Cardiovascular Quotes

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!

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

Old age is the lubricant of belief. When death knocks at the door, skepticism flies out the window. A serious cardiovascular fright and a person will even believe in Little Red Riding Hood.

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.

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

There isn’t much debate on the downsides of consumption of animal protein. Study after study has demonstrated that heavily animal-based diets are associated with high cardiovascular mortality and cancer risk.

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.

Research to date has shown that, like many other stressors, grief frequently leads to changes in the endocrine, immune, autonomic nervous, and cardiovascular systems; all of these are fundamentally influenced by brain function and neurotransmitters.

I honestly feel as though I’ve run an obstacle course to get here. In fact, I think, they should list shopping as a cardiovascular activity. My heart never beats as fast as it does when I see a “reduced by 50 percent” sign.

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.

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

Over time, regular exercise also increases the efficiency of the cardiovascular system, lowering blood pressure.

If she even so much as smiled at him, he would be thrilled to death. This was no mere figure of speech: having never gotten much exercise, Majime had little faith in his cardiovascular system and was not sure that his heart could withstand the impact of a Kaguya smile.

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.

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.

Magic is all well and good, but there are times when a high level of cardiovascular fitness is better.

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

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.

Statin drugs are meant to lower cholesterol in your blood. But there is an asymmetry, and a severe one. One needs to treat fifty high risk persons for five years to avoid a single cardiovascular event. Statins can potentially harm people who are not very sick, for whom the benefits are either minimal or totally nonexistent.

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.

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.)

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

cardiovascular functions are influenced by circadian rhythms, and as a result, heart attacks are much more common in the morning hours.

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

A balanced diet and a brisk daily walk will help keep you healthy, but there's nothing like a good-looking young man with a nice butt to help up your cardiovascular system.

The earliest and most dramatic changes in maternal physiology are cardiovascular. These changes improve fetal oxygenation and nutrition.

Magic is all well and good, but there are times when a high level of cardiovascular fitness is better. For

To help with cardiovascular issues, try the Zona Plus, a digitally controlled handheld device that uses the science behind isometric exercise to increase both vascular flexibility

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.

Sudden cardiovascular death also appears to be linked with solar geomagnetic activity.12 Heart-attack rates rise and fall according to solar-cycle activity:

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.

Unfortunately, this is the paradox you’ll face if you fear failure and refuse to release the brakes. The sweat of success is failure. While you can’t build cardiovascular endurance without sweating, you can’t experience success without failure. Failure is simply a natural response to success. If you avoid failure you will also avoid success. You can’t drive the road to wealth with the brakes engaged.

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

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

Chronic maladaptation to stress affects our brains and bodies in numerous ways, at numerous levels, including the neuroendocrine system, the autonomic nervous system, and the cardiovascular and immune systems.1

This healthy dependence is the essence of romantic love. The bodies of lovers are linked in a “neural duet.” One person sends out signals that alter the hormone levels, cardiovascular function, body rhythms, and even immune system of the other. In loving connection, the cuddle hormone oxytocin floods lovers’ bodies, bringing a calm joy and the sense that everything is right with the world. Our bodies are set up for this kind of connection.

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.

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.

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.

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.

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.

Research to date has shown that, like many other stressors, grief frequently leads to changes in the endocrine, immune, autonomic nervous, and cardiovascular systems; all of these are fundamentally influenced by brain function and neurotransmitters.” There

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.

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.

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.

Lo más nocivo para la salud de los humanos, aquí, no era ni el hambre ni las diarreas ni la malaria ni los virus ni las bacterias ni el cáncer ni las enfermedades respiratorias o cardiovasculares. El peor agente nocivo, el que más muertes ocasionaba entre los ciudadanos del país, eran los otros seres humanos.

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 pathophysiological consequences of ME/CFS are multi-systemic and may include: immune and neuroendocrine abnormalities; brain dysfunction and neurocognitive defects; cardiovascular and autonomic disturbances; abnormalities in energy production including mitochondrial dysfunction, and changes in the expression of certain genes.

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!

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.

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.

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.

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.

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.

Participants artificially awakened from sleep can experience a spike in blood pressure and an acceleration in heart rate caused by a burst of activity from the fight-or-flight branch of the nervous system.VI Most of us are unaware of another consequence of the alarm clock: the snooze button. The snooze feature means that you will repeatedly impose that cardiovascular spike again and again within a short span of time. Step and repeat this at least five days a week, and you begin to understand the possible consequences to your heart and nervous system across a life span.

Play, by definition, is carefree and unself-conscious. The great theoretician of play, Johan Huizinga, maintained that a fundamental feature of play is that it serves no other purpose. The purposelessness associated with play is hard to reconcile with our culture of high efficiency and constant accountability. More and more, we measure play by its benefits. We play squash for cardiovascular conditioning; we take our kids to dinner to expand their palates; we go on vacation to recharge. Yet if we’re plagued by self-awareness, obsessed with outcomes, or fearful of judgment, our enjoyment is inevitably compromised

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.

It is possible, just as it is with the auditory training of musicians, to begin using the feeling sense actively. This will increase neuronal development in the hippocampal and the cardiovascular (heart) system and with practice, over time, increase sensitivity to tiny modulations in that sensory flow. Sensitivity to the tiniest shifts in feeling will develop, just as they do in musicians with sound complexes. And, with experience, the ability to determine the meanings inside those feelings will become a reliable skill. In other words, it becomes possible to immediately know the intent of the dog as soon as it is seen/nonkinesthetically felt.

... and that did it. That brought those depthless blue eyes within a foot, perhaps six inches, maybe even closer, and something happened inside Enrique, like a guitar string suddenly unstrung. There was a shock and a vibration in his heart, a palpable break inside the cavity of his chest. He had dropped out of high school and never took a class in anatomy, but he did know that the cardiovascular system wasn't supposed to react as if it were the source and center of feeling. And yet he would have sworn to all and sundry - not that he expected to admit it to anyone - that Margaret, or at least her bright blue eyes, had just snapped his brittle heart.

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.

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.

Aerobic activity is beneficial in several ways. Exercise strengthens your cardiovascular system and improves your circulation, which means your body can deliver more blood to your brain when it’s working. Because the brain’s demand for oxygen and sugar rises when you’re concentrating hard, this can make the difference between grasping that insight or feeling like it’s just out of reach. A firing neuron uses as much energy as a leg muscle cell during a marathon. Further, sustained aerobic exercise stimulates the body to generate more small blood vessels in the brain, and a better-developed cerebral vasculature can deliver blood to the brain faster and more effectively. A 2012 study found that episodic memory improves as maximal oxygen capacity increases. (Conversely, comparative studies of adults who do and don’t exercise find that couch potatoes have lower scores on tests of executive function and processing speed and in middle age have faster rates of brain

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

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.

Descendants of people enslaved at the Whitney still live in the areas surrounding the former plantation. A few now work at the Whitney—ranging from a director-level position to tour guides to the front desk. But much of the community still suffers from the intergenerational poverty that plagues many formerly enslaved communities more than a century and a half after emancipation. Poverty is common in Wallace, Louisiana, the area encompassing the Whitney, where over 90 percent of the population is Black. Wallace is also one of a series of majority-Black communities lining the Mississippi River from Baton Rouge to New Orleans that—as a result of their proximity to petrochemical plants—form what is known as Cancer Alley. Neighborhoods here have some of the highest cancer risks in the country, and chemical emissions from these plants are linked to cardiovascular, respiratory, and developmental ailments. Civil rights leader Reverend Dr. William J. Barber II put it this way when describing the landscape of factories and refineries along the Mississippi River: “The same land that held people captive through slavery is now holding people captive through this environmental injustice and devastation.

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:

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.

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.

Then, decades later, in the 1970s, a hard-assed U.S. swim coach named James Counsilman rediscovered it. Counsilman was notorious for his “hurt, pain, and agony”–based training techniques, and hypoventilation fit right in. Competitive swimmers usually take two or three strokes before they flip their heads to the side and inhale. Counsilman trained his team to hold their breath for as many as nine strokes. He believed that, over time, the swimmers would utilize oxygen more efficiently and swim faster. In a sense, it was Buteyko’s Voluntary Elimination of Deep Breathing and Zátopek hypoventilation—underwater. Counsilman used it to train the U.S. Men’s Swimming team for the Montreal Olympics. They won 13 gold medals, 14 silver, and 7 bronze, and they set world records in 11 events. It was the greatest performance by a U.S. Olympic swim team in history. Hypoventilation training fell back into obscurity after several studies in the 1980s and 1990s argued that it had little to no impact on performance and endurance. Whatever these athletes were gaining, the researchers reported, must have been based on a strong placebo effect. In the early 2000s, Dr. Xavier Woorons, a French physiologist at Paris 13 University, found a flaw in these studies. The scientists critical of the technique had measured it all wrong. They’d been looking at athletes holding their breath with full lungs, and all that extra air in the lungs made it difficult for the athletes to enter into a deep state of hypoventilation. Woorons repeated the tests, but this time subjects practiced the half-full technique, which is how Buteyko trained his patients, and likely how Counsilman trained his swimmers. Breathing less offered huge benefits. If athletes kept at it for several weeks, their muscles adapted to tolerate more lactate accumulation, which allowed their bodies to pull more energy during states of heavy anaerobic stress, and, as a result, train harder and longer. Other reports showed hypoventilation training provided a boost in red blood cells, allowing athletes to carry more oxygen and produce more energy with each breath. Breathing way less delivered the benefits of high-altitude training at 6,500 feet, but it could be used at sea level, or anywhere. Over the years, this style of breath restriction has been given many names—hypoventilation, hypoxic training, Buteyko technique, and the pointlessly technical “normobaric hypoxia training.” The outcomes were the same: a profound boost in performance.* Not just for elite athletes, but for everyone. Just a few weeks of the training significantly increased endurance, reduced more “trunk fat,” improved cardiovascular function, and boosted muscle mass compared to normal-breathing exercise. This list goes on. The takeaway is that hypoventilation works. It helps train the body to do more with less. But that doesn’t mean it’s pleasant.

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 Morbidity and Obstructive Sleep Apnea Robert C. Basner, M.D. | 1405 words Volume 370:2339-2341 Number 24 June 12, 2014 Obstructive sleep apnea, a relatively common disorder in adults, is characterized by sleep-related periodic breathing, upper-airway obstruction and asphyxia, sleep disruption, and acute autonomic, arterial, and hemodynamic perturbations. Epidemiologic data show a strong association between untreated obstructive sleep apnea and incident cardiovascular morbidity and mortality. 1, 2 It is implicit that obstructive sleep apnea causes or propagates adverse cardiovascular outcomes and that its treatment may have a mitigating effect, and there are numerous instances in which explicit data have documented the efficacy of the treatment of obstructive sleep apnea in preventing or attenuating such outcomes. However, obstructive sleep apnea is typically identified along with cardiovascular, metabolic, and inflammatory disorders, and this “complicit” association confounds interpretation of the implicit and explicit associations between the treatment of obstructive sleep apnea and cardiovascular risk and outcomes.

Stuart Williams, a scientist at the Cardiovascular Innovation Institute in Louisville, Kentucky, is experimenting with taking fat-derived cells extracted during liposuction and mixing them with glue to print a heart. Williams believes that a 3D-printed “bioficial” heart may be possible in ten years.

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.

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.

REFERENCE RANGES FOR HOMOCYSTEINE Homocysteine (μmol/L) Category Greater than 29 Very high risk 15 to 29 High risk 11 to 15 Intermediate risk Less than 11 Normal Target Range: 6 to 8 μmol/L A homocysteine test is requested by a doctor when comprehensive blood work is needed to evaluate total cardiovascular risk.

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