Are you feeling overwhelmed by all the information about heart health? One day you're told you should avoid eggs, the next they are good for you. Should you consume butter or avoid it at all costs?
It's common to feel confused about cholesterol, diet, and exercise recommendations because there's so much conflicting information out there.
Maybe you've had a heart scare and want to take charge of your health, but you're not sure where to start beyond taking medication. Don't worry, you're not alone in this.
Many people find it challenging to manage their heart health effectively. It can feel like a constant uphill struggle. But I'm here with good news - there are better approaches available. Instead of just treating symptoms, we can address the root causes of heart issues. This way, you can take control of your health and enjoy life to its fullest.
Heart health is more than just cholesterol numbers and blood pressure readings. It involves various factors, including your genes, what you eat, inflammation in your body, hormone balance, and lifestyle choices. Conventional approaches often focus on managing symptoms, like prescribing cholesterol-lowering medications, without addressing the underlying causes of heart disease risk. This approach may not give you the complete picture of your heart health.
This is where a functional medicine approach to cardiovascular health is truly changing lives. By digging deeper and assessing a wide range of biomarkers, we can identify the root causes of CV risk and guide targeted interventions for your unique body and biochemistry. Through a comprehensive understanding of the body's cardiovascular system and using optimal lab ranges, we can develop a more holistic strategy for heart health that goes far beyond simply lowering cholesterol.
Key Factors That Contribute to Increased Cardiovascular Risk
To optimize your cardiovascular health, you need to understand what actually drives your risk. Here are some major factors that can increase your likelihood of cardiovascular disease (CVD):
Chronic Inflammation: Chronic Inflammation:
You may have persistent, low-grade inflammation in your body without realizing it. This silent threat can stem from various root causes, including exposure to environmental toxins like air pollution and pesticides, underlying infections that linger undetected, gut dysbiosis or leaky gut syndrome, chronic stress coupled with poor sleep habits, nutrient deficiencies or imbalances, and undiagnosed food sensitivities or allergies.
Left unchecked, this chronic inflammation can set off a cascade of harmful effects on your cardiovascular system. It can lead to the oxidation of LDL particles, transforming them into more dangerous forms that contribute to arterial plaque.
Plus, persistent inflammation can damage the delicate lining of your blood vessels, creating an environment perfect for plaque formation and accumulation. Over time, these processes significantly elevate your risk of cardiovascular disease, and this is why it's vital to address inflammation's root cause.
Insulin Resistance: Insulin resistance is a key factor in cardiovascular risk. This condition can develop due to several root causes, including a poor diet high in refined carbohydrates and sugars, frequent blood sugar spikes and crashes (often referred to as "blood sugar roller coasters"), chronic stress and elevated cortisol levels, lack of regular physical activity, insufficient sleep or poor sleep quality, and chronic inflammation. When insulin resistance occurs, it can lead to inflammation and damage to your blood vessels, potentially resulting in plaque buildup in your arteries over time.
Oxidized LDL: When your LDL particles become oxidized, they're more likely to contribute to plaque formation in your arteries. This process can trigger inflammatory responses within your blood vessels, leading to atherosclerosis.
Poor Lipid Balance: Your risk increases if you have high triglycerides, low HDL, a high LDL particle count, or unfavorable LDL particle sizes. Remember, it's not just about your total cholesterol levels, but the balance and nature of these lipids in your body.
Nutrient Deficiencies: Nutrient deficiencies can significantly impact heart health, and several key factors contribute to these deficiencies. If you're low on essential nutrients like magnesium, omega-3 fatty acids, or certain B vitamins, your heart health may suffer. These nutrients are crucial for your blood vessel function, heart rhythm, and overall cardiovascular stability. A poor diet lacking essential nutrients is often the primary culprit, but even with a seemingly healthy diet, gut health issues can impair nutrient absorption.
Chronic stress also plays a role by depleting vital nutrients, while certain medications can interact with and affect nutrient levels in the body. Not to mention, as you age, you may face absorption challenges that further complicate nutrient intake.
Genetics: Your genetic makeup, such as variations in the APOE gene, can influence how your body metabolizes cholesterol and fats, affecting your cardiovascular risk.
Essential Functional Medicine Labs for Cardiovascular Health
When evaluating cardiovascular health, functional medicine goes beyond the basic lipid panel and blood pressure measurements. Here’s a detailed look at the key lab markers to consider, along with their optimal ranges:
1. Total Cholesterol: The Basic Labs
What It Is: Total cholesterol is the sum of HDL , LDL and VLDL, or very low-density lipoprotein. Cholesterol is a waxy, fat-like substance that is vital for health. It help with building cell membranes, producing hormones (like estrogen, testosterone, and cortisol), and synthesizing vitamin D. While dietary cholesterol can contribute to levels, the liver produces about 75% of the body's cholesterol.
Optimal Range: Functional medicine typically aims for a total cholesterol level between 180-220 mg/dL. Levels significantly below this can be associated with hormonal imbalances and increased mortality, while higher levels necessitate a closer look at the cholesterol subtypes and other cardiovascular markers.
2. LDL (Low-Density Lipoprotein): The Carrier
What It Is: LDL is a lipoprotein that transports cholesterol to cells throughout the body. It is commonly referred to as "bad cholesterol," but this description is inaccurate, as LDL itself is not cholesterol but rather a cholesterol-transporting protein. In fact, LDL plays a crucial role in the body, delivering essential cholesterol to areas where it’s needed. The potential risk lies in small, dense LDL particles, which are more prone to oxidation and plaque formation compared to larger particles.
Optimal Range: Functional medicine focuses on the LDL particle size and number rather than solely on LDL-C (the amount of cholesterol carried by LDL). An LDL particle count below 1,000 nmol/L is considered optimal. Additionally, having predominantly large, buoyant LDL particles is preferable, as these are less likely to contribute to arterial plaque formation than small, dense LDL particles.
3. HDL (High-Density Lipoprotein): The Clean-Up Crew
What It Is: HDL is a lipoprotein often called "good cholesterol," though this term is also misleading. Like LDL, HDL is not cholesterol itself but a transporter that helps move cholesterol from tissues back to the liver for processing and excretion. Both LDL and HDL serve essential functions in cholesterol management. Higher HDL levels are generally associated with a reduced risk of cardiovascular disease (CVD), as HDL facilitates the removal of excess cholesterol, aiding in maintaining balance.
Optimal Range: A functional approach aims for HDL levels of >60 mg/dL for both men and women. However, the HDL-to-total cholesterol ratio is also important, with an ideal ratio being above 0.24. This balance is key to supporting overall cardiovascular health.
4. Oxidized LDL: The Real Danger
What It Is: Oxidized LDL forms when LDL particles react with free radicals in the body. This oxidized form is far more likely to contribute to inflammation, endothelial dysfunction, and the development of atherosclerosis.
Optimal Range: There is no standard range for oxidized LDL in conventional labs, but functional medicine practitioners aim to keep levels as low as possible through antioxidant-rich diets, lifestyle changes, and targeted supplements.
5. Apolipoprotein A-1 and B (ApoA-1 and ApoB): Risk Indicators
What They Are: ApoA-1 is the main protein in HDL particles, while ApoB is found in LDL and VLDL particles. ApoB is a more accurate marker of cardiovascular risk than total LDL because it reflects the number of atherogenic particles in the blood.
Optimal Range: For ApoA-1, levels should be >120 mg/dL. For ApoB, functional medicine practitioners aim for <80 mg/dL. A higher ApoB-to-ApoA-1 ratio indicates a greater risk of CVD.
6. Triglycerides: A Critical Indicator
What They Are: Triglycerides are fats carried in the blood from the food we eat. Elevated triglyceride levels are associated with an increased risk of metabolic syndrome and CVD.
Optimal Range: Functional medicine sets the optimal triglyceride level at <100 mg/dL. Additionally, the triglyceride-to-HDL ratio should be <2, as a higher ratio can indicate insulin resistance.
7. Insulin and HbA1c: Blood Sugar and Insulin Resistance
Insulin: High fasting insulin indicates insulin resistance, which is a major contributor to CVD. The optimal rangefor fasting insulin is <5 μIU/mL.
HbA1c: This marker reflects average blood sugar levels over the past 3 months. Functional medicine aims for an HbA1c between 4.8% - 5.2% to prevent oxidative stress and vascular damage associated with high blood sugar.
8. hsCRP (High-Sensitivity C-Reactive Protein): Inflammation Marker
What It Is: hsCRP measures low-grade inflammation in the body. Elevated hsCRP is linked to an increased risk of CVD.
Optimal Range: Functional medicine aims for <1.0 mg/L. Even mild elevations can indicate the need for lifestyle changes to reduce systemic inflammation.
9. Homocysteine: Methylation and Heart Health
What It Is: Homocysteine is an amino acid that is normally found in the blood in small amounts. High levels of homocysteine in the blood can lead to endothelial cell injury and lead to injury in the blood vessels. Also, when homocysteine is elevated it indicates problems with methylation—a crucial process in the body for cardiovascular health. High homocysteine can contribute to arterial damage and blood clots.
Optimal Range: Functional practitioners aim for 5-7 μmol/L. Addressing nutrient deficiencies (B vitamins) can help lower homocysteine.
10. Fibrinogen: Clotting Risk
What It Is: Fibrinogen is a protein involved in blood clot formation. High levels can indicate an increased risk of clot-related events like stroke or heart attack.
Optimal Range: Functional medicine targets a fibrinogen level between 200-300 mg/dL.
11. CMP (Comprehensive Metabolic Panel): Organ Function
What It Includes: This panel measures markers such as glucose, AST/ALT (liver enzymes), GGT, and bilirubin. Elevated liver enzymes can indicate liver stress or fatty liver, which is often associated with poor lipid metabolism and increased CV risk.
Optimal Ranges: Functional medicine prefers fasting glucose between 70-85 mg/dL, AST and ALT levels below 20 U/L, and GGT under 30 U/L to reduce oxidative stress.
12. APOE Genotype: Genetic Influence on Lipid Metabolism
What It Is: The APOE gene influences how the body processes cholesterol and fats. Certain variants (e.g., APOE4) are linked to a higher risk of heart disease and Alzheimer's.
Why It Matters: Understanding your APOE status can guide dietary and lifestyle choices to optimize cardiovascular health.
Why I Don’t Agree with Statins, Ever
You've probably heard about statins, those commonly prescribed medications for lowering cholesterol. Statins do a great job a lowering cholesterol because they reduce the formation of cholesterol in the body. While they're often touted as a go-to solution, it's important to understand that they come with some significant drawbacks. When you take statins, you might experience side effects like muscle pain, fatigue, or even cognitive issues. These aren't just minor inconveniences - they can seriously impact your quality of life.
Another concern is that statins can deplete your body's CoQ10, a nutrient that's crucial for your heart and muscle health. This means that while trying to help your heart, you might inadvertently be depriving it of something it needs.
Another important issue is that statins affect the brain, which is largely made of lipids. By lowering cholesterol, statins may inadvertently increase the risk of neurodegenerative conditions like Parkinson's disease, dementia, and Alzheimer's disease. Cholesterol plays a key role in brain function and cellular communication, and reducing it too much may have downstream effects on cognitive health.
Perhaps most importantly, statins often address the symptom (high cholesterol) without tackling the root causes of your cardiovascular risk. Things like inflammation, insulin resistance, or oxidized LDL are left unaddressed, which means you're not getting to the heart of the problem and it leaves these imbalances to continue manifesting into more serious problems.
That's why a functional medicine approach might be more beneficial for you. Instead of relying on statins, you can focus on making lifestyle changes, adjusting your diet, and using targeted supplements. This approach aims to naturally support healthy cholesterol levels and reduce inflammation, addressing your cardiovascular health more holistically. It's about working with your body, not just masking symptoms.
Why I Don’t Agree with Low-Fat Diets, Ever
You might think low-fat diets are good for your heart, but they can actually increase your cardiovascular risk. Here's why…
When you eat low-fat foods, you're often getting more sugar and refined carbs instead. Food companies add these to make up for the taste when they take out the fat. This can lead to insulin resistance and inflammation in your body.
Also, your body needs healthy fats. Things like omega-3s and monounsaturated fats help keep your good cholesterol levels up and your triglycerides down. They also help fight inflammation. If you cut out all fats, you're missing out on these important nutrients that your heart needs to stay healthy.
So when you go low-fat, you might actually be doing your heart a disservice. You're getting more of the stuff that can cause problems (like added sugars) and less of the stuff that can help (like healthy fats).
My Functional Approach to Cardiovascular Health
Best Diet for Heart Health
When it comes to supporting your cardiovascular health through diet, you have some delicious options. You'll want to include plenty of healthy fats in your meals. Think about adding omega-3 rich foods like salmon or flaxseed to your plate, or enjoying avocados, olive oil, nuts, and seeds. These fats are not just tasty; they're also great for your heart.
Beyond healthy fats, consuming certain diets like Keto, the Fasting Mimicking Diet (FMD), and intermittent fastingoffer additional heart health benefits. These approaches help regulate blood sugar by reducing glucose levels and improving insulin sensitivity, which is essential for protecting your cardiovascular system. They also promote autophagy, the process of healthy cell cleanup and recycling, which supports overall cellular health and can contribute to better heart function.
Fiber is another key player in your heart-healthy diet. You can boost your intake by incorporating oats, chia seeds, and legumes into your meals. These foods are excellent sources of soluble fiber, which helps manage your cholesterol levels. Plus, they're versatile and can be used in a variety of dishes.
Don't forget to load up on antioxidant-rich foods. Berries, leafy greens, and cruciferous vegetables are all fantastic choices. They're not only packed with nutrients but also help reduce oxidative stress in your body, which is beneficial for your overall cardiovascular health.
Lastly, you'll want to be mindful of your sugar and refined carb intake. Instead of reaching for processed snacks or sugary treats, opt for whole foods. This simple switch can help you maintain stable blood sugar and insulin levels, which is crucial for your heart health. Remember, small changes in your diet can make a big difference in how you feel and in supporting your cardiovascular system.
High-Quality Supplements for Heart Health
When it comes to supporting your heart health, supplements can be a valuable addition to your diet and lifestyle. You might want to consider adding omega-3 fatty acids to your routine. These can help you manage your triglyceride levels, reduce inflammation in your body, and support the health of your blood vessels. Another supplement to think about is magnesium. It's great for helping regulate your blood pressure, supporting your muscle function, and maintaining healthy blood vessel tone.
If you're currently taking statins, CoQ10 is an essential supplement to consider. It supports your mitochondrial function and overall heart health, which is particularly important if you're on statin medications. Lastly, don't forget about B vitamins. Specifically, B6, B12, and folate can be really helpful. They support proper methylation in your body and can help lower your homocysteine levels, which is good news for your heart.
Remember, while these supplements can be beneficial, it's always best to talk with a functional nutrition practitioner, like myself, before starting any new supplement regimen. They can help you determine the right supplements and dosages for your specific needs and health goals.
Lifestyle Practice for Heart Health
You know how important it is to take care of your heart, and exercise is one of the best ways to do that. When you get moving regularly, you're doing your body a big favor. Your good cholesterol levels go up, which is great news for your heart. Plus, you're helping your body use insulin more effectively and keeping inflammation in check.
Stress can really take a toll on your heart, but you've got some powerful tools to combat it. Things like meditation, yoga, or even just taking a few deep breaths can make a big difference. These practices help lower your stress hormones and reduce inflammation in your body.
Don't underestimate the power of a good night's sleep when it comes to your heart health. When you prioritize quality sleep, you're giving your body the chance to regulate hormones, control blood pressure, and keep inflammation at bay. All of these factors play a crucial role in keeping your heart healthy.
Are you ready to take a proactive approach to your cardiovascular health? As a functional nutrition practitioner, Eli Priest specializes in creating personalized plans that address your unique needs and health concerns. Whether you're looking to optimize your heart health, manage existing cardiovascular issues, or simply want to understand your body better, Eli can guide you on your wellness journey.
Ready to take the next step towards optimal cardiovascular health? Book a call with Eli today.
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