The Dr. Hyman Show - Exclusive Dr. Hyman+ Functional Medicine Deep Dive: Heart Health And Understanding Cholesterol

Episode Date: May 18, 2021

My team and I are excited to introduce our revolutionary new platform, Dr. Hyman+, which offers premium content, perks, and information available exclusively for Dr. Hyman+ members.  In this teaser episode, you’ll hear a preview of our latest Dr. Hyman+ Functional Medicine Deep Dive on Heart Health And Understanding Cholesterol with Dr. Neel Patel. To gain access to the full episode, head over to https://drhyman.com/plus/. With your yearly membership to Dr. Hyman+, you’ll gain access to: Ad-Free Doctor’s Farmacy Podcast episodes Access to all my docu-series, including Broken Brain 1, Broken Brain 2, Longevity Roadmap + bonus material Exclusive monthly Functional Medicine Deep Dives Monthly Ask Mark Anything by you and only for you

Hey everyone, it's Dr. Mark Hyman here. Now my team and I have been working hard on something that I'm so excited to share a little bit about today. It's a revolutionary new platform called Dr. Hyman Plus, which is a premium membership exclusive for my community. With Dr. Hyman Plus, you get a ton of private content and special access that no one else gets. This yearly membership gives you exclusive access to ad-free Doctors Pharmacy podcast episodes, access to all of my docuseries, including the Longevity Roadmap and Broken Brain 1 and 2, plus all the bonus content. You get monthly functional medicine deep dives where one of our doctors goes deep into a health topic to tell you everything you need to know to heal.

You'll also get access to a monthly Ask Mark Anything Q&A where I answer the Dr. Hyman Plus community's biggest health and wellness questions. This Q&A is only accessible with a membership. Now, because I'm so excited to share this premium membership content with you, I'm releasing a teaser of the brand new Functional Medicine Deep Dive episode diving into one of the most important topics in health. I hope you enjoy it and head over to drhyman.com forward slash plush. That's drhyman.com slash PLUS for more information. Okay, here we go. Hi, everyone. My name is Neil Patel and I'm a practicing cardiologist in California. It's been a pleasure today to discuss with you the functional medicine approach to understanding heart disease and cholesterol.

If you've ever had any questions surrounding your cholesterol or general health of your heart, we do feel like this presentation is definitely for you. In this functional medicine deep dive, we will focus on understanding cholesterol and its role in heart disease. I've been a practicing cardiologist for the last six years. Prior to that time, I completed my residency and fellowship in underserved areas, and it gave me a really unique experience. I saw countless patients following their doctor's exact orders. And yet, despite that, would have either progression of disease or worse outcomes. These experiences occurred over and over again. And it kind of led me to dig into deeper questions about health and disease. Was there perhaps a process that we were not addressing or not assessing? over again, and it kind of led me to dig into deeper questions about health and disease.

Was there perhaps a process that we were not addressing or not assessing? And if so, what was it? How can I meaningfully modify it if I can find it so that I can have a meaningful impact on this person's life? See, when it comes to chronic disease, it is commonly recommended that we make diet and lifestyle changes. But to be honest with you, after seeing a lot of patients follow their doctor's orders, it kind of led me to ask more questions like, what does that exactly mean? Because here we are telling them to follow a diet and lifestyle, yet we're not really giving proper guidelines for that individual in front of me. So we all know that diet and lifestyle changes are recommended by almost every doctor out there. But again, is the primary goal to lose weight? Because I've seen a lot of patients lose weight, and yet despite that, they don't feel they're

optimal. Or, and this is not to say, I should take a step back, this is not to say that most people will not benefit from losing excess weight. They absolutely will. But what about the person in front of me that has specific needs that are different from yours and mine? How can I help them really feel their optimal self? Could I dig into what their life looks like? Could I identify parts of their life that need attention? Or perhaps they need more testing. And if so, can I apply the results to the person in front of me? And again, they're coming to us not feeling good, having a whole host of nonspecific symptoms, yet maybe they're nonspecific because we're not looking in the right place. With all my questions and research, that's where I found functional medicine.

Or I should say, that's where I found the functional medicine approach. An approach that when it came to prevention, focused on identifying the individual specific dysfunctions and seeing how they tie into the symptoms or disease that the person is experiencing. But just to be clear, if my patient was having a heart attack, I'm not going to stop and dive into their diet and lifestyle at that specific moment. I would definitely recommend treatment to treat the problem at hand with the tools we have, and I would not recommend anyone who is having concerning symptoms any

differently. But after that, after the treatment with traditional medicine or interventions, what can we dive into to help them prevent their future events? And can we get to the root cause of what led them to this state in the first place. From my traditional teachings to exploring functional medicine, they both together have allowed me to ask more questions about my patient's heart health and guided me to deeper learning and research. From this is where I lead this presentation on heart health. So most questions revolving around heart health tend to be focused on having or concern of developing heart disease. In a more scientific way, it's coronary artery disease, narrowed heart arteries, the ones that you think of when someone has had a heart attack.

Why is this so important? Well, it's because it's still the number one killer in America, and it deserves our attention and focus. This is a list of common questions slash comments that I get in my office very regularly. Maybe some of them seem familiar. Maybe you've asked yourself this or your doctor this. How's my heart? Will I have a heart attack or heart disease runs in my family? There's nothing I can do to avoid it. Kind of this mindset of like, no matter what happens, I won't be able to identify my risk, nor will I be able to change that risk. And if my cholesterol is normal, am I safe from a heart attack? All valid questions, comments,

again, things that have come up in conversation very, very commonly. So again, if you're saying to yourself, I've asked all of those questions, then I'll have more information for you in this lecture and how to really look at the details of identifying your risk. We got to keep this key point actually in mind because when we discuss our health and well-being or the absence of disease, it's really the interplay of many, many different factors, right? Genetics, environmental exposures, diet, stress, things that you guys might be very familiar with. Hence, we need to give all of those areas our attention. So in this functional medicine presentation, we're going to look at a few goals. And as with all functional medicine approaches, we want to look for the root cause.

So disease is on one end of the spectrum, while health is on the other. To get from one to the next, there must be progression, which takes a very long time. And we want to look at the available information about what we know to cause health and what we know causes disease. And in this case, in this deep dive, we're going to focus on root causes of vascular disease and coronary artery disease, how to evaluate your individual risk, practical tips to lower your individual risk, and what are the foundational daily practices that you can put into place today to build sustainable health and longevity. So let's go over some statistics to make this a little bit more real. The numbers vary depending on which website you look at, but they're roughly around the same. The number one cause of death in America is still coronary artery disease,

heart disease in the traditional sense, heart attacks. That's about one in four people. Huge. And heart attacks, unfortunately, occur to one person every 40 seconds. That's tremendous. And about 800,000 Americans have a heart attack every year. So very big impact on our community, very impact on our life, on our quality of life. And I've seen plenty of people debilitated by this. And so it really is a passion of mine to really dig into why is this continuing? How can we really help people? So what is coronary artery disease? And just to kind of give the basics here, kind of the first steps that happen is that there's damage to the blood vessel lining. So the coronary arteries are the tubes or the blood vessels that bring the heart as a muscle, it's a blood supply. See the heart pumps blood to the rest of the body, but how does it do so? It needs its own fuel, so to speak, the blood and the arteries are

how it gets it. From there, you have damage from the blood vessel lining. From there, plaque can build up within that artery wall. And as you go, as you look at the slides from left to right, you can see that slowly as the plaque builds up in the artery walls, the artery gets more narrow. And as the artery gets more narrow, you get less and less blood flow to such a vital organ, such as the heart. So what about these traditional risk factors for coronary disease? Well, arterial or atherosclerosis is kind of hardening of the arteries in addition to plaque buildup. Hypertension is high blood pressure, high cholesterol. We're all familiar with what that means. We'll go into that. Diabetes, obesity, and of course, smoking.

So when we talk about elevated cholesterol, this is generally evaluated by a basic blood work lipid panel. So you may have a family history of high cholesterol. And in some cases, it is a genetic mutation that does not always allow you to clear the cholesterol from your bloodstream. But in most cases, it is related to other metabolic factors and conditions that can lead to excess cholesterol circulating in the blood. What about smoking? The use of tobacco leads to direct damage to the blood vessels.

And remember, once the blood vessel lining is damaged, it's susceptible for cholesterol and plaque to kind of enter the blood vessel and lead to narrowing. What about hypertension and its effect on coronary artery disease. Well, similarly to tobacco use, it places a high amount of stress on the inside of the arteries. And when that happens, again, you get damage. But over time, if your blood pressure is constantly high, that damage is almost occurring on a regular basis daily, most minutes of the day.

So just for numbers sake, a normal blood pressure is 120 systolic over 80 diastolic. Where on the other extreme stage, 2 hypertension is classified as a systolic blood pressure of over 140 with a diastolic of anything over than 90. So that's just more tangible numbers for you guys to have as you're thinking through this. So what about diabetes? Well, excess sugar within the bloodstream by itself damages blood vessels. You've heard this from other lectures. You've even heard this from the insulin resistance lecture from Dr. Boham. But extra sugar running around in the body that can't be processed is highly oxidizing and highly damaging. What about obesity?

Well, what we will discuss further is that fat tissue or adipose tissue is actually metabolically active. And in a way that actually promotes inflammation and raises our blood glucose level. So now you have, again, higher blood sugar running around in the blood stream, which is damaging. And in and of itself, it promotes inflammation. So both of which combined can lead to damaging blood vessels. So we looked at some of the traditional risk factors, but what are recommended ways of addressing them at this time? Well, if someone has high cholesterol, again, based on a basic blood work lipid panel, well, the first and foremost thing to do is to address elevated triglycerides and in general LDL,

which is the bad cholesterol I'm sure many of you have heard of. But when we get to that point where there's high cholesterol and high LDL, the therapy of choice is a statin medication. But what about when it comes to diet? When it comes to diet, the general recommendation is that it should be one that includes high amounts of fruits, vegetables, low saturated fats, also increasing monounsaturated fats, so very similar to a Mediterranean diet. Low glycemic index foods, so foods that don't spike your blood sugar quickly, nor for a long time. And then increasing omega-3 fatty acids, which are the anti-inflammatory fatty acids, versus omega-6, which is the pro-inflammatory or the fatty acids that increase inflammation. What about exercise? So exercise is recommended kind of generally in the

following sense. We will usually tell people 150 minutes of moderate exercise versus 75 minutes of strenuous exercise. And that's for the whole week. Now, I personally tell my patients that they should be exercising on a daily basis. And we will go into that why. But as a short answer, we spend a lot of time sitting and not so much in a state where our heart rates kind of get the variability of going up and down. So we really want to look at our lifestyle, look at our work, because a lot of us work from home now, and say to ourselves, well, if I'm spending most of my time in chair, I really owe it to my body to make sure that I exercise regularly to kind of get the joints moving, the blood pumping, the organs, all the extra blood from the elevated heart rate. But even though we recommend it, only about 20% of Americans actually get this level of activity.

So there's a lot of work that we can do there. What about weight loss? Well, obesity and being overweight is actually overtaking cigarette use as the leading modifiable cause of premature death. I mean, that is staggering, right? So here we have conditions that we, as people, actually can control. And it is overtaking cigarette use, which we all know to be very bad for our health. But those two controllable factors by us are overtaking cigarettes. So it's really, really, really important that we work on sustainable diet and lifestyle practices

to not only help our heart health, but to help our overall health. Well, I hope you enjoyed that teaser of exclusive content that you get every single month with Dr. Hyman Plus. If you want to listen to the full episode and get access to ad-free podcast episodes, plus all the content from my docuseries and, of course, any future ones we're going to release, plus monthly Ask Mark Anything episodes, plus monthly functional medicine deep dive episodes. I guess, right, that's why we call it Dr. Hyman Plus. Head over to drhyman.com forward slash plus. That's drhyman.com slash PLUS to learn more. I'll see you there.

Hi, everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not Thank you.