Expect

    Fasting has become one of the hottest topics in nutrition—but is it truly a game-changer for weight loss, metabolic health, and longevity, or just overhyped? In this episode of Vital Discourse, Dr. Ben Cilento and Dr. Lee Mandel sit down with nutrition expert Brandon Ward to separate fasting facts from fiction. Brandon breaks down what intermittent fasting actually is, why our bodies are evolutionarily designed for it, and the proven benefits including cellular autophagy, improved insulin sensitivity, reduced inflammation, and enhanced cognitive clarity. The conversation explores different fasting protocols (12, 16, 24, 48, and 72-hour fasts), what to expect at each stage, and why fasting outperforms simple calorie restriction for weight management. They debunk common myths—no, fasting won't tank your metabolism or cause muscle loss—and provide practical guidance on hydration, electrolytes, workout timing, and what to eat when breaking a fast. Dr. Ben shares his personal experience with 72-hour fasts, explaining the physiological shifts from glucose-burning to ketogenesis to autophagy, where damaged cells are eliminated and cancer risk may be reduced. Whether you're curious about starting a 16-hour daily fast or considering extended fasting for cellular rejuvenation, this episode delivers evidence-based insights you can actually use.

    32 min

  7. EPISODE 7

    Fitness Trends vs. Science: What You Need to Know with Brandon Ward

    Most people are training wrong—not because they're lazy, but because they lack proper programming and keep chasing fitness trends that change weekly. In this episode of Vital Discourse, Dr. Ben Cilento and Dr. Lee Mandel sit down with Brandon Ward, a former Division 1 athlete, certified strength and conditioning specialist, and owner of The Ludus gym in South Florida, to break down what actually works in fitness. Brandon reveals the most common training mistakes: no structured program, randomly repeating the same exercises, and jumping from trend to trend (high volume one week, heavy lifting the next, glute-focused the week after). He explains the critical difference between training for power and speed (athletes doing snatches, cleans, sled pushes) versus training for strength and aesthetics (slow, controlled movements that build stability). The conversation tackles major training questions: cardio versus weight training, free weights versus machines versus bodyweight exercises, and how to balance all three based on your goals and fitness level. Brandon walks through proper assessment—starting with interviews to understand wants versus needs, followed by biomechanical analysis of gait, posture, flexibility, and strength across different planes of motion. They discuss the fitness industry's biggest myths around pre-workout supplements (mostly just caffeine and sugar), protein timing (the anabolic window is overblown), and meal timing around workouts. Dr. Lee explains the physiology of why you should always do strength training before cardio: cardio slows neuromuscular signaling and increases injury risk, plus doing weights first depletes muscle glycogen so your cardio becomes a more efficient fat-burning session. The doctors and Brandon emphasize that training should be individualized—what works for a 25-year-old athlete differs drastically from what a 60-year-old needs for longevity. The episode closes with Brandon's philosophy from The Ludus (named after ancient Roman gladiator training schools): fitness isn't just about workouts, it's about teaching healthy lifestyle habits that foster long-term wellness.

    42 min

  8. EPISODE 8

    The Great Health Reversal: Eggs, Caffeine, Alcohol & What Changed

    Health advice has completely flipped—what doctors once told you was dangerous is now considered beneficial, and what seemed healthy is now recognized as harmful. In this episode of Vital Discourse, Dr. Ben Cilento and Dr. Lee Mandel expose how America's food and drug regulatory system shifted from protecting citizens to facilitating corporate interests. They trace the FDA's evolution from Teddy Roosevelt's 1906 protection against snake oil salesmen to today's "generally recognized as safe" (GRAS) loophole that allows 10,000 chemicals—banned in most other countries—into the U.S. food supply without safety testing. The doctors dissect the infamous 1992 food pyramid, revealing how breakfast cereal lobbies convinced Americans that 6-11 servings of grains daily and "breakfast as the most important meal" were science-based when they were actually corporate marketing. They explain why America's obesity rate exploded from 10-13% in 1960 to over 40% today, while diabetes jumped from 3% to nearly 15%, and for the third straight year, U.S. life expectancy is declining—a trend unique among developed nations. The conversation tackles major health reversals: eggs went from cholesterol villains to brain-boosting superfoods backed by 2025 research showing dietary cholesterol has minimal cardiovascular impact; caffeine shifted from dangerous stimulant to beneficial in moderation (3-5 cups daily); and the "French paradox" around wine was debunked—alcohol is harmful at any dose, despite what centenarians claim about their nightly scotch (they lived long in spite of it, not because of it). Dr. Ben shares insights from his ranch navigating USDA regulations, explaining why processed foods contain preservatives (benevolent: extending shelf life for affordable distribution; malevolent: addictive chemicals and cosmetic additives purely for profit). They expose forever chemicals (PFAS) lurking in non-stick cookware, stain-resistant carpets, cosmetics, and even dental floss—substances that never break down in your body and drive cancer rates. The doctors reveal why young men's testosterone has plummeted from 1200+ in the 1960s to 500-600 today, discuss nicotine's false health claims despite influencer marketing, and explain THC's paradox: limited medical benefits for chemotherapy nausea and anxiety versus widespread harm including psychosis risk, surgical complications, and the "flat affect generation" with no drive or ambition. They provide actionable guidance: read ingredient labels (if you can't pronounce it, look it up), only buy fruits starting with "9" to avoid toxic coatings, prioritize 1.6-2.2 grams of protein per kilogram of ideal body weight, embrace healthy fats, and remember that long-term eating patterns matter more than any single ingredient. The episode closes with a teaser on GMOs and CRISPR, promising a deep dive into genetic modification and "Frankenstein foods" already on your plate.

    59 min

  9. 10/12/2025

    Vital Discourse is Coming Soon!

    Vital Discourse is a new weekly podcast that provides deep dives into important health-related topics. On Vital Discourse, two surgeons and friends—Dr. Ben Cilento, M.D. and Dr. Lee Mandel, M.D., J.D., F.A.C.S., F.A.R.S.—help listeners start making sense of their health. Tune in each week to get the inside scoop on issues concerning health, policy, and law, with advice, interviews, debates, and straight talk you won’t find anywhere else. With backgrounds in military and law, Dr. Ben and Dr. Lee cut through the noise to bring you the guidance you need. In every episode, they help their audience navigate the healthcare system, find answers to their most pressing questions, and take steps to start feeling great, with lots of laughs along the way. No appointment necessary—the doctors are in. The first episode is coming soon.

    1 min

Trailer

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About

On Vital Discourse, two surgeons and friends—Dr. Ben Cilento, M.D. and Dr. Lee Mandel, M.D., J.D., F.A.C.S., F.A.R.S.—help you stop guessing and start making sense of your health. Tune in every week for the inside scoop on health, policy, and law, for advice, interviews, debates, and straight talk you won’t find anywhere else. With backgrounds in military and law, Dr. Ben and Dr. Lee cut through the noise and bring you the guidance you need. In each episode, they help listeners navigate the healthcare system, find answers to their most pressing questions, and take steps to start feeling great, with lots of laughs along the way. No appointment necessary—the doctors are in.

Information

  • Creator
    Dr. Ben Cilento and Dr. Lee Mandel
  • Years Active
    2K
  • Episodes
    9
  • Rating
    Clean
  • Copyright
    © Copyright 2026 Dr. Ben Cilento and Dr. Lee Mandel
  • Show Website
    Vital Discourse