How do decrease your risks of heart disease and cardiovascular related events

February was heart month. This is the time to pay attention to our heart health. Our body is integrated and that we are not parts but a whole. Our heart health suffers if we have poor metabolic health.
There is a heavy emphasis on LDL, low density lipid proteins, part of your cholesterol. Think of them as cars transporting cholesterol around. Is high LDL indicative of future risk of heart disease? Is high or low LDL beneficial? Conventional medicine says any LDL >100 needs to be treated with a drug. It used to mean we gave patients time to make lifestyle changes and then recheck the level and see if medication at that point was warranted but drugs, statins, drugs that lower cholesterol tend to be first line therapy not lifestyle changes. There is evidence that low, less than 100 LDL is a predictor for poor long term health, dementia, poor recovery in case of accident or catastrophic disease such as sepsis or anything else require intensive care. Statins are not risk free medications. They frequently cause muscle pain (they deplete our needed COQ10), can increase our risk for diabetes, dementia, peripheral neuropathy and depression. We do need cholesterol to function, to have good immune response and for hormone and brain health. But is this the best predictor of cardiac events, strokes or heart disease?
Research suggests otherwise, [1]current numbers are pointing to metabolic health and indicators are more predictive than LDL. This includes blood sugar, insulin levels, high blood pressure, triglycerides, smoking, abdominal fat/large waist line > 35 inches in women and >40 inches in men are better predictors. The best part is these are all fixable without medications. A new article in JAMA, Journal of American  Medical Association, https://jamanetwork.com/journals/jamacardiology/article-abstract/2775559, shows that metabolic indicators are better predictors than LDL. The study titled, Association of Lipid, Inflammatory and Metabolic Biomarkers With Age at Onset for Incident Coronary Heart Disease in Women points to the following metabolic markers:
1.High blood glucose/sugar, as more sugar is flooded into the body, more insulin is required to get sugar into cells. If your cells are stuffed with glucose due to high carb, high sugar and high processed/junk food diet, the extra glucose is packed on the body as fat especially in the abdomen. Insulin is a fat storage hormone. This leads to number 2.
2.   Increasing insulin levels which lead to increasing blood fats, see number 3.
3.  High triglycerides, these show insulin resistance. This means your cells are requiring more and more insulin to get blood sugar/glucose into cells. leads to number 4. High triglycerides occur with high carb/refined sugar intake, intake of high fructose corn syrup and alcohol use.
4.Increase waist circumference, as our waist expands the insulin resistance increases and the excess fat makes inflammatory cytokines and the inflammation causes other issues in the body but is a prerequisite for other diseases like strokes, heart attacks, dementia, cancer and diabetes.
5.  High blood pressure is usually a consequence of high blood sugar and insulin levels. The vessels become more stiff, increasing the pressure.
6. Smoking will increase blood pressure as it damages your vessels in addition to a long list of problems that occur with smoking.


There is good news is by adopting a therapeutic carbohydrate restriction diet, you can get this metabolic dysfunction to stop and have a healthy metabolic response. Tests/interventions that help with this are fasting blood sugar, fasting insulin, triglyceride levels, A1C ( measures 3 months' worth of blood sugar), measuring your waistline, baseline blood pressures taken over 7-10 days, not just one reading. Many primary care providers will only check your fasting blood glucose and A1C but these two tests can be within normal range for decades, but getting the insulin level lets you find insulin resistance early. Many times people are having post meal high blood sugars that are taking a prolonged time to get back down to normal and that is not captured with our current testing algorithm of fasting glucose and AC, but you may have symptoms of these and if you meet the criteria of metabolic syndrome see below then you have work to do to get metabolically healthy.


Metabolic Syndrome criteria:
Three out of 5
Treatment for any conditions below
Blood Pressure >=130/85
Fasting Blood Sugar >=100
HDL <40 Men or <50 Women
Waist circumference >40"M, >35"W
Triglycerides >150


[1] https://jamanetwork.com/journals/jamacardiology/article-abstract/2775559
Disclaimer: the information provided on the site is for educational purposes only and does not substitute for professional medical advice