Posts Tagged ‘atherosclerosis’

Sex and the Mediterranean Diet

February 1, 2014

Blog # 139

Sexuality is a very important part of our human existence, both for purposes of procreation as well as pleasure.  Although not a necessity for a healthy life, the loss or diminution of sexual function may result in loss of self-esteem, embarrassment, a sense of isolation and frustration, and even depression. Therefore, for many of us it is vital that we maintain our sexual health. Loss of sexual function further exacerbates progression of sexual dysfunction—the deficiency of genital blood flow that often causes sexual dysfunction produces a state of poor oxygen levels (hypoxia) in the genital tissues, which induces scarring (fibrosis) that further compounds the problem.  So “use it or lose it” is a very relevant statement when it comes to sexual function, as much as it relates to muscle function.

Healthy sexual function for a man involves a satisfactory libido (sex drive), the ability to obtain and maintain a rigid erection, and the ability to ejaculate and experience a climax. For a woman, sexual function involves a healthy libido and the ability to become aroused, lubricate adequately, to have sexual intercourse without pain or discomfort, and the ability to achieve an orgasm.   Sexual function is a very complex event contingent upon the intact functioning of a number of systems including the endocrine system (produces sex hormones), the central and peripheral nervous systems (provides the nerve control) and the vascular system (conducts the blood flow).

A healthy sexual response is largely about adequate blood flow to the genital and pelvic area, although hormonal, neurological, and psychological factors are also important.  The increase in the blood flow to the genitals from sexual stimulation is what is responsible for the erect penis in the male and the well-lubricated vagina and engorged clitoris in the female. Diminished blood flow—often on the basis of an accumulation of fatty deposits creating narrowing within the walls of blood vessels—is a finding associated with the aging. This diminution in blood flow to our organs will negatively affect the function of all of our systems, since every cell in our body is dependent upon the vascular system for delivery of oxygen and nutrients and removal of metabolic waste products.  Sexual dysfunction is often on the basis of decreased blood flow to the genitals from pelvic atherosclerosis, the accumulation of fatty deposits within the walls of the blood vessels that bring blood to the penis and vagina.

Sexual dysfunction may be a sign of cardiovascular disease. In other words, the quality of erections in a man and the quality of sexual response in a female can serve as a barometer of cardiovascular health. The presence of sexual dysfunction can be considered the equivalent of a genital stress test and may be indicative of a cardiovascular problem that warrants an evaluation for arterial disease elsewhere in the body (heart, brain, aorta, peripheral blood vessels).  The presence of sexual dysfunction is as much of a predictor of cardiovascular disease as is a strong family history of cardiac disease, tobacco smoking, or elevated cholesterol. The British cardiologist Graham Jackson has expanded the initials E.D. (Erectile Dysfunction) to mean Endothelial Dysfunction (endothelial cells being the type of cells that line the insides of arteries), Early Detection (of cardiovascular disease), and Early Death (if missed). The bottom line is that heart healthy is sexual healthy.

Many adults are beset with Civilization Syndrome, a cluster of health issues that have arisen as a direct result of our sedentary lifestyle and poor dietary choices.  Civilization Syndrome can lead to obesity, high blood pressure, and elevated cholesterol and can result in such health problems as diabetes, heart attack, stroke, cancer, and premature death.  The diabetic situation in our nation has become outrageous—20 million people have diabetes and more than 50 million are pre-diabetic, many of whom are unaware of their pre-diabetic state! It probably comes as no surprise that diabetes is one of the leading causes of sexual dysfunction in the United States.

Civilization Syndrome can cause a variety of health issues that result in sexual dysfunction.  Obesity (external fat) is associated with internal obesity and fatty matter clogging up the arteries of the body including the arteries which function to bring blood to the genitalia.  Additionally, obesity can have a negative effect on our sex hormone balance (the balance of testosterone and estrogens), further contributing to sexual dysfunction. High blood pressure will cause the heart to have to work harder to get the blood flowing through the increased resistance of the arteries. Blood pressure lowering medications will treat this, but as a result of the decreased pressure, there will be less forceful blood flow through the arteries.  Thus, blood pressure medications, although very helpful to prevent the negative effects of hypertension—heart attacks, strokes, etc.—will contribute to sexual dysfunction.  High cholesterol will cause fatty plaque buildup in our arteries, compromising blood flow and contributing to sexual dysfunction.  Tobacco constricts blood vessels and impairs blood flow through our arteries, including those to our genitals. Smoking is really not very sexy at all!  Stress causes a surge of adrenaline release from the adrenal glands. The effect of adrenaline is to constrict blood vessels and decrease sexual function.  In fact, men with priapism (a prolonged and painful erection) are often treated with penile injections of an adrenaline-like chemical.

A healthy lifestyle is of paramount importance towards the endpoint of achieving a health quality and quantity of life.  Intelligent lifestyle choices, including proper eating habits, maintaining a healthy weight, engaging in exercise, adequate sleep, alcohol in moderation, avoiding tobacco and stress reduction are the initial approach to treating many of the diseases that are brought on by poor lifestyle choices.  Sexual dysfunction is often in the category of a medical problem that is engendered by imprudent lifestyle choices.  It should come as no surprise that the initial approach to managing sexual issues is to improve lifestyle choices.  Simply by pursuing a healthy lifestyle, Civilization Syndrome can be prevented or ameliorated, and the myriad of medical problems that can ensue from Civilization Syndrome, including sexual dysfunction, can be mitigated.

In terms of maintaining good cardiovascular health (of which healthy sexual function can serve as a proxy), eating properly is incredibly important—obviously in conjunction with other smart lifestyle choices. Fueling up with the best and most wholesome choices available will help prevent the build up of fatty plaques within blood vessels that can lead to compromised blood flow. Poor nutritional decisions with a diet replete with fatty, nutritionally-empty choices such as fast food, puts one on the fast tract to clogged arteries that can make your sexual function as small as your belly is big!.

A classic healthy food lifestyle choice is the increasingly popular Mediterranean diet.  This diet, the traditional cooking style of the countries bordering the Mediterranean Sea including Spain, France, Greece, Cyprus, Turkey, Southern Italy, and nearby regions, has been popular for hundreds of years. The Mediterranean cuisine is very appealing to the senses and includes products that are largely plant-based, such as anti-oxidant rich fruits and vegetables, whole grains, nuts, seeds and legumes.  Legumes—including peas, beans, and lentils—are a wonderful source of non-animal protein.  Soybeans are high in protein, and contain a healthy type of fat.  Soy is available in many forms— edamame (fresh in the pod), soy nuts (roasted), tofu (bean curd), and soymilk. Fish and poultry are also mainstays of the Mediterranean diet, with limited use of red meats and dairy products.  The benefits of fish in the diet can be fully exploited by eating a good variety of fish.  Olive oil is by far the principal fat in this diet, replacing butter and margarine. The Mediterranean diet avoids processed foods, instead focuses on wholesome products, often produced locally, that are low in saturated fats and high in healthy unsaturated fats. The Mediterranean diet is high in the good fats (monounsaturated and polyunsaturated) which are present in such foods as olive, canola and safflower oils, avocados, nuts, fish, and legumes, and low in the bad fats (saturated fats and trans fats).  The Mediterranean style of eating provides an excellent source of fiber and anti-oxidants.  A moderate consumption of wine is permitted with meals.

Clearly, a healthy diet is an important component of a healthy lifestyle, the maintenance of which can help prevent the onset of many disease processes.  There are many healthy dietary choices, of which the Mediterranean diet is one.  A recent study reported in the International Journal of Impotence Research (Esposito, Ciobola, Giugliano et al) concluded that the Mediterranean diet improved sexual function in those with the Metabolic Syndrome, a cluster of findings including high blood pressure, elevated insulin levels, excessive body fat around the waist and abnormal cholesterol and triglyceride levels.  35 patients with sexual dysfunction were put on a Mediterranean diet and after two years blood test markers of endothelial function and inflammation significantly improved in the intervention group versus the control group. The intervention group had a significant decrease in glucose, insulin, low-density lipoprotein cholesterol (LDL—the “bad” cholesterol), triglycerides, and blood pressure, with a significant increase in high-density lipoprotein cholesterol (HDL—the “good” cholesterol).  14 men in the intervention group had glucose intolerance and 6 had diabetes at baseline, but by two years, the numbers were reduced to 8 and 3, respectively.

Why is the Mediterranean diet so good for our hearts and sexual health?  The Mediterranean diet is high in anti-oxidants—vitamins, minerals and enzymes that act as “scavengers” that can mitigate damage caused by reactive oxygen species.  Reactive oxygen species (also known as free radicals) are the by-products of our metabolism and also occur from oxidative damage from environmental toxins to which we are all exposed.  The oxidative stress theory hypothesizes that, over the course of many years, progressive oxidative damage occurs by the accumulation of the chemicals the accumulation of reactive oxygen species engender diseases, aging and, ultimately, death.  The most common anti-oxidants are Vitamins A, B-6, B-12, C, E, folic acid, lycopene and selenium.  Many plants contain anti-oxidants—they are concentrated in beans, fruits, vegetables, grain products and green tea.  Brightly colored fruits and vegetables are good clues as to the presence of high levels of anti-oxidants—berries, cantaloupe, cherries, grapes, mango, papaya, apricots, plums, pomegranates, tomatoes, pink grapefruit, watermelon, carrots, broccoli, spinach, kale, squash, etc.—are all loaded with anti-oxidants as well as fiber. A Mediterranean diet is also high in omega-3 fatty acids, a type of polyunsaturated fat present in oily fish including salmon, herring, and sardines.  Nuts—particularly walnuts—have high omega-3 fatty acid content.  Research has demonstrated that these “good” fats have numerous salutary effects, including decreasing triglyceride levels, slightly lowering blood pressure, and decreasing the growth rate of fatty plaque deposits in the walls of our arteries (atherosclerosis), thus reducing the risk of cardiovascular disease, stroke, and other medical problems. Mediterranean cooking almost exclusively uses olive oil, a rich source of monounsaturated fat, which can lower total cholesterol and LDL cholesterol while increasing HDL cholesterol. It is also a source of antioxidants including vitamin E.  People from the Mediterranean region generally drink a glass or two of red wine daily with meals. Red wine is a rich source of flavonoid phenols—a type of anti-oxidant—which protects against heart disease by increasing HDL cholesterol and preventing blood clotting, similar to the cardio-protective effect of aspirin.

The incorporation of a healthy and nutritious diet, such as the Mediterranean diet, is a cornerstone for maintaining good health in general, and vascular health, including sexual health, in particular.  The Mediterranean diet—my primary diet and one that I have incorporated quite naturally since it consists of the kinds of foods that I enjoy—is colorful, appealing to the senses, fresh, wholesome, and one that I endorse with great passion. Maintaining a Mediterranean dietary pattern has been correlated with less cardiovascular disease, cancer, and sexual dysfunction.  And it is very easy to follow.  It contains “good stuff”, tasty, filling, and healthy, with a great variety of food and preparation choices—plenty of colorful fresh fruit and vegetables, a variety of fish prepared in a healthy style, not fried or laden with heavy sauces, healthy fats including nuts and olive oil, limited intake of red meat, a delicious glass of red wine.  It’s really very simple and satisfying.  Of course the diet needs to be a part of a healthy lifestyle including exercise and avoidance of harmful and malignant habits including smoking, excessive alcohol, and stress.  So if you want a sexier style of eating, I strongly recommend that you incorporate the Mediterranean diet into your lifestyle.  Intelligent nutritional choices are a key component of physical fitness and physical fitness leads to sexual fitness.

Andrew Siegel, M.D.

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Author of: Male Pelvic Fitness: Optimizing Sexual and Urinary Health; in press and available in e-book and paperback formats in March 2014. www.MalePelvicFitness.com

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Heart Attacks Among My Fit Friends

July 7, 2012

Andrew Siegel, M.D.    Blog # 65

 

My good buddy V. had a heart attack a few weeks ago. He is a urologist in his mid 50’s, a non-smoker of medium build, and an avid recreational cyclist who puts in several hundred miles every week. If it wasn’t for his company and support, I would never have completed the 3 hour challenging bike ascent up Mt. Mitchell (elevation 6683 feet) in Asheville, North Carolina a few years ago.

After some intense cycling, he was taking a breather to wait for one of his cycling partners to catch up with the rest of the group when he developed extreme left shoulder pain and unrelenting sweating.  The unremitting pain was of intensity unlike any that he ever experienced, and in the ambulance in route to the hospital he gazed at his own EKG seeing the classic findings of a myocardial infarct.  He was given morphine for pain, nitroglycerin, aspirin and oxygen and after arriving in the ER was rapidly whisked to the cardiac catheterization lab.  He was found to have a complete occlusion of the right coronary artery and it wasn’t until a wire was passed through the occlusion that he felt dramatic pain relief.  After a stent was placed in the occluded artery, he was sent to the coronary care unit for monitoring.  He was discharged the following day on numerous medications and prescribed rest, time off work, and a specialized diet; he was also admonished to stop exercising until he finishes a program of cardiac rehabilitation.

When I spoke to him, he was extremely depressed about the situation, never having previously had any symptom of heart disease.  He had survived a life-threatening event, going from no medications to seven and having to severely restrict the physical activities that brought him so much pleasure.  To repeat, he was not overweight, not a tobacco user, and did not have high blood pressure, although his cholesterol ran on the high side of normal.  He did not have any family history of heart disease.  He had been a strong recreational cyclist for many years. He never paid attention to his diet because of his fast metabolism and vigorous exercise regimen, which always left him at a healthy weight.  V. is Italian and loves pasta, cheese and meat dishes and has always eaten anything and everything that he wanted.

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Now for the story of A., my good friend from surgical internship:  He became a heart surgeon and practiced in the Midwest for many years, but has recently relocated to the Southeast, where he is the Chief Medical Officer of a hospital.  Like V., A. was always in tip-top shape, a non-smoker and a running enthusiast.  As interns and surgical residents, we spent countless hours running the hills of the north shore of Long Island and each ended up having sibling chocolate Labrador Retrievers as pets.

A few years ago, several hours after a vigorous workout in his home gym, he was relaxing in the living room with his wife. As he stood up, he crumpled to the floor, obviously having passed out.  His wife found him to be pulseless and not breathing. Fortunately she was a RN and managed to maintain her composure and promptly initiated CPR after calling 911.  She continued the cardio-pulmonary resuscitation until the emergency team arrived.  When hooked up to a cardiac monitor he was found to be in a very abnormal rhythm called ventricular fibrillation.   After he was shocked, his heart resumed normal rhythm and he started breathing spontaneously.  Angiography in the hospital demonstrated severe coronary artery disease, and he underwent angioplasties and several stent placements.

A. was of average weight, a non-smoker, and a compulsive exerciser; however,  he had a strong family history of cardiac disease and never paid much attention to his diet. I recall his fondness for ice cream and his not uncommon consumption of a pint of Hagen-Daz at one sitting.

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The point that I wish to make is that maintaining a good weight, avoiding tobacco and pursuing regular exercise is not always enough for vitality and a healthy heart.  Particularly when there is a family history of heart disease, but also as a general health axiom, all efforts must be put in place to stem cardiovascular disease, the number one cause of death in the United States.  In addition to maintaining a good weight, avoiding tobacco and exercising, healthy eating is an indispensable and essential part of the effort—a sine qua non.

The quality and quantity of what we eat play an essential role in determining our health destiny.  The following is an excerpt from The Huffington Post written by Dr. David Katz entitled “Un-junking Ourselves.”  Although the subject of Dr. Katz’s discussion is a child, it is relevant to adults as well.

Think about a child — or former child — you love. This should be pretty easy for any parent, grandparent, aunt, uncle, or just about anybody else who has known a kid or ever been one.

Now, think about that child’s growth from year to year and ask yourself: What were they growing out of? What was the construction material? Matter can’t be constructed out of nothing — it comes from somewhere. If a child’s head is four inches higher off the floor this year than last year, then that four-inch platform of extra kid was built out of… something. What?  Food and nothing else. Food is the construction material — the only construction material — for the growing bodies of children we love.

We are, no doubt, all familiar with the expression “you are what you eat,” but given how most of us eat, it’s quite clear we don’t take it very seriously. And for some pretty good reasons. The human machine, and human fuel tank, are stunningly forgiving. We can throw almost anything in the tank, and run reasonably well for decades. We can’t build a machine fractionally so accommodating.

And, of course, we don’t look like what we eat. We eat donuts, and don’t sport big holes through our middles. We eat French fries, and don’t sprout French fry antennae. But you can’t judge what we are made of by what we look like, any more than you can judge a book by its cover — or a house by its paint. Our houses are, often, made mostly of wood — but look nothing like trees. Trees are cut down and, if you will, “digested” in a timber mill to produce wood that is turned into lumber. The lumber is then used to build houses that look nothing like the trees. But if that lumber is rotten, the house in question may look all right at first — but it will fare quite badly when the first big storm comes along. The quality of a house is rooted in the quality of its construction materials.

Ditto for us. The growing body of a child is built out of food. Nutrients are extracted from food, just as wood is extracted from trees. Rotten wood makes rotten houses. Rotten food makes… sick kids. The kids may look, and even feel, fine for a while. But every cell their bodies build depends on the quality of the available construction material it is offered. Every muscle fiber, every enzyme, every brain cell, every heart cell, every hormone. Maybe not right away — but eventually, rotten construction material catches up with us all.

No one I know throws any old junk into the tank of a car they hope will run well for the foreseeable future. No one I know willingly builds a home out of junk, or of rotten wood. But food is the one and only building material for the growing body of a child you love. How’s “junk” sounding now? And, by the way, every one of us adults is turning over literally hundreds of millions of cells daily. These need to be replaced, along with spent enzymes, hormones, neurotransmitters and the like. Where do WE get the construction material for this job? Think about it.  Right you are.

Bottom Line:  In the quest for fitness, vitality and health, it is necessary to maintain a healthy weight, exercise regularly and avoid tobacco. These efforts are important, but not sufficient to avoid cardiovascular disease; an essential additional factor is what we eat.  The quality of the foods that we ingest for fuel, metabolism and tissue rejuvenation are of great importance in terms of vitality and avoiding fatty plaque deposition in our arteries and cardiovascular disease.  It comes down to a largely plant-based diet with an abundance of different fruits and vegetables, whole grains, legumes, and lean protein sources.  Meat and dairy, unrefined carbohydrates, sugars, processed, junk and fast foods need to be consumed in moderation.  We literally are what we eat and the plaque lining our arteries is a reflection of our cumulative diet over our lifetime.  While genetics and luck are beyond our control, our lifestyle—including what or what not we decide to use as human building blocks—is well within our domain.  Today in my office, I skipped the Carvel ice cream cake and grabbed a Granny Smith apple instead…just not worth it!

My two friends are literally lucky to be alive as many are not so fortunate and succumb to cardiovascular disease.  A., being a cardiac surgeon and having put his event well behind him, has adapted well to his situation.  V. is currently somewhat depressed and is suffering from a form of post-traumatic stress disorder that not uncommonly follows the occurrence of a heart attack.  It behooves all of us to try to avoid potential life-threatening cardiac issues by maintaining a good BMI, eating healthy, exercising and avoiding tobacco.  We need to be especially vigilant when there is a strong family history and/or elevated cholesterol and under these circumstances, proactive cardiology care is certainly warranted.  Family history or not, it makes the utmost sense to keep in mind that “we are what we eat.”

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food

www.PromiscuousEating.com

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Gluttony, Sloth, & Cardiac Care or Healthy Lifestyle & Wellness

February 4, 2012

Blog # 44   Andrew Siegel, M.D.

 

February is American Heart Month, so I put my heart into this narrative about this amazingly engineered, all-important organ that serves us tirelessly and relentlessly. Like our pet canines, this organ requires to be  well fed, to be exercised, and to be given tender loving care.  Be kind to it and it will return the favor big time.

Two hundred years ago, the following words on angina pectoris (chest pain from coronary artery occlusion) from John Warren, M.D. were published in the very first issue of the New England Journal of Medicine and Surgery:

The disease itself is excited more especially upon walking up hill,

and after a meal; that thus excited, it is accompanied with a sensation,

which threatens instant death if the motion is persisted in;

and that on stopping, the distress immediately abates, or altogether subsides.

 

Two centuries later, we are infinitely wiser regarding the diagnosis and management of heart disease, yet unfortunately this illness is more prevalent than ever.  The saddest aspect of this is that coronary artery disease is largely a preventable and avoidable problem.  Every day, many hearts are broken because of the premature and unnecessary demise of loved ones who succumb to cardiac disease. It is my heart’s desire that we become better caretakers of ourselves and avoid the 600,000 deaths to heart disease and 130,000 deaths to strokes that occur every year in the USA.

Cardiovascular disease (CVD), including heart disease and stroke, is the number one cause of death in the USA and other industrial countries.  The only year since 1900 in which CVD was not the leading cause of death was in 1918, the year of the influenza pandemic.  CVD is also the leading cause of death in every region of the world except for sub-Saharan Africa.  The burden of CVD is increasing because of our longer life spans, continued tobacco use, physical inactivity, unhealthy food consumption, obesity, high blood pressure, elevated LDL cholesterol and prevalence of type 2-diabetes.

The following paragraph is a brief historical perspective of some of the important medical advances with respect to the management of heart disease.  The 50-year cardiovascular Framingham study (1948-1998) linked high blood pressure and high cholesterol with angina and heart attacks and originated the novel concept that coronary artery disease and its complications could be prevented.  The advent of the coronary care unit (CCU) vastly decreased the death rate of patients admitted with acute heart attacks by provided sophisticated monitoring with electrocardiograms, closed chest cardiac massage, and external defibrillation (using electric paddles to shock the heart back into a normal rhythm).   Cardiac catheterization and coronary arteriography lead to the birth of cardiac surgery and coronary revascularization (coronary artery bypass).  The field of interventional cardiology enabled balloon angioplasty revascularization of occluded coronary arteries without the need for cracking one’s chest open, using access through a thigh artery.  Cardiac stents, initially metal and currently drug eluting, were developed to prevent coronary re-occlusion.  Statin medications to lower LDL-cholesterol levels and many new and potent cardiac drugs have provided significant advances.  Implantable pacemakers and implantable pacemaker-ventricular defibrillators have further improved the prognosis of those suffering with cardiovascular disease. Sophisticated tests including echocardiograms, treadmill tests, isotope stress tests, Holter monitoring, and computerized tomography of the heart are readily available to help pinpoint the precise cardiac diagnosis.

Despite all of the aforementioned incredible technological advances, coronary artery disease remains highly prevalent and is a major widow-maker and widower-maker.  Why?  It’s really very simple—those all-important, tiny blood vessels that provide the lifeline of blood flow of oxygen and nutrients to that vital organ that pumps our blood 24/7/365 get blocked with fatty plaques.  With clogged coronary arteries, when increased demand is placed on our life-sustaining pump, not enough oxygen can get delivered through the compromised coronary arteries and we develop angina and possibly sustain damage to the heart muscle (a myocardial infarction or heart attack) or its electrical conduction system (an arrhythmia).  Tragically, this compromise to our heart and blood vessels is too often self-induced through bad eating habits, physical inactivity, and the use of tobacco.

To quote the insightful and poetic Dr. David Katz who says it all:

“We are all offspring of predecessors who lived in a world where calories were relatively scarce and hard to get, and physical activity constant, arduous and unavoidable. We now live in a world where physical activity is scarce and hard  to get, and calories constant, effortless and unavoidable.

Atherosclerosis is the process that gives rise to the fatty plaques in our arterial walls that compromise blood flow to our organs.  Atherosclerosisis a chronic arterial inflammation that develops slowly, gradually and progressively over many years.  It happens in response to the biological effects of risk factors.  It begins with changes in the endothelial cells, the unique cells that line arteries.  When subjected to these risk factors, endothelial cells change their permeability and allow white blood cells and LDL cholesterol entrance into the cells.  The risk factors include the following:

  • high blood pressure within the arteries
  • oxidative stress from free radicals (highly reactive molecules known as free radicals are created as a consequence of how our body reacts with oxygen; these interact with other molecules within cells and cause oxidative damage)
  • biochemical stimuli (chemicals from tobacco, high levels of bad fats like LDL cholesterol in the blood, food toxins)
  • inflammatory factors

The presence of white blood cells and LDL cholesterol within the endothelial cells gives rise to a cascade of chemical reactions that causes proliferation of both endothelial and smooth muscle cells and the formation of plaques.  Plaques lead to symptoms by restricting flow through the arteries involved, or alternatively, by provoking clotting that interrupts blood flow.  If the plaque ruptures, more clotting will occur at the site of the disruption, perpetuating the restricted flow, and additionally, the ruptured plaque can travel and jam other blood vessels.  LDL cholesterol is clearly a major culprit and atherosclerosis occurs in direct proportion to LDL levels.

Occlusion of the coronary arteries is a big deal because damage of the blood flow to the heart—the most important organ in our body—is a major concern.  However, it is important to know that the process of atherosclerosis is by no means unique to the heart—it is just that the effects of atherosclerosis on the heart—including angina, heart attacks, arrhythmias and death—are ever so dramatic.  It is critical to realize that if you have atherosclerosis in your coronary arteries, you can bet you have it in every artery in the body—including the aorta and those arteries providing blood to the brain, kidneys, intestines, legs, genitals, etc.  This can give rise to strokes or transient ischemic attacks, kidney disease, pain in the abdomen after meals, pain in the legs when walking, sexual dysfunction, etc.  Suffice it to say that intact blood flow to transport oxygen and nutrients to every cell in our body is our lifeline and we don’t want it compromised.

It is nothing short of wonderful that the medical fields of cardiology and cardiovascular surgery have become so evolved and sophisticated and that we have the medical and surgical resources to manage CVD so well.  Countless lives and loved ones have been saved from premature deaths.  That being the case, I must make an appeal from the bottom of my heart for preventive and pre-emptive measures that can keep the disease away and the cardiac team at bay.  Nature and nurture have roles in CVD and we can’t do a thing about the genetic blueprint that we inherited from our parents that can predispose us to CVD, but we do have incredible power to shape our health destiny with our lifestyle.  In my heart of hearts, I can assure you the truth and the validity of the following statement: Genes load the gun, but lifestyle pulls the trigger.  Even if genetics has been unkind to you, you have the authority and choice to pull the trigger, keep your finger on the trigger, or withdraw your finger from the trigger.

Prostate cancer is the number one cancer in men and one that I spend a great deal of my time managing and treating. Can you guess what the leading cause of death is in prostate cancer patients?  If your answer was prostate cancer, you are wrong.  The leading cause of death in men with prostate cancer is CVD.  After CVD, cancer happens to be the second leading cause of death in the USA and in most developed countries.  Most of our knowledge regarding lifestyle and dietary change for CVD prevention applies to cancer prevention as well.  One of the most dramatic reductions in both CVD and cancer has been through smoking cessation.   A heart-healthy diet and lifestyle will contribute to health improvements in every part of our human anatomy, whether it is the heart, colon, prostate or genitals.

As individuals, we must take responsibility for our health and make every effort towards maximizing our fitness and well-being.  We are the stewards of our own health destiny—no one else is.  Yes, we have physicians, sophisticated diagnostic tests, medications and surgery to help us when things go south, but simply by being smart and living a healthy lifestyle, we can avoid personal grief and the grief of our families.

Please take the following advice to heart:

Pearls to keep your heart ** healthy:

  1.  No smoking or tobacco
  2.  Maintain a healthy weight
  3.  Eat a healthy diet: nutrient-dense, non-processed, whole foods; lean protein including seafood which is abundant in heart-healthy omega-3 fats; eat meat and dairy sparingly (use fat-free dairy products); fruits, vegetables and legumes; nuts and seeds; whole-grain carbohydrates
  4.  Exercise daily: walking is great, but try to get some exercise that makes you sweat, breathe hard and gets your heart pumping. Exercise is all about adaptation. Our hearts and bodies are remarkably adaptable to the “stresses” that we place upon them, whether they be vigorous exercise or sitting on the couch.   
  5.  See a medical doctor for periodic health check-ups: don’t take better care of your car than you do of yourself!
  6.  Minimize and manage stress
  7.  Know your blood pressure and cholesterol levels and maintain them at healthy levels

 ** And every other organ in your body as well.

 

Heartfully Yours,

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food

www.PromiscuousEating.com