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Speaker 3: Well, hello, and welcome to Fearless Fabulous You. I am
Speaker 3: your host, Melanie Young, and welcome to what's starting to
Speaker 3: be my tenth season. Ten years that I have been
Speaker 3: hosting this show. Wow, amazing, how far I've come. This
Speaker 3: shows started as a way to empower women to take
Speaker 3: charge of their health because I had recovered from breast
Speaker 3: cancer and was rethinking my health and how I took
Speaker 3: care of myself as well as what I wanted to
Speaker 3: do with my life. And from that I wrote a
Speaker 3: book called Fearless Fabulous You, Lessons on Living Life on
Speaker 3: your Terms and thought, how am I going to promote
Speaker 3: this book? And I said, oh, I'm going to show
Speaker 3: our show called Fearless, Fabulous You and find amazing women
Speaker 3: to interview about how we all can live life on
Speaker 3: our terms in good health. So if you do follow me,
Speaker 3: you know that heart health is a recurring theme. I
Speaker 3: always do at least two shows on heart health and
Speaker 3: other health topics at least in one season, and today
Speaker 3: we're going to address it again. I have hit the
Speaker 3: ripe old age of over sixty. I'm north of sixty,
Speaker 3: and I have learned, as many of my friends and
Speaker 3: funds and followers also north of sixty, that your metabulism
Speaker 3: just changes. It stactually starts chase in your fifties, but
Speaker 3: it keeps changing. And a recent visit to my primary
Speaker 3: care physician, because I am very good at going to
Speaker 3: all my scheduled Dutch's appointments, revealed that my cholesterol was
Speaker 3: a bit high and my weight was definitely too high
Speaker 3: for my small frame. And granted, I live a life
Speaker 3: of incredible travel and eating and drinking good food and
Speaker 3: writing about wine, reporting on all that on my other show,
Speaker 3: That Connected Table, but it was kind of a wake
Speaker 3: up call, particularly after knowing that I have heart disease
Speaker 3: in my family. My grandmother died of of cardiac arrest
Speaker 3: very suddenly, and my father had ongoing heart issues which
Speaker 3: resulted in a quintuple bypass surgery and a stent. It's
Speaker 3: not what ultimately did him in he died of metastasized
Speaker 3: prostate cancer. But knowing that I have a family history
Speaker 3: of heart condition, and knowing that my cholesterol was high,
Speaker 3: and knowing that my weight was even higher, I gave
Speaker 3: myself a six week turnaround plan. Obviously, nothing really can happen.
Speaker 3: Everything can't be achieved in six weeks, but you can
Speaker 3: make headway. And I'm a believer that you do this
Speaker 3: by diet and exercise. In Changing habits doesn't mean giving
Speaker 3: up everything you love, particularly if it's what pays your bills,
Speaker 3: like wine and wine writing. But it means moderation and
Speaker 3: making smarter decisions. So I am going to be addressing
Speaker 3: this today with an expert on my show. We're going
Speaker 3: to be speaking with doctor Elizabeth Klotus, who is a
Speaker 3: BORED certified practicing cardiologist, founder of the Preventative Cardiology Clinic
Speaker 3: near Minneapolis, Minnesota, and she trained at Mayo Clinic and
Speaker 3: John Hopkins. She's got a off of information She's also
Speaker 3: founder and chief medical officer of Step one Foods, which
Speaker 3: we will discuss at the end of the show is
Speaker 3: foods that are to help with managing lowering your cholesterol.
Speaker 3: Which we're going to talk about what you know you
Speaker 3: should be eating, and I always hate talking about what
Speaker 3: you should not be eating, but we're going to talk
Speaker 3: about adding in more because it's about crowding out bad
Speaker 3: stuff and adding in good stuff. Before we get into
Speaker 3: the conversation, I did, like I always do, I popped
Speaker 3: on over to the Center of Disease Control CDC website
Speaker 3: to get some facts to set this up. Cholesterol high.
Speaker 3: Total cholesterol in the United States is pretty big topic.
Speaker 3: Between twenty seventeen and twenty twenty recent stats, ten percent
Speaker 3: of adults age twenty year older had total cholesterol levels
Speaker 3: above two forty milligrams, and about seventeen percent had high
Speaker 3: debts to high density lipoprotein HDO or good cholesterol levels
Speaker 3: below forty milligrams. It's a a lot of technical talk
Speaker 3: for some of you, so I'll let the doctor weigh in.
Speaker 3: But here's the thing. In summary, high cholesterol has no symptoms,
Speaker 3: so many people don't even know that their cholesterol is
Speaker 3: too high. We're going to talk about how you can
Speaker 3: check it. We're also going to talk about why it
Speaker 3: matters because, according to the CDC, having high cholesterol raises
Speaker 3: the risk for heart disease, the leading cause of death
Speaker 3: and stroke the fifth leading cause of death stroke and
Speaker 3: for women, heart disease and cardiac arrests is like number
Speaker 3: one as from per the American Heart Association. So women
Speaker 3: have a high risk for heart disease and often, as
Speaker 3: I have explained on this show, symptoms are not like
Speaker 3: men and they're different. So we're going to dive into
Speaker 3: all this, and most importantly the takeaway is what can
Speaker 3: you do starting now to maintain a healthy cholesterol for
Speaker 3: you through lifestyle changes. So, doctor Elizabeth Klotis, Liz, as
Speaker 3: you said before we went on, welcome to Fearless, Fabulous.
Speaker 4: You, Oh Melanie, thank you so much for having me.
Speaker 4: I'm excited to be here with you. And honestly, as
Speaker 4: I was listening to the intro, we you know we
Speaker 4: could sit down and have coffee and talk about this
Speaker 4: for hours because our I think approach to heart disease
Speaker 4: prevention and interest in this area obviously is very much
Speaker 4: on the same page. So I really look forward to
Speaker 4: our conversation today.
Speaker 3: Absolutely. You know, I always like to start with a
Speaker 3: little backstory because I like to explain who my guests are,
Speaker 3: which I semi did. But I am curious why you
Speaker 3: decided to become a cardiologist. Was there something in your
Speaker 3: own life that said I want to You know, there's
Speaker 3: always a reason you become a doctor, and it is
Speaker 3: a long road, and becoming a specialist is that even
Speaker 3: longer road? So what inspired you?
Speaker 4: Well, yeah, the long road is for sure true. I
Speaker 4: mean from the time I graduated high school, they to
Speaker 4: the time I hung up my cardiology shingle was fourteen
Speaker 4: years of uninterrupted education. So it's a it's a very
Speaker 4: long road to get here. And actually it's interesting because
Speaker 4: I didn't get here kind of the way a lot
Speaker 4: you know, I didn't pick the specialty the way a
Speaker 4: lot of people pick their specialties. Right, they had you know,
Speaker 4: they broke their leg when they were young, so they
Speaker 4: became an orthopedic surgeon, or you know, their mom had
Speaker 4: cancer so they became an oncologist. Actually, my just like
Speaker 4: in your family have a history of cancer, you're a
Speaker 4: personal history of cancer. My my family is cancer everywhere
Speaker 4: and yet that's not that's not why it's and I
Speaker 4: didn't become an oncologist. I chose cardiology honestly because of
Speaker 4: a mentor that I had during medical training. It's you know,
Speaker 4: I did a rotation on cardiology when I entered internal medicine.
Speaker 4: Because it's a it's a layered uh, it's a layered
Speaker 4: education process. First, you you know, do your medical school,
Speaker 4: then you do an intro interro medicine residency, and then
Speaker 4: you specialize and go on to cardiology, which then you
Speaker 4: can further sub specialize into things like electrophysiology or congestive
Speaker 4: heart failure, you know, transplant management, things like that. Anyway,
Speaker 4: but it was literally on the first day of my
Speaker 4: cardiology rotation that uh, that my mentor inspired me. He
Speaker 4: he just his peers batter. He's he's retired, but this
Speaker 4: was a male clinic, and he just made every single
Speaker 4: patient and every single cardiology problem seemed fascinating and and
Speaker 4: it's an amazing thing, feeled. I mean, the heart is
Speaker 4: a miracle if you think about it. I mean, it beats,
Speaker 4: it pumps blood, you know, just all on its little like,
Speaker 4: all on its little alone, sixty times a minute. Sixty
Speaker 4: minutes an hour, twenty four hours a day, seven days
Speaker 4: a week, fifty two weeks a year, for you know,
Speaker 4: a hundred years. It just keeps going. It's amazing. There's
Speaker 4: there's no engine that does that.
Speaker 3: So right, quite an engine. And it is, you know,
Speaker 3: what keeps us living because technically, if your heart isn't beating,
Speaker 3: you're dead. You know, you could be brain dead, but
Speaker 3: your heart can keep beating, right.
Speaker 4: Yeah, it's a it's an obviously it's an incredibly important organ.
Speaker 4: And you know, and I think the other thing honestly
Speaker 4: that attracted me to cardiology is because you can do
Speaker 4: so much, you know there, you know you can, and
Speaker 4: it's and it's such a wide breadth of almost subspecialties
Speaker 4: within cardiology. You can almost be a you know, a
Speaker 4: radiologist in some sense and read heart ultrasounds and heart
Speaker 4: sets and heart MRIs. Or you can be almost a
Speaker 4: surgeon and an insert stance and you know, or you know, pacemakers.
Speaker 4: You can you know, be like what I what I do,
Speaker 4: which is be on the prevention end. And actually my
Speaker 4: hope is to put myself out of work is so
Speaker 4: people don't don't need us anymore.
Speaker 3: So I always said that when I wrote my book
Speaker 3: to help women diagnose with breast cancer, I hope no
Speaker 3: one ever has to buy my book. You know, you know,
Speaker 3: it's amazing, doctor clot Is, that we take our hearts
Speaker 3: for granted. You know, we talk about women talk about love.
Speaker 3: They're always looking for love, They're always looking for their soulmate.
Speaker 3: They're always you know, expressing themselves and you know, I
Speaker 3: love you and emoging their heart. But we mistreat it
Speaker 3: by not taking care of it. And it is really
Speaker 3: the beating heart is what defines you as living. And
Speaker 3: if you've ever held someone like I have, who watch
Speaker 3: their the heartbeat die, which I did with my mother,
Speaker 3: I watched her heartbeat die, it is a very powerful
Speaker 3: thing to watch someone who is dying and the last
Speaker 3: thing you see is a beating heart. It is the
Speaker 3: last thing to go. And we take it for granted,
Speaker 3: don't you agree? I, you know, very much so.
Speaker 4: And I think it's because it just kind of keeps
Speaker 4: doing its job right and and it can take an
Speaker 4: awful lot of abuse, which is you know, which is
Speaker 4: which is amazing. And again, our bodies are so incredibly resilient,
Speaker 4: but at some point we you know, we exceed the
Speaker 4: capacity of our bodies to make up for what we're doing.
Speaker 4: And that's why it's so important to start early in
Speaker 4: terms of your prevention efforts, because both the building of
Speaker 4: disease or the prevention of disease are cumulative of you know,
Speaker 4: those those efforts or those habits, you know, multiply over time.
Speaker 4: And you're right in terms of women, this is our disease.
Speaker 4: You know, we we think about and you've had breast cancer.
Speaker 4: So I don't in any way want to diminish breast
Speaker 4: cancer as a you know, as a as a health threat.
Speaker 4: It's a terrible disease. It takes, it takes a lot
Speaker 4: of women's lives. But you know, one out of thirty
Speaker 4: women will die from breast cancer, one out of three
Speaker 4: will die from heart disease. So so heart disease is
Speaker 4: our disease, and it is almost entirely preventable. Eighty percent
Speaker 4: of it need not exist. And you know, a family
Speaker 4: history is a risk factor for sure, but family history
Speaker 4: genetics are not destiny. Genetics are a you know, a
Speaker 4: risk factor. They add about twenty percent. They account for
Speaker 4: about twenty percent of your risk, which means eighty percent
Speaker 4: is something you have some control over if you have
Speaker 4: family history. Right, you're starting a little bit behind an
Speaker 4: eight ball, but it doesn't mean you're fated to this.
Speaker 4: And this is an avoidable.
Speaker 3: Disease, absolutely, and with all risk predenttion. I like to
Speaker 3: start with I have a little quadrant, but the two
Speaker 3: big ones nutrition and movement. I never say exercise, I
Speaker 3: say movement, but it's exercise, and those are the two
Speaker 3: that can help reverse a lot of damage. But you
Speaker 3: do have to start early. And what's interesting is so
Speaker 3: many parents should be aware that it starts with, you know,
Speaker 3: teaching good habits as children to their children, so that
Speaker 3: you know they're not sedentary, they're not eating the wrong foods,
Speaker 3: they're eating balanced diets, and they're leading an active life.
Speaker 3: I want to this show is about cholesterol because a
Speaker 3: lot of people don't even understand what cholesterol is. And
Speaker 3: it is a big term, and there's different terms. So
Speaker 3: I want you to define the different types of cholesterol
Speaker 3: because people here there's good cholesterol, people here there's bad cholesterol.
Speaker 3: They hear of diet here. There's a lot of terms.
Speaker 4: Yeah, so first of all, just in general, what is cholesterol, Well,
Speaker 4: cholesterol is a waxy fat like substance that can be
Speaker 4: found in all sorts of places inside our body. Every
Speaker 4: cell wall of every cell within our bodies has some cholesterol.
Speaker 4: We use cholesterol to make hormones, bile acids, vitamin D,
Speaker 4: and other substances, so cholesterol is actually important for our
Speaker 4: body structure and function. The problem is, if there's too
Speaker 4: much cholesterol circulating in the blood stream, some of the
Speaker 4: excess it can become trapped in artery walls, and this
Speaker 4: build up is called plaque. And if enough of it accumulates,
Speaker 4: that plaque can narrow blood vessels and make them less flexible,
Speaker 4: causing what's you know, typically referred to as hardening of
Speaker 4: the arteries. And it is this process, that accumulation of
Speaker 4: plaque in our arteries that leads to these potentially devastating
Speaker 4: health events like heart attacks and strokes or the need
Speaker 4: for procedures such as you know, bypass surgery and stents.
Speaker 4: So it's a you know, this is a progressive disease.
Speaker 4: And to your point, it starts early. You know, autopsy data,
Speaker 4: this this build up of gunk inside our arteries, it
Speaker 4: starts very early. You know, in autopsy studies performed on
Speaker 4: soldiers killed in the Korean and Vietnam War. So these
Speaker 4: are young men in their twenties and thirties. They were
Speaker 4: already seeing significant plaque build up when autopsies done are
Speaker 4: on children. What a tragic thing to do an autopsy
Speaker 4: on a child. But we're starting to find the earliest
Speaker 4: precursors of plaque in children as young as ten. So
Speaker 4: the earlier we start with preventive measures, the better. Okay, Now, cholesterol,
Speaker 4: so we talked about kind of what it is generally
Speaker 4: the way to You can't, for the most part, feel
Speaker 4: that you have high cholesterol. By the time you feel
Speaker 4: things like a heart attack stroke bypester, you've had cholesterol
Speaker 4: for an high cholesterol pH an offully long time. Really,
Speaker 4: the only way to know if you have an abnormal
Speaker 4: cholesterol profile is to get checked with a blood test,
Speaker 4: and when you do that, you will get four numbers.
Speaker 4: One is the total cholesterol, and then you'll get HDL cholesterol,
Speaker 4: LDL cholesterol, and triglyceterides. Okay, total cholesterol. The total cholesterol
Speaker 4: is the sum of all the cholesterol in your body,
Speaker 4: so it's kind of everything that's below the line. Those
Speaker 4: three other numbers. Those three other numbers make up the
Speaker 4: total cholesterol. The total cholesterol should typically be under two hundred.
Speaker 4: It's malograms per deest leader or the units, but we'll
Speaker 4: stop talking about the units because they're all the same anyway.
Speaker 4: It should be under two hundred. But the total cholesterol
Speaker 4: is actually less important than what it's made up out of, right,
Speaker 4: because I just said there's good cholesterol, bad cholesterol, trigolystrides,
Speaker 4: and you can have various combinations of those three things
Speaker 4: and end up with the same total but with very
Speaker 4: different health implications. Okay, let's start with good cholesterol HDL.
Speaker 4: HDL is the good cholesterol. It's the happy cholesterol. You
Speaker 4: want to keep it high if it helps you remember
Speaker 4: which is which. HDL is the cholesterol that is not
Speaker 4: depositing in our arteries. It's on its way out. So
Speaker 4: you actually want this number as high as possible. In women,
Speaker 4: we're happy to see it should be over fifty, so
Speaker 4: you know that's where you should be. If you have
Speaker 4: an HDL cholesterol under fifty, that's its own risk factor
Speaker 4: for earlier atherospherosis, so it should be over fifty. LDL
Speaker 4: is the bad stuff. This is the cholesterol that's potentially
Speaker 4: depositing in our arteries. It's the lousy cholesterol. You want
Speaker 4: to keep it low. This is the cholesterol that you know,
Speaker 4: all physicians obsess over because LDL cholesterol is most tightly
Speaker 4: linked to heart disease risk. It's almost you know, a
Speaker 4: linear line between LDL and heart disease risks. So the
Speaker 4: higher it is, the higher your risk. Most cardiologists, actually
Speaker 4: all cardiologists would say, you know, everyone should be under
Speaker 4: one thirty for LDL as you accumulate risk factors, and
Speaker 4: that could be a family history of heart disease, or
Speaker 4: you have high blood pressure, you're a smoker. At some point,
Speaker 4: under one hundred would be better. Once you have documented
Speaker 4: heart or vascular disease, so you've had a heart attack
Speaker 4: or stroke or bypasser to your stent, your LDL should
Speaker 4: fall under seventy. Now the vast majority of us will
Speaker 4: require medications to get there, and there's even data to
Speaker 4: show that under fifty is additionally protective. So the main
Speaker 4: message around LDL is the lower, the better. The last
Speaker 4: component of a cholesterol profile are the triglycerides. Triglycerides are
Speaker 4: not much of a cholesterol particle. They're actually mostly fat,
Speaker 4: So if you try to add up the three numbers,
Speaker 4: you won't get to the total. It doesn't add up right.
Speaker 4: So the formula is actually good cholesterol plus bad cholesterol
Speaker 4: plus one fifth of the triglycerides gets you to the total.
Speaker 4: Triglyceride levels should be under one fifty in everyone, But
Speaker 4: the range of triglycerides is very broad, so it's just
Speaker 4: a different animal. It lives on a different scale. The
Speaker 4: lowest triglycerides I've ever seen and someone on no medications
Speaker 4: is twenty seven. But the highest I've ever seen is
Speaker 4: in the thousands. So it's a ginormous range. But everyone
Speaker 4: should be under one fifty. Triglycerides on their own are
Speaker 4: not much of a risk factor for heart disease per se.
Speaker 4: They tend to be more of an indicator of metabolic health.
Speaker 4: You know, the higher your triglycerides are, the more likely
Speaker 4: things are out of whack. You know your weight's not right,
Speaker 4: you're eating poorly, you're not exercising, you're drinking too much.
Speaker 4: You know that triglycerides will give you up, like they'll
Speaker 4: be the first ones to rise and say like something's
Speaker 4: not quite right here.
Speaker 3: That makes a lot of sense, So just to recap LDL.
Speaker 3: You want your LDLs low, right, Yes, you want your
Speaker 3: HDLs high mm and you want your triglycerides low yep. Right,
Speaker 3: And you should go to the doctor like I do
Speaker 3: with a shopping list. I go with a checklist. Now't
Speaker 3: ever go to your doctor unless you have a checklist.
Speaker 3: And I have a checklist. If everything I want check
Speaker 3: because I swear if they if I don't have that,
Speaker 3: then won't do it. So you got to go in
Speaker 3: there and demand that you get all the necessary tests
Speaker 3: so that you can have them as a benchmark and
Speaker 3: read the results because you get them in your portal.
Speaker 3: It's it's your benchmark to see what you need to
Speaker 3: do if you need to do any adjusting. Now, the
Speaker 3: logical way that these get adjusted from a physician standpoint
Speaker 3: is to prescribe medication.
Speaker 4: Right yep, high cholesterol. Here's a pill.
Speaker 3: And that would normally be what.
Speaker 4: That would normally be a statin. So this these are
Speaker 4: you know, medications that most people are familiar with because
Speaker 4: they've heard them, because they're because they're so frequently prescribed.
Speaker 4: The original ones were you know, called lipatour and crust store.
Speaker 4: Now they're all basically all generic, so that for maybe
Speaker 4: a torvas dat YEP or suba STAT and SIMBA STAT
Speaker 4: and so that. So that's the category of girls. It's
Speaker 4: actually the most widely one of the most widely prescribed
Speaker 4: drug categories on the.
Speaker 3: Planet, exactly besides annadepressants and most of the relaxers. I
Speaker 3: could go on, because I do have and I do
Speaker 3: like my primary care physician, but he loves to prescribe things,
Speaker 3: and I hate taking pills. So my husband's taking satins.
Speaker 3: I'm not because I I don't. So there's a big
Speaker 3: reason I don't like taking drugs, prescription medication unless absolutely necessary.
Speaker 3: And the biggest reason is that I write about wine.
Speaker 3: It is a job, and I know that there are interactions,
Speaker 3: and I read interactions carefully. I also know that you
Speaker 3: can't operate a car, and there are certain things that
Speaker 3: affect your decision making. And I am one of those
Speaker 3: people who does not do well on prescription medication. I
Speaker 3: get foggy. I have had reactions from itching to brain
Speaker 3: fog to whatever. I also know that you have to
Speaker 3: be very careful if you drink wine, you've got to
Speaker 3: watch that, and if you're oper aning machinery. So for me,
Speaker 3: very few work and my mother was the same way.
Speaker 3: She would have reactions. You've got to be very careful.
Speaker 3: It's not that they're bad. You have to do what's
Speaker 3: right for you. My husband is taking a stat However,
Speaker 3: I'm a big believer that you you know, change a
Speaker 3: start with you and not what you pop. And it's
Speaker 3: not the pill you pop in your mouth, but the
Speaker 3: food you pop in your mouth. And if you want
Speaker 3: to get rid of the gunk, get rid of the junk.
Speaker 4: Could not have said it better myself. I'm going to
Speaker 4: use that line. Okay, pray.
Speaker 3: I do like to speak, but that is something I
Speaker 3: say quite a bit, and you know, I'm a big
Speaker 3: believer in it. It's hard, it's not easy to follow.
Speaker 3: But you go into the doctor and you find out
Speaker 3: you're twenty five pounds overweight in your cholesterol sigh, you go,
Speaker 3: I think I'm going to do something about it because
Speaker 3: I don't want to get sick. So again, this is
Speaker 3: a blood test. Anyone can have it. Is there a
Speaker 3: certain age that people should be starting to get their
Speaker 3: cholesterol check or should just be part of your Yeah.
Speaker 4: So actually, you know, it's it's recommended that the first
Speaker 4: cholesterol check happened in childhood and and you know a
Speaker 4: good rule of thumb. And this isn't exactly you know,
Speaker 4: like the you know, US Preventive Services Task Force would say,
Speaker 4: but it's close enough and it's really easy to remember
Speaker 4: once you know, before you turn ten, you know, twice
Speaker 4: in your or sorry, once in your teens, twice in
Speaker 4: your twenties, you know, three times in your thirties, four
Speaker 4: times in your forties, at least every other year in
Speaker 4: your fifties, and then yearly sixty onwards. So it's you know,
Speaker 4: it's it's something that should increase in prextent. It assumes
Speaker 4: your your your numbers are normal, right, you may need
Speaker 4: more free checks if they're abnormal or you're being started
Speaker 4: on a therapy or you're using diet to modify this,
Speaker 4: so then then you're going to need more frequent assessment.
Speaker 4: But but if otherwise everything looks good, that's that's a
Speaker 4: pretty good way to think about it, and it's easy
Speaker 4: to remember.
Speaker 3: Also if you're having life changes. I am going to
Speaker 3: safely assume that if you're pregnant, or you're going through menopause,
Speaker 3: or you're in some kind of treatment, that you have
Speaker 3: to watch things because there are certain types of things
Speaker 3: that will increase your cholesterol based on that.
Speaker 4: Yeah. Yeah, so so with pregnancy we can see changes
Speaker 4: in cholesterol, but honestly, we don't really measure cholesterol during
Speaker 4: this time. We don't do anything about it because there
Speaker 4: are no safe treatments for cholesterol during pregnancy, not because
Speaker 4: they're they're intrinsically unsafe, it's just they've not been tested
Speaker 4: and so, you know, and this is actually a big
Speaker 4: problem in general for women who are are pregnant or
Speaker 4: of child bearing age. They're typically excluded from all trials,
Speaker 4: right because no one, no one wants to you know,
Speaker 4: do anything that could in any way potentially you know,
Speaker 4: hurt the fetus. So so we have a big gap
Speaker 4: in knowledge as to what to do, you know, in
Speaker 4: in that patient population. But you know, once you're once
Speaker 4: you're you know, you're not going to have any more children,
Speaker 4: you're using contraception, or you're you know, past past reproductive age,
Speaker 4: you know that obviously we can use all sorts of medications.
Speaker 4: There's there's all sorts of options for that, which is
Speaker 4: where diet becomes really important, you know, for for women
Speaker 4: during their reproductive years, and lifestyle becomes really important. In
Speaker 4: terms of menopause. Boy, that is a big time where
Speaker 4: cholesterol profiles can change. So remember at the beginning, I said,
Speaker 4: you know, we use cholesterol for all sorts of things,
Speaker 4: right to make cell walls, to make hormones, to make
Speaker 4: file well in order to use that. The truth is
Speaker 4: we can actually make most of the cholesterol we need
Speaker 4: for those functions inside our cells. We actually don't need
Speaker 4: a lot of circulating LDL cholesterol to be around to use.
Speaker 4: But if we're if we're going to use, but if
Speaker 4: it's out there and in the bloodstream, it's kind of
Speaker 4: like sound money, like one of both making it inside.
Speaker 4: When you just grab it, you know, take it inside
Speaker 4: the cell and use it for what you need. But
Speaker 4: in order to grab it, you need a receptor and
Speaker 4: that receptor has to be primed and active to pick
Speaker 4: up an LDL particle, so bad cholesterol particle from you know,
Speaker 4: from the storage time, from from the bloodstream and bring
Speaker 4: it inside the cell. Okay, Estrogen up regulates LDL receptors.
Speaker 4: It makes them way more active. So when we have
Speaker 4: estrogen around, our LDL levels are lower. Our cholesterol, especially
Speaker 4: that the bad cholesterol levels are lower because we're very
Speaker 4: efficient at grabbing it from our bloodstream and bringing it
Speaker 4: inside ourselves. When we lose estrogen during menopause, you know,
Speaker 4: when we go through menopause, that that protective sort of
Speaker 4: booster for those LDL receptors goes away, and all of
Speaker 4: a sudden, we're left with kind of lazy LDL receptors.
Speaker 4: And so what a lot of women experience is like, wait,
Speaker 4: my weight's the same, I'm exercising the same, I'm eating
Speaker 4: the same stuff, and my ld all just went through
Speaker 4: the roof your It's that estrogen loss is what happened.
Speaker 3: Wow, that's interesting. I have no ESG because I went
Speaker 3: through menopause and I had estrogen receptor positive cancer, so
Speaker 3: they blasted me with romats inhibitors. So I have no estrogen,
Speaker 3: although I feel very president and fabulous. But you know,
Speaker 3: that's probably another reason why my cholesterol went a little off.
Speaker 3: But like I said, it's under control. But it was off.
Speaker 3: But a lot of it was lifestyle. So let's talk
Speaker 3: about diet. First of all, exercise is critical. It goes
Speaker 3: hand in hand with diet. You really can't do one
Speaker 3: without the other. They are the Handsle and Gretel. They
Speaker 3: are the tweetlede and tweedled dumb. They work together. You
Speaker 3: can't just exercise and keep eating what you want, and
Speaker 3: you can't just you know, stop eating in that exercise.
Speaker 3: They are essential. There are other things as well, right, sleep,
Speaker 3: stress management, your mental health. Those are all the not
Speaker 3: the milking exactly, but it's really critical. So let's talk
Speaker 3: about diet because there are foods that can help lower cholesterol.
Speaker 3: It's not they're not magic pills, but they are easy
Speaker 3: to add into a diet and to replace other things. Right,
Speaker 3: So give us some examples.
Speaker 4: Okay, so I'll talk a little bit more in generality
Speaker 4: for more categories of foods. So the things that influence
Speaker 4: and I'm just going to focus on LDL because that's
Speaker 4: the particle where really, you know, laser, you know, laser
Speaker 4: focused on in cardiology. So the things that are going
Speaker 4: to impact your LDL level from a dietary perspective are
Speaker 4: going to be the types of fats you eat and
Speaker 4: the types of carbs you eat. It has very little
Speaker 4: to do with how much cholesterol you consume. It has
Speaker 4: very little to do with how much protein you consume.
Speaker 4: So you can kind of leave those those two things
Speaker 4: to the side. So let's do the fats first. The
Speaker 4: fats that you should be avoiding are saturated fats. Those
Speaker 4: are fats that are solid at room temperature. They come
Speaker 4: primarily from animal sources butter, cheese, the marbling, and beef,
Speaker 4: the fat and chicken. Saturated fats at best are going
Speaker 4: to be neutral, meaning they're not going to help you.
Speaker 4: In many people, they raise LDL cholesterol, and they do
Speaker 4: that through kind of the same way as losing estrogen.
Speaker 4: They downregulate LVL receptors, and in some people that can
Speaker 4: be a really profound effect. Like you know, some people
Speaker 4: go on a keto diet and their LDL goes through
Speaker 4: the roof. So saturated fats are going if anything, they're
Speaker 4: going to raise LDL. They're also pro inflammatory, and all
Speaker 4: of these things that we're actively trying to avoid, cancer, dementia,
Speaker 4: heart disease, these are all driven in part by inflammation.
Speaker 4: So you don't want to be throwing you know, you
Speaker 4: want to be tamping that down. You're not throwing gasoline
Speaker 4: on a fire. Right now, that doesn't mean you should.
Speaker 4: You need to eat a low fat diet. Unsaturated fat,
Speaker 4: So those fats that are liquid at room temperature, so
Speaker 4: fats like olive oil, the oils and nuts and seeds,
Speaker 4: oils and fish, avocados. Those fats are perfectly fine to eat.
Speaker 4: They're at worse neutral, so they're not going to hurt you.
Speaker 4: In most people. They upregulate LDL receptors so your LDL
Speaker 4: levels fall. They also help raise HDL cholesterol and lower triglystride,
Speaker 4: so they give you an overall better cholesterol profile, and
Speaker 4: they're anti inflammatory. The only caveat I'm going to put
Speaker 4: around unsaturated fats is that you should eat them as
Speaker 4: close to their original form as possible. So when I'm
Speaker 4: talking when I say fish, I mean like you know,
Speaker 4: boiled or you know, or poach salmon, I'm not talking
Speaker 4: you know fish sticks. And I'm talking raw nuts right,
Speaker 4: not roasted, salted, you know, barbecue flavored almonds, right like that.
Speaker 4: That's not it, because those those unsaturated fats are pretty delicate,
Speaker 4: and the more we mess with with the food, the
Speaker 4: more we potentially the nature the benefits those fats and
Speaker 4: the benefits that they carry, and we add things that
Speaker 4: we don't need. Okay, that's the fat story.
Speaker 3: Well, I also want to just interject one thing. It's
Speaker 3: also about using measuring spoons because Marion Nessel, who's the
Speaker 3: heads the NYU Center for Food Studies and is a
Speaker 3: is a righteter dietitian. You know, they all have calories.
Speaker 3: So it's not like you can just drizzle your olive
Speaker 3: oil all over the place lavishly, a tablespoon of oil,
Speaker 3: no matter what is about one hundred and twenty calories.
Speaker 4: Yes, no, absolutely, so thanks for pointing that out, because
Speaker 4: it's it's you know, there is a calorie. You know,
Speaker 4: there is a calorie you know price here. So so
Speaker 4: it's not about drinking a gallon of you know, olive
Speaker 4: oil every day. But but but if you're if you're
Speaker 4: going to have some fat in your diet, it's it
Speaker 4: should be unsaturated. All quick note about coconut because it
Speaker 4: comes from plant, these sources, but it's but it's solid
Speaker 4: at room temperature. From a cholesterol perspective, it's much more
Speaker 4: like beef fat than it is like olive oil. So
Speaker 4: you know, coconut oil is wonderful on your body less
Speaker 4: so inside your body exactly.
Speaker 3: And I'm a big believer in putting it on your body.
Speaker 3: To me, it's lotion, but it's not what you want
Speaker 3: to ingest and I think just that whole visual of
Speaker 3: if it's solid room temperature, that kind of gives it away.
Speaker 3: Maybe that's not your best fat.
Speaker 4: Yes, yes, okay, moving on to the carbs. So carbs,
Speaker 4: you know, it's not about a low carb diet. It
Speaker 4: is about a very choosy carb diet. So what you
Speaker 4: want to avoid are simple processed carbohydrates. You want to
Speaker 4: just like for the unsaturated fats, you want to eat
Speaker 4: your carbs as close to their original form as possible.
Speaker 4: So brown rice, not rice krispies, and apple not apple
Speaker 4: sauce or apple juice, right, go upstream as far as
Speaker 4: you possibly can. And the reason for that is because
Speaker 4: whether carbs are super processed or whole and unprocessed, all
Speaker 4: carb hydrates are ultimately digested and absorbed as sugar. And
Speaker 4: it's just kind of how quickly does that digestion happen
Speaker 4: and how high does the sugar go? If you eat
Speaker 4: a bowl of rice Christie's, your body looks at that
Speaker 4: and says like child's play, Like I can digest it
Speaker 4: like that. I mean, it's just the inner most part
Speaker 4: of a rice grain. It's been mild, it's been puffed,
Speaker 4: it's been extruded. You know, I'm you know, this is
Speaker 4: going to take me nothing to digest. It's predigested for me.
Speaker 4: And that's what happens. It gets broken down quickly, absorbed quickly,
Speaker 4: and your blood sugar spiral upwards. And what happens next
Speaker 4: Insulin spikes and insulin is there to put you know,
Speaker 4: all the sugar away. But insulin is a storage hormone.
Speaker 4: It shifts our body into storage mode. What's the storage
Speaker 4: from of cholesterol? LDL? LDL levels go up when insulin
Speaker 4: levels are high. What's the non storage from of cholesterol hdl?
Speaker 3: HDL levels can be.
Speaker 4: Depressed when in some levels are high. What's the storage
Speaker 4: form of sugar? It's actually triglystrides. You can think of
Speaker 4: our body as having kind of covered space to put sugar,
Speaker 4: you know, away, because we need it in reserve, you know,
Speaker 4: if you're we needed for instant energy. So it's good
Speaker 4: to have some sugar like ready to go. But that
Speaker 4: covered space is finite. And and if you just ate
Speaker 4: a big bowl of rice crispies and your and your
Speaker 4: body just got flooded with sugar, the bie says, well, okay,
Speaker 4: I've filled my I filled my cupboards. But I still
Speaker 4: have all this sugar floating around. What am I going
Speaker 4: to do with it? Oh? I know, I'll concentrate it.
Speaker 4: I'll turn it into fat and triglystride levels go up.
Speaker 4: So some of the worst cholesterol profiles I've seen have
Speaker 4: been in people who eat a no cholesterol, no fat diet,
Speaker 4: and they will say, like, look, zero zero zero on
Speaker 4: the package. It's like this is great for me, and
Speaker 4: I go like, no, you're eating rice cakes and fat
Speaker 4: free cookies. You know, stop that. You're you're inadvertently triggering
Speaker 4: a biochemical response that is comple completely counterproductive to what
Speaker 4: you're trying to achieve. Okay, now, if you eat the
Speaker 4: brown rice, right, the brown rice hits your digestive system,
Speaker 4: and the bodybook send says like, oh, well thanks a lot,
Speaker 4: it's gonna take me a while. I've got brand, I've
Speaker 4: got germ. I got to break this down. It's gonna
Speaker 4: you know, it's gonna take me a while. So instead
Speaker 4: of blood sugar is you know, just zipping up like crazy,
Speaker 4: you know, they kind of go low and slow, so
Speaker 4: your your insulin levels are much lower and you're not
Speaker 4: triggering this counterproductive response. The other thing that whole carbohydrates
Speaker 4: bring to the party are fiber and plant steriles. Fiber works.
Speaker 4: So let me go back. So there's a natural elimination
Speaker 4: process for LDL. We didn't talk about that, and that's
Speaker 4: related to making bile. So you can think of a
Speaker 4: big funnel of LDL coming back to the liver where
Speaker 4: it gets taken up and turned to bile, and then
Speaker 4: that bile gets dumped in digestive system when we eat,
Speaker 4: gets used up in the digestive process, and out it goes.
Speaker 4: So that's kind of an exit strategy for LDL. Now,
Speaker 4: most of us are pretty efficient and so instead of
Speaker 4: just letting all that bile run out, we will reabsorb
Speaker 4: any bile that doesn't get used up in the digestive process.
Speaker 4: We put it back so it's ready for the next meal. Okay,
Speaker 4: well what does that mean. Well, it means that funnel
Speaker 4: of LVL doesn't have to be nearly as big, right,
Speaker 4: and so we can keep more LVL floating around in
Speaker 4: the bloodstream. This is actually the mechanism that the original
Speaker 4: cholesterol lowering drugs used. We don't prescribe them anymore, but
Speaker 4: they were called bile acid resins and they literally bound
Speaker 4: bil and digestive system and you eliminate through the stool
Speaker 4: and it worked. LDL levels dropped. The problem was they
Speaker 4: were messy powders. You had to take eight pills a day.
Speaker 4: People got digestive upset. It was really very unpleasant. So
Speaker 4: when Stanton's came along, like wait, one little pill versus
Speaker 4: all this than that, So we don't use them much anymore.
Speaker 4: But the process they were leveraging is continuing to happen
Speaker 4: in our body. So back to food and back to
Speaker 4: whole unprocessed carbs because they help leverage this mechanism. So
Speaker 4: whole unprocessed carbohydrates bring fiber and plant sterols to the party.
Speaker 4: Fiber works because we can't digest it. So you get
Speaker 4: a fiber molecule, bile acid molecule, tries digestive, try suggest it,
Speaker 4: you know, can't do it, and before it figures out
Speaker 4: like I'm not getting anywhere, it's past the point of
Speaker 4: no return. So in many ways fiber acts like those medications.
Speaker 4: It traps bile in the digestive system, so you know,
Speaker 4: escort it out of your system, so your LBL levels drop.
Speaker 4: Plant sterols are natural plant components found in whole unprocessed foods,
Speaker 4: and they're actually the plant version of cholesterol. Remember how
Speaker 4: I said everything cell and our cell wall and our
Speaker 4: body has you know, has some cholesterol on it. Well,
Speaker 4: same thing goes in plants. Plants have their own cells
Speaker 4: and cell walls, and they contain their their version of cholesterol.
Speaker 4: And that sounds crazy, like why would you eat cholesterol
Speaker 4: the lower cholesterol. But the reason why this works is
Speaker 4: because plant sterols are similar but different. They're similar enough
Speaker 4: that when they're in our digestive system, the body looks
Speaker 4: at them and says like, oh, hey, you're like one
Speaker 4: of those file guys. I'm supposed to be absorbed. Oh
Speaker 4: you're really important. Here's your absorption site, welcome back. Well,
Speaker 4: the plant sterol shows up and it's just slightly different
Speaker 4: enough that it can't get through, and so it blocks
Speaker 4: an absorption site, meaning while behind it has one less
Speaker 4: strawway to get back in and we waste more bile.
Speaker 4: So this is why you know, whole food vegans and
Speaker 4: vegetarians tend to have significantly lower cholesterol than most of us.
Speaker 4: They're you know, they're eating a lot of fiber and
Speaker 4: plant sterols naturally, so they're really leveraging this you know
Speaker 4: this you know elimination pathway. They're also not triggering that
Speaker 4: counterproductive insul response because all the carbs they're eating are complex.
Speaker 4: Oh and by the way, all their fats are plant based, right,
Speaker 4: so there, so they're not eating saturated fat that's causing
Speaker 4: the their you know, receptors to downregulate. So anyway, there
Speaker 4: you go, watch your fats, watch your carbs exactly.
Speaker 3: And you know, when you eat healthy carbs, you're your
Speaker 3: fuller longer also, which is important to unders so you
Speaker 3: don't tend to overrate. I mean, you know, I'm going
Speaker 3: to zero in on one oat you know, oat meal.
Speaker 4: Oh my god, that keeps you full four hours.
Speaker 3: Yeah, well you know, and I know I had Step
Speaker 3: one company that you founded that focuses on foods at
Speaker 3: lower cholesterol. I was sent some samples. I'm not an
Speaker 3: energy bar girl, but I do. I make myself heat oatmeal.
Speaker 3: Here's my tip. If you don't like oatmeal, I don't
Speaker 3: like hot oatmeal. So what I do is I make
Speaker 3: overnight oats. For some reason, I like it with its
Speaker 3: chilled and small, not a big bowl, because you are
Speaker 3: so full from it versus hot, which just feels like
Speaker 3: it's not for me. But so if you don't like
Speaker 3: something one way, chill it or sprinkle it. So you
Speaker 3: have some that you sprinkle on top of other things,
Speaker 3: so you can sprinkle and it still provides you fiber
Speaker 3: and you do feel fuller, because I think that's the
Speaker 3: one thing. If I have it oatmeal in the morning,
Speaker 3: i am. And I've been doing a lot of weightlifting
Speaker 3: because I'm also really ramping up the way I exercise
Speaker 3: because I plateaued, So that's been helping in terms of that.
Speaker 3: Another one, you know, there are fruits and vegetables high
Speaker 3: in fiber. An apple, you know, there's a reason they
Speaker 3: say an apple a day, right, Yes, eats.
Speaker 4: The doctor away. Yeah.
Speaker 3: So other than oat meal, and whether you sprinkle it
Speaker 3: or overnight it or anybody just don't happen in a cookie,
Speaker 3: sugar and everything.
Speaker 4: Yeah, yeah, yeah.
Speaker 3: What are some other foods that you would recommend that are.
Speaker 4: High in that are hid fiber? You know, boy beans, legoons,
Speaker 4: you know, super high in fiber. Actually, avocados are high fiber.
Speaker 4: People don't think about that, but they are, and they're
Speaker 4: they also have all those good chats. So it's another
Speaker 4: reason why when you eat some GUACAMOLEA you're like, I'm full, Like, so.
Speaker 3: Just don't eat it with tons of chips, you know,
Speaker 3: to do guacamole, is I buy carrot strips? Yeah, those
Speaker 3: are my crunch or you can cut up a cucumber
Speaker 3: crunch or something that has crunch basically, and then my
Speaker 3: husband's eating the chips. I hit for the strips.
Speaker 4: Yep, excellent, excellent. Yeah. So you know, I mean really
Speaker 4: almost any whole fruit or vegetable is going to have
Speaker 4: to have fiber. You know, leafy greens, you know, high
Speaker 4: in fiber. It's it's all. Any you know, any plant
Speaker 4: based food, so long as it's whole, is going to
Speaker 4: is going to give you fiber. And you know, and
Speaker 4: and it's only when we mess with things that we
Speaker 4: start to strip those you know, some of those beneficial
Speaker 4: that beneficial ruffage out. So if you you know, if
Speaker 4: you crave orange juice, have the orange instead eat the
Speaker 4: orange because you know, the orange juice when you when
Speaker 4: you squeeze it, you leave the pulp and tiff and
Speaker 4: and that's that's where the magic is.
Speaker 3: And if you must buy orange juice to get it
Speaker 3: with the pulp of the Beth. I'm not a big juicer.
Speaker 3: I do like juice, but I watch sugar like hawk,
Speaker 3: So I stay with vegetables. But you know, again, you
Speaker 3: lose the fiber aspect of it. So why did you
Speaker 3: decide to create Step one Foods, which is your product?
Speaker 3: Just to be clear, I have no affiliation, but it is.
Speaker 3: It is for people who can't figure it out themselves.
Speaker 4: Yeah, you know, I mean along the way, you know,
Speaker 4: I mean literally, you know, we started talking about, you know,
Speaker 4: high cholesterol, here's a pill. Well that's what physicians are
Speaker 4: taught to do. And you know, and and and as
Speaker 4: I look back on my education, I was educated some
Speaker 4: pretty you know, some wonderful institutions. I got the wrong advice.
Speaker 3: You know.
Speaker 4: It's the all the things that I'm treating with drugs.
Speaker 4: High cholesterol, high blood pressure, you know, high blood sugar.
Speaker 4: You know, these are conditions that are caused in part
Speaker 4: or in whole by food. And if something is caused
Speaker 4: in part or in whole by food, step one should
Speaker 4: be change the food. The problem is that if you're
Speaker 4: trying to actually influence a you know, a cholesterol number
Speaker 4: or a blood pressure number, you know, you really have
Speaker 4: to know what you're doing. Like you know, it's it's
Speaker 4: not just a matter of eating better, although that'll help,
Speaker 4: but it's really about being strategic and making sure that
Speaker 4: you get enough fiber, enough you know, plant steriles, enough
Speaker 4: healthy fats, those omega three fatty acids, enough antioxidant to
Speaker 4: actually you know, get a benefit. And and this is
Speaker 4: where it gets really hard for people because you know,
Speaker 4: they try, but they just don't can't do it quite
Speaker 4: right because it's hard. You know, you're measuring your thing
Speaker 4: and you're buying all sorts of ingredients. Things go bad
Speaker 4: in your fridge. So so the whole idea behind Step
Speaker 4: one foods was Okay, let's just make this easy. You
Speaker 4: know this this is we know what people need, we
Speaker 4: can deliver it in just two small servings of food
Speaker 4: a day. We don't have to own your stomach from
Speaker 4: from morning tonight. We can just you know, we can
Speaker 4: just supplement what you're doing with this and then you know,
Speaker 4: let's see what happens and lo and behold, you know,
Speaker 4: people can see just with this tiny, tiny, little intervention.
Speaker 4: And the foods, by the way, you know, for for listeners,
Speaker 4: are snack bars. They're you know, the things that people
Speaker 4: are eating already, so snack bars, instant oatmeal, pancake mix,
Speaker 4: smoothie mix. You know, there's there's a you were talking
Speaker 4: about a sprinkle. There's like a sprinkle product which you
Speaker 4: can just you know, add to like yogurt or something
Speaker 4: else that you're eating to really boost the nutritional content
Speaker 4: of that and kind of get you to the nutrient
Speaker 4: levels you need to affect cholesterol levels. And sorry, go ahead.
Speaker 3: Yeah, No, Sprinkles are easy for people that can't deal
Speaker 3: with other things. Sprinkling is good, you know, and other
Speaker 3: things to sprinkler nuts, you know, unsolved with nuts or seeds.
Speaker 3: You know, we sprinkle a lot on our salads. We
Speaker 3: sprinkle a lot on our Sprinkling is good if you're
Speaker 3: sprinkling right things. Just don't sprinkle sugar, you know, think
Speaker 3: about what you sprinkle and it does work, and you
Speaker 3: know at something with oats is good. But again look
Speaker 3: for stuff that's low and sugar. We only have about
Speaker 3: a minute left. I do need to ask you, is
Speaker 3: there anything on the front of reducing cholesterol managing and
Speaker 3: that you're excited about that has in your crystal ball.
Speaker 4: Well, you know, my hope is that while we develop
Speaker 4: new drugs. And you know, and I'm not anti drug
Speaker 4: I prescribe medications all the time. Some patients need them
Speaker 4: there they're important, they can be life saving. But I
Speaker 4: hope that in my lifetime we see a change in
Speaker 4: the food environment. Look, we we live in a dysfunctional
Speaker 4: food environment. We are surrounded by hyperpalatable, calorie dense, nutrient
Speaker 4: poor foods that are delicious, made to be addictive, inexpensive,
Speaker 4: and advertised NonStop. What could go wrong? Well, what can
Speaker 4: go wrong is the health of our country. And you know,
Speaker 4: and we need a different path. And I'm hoping that
Speaker 4: Step one foods can be you know, the little standard
Speaker 4: bearer of how we can do things differently and how
Speaker 4: we can yield measurable health improvements in as little as
Speaker 4: thirty days. I mean, our clinical trial showed that some
Speaker 4: people had medication level statin level cholesterol reductions with our
Speaker 4: too little, you know, too little servings a day intervention
Speaker 4: in thirty days. I mean, if you're someone who can't
Speaker 4: tolerate statins, you don't want to take them. You've tried
Speaker 4: them and you know they didn't you know, they didn't
Speaker 4: work out for you, Like this could be a game changer.
Speaker 4: And you don't need to commit to it forever. It's
Speaker 4: just thirty days and you can see whether or not
Speaker 4: it works for you.
Speaker 3: Well, I know I'm doing thirty days right now of
Speaker 3: working with and I just want to in order to
Speaker 3: you wrap this uppropriately. If you are considering making changes,
Speaker 3: particularly in your diet, make sure you do it with
Speaker 3: the advice and the consent of your primary care physician,
Speaker 3: and don't do anything dramatic. I mean, I've consulted with
Speaker 3: my doctors, my gastro entrologists because I had some GI
Speaker 3: issues and my PCP before I even started adjusting things
Speaker 3: in my diet. And I have a pretty healthy diet
Speaker 3: as is, but we're testing a few things to take
Speaker 3: out to see if it will help the GI track.
Speaker 3: And I also ramped up my exercise. So the bottom
Speaker 3: line is you have the power within you, as I
Speaker 3: say at the individual, you have the power within you
Speaker 3: lend of the good Witch to make the changes you
Speaker 3: want to stay healthy for the long term. But you
Speaker 3: have to do it today, and you have to commit
Speaker 3: to it, and you have to do it in cooperation
Speaker 3: with the people that are your board of advisors, which
Speaker 3: are your physicians, and you have to make the change.
Speaker 3: I want to thank you again, doctor Elizabeth Clotis, who
Speaker 3: is a Board certified cardiologist, for sharing your expertise today
Speaker 3: on Fearless Fabulous You. I think it was very helpful.
Speaker 3: I thought you opened a lot of answered a lot
Speaker 3: of questions about cholesterol. You know, listen to the doctor,
Speaker 3: not doctor Google. Get your information from credible sources, and
Speaker 3: that's what I ask everybody to do, and don't share
Speaker 3: things that you are not expert in. Listen to experts.
Speaker 3: You've been listening to Fearless Fabulous You. I hope you
Speaker 3: enjoy this. You can listen to all my shows on iHeart, Spotify, Apple,
Speaker 3: and about thirty five other podcasts on demand anytime, so
Speaker 3: check it out and check me out at melaniehung dot
Speaker 3: com and Melanie Fabulous. I thank you again for joining me,
Speaker 3: doctor Clotus, and to all my listeners. You got this
Speaker 3: day fearless and fabulous