February 17, 2020
I hope that over the last five weeks, I have sufficiently laid the case for heart disease as a complex disorder that is far from just a cholesterol issue. It may be worth a reread in its entirety before reading todays missive on the to do list. I think that the issue at hand is primarily a dysfunctional relationship between host genetics, inflammatory lifestyle choices and time.
As I think about my father's and my heart disease risk factors, I immediately think about my two minions and how I can prevent these issues from coming to life in them as they are genetically 50% of me.
Turning back to Dr. Mark Houston, I think that his approach makes the most sense for my family and my patients.
He states, "micronutrients, macronutrients and optimal nutrition and nutritional supplements can prevent, control and treat hypertension through numerous mechanisms related to vascular biology. These treatments are complementary to drug therapy. Oxidative stress, inflammation and autoimmune dysfunction initiate and propagate hypertension and cardiovascular disease." Note here that he says, "complementary to drug therapy" which is the key for many as they struggle with lifestyle alterations.
Thus, at this time we need to take a 30,000 foot view of prevention and disease mitigation to reduce the risk of all heart based metabolic disease. We need to focus on reducing the core risk factors for the development of disease: Inflammation, insulin resistance, toxin exposure, sloth and mental stress.
1) We have known for years that smoking and exposure to toxins are major drivers of CAD and other metabolic derangements in the body through oxidative, mitochondrial and DNA stress. Avoid all toxins in your family's environment, diet and water. See www.ewg.org for information on toxin avoidance. Consider water filtration and air purification systems at your home environment. Avoid all potential chemical toxicities whether via skin exposure, air, food or water.
2) Clearly, we need to eliminate trans fats and reduce our consumption of processed pro-oxidant vegetable oils known as refined industrial omega 6 fats. The biggest culprits are heated corn, soy, canola oils. Excessive volumes of animal based saturated fats are also a clear line to insulin resistance and cardiac inflammation. Help your intestinal microbiome, mitochondria and cell membranes stay alive and happy by significantly reducing these foods.
3) Dramatically reduce or eliminate altogether refined carbohydrates like flour and added sugars from your family's diet. This has multiple effects including balancing metabolic hormones, increasing insulin sensitivity, improving the gut flora composition, reducing small dense LDL cholesterol levels, decreasing fat cell proliferation and reducing overall inflammation. This is likely the most important recommendation off of this list.
4) Ensure adequate micronutrients for full cellular functioning throughout the vascular system. Magnesium, calcium, zinc, potassium are needed in higher volumes in most Americans. Limit sodium to allow the sodium to potassium ratio to rise.
5) Increase the consumption of soluble fiber to enhance gut flora growth, improve endothelial function and regulate bowel function. Aim for greater than 50 grams daily for the average teenager or adult.
6) Brush and floss your child's teeth daily to prevent abnormal oral bacterial flora from proliferating and turning into a bacterial seed of heart disease. Reducing flour and sugar also provides protection in the oral cavity.
7) Exercise vigorously 3-5 days a week to stimulate the production of nitric oxide, a chemical that dilates blood vessels. Try having your children vary the intensity to put stress on the system. Mix up cardio training with resistance training. This is a great thing for heart disease prevention.
8) Reduce stress through meditation, yoga and prayer. This is rapidly rising on the list of critical heart healthy lifestyle choices.
9) Sleep 7-8 hours per night for rejuvenation and stress reduction. This is also gaining significant steam is the literature for all cause disease mitigation.
10) Learn about your genetics. Over the coming years, we will have evolving information regarding gene environment interactions that can be acted upon to reduce the risk of all disease including CAD.
The key to this discussion is the fact that we have the ability to delay if not halt most lifestyle diseases by modifying our and our children's choices. The above top ten is really a primer for most disease. Heart disease is just one of the more common and deadly issues that we face.
The cholesterol lipid hypothesis is still aggressively pursued by most adult physicians with statins as a class of medicine that is here to stay for the foreseeable future as lives are being saved in the absence of effective lifestyle modification. My goal has been to show a preventative approach that can forestall this disease and an alternative hypothesis for why cholesterol is what it is and does what it does.
I still hold true to the belief that cholesterol is necessary and not bad unless it becomes unbalanced by epigenetic forces that are based on our lifestyle choices. Change these lifestyle factors and you may be able to be medicine free and make your cardiologist very happy!....or your pediatrician that wants your child to be medicine free forever!
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Kasselman Atherosclerosis Article
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Cani Diabetes Article 2008
Cani Gut Article