According to a recent (May 2024) study published in the Annals of Internal Medicine…

Low testosterone in men was associated with an increased risk for all-cause mortality (death) while very low testosterone levels were associated with increased risk of cardiovascular death (1, 2).

In a systemic review and meta-analysis, researchers included 11 studies with more than 24,000 participants to analyze the associations of sex hormones with mortality and heart disease risk in aging men. According to the study authors, their data supported the hypothesis—and provided much-needed clarity—that hypogonadism (a condition where the male body is unable to produce normal amounts of testosterone, resulting in low testosterone) is associated with higher cardiovascular and all-cause mortality (3).

This is yet another reason why men—no matter their age—should know their testosterone level—even if it is to establish a baseline for future reference. Simply order your own testosterone and prostate panel—no doctor’s visit required—on sale until July 31st for $149.

In my article Testosterone and Men’s Health, I highlighted the vital role that testosterone plays in men’s health. I also discussed the physicatl and mental health consequences for men with low testosterone; why low testosterone is so prevalent—even among young men; and how to boost testosterone naturally.

Cause or Consequence?

When it comes to testosterone and men’s heart health…

Does having low testosterone cause increased risk of adverse cardiovascular events in men? Or is low testosterone a consequence of having coronary artery disease (CAD)?

Studies have suggested evidence for both.

However, the relationship between low testosterone and an increased risk of developing—or dying from—heart disease is neither simple nor direct. It is a complex and multi-factorial relationship.

One of the main causes of low testosterone levels is male hypogonadism, where the body is unable to produce normal amounts of testosterone, resulting in low testosterone,because of abnormal signaling hormones being released from the brain. For young, healthy men in their 20s, this signaling hormone rapidly messages the testes to make more sperm and testosterone. However, as men age and/or they experience chronic stress, their signaling hormones can lose speed, reducing the amount of testosterone being produced. Low testosterone symptoms can present as low libido (sex drive), changes in sleep patterns, difficulty concentrating, reduced muscle strength/muscle mass, decreased bone density, depression and fatigue.

Hypogonadism, characterized by low testosterone, is categorized as one of two types (4):

Primary. This type of hypogonadism is generally associated with a problem in the testicles, whether a congenital or genetic defect, testicular injury or trauma, autoimmune disorder or an infection affecting the testes (5).

Secondary. This type of hypogonadism is where low testosterone levels can be attributed to a problem in the hypothalamus or the pituitary gland, parts of the brain that signal the testicles to produce testosterone. This is a signaling issue, like a faltering Internet connection.

Secondary hypogonadism can be caused by pituitary disorders or by lifestyle factors, such as taking certain medications (e.g., opioids, anti-psychotics, antidepressants, etc.) that suppress testosterone production and/or having a chronic disease, like Type 2 diabetes, hypertension and/or obesity. (6)

Why Metabolic Health Matters

A common theme that underlines the association between low testosterone and increased cardiovascular risk in men is poor metabolic health.

“Metabolic health” is a term that describes how well we generate and process energy in the body (7). When we are metabolically healthy, the following 5 metabolic markers are at optimal levels—without the use of medications:

1. 1. 1. Blood sugar
      2. Triglycerides
      3. HDL “good” cholesterol
      4. Blood pressure
      5. Waist circumference

Metabolic health is also defined as the absence of “metabolic syndrome” (described below).

Each one of the conditions listed below individually increases your cardiovascular risk. However, “metabolic syndrome” consists of a group of conditions that, together, significantly increase your risk of heart disease, Type 2 diabetes and stroke.

If you have 3 or more of the following conditions, you are considered to have metabolic syndrome (8):

1. 1. 1. High blood sugar. Your fasting blood sugar is 100 mg/dL or higher.

1. 1. 2. Hypertriglyceridemia (high triglycerides). Your triglycerides are 150 mg/dL or greater.

1. 1. 3. Low HDL “good” cholesterol: For men, “low” HDL is less than 40 mg/dL; for women, “low” HDL is less than 50 mg/dL.

1. 1. 4. High blood pressure: Your systolic (top number) is 130 mmHg or higher and your diastolic (bottom number) is 85 mmHg or higher.

1. 1. 5. Large waist circumference. Greater than 40 inches (for men). Greater than 35 inches (for women).

In a 2018 study, published in Metabolic Syndrome and Related Disorders, researchers from the University of North Carolina at Chapel Hill analyzed data from 8,721 adults—consisting of men and women aged 20 and older—from the 2009 to 2016 National Health and Nutrition Examination Survey (NHANES).

What they found:  only 1 in 8 adults in the US—(just 12%!)—have optimal metabolic health (9).  Post-COVID, that percentage is likely even less.

 *Keep in mind: you can still be metabolically unhealthy even if you are at a “normal” weight.

 That said, poor metabolic health often goes hand-in-hand with being overweight or obese, which also increases risk of heart disease. According to the latest NIH statistics, among men aged 20 or older, 34% are overweight and 43% are obese (10).

And…being overweight or obese can lower testosterone levels in men.

How? There are two ways…

First, a large waist circumference (greater than 40 inches for men) indicates excess abdominal fat. An enzyme called “5-aromatase” is present in belly fat; and this enzyme is responsible for converting testosterone into estrogen (the female sex hormone). More belly fat = increased aromatase activity, which leads to an undesirable hormonal imbalance for men: less testosterone and more estrogen. This is why obese men typically have higher levels of estrogen than men who are of normal weight.

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What you can do

The best defense is a good offense. If you discover that your testosterone is less than optimal…that good news is that lifestyle modifications can help you raise testosterone levels naturally.

1.  Start by getting tested. Click here to order your own testosterone and prostate panel—no doctor’s visit required—on sale until July 31st for $149.

2.  Maintain a healthy weight or lose weight.

3.  Commit to lifestyle modifications that support metabolic health, including:

1. 1. 1. Food choices. Reduce consumption of ultra-processed foods; choose whole foods; reduce intake of refined carbohydrates, seed oils and sugar.
      2. Movement. Sit less. Lift weights. Interval train.
      3. Stress. Reduce!
      4. Sleep. Prioritize!
      5. Supplement. As appropriate.
      6. Endocrine-disrupting toxins.

4.  Get support. Feeling overwhelmed or confused about how to start making better food choices? Click here to schedule a FREE 15-minute Discovery phone consultation with me to see how I can best support you.

Sources

1, 3  “Low testosterone levels in men associated with mortality risk.” I.M. Matters from American College of Physicians (ACP). Endocrinology. May 14, 2024.

2   Yeap, B. B. et al. “Associations of Testosterone and Related Hormones with All-Cause and Cardiovascular Mortality and Incident Cardiovascular Disease in Men: Individual Participant Data Meta-analyses”. Annals of Internal Medicine. Vol. 177, No. 6, pp. 768-781. June 2024.

4, 5, 6  Kumar P, Kumar N, Thakur DS, Patidar A. Male hypogonadism: Symptoms and treatment. J Adv Pharm Technol Res. 2010 Jul;1(3):297-301.

7  Means, C. (2020, June 18). “The Ultimate Guide to Metabolic Health”. Levels | Metabolic Insights.

8  “Metabolic Syndrome”. Cleveland Clinic. 9/13/23.

9  Araújo, J., Cai, J. and Stevens, J. “Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016.” Metabolic Syndrome and Related Disorders. Vol. 17, Issue 1, pp. 46-52. Feb. 2019.

10  NIH, National Institute of Diabetes and Digestive and Kidney Diseases. Overweight & Obesity Statistics.

11  Arnarson, A. “Can Boosting Your Testosterone Help You Lose Fat?” Healthline. June 13, 2023.

12  George JT, Millar RP, Anderson RA. Hypothesis: kisspeptin mediates male hypogonadism in obesity and type 2 diabetes. Neuroendocrinology. 2010; 91 (4):302-7.

13   Lee HK, Lee JK, Cho B. The role of androgen in the adipose tissue of males. World J Mens Health. 2013 Aug;31(2):136-40.

In my previous post, I talked about how high LDL (“bad”) cholesterol (LDL-C)—as measured on a basic lipid panel—is a poor predictor of heart disease.

However, Lipoprotein(a), also called Lp(a), is a dangerous variant of LDL “bad” cholesterol because it is small, very dense and penetrates the lining of the arteries easily (1). An elevated Lp(a) level is a significant risk factor for cardiovascular disease.

Similar to LDL, Lp(a) contains an Apolipoprotein B molecule and a cholesterol-rich lipid core. However, unlike LDL, Lp(a) has a unique sugar protein on its surface which makes it much more likely to cause blood clotting leading to stroke, heart attacks, deep venous thrombosis, and pulmonary embolus. 

Testing your Lp(a) level is something that everyone should do at least once in their lifetime—especially if you have a family history of heart disease or stroke before the age of 55.

Unfortunately, Lp(a) is not measured on a standard (basic) cholesterol panel—and insurance companies refuse to pay to have it tested. Luckily, Lp(a) is included in this Advanced Cholesterol Panel.

Lipoprotein(a) is a genetically inherited lipoprotein, which means that it runs in families. Your Lp(a) level is considered “high” if it is greater than or equal to 125 nmol/L (or >/=50 mg/dL). A high Lp(a) level means that you have an increased risk of heart attack, stroke, peripheral artery disease and aortic stenosis—independent of other risk factors (2).

If you have elevated Lp(a)…you are not alone…

Globally, roughly 1 in 5 people have inherited high Lp(a). That translates to 73 million Americans. Unfortunately, most people with high Lp(a) are unaware they have it (3).

 Why it is important to know if you have elevated Lp(a)

–Lp(a) is responsible for 8% of all cardiac deaths—with no other risk factors present.

–A high level of Lp(a) can triple your risk of heart attack or stroke—regardless of your age, diet or lifestyle. Even fit and healthy people can have high Lp(a) levels (4).

–If an adult has high Lp(a), there is at least a 50% chance of their child inheriting it.

–Your Lp(a) level is primarily (70-90%) genetically determined (5). However, some conditions can increase your Lp(a) level, including diabetes, chronic kidney disease, nephrotic syndrome, thyroid dysfunction (hypothyroidism or hyperthyroidism) and post-menopause for women because estrogen levels are lower (6, 7, 8).

Most importantly, knowing your Lp(a) level means that you can be proactive about supporting your heart health. If your Lp(a) is high…it is time to get serious about making anti-inflammatory, whole food-based choices; moving your body on a regular basis; eating foods high in omega-3s; and limiting or cutting out alcohol, refined carbohydrates, processed/fast/junk foods, and sugar.

Are you ready to get the full picture on your cholesterol?

Click here to learn more about the Advanced Cholesterol Panel, which includes Lp(a). In addition, you get the standard lipid panel + advanced cholesterol biomarkers + a bonus test for inflammation (hs-CRP). This is direct lab testing, meaning you order your own labs…no doctor’s visit required. You can schedule your blood draw up to a year afterwards.

The interrelationship of the advanced cholesterol biomarkers can tell you a lot about how well (or poorly) your vascular system is going to age. You have an opportunity to nip potentially serious issues in the bud and/or take action to get things back on track.

You will be emailed your lab results back in 7 to 10 days via a secure platform. You can then take these results to the practitioner of your choice to review. Including me…I offer two options for a lab review consultation. Contact me here.

Sources

1, 7  Connolly, Liam. Lipoprotein(a): “A less understood but critical risk factor for heart disease.” UC Davis Health. 22 Feb. 2023.

2, 6  American Heart Association. “What is Lp(a)?. Heart.org.

3  Wilson, D.P. et al. “Use of Lipoprotein(a) in clinical practice: A biomarker whose time has come. A scientific statement from the National Lipid Association.” Journal of Clinical Lipidology. Vol. 16, Issue 5, e77-e95. Sept. 2022.

5  Hopkins, A. Lipoprotein(a): The one biomarker that could change everything. YourLabwork.com.

4  Reyes-Soffer, G et al. “Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association”. Arteriosclerosis, Thrombosis and Vascular Biology. Jan. 2022. Vol. 42, Issue 1, e48-e60.

8 Šuran D, Blažun Vošner H, Završnik J, Kokol P, Sinkovič A, Kanič V, Kokol M, Naji F, Završnik T. Lipoprotein(a) in Cardiovascular Diseases: Insight From a Bibliometric Study. Front Public Health. 2022 Jul 5.

Compared to this Advanced Cholesterol Panel, the standard cholesterol panel, which includes Total Cholesterol; LDL (“bad) cholesterol; HDL (“good”) cholesterol and Triglycerides, is woefully inadequate—and outdated—if you are trying to determine your risk for heart disease.

There’s no question that cardiovascular disease (CVD) is the leading cause of death in the U.S. Yet, more than half (51%) of Americans are not aware of this, according to a recent Harris Poll survey conducted on behalf of the American Heart Association in November 2023 (1). Consider the following (2):

• • On average, someone dies of CVD every 34 seconds in the U.S.
  • There are about 1,905 deaths from heart disease, each day in the U.S., including heart attacks.
  • Approximately every 40 seconds, someone in the U.S. will have a heart attack.
  • Each year in the U.S., there are about 605,000 new heart attacks and 200,000 recurrent attacks. Of these, an estimated 170,000 are silent—without significant symptoms.

Heart health awareness often only begins when people are told that because they have “high cholesterol”, they are at greater risk for heart disease.

Conventional medical doctors are likely to prescribe a statin if your LDL, or “bad” cholesterol, is high.

On a standard lipid panel, the following are considered “ideal” numbers.

• • Total Cholesterol:  <200
  • LDL (“bad” cholesterol):  <130
  • HDL (“good” cholesterol):  >50 for women) and >40 for men
  • Triglycerides:  <150

However, your total cholesterol and LDL numbers are not accurate predictors of heart disease risk. Unfortunately, this is still a widespread belief in the conventional medical establishment.

My High Cholesterol Story

Twelve years ago, I was prescribed a statin by my osteopath because my total cholesterol had crept up from 211 to 294 over a period of two years, and my LDL was 183. Never mind that my HDL was 103 and my triglycerides were 43. At the time, I was very physically fit—running 30 miles a week in addition to weight training—cooking most meals, and I had healthy lifestyle habits.

When my osteopath prescribed a statin, I immediately stopped seeing her. I had zero interest in taking a pharmaceutical drug with a wide range of potential side effects, including headaches; difficulty sleeping; digestive issues; lower back pain; muscle pain; weakness; fatigue; liver damage; kidney failure; cataracts; confusion; memory loss; sexual dysfunction, including impotence; and diabetes (3, 4, 5).

After researching my options, I began working with a functional medicine doctor who did extensive lab work to uncover the root cause of my symptoms. Among the results…my total cholesterol was 334 and my LDL was 185. But, instead of pronouncing me a sure candidate for taking a statin, this functional medicine doctor diagnosed me with Hashimoto’s thyroiditis (autoimmune thyroid dysfunction) and severe adrenal exhaustion. I was prescribed a natural thyroid hormone and supplements to support my adrenal glands. Once I received my diagnosis, I was also proactive about supporting my thyroid and adrenal health. I eliminated specific inflammatory foods from my diet. I prioritized rest and relaxation. I incorporated stress reduction strategies into my lifestyle. After several months, my “high cholesterol” dropped significantly.

What I learned from my “high cholesterol” experience is that, with the exception of genetics, “high cholesterol” is often a proxy for some form of inflammation and/or oxidation happening in your body. Underlying causes for high cholesterol can include (6):

1. 1. 1.   Poor thyroid function (as was my case).
      2.   Chronic bacterial or viral infection.
      3.   Metabolic dysfunction, such as insulin resistance or metabolic syndrome.
      4.   Gut dysbiosis (an imbalance of good vs. bad gut bacteria).
      5.   Exposure to environmental toxins in our air, food, water, household and personal care products. For example, heavy metals, such as lead, mercury and/or cadmium (7, 8).
      6.   Taking medications for acne, high blood pressure, cancer, HIV/AIDs, irregular heart rhythms or organ transplants (9).

Unfortunately, the conventional medical approach to heart disease is based on faulty, outdated science, otherwise known as the “diet-heart hypothesis” which harks back to the 1950s.

Widely accepted as “fact”—without evidence—for over 60 years, this hypothesis maintains that high cholesterol is a significant risk factor for coronary heart disease. And that saturated fat and cholesterol-rich foods “cause” heart disease by raising serum cholesterol.

How the diet-heart myth started

Ancel Keys, a physiologist who studied the influence of diet on health, first proposed the diet-heart hypothesis in the 1950s. His idea was based on a handful of small feeding experiments conducted on humans, as well as some animal data, that suggested high blood cholesterol caused fatty deposits thought to clog arteries and cause heart attacks (10).

Between 1952 and 1956, Keys conducted informal exploratory studies on the relationship between serum cholesterol levels and heart attack rates (11). In 1958, Keys launched his famous Seven Countries Study (SCS), which followed 12,770 men in 16 locations within seven countries, including Italy, Greece, Yugoslavia, Finland, the Netherlands, Japan and the United States.

A marriage of politics, nutrition and corporate influence

In 1960, Keys was appointed to the American Heart Association’s (AHA) nutrition committee and was able to convince his colleagues to recommend his diet-heart idea—even without firm evidence—as official AHA policy. By 1961, the American Heart Association was recommending that all men (and, later, women) decrease their consumption of saturated fat and to replace these fats with polyunsaturated vegetable oils (e.g., canola, corn, safflower and soybean oils) to protect against heart disease. A conflict of interest worth noting: in 1948, the AHA had received $1.7 million (apx. $20 million in today’s dollars) from Proctor & Gamble, the makers of Crisco oil, a shortening made entirely of “vegetable oils”, marketed today as “cholesterol free” and “gluten-free” (12). Hmmmm.

In 1975, Keys published the results of his Seven Countries Study in the American Heart Association journal, which showed a seemingly strong correlation between consumption of saturated fat and deaths from heart disease (13).

In 1980, the U.S. government adopted the American Heart Association’s advice to limit saturated fat as official policy for all Americans (14).

More recently, in 2020, the AHA, itself, published a meta-analysis of observational studies and randomized controlled trials about the role of saturated fat in “causing” heart disease. The result?

Despite the long-time recommendation to eliminate or reduce red meat, full-fat dairy products, butter and eggs…this meta-analysis found that total dairy, milk, high-fat dairy, cheese, butter, eggs and unprocessed red meats are NOT associated with cardiovascular disease outcomes. Coconut oil, a rich source of saturated fat at 92% of total fat, decreased LDL cholesterol compared with butter and elicited no change in LDL cholesterol compared with olive oil (15).

In the decades following his published results, Keys was—and is—criticized for “cherry-picking” the seven countries and his data to “prove” his hypothesis, also known as confirmation bias. For example, Keys did not include countries like France, Germany or Switzerland, where people consumed large quantities of saturated fat (e.g., cheese, cream, butter and red meat), yet experienced low rates of heart disease—similar to the countries featured in the Seven Countries Study (16).

Remember: correlation does not imply causation. Just because two variables (e.g., high cholesterol and heart disease) seemingly move together in the same direction does not automatically mean that one variable “causes” the other. For example, let’s say both ice cream consumption and murder rates increase dramatically in the summer; should we automatically assume that eating more ice cream “causes” a spike in murders? It’s a ridiculous example, but you get the idea…

Understanding why cholesterol is NOT your enemy

Despite its bad rap, cholesterol is vital to our health. In fact, life as we know it could not exist without cholesterol.

Cardiologist Dr. Stephen Sinatra writes in The Great Cholesterol Myth (17):

“Cholesterol is a basic raw material made by your liver, your brain and virtually every cell in your body. Enzymes convert it into vitamin D, sex hormones (e.g., estrogen, progesterone, and testosterone) as well as stress hormones, and bile salts for digesting and absorbing fats. 

The brain is particularly rich in cholesterol and accounts for approximately one-quarter of all the cholesterol we have in our bodies. Neuronal communication depends on cholesterol: lower levels of cholesterol are linked to poorer cognitive performance.”

One adverse side effect of taking cholesterol-lowering statins is memory loss, including fuzzy thinking and/or learning difficulties (18). Personally, I have several friends with a parent now struggling with dementia or Alzheimer’s after taking a statin.

Our immune system also depends on cholesterol because our immune cells require cholesterol for activation; cholesterol can play an important anti-inflammatory role in fighting bacteria and infections (19, 20).

The other important thing to understand about cholesterol?

Only 20% of the cholesterol comes from the foods we eat!! The other 80% is produced inside of our bodies—by the liver (21).

Several cholesterol feeding studies—where volunteers were fed 2 to 4 eggs daily and their cholesterol was measured—have attempted to clarify the relationship between dietary cholesterol and the development of coronary heart disease. What researchers found: Dietary cholesterol has minimal—if any—impact on blood cholesterol levels in roughly 75% of the population.

The other 25% were deemed “hyper responders” because, in this group, dietary cholesterol modestly increased both LDL (“bad” cholesterol) and HDL (“good” cholesterol”); however, dietary cholesterol did not affect the ratio of LDL to HDL or increase the risk of heart disease (22, 23).

Why LDL “bad” cholesterol doesn’t tell the whole story…

It is important to understand: you don’t have a cholesterol level “in your blood”. Cholesterol is a sterol, a combination of a steroid and alcohol. Cholesterol is fat-soluble and blood is mostly water. Cholesterol, itself, can’t travel in the blood because it is hydrophobic, which means it cannot be mixed with—or dissolved in—water. In order for cholesterol to travel anywhere in the body, it has to be encased in a protective structure, which are special proteins called “lipoproteins”. Classified according to their density, LDL (low-density lipoprotein) and HDL (high-density lipoprotein) are the two lipoproteins typically associated with heart disease (24).

Imagine that your bloodstream is a highway. The lipoproteins are the cars that transport its passengers (cholesterol and fats) around your body. It was once commonly believed that the number of passengers in the car (e.g., the concentration of cholesterol in the LDL particle) was a main contributor to the development of heart disease.

However, more recent studies suggest that it is the number of cars on the road (e.g., total number of LDL particles) that matter most (25). In other words, the more cars there are on the highway—visualize rush hour traffic on the LA freeway—the greater your risk of having an accident; the number of passengers—whether it’s 1 person or 4 people—in your car is irrelevant.

Coronary arteries are hollow tubes, and the endothelium (lining) of the artery is only one cell deep—like a very flimsy “guard rail”! The blood, which carries lipoproteins like LDL is in constant contact with the endothelial lining. As a result, the more cars (lipoproteins) are on the highway, the higher the likelihood that some cars will “crash” into the fragile lining of the artery. Again, I’m making the point that knowing the actual number of LDL particles in your bloodstream tells you more about your heart disease risk than a “high” LDL cholesterol number.

Yes, your LDL cholesterol level (LDL-C) can be concordant with your LDL particle number (LDL-P), meaning that when LDL cholesterol is high, LDL particle size is high and vice versa. However, these markers can also be discordant, meaning that your LDL cholesterol (LDL-C) may be “normal” or even “low”, but the number of LDL particles (LDL-P) is “high” (25).

In a study published in the Journal of Clinical Lipidology, researchers recruited 6,814 participants, an ethnically diverse group of men and women, between the ages 45 to 84, who were free of cardiovascular disease (CVD) at the start of the study. Researchers tracked study participants for CVD events: there were 319 cardiac events—including heart attacks, coronary heart disease death, angina (chest pain due to reduced blood flow to the heart), stroke, stroke death or other CVD death—over a 5.5 year period.’’

What researchers found: Concordant LDL-C and LDL-P (in other words, both numbers were high) were associated with increased risk of CVD. However, when the LDL particle number  and LDL cholesterol were discordant (for example, “high” LDL particle number vs. a “normal” LDL cholesterol), the LDL particle number was more strongly associated with risk of a CVD event, including heart attack, stroke and death (26).

Get the right cholesterol tests to assess heart disease risk…

Conventional medical doctors still use the standard lipid panel as a basis to determine your risk for heart disease. Keep in mind, too, that financial incentives for prescribing statins play a role in driving the global statin market size, a reported $15.4 billion (US dollars) in 2023 (27).

Did you know: nearly 80% of people with coronary artery disease have standard cholesterol tests that fall within “normal” ranges?  This suggests that routine cholesterol tests—established over 50 years ago—fail to identify a large number of people at risk for heart attacks—who, if aware of their risk, could make changes in their food choices and lifestyle habits to reduce their risk of heart disease.

This is why I am a big fan of—and regularly use—this Advanced Cholesterol Panel to stay on top of my heart health—especially because I am hypothyroid and also susceptible to chronic viral infections, like Epstein-Barr, which can be underlying causes of high cholesterol.

The Advanced Cholesterol Panel includes the standard lipid panel PLUS cholesterol markers that more accurately predict your risk of heart disease.

The sale ($155) ends on February 29th. You can purchase the panel now—and schedule your blood draw later—up to 1 year from date of purchase.  *Note: This is direct lab testing. Meaning…you order your own labs. No doctor’s visit required. IF you live in New York or New Jersey, you will not be able to access direct lab testing. However, you can order your labs online, then travel to Connecticut, Pennsylvania or Massachusetts (this is where I go) for your blood draw.

You will be emailed your results 1 week from your blood draw. You can then take your labs to the healthcare practitioner of your choice. Or consult with me if you choose.

Click here to order the Advanced Cholesterol Panel.

In addition to the standard lipid panel, the Advanced Cholesterol Panel includes advanced biomarkers like:

–LDL particle number. I’ve covered this at length in this e-newsletter. A high LDL particle number is associated with an increased risk of heart disease.

–Apolipoprotein B: Apolipoprotein B is a protein found on LDL cholesterol particles. A high number of Apo-B containing lipoproteins is associated with more cholesterol ending up in your artery wall. Elevated levels of apolipoprotein B are associated with an increased risk of heart disease and heart attack.

–Lipoprotein (a). A type of LDL cholesterol that, when high, is associated with an increased risk of heart disease.

–Peak size and Pattern. This size and pattern of LDL cholesterol particles provide useful information about your cardiovascular risk. *Small, dense LDL particles are associated with an increased risk of heart disease.

–HDL Large.  HDL (“good” cholesterol) large particles are associated with a lower risk of heart disease.

Sources

1, 2  American Heart Association (AHA). 1/24/24.

3  Drugs.com. Side effects of statins. 8/22/23.

4  Heathline.com. Statins: Uses, Risks and Side Effects. 3/29/22.

5, 6, 23, 24, 25  Kresser, C. The Diet-Heart Myth: Learn how to prevent and treat heart disease naturally.

7 NDTV. Increased Exposure To Lead and Mercury May Raise Cholesterol: 5 Good Cholesterol Foods.  Nov. 6, 2018.

8  Buhari O, Dayyab FM, Igbinoba O, Atanda A, Medhane F, Faillace RT. The association between heavy metal and serum cholesterol levels in the US population: National Health and Nutrition Examination Survey 2009-2012. Hum Exp Toxicol. 2020 Mar;39(3):355-364.

9  Mayo Clinic. High Cholesterol. Jan 11, 2023.

10, 12, 13, 14, 16 Teicholz N. A short history of saturated fat: the making and unmaking of a scientific consensus. Curr Opin Endocrinol Diabetes Obes. 2023 Feb 1;30(1):65-71.

11  Seven Countries Study.

15  Jeffery L Heileson, Dietary saturated fat and heart disease: a narrative review, Nutrition Reviews, Volume 78, Issue 6, June 2020, Pages 474–485.

17, 20  Bowden, J. and Sinatra, S. The Great Cholesterol Myth: Why Lowering Your Cholesterol Won’t Prevent Heart Disease and the Statin Free Plan That Will. Revised and Expanded. Quarto Publishing Group, 2020.

18  Wenner Moyer, M. (2010, Sept. 1). It’s Not Dementia, It’s Your Heart Medication: Cholesterol Drugs and Memory. Scientific America.

19  Ryan J. King, Pankaj K. Singh, Kamiya Mehla, The cholesterol pathway: impact on immunity and cancer. Trends in Immunology. Volume 43, Issue 1, 2022, Pages 78-92.

21  Corliss, J. (2017, Feb. 6). How it’s made: Cholesterol production in your body. Harvard Health Publishing.

22  Kratz M. Dietary cholesterol, atherosclerosis and coronary heart disease. Handb Exp Pharmacol. 2005;(170):195-213.

26  Otvos JD, Mora S, Shalaurova I, Greenland P, Mackey RH, Goff DC Jr. Clinical implications of discordance between low-density lipoprotein cholesterol and particle number. J Clin Lipidol. 2011 Mar-Apr;5(2):105-13.

27  IMARC. Statin Market Report by Type (Synthetic Statins, Natural Statins), Therapeutic Area (Cardiovascular Disorders, Obesity, Inflammatory Disorders, and Others), Drug Class (Atorvastatin, Fluvastatin, Lovastatin, Pravastatin, Simvastatin, and Others), Application (Dyslipidemia, and Others), Distribution (Hospitals, Clinics, and Others), and Region 2024-2032.

What nutrient is absolutely essential for a healthy heart?

If you guessed “chocolate”….close, but no cigar! It’s the mineral magnesium.

Vital for heart health, magnesium:

1.   Prevents muscle spasms of the heart blood vessels…which can lead to a heart attack.

2.   Prevents muscle spasms of the peripheral blood vessels…which can lead to high blood pressure.

3.   Prevents calcium build-up in cholesterol plaque in arteries…which leads to clogged arteries. (1)

Magnesium is necessary for the proper functioning of 700-800 enzyme systems in the body. Magnesium helps create energy. As our body’s fourth most abundant mineral, magnesium plays a vital role in (2):

§  Regulating blood pressure, heart rate and blood sugar levels

§  Maintaining nerve function §  Keeping muscles relaxed

§  Alleviating stress, anxiety and depression

Keep in mind: While magnesium is a potent mineral that confers many essential health benefits, it works synergistically with other important nutrients that support heart health, including B vitamins, vitamin D3 with K2 and omega 3 fatty acids.

Magnesium and Your Heart

Magnesium is a mineral and a key electrolyte. Adequate magnesium is positively associated with heart health. Conversely, magnesium deficiency is implicated in many chronic health conditions, including heart disease. To this point…a study, published in Atherosclerosis, found that people who had low serum magnesium levels were more than twice as likely to die of heart disease. Low serum magnesium levels were also associated with an increased risk of death from all causes (3).

Heart conditions where magnesium can be significantly beneficial include:

–Arteriosclerosis / Atherosclerosis. Arteriosclerosis occurs when your blood vessels (carrying oxygen and nutrients from the heart to the rest of the body) become thick and stuff, which can restrict blood flow from your heart to your organs and tissues (4).

Atherosclerosis. This (preventable) condition is a specific type of arteriosclerosis caused by fatty plaque build-up in and on your artery walls. Plaque build-up causes your arteries to narrow, reducing the supply of oxygen-rich blood to vital organs in the body, including the heart (5). If/when the plaque bursts, this leads to a blood clot (6). The damaged tissue starts an inflammatory process that attracts “bad” cholesterol and calcium, creating scar tissue (7).

In the Framingham Heart Health Study, researchers found that magnesium exerted a protective effect in strokes and fatal coronary heart disease. In this study, higher magnesium intake—through diet and supplementation—was associated with less arterial calcification (hardening of the arteries). (8)

–Arterial stiffness. Arterial stiffness occurs when the walls of large arteries, especially the aorta, lose elasticity over time (9). Studies suggest that increased arterial stiffness can precede hypertension as well as heart disease (10). Arterial stiffness also increases the risk of developing heart disease in Type 2 diabetics.

The good news? Supplementing with magnesium can help reduce arterial stiffness, a marker for heart disease.

In a 2015 clinical trial, 52 overweight and slightly obese adults—50% men, 50% women (post-menopausal only), aged 45 to 70—were selected. The participants were given 350 mg magnesium citrate per day in 3 divided doses. After six months, participants experienced a significant reduction in arterial stiffness (11).

–High Blood Pressure.

High blood pressure (hypertension) is another risk factor for heart disease.

Hypertension is either primary or secondary. Primary hypertension occurs in 90 to 95 percent of those diagnosed with hypertension. Secondary hypertension, usually indicative of another disease (e.g., atherosclerotic renal artery stenosis, renal failure, or hypothyroidism), occurs in 5 to 10 percent of all hypertensive patients. (12). Causes of primary hypertension can include dehydration, high cholesterol, insulin resistance, obesity, high alcohol intake, poor diet, smoking, stress, a sedentary lifestyle and excessive consumption of processed salt / table salt (13, 14).

However, according to Dr. Carolyn Dean, a medical doctor, naturopath and author of The Magnesium Miracle, one major cause of hypertension that is overlooked is magnesium deficiency.

A meta-analysis, published in the journal Hypertension suggests a causal link between low magnesium and high blood pressure.  Researchers found that taking 300 mg per day of supplemental magnesium for one month was helpful in significantly reducing blood pressure (15).

–Heart Attack (Myocardial Infarction).

A heart attack is caused by a blockage that stops blood flow to the heart (16). A heart attack refers to the death of heart muscle tissue due to loss of blood supply and is technically considered a “circulation” problem (17). A blood clot typically causes this blockage—and can be sudden and complete.

How does this happen? Coronary arteries transport oxygen-rich blood to the heart. However, plaque build-up causes coronary arteries to become narrow. If the plaque ruptures, a blood clot forms, and part of the blood clot may break away and clog one of the coronary arteries. This creates a blockage that starves the heart muscle of blood (and oxygen), triggering a heart attack (18).

In the event of a heart attack, studies suggest that intravenous magnesium can have beneficial effects if administered 1) before any other drugs and 2) immediately after onset of a heart attack (19, 20).

According to Dean, administering magnesium ASAP after a heart attack can “improve the aftermath of a heart attack by preventing rhythm problems, increasing blood flow to the heart by dilating blood vessels, protecting the damaged heart muscle against calcium overload, improving heart muscle function, breaking down any blood clots breaking arteries and reducing free radical damage.”(21)

–Cardiac Arrest.

Cardiac arrest happens when your heart suddenly and unexpectedly stops beating because the heart’s pumping function is “arrested” or stopped (22). To be clear, a heart attack is NOT the same as cardiac arrest. However, having a heart attack can cause cardiac arrest.

Studies have found that “hypomagnesemia”, a term that refers to an abnormally low level of magnesium in the blood (<0.65 mmol/L), is a known risk factor for cardiac arrest (23).

Beyond Heart Health…

In addition to heart health, magnesium is a key mineral and electrolyte for our overall health, hormonal balance, energy, mood and vitality. Unfortunately, most of us—some experts estimate up to 90% of Americans—are deficient in magnesium (24).

Including me.  I had low magnesium…

In the 2010s, I was in what most people would consider peak physical shape. At the time, I was an intense exerciser, working out about two to three hours a day, 5 to 6 days a week. As a runner, I logged about 35-40 miles a week and strength-trained most days as well. I looked healthy and fit, yet I struggled with what felt like alarming symptoms: muscle cramps and spasms, random muscle twitches, foot pain, chronic tendonitis, intense anxiety, a racing heart, and heart palpitations that prevented—or disrupted—my sleep.  And, although I was in top running form, I had high blood pressure!  My blood pressure ranged from 130 to 140 (systolic) / 90 to 99 (diastolic)…and, once as high as 160/100. One nutritionist suspected an electrolyte imbalance, but she focused on potassium and calcium—not magnesium. Drinking potassium-rich V-8 and tomato juice and taking calcium supplements did absolutely NOTHING for me.  At the time, I did not realize that magnesium, which is also an electrolyte, can be quickly depleted by overtraining. Three years later, I discovered magnesium and, for me, personally, it was a life-changing supplement.

What Causes a Magnesium Deficiency?

Our modern convenience-based lifestyle depletes magnesium. We lose magnesium when we (25):

• • • Eat processed foods.
    • Consume a high sugar diet.
    • Eat refined or simple carbohydrates.
    • Regularly consume caffeine: coffee, tea, soda or energy drinks.
    • Eat zero or too little leafy greens.
    • Experience chronic stress: physical, emotional, mental.
    • Trauma
    • Sweat excessively (from physical exertion).
    • Overtrain or over-exercise.
    • Take synthetic hormones, like birth control pills or conventional HRT (Hormone Replacement Therapy).
    • Sleep too few hours; sleep off-circadian rhythm; or, have poor quality sleep.
    • Drink alcohol.
    • Use marijuana. *Whether you use marijuana recreationally or therapeutically (to treat a medical condition), it drains magnesium stores.
    • Use prescription drugs—the vast majority of which deplete magnesium—including, but not limited to: antibiotics, bronchodilators (for asthma), diuretics, corticosteroids (oral and inhaled), proton pump inhibitors (for acid reflux), antacids, blood pressure medications, immunosuppressants and statins (26).

What does a magnesium deficiency feel like?

Magnesium is involved in multiple pathways throughout the brain and body. Consequently, a long list of potential symptoms and behaviors can indicate magnesium deficiency, including, but not limited to the following (27):

Physical Symptoms

• • • Muscle cramps or spasms
    • Muscle twitching
    • Tremors of the hands
    • Menstrual pain / cramps
    • PMS (Pre-Menstrual Syndrome)
    • Constipation
    • Digestive issues: undigested fat in stool, IBS, Crohn’s, diarrhea, etc.
    • Food cravings (especially carbohydrates, chocolate, salt and junk food)
    • Headaches / Migraines
    • Heart: arrhythmia, heart palpitations
    • High blood pressure
    • Low calcium and/or low potassium
    • Osteoporosis
    • Insomnia

Mood Imbalances

• • • Anger
    • Apathy
    • Anxiety
    • Depression
    • Irritability

What are food sources of magnesium?

• • • Seafood.  Kelp, dulse
    • Dark leafy greens and cruciferous vegetables. Spinach, Swiss chard, collard greens, dandelion greens, broccoli, and cauliflower
    • Fish.  Halibut, mackerel
    • Nuts.  Almonds, cashews, Brazil nuts, pecans
    • Seeds.  Pumpkin seeds, sunflower seeds, sesame seeds
    • Gluten-free pseudocereal “super seeds”. Buckwheat, quinoa
    • Fruit.  Dried figs, apricots, dates, blackberries

Dark chocolate is often touted as being high in magnesium, and it is—in its raw, unsweetened form—as in raw cacao nibs, raw cacao powder or unsweetened cocoa powder. A high quality, organic dark chocolate bar (85% cacao or higher) is also an excellent source of magnesium. My go-to favorite is 95% cacao; my second favorite is 85% cacao.

Unfortunately, it is virtually impossible to get enough magnesium from food alone.

Modern farming practices, such as the use of commercial fertilizers, have dramatically depleted our soil of nutrients over the last century; this was noted in a U.S. Senate document as far back as 1936 (28)!

The following are direct excerpts from U.S. Senate Document 264, dated June 5th, 1936:

“The alarming fact is that foods (fruits, vegetables and grains) now being raised on millions of acres of land that no longer contain enough of certain minerals are starving us—no matter how much of them we eat. No man of today can eat enough fruits and vegetables to supply his system with the minerals he requires for perfect health because his stomach isn’t big enough to hold them.

It is bad news to learn from our leading authorities that 99% of the American people are deficient in these minerals, and that a marked deficiency in any one of the more important minerals actually results in disease. Any upset of the balance, any considerable lack or one or another element, however microscopic the body requirement may be, and we sicken, suffer, shorten our lives.”

Most of us also lead fast-paced, stressful lives that include processed foods, caffeine, sugar, alcohol, too little sleep, inadequate hydration and/or taking medications, all of which conspire to keep magnesium levels low. Since discovering magnesium a decade ago, I have been supplementing with several different forms—even though I eat organic foods, filter my water, cook virtually all of my own meals and do not take medications. I have hypothyroidism and adrenal dysfunction, which makes me even more sensitive and susceptible to stress of all kinds. I test my Magnesium RBC regularly, every 3 to 6 months, as magnesium is key for hormonal balance.

Are YOU deficient in magnesium?

Always test. Don’t guess. Taking a magnesium supplement willy-nilly without knowing your baseline level is like trying to lose weight without bothering to weigh yourself at the outset of a weight loss journey. Magnesium is stored mostly in your bones, soft tissues, and cells. Less than 1% of total magnesium is stored in your blood. This is why getting a standard serum (blood) test for magnesium (which doctors typically ordered if you request bloodwork for magnesium) is a highly inaccurate measure of total magnesium in the body.

If you want an accurate evaluation of your magnesium status, ask specifically for a Magnesium RBC (Red Blood Cell) test, which measures the magnesium level in red blood cells. You can ask your doctor for this test or order your own test here (click on Nutrient Panel; a menu will drop down).

The higher end of the lab reference range is optimal.  Within a typical lab reference range of 4.2 to 6.8 for Magnesium RBC, the optimal level is 6.0 to 6.5 (29).

Supplementing with Magnesium

How much you take is very individual; it depends on how depleted you are. Overall, most Americans are below baseline intake. Two out of three Americans do NOT consume the recommended daily allowance (RDA) for magnesium: 320 mg for women and 420 mg for men (30). Dean also points out: At best, your body is actually only absorbing about half of what is taken in (31).

There are different types of magnesium. Magnesium citrate powder is a popular form. Magnesium oxide, the form that doctors will often recommend to patients, is the last absorbable form of magnesium (about 4%).

Personally, I use the following types of magnesium, which are highly absorbable and beneficial for increasing intracellular levels of magnesium:

—Transdermal magnesium oil

—Magnesium glycinate

—Slow-release magnesium malate + B Vitamin co-factors

Supplementing with magnesium is fairly safe. There are, however, 4 exceptions who should NOT supplement with magnesium: Those who have 1) kidney failure, 2) myasthenia gravis, 3) excessively slow heart rate or 4) bowel obstruction (32).

In The Magnesium Miracle, Dean notes that, even when taken at high doses, an oral magnesium, like magnesium citrate, has no side effects, except loose stools. This laxative-like effect is the body’s fail-safe mechanism of releasing any excess magnesium that it does not need. It is also a sign to either reduce the overall dosage or to take smaller amounts in divided doses.

That said, if you are taking prescription medications, check with your doctor first before supplementing with magnesium.

CONTINUE READING:  6 Easy Ways to Get More Magnesium

Sources

1, 2, 7, 13, 19, 21, 25, 27, 29, 31, 32  The Magnesium Miracle by Carolyn Dean. 2nd Edition. Aug. 15, 2017.

3  Reffelmann T, Ittermann T, Dörr M, Völzke H, Reinthaler M, Petersmann A, Felix SB. Low serum magnesium concentrations predict cardiovascular and all-cause mortality. Atherosclerosis. 2011 Nov;219(1):280-4. doi: 10.1016/j.atherosclerosis.2011.05.038. Epub 2011 Jun 12. PMID: 21703623.

4, 6  MayoClinic.org.

5  NIH. Artherosclerosis.

8  Hruby A, O’Donnell CJ, Jacques PF, Meigs JB, Hoffmann U, McKeown NM. Magnesium intake is inversely associated with coronary artery calcification: the Framingham Heart Study. JACC Cardiovasc Imaging. 2014 Jan;7(1):59-69. doi: 10.1016/j.jcmg.2013.10.006. Epub 2013 Nov 27. PMID: 24290571; PMCID: PMC3957229.

9, 10  Oh, Y.S. Arterial stiffness and hypertension. Clin Hypertens 24, 17 (2018). https://doi.org/10.1186/s40885-018-0102-8.

11  Peter J Joris, Jogchum Plat, Stephan JL Bakker, Ronald P Mensink, Long-term magnesium supplementation improves arterial stiffness in overweight and obese adults: results of a randomized, double-blind, placebo-controlled intervention trial, The American Journal of Clinical Nutrition, Volume 103, Issue 5, May 2016, Pages 1260–1266.

12  Charles L, Triscott J, Dobbs B. Secondary Hypertension: Discovering the Underlying Cause. Am Fam Physician. 2017 Oct 1;96(7):453-461.

14  Carretero, O.A. and Oparil, S. Essential Hypertension. Circulation. Vol. 101, Issue 3, 25 Jan. 2000; Pages 329-335

15  Zhang X, Li Y, Del Gobbo LC, Rosanoff A, Wang J, Zhang W, Song Y. Effects of Magnesium Supplementation on Blood Pressure: A Meta-Analysis of Randomized Double-Blind Placebo-Controlled Trials. Hypertension. 2016 Aug;68(2):324-33.

16, 17  American Heart Association. Cardiac Arrest.

18  American Heart Association. Acute Coronary Syndrome.

19  Antman, Elliot M. Magnesium in Acute MI. Circulation. Vol. 92, Issue 9, 1 Nov. 1995. Pages 2367-2372.

22  NIH. What Is a Heart Attack?

23  Del Gobbo LC, Imamura F, Wu JH, de Oliveira Otto MC, Chiuve SE, Mozaffarian D. Circulating and dietary magnesium and risk of cardiovascular disease: a systematic review and meta-analysis of prospective studies. Am J Clin Nutr. 2013 Jul; 98 (1):160-73.

24  Epsom Salt Council. Oct. 23, 2019

26  Drug Muggers: Which Medications Are Robbing Your Body of Essential Nutrients by Suzy Cohen, RPh

28  U.S. Senate Document 264. 74th Congress, 2nd Session, June 5, 1936.

 30  King DE, Mainous AG 3rd, Geesey ME, Woolson RF. Dietary magnesium and C-reactive protein levels. J Am Coll Nutr. 2005 Jun;24(3):166-71.

Did you know:

….supplementing with high doses of calcium and vitamin D—without vitamin K2­—increases your risk for calcium-related osteoporosis and arthrosclerosis? In her book Vitamin K2 and the Calcium Paradox, Dr. Kate Rheaume-Bleue, a naturopathic physician and Canadian radio and television health expert, describes this phenomenon as “The Calcium Paradox”: “a mysterious concurrent calcium deficiency (in the skeleton) and calcium excess (in the arteries) that underlies two major health concerns of our time, osteoporosis and heart disease.”

Why Vitamin K Matters

There are two forms of Vitamin K: K1 and K2. Vitamin K1, or phylloquinone, is used by the liver and plays an important role in maintaining healthy blood clotting function. Vitamin K1 is found primarily in plant-based sources, like dark leafy greens.

Top sources of Vitamin K1 include kale, spinach, mustard greens, collard greens, Swiss chard, turnip greens, parsley, broccoli, Brussels sprouts and romaine lettuce.

Vitamin K2, also called menaquinone, goes straight to vessel walls, bones and soft tissues.

Produced by grass-fed animals and lactic acid bacteria, Vitamin K2 is naturally present in fermented foods such as sauerkraut, cheese and Japanese natto (soybeans fermented with bacillus subtilis, a soil bacterium), an exceptionally high source of K2 (about 1,103 mcg per 3-1/2 oz serving).

Studies suggest that Vitamin K2 plays a significant role in cardiovascular health, preventing osteoporosis (it helps form strong bones), and helping reduce risk of prostate cancer.  It may also be beneficial in preventing wrinkles and premature aging.

An intimate relationship:  Vitamin K2, Vitamin D and Calcium

How it works: Vitamin D promotes bone health by helping you absorb calcium. However, you need Vitamin K2 to get calcium to where your body needs it—and to prevent it from being deposited in the wrong places. In this way, Vitamin K2 serves as a metaphorical “traffic cop”, directing calcium to the right places and preventing calcium from depositing in the wrong places, all the while working synergistically with Vitamin D. For example, K2 activates a special protein called osteocalcin, which directs the calcium to the “right” places, like your bones and teeth. K2 also activates another protein called Matrix Gla Protein (MGP), which sweeps calcium out of the “wrong” places, such as soft tissues, including veins and arteries, thereby preventing calcification, or “hardening” of the arteries.

Adequate consumption of K2 ensures strong bones and clear arteries—Rheames-Bleue suggests about 180-200 micrograms of K2 for the “average healthy person”.  (More K2 may be required if you are supplementing with high doses of vitamin D). Without enough K2 in our diet to activate K2 proteins, like osteocalcin and MGP, we are—over time—susceptible to “the calcium paradox”, increasing our risk for osteoporosis, heart disease and cancer.

Under Study: Vitamin K2

Heart health

In the Rotterdam study, researchers in the Netherlands tracked the vitamin K intakes of subjects between 1990 and 1993 and measured the extent of heart disease and failure (death from heart disease) in each subject, and how it related to K2 intake and arterial calcification. Researchers found calcification of the arteries to be the best predictor of heart disease.

Those in the highest third of vitamin K2 intakes were 52 percent less likely to develop severe calcification of the arteries, 41 percent less likely to develop heart disease, and 57 percent less likely to die from it. 

Intake of vitamin K1 had no effect on any cardiovascular outcome.¹

Bone health

Vitamin K2 helps to activate vitamin K-dependent proteins responsible for healthy tissues and bones.  Several Japanese trials have shown that K2 prevent further bone loss in postmenopausal women and, in some cases, increase bone mass in women with osteoporosis.²

Prostate cancer

Study results of the European Prospective Investigation into Cancer and Nutrition (EPIC) suggest that increased intake of vitamin K2 may reduce the risk of prostate cancer by 35 percent.³

The X Factor

In 1945, Dr. Weston Price, a dentist and author of the landmark book Nutrition and Physical Degeneration, described a new vitamin-like activator—which he called “Activator X”—that played an important role in the assimilation of minerals, protecting against tooth decay and preventing calcification of the arteries leading to heart disease.  It is also an important component of the brain.  His testing revealed that “Activator X” was present in butterfat, the organs and in the fat of animals grazing on green grass. Activator X was later identified as Vitamin K2. Why are grass-fed animals an important source of K2? Because vitamin K1 is found in the green tissues of rapidly growing green plants, including grass.  When animals eat grass, their tissues, including mammary glands (think dairy), convert part of K1 into vitamin K2 (though the ability to make this conversion varies between species). As a fat-soluble vitamin, K2 works synergistically, and is most effective when consumed with two other fat-soluble activators: vitamins A and D. For example, Price found the combination of cod liver oil (high in vitamins A and D) and grass-fed butter (high in vitamin K2) to be superior to that of taking just cod liver oil.

Best food sources of vitamin K2

According to researcher Christopher Masterjohn, the following fermented foods and grass-fed animal or dairy products contain the highest amounts of vitamin K2:

• Natto
• Goose liver pate
• Hard cheeses: Gouda contains the highest amount
• Egg yolk (from pastured chickens)
• Butter from grass-fed or pasture-raised cows *Commercial butter from grain-fed cows will contain notably lower levels of K2.
• Chicken liver (ideally, from free-roaming all-natural chickens)
• Salami
• Chicken breast
• Chicken leg
• Ground beef (medium-fat)
• Bacon
• Calf liver
• Sauerkraut

Modern lifestyles and food choices find many of us falling short on consuming traditional food sources of Vitamin K2 and few foods contain significant amounts of Vitamin D3. If you choose to supplement, I recommend this brand of Vitamin D3 with K2, a liquid form that I have found to be highly bioavailable and effective. You measure out the amount of D3 you intend to take in meted drops—and the K2 is proportionate to the amount consumed. No higher math required!

Sources:

1  The Journal of Nutrition, Volume 134, Issue 11, November 2004, Pages 3100–3105.

2  European Journal of Nutrition. 2004 Dec; 43(6):325-35

3  American Journal of Clinical Nutrition. 2008 Apr; 87(4):985-92

4  Masterjohn, C. 2008, Feb. 14, On the Trail of the Elusive X Factor. westonaprice.org,

Follow your heart.

A loving heart is the truest wisdom.

Kind-hearted. Pounding heart. Heartbroken.

The heart been long been regarded as an organ of emotion.

The heart is not only central to our emotional system; it affects—and is affected—by what we feed our body (food, drink, movement) and our mind (thoughts, perceptions of reality).

Managing your emotions is key to building resilience and effectively coping with stress, which can go a long way toward improving heart health.

Valentine’s Day celebrates the emotion of love, traditionally associated with the heart. Since 1963, February (the entire month) has also been dedicated to raising awareness about heart health.  In the U.S., heart disease is the #1 killer of both men and women. Approximately 610,000 Americans die of heart disease every year; that’s 1 in every 4 deaths.¹

But we should be mindful of our heart health beyond February.

Managing our emotions is essential for a healthy heart. However, since unexpressed, repressed or negative emotions can manifest as physical symptoms, it is also important to understand the physical risk factors for heart disease.

Physical Risk Factors for Heart Disease

Stereotype: The “typical” heart attack victim is a Type A (workaholic) male executive in his 50s.

Fact: Heart attacks are affecting younger people today. A study published recently in the medical journal, Circulation, found that the overall proportion of heart attack-related hospital admissions in the U.S, attributable to “young” patients (men and women aged 35 to 54) rose from 27% in 1995-99, to 32% in 2010-14, with the largest increase (from 21% to 31%) among young women.²

The reality is that the risk factors leading to heart disease can happen at ANY age.

These include:

Overweight and Obesity. Over 70% of American adults are overweight; of this 70%, 40% of American adults (more than 1 in 3) are obese, and 18.5% of children (apx. 1 in 6), ages 2 to 19, are obese. Extra weight puts stress on the heart.³

High blood pressure. Uncontrolled blood pressure increases risk of heart disease and stroke.

High cholesterol. Obesity, smoking, diabetes, physical inactivity and unhealthy food choices contribute to an increase in bad cholesterol.

Smoking. Smoking damages the blood vessels and can cause heart disease.

Diabetes. 1 in 10 Americans has diabetes, a condition where sugar builds up in the blood.

Lack of physical activity. Only 23.5% of Americans, 18 and older, meet the recommended guidelines for aerobic and strength-training activity.⁴

Excessive alcohol consumption. Heavy drinking or alcohol abuse can lead to heart failure, known as alcoholic cardiomyopathy, or alcohol toxicity to the heart muscle.^5,6

Alcoholic cardiomyopathy is most common in men, ages 35 to 50, with a history of heavy, long-term (apx. 5 to 15 years) drinking. For men, “heavy drinking” is more than 4 drinks daily or more than 14 drinks per week. For women, heavy drinking is more than 3 drinks daily or more than 7 drinks per week.

Poor diet. Only 1 in 10 Americans eats the recommended 5-9 servings of fruits and vegetables every day. Diets high in unhealthy fats, sugar (added and/or artificial sweeteners), refined carbohydrates and processed foods increase risk of heart disease.⁷
 

Emotional Risk Factors for Heart Disease

In my practice, I see clients who often feel overwhelmed by stress.

No question about it: modern life is stressful. And negative emotions often drive our unhealthy food choices and lifestyle habits.

Feeling frustrated because you’re not getting the recognition you deserve at work? Maybe this is why you have an intimate relationship with comfort foods, like pizza, takeout Chinese and ice cream. Feeling trapped in an unhappy marriage or job? Maybe it feels more bearable when you pound wine or cocktails every night. Feeling angry because you feel like you do 85% of the work at work—and at home? Maybe that’s why you look forward to zoning out in front of the television (until 1 or 2 AM) after the kids are in bed. Feeling anxious because your latest entrepreneurial venture tanked? Maybe it feels like smoking or vaping helps calm your anxiety.

Chronic, negative emotions can feed inflammation and adversely affect heart health. These include:

Anxiety or anxiety disorder (e.g., panic disorder, post-traumatic stress disorder, obsessive-compulsive disorder). Anxiety may be associated with rapid heart rate, increased blood pressure and decreased heart rate variability.⁸

Anger. Studies have suggested that outbursts of anger or episodes of intense anger can increase the risk of heart attack, stroke or other cardiovascular events.⁹

Stress. Emotional stress can lead to behaviors and factors that increase your risk of heart disease: overeating, lack of exercise, drinking alcohol and smoking can lead to high blood pressure and high cholesterol.

Depression. Depression is common in people with heart disease or who have undergone a coronary artery bypass.¹⁰ However, depression, itself, is an independent risk for heart disease—even without known heart disease.¹¹

Grief. Heart attack risk can increase significantly during the days and weeks after the death of a loved one.¹²  Stress, caused by intense grief, can increase heart rate, blood pressure and blood clotting, raising chances of a heart attack.  At the beginning of the grieving process, people are more likely to experience less sleep, low appetite and higher cortisol (a stress hormone) levels, which can also increase heart attack risk.¹³

Even if you don’t have heart disease or you’ve never had a heart attack, emotional stress still affects your heart. For example, in a 1997 study, researchers monitored EKG (electrocardiograph) changes in healthy physicians during emergency calls while they were on hospital duty. The EKG changes that occurred before and during the first 30 seconds of an emergency call indicated oxygen deprivation and abnormal heart rhythms.¹⁴

A 2016 study, published in Trends in Cardiovascular Medicine, explored the brain-heart connection. Researchers found that negative emotions (considered “brain-based”), such as stress, anger and depression, can increase the frequency of heart arrhythmias (irregular heart beat).¹⁵

An earlier study found that depression—whether major or minor—is a risk factor for a fatal cardiac event. Even in people without prior heart disease, major depression (versus minor) doubles the risk of dying from heart-related causes.¹⁶
 

The Heart, Emotions and Stress

The heart and brain have a two-way communication system.

Our thoughts or emotional state can greatly affect our physical well-being.

The heart has its own “brain” and nervous system, which send signals to the brain (in the head), influencing how the brain processes emotions and cognitive function, including attention, perception, memory and problem-solving.¹⁷

When we experience a specific feeling or thought, it affects our autonomic nervous system (ANS) by releasing neuropeptides, nerve proteins that link perception in the brain to the body and emotions. The quality of the emotional signal our heart sends to our brain determines the type of chemicals our brain releases into our body.  “Stress” is usually rooted in unmanaged negative emotions.¹⁸

For example, let’s say that you are going through a nasty divorce, including a custody battle. You feel fear and anxiety (the emotions at the root of your stress) about the outcome. This stress triggers the release of cortisol and adrenaline, two “fight-or-flight” stress hormones, in anticipation of a perceived danger. Cortisol and adrenaline “rally the troops” by sending energy to your muscles, increasing your heart rate, blood pressure and breathing rate, while, at the same time, shutting down digestion, reproduction, growth and immunity (unimportant metabolic processes if your body is preparing to flee a tiger!).

When your body is in continual high-alert “EMERGENCY!” mode, these stress hormones and neuropeptides can cause health problems, from high blood pressure and digestive issues, to problems with your memory, immune system—and your heart.

Studies conducted by HeartMath Institute, a non-profit organization specializing in emotional physiology, resilience and stress management, show that emotions affect your heart rate variability (HRV), a measure of beat-to-beat changes in heart rate. Different patterns of heart activity influence cognitive and emotional function.¹⁹

For example, if you are under duress and experiencing negative emotions, such as anger, frustration and anxiety, your heart rhythm pattern will be irregular and chaotic (mirroring your feelings). This creates “distressed” neural signals, traveling from your heart to your brain, that limit cognitive function. This is why, under stress, you may act impulsively (e.g., go on an online shopping spree) or make rash (bad) decisions (e.g., drink and drive).

On the other hand, positive emotions, like gratitude, appreciation and caring, produce a regular, stable heart rhythm pattern. When the brain receives these harmonized neural signals, your stress hormones decrease, and your immune system is stronger. When you are in a positive emotional state, you will likely be thinking clearly and making effective (good) decisions.

The pattern of our HRV reflects how well we can adapt to stress; it serves as a marker of our physical resilience and our ability to change behavior (when necessary).²⁰
 

How to Get (and Stay) on a Positive Emotional Track

Emotions are at the core of our “stress” experience. Our thoughts, too, tend to carry an emotional charge.

Neuroscience researchers have found that emotional processes operate at a higher speed than thought processes, and can bypass the mind’s linear reasoning process.²¹ As a result, what you think does not always result in how you feel.

This is why feeling positive involves more than just thinking positive.

So, how can we cultivate confidence, emotional positivity and emotional resilience?

By actually facing, acknowledging and moving through uncomfortable feelings.

Let’s face it: nobody wants to deal with painful, uncomfortable feelings. Most of us prefer to disconnect or distract ourselves from feeling bad. We do this by ignoring our feelings, doubting or questioning whether our feelings are even valid, and/or by engaging in addictive escapism behaviors (alcohol, drugs, overeating, binge-eating, compulsive shopping, electronic distractions, zoning out in front of the television)—anything that enables us to “check out”.

Even socially accepted behaviors, like exercising, being in constant multi-tasking “busy” mode, or being work-obsessed, can serve as distractions from uncomfortable feelings. In my past life as a freelance writer, I often dealt with my work-related feelings of frustration and anger by pounding my body with aggressive over-exercise (spending 2-3 hours at the gym). This “healthy” behavior—and my results—were praised; nonetheless, it was a distraction from what I was feeling inside. In the end, over-exercise drove my hormones into the ground and crashed my immune system.

In her illuminating new book, 90 Seconds to a Life You Love, psychologist Dr. Joan Rosenberg, gives practical guidance and strategies for creating emotional confidence and resilience. She writes:

“As paradoxical as it seems, the answer is tied to your capacity to tolerate pain—or your ability to handle unpleasant feelings. The more you are able to face the pain you experience, the more capable you become. The essential keys to developing confidence, feeling emotionally strong, and being resilient involve an openness to change, a positive attitude toward pain, a willingness to learn from any experience, and a capacity to experience and express unpleasant feelings.”

Her “Rosenberg Reset”, which helps you move through unpleasant feelings, is a simple 3-step formula: One choice. Eight feelings. 90 seconds.

1. The “one choice” is to be present and to be aware of how you feel from moment-to-moment; this may include experiencing unpleasant feelings in the process.

2. The eight common unpleasant feelings include: 1) sadness; 2) shame; 3) helplessness; 4) anger; 5) embarrassment; 6) disappointment; 7) frustration; and 8) vulnerability.

3. You endure these unpleasant feelings by riding one or more 90-second waves of bodily sensations—like warm cheeks (e.g., feeling embarrassed), a pounding heart (e.g., feeling angry), or a heavy pit in the stomach (e.g., feeling deep disappointment)—that may accompany uncomfortable feelings. Pay attention: these physical sensations are how the body communicates our feelings to us.²²

Rosenberg contends that major life choices—a spouse/partner; the “perfect” job, the college of your choice—can influence the opportunities we have in life, but not our overall happiness, sense of peace and well-being.  Instead, she maintains, it is our moment-to-moment decisions that have a cumulative effect on our health and well-being.

For example, did you voice your true opinion at a work meeting? Did you trust your gut reaction on an awkward first date? Did you express how you really felt when a friend cancelled lunch last minute and rescheduled for the umpteenth time? All of these moment-to-moment decisions to address or ignore your feelings add up to how confident—and competent—you feel in navigating unpleasant emotions.²³

It is like building an emotional “muscle” that, over time, enables you to speak your truth. By consistently experiencing and dealing with difficult feelings, Rosenberg maintains, you increase your capacity to engage in courageous conversations, which can enhance relationships and deepen the purpose and meaning of your life.
Perhaps, it only makes sense that the root of the word “courage” is “cor”, the Latin word for “heart”. And the original meaning of the word “courage” was “To speak one’s mind by telling all one’s heart”.
 
 
 

Sources:

¹  Centers for Disease Control and Prevention, Heart Disease Facts.
²  Circulation. Nov. 2018; 139:1047–1056
³  AAFP.org
⁴  CDC. National Center for Health Statistis.
⁵  Herz. 2016; 41(6): 484–493.
⁶  Curr Atheroscler Rep.2008 Apr; 10(2): 117–120.
⁷  CDC: Division of Heart Disease & Stroke Prevention.
⁸  John Hopkins Medicine: Heart & Vascular Institute.
⁹  European Heart Journal.  2014 Jun 1; 35(21):1404-10.
¹⁰  Cleveland Clinic: Depression & Heart Disease.
¹¹  University of Iowa Hospital & Clinics.
¹²  Science Daily. Jan. 10, 2012
¹³  Circulation. Jan. 9, 2012.
¹⁵  Journal of the American College of Cardiology. Vol. 30, Issue 3, July 1997, pp. 774-779
¹⁶ Trends in Cardiovascular Medicine. Vol. 26. Issue 1. Jan. 2016, pp. 78-80.
¹⁷  Archives of General Psychiatry. Vol. 58, Issue 3, Mar 2001, pp. 221-227. University of Groningen.
^{19, 20}  HeartMath Institute
^{18, 21}  Stress in Health and Disease. Wiley-VCH. 2006.
^{22, 23}  90 Seconds to a Life You Love.  Joan I. Rosenberg. Little Brown. 2019.

For example: Do you avoid eating red meat because you believe that it will give you heart disease? Do you wonder why dark chocolate—perhaps a frequent craving—has heart health benefits?  Do you believe that eating “low-fat” is heart smart?  Do you think that you are immune to getting heart disease because you’re only in your 20s or 30s?

First, it’s important to understand the two main drivers of heart disease: inflammation and oxidative damage.

Chronic low level inflammation at the cellular level—known as the “silent killer”—can develop without pain and also lead to obesity, diabetes, cancer and heart disease. Oxidative damage occurs when cells have been exposed to oxygen (think apple slices that turn brown because they were exposed to oxygen), leading to the creation of unstable molecules called “free radicals”. Damage from free radicals causes inflammation, which damages your DNA, cell membranes and tissues. In turn, this chronic inflammation can produce an abundance of free radicals, which then creates more inflammation. A vicious cycle ensues.

What causes inflammation and oxidative damage?  The main offenders are (but are not limited to):

1)    Chronic, ongoing stress
2)    Smoking
3)    A poor, high sugar diet
4)    A sedentary lifestyle

Relative youth (being in your 20s or 30s) does not provide immunity from heart disease. The Bogalusa Study, a long-term community study of a bi-racial population in a small Louisiana town, found that causes of adult heart disease actually begin in childhood—as early as age 8.  According to the study, documented anatomic changes occur by 5 to 8 years of age.  Ideally, a heart-healthy lifestyle begins in childhood.

Here’s the great news… Heart disease can largely be prevented, even reversed, through diet and lifestyle changes.
 

Making the following shifts can go a long way towards protecting your heart.

 
1.  Manage your blood sugar!
Studies show blood sugar imbalances contribute to heart disease. Stabilize your blood sugar by eating regular meals that include protein, healthy fat, fiber and—depending on your carbohydrate tolerance—a low-to-moderate amount of healthy starch carbohydrates (e.g., sweet potatoes, winter squashes, etc.) at every meal.
 
2. Choose grass-fed red meat (and AVOID factory-farm and processed red meats).
Despite alarmist headlines that warn “eating red meat increases risk of heart disease!”, humanely raised animal protein and healthy fats have their place in a heart-healthy diet.  Not all meat is created equal!  Animals raised in factory farms endure stressful living conditions, are given antibiotics, fed GMO grains, along with waste by-products, and are more likely to be contaminated by bacteria.  On the other hand, animals raised on pasture eat their natural diet (grass) and contain less overall fat and more heart disease-fighting antioxidants, like vitamin E.  Pasture-raised animals (meaning they eat grass from start to finish—no grains), such as beef, lamb, bison and game, are excellent sources of lean protein and healthy fats, including conjugated linoleic acid (CLA, which has been linked to long-term weight management) and omega 3 fats (yes, the same omega 3 in wild-caught salmon), which can help stabilize blood sugar and raise HDL (good cholesterol).
 
3.  Get enough zinc.
A little zinc (8 to 11 mg is the daily recommended allowance) goes a long way.

But, as we age, zinc levels tend to decrease—just as cardiovascular risk increases.  Zinc is a trace mineral involved in many enzymatic reactions and essential functions in the cell. Low zinc levels are associated with a greater susceptibility to oxidative stress. Studies have found that zinc levels are often significantly lower in people with heart-related conditions, such as atherosclerosis (scarring of the arteries due to fatty plaques), coronary artery disease, angina and cardiac ischemia (reduced blood flow to the heart).

In a recent study, University of Leicester researchers found that zinc plays an important role in regulating heartbeat and promoting normal cardiac function. Your body absorbs approximate 20 to 40% of zinc in food. Animal foods, such as oysters, grass-fed beef, pasture-raised lamb, and unsweetened dark chocolate, are excellent sources of zinc—and better absorbed than zinc from plant foods. 

Zinc is best absorbed when taken with a meal containing protein. Don’t begin supplementing with zinc without first asking your doctor to run a Zinc RBC (Red Blood Cell) blood test to determine if you have a zinc deficiency.
 
4.  Watch your sugar intake.
Eating a high sugar diet is associated with a significantly higher risk of dying from heart disease—even if you are not overweight, according to a major study published in JAMA Internal Medicine. Over a period of 15 years, researchers, who tracked participants’ added sugar consumption as it related to heart disease, found that the chances of dying from heart disease rose in tandem with the percentage of sugar in the diet—regardless of age, sex, physical activity level and body mass index. Drinking sugar-sweetened beverages is also associated with higher rates of death from heart disease.

Sugar is not just in foods that taste obviously sweet.

Today, sugar is added to most packaged, processed and prepared foods, including fast food, takeout and restaurant fare. Bottom line: Read labels!  A food, like yogurt, marketed as “low fat” is high in sugar. And, when eating out, ask what ingredients are going into your meal.
 
5. Supplement with magnesium.
If you frequently crave chocolate, you are likely craving magnesium. Known as the “calming” mineral, magnesium is essential for heart health. Responsible for over 700 enzyme-activated biochemical reactions in the body, magnesium plays a vital role in regulating blood pressure, heart rate and blood sugar levels.  Low levels of magnesium are associated with angina, congestive heart failure, ischaemic heart disease (reduced blood supply to the heart), cardiac arrhythmias, high cholesterol, hypertension (high blood pressure) and other conditions, including anxiety and depression.  A high sugar diet, alcohol, chronic stress and long-term use of prescription medications deplete your magnesium stores. 

Unfortunately, modern farming methods have depleted our soils, making it virtually impossible to get adequate magnesium from food alone. You can ask your doctor to run a Magnesium RBC (Red Blood Cell) blood test to determine deficiency, but you are likely to “feel” a magnesium deficiency as it often manifests as significant symptoms, including PMS, problems sleeping, anxiety, mood swings, high blood pressure and cardiovascular disease.   I recommend the following brands of magnesium (click on the links): Magnesium Glycinate and Magnesium Citrate/Malate.
 
6.  Avoid or minimize alcohol intake.
Despite what you may have heard otherwise, alcohol is not a health food!  Sorry.  Alcohol—yep, including red wine—can raise triglycerides, contribute to fatty liver and create blood sugar imbalances. High triglycerides can contribute to hardening of the artery walls, increasing your risk of heart disease. Alcohol, including wine, will increase levels of insulin, the fat-storing hormone.

Chronically high insulin levels leads to insulin resistance, which manifests in many chronic conditions and diseases, from obesity and diabetes, to rheumatoid arthritis and cancer. Insulin resistance also causes inflammation—a primary risk factor for heart disease.
 
7.  Be proactive in addressing negative emotions.
The mind-body connection is powerful. In a study, published in Biological Psychiatry, University of Pittsburgh researchers found a strong association between negative emotions, brain circuitry, inflammation and heart disease. How well someone responds to negative emotions, such as stress, anxiety, fear, anger and depression, is linked to their risk of having a heart attack or stroke. 

Increasing positive emotions through laughter, mindfulness, meditation and strong social connections, as well as stress management practices (like regular daily movement), can reduce inflammation; and, consequently, reduce your risk of heart disease.
 

Recipes for a Well-Fed Heart

Skillet-Cooked Lamb Steaks
Cowboy (Rib-eye) Steaks with Espresso Rub
Braised Lacinato Kale Chiffonade
Ultra-Dark Chocolate Sweet Potato Brownies
No Guilt Flourless Chocolate Cake

 
When it comes to having a healthy heart, it’s important to know your numbers. Even if you’re in your 20s or 30s, you’re not “too young” to start making heart-healthy food and lifestyle choices. Two of my friends who wrestled with heart disease experienced two different outcomes. One—a hard-driving 37-year-old tech entrepreneur, who was motivated to change his diet and a few bad habits after his heart attack—survived. The other, a talented 46-year-old photographer, who lived and ate on-the-run—working long hours and sleeping too little—unexpectedly died of a cardiac arrest during a conference he was attending.

In heart disease research, younger groups (between ages 25-55) have historically been considered “low risk”. This may be changing. In a 2015 study published last year in Circulation, researchers tracked heart disease death rates among adults aged 25 years and older. Between 1979 and 2011, heart disease deaths fell dramatically among those over age 65. However, there was considerably less improvement in heart disease death rates among those under age 55, especially for women—attributed to increasing rates of diabetes and obesity in younger adults, as well as non-traditional risk factors, such as stress and depression, common among young women with early-onset heart disease.
 

Symptoms of inflammation (and why it matters)

 
The sooner you get familiar with your numbers, the greater your success in lowering—even reversing—your risk for heart disease, as well as other chronic conditions and diseases.
The most relevant numbers are markers of inflammation.

Why? Inflammation is your body’s response to stress—whether from your diet, lifestyle or environment. Think of what happens when you sprain your ankle or burn your hand: you experience immediate pain, swelling and redness.

This kind of acute inflammation is good, but our modern, convenience-oriented lifestyle contributes to an epidemic of chronic, low-grade inflammation that most of us experience in the form of skin disorders (rashes, “adult acne”, eczema, psoriasis), joint aches and pains, chronic headaches, digestive distress, IBS, allergies, or fatigue—our body’s way of communicating with us that things are out of balance.When your body’s systems experience a constant inflammatory response, you are more susceptible to accelerated aging (internally and externally) and chronic diseases and conditions, including heart disease, stroke, cancer, diabetes, obesity and arthritis.

One of the main factors contributing to chronic low-grade inflammation are the foods that we eat. Typical culprits include sugar, junk food / processed / fast foods, gluten, grains and dairy.
 

Markers of Inflammation:  Know your numbers!

 
You will also want to get familiar with other markers of inflammation (see list below).

High Sensitivity C-Reactive Protein (hs-CRP). Your level of CRP increases in response to inflammation. Higher levels of CRP are linked with greater risk of heart attack. Ideally, your hs-CRP is <1.0 mg/L (low risk for developing cardiovascular disease). An hs-CRP level of >3.0 indicates high risk for heart disease. *Note: “Normal” values may vary slightly among different labs.

Vitamin D (25-hydroxy vitamin D). Recent studies link low levels of vitamin D to an increased risk of heart disease. Optimal vitamin D levels are between 50-70 ng/ml. In cases of cancer or heart disease, the recommended level is even higher: 70-100 ng/ml.

Hemoglobin A1c. If you have a family history of diabetes, heart disease or overweight / obesity this is an important number to know. This is a blood test that reflects your average blood sugar level for the past 2-3 months. Optimal is <5.7% (low risk of diabetes). An A1c of 6.5% or higher indicates diabetes.

Homocysteine. At high levels, homocysteine, an amino acid, can damage the lining of the arteries and promote blood clotting, raising your risk for heart disease, heart attacks, blood clots and strokes. Ideally, your homocysteine levels are below 15 mmol/L. Above 15mmol/L is considered “high”.
 

Metabolic Syndrome

 
This is a group of risk factors that raises your risk of heart disease, stroke and diabetes. Three (3) or more of these risk factors (listed below) = metabolic syndrome = increased risk of heart disease.

1. Large waist size. This indicates excess body fat around the waist.
–For men: 40 inches or larger
–For women: 35 inches or larger

2. High triglycerides.
Your triglycerides are 150 mg/dL or higher OR You are using a cholesterol medicine

3. Low HDL “good” cholesterol.
–For men: Your HDL is less than 40 mg/dL
–For women: Your HDL is less than 50 mg/dL

4. High blood pressure.
Your blood pressure is 135/85 mm Hg OR You are using high blood pressure medicine

5. High fasting blood glucose. *This is a leading indicator of inflammation.
Optimal: your fasting blood glucose is  less than 85 mg/dL.  Note: most labs define “normal” as under 100 mg/dL.

*Note: If your blood glucose level is between 100 and 125 mg/dL, you have pre-diabetes. At this point, it is still possible — and important —to make diet and lifestyle changes to prevent pre-diabetes from developing into Type 2 diabetes.
 

Get Guidance and Support

 
Need help making sense of your numbers?  Contact me to schedule a Lab Consultation.  Or, if you want to be pro-active in improving your numbers, consider my video-only service: Optimize Your Wellness.
 

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Heart Truths

We speak “from the heart”, trust “our heart” and seek a “heart connection”. The heart is an emotional and spiritual symbol of love and truth.

Physiologically, the heart is a powerful, muscular organ vital to our existence. Did you know that our heart beats:
» 72 times a minute?
» 100,000 times a day?
» 3.6 million times a year?
» …that our heart creates enough energy to drive a truck 20 miles every day?!

Our heart does so much for us; yet, sadly, heart disease is the #1 killer of Americans. It’s never too early to nourish your heart. Below…debunking 5 heart health myths.
 

Debunking 5 Heart Health Myths

Myth #1: Heart disease is a “man’s disease”.

Actually, heart disease is the leading cause of death for both men (1 in every 4 male deaths) and women (1 in 3 female deaths) in the U.S. Between 70 to 89% of sudden cardiac events occur in men. However, many women fail to realize that heart disease should be their top health concern: 90% of women have one or more risk factors for developing heart disease. For perspective: while 1 in 31 women die of breast cancer, 1 in 3 die of heart disease.

Myth #2: Your total cholesterol and LDL are the best predictors of heart disease.

Nope. It’s your triglycerides, the main form of fat found in your bloodstream. High trigylcerides are an independent risk factor for heart attack and stroke. The “normal” range for triglycerides is <130.

Also: divide your triglycerides by your HDL to get the Triglycerides/HDL ratio. According to research published in Circulation and the Journal of the American Heart Association, this ratio is a powerful predictor of heart disease. Less than 2 is ideal; 4 or more is too high.

Myth #3: “Vegetable” oils, like canola, corn and safflower are “heart healthy”; traditional saturated fats, like butter, lard and tallow, are “bad for you”.

I know…“vegetable oil” sounds healthy, doesn’t it? However, the oils mentioned above, along with soy, cottonseed and sunflower, are high in omega-6 polyunsaturated fatty acids (a.k.a., PUFA), making them unstable. When PUFA oils are stored at room temperature—eg, at the grocery store—they become rancid to some degree. When heated, PUFA oils oxidize, causing inflammation in the body. Chronic inflammation can lead to heart disease. PUFA oils are also processed with high heat and harsh chemicals, like hexane, a carcinogen.

On the other hand, traditional saturated fats from quality (ideally, grass-fed) sources, like butter, lard and tallow, are solid at room temperature and stable when used for high-heat cooking. They do not oxidize like vegetable oils.

Myth #4: Eating fat, especially saturated fat, makes you fat—and contributes to heart disease.

Are we still having this conversation?! Dr. Rajiv Chowdhury, a cardiovascular epidemiologist at Cambridge University, made media waves last March when his study on saturated fatty acids published in the Annals of Internal Medicine. His conclusion? The evidence does not support current guidelines, which restrict the consumption of saturated fats to prevent heart disease. This wasn’t new news either: a 2010 study had similar findings.

According to Nina Teicholz, who spent a decade researching the effects of dietary fats on health, especially saturated fat, for her book The Big Fat Surprise: “There has never been solid evidence for the idea that saturated fats cause disease.” This half-century bias against saturated fat, she says, was perpetuated by “a mixture of personal ambition, bad science, politics and bias.”

In fact, for women, who contract heart disease in a way that is different than men, growing evidence shows that eating a diet low in saturated fat increases their risk of having a heart attack because their “good” HDL cholesterol drops dramatically, says Teicholz. CLICK HERE to learn about the health benefits of saturated fat.

Sugar is the real culprit, contributing to inflammation and oxidative damage, increasing risk of heart disease.

Myth #5: Frequent, high-mileage cardio is good for heart health.

As someone who has been running since the age of 13, I’ve been guilty of what former competitive distance runner and fitness author Mark Sisson calls “chronic cardio”. Until a few years ago, I regularly logged 30-40 miles a week—and I wasn’t even training for a race!

While regular aerobic exercise is a good thing, excessive cardio is NOT. Endurance athletes (like marathoners) are at greater risk for atrial fibrillations (heart arrhythmia, or, irregular heartbeat) than non-runners. Why? Because they are at increased risk for scar tissue formation in the heart and myocardial injury to the heart, as well as high levels of inflammation (brought on by training) that may trigger cardiac events. In a study of competitive endurance veteran athletes (a group of men, aged 50+, all of whom had completed at least 100 marathons), researchers found that half of these longtime athletes—particularly the men who had trained the longest and hardest—showed some heart muscle scarring.

If you’re focused and giving it your all (not socializing in between!), a 45-minute workout should suffice. Better yet, consider High Intensity Interval Training (HIIT), short bursts of high-intensity exercise that give you more benefits in less time (eg, 20 minutes).