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Preventing Heart Disease

The Top Three Determinants and the Top Seven Methods of Measuring Heart Health

The first of the top three determinants for heart health is chronic stress: We all have it what with the economy the way it is, the heinous and scarily random violence reported on the news every night, the suicide bombers and the continuing conflicts in the Middle East, peculiar yet frightening occurrences like the odd death of Natasha Richardson, mothers murdering their children, shooting rampages, the mutating bird flu in San Diego. Stress is real, it's here so what can we do to mitigate its effects on us, other than turn off our TV and have an absolute news embargo?

Here is one very important thing we can do: Sit quietly all by yourself doing nothing for 20 minutes every day. Some people call this "meditation" but this word sometimes gets people all crazy because they consider this pressure and therefore more stress, and they end up not sitting quietly. If you just call it sitting quietly, then it doesn't have that demanding onus to it. You don't have to become a Buddhist to reduce your stress and sitting quietly for 20 minutes every day is not a religion. It's simple: It's just sitting quietly somewhere peaceful all by your self.

Furthermore, watch your breathing during the day. If you are like me, you tend to hold your breath while you are concentrating, are upset or talking to someone. Pay attention and several times a day key into your breath. Or, just call 303-440-6526 and listen to my voice message!

The second determinant of heart health is exercise: I know, I am a boring and broken ever-repeating record about this. But really, you MUST. I am not saying that you should be an uber-athlete. In fact, too much exercise is quite unhealthy on many levels. There was a study done in 1989 looking at 13,000 people over a period of 8 years and found that "the greatest benefit from exercising occurred in people who went from being mostly sedentary to engaging in moderate exercise for 20 to 30- minutes a day." (www.drbenkim.com) Get some comfortable shoes and just walk. Go out your front door and walk one way for 15 minutes, then walk back home for the other 15, or hike in a beautiful place. Get a dog that you have to walk. Make this work for you and be committed about it.

The third determinant has to do with the choices you make in food. My current and very easy recommendation is to follow the Mediterranean way of eating with lots of good EVOO, nuts, lean meats and many veggies and fruits. Click here Eat like the Greeks. This will give you more information. You might want to read the Hot News called Intuitive Eating as well.

Other tidbits: I am not barbecuing, broiling or frying or otherwise charring meats anymore due to the unhealthy cancer-causing agents caused by burning meat. (Yes, my Neanderthal genes miss the large hunks of charred, wonderful smelling animal body parts at times!) It's best to slow cook or bake any meat or fish. Eggs are best eaten poached or soft-boiled. Steaming is the way to go with vegetables. Raw (not meat) is wonderful esp. in the warmer months and I find myself craving more and more raw foods concurrent with the rise in produce at the Farmer's Market as the summer deepens. Organic food is preferred, although there are some foods which are acceptable non-organic. (Ask me for a chart.) Sugar is verboten. Honor your food allergies.

What about genes? My Mom died of heart disease at age 77 and my father of a stroke at age 74, so I know where my preventive work is cut out for me. However, I did read somewhere that only 4% of our longevity is related to our parents' ages at death. This means that genes and parental causes of death may have a predictive or predisposing factor towards certain disease processes, but optimistically this also means that lifestyle choices have a huge significance. It's nice to know that there is a lot that we can do about our health and longevity rather than being victimized by parental histories.

How can we determine the state of our cardiovascular health? Well, there are seven measures:

Waistline: There's been an awful lot of commotion about this lately. Pear shapes are better than apples, women should not have a waistline of over 35 inches, men over 40 inches and so forth. So, for this measure, just use your eyes and look in the mirror - how's your belly doing? Determine how comfortable the waistline on your pants feels and do your best to keep the excess fat off your middle and keep yourself trim-ish. Sometimes hormonal changes in women at menopause change the distribution of fat in the body and some of us have to be a bit more careful about the addition of a belly and a thicker waistline in older age. (That's why I used the "ish" after the "trim!") Ladies, do the best you can within your normal redistribution in the "middle age hormonal spread" issue.

Blood pressure. I think BP is very important and I have no problem with my patients taking BP medication if that is the only way to keep their blood pressure in the normal and healthy range. Get yourself a BP wrist cuff at Costco and try for a consistent 120 systolic over 75 diastolic.

Blood Sugar: Keep your glucose levels under 100 and you won't have a problem with thick blood, dangerous spikes in blood sugar, a decrease of oxygen and nutrients to your cells which is turn can cause nerve damage, congestive heart failure, stroke and of course, Type II diabetes. Just keep your sugar consumption (this means alcohol, too) at zero and your bad carbs low and you should be able to keep your blood sugar in the normal range.

Cholesterol: I mention this only because I would be declared heretical if I didn't. I have very definite opinions about cholesterol levels and statin drugs and have written extensively about it. (Read Skullduggery in the Heart Health Business (11/08) under Hot News. I think that elevated (Elevated by whose measure, by the way? The drug companies?) cholesterol is just one of many indices that go into heart health and, in my book, statins are never an option. They are very destructive to some people and yes, they lower cholesterol quite well, but no one really knows what this means. In fact, too low cholesterol (under 150) can leave you vulnerable to immune and hormonal dysfunction and can create strokes and cancer. I don't even have my cholesterol measured anymore. Go ahead and get yours measured, but my advice is to not take a statin drug under any circumstance no matter what your well-meaning and persuasive MD says.

Homocysteine: I have this blood test measured routinely and like it in the vicinity of 6-8. Imagine toodling along in your car with your muffler turned into the interior of your car so that you are constantly breathing all the exhaust fumes. Homocysteine is the toxic byproduct of protein metabolism (like exhaust is the byproduct of petroleum combustion) and if you can't get rid of it, it becomes like car exhaust in your body and is a pretty big risk factor for heart disease. It's easy to normalize with adequate folate and B12.

C-reactive Protein or hs-CRP: This is a biggie and measures the inflammation in your entire body, including your heart. I get this measured routinely as well. The more inflammation you have in your body, the more vascular strain and injury you have, the more the body slaps cholesterol band aids on the wounds in the vascular system, the more you are at risk for atherosclerosis and plaque build-up. A value of less than 1 is best, but a 2 is acceptable. If you eat an 80% plant based diet, I doubt if you will have much trouble with hs-CRP. "Eat food. Not too much. Mostly plants." This statement from Michael Pollan from his book, In Defense of Food is the way to lower CRP levels. Then add some important natural anti-inflammatories like the omega oils and quercitin.

Vitamin D levels: These levels have to do with cancer protection and overall health, including that of your arteries. The reported lab levels for normal are much too low. Shoot for something in the range of more than 50 but less than 80.

You may have to ask for the last three tests as they are not done routinely.

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