Cardiovascular Health Quotes

Ultimately, forgiveness is usually about one thing—“This is for me, not for you.” Hatred is exhausting; forgiveness, or even just indifference, is freeing. To quote Booker T. Washington, “I shall allow no man to belittle my soul by making me hate him.” Belittle and distort and consume. Forgiveness seems to be at least somewhat good for your health—victims who show spontaneous forgiveness, or who have gone through forgiveness therapy (as opposed to “anger validation therapy”) show improvements in general health, cardiovascular function, and symptoms of depression, anxiety, and PTSD. Chapter 14 explored how compassion readily, perhaps inevitably, contains elements of self-interest. The compassionate granting of forgiveness epitomizes this.41

Your body is an intelligent organism; it knows how to heal itself.

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.

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.

These heart hiccups are not sustainable in the long term, not to my mental or cardiovascular health. I’m only a humble beginner at this whole pining thing, but I can safely state that living with some guy you used to hate and somehow ended up slipping in love with is not a wise move. Trust me, I have a doctorate. (In a totally unrelated field, but still.)

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

deep sleep for learning and memory, not to mention all branches of bodily health, from cardiovascular and respiratory, to metabolic, energy balance, and immune function.

Of the many 'firsts' with which I have been involved at the Texas Heart Institute —including the first successful human heart transplant in the United States and the first total artificial heart transplant in the world—the achievement that may have the greatest impact on health care did not occur in the operating room or in the research laboratory. It happened on a piece of paper... when we created the first-ever packaged pricing plan for cardiovascular surgical procedures.

Surprisingly, though, cardiovascular exercise has demonstrated the least benefit in older adults. By contrast, Teresa Liu-Ambrose, PhD, of the University of British Columbia, has found that resistance training with weights improves cognition.

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.

So in 1932, the US Public Health Service began its “Study of Syphilis in the Untreated Negro Male.” Government researchers promised free medical care to six hundred syphilis-infected sharecroppers around Tuskegee, Alabama. They secretly withheld treatment to these men and waited for their deaths, so they could perform autopsies. Researchers wanted to confirm their hypothesis that syphilis damaged the neurological systems of Whites, while bypassing Blacks “underdeveloped” brains and damaging their cardiovascular systems instead. The study was not halted until the press exposed it in 1972.

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.

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.

For cardiovascular health, I believe that finding comes from a “global experiment” in which 1.5 billion people are forced to reduce their sleep by one hour or less for a single night each year. It is very likely that you have been part of this experiment, otherwise known as daylight savings time. In the Northern Hemisphere, the switch to daylight savings time in March results in most people losing an hour of sleep opportunity. Should you tabulate millions of daily hospital records, as researchers have done, you discover that this seemingly trivial sleep reduction comes with a frightening spike in heart attacks the following day. Impressively, it works both ways. In the autumn within the Northern Hemisphere, when the clocks move forward and we gain an hour of sleep opportunity time, rates of heart attacks plummet the day after. A similar rise-and-fall relationship can be seen with the number of traffic accidents, proving that the brain, by way of attention lapses and microsleeps, is just as sensitive as the heart to very small perturbations of sleep. Most people think nothing of losing an hour of sleep for a single night, believing it to be trivial and inconsequential. It is anything but.

Downstairs in the body, sleep restocks the armory of our immune system, helping fight malignancy, preventing infection, and warding off all manner of sickness. Sleep reforms the body’s metabolic state by fine-tuning the balance of insulin and circulating glucose. Sleep further regulates our appetite, helping control body weight through healthy food selection rather than rash impulsivity. Plentiful sleep maintains a flourishing microbiome within your gut from which we know so much of our nutritional health begins. Adequate sleep is intimately tied to the fitness of our cardiovascular system, lowering blood pressure while keeping our hearts in fine condition.

that drinking diet soda was associated with a 43 percent increase in risk of vascular events (strokes and heart attacks). The 2008 Atherosclerosis Risk in Communities Study (ARIC)10 found a 34 percent increased incidence of metabolic syndrome in diet soda users, which is consistent with data from the 2007 Framingham Heart Study,11 which showed a 50 percent higher incidence of metabolic syndrome. In 2014, Dr. Ankur Vyas from the University of Iowa Hospitals and Clinics 12 presented a study following 59,614 women over 8.7 years in the Women’s Health Initiative Observational Study. The study found a 30 percent increase risk of cardiovascular events (heart attacks and

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.

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.

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.

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.

So certain were experts that neonates felt no pain that through the mid-1980s major surgeries on newborn babies were sometimes performed without anesthesia. These included major cardiovascular procedures requiring prying open rib cages, puncturing lungs, and tying off major arteries. Though provided with no pharmacologic agents to blunt the pain that cracking ribs or cutting through the sternum might have induced, babies were given powerful agents to induce paralysis—ensuring an immobile (and undoubtedly terrified) patient on whom to operate. Jill Lawson’s remarkable story of her premature son, Jeffrey, and his unanesthetized heart surgery provides a heartbreaking account of such a procedure. After Jeffrey’s death in 1985, Lawson’s campaign to educate the medical profession about the need to treat pain in the young literally changed the field. And likely led to improved awareness of pain in animals, too. bA technique called clicker training pairs a metallic tick-tock! with a food treat every time the animal performs a desired behavior. Eventually the animal comes to associate the sound of the clicker with the feel-good neurochemical rewards of the food. When the treat is discontinued, the animal will continue doing the behavior, because

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:

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.

Dr. Steven Blair is a renowned exercise researcher at the Arnold School of Public Health at the University of South Carolina. His research shows that excess weight is not “the enemy.” Not getting enough exercise and being cardiovascularly unfit are much greater contributors to poor health than any extra pounds can be. Blair stands firmly by his research showing that fit, fat people outlive thin, unfit people.

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.

Part One—The Lipid Panel. Used to evaluate heart health, this panel comprises of four biological markers representing the four types of fat found in the blood—triglycerides, total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL). Two additional measures of cardiovascular health, homocysteine and c-reactive protein (CRP), may also be measured as part of a more comprehensive profile. These two labs are discussed in Part Six, “Optional Tests” (see page 8). •  Part Two—The Basic Metabolic Panel. The labs used to evaluate metabolism measure blood sugar regulation, electrolyte and fluid balance, and kidney function. Biomarkers included in this panel are glucose, calcium, sodium, potassium, blood urea nitrogen (BUN), and creatinine. •  Part Three—The Hepatic Function Panel. This panel determines how well your liver is functioning by measuring levels of different proteins produced and processed by the liver, like albumin and globulin, as well as liver enzymes. •  Part Four—The Complete Blood Count (CBC) Panel. The lab values measured in the complete blood count (CBC) panel include red blood cells, white blood cells, platelets, and hemoglobin. Maintaining healthy levels of these biomarkers affect your vitality and energy, immune system, and cardiovascular health. •  Part Five—Hormones. Although they are not always included in a routine blood test, hormones should be periodically tested, especially in aging adults. Hormones such as estrogen, testosterone, progesterone, DHEA, and prostate specific antigen (PSA) play an integral role in reproductive wellness and affect other aspects of health. Maintaining balanced levels can slow down the aging process, for instance. Hormones involved in metabolism, like the thyroid hormones and the stress hormone cortisol, are also discussed in this section. •  Part Six—Optional Tests. This final part of the book highlights four tests—homocysteine, c-reactive protein (CRP), vitamin D, and magnesium—that are not typically measured unless requested, or if a standard blood test shows an abnormality that requires a more in-depth analysis. These tests can provide a more complete picture of heart health, immunity, calcium absorption, blood sugar regulation, and a number of other vital processes.

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.

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.

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.

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.

Even a few minutes of meditation in the morning and evening can allow your lymph to flow to the more urgent needs of your cardiovascular system, for recovery and prevention. Meditation and mindfulness practice have been documented to lower stress levels, and decrease cholesterol and blood pressure directly. As

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.

STEP ONE: DECIDE & GET THE INFORMATION YOU NEED 1. Decide what you truly want for your life physically. What is the result that you’re truly after? Do you want more energy? More vitality? More strength? More flexibility? Do you want to start to rejuvenate your body? Revitalize it? Bring more youth to it? 2. Get the information that you need. Get yourself tested, so you can maximize your energy by: Knowing whether there are toxic metals in your system that are getting in the way of your well-being. Knowing if your hormones are in balance, which can make a giant difference in how you feel day to day. And then ideally, do the things that will give you peace of mind for yourself and for your family. Get the GRAIL test plus a full-body MRI so that you can know that there’s nothing to be concerned about with cancer. GRAIL can even be done even in your home, with a simple blood test. If it’s appropriate, I would consider scheduling a CCTA Test so that you know exactly where your cardiovascular health is and what needs to be done to stay strong and healthy for years to come. Consider getting the Alzheimer’s Test so that you know if you’re genetically predisposed, and also come up with a lifestyle plan that will reduce your risk. If you do this far enough in advance, there are a variety of tools in this book that can make a difference. Who’s in your family or friendship base whom you would like to also make sure gets tested to look out for their well-being and help them to maximize the quality of their life. Last, if you want to have some fun, you can discover what your true age is. As I mentioned earlier, I was thrilled to discover that my chronological age of 62 is only 51 years biologically. I think you’ll be surprised. If it’s not where you want it to be, there are so many things within these pages that you can do to change it.

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.

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.

Did you know that if you’re a middle-aged woman, you have only a small window of opportunity between the beginning of perimenopause and the start of menopause to start estrogen replacement therapy to protect not only your brain but also your bones and cardiovascular system? I did not, until I dug into the science, because as a woman who was diagnosed with a stage 0 breast lump, I was scared off like so many of us from the results of the Women’s Health Initiative, which got blasted out all over the news and initially showed a link between estrogen replacement therapy and breast cancer, but guess what? That study had so many flaws, its findings are little more than useless and possibly harmful. Worse, women like me without uteri show a decrease in breast cancer with estrogen replacement therapy. But this information never made it either into the headlines or into our gynecologists’ offices. I had to find it in scientific publications such as The Lancet online. In fact, get this: Our medical system barely trains gynecologists in menopausal medicine. A recent study found that only 20 percent of ob-gyn residency programs in the U.S. provide any menopause training. Yes, any. Which means that 80 percent of all gynecological residents in school today are getting no training whatsoever in post-reproductive women’s health. These are people whose job it is to know everything going on in our ladyparts, but they have not been taught the basic tenets of how to care for either us or our plumbing after we stop menstruating. And by “us” I mean 30 percent of all women alive on earth at any given moment. Half of my middle-aged female friends deal with chronic urinary tract infections. Oh, well, we think, throwing up our hands in defeat and consuming far too many antibiotics than are rational or safe or even good for the future safety of humanity. It took Dr. Rachel Rubin, a urologist in Washington, D.C., reaching out to me over Twitter to explain that UTIs in menopausal women do not have to be recurrent. They can be mitigated with, yes, vaginal estrogen. Not once was I ever

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.

Twelve of the eighteen studies also looked at arterial and cardiovascular health. Ten studies reported improvements in various measurements of arterial stiffness, with five studies reporting large decreases in blood pressure.

The combined results of these studies led to the conclusion that “six to twelve weeks of WBVT in obese individuals generally led to a reduction in fat mass and cardiovascular improvements.

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.

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

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.

the heart that beats dynamically in response to a sense of connection with others produces a coherence that measurably improves physical and mental well-being, while the heart that feels disconnected beats rigidly to its own isolated rhythm, leading to poor cardiovascular and respiratory health and other illnesses.

Here are just some of the results research has shown can come from optimistic thinking62 : A longer, happier life Fewer symptoms of depression Lower levels of stress Better cardiovascular health Lower risk of Alzheimer’s disease Higher levels of well-being More positive emotions Greater resilience and coping skills during difficult times Greater productivity More compassion Greater kindness Fewer negative thoughts Better sleep

Between the risk of psychosis, increased rates of anxiety and depression, and cardiovascular disease, “harmless” is not the word I would use to describe the drug. Sure, it may be less lethal than cocaine, but it’s not exactly an organic kale salad.

So here we are today, where we have toxicologists and experts in food safety who disagree with the AHA’s position on the safety of polyunsaturated fats, and, because the AHA’s vast influence gives it control over nutrition thought, these professionals have trouble getting necessary work funded. Meanwhile, the AHA continues to actively promote seed oils, and it continues to support those, like Dr. Walter Willett, who dismiss or discredit experts like Dr. Chris Ramsden who are producing evidence to the contrary. In other words, the AHA is effectively blocking progress in medical science, and, perhaps most egregiously, it is promoting a diet that’s actively harming our cardiovascular health. In the beginning, however, the association’s culture was very different. When the AHA was founded in 1924, it was supported only with annual dues from a small collection of doctors concerned about the growing problem of heart disease. Heart attacks skyrocketed after World War I, and the organization felt the pressure of knowing there was so much to learn but such little funding to do the necessary research. In 1942, AHA executive director H. M. “Jack” Marvin, a New Haven, Connecticut, cardiologist, made an ambitious proposal to solve the AHA’s “chronic fiscal problems.” Lack of funds stood in the way of two of the organization’s highest-priority goals: sponsoring research and establishing public health and lay education programs. Without fundraising, the organization would be limited to utilizing the small pool of government funds to achieve its goals. And that pool had just grown a little too crowded for the AHA’s tastes.

Recreation for Seniors: Enhancing Physical, Emotional & Social Well-Being Introduction: Recreation for senior citizens is a range of activities designed to promote physical, emotional, and social well-being. These activities focus on gentle exercise, cognitive stimulation, and fostering social connections. Some of these activities include yoga, arts & craft, gardening, music & dance, games and group outings. Importance: Recreation for senior citizens is important as it directly impacts their overall well-being in several ways: Physical Health: Engaging in physical activities, even low-impact ones, helps seniors maintain mobility, balance, strength, and cardiovascular health, reducing the risk of falls and chronic diseases. Mental Health: Recreational activities stimulate cognitive functions, which can help delay the onset of dementia and Alzheimer’s. They also improve memory, concentration, and problem-solving skills. Emotional Well-being: Participating in enjoyable activities helps reduce feelings of loneliness, depression, and anxiety, fostering a sense of belonging, purpose and joy in daily life. Conclusion: Recreation enriches seniors’ lives by offering opportunities for creativity, learning, and fun. It provides structure to their days and gives them something to look forward to, leading to a happier, more fulfilling lifestyle. Why Second Innings House: At Second Innings House, we know how important recreational activities are for seniors. We offer a range of fun and engaging programs that help our residents stay active, happy, and connected. Our activities aren’t just for our residents – other seniors from the community are welcome to join in through a simple subscription plan at our Senior Social Centre. Whether it’s yoga, arts, or social games, every activity is designed to improve well-being and create a sense of belonging. Join us at Second Innings House Senior Social Centre, where seniors can enjoy each day, stay connected, and live life to the fullest! Second Innings House, a home away from home!

After years of examining the accumulating evidence, eight top health organizations joined forces and agreed to encourage Americans to eat more unrefined plant food and less food from animal sources, as revealed in the dietary guidelines published in the Journal of the American Heart Association. These authorities are the Nutrition Committee of the American Heart Association, the American Cancer Society, the American Academy of Pediatrics, the Council on Cardiovascular Disease in the Young, the Council on Epidemiology and Prevention, the American Dietetic Association, the Division of Nutrition Research of the National Institutes of Health, and the American Society for Clinical Nutrition. Their unified guidelines are a giant step in the right direction. Their aim is to offer protection against the major chronic diseases in America, including heart disease and cancer. “The emphasis is on eating a variety of foods, mostly fruits and vegetables, with very little simple sugar or high-fat foods, especially animal foods,” said

Both types of diabetes accelerate the aging of our bodies. Having diabetes greatly speeds up the development of atherosclerosis, or cardiovascular disease. Diabetes also ages and destroys the kidney and other body systems. Forty thousand amputations per year are due to complications of diabetes. It is the leading cause of blindness in adults and of kidney failure.

As a person releases blame and negative feelings, he receives lower blood pressure, a better immunity, greater cardiovascular health, and a fuller, more vibrant life.

Unsaturated fatty acids have at least one double bond between carbon atoms. This gives them properties that make them more healthful. Eaten in appropriate amounts, they may help lower blood levels of cholesterol and triglycerides and decrease the risk of cardiovascular disease. They are found mainly in plant foods.

Simple Regression   CHAPTER OBJECTIVES After reading this chapter, you should be able to Use simple regression to test the statistical significance of a bivariate relationship involving one dependent and one independent variable Use Pearson’s correlation coefficient as a measure of association between two continuous variables Interpret statistics associated with regression analysis Write up the model of simple regression Assess assumptions of simple regression This chapter completes our discussion of statistical techniques for studying relationships between two variables by focusing on those that are continuous. Several approaches are examined: simple regression; the Pearson’s correlation coefficient; and a nonparametric alterative, Spearman’s rank correlation coefficient. Although all three techniques can be used, we focus particularly on simple regression. Regression allows us to predict outcomes based on knowledge of an independent variable. It is also the foundation for studying relationships among three or more variables, including control variables mentioned in Chapter 2 on research design (and also in Appendix 10.1). Regression can also be used in time series analysis, discussed in Chapter 17. We begin with simple regression. SIMPLE REGRESSION Let’s first look at an example. Say that you are a manager or analyst involved with a regional consortium of 15 local public agencies (in cities and counties) that provide low-income adults with health education about cardiovascular diseases, in an effort to reduce such diseases. The funding for this health education comes from a federal grant that requires annual analysis and performance outcome reporting. In Chapter 4, we used a logic model to specify that a performance outcome is the result of inputs, activities, and outputs. Following the development of such a model, you decide to conduct a survey among participants who attend such training events to collect data about the number of events they attended, their knowledge of cardiovascular disease, and a variety of habits such as smoking that are linked to cardiovascular disease. Some things that you might want to know are whether attending workshops increases

He goes on to make a specific recommendation that running two to five days per week for a total of ten to fifteen miles, at around a ten-minute-per-mile pace, is ideal for bulletproof cardiovascular health.

Some of these results were predictable, but others took me totally by surprise. Here’s what happened to various blood markers prior to and immediately after my fast:           PRE-FAST      POST-FAST      Total cholesterol      295      195      LDL-C      216      131      HDL-C      61      50      Triglycerides      90      68      LDL-P      2889      1664      Small LDL-P      1446      587      Lp(a)      441      143      Fasting insulin      13.9      10.0      hsCRP      1.6      .94   Most of those numbers are related to cardiovascular health, including advanced cholesterol tests.

Fish oil is a rich source of the omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), which are converted into hormone-like substances called prostaglandins that impact cardiovascular health and regulate cell activity. Extra virgin olive oil is full of antioxidants and its monounsaturated fatty acids help balance cholesterol levels. Avocados contain high levels of oleic acid, which helps protect against breast cancer. They also contain lutein, tocopherols, and the carotenoids zeaxanthin, alpha-carotene, and beta-carotene, which help protect against prostate cancer. WHAT

What causes cardiovascular disease is the sugar and high-fructose corn syrup in your diet. As

Like most of the herbs, the leaves of Ginseng are not sought. The root is where the key ingredient is. The root is usually available dried and sliced. Have you ever heard of Yin Yang concept? Do not confuse it with the cartoon characters. Basically, a person should have a balance between Yin and Yang energy. High level of Yin would lead to lack of energy, which can be rectified by consuming Yang filled Ginseng. An increase in the level of Yang would also cause medical conditions, which can be cured by consuming herbs that are rich in Yin. If you do not believe in the Chinese explanation, here is the Western explanation for you. The Ginseng has a powerful adaptogen. The Adaptogen is a non-toxic substance which helps you to increase the resistance of the body to physical, chemical and biological stress. This is achieved by the Ginseng’s ability to stimulate the nerves in the body for healthy functioning of the endocrine glands and the cardiovascular system. Medical

Cardio fitness is an important part of getting in shape and improving your overall health. Any exercise that is aerobic, in which you increase the amount of oxygen you take in and your heart pumps more blood, improves not only your cardiovascular health but your level of fitness as well as helping you lose weight.

Brain and mood disorders, migraines, osteoporosis, diabetes, cardiovascular diseases, bowel diseases, autoimmune diseases, inflammatory disorders, and cancer are rampant. Grains are rarely suspected as the original culprit, though every one of these disorders, among many more, can potentially be traced to often insidious gluten intolerance. Gluten sensitivity is only rarely obvious to the afflicted, and many people are even entirely surprised to learn they have this sensitivity. I know I was. Only an estimated 1 percent of all gluten sensitivity or celiac disease is ever diagnosed.

the people who are best at telling jokes tend to have more health problems than the people laughing at them. A study of Finnish police officers found that those who were seen as funniest smoked more, weighed more, and were at greater risk of cardiovascular disease than their peers [10]. Entertainers typically die earlier than other famous people [11], and comedians exhibit more “psychotic traits” than others [12]. So just as there’s research to back up the conventional wisdom on laughter’s curative powers, there also seems to be truth to the stereotype that funny people aren’t always having much fun. It might feel good to crack others up now and then, but apparently the audience gets the last laugh.

Estradiol—Estradiol is the strongest estrogen; it helps you think clearly. It is produced in the ovaries and has many protective effects, including maintaining bone density, improving growth hormone production and cardiovascular function, keeping your blood from getting “sticky,” supporting cognitive function and mood, assisting in growth hormone release, and improving your lipids profile. Too much estradiol can be associated with estrogen-related cancers, but deficiencies can lead to osteoporosis, heart disease, dementia, and other diseases of aging. Estradiol keeps you looking and feeling young and vibrant. It also provides antiaging protection for the skin. And it even helps prevent weight gain. Researchers at Yale University have found that estradiol suppresses appetite using the same pathways in the brain as leptin, which is one of the hormones that regulate appetite.

Physically. Fredrickson has found that positive emotions improve physical well-being by increasing strength and cardiovascular health as well as by improving coordination, sleep, and immune function. Additionally, positive emotions are associated with reduced inflammation.20 In other words, being happier helps to keep you healthier, even if you work in a high-intensity or stress-inducing environment. In fact, positive emotions speed up recovery from the cardiovascular impact of stress.

To be sure you are getting a sufficient supply you would need to eat about 12 ounces of fatty fish per week. A simpler and perhaps safer source, given the mercury content of some fish, is fish oil capsules, which are made with oil from fatty fish that’s been purified to remove mercury and other toxins. Fish oil capsules are available at drugstores, grocery stores, and discount and large-box stores. The dose that appears to confer protection from cardiovascular disease, mainly by preventing fatal heart rhythms, is three 1-gram capsules per day, each containing 180 mg of eicosapentaenoic acid and 120 mg of docosahexaenoic acid. Higher doses probably don’t improve heart health.

In addition, unconscious breathing is often quite ineffective, as are many other acts when they’re done without purpose or control. It’s estimated that approximately one-third of all people don’t even breathe well enough to sustain normal health. These people don’t get enough oxygen, don’t eliminate enough carbon dioxide, don’t sufficiently activate pulmonary neuropeptides, don’t give the heart the support it needs, and don’t adequately program the autonomic nervous system to operate in the healing, parasympathetic mode. This set of interrelated health insults causes innumerable problems. The most obvious are pulmonary problems, such as asthma and congestive lung disorders. However, because the body is comprised of a network of interlocking, interdependent systems, breathing problems can also cause cardiovascular disorders, mood

The high level of meat and saturated fat consumption in the USA and other high-income countries exceeds nutritional needs and contributes to high rates of chronic diseases such as cardiovascular disease, diabetes mellitus and some cancers.

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

Every individual, whether a patient under our care or a team member within our leadership, deserves to receive the highest level of care and support that we can provide.

Exercise can induce autophagy, just like intermittent fasting. It is one of the best ways to alleviate the growing rates of diabetes, cancer, and cardiovascular complications.

HDL is often referred to as “good” because it helps remove cholesterol from the blood vessels and carries it back to the liver for processing and elimination from the body. This process of reverse cholesterol transport can help prevent the buildup of plaque in the arteries and reduce the risk of heart disease and stroke. Therefore, high levels of HDL in the bloodstream are considered beneficial for cardiovascular health. Meanwhile, LDL (low-density lipoprotein) is often referred to as “bad” cholesterol because it can deposit cholesterol in the walls of the arteries, leading to the formation of plaque. This process, known as atherosclerosis, can narrow the arteries and increase the risk of heart disease and stroke.

Should you be eating soy? There’s been some debate about soy due to the perception of its carrying estrogen, but I want you to understand that phytoestrogens aren’t estrogen, nor do they act like human estrogen. Instead, phytoestrogens are isoflavones, one of the unique phytochemicals in soy beans. There are actually three soy isoflavones: genistein, daidzein, and glycitein. They have a number of health benefits, including: lowering cholesterol, strengthening bones, treating menopausal symptoms, lowering risk of coronary heart disease, and reducing risk of prostate/colon/breast/ovarian cancers. Want even more good news about soy? There are certain gut bacteria that can convert soy isoflavones into an even more beneficial compound called equol. This is like a supercharged isoflavone, giving you even more cardiovascular, bone, and menopausal health benefits. Unfortunately, you need to have the bacteria in order to do this. Equol can be produced by 50 to 60 percent of Asian people but just 30 percent of Westerners. For what it’s worth, diets high in carbohydrates (really meaning fiber) and low in saturated fat are associated with equol production, while antibiotics appear to hinder it. I recommend consuming only non-GMO and organic soy in its whole-foods forms: edamame, tofu, miso, tempeh, tamari, and unsweetened soy milk. Model your soy consumption after the way they do it in Asia. For some delicious ways to consume soy, check out the recipes in Chapter 10.

Using this technique, Baum et al constructed a forest that contained 1,000 decision trees and looked at 84 co-variates that may have been influencing patients' response or lack of response to the intensive lifestyle modifications program. These variables included a family history of diabetes, muscle cramps in legs and feet, a history of emphysema, kidney disease, amputation, dry skin, loud snoring, marital status, social functioning, hemoglobin A1c, self-reported health, and numerous other characteristics that researchers rarely if ever consider when doing a subgroup analysis. The random forest analysis also allowed the investigators to look at how numerous variables *interact* in multiple combinations to impact clinical outcomes. The Look AHEAD subgroup analyses looked at only 3 possible variables and only one at a time. In the final analysis, Baum et al. discovered that intensive lifestyle modification averted cardiovascular events for two subgroups, patients with HbA1c 6.8% or higher (poorly managed diabetes) and patients with well-controlled diabetes (Hba1c < 6.8%) and good self-reported health. That finding applied to 85% of the entire patient population studied. On the other hand, the remaining 15% who had controlled diabetes but poor self-reported general health responded negatively to the lifestyle modification regimen. The negative and positive responders cancelled each other out in the initial statistical analysis, falsely concluding that lifestyle modification was useless. The Baum et al. re-analysis lends further support to the belief that a one-size-fits-all approach to medicine is inadequate to address all the individualistic responses that patients have to treatment. 

These foods are typically on the edges of your grocery store. These include foods such as fruits, vegetables, meats, fish, nuts, and beans. If it has any ingredients that you can’t pronounce ─ especially preservatives or chemicals, it doesn’t belong in your body. Here are a few rules to go by: Limit, or avoid altogether, processed or refined sugar. It promotes inflammation, weight gain, diabetes and cardiovascular disease, and is truly the biggest evil in our diet. Plant-based proteins should be the cornerstone of at least two of your three daily meals. If you choose to incorporate animal-based proteins in your diet:

While the reasons remain unclear, insomnia is almost twice as common in women than in men, and it is unlikely that a simple unwillingness of men to admit sleep problems explains this very sizable difference between the two sexes. Race and ethnicity also make a significant difference, with African Americans and Hispanic Americans suffering higher rates of insomnia than Caucasian Americans—findings that have important implications for well-recognized health disparities in these communities, such as diabetes, obesity, and cardiovascular disease, which have known links to a lack of sleep.

The heart benefit of the low-fat diet was not proven false until 2006 with the publication of the Women’s Health Initiative Dietary Modification Trial and the Low-Fat Dietary Pattern and Risk of Cardiovascular Disease study,6 some thirty years after the low-fat approach became enshrined in nutritional lore. By that time, like a supertanker, the low-fat movement had gained so much momentum that it was impossible to turn it aside.

YOUR LONGEVITY HEALTH, FITNESS & LONGEVITY WEEKLY CHECKLIST 1. Hydrate. Drink half your body weight in ounces of water per day. Add some fresh lemon and a pinch of Celtic sea salt to optimize your hydration and electrolyte balance. 2. Eat foods closest to their natural source. Avoid processed carbs, and low quality processed meats. 3. Decrease Disease Risk. Consume at least one serving of cruciferous vegetables per day including broccoli sprouts, cauliflower, broccoli, brussels sprouts, or kale. 4. Commit to a structured eating window. Consume meals in an 8 to 12 hours and fast for 12-16 hour window each day. 5. Stay consistent with sleep. Go to sleep and wake up at about the same times each day. 6. Get strong. Perform three resistance training sessions per week. 7. Strengthen your heart, lungs, and build endurance with 3 cardiovascular exercise sessions of 20 to 30 minutes each session. 8. Consider the power of using heat and cold to use positive stressors to lower your blood pressure, reduce inflammation, reduce your risk of Alzheimer’s, and cut your risk of cardiovascular disease by up to 50%.

Omega-3 optimizer: SmartPrime-Om: With his partners, Dr. Lopez has leveraged artificial intelligence to identify a cocktail of methylation pathway nutrients and plant-based bioactive ingredients found in sesame seed oil extract that can expand the benefits of fish oil and increase activity of genes and enzymes responsible for increasing the body’s “pool” of omega-3s like DHA, DPA, and EPA. SmartPrime-Om also promotes delivery of omega-3s in the ideal biochemical phospholipid package to increase benefits for most cells, tissues, and major organs. 8. 23Vitals for nutraceutical immune optimization was formulated to shore up our bodies on a molecular level and rejuvenate our immune system. It contains 23 bioactive ingredients, covering more than fifty human clinical trials showing immune system bolstering, and other ingredients to support our digestive tract, respiratory, and cardiovascular health, and muscle and joint recovery from exercise stress. It’s designed to promote a healthy immune response when we need to fight off a challenge, and then tone down inflammation once the threat has been neutralized and the “wave” has receded. Available in a ready-to-mix powder. I use this personally, and am also an investor in the company.

Every year we get screening tests for all kinds of things. We receive colonoscopies and mammograms to rule out cancer; we have cholesterol and blood pressure checks to analyze our cardiovascular health; some of us even get tested for nutrient deficiencies and have blood analyses for our liver and kidneys. But no one goes to their doctor and gets an immune system checkup.

Physical effects, both long and short term, include: Racing heart, headache, nausea, muscle tension, fatigue, dry mouth, dizzy feelings, increase in breathing rate, aching muscles, trembling and twitching, sweating, disturbed digestion, immune system suppression and memory issues. Your body was designed to endure brief moments of acute stress, but chronic stress (stress that is ongoing) can start to cause chronic health conditions, like cardiovascular disease, insomnia, hormonal dysregulation and so on. If the ordinary physical experience of stress is prolonged, the physical effects can have consequences in the rest of your life… Mental and psychological effects include: Exhaustion and fatigue, feeling on edge, nervousness, irritability, inability to concentrate, lack of motivation, changes to libido and appetite, nightmares, depression, feeling out of control, apathy and so on. Stress can reinforce negative thinking patterns and harmful self-talk, lower our confidence, and kill our motivation. More alarming than this, overthinking can completely warp your perception of events in time, shaping your personality in ways that mean you are more risk averse, more negatively focused and less resilient. When you’re constantly tuned into Stress FM you are not actually consciously aware and available in the present moment to experience life as it is. You miss out on countless potential feelings of joy, gratitude, connection and creativity because of your relentless focus on what could go wrong, or what has gone wrong. This means you’re less likely to recognize creative solutions to problems, see new opportunities and capitalize on them, or truly appreciate all the things that are going right for you. If you are constantly in a low-level state of fear and worry, every new encounter is going to be interpreted through that filter, and interpreted not for what it is, but for what you’re worried it could be.  Broader social and environmental effects include: Damage to close relationships, poor performance at work, impatience and irritability with others, retreating socially, and engaging in addictive or harmful behaviors. A person who is constantly stressed and anxious starts to lose all meaning and joy in life, stops making plans, cannot act with charity or compassion to others, and loses their passion for life. There is very little spontaneity, humor or irreverence when someone’s mind is too busy catastrophizing, right? As you can imagine, the physical, mental and environmental aspects all interact to create one, unified experience of overthinking and anxiety. For example, if you overthink consistently, your body will be flooded with cortisol and other stress hormones. This can leave you on edge, and in fact cause you to overthink even more, adding to the stress, changing the way you feel about yourself and your life. You might then make bad choices for yourself (staying up late, eating bad food, shutting people out) which reinforce the stress cycle you’re in. You may perform worse at work, procrastinating and inevitably giving yourself more to worry about, and so on…

American Journal of Medicine41 and Reviews in Cardiovascular Medicine42 in 2020 are,

Vitamin D3 boasts a strong safety profile, along with broad and deep evidence that links it to brain, metabolic, cardiovascular, muscle, bone, lung, and immune health. New and emerging research suggests that vitamin D supplements may also slow down our epigenetic/biological aging.29, 30 2. Omega-3 fish oil: Over the last thirty years or so, the typical Western diet has added more and more pro-inflammatory omega-6 polyunsaturated fatty acids versus anti-inflammatory omega-3 PUFAs. Over the same period, we’ve seen an associated rise in chronic inflammatory diseases, including obesity, cardiovascular disease, rheumatoid arthritis, and Alzheimer’s disease. 31 Rich in omega-3s, fish oil is another incredibly versatile nutraceutical tool with multi-pronged benefits from head to toe. By restoring a healthier PUFA ratio, it especially helps your brain and heart. Regular consumption of fatty fish like salmon has been linked to a lower risk of congestive heart failure, coronary heart disease, sudden cardiac death, and stroke.32 In an observational study, omega-3 fish oil supplementation was also associated with a slower biological clock.33 3. Magnesium deficiency affects more than 45 percent of the U.S. population. Supplements can help us maintain brain and cardiovascular health, normal blood pressure, and healthy blood sugar metabolism. They may also reduce inflammation and help activate our vitamin D. 4. Vitamin K1/K2 supports blood clotting, heart/ blood vessel health, and bone health.34 5. Choline supplements with brain bioavailability, such as CDP-Choline, citicoline, or alpha-GPC, can boost your body’s storehouse of the neurotransmitter acetylcholine and possibly support liver and brain function, while protecting it from age-related insults.35 6. Creatine: This one may surprise you, since it’s often associated with serious athletes and fitness buffs. But according to Dr. Lopez, it’s “a bona fide arrow in my longevity nutraceutical quiver for most individuals, and especially older adults.” As a coauthor of a 2017 paper by the International Society for Sports Nutrition, Dr. Lopez, along with contributors, stated that creatine not only enhances recovery, muscle mass, and strength in connection with exercise, but also protects against age-related muscle loss and various forms of brain injury.36 There’s even some evidence that creatine may boost our immune function and fat and carbohydrate metabolism. Generally well tolerated, creatine has a strong safety profile at a daily dose of three to five grams.37 7.

This book asks quite a lot of you in your quest to be fit and fierce. Twelve minutes of exercise, though astoundingly short in terms of the benefits they provide, is still not trivial. You are swinging a heavy weight for dozens, even hundreds of times a day. There had better be a pretty good reason why. There is! The kettlebell swing, with its mix of cardiovascular effort and fat-burning, muscle-building, strength-training may well be the best single exercise! Your kettlebell swings reward you, per swing, and per minute: • You look better! Fat loss, muscle tuning, body shaping, booty toning and posture improvement benefit your appearance, just as they improve your endurance, strength and health. • Your body is reshaped rapidly and muscles strengthened by your swings. Flab on your arms is replaced by functional muscle. Flabby thighs become sleek. • Your training makes you smarter. Well, at least helps you think better. Your swings flood your brain with fresh, oxygenated blood and top it off with a dose of testosterone. • Your general physical abilities improve markedly. You are better able to move, to carry things, to pick up kids, to play sports, to make love, to respond to emergencies with strength and endurance. • Your swings help your posture, allowing you to stand tall. The posterior chain, so well worked with kettlebell swings, includes the key posture muscles. • Your training makes your butt look smaller! Actually your butt becomes shapelier, as the gluteal muscles in the buttocks are key lifters of the kettlebell. You strengthen and shape you entire posterior chain. This focused exercise lifts, firms, tightens and highlights these assets. Each swing makes your butt look better! • The kettlebell swing may be the most effective single exercise for your heart. Swinging the weight rapidly brings your heart into the training zone.

Your kettlebell exercises strengthen your bones and fight osteoporosis. • Kettlebell swings are great for the back and can help overcome back pain and immobility. • Kettlebell swings are the fastest exercise. You can go from sitting to full exertion in seconds and be all done in little over a minute. • With your daily workouts, you will be fierce. And why not? You are slimmer, harder, taller, smarter, fitter, and your booty be bad! The twelve minutes are not done at once. As a matter of fact, eight sessions, each 90 seconds long may be optimal for exertion and spacing for maximizing metabolic risk protection.  Eight sessions has you exercising frequently throughout the day, in quick, easy sessions. Well, quick at least. Your twelve minutes is roughly the cardiovascular equivalent of running an eight minute mile pace for a mile and a half in 12 minutes. A moderate daily aerobic workout is a key component of nearly any health regimen.  It is very good for your heart health to raise your heart rate and respiration with cardiovascular exercise on a daily basis. In many ways, the first minute and a half of running a long distance is the most difficult part of a run, as the body shifts from rest to intense exercise. In this same way, the 90 second kettlebell swings are quite intense, as your body adjusts from no-load to heavy exertion immediately. Kettlebell swings represent a type of interval training, a short burst of intense exercise. Twelve minutes a day of kettlebell swings build muscle.  Muscles, generally, are a good thing, helping us be athletic, protecting us from injury, burning lots of calories and basically looking good. Twelve minutes per day is a very short time to build muscle, compared say, to a construction worker doing demanding physical labor all day. The construction worker will be well muscled, but not necessarily better than yourself, because you are harnessing the weight training effect with your kettlebell swings. You can build significant muscle size and strength with just these few minutes each day, while not having to spend the entire day in hard labor.

Cardiovascular endurance is another vital aspect of total fitness. It will help you to sustain aerobic exercise and is an indication of the health of your heart and lungs. The more cardiovascular endurance you have, the more efficiently your heart is able to pump oxygenated blood to your muscles.

Garlic has three very important cardiovascular effects: One, it lowers blood pressure and is a key component in any natural approach to treating hypertension. Two, it lowers cholesterol and fats (triglycerides) in the blood, raising the protective (HDL) fraction of total cholesterol while reducing the susceptibility of the harmful (LDL) fraction to oxidation and thereby diminishing its potential to damage artery walls. Three, garlic inhibits blood clotting by reducing the tendency of platelets to clump together.

When it comes to cardiovascular exercise, the general guidelines recommend doing between 20 and 60 minutes. However, this will depend on the intensity of the exercise you are doing. Steady state low intensity cardio, such as walking on a treadmill, can be done for up to an hour at a time. In contrast, high intensity interval training (HIIT), which involves short sprints followed by even shorter rest intervals, should only last for a maximum of 20 minutes.

You have the power to be the master of your physical destiny Eliminate negative self-talk Use visualization to enforce your positive mindset Create SMART goals that are specific, measurable, achievable, realistic and time bound Learn to love exercise by forgetting the past, pacing yourself, ditching excuses and overcoming insecurities Build the exercise habit with cues, routines and rewards Use the FITT Principle to create your ideal workout program Work through all three energy systems to achieve total fitness Vary your training heart rate zone for total cardiovascular fitness

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When communicating science to the general public in lectures or writing, I’m always wary of bombarding an audience with never-ending mortality and morbidity statistics, lest they themselves lose the will to live in front of me. It is hard not to do so with such compelling masses of studies in the field of sleep deprivation. Often, however, a single astonishing result is all that people need to apprehend the point. For cardiovascular health, I believe that finding comes from a “global experiment” in which 1.5 billion people are forced to reduce their sleep by one hour or less for a single night each year. It is very likely that you have been part of this experiment, otherwise known as daylight savings time. In the Northern Hemisphere, the switch to daylight savings time in March results in most people losing an hour of sleep opportunity. Should you tabulate millions of daily hospital records, as researchers have done, you discover that this seemingly trivial sleep reduction comes with a frightening spike in heart attacks the following day. Impressively, it works both ways. In the autumn within the Northern Hemisphere, when the clocks move forward and we gain an hour of sleep opportunity time, rates of heart attacks plummet the day after. A similar rise-and-fall relationship can be seen with the number of traffic accidents, proving that the brain, by way of attention lapses and microsleeps, is just as sensitive as the heart to very small perturbations of sleep. Most people think nothing of losing an hour of sleep for a single night, believing it to be trivial and inconsequential. It is anything but.

According to experts in the Mayo Clinic, positive thinking will enhance your life, minimize depression and stress levels, give you more immunity to the common cold, improve your overall psychological and physical well-being, boost your cardiovascular health and protect you from cardiovascular disease.

So, why is it that from the start of the pandemic the young and middle-aged in marginalized groups, not just Black and brown but Indigenous groups and people in poor white rural communities, have been more likely to suffer severe COVID-19 and die from it than their white, more affluent counterparts? The answer is part of a broader question: Why are the largest health inequities between these groups and nationwide averages—whether in infectious disease or the early onset of chronic conditions of aging such as cardiovascular disease, hypertension, and diabetes—seen among those aged twenty-five to sixty-five?7 The COVID-19 pandemic has thrown these inequities into stark relief. It’s not just that Black Americans are nearly twice as likely to die of COVID-19 as white Americans.8 Consider these statistics (among the many, many more you will see in chapters to come): Black mothers die during childbirth at an overall rate that is nearly three times as high as the rate for white mothers.9 For Black mothers in their mid-to-late thirties, the figures are even more dire: They die at a rate five times higher than white mothers of comparable age.10 Yet, the working- and reproductive-age years are those we have been led to believe should be the healthiest, following the higher-risk periods of infancy, childhood, and adolescence, and before the most serious risks of aging set in.