Cardiovascular Disease Quotes

Primitive societies are largely free of cardiovascular disease, cancer, dental cavities, economic theories, lounge music, and other modern ailments.

Conventional belief holds that after triumphing over a mid-career bout with polio, FDR went on to serve two vigorous terms as gov- ernor of New York and three-plus more as president of the United States, succumbing unexpectedly to a stroke on April 12, 1945. In truth, Franklin spent those eventful twenty-four years battling swarms of maladies including polio’s ongoing crippling effects, life-threatening gastrointestinal bleeding, two incurable cancers, severe cardiovascular disease, and epilepsy.

Remember laughing? Laughter enhances the blood flow to the body’s extremities and improves cardiovascular function. Laughter releases endorphins and other natural mood elevating and pain-killing chemicals, improves the transfer of oxygen and nutrients to internal organs. Laughter boosts the immune system and helps the body fight off disease, cancer cells as well as viral, bacterial and other infections. Being happy is the best cure of all diseases!

You are no less or more of a man or a woman or a human for having depression than you would be for having cancer or cardiovascular disease or a car accident.

When your conscientiousness impels you to take on more than you can handle, you begin to lose interest, even in tasks that normally engage you. You risk your physical health. 'Emotional labor,' which is the effort we make to control and change our own emotions, is associated with stress, burnout, and even physical symptoms like and increase in cardiovascular disease.

During the time of stress, the “fight-or-flight” response is on and the self-repair mechanism is disabled. It is then when we say that the immunity of the body goes down and the body is exposed to the risk for disease. Meditation activates relaxation, when the sympathetic nervous system is turned off and the parasympathetic nervous system is turned on, and natural healing starts.

People who are time poor are less happy, less productive, and more stressed-out.6 They exercise less, eat fattier food, and have a higher incidence of cardiovascular disease.7 Time

As is the case for diabetes and cardiovascular disease, central obesity [belly fat] is also a risk factor for dementia.

It’s the combination of fat and a relatively high intake of carbohydrates—particularly refined ones—that can become a deadly recipe for obesity, diabetes, cardiovascular disease, and a host of other ills.

You are no less or more of a man or a woman or a human for having depression than you would be for having cancer or cardiovascular disease or a car accident. So what should we do? Talk. Listen. Encourage talking. Encourage listening. Keep adding to the conversation. Stay on the lookout for those wanting to join in the conversation.

These studies all came to the same startling conclusion: the low-carb diet was significantly better for weight loss than the low-fat diet. Even more stunning was that all the important risk factors for cardiovascular disease—including cholesterol, blood sugar level, and blood pressure—were also much improved on the low-carb diet.

By 1991, for instance, epidemiologist surverys in populations had revealed that high cholesterol was NOT associated with heart disease or premature death in women. Rather, the higher the cholesterol in women, the longer they lived, a finding that was so consistent across populations and surveys that it prompted an editorial in the American Heart Associations journal, Circulation: "We are coming to realize," the three authors, led by UC San Francisco epidemiologist Stephen Hulley, wrote, "the the results of cardiovascular research in men, which represents the great majority of the effort thus far, may not apply to women.

The mental and physical diseases we face in old age are tied together through the cardiovascular system and metabolic system. A

Cardiovascular disease remains the #1 killer of people in the United States today—accounting for more deaths than all forms of cancer combined.

Emotional labor,” which is the effort we make to control and change our own emotions, is associated with stress, burnout, and even physical symptoms like an increase in cardiovascular disease.

In the United States alone, more than eighty million people suffer from cardiovascular disease, and the cost to the nation of treating heart disease has been put as high as $300 billion a year.

Even borderline deficiencies of magnesium can negatively affect the heart, and not surprisingly, there is a considerable amount of evidence associating low levels of magnesium with cardiovascular disease.21

People who sleep less than seven hours a night are more likely to suffer from cardiovascular disease, heart attack, stroke, asthma, arthritis, depression, and diabetes and are almost eight times more likely to be overweight.

These epidemiological and experimental studies have provided evidence for a dietary pattern that is associated with reduced risk of developing cancer, atherosclerosis and cardiovascular disease, hypertension and stroke, and type II diabetes.

When your conscientiousness impels you to take on more than you can handle, you begin to lose interest, even in tasks that normally engage you. You also risk your physical health. “Emotional labor,” which is the effort we make to control and change our own emotions, is associated with stress, burnout, and even physical symptoms like an increase in cardiovascular disease. Professor Little believes that prolonged acting out of character may also increase autonomic nervous system activity, which can, in turn, compromise immune functioning.

WHAT’S GOOD FOR THE HEART IS GOOD FOR THE BRAIN. That is, vascular health (meaning low apoB, low inflammation, and low oxidative stress) is crucial to brain health. WHAT’S GOOD FOR THE LIVER (AND PANCREAS) IS GOOD FOR THE BRAIN. Metabolic health is crucial to brain health. TIME IS KEY. We need to think about prevention early, and the more the deck is stacked against you genetically, the harder you need to work and the sooner you need to start. As with cardiovascular disease, we need to play a very long game. OUR MOST POWERFUL TOOL FOR PREVENTING COGNITIVE DECLINE IS EXERCISE. We’ve talked a lot about diet and metabolism, but exercise appears to act in multiple ways (vascular, metabolic) to preserve brain health; we’ll get into more detail in Part III, but exercise—lots of it—is a foundation of our Alzheimer’s-prevention program.

After hearing much from his patients about alleged faith-healing, a Minnesota physician named William Nolen spent a year and a half trying to track down the most striking cases. Was there clear medical evidence that the disease was really present before the ‘cure’? If so, had the disease actually disappeared after the cure, or did we just have the healer’s or the patient’s say-so? He uncovered many cases of fraud, including the first exposure in America of ‘psychic surgery’. But he found not one instance of cure of any serious organic (non-psychogenic) disease. There were no cases where gallstones or rheumatoid arthritis, say, were cured, much less cancer or cardiovascular disease. When a child’s spleen is ruptured, Nolen noted, perform a simple surgical operation and the child is completely better. But take that child to a faith-healer and she’s dead in a day.

The “concerns” about low-carbohydrate diets still revolve around the imagined risk of cardiovascular disease from fat in the diet despite the continued failure to show any risk. Carbohydrate restriction, however, improves the usual markers, notably HDL (“good cholesterol”) and triglycerides.

Nobel laureate Elizabeth Blackburn is more optimistic and says, "Every sign, including genetics, says there's some causality [between telomeres] and the nasty things that happen with aging." She notes that there is a direct link between the shortened telomeres and certain diseases. For example, if you have shortened telomeres- if your telomeres are in the bottom third of the population in terms of length-then your risk of cardiovascular disease is 40 percent greater. "Telomere shortening," she concludes, "seems to underlie the risks for the diseases that kill you...heart disease, diabetes, cancer, even Alzheimer's.

The first time I heard Robert Anda present the results of the ACE study, he could not hold back his tears. In his career at the CDC he had previously worked in several major risk areas, including tobacco research and cardiovascular health. But when the ACE study data started to appear on his computer screen, he realized that they had stumbled upon the gravest and most costly public health issue in the United States: child abuse. He had calculated that its overall costs exceeded those of cancer or heart disease and that eradicating child abuse in America would reduce the overall rate of depression by more than half, alcoholism by two-thirds, and suicide, IV drug use, and domestic violence by three-quarters. 20 It would also have a dramatic effect on workplace performance and vastly decrease the need for incarceration.

Better health and better nutrition—above all, greater intakes of high-quality animal protein (milk, dairy products, meat, and eggs)—have driven the shift, and being taller is associated with a surprisingly large number of benefits. These do not include generally higher life expectancy, but a lower risk of cardiovascular diseases, and also higher cognitive ability, higher lifetime earnings, and higher social status. Correlation between height and earnings was first documented in 1915 and has since been confirmed repeatedly, for groups ranging from Indian coal miners to Swedish CEOs. Moreover, the latter study showed that the CEOs were taller in firms with larger assets!

Peter M. Nilsson, professor of cardiovascular research, recently spoke in front of five hundred doctors at a big conference in Stockholm. He summarized it like this: “This means we have to put an end to this. There is no correlation between saturated fat intake and cardiovascular disease.” Could it be clearer? Perhaps like this: game over.

more aggressive treatment approaches are necessary if cardiovascular and/or neurological systems are significantly involved.

The more aerobically fit you are, the better your heart can pump blood, the longer it takes you to get out of breath, and the farther and faster you’re able to bike or run or swim. One more thing: It also happens to be the form of fitness that helps you live longer and live better by reducing your chances of developing ailments like cardiovascular disease and diabetes.

Dr. Murthy confirms the connection between loneliness and our physical health, explaining that loneliness is associated with a greater risk of cardiovascular disease, dementia, depression, and anxiety. And at work, he states that loneliness “reduces task performance, limits creativity, and impairs other aspects of executive function such as reasoning and decision making.

We need to reexamine how the blood circulates in the body, and revise our understanding of why and how the heart gets sick and how to heal an ailing heart. And we need to do this in the context of society and its injustices, and our ecosystems and the damage we’ve done to them, in much the same way we must treat the heart, not in isolation, but within the context of the body.

CRP is a marker for inflammation that is directly associated with overall heart and cardiovascular health. In multiple studies, CRP has been identified as a potent predictor of future cardiovascular health

Let’s think about what this does to just one system, the cardiovascular: Chronically activated stress response means chronically increased blood pressure, which is like constantly turning a firehose on in your blood vessels, when those vessels were designed by evolution to handle only a gently flowing stream. The increased wear and tear on your blood vessels leads to increased risk for heart disease. That’s how chronic stress leads to life-threatening illness.

Calorie restriction extends the life span of every organism so far tested, including yeast, worms, flies, rodents, and monkeys. It also slows or even prevents age-related diseases, including dementia, diabetes, cardiovascular and coronary disease, neurodegenerative disorders, and several types of cancer.

High levels of everyday discrimination contribute to narrowing the arteries over time,” said the Harvard social scientist David R. Williams. “High levels of discrimination lead to higher levels of inflammation, a marker of heart disease.” People who face discrimination, Williams said, often build up a layer of unhealthy fat, known as visceral fat, surrounding vital organs, as opposed to subcutaneous fat, just under the skin. It is this visceral fat that raises the risk of diabetes and cardiovascular disease and leads to premature death. And it can be found in people of all ethnicities based on their experience of discrimination.

The determinants of this excess mortality remain unclear; however, reports suggest increased risk from gastrointestinal, respiratory, cardiovascular, infectious, and hematologic diseases among RA patients compared with controls.” 166 Unlike many conditions, no one can tell people how to avoid developing RD or decrease their risk of death.

Therapeutic fasting accelerates the healing process and allows the body to recover from serious disease in a dramatically short period of time. In my practice I have seen fasting eliminate lupus and arthritis, remove chronic skin conditions such as psoriasis and eczema, heal the digestive tract in patients with ulcerative colitis and Crohn’s disease, and quickly eliminate cardiovascular diseases such as high blood pressure and angina. In these cases the recoveries were permanent: fasting enabled longtime disease sufferers to unchain themselves from their multiple toxic drugs and even eliminate the need for surgery, which was recommended to some of them as their only solution.

One last bit of bad news. We’ve been focusing on the stress-related consequences of activating the cardiovascular system too often. What about turning it off at the end of each psychological stressor? As noted earlier, your heart slows down as a result of activation of the vagus nerve by the parasympathetic nervous system. Back to the autonomic nervous system never letting you put your foot on the gas and brake at the same time—by definition, if you are turning on the sympathetic nervous system all the time, you’re chronically shutting off the parasympathetic. And this makes it harder to slow things down, even during those rare moments when you’re not feeling stressed about something. How can you diagnose a vagus nerve that’s not doing its part to calm down the cardiovascular system at the end of a stressor? A clinician could put someone through a stressor, say, run the person on a treadmill, and then monitor the speed of recovery afterward. It turns out that there is a subtler but easier way of detecting a problem. Whenever you inhale, you turn on the sympathetic nervous system slightly, minutely speeding up your heart. And when you exhale, the parasympathetic half turns on, activating your vagus nerve in order to slow things down (this is why many forms of meditation are built around extended exhalations). Therefore, the length of time between heartbeats tends to be shorter when you’re inhaling than exhaling. But what if chronic stress has blunted the ability of your parasympathetic nervous system to kick the vagus nerve into action? When you exhale, your heart won’t slow down, won’t increase the time intervals between beats. Cardiologists use sensitive monitors to measure interbeat intervals. Large amounts of variability (that is to say, short interbeat intervals during inhalation, long during exhalation) mean you have strong parasympathetic tone counteracting your sympathetic tone, a good thing. Minimal variability means a parasympathetic component that has trouble putting its foot on the brake. This is the marker of someone who not only turns on the cardiovascular stress-response too often but, by now, has trouble turning it off.

Double pneumonia and an overscheduled life can happen to anyone, of course, but for Little, it was the result of acting out of character for too long and without enough restorative niches. When your conscientiousness impels you to take on more than you can handle, you begin to lose interest, even in tasks that normally engage you. You also risk your physical health. “Emotional labor,” which is the effort we make to control and change our own emotions, is associated with stress, burnout, and even physical symptoms like an increase in cardiovascular disease. Professor Little believes that prolonged acting out of character may also increase autonomic nervous system activity, which can, in turn, compromise immune functioning.

Some studies have shown that hypertension occurs less frequently among vegetarians than among nonvegetarians, regardless of body weight or sodium intake. Intake of red meat has been linked to a higher risk of colorectal cancer. Vegetarians, including lacto-ovo and vegan, have reduced incidences of diabetes and lower rates of cancer than nonvegetarians, particularly for gastrointestinal cancer.47,48 Vegetarian-style diet patterns are associated with lower all-cause mortality.49 Vegetarian-style eating patterns are being used for the prevention and therapeutic dietary treatment of numerous chronic conditions, including overweight and obesity, cardiovascular disease (hyperlipidemia, ischemic heart disease, and hypertension), diabetes, cancer, and osteoporosis.50

Triglyceride-to-HDL Ratio After assessing each of these five biomarkers, there is one more step: calculate your triglyceride-to-HDL ratio to better understand insulin sensitivity. Simply divide your triglycerides by your HDL. Interestingly, studies have shown that this value correlates well with underlying insulin resistance. So even if you are unable to access a fasting insulin test, the triglyceride-to-HDL ratio can give you a general sense of where you’re at. According to Dr. Mark Hyman, “the triglyceride-to-HDL ratio is the best way to check for insulin resistance other than the insulin response test. According to a paper published in Circulation, the most powerful test to predict your risk of a heart attack is the ratio of your triglycerides to HDL. If the ratio is high, your risk for a heart attack increases sixteen-fold—or 1,600 percent! This is because triglycerides go up and HDL (or ‘good cholesterol’) goes down with diabesity.” Dr. Robert Lustig agrees: “The triglyceride-to-HDL ratio is the best biomarker of cardiovascular disease and the best surrogate marker of insulin resistance and metabolic syndrome.” In children, higher triglyceride-to-HDL is significantly correlated with mean insulin, waist circumferences, and insulin resistance. In adults, the ratio has shown a positive association with insulin resistance across normal weight and overweight people and significantly tracks with insulin levels, insulin sensitivity, and prediabetes. Perplexingly, the triglyceride-to-HDL ratio is not a metric used in standard clinical practice. If you remember one thing from this chapter, remember this: you need to know your insulin sensitivity. It can give you lifesaving clues about early dysfunction and Bad Energy brewing in your body, and is best assessed by a fasting insulin test, discussed below. Right now, this is not a standard test offered to you at your annual physical. I implore you to find a way to get a fasting insulin test or to calculate your triglyceride-to-HDL ratio every year. Do this for your children, as well. And take the steps outlined in the following chapters to ensure it does not start creeping up. RANGES: Range considered “normal” by standard criteria: none specified in standard criteria Optimal range: Anything above a ratio of 3 is strongly suggestive of insulin resistance. You want to shoot for less than 1.5, although lower is better. I recommend aiming for less than 1.

A meta-analysis of four cohort studies following the diets, diseases, and deaths of more than a quarter million people found that those who eat lower-carb diets suffer a significantly higher risk of all-cause mortality, meaning they live, on average, significantly shorter lives.4188 The risk of cardiovascular disease specifically appears to depend on the source of fat. In a Harvard study of heart attack survivors, those who adhered more to a lower-carb diet based on animal sources of fat and protein had a 50 percent higher risk of dying from a heart attack or stroke, but no such association was found for lower-carb diets based on plant sources.4189 These studies were based on low-carb scoring systems, though, so they speak more to the risks of lower-carb eating rather than a truly low-carb ketogenic diet.

If we want to be healthy, we need to eat and move about a little more like our ancient ancestors did. That doesn’t mean we have to eat tubers and hunt wildebeest. It means we should consume a lot less processed and sugary foods and get more exercise. Failure to do that, however, is what is giving us the disorders like type 2 diabetes and cardiovascular disease that are killing us in great numbers. Indeed, as Lieberman notes, medical care is actually making things worse by treating the symptoms of mismatch diseases so effectively that we “unwittingly perpetuate their causes.” As Lieberman puts it with chilling bluntness, “You are most likely going to die from a mismatch disease.” Even more chillingly, he believes that 70 percent of the diseases that kill us could easily be preventable if we would just live more sensibly.

As devasting as it is, cirrhosis is not the only end point I’m worried about here. I care about NAFLD and NASH — and you should too — because they represent the tip of the iceberg of a global epidemic of metabolic disorders, ranging from insulin resistance to type 2 diabetes. Type 2 diabetes is technically a distinct disease, defined very clearly by glucose metrics, but I view it as simply the last stop on a railway line passing through several other stations, including hyperinsulinemia, prediabetes, and NAFLD/NASH. If you find yourself anywhere on this train line, even in the early stages of NAFLD, you are likely also en route to one or more of the three Horsemen diseases (cardiovascular disease, cancer, and Alzheimer’s disease). As we will see in the next few chapters, metabolic dysfunction vastly increases your risks for all of these.

The renaming of ME to Chronic Fatigue Syndrome (CFS) in 1988, giving misplaced emphasis to “fatigue”, trivializes the substantial disability of the disease 1 – which can extend to the wheelchair or bed-bound requiring 24 hour care ME/CFS is characterized by neurological, immunological, gastrointestinal, cardiovascular and musculoskeletal features – severe forms can present with paresis, seizures, intractable savage headaches and life threatening complications.

One of the facts that has been confirmed over the past decade of research is the higher incidence of cardiovascular deaths compared with the general population . 167 While little is known about why, the mortality gap has widened for people with rheumatoid disease. 168 Lifespan is estimated to be shortened by five to fifteen years. Some reports show mortality for PRD is not improving overall, 169 , 170 , 171 , 172 while others show mortality improvement with substantial disparities between populations.

HUNGER AND OBESITY The change in diets around the world is also creating a global obesity epidemic—and in its wake a global diabetes epidemic—even as more than 900 million people in the world still suffer from chronic hunger. In the United States, where many global trends begin, the weight of the average American has increased by approximately twenty pounds in the last forty years. A recent study projects that half the adult population of the United States will be obese by 2030, with one quarter of them “severely obese.” At a time when hunger and malnutrition are continuing at still grossly unacceptable levels in poor countries around the world (and in some pockets within developed countries), few have missed the irony that simultaneously obesity is at record levels in developed countries and growing in many developing countries. How could this be? Well, first of all, it is encouraging to note that the world community has been slowly but steadily decreasing the number of people suffering from chronic hunger. Secondly, on a global basis, obesity has more than doubled in the last thirty years. According to the World Health Organization, almost 1.5 billion adults above the age of twenty are overweight, and more than a third of them are classified as obese. Two thirds of the world’s population now live in countries where more people die from conditions related to being obese and overweight than from conditions related to being underweight. Obesity represents a major risk factor for the world’s leading cause of death—cardiovascular diseases, principally heart disease and stroke—and is the major risk factor for diabetes, which has now become the first global pandemic involving a noncommunicable disease.* Adults with diabetes are two to four times more likely to suffer heart disease or a stroke, and approximately two thirds of those suffering from diabetes die from either stroke or heart disease.† The tragic increase in obesity among children is particularly troubling; almost 17 percent of U.S. children are obese today, as are almost 7 percent of all children in the world. One respected study indicates that 77 percent of obese children will suffer from obesity as adults. If there is any good news in the latest statistics, it is that the prevalence of obesity in the U.S. appears to be reaching a plateau, though the increases in childhood obesity ensure that the epidemic will continue to grow in the future, both in the U.S. and globally. The causes of this surge in obesity are both simple—in that people are eating too much and exercising

Broadly speaking, components of processed foods and animal products, such as saturated fat, trans fat, and cholesterol, were found to be pro-inflammatory, while constituents of whole plant foods, such as fiber and phytonutrients, were strongly anti-inflammatory.938 No surprise, then, that the Standard American Diet rates as pro-inflammatory and has the elevated disease rates to show for it. Higher Dietary Inflammatory Index scores are linked to a higher risk of cardiovascular disease939 and lower kidney,940 lung,941 and liver function.942 Those eating diets rated as more inflammatory also experienced faster cellular aging.943,944 In the elderly, pro-inflammatory diets are associated with impaired memory945 and increased frailty.946 Inflammatory diets are also associated with worse mental health, including higher rates of depression, anxiety, and impaired well-being.947 Additionally, eating more pro-inflammatory foods has been tied to higher prostate cancer risk in men948,949,950 and higher risks of breast cancer,951,952 endometrial cancer,953 ovarian cancer,954 and miscarriages in women. Higher Dietary Inflammatory Index scores are also associated with more risk of esophageal,955 stomach,956 liver,957 pancreatic,958 colorectal,959 kidney,960 and bladder961 cancers, as well as non-Hodgkin lymphoma.962 Overall, eating a more inflammatory diet was associated with 75 percent increased odds of having cancer and 67 percent increased risk of dying from cancer.963 Not surprisingly, those eating more anti-inflammatory diets appear to live longer lives.964,965,966,967 But how does the Dietary Inflammatory Index impact body weight? Obesity and Inflammation:

An extensive biomedical literature has established that individuals are more likely to activate a stress response and are more at risk for a stress-sensitive disease if they (a) feel as if they have minimal control over stressors, (b) feel as if they have no predictive information about the duration and intensity of the stressor, (c) have few outlets for the frustration caused by the stressor, (d) interpret the stressor as evidence of circumstances worsening, and (e) lack social support-for the duress caused by the stressors. Psychosocial stressors are not evenly distributed across society. Just as the poor have a disproportionate share of physical stressors (hunger, manual labor, chronic sleep deprivation with a second job, the bad mattress that can't be replaced), they have a disproportionate share of psychosocial ones. Numbing assembly-line work and an occupational lifetime spent taking orders erode workers' sense of control. Unreliable cars that may not start in the morning and paychecks that may not last the month inflict unpredictability. Poverty rarely allows stress-relieving options such as health club memberships, costly but relaxing hobbies, or sabbaticals for rethinking one's priorities. And despite the heartwarming stereotype of the "poor but loving community," the working poor typically have less social support than the middle and upper classes, thanks to the extra jobs, the long commutes on public transit, and other burdens. Marmot has shown that regardless of SES, the less autonomy one has at work, the worse one's cardiovascular health. Furthermore, low control in the workplace accounts for about half the SES gradient in cardiovascular disease in his Whitehall population.

Weight stigma can contribute to health problems in a number of ways. Perhaps the most obvious one is that it’s stressful to be stigmatized for your size, and stress takes a physical toll on your body. The scientific term for this toll is allostatic load, meaning the cumulative effect of chronic stressors on multiple systems in the body: the cardiovascular system, the sympathetic and parasympathetic nervous systems, and metabolism. Because it looks at the entire body rather than isolated parts, allostatic load has been shown to be a more robust predictor of chronic-disease risk than other markers. And the research is clear that weight stigma has seriously detrimental whole-body effects. One study that followed close to 1,000 participants for ten years found that those who reported experiencing significant weight stigma over that period were twice as likely to have a high allostatic load as those who didn’t—regardless of actual BMI.5 In other words, weight stigma is an independent risk factor for physiological stress.

1. Oral Involvement 2. Laryngeal Involvement 3. Cardiovascular Involvement 4. Skin: rashes, vitiligo, Raynaud’s 5. Constitutional symptoms: including fever, fatigue, and muscle wasting (cachexia), infections 6. Rheumatoid vasculitis and blood vessel disease 7. Lung Involvement 8. Kidney involvement 9. Eye involvement 10. Other organs: including spleen, liver, lymph system, gut KEY POINTS 1. Some symptoms and antibodies can precede diagnosis over 10 years. 2. Many studies indicate RD begins in the lungs, before joint symptoms are diagnosable. 3. RD is often called an “invisible”illness because symptoms are not obvious to casual observers. 4. Doctors must be more aware that systemic symptoms like fatigue may indicate serious problems. 5. Extra-articular disease has been proven to affect most PRD, but is still not widely recognized. 6. Acknowledging rheumatoid disease that exists beyond and before joint inflammation (arthritis) could bring a) Improved care for lower mortality b) Improved research for better treatments c) Improved diagnosis for increased remissions

And, even more important for our purposes, these facts are sturdy enough that we can build a sensible diet upon them. Here they are: FACT 1. Populations that eat a so-called Western diet—generally defined as a diet consisting of lots of processed foods and meat, lots of added fat and sugar, lots of refined grains, lots of everything except vegetables, fruits, and whole grains—invariably suffer from high rates of the so-called Western diseases: obesity, type 2 diabetes, cardiovascular disease, and cancer. Virtually all of the obesity and type 2 diabetes, 80 percent of the cardiovascular disease, and more than a third of all cancers can be linked to this diet. Four of the top ten killers in America are chronic diseases linked to this diet. The arguments in nutritional science are not about this well-established link; rather, they are all about identifying the culprit nutrient in the Western diet that might be responsible for chronic diseases. Is it the saturated fat or the refined carbohydrates or the lack of fiber or the transfats or omega-6 fatty acids—or what? The point is that, as eaters (if not as scientists), we know all we need to know to act: This diet, for whatever reason, is the problem. FACT 2. Populations eating a remarkably wide range of traditional diets generally don’t suffer from these chronic diseases. These diets run the gamut from ones very high in fat (the Inuit in Greenland subsist largely on seal blubber) to ones high in carbohydrate (Central American Indians subsist largely on maize and beans) to ones very high in protein (Masai tribesmen in Africa subsist chiefly on cattle blood, meat, and milk), to cite three rather extreme examples. But much the same holds true for more mixed traditional diets. What this suggests is that there is no single ideal human diet but that the human omnivore is exquisitely adapted to a wide range of different foods and a variety of different diets. Except, that is, for one: the relatively new (in evolutionary terms) Western diet that most of us now are eating. What an extraordinary achievement for a civilization: to have developed the one diet that reliably makes its people sick! (While it is true that we generally live longer than people used to, or than people in some traditional cultures do, most of our added years owe to gains in infant mortality and child health, not diet.) There is actually a third, very hopeful fact that flows from these two: People who get off the Western diet see dramatic improvements in their health. We have good research to suggest that the effects of the Western diet can be rolled back, and relatively quickly.

As Dr. Fauci’s policies took hold globally, 300 million humans fell into dire poverty, food insecurity, and starvation. “Globally, the impact of lockdowns on health programs, food production, and supply chains plunged millions of people into severe hunger and malnutrition,” said Alex Gutentag in Tablet Magazine.27 According to the Associated Press (AP), during 2020, 10,000 children died each month due to virus-linked hunger from global lockdowns. In addition, 500,000 children per month experienced wasting and stunting from malnutrition—up 6.7 million from last year’s total of 47 million—which can “permanently damage children physically and mentally, transforming individual tragedies into a generational catastrophe.”28 In 2020, disruptions to health and nutrition services killed 228,000 children in South Asia.29 Deferred medical treatments for cancers, kidney failure, and diabetes killed hundreds of thousands of people and created epidemics of cardiovascular disease and undiagnosed cancer. Unemployment shock is expected to cause 890,000 additional deaths over the next 15 years.30,31 The lockdown disintegrated vital food chains, dramatically increased rates of child abuse, suicide, addiction, alcoholism, obesity, mental illness, as well as debilitating developmental delays, isolation, depression, and severe educational deficits in young children. One-third of teens and young adults reported worsening mental health during the pandemic. According to an Ohio State University study,32 suicide rates among children rose 50 percent.33 An August 11, 2021 study by Brown University found that infants born during the quarantine were short, on average, 22 IQ points as measured by Baylor scale tests.34 Some 93,000 Americans died of overdoses in 2020—a 30 percent rise over 2019.35 “Overdoses from synthetic opioids increased by 38.4 percent,36 and 11 percent of US adults considered suicide in June 2020.37 Three million children disappeared from public school systems, and ERs saw a 31 percent increase in adolescent mental health visits,”38,39 according to Gutentag. Record numbers of young children failed to reach crucial developmental milestones.40,41 Millions of hospital and nursing home patients died alone without comfort or a final goodbye from their families. Dr. Fauci admitted that he never assessed the costs of desolation, poverty, unhealthy isolation, and depression fostered by his countermeasures. “I don’t give advice about economic things,”42 Dr. Fauci explained. “I don’t give advice about anything other than public health,” he continued, even though he was so clearly among those responsible for the economic and social costs.

Red Meat, Gut Bacteria, and Heart Disease The high-protein intake from animal products doesn’t just accelerate aging and produce cancer. Excessive meat intake has also been associated with an elevated risk of cardiovascular death.29 For example, combined data

Cardiovascular disease affects women as well as men. Women actually outnumber men in the prevalence of cases of cardiovascular disease and in related deaths, with about 53 percent of the deaths from cardiovascular disease occurring in women. Although studies repeatedly show that women are much more anxious about developing breast cancer than cardiovascular disease, one of every 2.4 deaths in women is caused by cardiovascular disease, compared to one in thirty from breast cancer.

In Super Genes, Chopra and Tanzi acquaint us with new research that shows that “Some microbiomes may work better at nutrient extraction than others, with obese people extracting too much and skinny people extracting too little.” They also tell us that the microbiome reaches beyond digestion into every part of the body, and “It’s now known that gut bacteria produce neuroactive compounds that interact with brain cells and which can even control the expression of our own genes through epigenetics. When the natural balance of the microbiome becomes disrupted and unbalanced, we call it dysbiosis, yet only now is it being discovered that far from being just a digestive problem, dysbiosis is systemic in the damage it causes. The range of disorders linked to it is growing but is already startling in its numbers: links have been found to asthma, eczema, Crohn’s disease, multiple sclerosis, autism, Alzheimer’s disease, rheumatoid arthritis, lupus, obesity, cardiovascular disease, atherosclerosis, cancer, and malnutrition. Avenues for new treatments are leading down the same road—to the microbiome.

researchers found that whether omega-3 oils were consumed in fish or as supplements, they offered no significant protection against cardiovascular disease, cancer, or risk of death.2

Hardly a “suck” on the US welfare state, undocumented immigrants pay $ 11.6 billion in local and state taxes each year. 10 Immigrants live an average of 3.4 years longer than native-born Americans, are less likely to develop obesity, alcoholism, and depression, and are less likely to die from cardiovascular diseases or cancer. 11 Young immigrant men (ages 18 to 39) are sent to jail at roughly half the rate of native-born men of the same age. 12 And immigrant communities experience significantly less crime than predominately native-born neighborhoods. 13

Further, researchers began compiling a list of diseases absent in indigenous populations, no matter where they lived on the planet, including and especially cardiovascular disease, high blood pressure, type 2 diabetes, arthritis, psoriasis, dental cavities, and acne. Note that this list includes some of the very diseases that constitute our worst problems today.

ApoB (Apolipoprotein B) Normal - 40-125 mg/dL Less than 100 mg/dL is considered desirable for low or intermediate risk individuals Less than 80 mg/dL is considered desirable for high risk individuals, such as those with cardiovascular disease or diabetes TRIGLYCERIDES Good - 149 mg/dL or lower Borderline - 150 to 199 mg/dL High - 200 mg/dL and above FASTING BLOOD GLUCOSE (after not eating for at least 8 hours) Normal - 70 to 100 mg/dL Pre-Diabetes Fasting Blood Glucose -101 to 126 mg/dL Pre-Diabetes 2 Hours Blood Glucose - 140 to 200 mg/dL Diabetes Fasting Blood Glucose - 126 mg/dL or higher Diabetes 2 hours Blood Glucose - over 200 mg/dL HA1C (tests average blood sugar level for past two to three months) Normal - Below 5.7 percent Prediabetes - 5.7 to 6.4 percent (high risk of developing diabetes) Diabetes - 6.5 percent BMI (Body Mass Index which is the percentage of body weight that comes from fat Underweight - Below 18.5 Normal - 18.5 to 24.9 Overweight - 25 to 29.9 Obese - 30 or higher HOMOCYSTEINE Optimal - 10 to 12 µmol/L) 13.4 <10.4µmol/L Normal - 4 to 15 µmol/L) Moderate - 15 to 30 µmol/L) Intermediate - 30 to 100 µmol/L) Severe - Greater than 100 µmol/L) CRP (C-Reactive Protein)

Low Risk of Cardiovascular Disease - Less than 1 mg/L Moderate Risk of Cardiovascular Disease - 1 to 2.9 mg/L High Risk of Cardiovascular Disease - 3 or higher mg/L Further Testing Suggested to Find out the Cause of Severe Inflammation - 10 or higher mg/L CRP-HS (C-Reactive High Sensitivity) Lower Relative Risk - Less than 1.0 Average Relative Risk - Average Risk TSH (Thyroid Stimulating Hormone) Normal Range - 0.4 to 4.2 ml/L T4 (Free Thyroid) Normal Range - 0.78 to 2.19 ng/dL T4 (Total Thyroid) Normal Range – 5.53 to 11.00 mcg/dL T3 (Free Thyroid) Normal Range - 2.5 to 5.3 pg/mL SECTION 2

N-TERMINAL-PRO-B-type NATRIURETIC PEPTIDE (NT-proBNP) A "non-traditional" blood protein made in the heart and found in the blood. High levels are associated with increased risks of cardiovascular disease, heart attack, and heart failure development. High levels are associated with development of heart failure and worse prognosis. Goal values Less than 125 pg/mL

URINE ALBUMIN/CREATININE RATIO (Ualb/Cr) Albumin is a protein found in urine that can be a sign of increased risk for kidney disease, diabetes complications, and cardiovascular risks. If high levels of Ualb/CR are present, close attention to blood pressure control, including use of specific blood pressure medications that help protect the kidney, may be recommended. Aggressive risk reduction efforts such as closer attention to lipid levels, blood pressure control, and diabetes control are suggested. Goal values More than 30 mg/g suggests increased risk for CVD and diabetic nephropathy More than 300 mg/g signals clinical nephropathy

APOLIPOPROTEIN A1 (Apo A1) Apo A1 is the major protein of HDL (good) cholesterol. Low levels of Apo A1 is associated with increased risk of early cardiovascular disease, and may be seen more often in patients with a high-fat diet, inactivity, and central obesity.

APOLIPOPROTEIN B (ApoB) A major protein found in cholesterol particles. New research suggests ApoB may be a better overall marker of risk than LDL (bad cholesterol) alone. Goal values Less than 100 mg/dL for those with low/intermediate risk Less than 80 mg/dL for high-risk individuals, such as those with cardiovascular disease or diabetes

GLOBAL RISK SCORE (GRS) An answer based test score that looks at a person’s risk factors. The GRS weighs risk factors in importance and then gives a percentage risk of the patient developing heart disease or having a heart attack within the next 10 years. Goal values Less than 10% = low risk 10% to 20% = intermediate risk Greater than 20% = high risk GRS information is important to develop a plan to improve your cardiovascular health. Call the Preventive Cardiology and Rehabilitation Program at 216-444-9353 or toll-free 800-2232273, ext. 49353 to be evaluated and get started … Monday thru Friday, Eastern Standard Time.

HIGH SENSITIVITY C-REACTIVE TEST (HS-CRP, US-CRP or CRP for short) A simple blood test that reports inflammation changes in the body. Inflammation puts a person at increased risk for heart attack and inflammation is now considered a driver of heart disease. Inflammation (swelling) of the arteries is a risk factor for cardiovascular disease. It has been linked to an increased risk of heart disease, heart attack, sudden death, stroke, and peripheral arterial disease. It has also been linked to an increased risk of restenosis, or the re-closing of an artery that has been treated with balloon angioplasty. High Sensitivity (also called Ultra-sensitive) C-reactive protein is known as HS-CRP, US-CRP or CRP for short. It is a protein found in the blood and what we call a "marker" for inflammation, meaning its presence indicates a heightened state of inflammation in the body. Inflammation is a normal response to many physical states including fever, injury and infection. Inflammation plays a role in the initiation and progression of cardiovascular disease.

HS-CRP, combined with a Global Risk Evaluation (GRE) can provide an overall view of cardiovascular risk. This information is important to develop a plan to improve your cardiovascular health. Call the Preventive Cardiology and Rehabilitation Program at 216-444-9353 or toll-free 800-2232273, ext. 49353 to be evaluated and get started … Monday thru Friday, Eastern Standard Time.

Perhaps the most significant thing to be aware of here, for anyone who works a desk job, is that sitting is an independent health risk factor—meaning that even if you do exercise, sitting for eight hours each day will still damage your health.124 According to Thomas Yates, MD, “Even for people who are otherwise active, sitting for long stretches seems to be an independent risk factor for conditions like diabetes, cardiovascular disease, and kidney disease.”125

Moreover, staying physically fit has numerous other benefits, including improving cardiovascular health, moderating your blood pressure, boosting your HDL (“good”) cholesterol, and lowering your triglycerides. Both aerobic exercise and weight-bearing exercise also improve your balance (so you are less likely to injure yourself in a fall), lift your mood and alleviate stress, up your energy level, and enhance the quality of your sleep. And that’s just for starters.

As for fructose, its metabolic effects are even more damaging. Unlike glucose, fructose can only be metabolized by certain cells in the body. In fact, the body treats fructose like a toxin, doing whatever it can to keep it out of the bloodstream. Like other toxins, the only place fructose can be metabolized is in the liver, where some of it can be burned for energy. What’s left, however, is then packaged into triglycerides (fat) that are then released into the bloodstream. The more fructose we eat, the higher our blood triglyceride levels. Elevated levels of triglyceride in the bloodstream are a well-established marker of cardiovascular disease risk.

The following are guidelines for people at high risk of developing dementias (given family history or early cognitive decline): Adopt the Longevity Diet and the periodic FMD. Incorporate plenty of olive oil (50 milliliters per day) and nuts (30 grams per day). Drink coffee. For people at relatively low risk of AD, keep it to one or two cups a day; for people at high risk, drink up to three or four cups a day. Speak to your doctor if you have problems. Take 40 milliliters of coconut oil per day but consider potential heart disease risk (people with or at risk for cardiovascular disease should not use coconut oil). Avoid saturated fats and trans fats. Avoid all animal-based products with the exception of low-mercury fish and cheese or other dairy products from goat’s milk. Follow a high-nourishment diet containing omega-3, B vitamins, and vitamins C, D, and E. Take a multivitamin and mineral every day.

A recent review summarizes the substantial evidence of their role in blood vessel formation and their therapeutic effect for many different conditions, particularly for cardiovascular diseases (ischemia, myocardial infarction, etc.), diabetes ulcers, burns, and wound healing.5

There is now good dietary information for the two chief conditions referring to mental decline. On the modest side, there is a condition called "cognitive impairment" or "cognitive dysfunction." This condition describes the declining ability to remember and think as well as one once did. It represents a continuum of disease ranging from cases that only hint at declining abilities to those that are much more obvious and easily diagnosed. Then there are mental dysfunctions that become serious, even life threatening. These are called dementia, of which there are two main types: vascular dementia and Alzheimer's disease. Vascular dementia is primarily caused by multiple little strokes resulting from broken blood vessels in the brain. It is common for elderly people to have "silent" strokes in their later years. A stroke is considered silent if it goes undetected and undiagnosed. Each little stroke incapacitates part of the brain. The other type of dementia, Alzheimer's, occurs when a protein substance called beta-amyloid accumulates in critical areas of the brain as a plaque, rather like the cholesterol-laden plaque that builds up in cardiovascular diseases.

The separation of mind and body that informs medical practice is also the dominant ideology in our culture. We do not often think of socio-economic structures and practices as determinants of illness or well-being. They are not usually “part of the equation.” Yet the scientific data is beyond dispute: socio-economic relationships have a profound influence on health. For example, although the media and the medical profession — inspired by pharmaceutical research — tirelessly promote the idea that next to hypertension and smoking, high cholesterol poses the greatest risk for heart disease, the evidence is that job strain is more important than all the other risk factors combined. Further, stress in general and job strain in particular are significant contributors both to high blood pressure and to elevated cholesterol levels. Economic relationships influence health because, most obviously, people with higher incomes are better able to afford healthier diets, living and working conditions and stress-reducing pursuits. Dennis Raphael, associate professor at the School of Health Policy and Management at York University in Toronto has recently published a study of the societal influences on heart disease in Canada and elsewhere. His conclusion: “One of the most important life conditions that determine whether individuals stay healthy or become ill is their income. In addition, the overall health of North American society may be more determined by the distribution of income among its members rather than the overall wealth of the society…. Many studies find that socioeconomic circumstances, rather than medical and lifestyle risk factors, are the main causes of cardiovascular disease, and that conditions during early life are especially important.” The element of control is the less obvious but equally important aspect of social and job status as a health factor. Since stress escalates as the sense of control diminishes, people who exercise greater control over their work and lives enjoy better health. This principle was demonstrated in the British Whitehall study showing that second-tier civil servants were at greater risk for heart disease than their superiors, despite nearly comparable incomes. Recognizing the multigenerational template for behaviour and for illness, and recognizing, too, the social influences that shape families and human lives, we dispense with the unhelpful and unscientific attitude of blame. Discarding blame leaves us free to move toward the necessary adoption of responsibility, a matter to be taken up when we come in the final chapters to consider healing.

ME has been classified as a neurological condition at least since 1968 (this should have been 1969)…however, for all these years, sufferers from this awful debilitating illness have been ignored, derided and mistreated…. Many thousands of peer-reviewed scientific papers from researchers around the world demonstrate that ME is a physical disease which has endocrine, immune and cardiovascular effects, as well as neurological symptoms…. It is distinct from chronic fatigue which is a symptom of many diseases….

High animal protein in take was positively associated with mortality and high plant protein intake was inversely associated with mortality, especially among individuals with at least 1 lifestyle risk factor. Substitution of plant protein for animal protein, especially that from processed red meat, was associated with lower mortality, suggesting the importance of protein source.

Accordingly, the authors concluded: ‘Irrespective of the possible limitations of the ecological study design, the undisputed finding of our paper is the fact that the highest CVD [cardiovascular disease] prevalence can be found in countries with the highest carbohydrate consumption whereas the lowest CVD prevalence is typical of countries with the highest intake of fat and protein.

a 2014 meta-analysis (a compilation of many similar studies) showing that vegetarian diets may be particularly good at lowering blood pressure.110 And the more plants, perhaps, the better. Meat-free diets in general “confer protection against cardiovascular diseases . . . some cancers and total mortality,” but completely plant-based diets “seem to offer additional protection for obesity, hypertension, type-2 diabetes, and cardiovascular mortality.”111

Over the years, I have cared for loved ones with advanced Alzheimer, late stage cardiovascular and renal disease and Stage 4 cancer. But none of those experiences prepared me for being a carer for a Severe or Very Severe ME patient. The breadth, severity and unprediciability of the symptoms and dysfunction from one person ro the next and from one day to the next can be hard to comprehend and mainstream medical education doesn't help.

Oil Is Not a Whole, Natural Food and Does Not Grow on Trees Although vegetable oils (such as olive, sesame, soybean, and canola oils) are relatively low in saturated fat and higher in unsaturated fats, you should use these processed foods minimally or not at all. Oils lack the beneficial factors that whole nuts and seeds contain. Nuts and seeds contain fiber, minerals, antioxidants, and other phytochemicals in addition to healthy fats that contribute to cardiovascular health.60 Most of these nutrients are missing in refined oils.

Walnuts in particular have been associated with a host of positive biological effects, such as improved cardiovascular parameters, enhanced brain viability with aging, reduced cardiovascular deaths, and longer life span.

for good health, avoid the scary and intense blood-sugar roller coaster (peaks followed by crashes) and stick to the cute and gentle blood-sugar caterpillar ride (slow and steady ups and downs). Having a high glucose response to your meals is a risk factor for obesity, diabetes, cardiovascular disease, and other metabolic disorders, and it’s also a predictor of higher overall mortality.

Despite some scientific debate, numerous studies over the past twenty-plus years have shown that it’s very much possible to be “fat and fit.” For example, a 2017 study of more than five thousand people28 and a 2014 meta-analysis of ten studies with nearly ninety-three thousand participants29 found no increased risk of cardiovascular disease or death for physically active higher-weight people. Additionally, a 2021 review of the evidence found that most cardiometabolic risk factors associated with high body mass index (BMI) can be improved with physical activity independent of weight loss, and that increases in cardiorespiratory fitness or physical activity are consistently associated with greater reductions in mortality risk than is intentional weight loss.

The same group of researchers who studied the articles about COURAGE also analyzed the medical literature to discover just how long it takes the medical community to abandon a practice after a therapy is proven ineffective. They tracked citations to three major practices that were found not to work: beta-carotene to prevent cancer; estrogen to prevent Alzheimer’s disease; and vitamin E to lower cardiovascular risk. They found that 10 years passed before the research community stopped referencing the flawed practice. This estimate of a decade of inertia fits with our own experience. It takes that long for the train of medical practice to stop.

EC Synkowski based the 800-Gram Challenge on a 2017 study published in the International Journal of Epidemiology. The researchers analyzed ninety-five studies and concluded that eating 800 grams of fruits and vegetables a day was associated with a lower risk of cardiovascular disease, some cancers, and, in fact, all causes of death. In particular, apples, pears, citrus fruits, green leafy vegetables, salads, and cruciferous vegetables (like broccoli and cauliflower) lowered cardiovascular disease and incidence of death; green and yellow vegetables and cruciferous vegetables were associated with lowering cancer risk. Research has long suggested that produce has a protective effect, not just against heart disease and cancer but also other maladies like diabetes and stroke.

The first time I heard Robert Anda present the results of the ACE study, he could not hold back his tears. In his career at the CDC he had previously worked in several major risk areas, including tobacco research and cardiovascular health. But when the ACE study data started to appear on his computer screen, he realized that they had stumbled upon the gravest and most costly public health issue in the United States: child abuse. He had calculated that its overall costs exceeded those of cancer or heart disease and that eradicating child abuse in America would reduce the overall rate of depression by more than half, alcoholism by two-thirds, and suicide, IV drug use, and domestic violence by three-quarters. It would also have a dramatic effect on workplace performance and vastly decrease the need for incarceration.

Infrared heat therapy has been shown to provide strong therapeutic benefits, from increasing the circulation of blood and lymphatic fluids, including relief from chronic pains, healing acne, and providing significant benefits for those suffering from cardiovascular disease.

the Horsemen: cardiovascular and cerebrovascular disease, cancer, Alzheimer’s disease and related neurodegenerative conditions, and type 2 diabetes and related metabolic dysfunction.

It’s important to understand that ageing does not itself cause chronic illnesses such as cardiovascular disease, diabetes or cancer. Instead, a persistent exposure to unhealthy lifestyles and other toxic external factors, like poor nutrition, sedentary lifestyle, psychological stress, smoking and pollution, accelerates the deterioration of organs and increases the risk of developing multiple, chronic medical conditions.

Symptoms of poor sympathetic response include suffering from chronic high blood pressure that puts more “wear and tear” on the heart (men are already three times more likely to have cardiovascular disease), disruption of immune function (even making it attack itself with “autoimmune disease”), poor digestion and gut health that blocks needed nutrient absorption,2 poor critical thinking skills and even faster aging.

Immunomes Project, which uses AI and machine learning to home in on the most significant blood biomarkers. Their conclusion? The best gauges of our inflammation level—and our inflammatory age—are about 7,500 proteins. Edifice has condensed this large set to a core panel of five protein biomarkers—and their predictive power is startling. They can foretell frailty seven years before it happens. They can predict cardiovascular aging—arterial stiffness and heart thickness—even in currently healthy people. The Edifice blood test and iAge metric is also able to pinpoint people with undiagnosed autoimmune diseases. This technology is up and running today, and should be commercially available by mid-2022. It costs $250 per test, or you can get a subscription service for $60 per month. But Edifice isn’t stopping there. Once you know your iAge, what can you do to improve your outlook? Beyond lifestyle guidance, Edifice Health will also offer personalized supplements—currently under study by an Institutional Review Board—to improve a client’s inflammatory profile.

Lp(a), homocysteine, and ferritin can be influenced by genetics. A predisposition to high blood pressure can be genetic. But we believe that many people use genetics as an excuse to do nothing.

When we compared the two indexes using diet data from the Nurses’ Health Study and the Health Professionals Follow-Up Study, the Alternative Healthy Eating Index was far better at predicting the development of cardiovascular disease and other chronic conditions

Your twelve minutes of daily kettlebell swings could theoretically be done in one 12 minute stretch. Doing so might provide the most cardiovascular benefits, as the session would move your heart rate up into the training zone nearly immediately, and keep it there for some minutes.  These long minutes with your heart in the training zone provide huge cardiovascular conditioning and risk reduction benefits.

On the other hand, quickly bringing your heart rate up, repeatedly, as in the case of interval training, also provides cardiovascular benefits. Just as interval sprints are superior to plain jogging in providing cardiovascular conditioning, it may well be the one minute, or 90 second, or two minute kettlebell swing sessions provide even more benefits than one long session.

Some trainers advocate 2 minute swing sessions, claiming that the 120 seconds of continuous exercise is better for the cardiovascular system as it keeps the heart rate up longer in the training zone. A big advantage of 2 minute swing sessions is that you only need six daily sessions to get your 12 minutes.

The heart is essentially a muscular pump connected to an elaborate network of branching tubes. Although there are several kinds of cardiovascular disease, almost all arise from something going wrong in either the tubes or the pump. Most problems start with the tubes, primarily the arteries that carry blood from the heart to every nook and cranny of the body. Like the pipes in a building, arteries are vulnerable to getting clogged with unwanted deposits. This hardening of the arteries, termed atherosclerosis, starts with the buildup of plaque—a gloppy mixture of fat, cholesterol, and calcium—within the walls of arteries. Plaques, however, don’t simply accumulate in arteries like crud settling in a pipe. Instead, they are dynamic, changing, growing, shifting, and sometimes breaking. They develop when white blood cells in arteries trigger inflammation by reacting to damage usually caused by a combination of high blood pressure and so-called bad cholesterol that irritates the walls of the artery. In an effort to repair the damage, white blood cells produce a foamy mixture that incorporates cholesterol and other stuff and then hardens. As plaque accumulates, arteries stiffen and narrow, sometimes preventing enough blood from flowing to the tissues and organs that need it and further driving up blood pressure. One potentially lethal scenario is when plaques block an artery completely or detach and obstruct a smaller artery elsewhere. When this happens, tissues are starved of blood (also called ischemia) and die. Plaques can also cause the artery wall to dilate, weaken, and bulge (an aneurysm) or to tear apart (a rupture), which can lead to massive bleeding (a hemorrhage). Blocked and ruptured arteries create trouble anywhere in the body, but the most vulnerable locations are the narrow coronary arteries that supply the heart muscle itself. Heart attacks, caused by blocked coronary arteries, may damage the heart’s muscle, leading to less effective pumping of blood or triggering an electrical disturbance that can stop the heart altogether. Other highly vulnerable arteries are in the brain, which cause strokes when blocked by blood clots or when they rupture and bleed. To this list of more susceptible locations we should also add the retinas, kidneys, stomach, and intestines. The most extreme consequence of coronary artery disease is a heart attack, which, if one survives, leaves behind a weakened heart unable to pump blood as effectively as before, leading to heart failure.

To explore how physical activity helps but doesn’t entirely prevent cardiovascular diseases, let’s return to the trinity of intertwined factors that are the root causes of the problem: high cholesterol, high blood pressure, and inflammation. Cholesterol. A cholesterol test usually measures the levels of three molecules in your blood. The first is low-density lipoprotein (LDL), often termed bad cholesterol. Your liver produces these balloon-like molecules to transport fats and cholesterol throughout your bloodstream, but some LDLs have a harmful tendency to burrow into the walls of arteries, especially when blood pressure is high. These intrusions cause an inflammatory reaction that generates plaques. The second type of cholesterol is high-density lipoprotein (HDL), sometimes called good cholesterol, because these molecules scavenge and return LDLs back to the liver. The third type are triglycerides, fat molecules that are floating freely in the bloodstream and a signpost for metabolic syndrome. To make a long story short, diets rich in sugar and saturated fats contribute to cardiovascular disease because they promote high levels of plaque-forming LDLs. Conversely, physical activity helps prevent cardiovascular disease by lowering triglycerides, raising HDL levels, and to a lesser degree lowering LDL. Blood pressure. A blood pressure test gives you two readings: the higher (systolic) number is the pressure your heart’s main chamber overcomes when it squeezes blood throughout your body; the lower (diastolic) number is the pressure your heart experiences as its main chamber fills with blood. By convention high blood pressure is a reading greater than 130/90 or 140/90. Blood pressures above these values are concerning because, unabated, they damage the walls of arteries, making them vulnerable to invasion by plaque-inducing LDLs. As we already saw, once plaques start to form, blood pressure can rise, potentially stimulating yet more plaques. Chronically high blood pressure also strains the heart, causing it to thicken abnormally and weaken. By forcing more blood to flow more rapidly through arteries, physical activity stimulates the generation of new arteries throughout the body and helps keep existing arteries supple, protecting against high blood pressure. Inflammation. Plaques don’t form out of the blue but instead occur when white blood cells in the bloodstream react to the inflammation caused by LDLs and high blood pressure. Chronic inflammation also increases one’s likelihood of developing plaques from high cholesterol and blood pressure.40 And, as we have previously seen, while inflammation is caused by factors such as obesity, junky diets, excess alcohol, and smoking, it is substantially lowered by physical activity.

The key word here is recurrence. A review of 11 large-scale studies covering some 65,000 patients, published in the JAMA (Journal of the American Medical Association) Internal Medicine, showed no evidence that statins had any benefits for heart disease prevention in patients who had not been previously diagnosed with a cardiovascular condition.2 Even worse, you may have to endure some unpleasant side effects—such as muscle aches, headaches, and bloating—without any definite benefit.