WEBVTT 1 00:00:00.120 --> 00:00:03.359 The topics and opinions expressed on the following show are solely those of the hosts 2 00:00:03.399 --> 00:00:07.200 and their guests, and not those of W FOURWN Radio It's employees or affiliates. 3 00:00:07.360 --> 00:00:11.080 We make no recommendations or endorsements for radio show programs, services, or 4 00:00:11.080 --> 00:00:15.240 products mentioned on air or on our web. No liability, explicit or implied 5 00:00:15.320 --> 00:00:19.640 shall be extended to w FOWN Radio It's employees or affiliates. Any questions or 6 00:00:19.679 --> 00:00:22.879 comments should be directed to those show hosts. Thank you for choosing W four 7 00:00:22.960 --> 00:00:46.240 WN Radio. Well, hello, and welcome to Fearless Fabulous You. I 8 00:00:46.320 --> 00:00:49.880 am your host, Melanie Young, and welcome to what's starting to be my 9 00:00:49.960 --> 00:00:55.719 tenth season. Ten years that I have been hosting this show. Wow, 10 00:00:56.640 --> 00:01:00.200 amazing, how far I've come. This show started as a way to empower 11 00:01:00.240 --> 00:01:04.879 women to take charge of their health because I had recovered from breast cancer and 12 00:01:06.319 --> 00:01:08.640 was rethinking my health and how I took care of myself as well as what 13 00:01:08.680 --> 00:01:12.439 I wanted to do with my life. And from that I wrote a book 14 00:01:12.439 --> 00:01:17.359 called Fearless Fabulous You, Lessons on Living Life on your Terms and thought, 15 00:01:17.400 --> 00:01:19.040 how am I can I promote this book? And I said, oh, 16 00:01:19.079 --> 00:01:23.120 I'm gonna shore our show called Fearless, Fabulous You and find amazing women to 17 00:01:23.239 --> 00:01:27.319 interview about how we all can live life on our terms in good health. 18 00:01:29.000 --> 00:01:32.959 So if you do follow me, you know that hard health is a recurring 19 00:01:33.079 --> 00:01:38.200 theme. I always do at least two shows on hard health and other health 20 00:01:38.719 --> 00:01:42.799 topics at least in one season, and today we're going to address it again. 21 00:01:44.280 --> 00:01:47.719 I have hit the ripe old age of over sixty. I'm north of 22 00:01:47.760 --> 00:01:53.760 sixty, and I have learned, as many of my friends and followings and 23 00:01:53.840 --> 00:01:59.719 followers also north of sixty, that your metabolism just changes. It actually starts 24 00:01:59.719 --> 00:02:05.640 to change in your fifties, but it keeps changing. And a recent visit 25 00:02:05.719 --> 00:02:08.800 to my primary care position, because I am very good at going to all 26 00:02:08.840 --> 00:02:15.479 my scheduled duchess appointments, revealed that my cholesterol was a bit high and my 27 00:02:15.520 --> 00:02:22.439 weight was definitely too high for my small frame. And granted I live a 28 00:02:22.479 --> 00:02:25.560 life of incredible travel and eating and drinking good food and writing about wine, 29 00:02:27.000 --> 00:02:30.120 reporting on all that on my other show that Connect a Table, but it 30 00:02:30.199 --> 00:02:34.960 was kind of a wake up call, particularly after knowing that I have heart 31 00:02:35.000 --> 00:02:39.560 disease in my family. My grandmother died of cardiac arrest very suddenly, and 32 00:02:39.639 --> 00:02:46.719 my father had ongoing heart issues which resulted in a quintuple bypass surgery and a 33 00:02:46.840 --> 00:02:53.319 stent. It's not what ultimately did him in he died of metastasized pustate cancer. 34 00:02:53.599 --> 00:03:00.599 But knowing that I have a family history of heart condition, and knowing 35 00:03:00.639 --> 00:03:06.199 that my cholesterol was high, and knowing that my weight was even higher, 36 00:03:06.240 --> 00:03:12.159 I gave myself a six week turnaround plan. Obviously, nothing really can happen. 37 00:03:12.319 --> 00:03:15.120 Everything can't be achieved in six weeks, but you can make headway. 38 00:03:15.599 --> 00:03:21.000 And I'm a believer that you do this by diet and exercise. In Changing 39 00:03:21.159 --> 00:03:25.520 habits doesn't mean giving up everything you love, particularly if it's what pays your 40 00:03:25.520 --> 00:03:30.960 bills, like wine and wine writing. But it means moderation and making smarter 41 00:03:31.080 --> 00:03:37.360 decisions. So I am going to be addressing this today with an expert on 42 00:03:37.680 --> 00:03:44.479 my show. We are going to be speaking with doctor Elizabeth Clotis, who 43 00:03:44.599 --> 00:03:53.199 is a board certified practicing cardiologist, founder of the Preventative Cardiology Clinic near Minneapolis, 44 00:03:53.319 --> 00:03:59.080 Minnesota, and she trained at Mayo Clinic and John Hopkins. She's got 45 00:03:59.080 --> 00:04:04.520 alf of information. She's also founder and chief medical officer of Step one Foods, 46 00:04:04.960 --> 00:04:12.560 which we will discuss at the end of the show is foods that are 47 00:04:12.560 --> 00:04:16.199 to help with managing and lowering your cholesterol. Which we're going to talk about 48 00:04:16.240 --> 00:04:19.680 what you know you should be eating, and I always hate talking about what 49 00:04:19.720 --> 00:04:23.879 you should not be eating, but we're going to talk about adding in more 50 00:04:24.279 --> 00:04:28.800 because it's about crowning out bad stuff and adding in good stuff. Before we 51 00:04:28.879 --> 00:04:31.839 get into the conversation, I did like I always do, I popped on 52 00:04:31.920 --> 00:04:39.319 over to the Center of Disease Control CDC website to get some facts to set 53 00:04:39.319 --> 00:04:46.439 this up. Cholesterol high Total cholesterol in the United States is pretty big topic. 54 00:04:46.560 --> 00:04:51.920 Between two thousand and seventeen and twenty twenty twenty recent stats, ten percent 55 00:04:51.959 --> 00:04:57.680 of adults aged twenty or older had total cholesterol levels above two forty milligrams. 56 00:04:57.680 --> 00:05:02.639 At about seventeen percent had high deads the high density lipoprotein HDL or good cholesterol 57 00:05:02.720 --> 00:05:08.800 levels below forty milligrams. That's a lot of technical talk for some of you, 58 00:05:08.920 --> 00:05:13.319 so I'll let the doctor weigh in. But here's the thing. In 59 00:05:13.399 --> 00:05:16.120 summary, high cholesterol has no symptoms, so many people don't even know that 60 00:05:16.160 --> 00:05:19.639 their cholesterol is too high. We're going to talk about how you can check 61 00:05:19.680 --> 00:05:24.560 it. We're also going to talk about why it matters because, according to 62 00:05:24.560 --> 00:05:29.680 the CDC, having high cholesterol raises the risk for heart disease, the leading 63 00:05:29.759 --> 00:05:34.560 cause of death and stroke the fifth leading costs of death stroke and for women, 64 00:05:35.399 --> 00:05:42.040 heart disease and cardiac aris is like number one as from per the American 65 00:05:42.040 --> 00:05:48.800 Heart Association. So women have a high risk for heart disease and often, 66 00:05:48.879 --> 00:05:56.040 as I have explained on this show, symptoms are not like men and they're 67 00:05:56.079 --> 00:05:59.360 different. So we're going to dive into all this, and most importantly the 68 00:05:59.399 --> 00:06:05.920 takeaway is what can you do starting now to maintain a healthy cholesterol for you 69 00:06:08.040 --> 00:06:12.560 through lifestyle changes. So, doctor Elizabeth cloonas Liz, as you said before 70 00:06:12.560 --> 00:06:16.120 we went on, Welcome to Fearless. Fabulous you, Melanie, thank you 71 00:06:16.160 --> 00:06:20.160 so much for having me. I'm excited to be here with you. And 72 00:06:20.240 --> 00:06:24.839 honestly, as I was listening to the intro, we you know we could 73 00:06:24.879 --> 00:06:29.120 sit down and have coffee and talk about this for hours because our I think 74 00:06:29.199 --> 00:06:34.240 approach to heart disease prevention and interest in this area obviously is very much on 75 00:06:34.759 --> 00:06:39.839 the same page. So I really look forward to our conversation today. Absolutely. 76 00:06:40.160 --> 00:06:43.279 You know, I always like to start with a little backstory because I'd 77 00:06:43.279 --> 00:06:46.720 like to explain who my guests are, which I semi did. But I 78 00:06:46.800 --> 00:06:53.720 am curious why you decided to become a cardiologist. Was there something in your 79 00:06:53.759 --> 00:06:56.920 own life that said, I want to know, there's always a reason you 80 00:06:56.959 --> 00:07:00.279 become a doctor, and it is a long road, and becoming a specialist 81 00:07:00.319 --> 00:07:05.439 is that even longer road? So what inspired you? Well, yeah, 82 00:07:05.519 --> 00:07:10.720 the long road is for sure true. I mean from the time I graduated 83 00:07:10.800 --> 00:07:15.600 high school so they to the time I hung up my cardiology shingle was fourteen 84 00:07:15.680 --> 00:07:20.879 years of uninterrupted education. So it's a it's a very long road to get 85 00:07:20.959 --> 00:07:27.160 here. And actually it's interesting because I didn't get here kind of the way 86 00:07:27.319 --> 00:07:30.399 a lot you know, I didn't pick the specialty the way a lot of 87 00:07:30.439 --> 00:07:33.399 people picked their specialties. Right they had you know, they broke their leg 88 00:07:33.439 --> 00:07:36.680 when they were young, so they became an orthopedic surgeon, or you know, 89 00:07:36.720 --> 00:07:42.040 their mom had cancer, so they became an oncologist. Actually, my 90 00:07:42.360 --> 00:07:46.480 just like in your family a history of cancer or a personal history of cancer. 91 00:07:46.399 --> 00:07:54.680 My my family as cancer everywhere and yet that's not that's not why. 92 00:07:54.800 --> 00:08:01.920 And I didn't become an oncologist. I chose cardiology honestly because of a mentor 93 00:08:01.279 --> 00:08:07.600 that I had during medical training. Um. It's you know, I did 94 00:08:07.639 --> 00:08:11.920 a rotation on cardiology when I entered internal medicine. Because it's a it's a 95 00:08:13.040 --> 00:08:16.879 layered um um, it's a layered education process. First, you you know, 96 00:08:18.000 --> 00:08:20.920 oud your medical school, then you do an intro introl medicine residency, 97 00:08:22.079 --> 00:08:24.839 and then you specialize and go on to cardiology, which then you can further 98 00:08:24.879 --> 00:08:31.680 subspecialize into things like electrophysiology or congestive heart failure, you know, transplant management, 99 00:08:31.720 --> 00:08:35.919 things like that. Anyway, Um, but it was literally on the 100 00:08:35.960 --> 00:08:43.039 first day of my cardiology rotation that that my mentor inspired me. He just 101 00:08:43.279 --> 00:08:48.000 um, his name is pures Batarad. He's he's retired, but this was 102 00:08:48.039 --> 00:08:56.360 at Mayo Clinic and he just made every single patient and every single cardiology problem 103 00:08:56.840 --> 00:09:01.879 seemed fascinating and and it's an amazing being filed. I mean, the heart 104 00:09:01.039 --> 00:09:05.759 is a miracle if you think about it. I mean, it beats, 105 00:09:05.799 --> 00:09:09.879 it pumps blood, you know, just all on its little all on its 106 00:09:09.919 --> 00:09:15.799 little loan. Sixty times a minute, sixty minutes an hour, twenty four 107 00:09:15.840 --> 00:09:18.000 hours a day, seven days a week, fifty two weeks a year, 108 00:09:18.120 --> 00:09:22.480 for you know, a hundred years. It just keeps going. It's amazing. 109 00:09:22.559 --> 00:09:28.759 There's there's no engine that does that, so quite an engine. And 110 00:09:28.840 --> 00:09:31.799 it is, you know, what keeps us living because technically, if your 111 00:09:31.799 --> 00:09:35.399 heart isn't beating, you're dead. You know, you can be brain dead, 112 00:09:35.519 --> 00:09:41.080 but your heart can keep beating, right, Yeah, it's it's obviously 113 00:09:41.080 --> 00:09:45.039 it's an incredibly important organ. And you know, and I think the other 114 00:09:45.080 --> 00:09:48.919 thing honestly that attracted me to cardiology is because you can do so much, 115 00:09:48.360 --> 00:09:52.159 you know there, you know you can, and it's and it's such a 116 00:09:52.200 --> 00:09:58.639 wide breadth of almost subspecialties within cardiology. You can almost be a you know, 117 00:09:58.639 --> 00:10:03.960 a radiologist in some sense and read heart ultrasounds and heart sets and heart 118 00:10:03.080 --> 00:10:09.279 MRIs. Or you can be almost a surgeon and in cert stents and you 119 00:10:09.279 --> 00:10:13.440 know, or you know, the pacemakers. You can um you know, 120 00:10:13.519 --> 00:10:16.399 be like what I what I do, which is be on the prevention end. 121 00:10:16.480 --> 00:10:20.440 And actually, you know, my hope is to put myself out of 122 00:10:20.480 --> 00:10:24.759 work, is so people don't don't need us anymore. So I always said 123 00:10:24.799 --> 00:10:28.679 that when I wrote my book to help women diagnose with breast cancer, I 124 00:10:28.720 --> 00:10:31.799 hope no one ever has to buy my book. You know, you know 125 00:10:31.879 --> 00:10:35.120 it's amazing, um, doctor Clote, is that we take our hearts for 126 00:10:35.200 --> 00:10:39.879 granted. You know, we talk about women talk about love. They're always 127 00:10:39.879 --> 00:10:43.399 looking for love, They're always looking for their soulmate. They're always you know, 128 00:10:43.440 --> 00:10:46.720 expressing themselves and you know, I love you and emoging their heart. 129 00:10:48.279 --> 00:10:52.840 But we mistreat it by not taking care of it. And it is really 130 00:10:52.480 --> 00:10:58.519 the beating heart is what defines you as living. And if you've ever held 131 00:10:58.559 --> 00:11:03.159 someone like I have, who watched their the heartbeat die, which I did 132 00:11:03.159 --> 00:11:07.559 with my mother, I watched a heartbeat die, it is a very powerful 133 00:11:07.639 --> 00:11:11.879 thing to watch someone who is dying. And the last thing you see is 134 00:11:11.919 --> 00:11:16.080 a beating heart. It is the last thing to go. And we take 135 00:11:16.120 --> 00:11:24.080 it for granted, don't you agree? I? You know, very much 136 00:11:24.120 --> 00:11:28.200 so. And I think it's because it just kind of keeps doing its job 137 00:11:28.000 --> 00:11:33.039 right and and and it can take an awful lot of abuse, which is 138 00:11:33.240 --> 00:11:37.120 you know what, which is which is amazing. And again, our bodies 139 00:11:37.159 --> 00:11:43.960 are so incredibly resilient, but at some point we you know, we exceed 140 00:11:45.360 --> 00:11:50.360 the capacity of our bodies to make up for what we're doing. And that's 141 00:11:50.360 --> 00:11:54.440 why it's so important to start early in terms of your prevention efforts, because 142 00:11:54.600 --> 00:12:00.679 both the building of disease or the prevention of disease are cumulative of you know, 143 00:12:00.759 --> 00:12:05.559 those those efforts or those habits, you know, multiply over time. 144 00:12:05.080 --> 00:12:09.720 And you're right in terms of women, this is our disease. You know, 145 00:12:09.879 --> 00:12:13.559 we we think about and you've had breast cancer, so I don't in 146 00:12:13.600 --> 00:12:18.440 any way want to diminish breast cancer as a you know, as a as 147 00:12:18.480 --> 00:12:20.600 a health threat. It's a terrible disease. It takes, it takes a 148 00:12:20.639 --> 00:12:26.519 lot of women's lives. But you know, one out of thirty women will 149 00:12:26.559 --> 00:12:30.960 die from breast cancer, one out of three will die from heart disease. 150 00:12:31.440 --> 00:12:37.360 So so heart disease is our disease, and it is almost entirely preventable. 151 00:12:37.840 --> 00:12:41.720 Eighty percent of it need not exist. And you know, a family history 152 00:12:43.039 --> 00:12:48.039 is a risk factor for sure, but family history genetics are not destiny. 153 00:12:48.320 --> 00:12:54.320 Genetics are a you know, a risk factor. They add about twenty percent, 154 00:12:54.519 --> 00:12:58.399 they account for about twenty percent of your risk, which means eighty percent 155 00:12:58.759 --> 00:13:01.960 is something you have some troll over. If you have family history, right, 156 00:13:01.960 --> 00:13:05.120 you're you're starting a little bit behind an eight ball, but it doesn't 157 00:13:05.159 --> 00:13:11.039 mean you're faded to this, and this is an avoidable disease, absolutely, 158 00:13:11.159 --> 00:13:18.960 and with all risk predension. I like to start with I have a little 159 00:13:18.039 --> 00:13:24.679 quadrant, but the two big ones nutrition and movement. I never say exercise 160 00:13:24.720 --> 00:13:30.120 as say movement, but it's exercise, and those are the two that can 161 00:13:30.240 --> 00:13:37.360 help reverse a lot of damage. But you do have to start early. 162 00:13:37.480 --> 00:13:46.639 And what's interesting is so many parents should be aware that it starts with teaching 163 00:13:46.679 --> 00:13:52.360 good habits as children to their children, so that you know they're not sedentary, 164 00:13:52.679 --> 00:13:58.799 they're not eating the wrong foods, they're eating balanced diets, and they're 165 00:13:58.879 --> 00:14:03.159 leading an active life. I want to this show is about cholesterol because a 166 00:14:03.159 --> 00:14:07.840 lot of people don't even understand what cholesterol is. And it is a big 167 00:14:07.000 --> 00:14:11.559 term, and there's different terms. So I want you to define the different 168 00:14:11.600 --> 00:14:16.279 types of cholesterol because people here there's good cholesterol, people here there's bad cholesterol. 169 00:14:16.360 --> 00:14:20.879 They hear of diet. There's a lot of terms. Yeah, So 170 00:14:20.879 --> 00:14:24.960 so first of all, just in general, what is cholesterol well, cholesterol 171 00:14:26.279 --> 00:14:31.840 is a waxy, fat like substance that can be found in all sorts of 172 00:14:31.879 --> 00:14:37.159 places inside our body. Every cell wall of every cell within our bodies has 173 00:14:37.240 --> 00:14:43.960 some cholesterol. We use cholesterol to make hormones, bile acids, vitamin D, 174 00:14:43.360 --> 00:14:48.360 and other substances. So cholesterol is actually important for our body structure and 175 00:14:48.480 --> 00:14:54.799 function. The problem is, if there's too much cholesterol circulating in the bloodstream, 176 00:14:54.360 --> 00:14:58.320 some of the excess can be it can be contrapped in artery walls, 177 00:15:00.080 --> 00:15:03.559 and this buildup is called plaque. And if enough of it accumulates, that 178 00:15:05.159 --> 00:15:09.879 plaque can narrow blood vessels and make them less flexible, causing what's you know, 179 00:15:09.960 --> 00:15:15.840 typically referred to as hardening of the arteries. And it is this process, 180 00:15:16.039 --> 00:15:20.759 that accumulation of plaque in our arteries that leads to these potentially devastating health 181 00:15:20.759 --> 00:15:24.559 events like heart attacks and strokes or the need for procedures such as you know, 182 00:15:24.679 --> 00:15:30.240 bypass surgery instants. So it's a you know, this is a progressive 183 00:15:30.279 --> 00:15:35.559 disease. And to your point, it starts early, you know, autopsy 184 00:15:35.720 --> 00:15:39.399 data, this buildup of gunk inside our arteries, it starts very early, 185 00:15:41.080 --> 00:15:46.480 you know, in autopsy studies performed on soldiers killed in the Korean and Vietnam 186 00:15:46.519 --> 00:15:50.080 War. So these are young men in their twenties and thirties. They were 187 00:15:50.080 --> 00:15:56.320 already seeing significant plaque build up when autopsy's done on children. What a tragic 188 00:15:56.399 --> 00:16:00.639 thing to do an autopsy on a child. But we're starting to find the 189 00:16:00.679 --> 00:16:07.080 earliest precursors of plaque in children as young as ten. So the earlier we 190 00:16:07.159 --> 00:16:11.799 start with, you know, preventive measures, the better. Okay, Now, 191 00:16:11.879 --> 00:16:15.679 cholesterol, so we talked about kind of what it is generally the way 192 00:16:15.720 --> 00:16:19.799 to you can't, for the most part, feel that you have high cholesterol. 193 00:16:19.840 --> 00:16:22.960 By the time you feel things like a heart attack, stroke bypass, 194 00:16:25.039 --> 00:16:27.679 you've had cholesterol for a high cholesterol phone off, well, young time. 195 00:16:29.120 --> 00:16:33.120 Really, the only way to know if you have an abnormal cholesterol profile is 196 00:16:33.159 --> 00:16:37.399 to get checked with a blood test. And when you do that, you 197 00:16:37.440 --> 00:16:41.200 will get four numbers. One is the total cholesterol, and then you'll get 198 00:16:41.759 --> 00:16:47.879 HDL cholesterol, LVL cholesterol, and trigolysterides. Okay, total cholesterol. The 199 00:16:47.919 --> 00:16:51.559 total cholesterol is the sum of all the cholesterol in your body, so it's 200 00:16:51.639 --> 00:16:55.200 kind of everything that's below the line. Those those three other numbers. Those 201 00:16:55.240 --> 00:16:59.840 three other numbers make up the total cholesterol. The total cholesterol should typically be 202 00:17:00.080 --> 00:17:03.440 under two hundred. It's melligrams, prodest leader or the units, but we'll 203 00:17:03.440 --> 00:17:07.480 stop talking about the units because they're all the same anyway. It should be 204 00:17:07.559 --> 00:17:11.400 under two hundreds. But the total cholesterol is actually less important than what it's 205 00:17:11.400 --> 00:17:14.880 made up out of, right, because I just said there's good cholesterol, 206 00:17:14.920 --> 00:17:18.720 bad cholesterol, triglysrides, and you can have various combinations of those three things 207 00:17:18.759 --> 00:17:23.039 and end up with the same total, but with very different health implications. 208 00:17:23.559 --> 00:17:30.319 Okay, let's start with good cholesterol HDL. HDL is the good cholesterol. 209 00:17:30.359 --> 00:17:33.359 It's the happy cholesterol. You want to keep it high if it helps you 210 00:17:33.440 --> 00:17:38.359 remember which is which. HDL is the cholesterol that is not depositing in our 211 00:17:38.440 --> 00:17:41.759 arteries. It's on its way out. So we actually want this number as 212 00:17:41.839 --> 00:17:45.519 high as possible. In women, we're happy to see it should be over 213 00:17:45.599 --> 00:17:49.720 fifty, so you know that's where you should be. If you have an 214 00:17:49.839 --> 00:17:56.480 HDL cholesterol under fifty, that's its own risk factor for earlier atheroscurosis, So 215 00:17:56.519 --> 00:18:03.160 it should be over fifty. LDL is the bad stuff. This is the 216 00:18:03.240 --> 00:18:07.640 cholesterol that's potentially depositing in our arteries. It's the lousy cholester. You want 217 00:18:07.640 --> 00:18:11.119 to keep it low. This is the cholesterol that you know, all physicians 218 00:18:11.119 --> 00:18:19.200 obsess over because LDL cholesterol is most tightly linked to heart disease risk. It's 219 00:18:19.319 --> 00:18:26.319 almost, you know, a linear line between LDL and heart disease risks. 220 00:18:26.359 --> 00:18:30.720 So the higher it is, the higher your risk. Most cardiologists, actually 221 00:18:30.759 --> 00:18:34.440 all cardiologists would say, you know, everyone should be under one thirty for 222 00:18:34.680 --> 00:18:40.440 LDL as you accumulate risk factors, and that could be a family history of 223 00:18:40.519 --> 00:18:42.480 heart disease, or you have high blood pressure, you're a smoker. At 224 00:18:42.519 --> 00:18:48.559 some point, under a hundred would be better. Once you have documented heart 225 00:18:48.640 --> 00:18:53.000 or vascular disease, so you've had a heart attack or stroke, or bypassers 226 00:18:53.079 --> 00:18:57.279 or your stent, your LDL should fall under seventy. Now the vast majority 227 00:18:57.319 --> 00:19:02.319 of us will require medications to get there, and there's even data to show 228 00:19:02.359 --> 00:19:07.759 that under fifty is additionally protective. So the main message around LDL is the 229 00:19:07.880 --> 00:19:12.960 lower, the better. The last component of a cholesterol profile are the triglycerides. 230 00:19:14.079 --> 00:19:17.920 Triglycerides are not much of a cholesterol particle, they're actually mostly fat, 231 00:19:18.480 --> 00:19:21.279 so if you try to add up the three numbers, you won't get to 232 00:19:21.319 --> 00:19:25.319 the total. It doesn't add up right. So the formula is actually good 233 00:19:25.440 --> 00:19:30.400 cholesterol plus bad cholesterol plus one fifth of the triglysrides get you to the total. 234 00:19:30.799 --> 00:19:40.119 Triglyceride levels should be under one fifty and in everyone but the But the 235 00:19:40.240 --> 00:19:44.839 range of triglyceterides is very broad, so it's just a different animal. It 236 00:19:44.839 --> 00:19:48.880 lives on a different scale. The lowest triglysides I've ever seen in someone on 237 00:19:48.960 --> 00:19:52.799 no medications is twenty seven, but the highest I've ever seen is in the 238 00:19:52.880 --> 00:19:57.160 thousands, So it's a ginormous range. But everyone should be under one fifty. 239 00:19:57.440 --> 00:20:03.599 Triglycerides on their own are not much of a risk factor for heart disease 240 00:20:03.680 --> 00:20:07.160 per se. They tend to be more of an indicator of metabolic health. 241 00:20:07.920 --> 00:20:11.920 You know, the higher your triglycerides are, the more likely things are out 242 00:20:11.920 --> 00:20:17.079 of whack. You know your weight's not right, you're eating poorly, you're 243 00:20:17.119 --> 00:20:21.920 not exercising, you're drinking too much. You know that triglycerides will give you 244 00:20:22.000 --> 00:20:26.480 up, like they'll be the first ones to rise and say like something's not 245 00:20:26.599 --> 00:20:30.319 quite right here. That makes a lot of sense. So just to recap 246 00:20:30.920 --> 00:20:37.319 LDL. You want your LDLs low right, yes, you want your HDLs 247 00:20:37.400 --> 00:20:45.599 high m and you want your triglycerides low yeah, right, And you should 248 00:20:45.599 --> 00:20:48.519 go to the doctor like I do with a shopping list. I got with 249 00:20:48.559 --> 00:20:51.279 a checklist. Now't ever go to your doctor unless you have a checklist. 250 00:20:51.279 --> 00:20:53.200 And I have a checklist. If everything I want check because I swear if 251 00:20:53.200 --> 00:20:56.160 they if I don't have that, they won't do it. So you got 252 00:20:56.160 --> 00:21:02.160 to go in there and demand that you get all the necessary tests so that 253 00:21:02.240 --> 00:21:06.160 you can have them as a benchmark and read the results because you get them 254 00:21:06.200 --> 00:21:10.720 in your portal. It's it's your benchmark to see what you need to do 255 00:21:10.839 --> 00:21:15.359 if you need to do any adjusting. Now, the logical way that these 256 00:21:15.480 --> 00:21:22.440 get adjusted from a physician standpoint is to prescribe medication. Right yep, high 257 00:21:22.519 --> 00:21:30.559 cholesterol. Here's a pill and that would normally be what that would normally be 258 00:21:30.599 --> 00:21:36.079 a stat And so these are you know, medications that most people are familiar 259 00:21:36.119 --> 00:21:40.440 with because they've heard them, because they're because they're so frequently prescribed. The 260 00:21:40.480 --> 00:21:44.839 original ones were you know, called lipatore and crest store um, now they're 261 00:21:44.839 --> 00:21:48.200 all basically all generic. So that was a penalty for maybe a Torvos stat 262 00:21:48.240 --> 00:21:52.559 and YAP or Suba stat and Simba stat and so that. So that's the 263 00:21:52.599 --> 00:21:57.240 category of arts. It's actually the most widely one of the most widely prescribed 264 00:21:57.680 --> 00:22:04.160 drug categories on the planet exactly besides an indepressants and most of the relaxers. 265 00:22:04.240 --> 00:22:07.319 I could go on because I do have and I do like my primary care 266 00:22:07.319 --> 00:22:11.519 physician, but he loves to prescribe things, and I hate taking pills. 267 00:22:11.000 --> 00:22:18.240 So my husband's taking satins. I'm not because I don't. So there's a 268 00:22:18.279 --> 00:22:25.279 big reason I don't like taking drugs prescription medication unless absolutely necessary. And the 269 00:22:25.279 --> 00:22:32.000 biggest reason is that I write about wine. It is a job, and 270 00:22:32.359 --> 00:22:40.519 I know that there are interactions, and I read interactions carefully. I also 271 00:22:40.640 --> 00:22:45.039 know that you can't operate a car, and there are certain things that affect 272 00:22:45.079 --> 00:22:48.720 your decision making. And I am one of those people who does not do 273 00:22:48.880 --> 00:22:56.880 well on prescription medication. I get foggy. I have had reactions from itching 274 00:22:57.000 --> 00:23:00.400 to brain fog to whatever. And I also know that you have to be 275 00:23:00.480 --> 00:23:03.839 very careful if you drink wine. You've got to watch that and if you 276 00:23:03.920 --> 00:23:08.960 offer any machinery, So for me, very few work. And my mother 277 00:23:10.079 --> 00:23:14.240 was the same way. She would have reactions. You've got to be very 278 00:23:14.240 --> 00:23:17.119 careful. It's not that they're bad, as you have to do what's right 279 00:23:17.160 --> 00:23:19.920 for you. My husband is taking a statin. However, I'm a big 280 00:23:19.920 --> 00:23:26.039 believer that you you know, change a start with you and not what you 281 00:23:26.039 --> 00:23:27.720 pop. And it's not what the pillow you pop in your mouth, but 282 00:23:27.759 --> 00:23:30.720 the food you pop in your mouth. And if you want to get rid 283 00:23:30.759 --> 00:23:36.279 of the gunk, get rid of the junk. Could not have said it 284 00:23:36.319 --> 00:23:40.839 better myself. I'm going to use that line. I do like to speak 285 00:23:40.839 --> 00:23:45.880 credited, but that is something I say quite a bit, and you know, 286 00:23:45.039 --> 00:23:48.519 I'm a big believer in it. It's hard, it's not easy to 287 00:23:48.640 --> 00:23:52.839 follow. But you go into the doctor and you find out your twenty five 288 00:23:52.839 --> 00:23:55.519 pounds overweight, in your cholesterols high, you go, I think I'm going 289 00:23:55.559 --> 00:24:00.559 to do something about it because I don't want to get sick. So again, 290 00:24:00.799 --> 00:24:04.960 this is a blood test anyone can have it. Is there a certain 291 00:24:06.039 --> 00:24:08.880 age that people should be starting to get their cholesterol check or should just be 292 00:24:10.000 --> 00:24:15.240 part of your and so so actually, um, you know, it's it's 293 00:24:15.599 --> 00:24:22.279 recommended that the first cholesterol check happen in childhood. And and you know a 294 00:24:22.319 --> 00:24:26.319 good rule of thumb. And this isn't exactly you know, like the you 295 00:24:26.359 --> 00:24:30.680 know, US Preventative Services Task Force would say, but it's close enough and 296 00:24:30.720 --> 00:24:37.079 it's really easy to remember once you know, before you turn ten, you 297 00:24:37.119 --> 00:24:41.920 know, um, twice in your sorry, once in your teams, twice 298 00:24:41.960 --> 00:24:45.200 in your twenties, you know, three times in your thirties, four times 299 00:24:45.200 --> 00:24:48.799 in your forties, at least every other year in your fifties, and then 300 00:24:48.920 --> 00:24:55.599 yearly sixty onwards. So it's you know, it's it's something that should increase 301 00:24:55.640 --> 00:24:57.880 in for extent. It assumes your your your numbers are normal, right, 302 00:24:57.920 --> 00:25:03.039 you may need more free quin checks if they're abnormal or you're being started on 303 00:25:03.079 --> 00:25:07.559 a therapy or you're using diet to modify this, so then you're going to 304 00:25:07.599 --> 00:25:11.240 need more frequent assessment. But but if otherwise everything looks good, that's that's 305 00:25:11.240 --> 00:25:15.759 a pretty good way to think about it, and it's easy to remember. 306 00:25:15.160 --> 00:25:19.319 Also if you're having life changes, I am going to safely assume that if 307 00:25:19.359 --> 00:25:26.240 you're pregnant or you're going through menopause, or you're in some kind of treatment 308 00:25:26.920 --> 00:25:30.799 that you have to watch things because there are certain types of things that will 309 00:25:32.119 --> 00:25:37.400 increase your cholesterol based on that. Yeah, yeah, so with pregnancy we 310 00:25:37.440 --> 00:25:41.839 can see changes in cholesterol, but honestly, we don't really measure cholesterol during 311 00:25:41.880 --> 00:25:47.279 this time. We don't do anything about it because there are no safe treatments 312 00:25:47.400 --> 00:25:52.720 for cholesterol during pregnancy, not because they're they're intrinsically unsafe, it's just they've 313 00:25:52.759 --> 00:25:56.359 not been tested and so, you know, and this is actually a big 314 00:25:56.440 --> 00:26:03.160 problem in general for women who are are pregnant or of childbearing age. They're 315 00:26:03.160 --> 00:26:07.799 typically excluded from all trials, right because no one, no one wants to, 316 00:26:07.440 --> 00:26:11.279 you know, do anything that could in any way potentially you know, 317 00:26:11.920 --> 00:26:15.599 hurt the fetus. So so we have a big gap in knowledge as to 318 00:26:15.680 --> 00:26:19.640 what to do, you know, in in that patient population. UM. 319 00:26:19.839 --> 00:26:23.759 But you know, once you're once you're you know you're not going to have 320 00:26:23.759 --> 00:26:27.480 any more children, you're using contraception, or you're you know, past past 321 00:26:27.880 --> 00:26:32.559 reproductive age. UM, you know that obviously we can use all sorts of 322 00:26:32.559 --> 00:26:36.279 medications. There's there's all sorts of options for that UM, which is where 323 00:26:36.279 --> 00:26:41.720 a diet becomes really important, you know, for for um women in during 324 00:26:41.759 --> 00:26:47.960 their reproductive years, and lifestyle becomes really important in terms of menopause. Um, 325 00:26:48.440 --> 00:26:53.599 boy, that is a big time where cholesterol profiles can change. So 326 00:26:53.720 --> 00:26:57.240 remember how at the beginning I said, you know, we use cholesterol for 327 00:26:57.319 --> 00:27:00.920 all sorts of things, right to make cell walls, to make hormones, 328 00:27:02.039 --> 00:27:06.440 to make file um well in order to use them. The truth is we 329 00:27:06.440 --> 00:27:11.039 can actually make most of the cholesterol we need for those functions inside our cells. 330 00:27:11.079 --> 00:27:17.079 We actually don't need a lot of circulating LBL cholesterol to be around to 331 00:27:17.319 --> 00:27:19.640 to to use. But if we're if we're going to use but if it's 332 00:27:19.680 --> 00:27:22.680 out there in the bloodstream, it's kind of like sound money. It's like 333 00:27:22.880 --> 00:27:26.480 one both making it and inside we you need just grab it, you know, 334 00:27:26.559 --> 00:27:30.519 take it inside the cell and use it for what you need. But 335 00:27:30.640 --> 00:27:34.279 in order to grab it, you need a receptor, and that receptor has 336 00:27:34.359 --> 00:27:38.839 to be primed and active to pick up an LDL particle, So a bad 337 00:27:38.920 --> 00:27:44.720 cholesterol particle from you know, from the storage time, from from the bloodstream 338 00:27:44.720 --> 00:27:49.880 and bring it inside the cell. Okay, Estrogen up regulates LDL receptors. 339 00:27:49.920 --> 00:27:55.440 It makes them way more active. So when we have estrogen around, our 340 00:27:55.680 --> 00:28:00.200 LDL levels are lower, our cholesterol, especially that the bad cholesterol levels are 341 00:28:00.240 --> 00:28:04.720 lower because we're very efficient at grabbing it from our bloodstream and bringing it inside 342 00:28:04.720 --> 00:28:10.759 ourselves. When we lose estrogen during menopause, you know, when we go 343 00:28:10.799 --> 00:28:15.880 through menopause, that that protective sort of booster for those LDAL receptors goes away, 344 00:28:17.319 --> 00:28:21.799 and all of a sudden we're left with kind of lazy LDAL receptors. 345 00:28:21.839 --> 00:28:26.200 And so what a lot of women experience is like, wait, my weight's 346 00:28:26.240 --> 00:28:29.279 the same, I'm exercising the same, I'm eating the same stuff, and 347 00:28:29.359 --> 00:28:33.039 my ld all just went through the roof. It's your it's that estrogen loss 348 00:28:33.720 --> 00:28:40.319 is what happened. Wow, that's interesting. I have no ESG because I 349 00:28:41.039 --> 00:28:45.960 went to menopause and I had estrogen receptor positive cancer, so they blasted me 350 00:28:45.039 --> 00:28:48.680 with romatise inhibitors. So I have no estrogen, although I feel very presitive, 351 00:28:48.720 --> 00:28:53.079 fabulous, But you know, that's probably another reason why my cholesterol went 352 00:28:53.119 --> 00:28:57.119 a little off. But like I said's under control. But it was off, 353 00:28:57.319 --> 00:29:03.079 but a lot of it was lifestyle. So let's talk about diet. 354 00:29:03.640 --> 00:29:11.000 First of all, exercise is critical. It goes hand in hand with diet. 355 00:29:11.160 --> 00:29:15.920 Really can't do one without the other. They are the handsel and Gretel. 356 00:29:15.039 --> 00:29:21.519 They are the tweedledee and tweedledum. They work together. You can't just 357 00:29:21.640 --> 00:29:23.599 exercise it keep eating what you want, and you can't just you know, 358 00:29:23.680 --> 00:29:30.279 stop eating and that exercise they are essential. There are other things as well, 359 00:29:30.759 --> 00:29:36.039 right, sleep, dress, management, your mental health. Those are 360 00:29:36.119 --> 00:29:42.200 all that not the exactly, but it's really critical. So let's talk about 361 00:29:42.319 --> 00:29:48.920 diet because there are foods that can help lower cholesterol. It's not they're not 362 00:29:48.000 --> 00:29:53.680 magic pills, but they are easy to add into a diet and to replace 363 00:29:53.799 --> 00:30:00.400 other things. Right, So give us some examples. Okay, so I'll 364 00:30:00.400 --> 00:30:03.599 talk a little bit more in generalities, so more categories of food. So 365 00:30:04.720 --> 00:30:10.240 the things that influence and I'm just going to focus on LDL because that's that's 366 00:30:10.319 --> 00:30:15.519 that's that's the particle we're really you know, laser, you know laser focused 367 00:30:15.519 --> 00:30:19.200 on in cardiology. So the things that are going to impact your LDL level 368 00:30:19.240 --> 00:30:22.880 from a dietary perspective are going to be the types of fats you eat and 369 00:30:22.960 --> 00:30:26.880 the types of carbs you eat. It hasn't very little to do with how 370 00:30:26.960 --> 00:30:30.839 much cholesterol you consume. It has very little to do with how much protein 371 00:30:30.880 --> 00:30:34.039 you consume, So you can kind of leave those those two things to the 372 00:30:34.119 --> 00:30:38.200 side. So let's do the fats first. The fats that you should be 373 00:30:38.240 --> 00:30:42.799 avoiding are saturated fats. Those are fats that are solid at room temperature. 374 00:30:42.839 --> 00:30:48.839 They come primarily from animal sources butter, cheese, the marbling, and beef 375 00:30:48.880 --> 00:30:52.880 the fat and chicken. Saturated fats at best are going to be neutral, 376 00:30:52.960 --> 00:30:59.079 meaning they're not going to help you. In many people, they raise LDL 377 00:30:59.200 --> 00:31:03.920 cholesterol, and they do that through kind of the same way as losing estrogen. 378 00:31:03.960 --> 00:31:07.799 They down regulate LDL receptors, and in some people that can be a 379 00:31:07.880 --> 00:31:11.240 really profound effect, Like you know, some people go on a keto diet 380 00:31:11.279 --> 00:31:17.440 and their LDL goes through the roof. So saturated fats are going, if 381 00:31:17.440 --> 00:31:22.440 anything, they're going to raise LDL. They're also pro inflammatory, and all 382 00:31:22.440 --> 00:31:26.240 of these things that we're actively trying to avoid, cancer, dementia, heart 383 00:31:26.240 --> 00:31:30.920 disease, these are all driven in part by inflammation. So you don't want 384 00:31:30.920 --> 00:31:33.519 to be throwing, you know, you want to be tamping that down, 385 00:31:33.640 --> 00:31:38.119 not throwing gasoline on a fire. Right Now, that doesn't mean you should. 386 00:31:38.440 --> 00:31:42.759 You need to eat a low fat diet. Unsaturated fats, so those 387 00:31:42.759 --> 00:31:48.200 fats that are liquid at room temperature, so fats like olive oil, the 388 00:31:48.240 --> 00:31:52.759 oils and nuts and seeds, oils and fish, avocados, those fats are 389 00:31:53.160 --> 00:31:57.799 perfectly fine to eat. They're at worst neutral, so they're not going to 390 00:31:57.880 --> 00:32:04.279 hurt you. In more people, they upregulate LDL receptors so your LDL levels 391 00:32:04.359 --> 00:32:08.799 fall. They also help raise HDL cholesterol and lower triglyceride, so they give 392 00:32:08.839 --> 00:32:15.480 you an overall better cholesterol profile and their anti inflammatory. The only caveat I'm 393 00:32:15.480 --> 00:32:21.960 going to put around um unsaturated fats is that you should eat them as close 394 00:32:22.039 --> 00:32:24.519 to their original form as possible. So when I'm talking when I say fish, 395 00:32:24.720 --> 00:32:30.200 I mean like you know, broiled or you know, or poach salmon, 396 00:32:30.440 --> 00:32:35.039 I'm not talking you know fish sticks. And I'm talking raw nuts right, 397 00:32:35.240 --> 00:32:39.440 not roasted, salted, you know, barbecue flavored almonds right like that. 398 00:32:39.599 --> 00:32:45.960 I think that's not it because those those unsaturated fats are pretty delicate, 399 00:32:45.039 --> 00:32:50.000 and the more we mess with with the food, the more we potentially the 400 00:32:50.240 --> 00:32:53.960 nature the benefits to those fats and the benefits that they carry, and we 401 00:32:54.079 --> 00:32:58.440 add things that we don't need. Okay, that's the fat story. Well 402 00:32:58.480 --> 00:33:01.559 I also want to just interject one thing, and it's also about using measuring 403 00:33:01.640 --> 00:33:08.759 spoons. Because Marion Nessel, who is uh this heads the NYU Center for 404 00:33:08.799 --> 00:33:14.240 Food Studs and is a right your dietitian. You know, they all have 405 00:33:14.319 --> 00:33:17.799 calories. So it's not like you can just drizzle your olive all all over 406 00:33:17.839 --> 00:33:22.440 the place lavishly, because I think it's a tablespoon of oil no matter what 407 00:33:22.599 --> 00:33:27.759 is about one hundred and twenty calories. Yes, you know, absolutely so, 408 00:33:27.759 --> 00:33:30.839 so thanks for pointing that out, because it's it's you know, there 409 00:33:30.960 --> 00:33:35.079 is a calorie. You know, there is a calorie um you know price 410 00:33:35.200 --> 00:33:37.279 here. So so it's not about drinking a gallon of a you know, 411 00:33:37.640 --> 00:33:42.200 olive oil every day. But but but but if you're if you're going to 412 00:33:42.279 --> 00:33:45.319 have some fat in your diet, it's it should be unsaturated. Right. 413 00:33:45.359 --> 00:33:49.559 Oh oh, quick note about coconut because it comes from plant bas sources. 414 00:33:49.680 --> 00:33:52.599 But it's but it's solid at room temperature. From a cholesterol perspective, it's 415 00:33:52.680 --> 00:33:57.599 much more like beef fat than it is like olive oils so um. You 416 00:33:57.640 --> 00:34:02.599 know, coconut oil is wonderful on your body less so inside your body exactly. 417 00:34:02.640 --> 00:34:05.640 And I'm a big believer. I'm putting it on your body. It 418 00:34:05.720 --> 00:34:07.480 to me it's lotion, but it's not what you want to jest And I 419 00:34:07.559 --> 00:34:14.280 think just that whole visual of if it's a solid room temperature, that kind 420 00:34:14.280 --> 00:34:16.800 of gives it away. Maybe that's not your best bat Yes, yes, 421 00:34:17.440 --> 00:34:24.639 okay, moving onto the carbs. So carbs, you know it's not about 422 00:34:24.639 --> 00:34:30.440 a low carb diet. It is about a very choosy carb diet. So 423 00:34:30.840 --> 00:34:37.400 what you want to avoid are simple processed carbohydrates. You want to just like 424 00:34:37.519 --> 00:34:40.599 for the unsaturated fats, you want to eat your carbs as close to their 425 00:34:40.639 --> 00:34:45.000 original form as possible. So brown rice, not rice crispies, an apple 426 00:34:45.159 --> 00:34:50.159 not apple sauce or apple juice, right, go upstream as far as you 427 00:34:50.239 --> 00:34:57.719 possibly can. And the reason for that is because whether carbs are superprocessed or 428 00:34:57.880 --> 00:35:02.559 whole and unprocessed, all carbo hydrates are ultimately digested and absorbed as sugar. 429 00:35:04.280 --> 00:35:07.320 And it's just kind of how quickly does that digestion happen and how high does 430 00:35:07.360 --> 00:35:13.519 the sugar go? If you eat a bowl of rice crispies. Your body 431 00:35:13.559 --> 00:35:16.440 looks at that and says like child's play, Like I can digest it like 432 00:35:16.480 --> 00:35:22.800 that. I mean, it's just the inner most part of a rice grain. 433 00:35:22.159 --> 00:35:27.639 It's been milled, it's been puffed, it's been extruded. You know, 434 00:35:27.800 --> 00:35:30.239 I'm you know, this is going to take me nothing to digest. 435 00:35:30.280 --> 00:35:32.880 It's predigested for me. And that's what happens. It gets broken down quickly, 436 00:35:32.880 --> 00:35:37.880 absorbed quickly, and your blood sugar spiral upwards. And what happens next 437 00:35:37.960 --> 00:35:43.960 Insulin spikes and insulin is there to put you all the sugar away. But 438 00:35:44.159 --> 00:35:49.639 insulin is a storage hormone. It shifts our body into storage mode. What's 439 00:35:49.639 --> 00:35:54.000 the storage from of cholesterol? LDL? LDL levels go up when insulin levels 440 00:35:54.000 --> 00:36:00.079 are high. What's the non storage from of cholesterol hdl? HDL levels and 441 00:36:00.159 --> 00:36:02.840 be depressed when in some levels are high. What's the storage form of sugar? 442 00:36:04.320 --> 00:36:08.360 It's actually triglysterrides. You can think of our body as having kind of 443 00:36:08.400 --> 00:36:13.519 covered space to put sugar, you know, away, because we need it 444 00:36:13.519 --> 00:36:15.239 in reserve, you know, if you're we needed for instant energy. So 445 00:36:15.280 --> 00:36:20.320 it's good to have some sugar like ready to go, but that covered space 446 00:36:20.440 --> 00:36:23.599 is finite. And and if you just ate a big bowl of rice crispies 447 00:36:23.639 --> 00:36:27.639 and you and your bide just got flooded with sugar, the bid says, 448 00:36:27.679 --> 00:36:30.440 well, okay, I filled, I filled my covers, but I still 449 00:36:30.519 --> 00:36:31.400 all this sugar floating around. What am I going to do with it? 450 00:36:31.800 --> 00:36:36.880 Oh? I know, I'll concentrate it. I'll turn it into fat and 451 00:36:36.920 --> 00:36:40.840 triglystride levels go up. So some of the worst cholesterol profiles I've seen have 452 00:36:40.920 --> 00:36:45.800 been in people who eat a no cholesterol, no fat diet, and they 453 00:36:45.800 --> 00:36:47.480 will say, like, look, zero zero zero on the package. It's 454 00:36:47.480 --> 00:36:51.239 like this is great for me, And I go like, no, you're 455 00:36:51.239 --> 00:36:54.239 eating rice cakes and fat free cookies. You know stop that. You're you're 456 00:36:54.320 --> 00:37:01.840 inadvertently triggering a biochemical response that is completely counterproductive to what you're trying to achieve. 457 00:37:02.599 --> 00:37:06.000 Okay, Now, if you eat the brown rice, right, the 458 00:37:06.039 --> 00:37:09.360 brown rice hits your digestive system and the body looks at and says like, 459 00:37:09.639 --> 00:37:13.679 oh, well, thanks a lot. It's gonna take me a while. 460 00:37:13.920 --> 00:37:15.400 I've got brand, I've got germ. I got to break this down. 461 00:37:15.519 --> 00:37:19.159 It's gonna you know it's gonna take me a while. So instead of blood 462 00:37:19.159 --> 00:37:22.360 sugars you know, just zipping up like crazy, you know, they kind 463 00:37:22.360 --> 00:37:27.639 of go low and slow, so your your insulin levels are much lower and 464 00:37:27.760 --> 00:37:36.559 you're not triggering this counterproductive response. The other thing that whole carbohydrates bring to 465 00:37:36.800 --> 00:37:44.320 the party are fiber and plants, steriles, fiber works. So let me 466 00:37:44.360 --> 00:37:47.440 go back. So there's a natural elimination process for LDL. We didn't talk 467 00:37:47.440 --> 00:37:52.000 about that, and that's related to making bile. So you can think of 468 00:37:52.039 --> 00:37:59.280 a big funnel of LDL coming back to the liver where it gets taken up 469 00:37:59.320 --> 00:38:02.199 and turned to bile, and then that bile gets dumped in the digestive system 470 00:38:02.199 --> 00:38:06.920 when we eat, gets used up in the digestive process, and out it 471 00:38:06.960 --> 00:38:10.519 goes. So that's kind of an exit strategy for LBL. Now, most 472 00:38:10.559 --> 00:38:15.960 of us are pretty efficient and so instead of just letting all that bile run 473 00:38:16.000 --> 00:38:21.440 out, we will reabsorb any bile that doesn't get used up in the digestive 474 00:38:21.440 --> 00:38:23.920 process. We put it back so it's ready for the next meal. Okay, 475 00:38:23.960 --> 00:38:28.239 what does that mean, Well, it means that funnel of LBL doesn't 476 00:38:28.280 --> 00:38:30.920 have to be nearly as big, right, and so we can keep more 477 00:38:30.039 --> 00:38:36.440 LBL floating around in the bloodstream. This is actually the mechanism that the original 478 00:38:36.480 --> 00:38:39.079 cholesterol lowering drugs used. They're not we don't prescribe them anymore, but they 479 00:38:39.119 --> 00:38:45.519 were called bile acid resins and they literally bound violent digestive system and you eliminate 480 00:38:45.559 --> 00:38:50.519 through the stool and it worked. LBL levels dropped. The problem was they 481 00:38:50.519 --> 00:38:52.360 were messy powders. You had to take eight pills a day, People got 482 00:38:52.360 --> 00:38:57.880 digestive upset. It was really very unpleasant. So when statins came along, 483 00:38:57.920 --> 00:39:00.360 like wait, one little pill versus all this, like I'm than that. 484 00:39:00.239 --> 00:39:06.239 So we don't use them much anymore. But the process they were leveraging is 485 00:39:06.719 --> 00:39:10.480 continuing to happen in our body. So back to food and back to whole 486 00:39:10.599 --> 00:39:20.239 unprocessed carbs because they help leverage this mechanism. So whole unprocessed carbohydrates bring fiber 487 00:39:20.280 --> 00:39:25.159 and plant sterols to the party. Fiber works because we can't digest it, 488 00:39:25.239 --> 00:39:29.760 So you get a fiber molecule. Bio acid molecule tries digest it, tries 489 00:39:29.760 --> 00:39:31.840 to suggest it, you know, can't do it, and before it figures 490 00:39:31.880 --> 00:39:35.599 out like I'm not getting anywhere. It's past the point of no return. 491 00:39:35.800 --> 00:39:40.400 So in many ways, fiber acts like those medications. It traps bile in 492 00:39:40.800 --> 00:39:45.840 the digestive system, so you escorted out of your system, so your LBL 493 00:39:45.920 --> 00:39:53.960 levels drop. Plant sterols are natural plant components found in whole, unprocessed foods, 494 00:39:54.000 --> 00:39:59.920 and they're actually the plant version of cholesterol. Remember how I said everything 495 00:40:00.199 --> 00:40:02.199 cell in our cell wall in our body has, you know, has some 496 00:40:02.320 --> 00:40:06.199 cholesterol in it. Well, same thing goes in plants. Plants have their 497 00:40:06.199 --> 00:40:10.079 own cells and cell walls, and they contain their version of cholesterol. And 498 00:40:10.199 --> 00:40:15.800 that sounds crazy, like why would you eat cholesterol the lower cholesterol? But 499 00:40:15.920 --> 00:40:22.280 the reason why this works is because plants steriles are similar but different. They're 500 00:40:22.320 --> 00:40:25.280 similar enough that when they're in our digestive system, the body looks at them 501 00:40:25.320 --> 00:40:29.039 and says like, oh, hey, you're like one of those bile guys. 502 00:40:29.079 --> 00:40:31.000 I'm supposed to be absorbed. Oh you're really important. Here's your absorption 503 00:40:31.039 --> 00:40:35.760 site, welcome back. Well, the plants sterile shows up and it's just 504 00:40:35.960 --> 00:40:39.920 slightly different enough that it can't get through and so it blocks an absorption site, 505 00:40:39.960 --> 00:40:44.880 meaning while behind it has one less storway to get back in and we 506 00:40:44.920 --> 00:40:50.039 waste more bile. So this is why you know, whole food vegans and 507 00:40:50.119 --> 00:40:54.719 vegetarians tend to have significantly lower cholesterol than most of us. They're you know, 508 00:40:54.760 --> 00:40:59.199 they're eating a lot of fiber and plants steriles naturally, so they're really 509 00:40:59.320 --> 00:41:04.760 leveraging this you know, this um you know, elimination pathway. They're also 510 00:41:04.840 --> 00:41:09.559 not triggering that counterproductive insult response because all the carbs they're eating are complex. 511 00:41:09.760 --> 00:41:14.480 Oh and by the way, all their fats or plant baste, right, 512 00:41:14.599 --> 00:41:19.119 so they're so they're not eating saturated fat that's causing the their you know, 513 00:41:19.199 --> 00:41:23.360 receptors to downregulate. So anyway, there you go, watch your fats, 514 00:41:23.440 --> 00:41:29.800 watch your carbs exactly. And you know, when you eat healthy carps, 515 00:41:29.840 --> 00:41:34.280 you're you're fuller longer also, which is important to undercrutely, so you don't 516 00:41:34.360 --> 00:41:36.719 tend to overrate. I mean, you know, oh, I'm going to 517 00:41:37.119 --> 00:41:42.880 zero in on one, you know, oatmeal um to keeps you full for 518 00:41:43.000 --> 00:41:46.639 hours. Yeah, well you know, and I know I had Step one, 519 00:41:46.840 --> 00:41:52.559 the company that you found it that focuses on foods that lower cholesterol. 520 00:41:52.760 --> 00:41:58.320 I sent some samples. I'm not an energy bar girl. But I I 521 00:41:58.360 --> 00:42:01.880 do. I make myself heat oat meal. Here's my tip if you don't 522 00:42:01.880 --> 00:42:06.079 like oatmeal. I don't like hot oatmeal. So what I do is I 523 00:42:06.159 --> 00:42:09.199 make overnight oats. For some reason, I like it with it's chilled and 524 00:42:09.480 --> 00:42:15.079 small, not a big bowl, because you are so full from it versus 525 00:42:15.079 --> 00:42:19.119 hot, which just feels like it's not for me. But so if you 526 00:42:19.159 --> 00:42:23.400 don't like something one way, chill it or sprinkle it, so you have 527 00:42:23.639 --> 00:42:28.679 some that you sprinkle on top of other things. You can sprinkle and it 528 00:42:28.800 --> 00:42:34.280 still provides you fiber and you do feel fuller, because I think that's the 529 00:42:34.360 --> 00:42:36.960 one thing. If I have it oatmeal in the morning, I am. 530 00:42:37.000 --> 00:42:40.239 And I've been doing a lot of weightlifting because I'm also really ramping up the 531 00:42:40.239 --> 00:42:45.480 way I exercise because I plateaud So that's been helping in terms of that. 532 00:42:45.920 --> 00:42:50.639 Another one. You know, there are fruits and vegetables high and fiber. 533 00:42:50.800 --> 00:42:52.840 An apple. You know, there's a reason they say an apple a day, 534 00:42:52.920 --> 00:42:59.320 right, Yes, keep the doctor away. Yeah. So other than 535 00:42:59.599 --> 00:43:07.480 oat meal, and whether you sprinkle it or overnight it or anybody, just 536 00:43:07.519 --> 00:43:16.239 don't happen in a cookie, sugar and everything. Yeah, yeah. Yeah. 537 00:43:16.280 --> 00:43:22.559 What are the other foods that you would recommend that are high end that 538 00:43:22.639 --> 00:43:27.000 are hid fiber um? You know, boy beans, lagus um, you 539 00:43:27.039 --> 00:43:30.239 know, super high end fiber. Actually, avocados are high fiber. People 540 00:43:30.280 --> 00:43:34.199 don't think about that, but they are. And there they also have all 541 00:43:34.199 --> 00:43:37.280 those good fats. So it's another reason why when you eat some guacomole, 542 00:43:37.400 --> 00:43:40.400 you're like, I'm full, like um, so it just don't eat it 543 00:43:40.440 --> 00:43:44.920 with tons of chips. You know, good I to do guacamole? Is 544 00:43:44.960 --> 00:43:51.239 I buy carrot strips? Yeah? Those are my crunch or you can cut 545 00:43:51.320 --> 00:43:57.159 up a cucumber crunch or something that has crunch basically, and when my husband's 546 00:43:57.159 --> 00:44:02.119 eating the chips, I hit for the strips. Yeah, excellent, excellent. 547 00:44:02.239 --> 00:44:07.480 Yeah. So you know, I mean really almost any whole fruit or 548 00:44:07.559 --> 00:44:10.679 vegetable is going to have to have fiber. You know, leafy greens, 549 00:44:10.840 --> 00:44:15.239 you know, high and fiber. It's it's all. Any you know, 550 00:44:15.360 --> 00:44:20.320 any plant based food, so long as its whole is going to is going 551 00:44:20.400 --> 00:44:24.239 to give you fiber. And you know, and and it's only when we 552 00:44:24.360 --> 00:44:30.400 mess with things that that we start to strip those you know, some of 553 00:44:30.400 --> 00:44:34.760 those beneficial that beneficial roughage out. So if you you know, if you 554 00:44:34.800 --> 00:44:38.559 crave orange juice, have the orange instead eat the orange because you know, 555 00:44:38.599 --> 00:44:43.039 the orange juice when you when you squeeze it, you leave the pulp and 556 00:44:43.119 --> 00:44:49.400 piff and and that's that's where the magic is. And if you must buy 557 00:44:49.400 --> 00:44:52.199 orange juice, get it with the pulp of the bed. I'm not a 558 00:44:52.199 --> 00:44:55.440 big juice or I do. I like juice, but I watch sugar like 559 00:44:57.199 --> 00:45:00.280 hawk, so I stay with vegetables. But yeah, again you lose the 560 00:45:00.320 --> 00:45:07.679 fiber aspect of it. So why did you decide to create Step one foods 561 00:45:08.000 --> 00:45:14.800 um which was your product? Just to be clear, I have no affiliation, 562 00:45:15.199 --> 00:45:17.440 but it is it is for people who can't figure it out themselves. 563 00:45:17.840 --> 00:45:23.239 Yeah, yeah, you know, I mean along the way, you know, 564 00:45:23.360 --> 00:45:27.320 I mean literally, you know, we started talking about, you know, 565 00:45:27.360 --> 00:45:30.719 high cholesterol. Here's a phill. Well that's what physicians are taught to 566 00:45:30.800 --> 00:45:35.159 do. And you know, and and and as I look back on my 567 00:45:35.440 --> 00:45:39.039 education, I was educated some pretty you know, some wonderful institutions. Um, 568 00:45:39.079 --> 00:45:45.199 I got the wrong advice. You know. It's the all the things 569 00:45:45.239 --> 00:45:47.880 that I'm treating with drugs, high cholesterol, high blood pressure, you know, 570 00:45:49.000 --> 00:45:52.480 high blood, sugar, um. You know, these are conditions that 571 00:45:52.519 --> 00:45:55.920 are caused in part or in whole by food. And if something is caused 572 00:45:55.920 --> 00:46:00.400 in part or in whole by food, step one should be change change the 573 00:46:00.440 --> 00:46:06.719 food. The problem is that if you're trying to actually influence a you know, 574 00:46:06.840 --> 00:46:09.280 a cholesterol number or blood pressure number, you know, you really have 575 00:46:09.360 --> 00:46:13.320 to know what you're doing, like you know, it's it's not just a 576 00:46:13.360 --> 00:46:19.000 matter of eating better, although that'll help, but but it's really about being 577 00:46:19.039 --> 00:46:23.119 strategic and making sure that you get enough fiber, enough you know, plants, 578 00:46:23.159 --> 00:46:29.199 steriles, enough healthy fats, those Omega three fatty acids, enough antioxids 579 00:46:29.239 --> 00:46:32.760 to actually you know, get a benefit. And this is where it gets 580 00:46:32.840 --> 00:46:37.719 really hard for people because you know, they try, but they just don't 581 00:46:37.920 --> 00:46:40.360 can't do it quite right because it's hard. You know, you're measuring your 582 00:46:40.960 --> 00:46:45.119 you're buying all sorts of ingredients. Things go bad in your fridge. So 583 00:46:45.119 --> 00:46:50.559 so the whole idea behind Step one foods was Okay, let's just make this 584 00:46:50.679 --> 00:46:53.480 easy. You know this this is we know what people need, we can 585 00:46:53.559 --> 00:46:59.599 deliver it in just two small servings of food a day. We don't have 586 00:46:59.679 --> 00:47:02.519 to own your stomach from from morning tonight. We can just you know, 587 00:47:02.559 --> 00:47:07.880 we can just supplement what you're doing with this and then you know, let's 588 00:47:07.880 --> 00:47:12.800 see what happens and lo and behold, you know, people can see just 589 00:47:12.880 --> 00:47:16.280 with this tiny, tiny, little intervention. And the foods by the way, 590 00:47:16.360 --> 00:47:20.920 you know, for for listeners, are snack bars there, you know, 591 00:47:20.960 --> 00:47:23.199 the things that people are eating already, So snack bars, instant oatmeal, 592 00:47:23.880 --> 00:47:28.719 pancake mix, moodie mix. Um. You know, there's there's a 593 00:47:29.039 --> 00:47:30.920 you're talking about a sprinkle. There's like a sprinkle product which you can just 594 00:47:31.039 --> 00:47:35.000 you know, add to like yogurt or something else that you're eating to really 595 00:47:35.039 --> 00:47:38.440 boost the nutritional content of that and kind of gets you to the nutrient levels 596 00:47:38.440 --> 00:47:44.360 you need to affect cholesterol levels. And sorry, go ahead, Yeah, 597 00:47:44.480 --> 00:47:49.079 no, Sprinkles are easy for people that can't deal with other things. Sprinkling 598 00:47:49.159 --> 00:47:51.519 is good, you know, and other things to sprinkler nuts, you know, 599 00:47:51.679 --> 00:47:55.719 unsalted nuts or seeds. You know, we sprinkle a lot on our 600 00:47:55.719 --> 00:48:00.199 salads. We sprinkle a lot on our Sprinkling is good if you're sprinkling right. 601 00:48:00.239 --> 00:48:02.000 Thing. Just don't sprinkle sugar, you know, think about what you 602 00:48:02.000 --> 00:48:07.840 sprinkle. Um, and and it does work, and you know, at 603 00:48:07.880 --> 00:48:10.519 something with oats is good, but again look for stuff that's low and sugar. 604 00:48:10.760 --> 00:48:14.159 We only have about a minute left. I do need to ask you, 605 00:48:14.239 --> 00:48:17.159 is there anything on the front of reducing cholesterol managing it that you're excited 606 00:48:17.199 --> 00:48:24.039 about that hasn't in your crystal ball? Well, you know, my hope 607 00:48:24.840 --> 00:48:29.440 is that while we develop new drugs, and you know, and I'm not 608 00:48:29.440 --> 00:48:32.800 anti drug I prescribe medications all the time. Some patients need them. They're 609 00:48:32.840 --> 00:48:38.079 they're important, they can be life saving. But I hope that in my 610 00:48:38.159 --> 00:48:45.199 lifetime we see a change in the food environment. Look, we we live 611 00:48:45.320 --> 00:48:52.239 in a dysfunctional food environment. We are surrounded by hyperpalatable, calorie dense, 612 00:48:52.559 --> 00:48:59.079 nutrient poor foods that are delicious, made to be addictive, inexpensive, and 613 00:48:59.239 --> 00:49:02.639 advertising NonStop. What could go wrong? Well, what can go wrong is 614 00:49:02.639 --> 00:49:07.239 the health of our country. And you know, and we need a different 615 00:49:07.280 --> 00:49:13.559 path. And I'm hoping that Step one foods can be you know, the 616 00:49:13.599 --> 00:49:20.039 little standard bearer of how we can do things differently and how we can yield 617 00:49:20.519 --> 00:49:23.519 measurable health improvements in as little as thirty days. I mean, our clinical 618 00:49:23.559 --> 00:49:30.480 trial showed that some people had medication level staton level cholesterol reductions with our too 619 00:49:30.599 --> 00:49:37.199 little you know, too little servings a day intervention in thirty days. I 620 00:49:37.199 --> 00:49:39.599 mean, if you're someone who can't tolerate statins, you don't want to take 621 00:49:39.639 --> 00:49:44.119 them. You've tried them and you know they did they didn't you know they 622 00:49:44.119 --> 00:49:46.239 didn't work out for you, Like this could be a game changer, and 623 00:49:46.280 --> 00:49:51.280 you don't need to commit to it forever. It's just thirty days and you 624 00:49:51.320 --> 00:49:53.639 can see whether or not it works for you. Well, I know I'm 625 00:49:53.639 --> 00:49:59.519 doing thirty days right now of working with and I just want to in order 626 00:49:59.599 --> 00:50:04.880 to wrap this appropriately, if you are considering making changes, particularly in your 627 00:50:04.920 --> 00:50:07.239 diet, make sure you do it with the advice and the consent of your 628 00:50:07.360 --> 00:50:12.199 primary care physician. So and don't do anything dramatic. I mean, I've 629 00:50:12.239 --> 00:50:16.639 consulted with my doctors, my gastroentologists because I had some GI issues and my 630 00:50:16.719 --> 00:50:22.320 PCP before I even started adjusting things in my diet. And I have a 631 00:50:22.360 --> 00:50:24.920 pretty healthy diet as is, but we're testing a few things to take out 632 00:50:25.440 --> 00:50:30.000 to see if it will help the GI track. And I also ramped up 633 00:50:30.039 --> 00:50:32.679 my exercise. So the bottom line is you have the power within you, 634 00:50:32.719 --> 00:50:37.039 because I say at the endividually, you have the power within you blend of 635 00:50:37.079 --> 00:50:42.039 the good Witch to make the changes you want to stay healthy for the long 636 00:50:42.159 --> 00:50:45.559 term. But you have to do it today, and you have to commit 637 00:50:45.599 --> 00:50:50.239 to it, and you have to do it in cooperation with the people that 638 00:50:50.320 --> 00:50:54.320 are your board of advisors, which are your physicians, and you have to 639 00:50:54.639 --> 00:51:00.280 make the change. I want to thank you again, doctor Elizabeth Clotas, 640 00:51:00.679 --> 00:51:06.920 who is a board certified cardiologist, for sharing your expertise today on Fearless Fabulous 641 00:51:06.960 --> 00:51:08.760 Shoe. I think it was very helpful. I thought you opened a lot 642 00:51:08.760 --> 00:51:13.960 of answered a lot of questions about cholesterol. You know, listen to the 643 00:51:14.079 --> 00:51:20.079 doctor, not doctor Google. Get your information from credible sources, and that's 644 00:51:20.119 --> 00:51:22.800 what I ask everybody to do. And don't share things that you are not 645 00:51:23.000 --> 00:51:28.960 expert in. Listen to experts. You've been listening to Fearless Fabulous Shoe. 646 00:51:29.079 --> 00:51:31.039 I hope you enjoy this. You can listen to all my shows on iHeart, 647 00:51:31.119 --> 00:51:36.679 Spotify, Apple On about thirty five other podcasts on demand anytime, so 648 00:51:36.880 --> 00:51:40.159 check it out and check me out at Melanie Young dot com and Melanie Fabulous. 649 00:51:40.199 --> 00:51:44.400 I thank you again for joining me, Doctor Clotis, and to all 650 00:51:44.480 --> 00:52:05.199 my listeners you got this day fearless and fabulous cast to play usual Ton