But research shows this mineral plays a surprisingly important role in type 2 diabetes — and it’s one that’s often overlooked.

Magnesium is involved in over 300 enzymatic reactions in the body, including those critical to how insulin works. It helps regulate glucose uptake into cells, influences insulin sensitivity, and supports vascular health.

Yet studies show that people with type 2 diabetes often have lower magnesium levels — both inside their cells and in circulation — especially when blood sugar control is poor.

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Why magnesium matters in diabetes

When magnesium levels drop, insulin can’t do its job as effectively. That means cells don’t take in glucose efficiently, worsening insulin resistance and raising blood sugar levels.

This cycle can create further magnesium losses, particularly through the kidneys, leading to an ongoing deficit.

Over time, low levels have been linked not only to worsening diabetes but also to complications like high blood pressure, kidney dysfunction, arrhythmias, and even cognitive decline.

The two-way connection—and what to do about it

So, does low magnesium cause diabetes, or does diabetes cause low magnesium? The answer is both.

A diet too low in magnesium can impair insulin action, increasing the risk of diabetes, while diabetes itself promotes magnesium loss. This two-way relationship means that people with diabetes are especially vulnerable to deficiency, and people who are deficient are at higher risk of developing diabetes.

Some research suggests magnesium supplements can improve fasting glucose, insulin sensitivity, and blood vessel function, but results aren’t consistent.

That’s likely because not everyone with diabetes is magnesium-deficient to begin with, so supplement studies may dilute the true effect.

The American Diabetes Association does not currently recommend routine supplementation for blood sugar control. More research is needed before magnesium supplements can be broadly prescribed as a diabetes therapy.

What we do know is that magnesium-rich diets consistently lower the risk of developing type 2 diabetes and metabolic syndrome.

People who consume more magnesium-rich foods — nuts, seeds, legumes, leafy greens, and whole grains — tend to have better insulin sensitivity, lower inflammation, and a reduced risk of progressing from prediabetes to diabetes.

These foods also deliver other protective nutrients, like fiber, antioxidants, and plant sterols, that work together to support metabolic and cardiovascular health.

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Food first, supplements if needed

It’s important to note that magnesium from food is safe and doesn’t carry the risks associated with high-dose supplements.

Too much supplemental magnesium — especially in forms like magnesium oxide, carbonate, or chloride — can cause diarrhea, nausea, or abdominal cramps.

Extremely high doses can even lead to toxicity, with dangerous effects on heart rhythm and blood pressure. Supplements can also interact with common medications, including antibiotics, diuretics, and some acid reflux drugs.

That’s why the best approach is food first. Spinach, pumpkin seeds, black beans, almonds, edamame, and whole grains are all excellent sources.

If a supplement is considered, it should only be done under medical supervision, especially for people with kidney disease or those taking multiple medications.

The bottom line

Magnesium isn’t a cure for diabetes, but it is a nutrient that plays a critical role in how insulin works and how blood sugar is managed.

Ensuring your diet includes magnesium-rich foods is a safe, natural, and impactful way to support glucose control and protect against complications. Supplements may help in some cases, but food remains the most reliable and safest source.

At Step One Foods, many of our products naturally deliver magnesium along with other nutrients that support cholesterol, blood sugar, and vascular health. That’s because they’re made with ingredients naturally rich in magnesium — like oats, nuts and seeds, legumes, dried fruit, and even dark chocolate. By eating real food in the right combinations, you can take meaningful steps toward better outcomes.

The post Magnesium’s overlooked link to type 2 diabetes appeared first on Easy Health Options®.

Some people dismiss it as a myth, others believe it’s the sole cause of heart disease.

The truth lies in between.

Cholesterol is real, it matters, and the way we understand it can have a profound impact on cardiometabolic health.

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Myth 1: All cholesterol is bad

Cholesterol itself isn’t harmful. In fact, your body needs it to build cell membranes, produce hormones, and aid in digestion. What matters most isn’t whether cholesterol is present, but how it’s carried in your bloodstream.

LDL (low-density lipoprotein) cholesterol can contribute to plaque buildup in arteries if levels are too high.

HDL (high-density lipoprotein) cholesterol helps remove excess cholesterol from the bloodstream.

Although the balance matters, your LDL level is probably the most important value when it comes to avoiding heart disease. The lower your LDL, the lower your risk for cardiovascular events.

In fact, data from multiple randomized controlled trials show that populations with lower LDL levels consistently experience fewer cardiovascular events.

Myth 2: Cholesterol is a “myth”

At Step One, I sometimes hear from people who insist cholesterol doesn’t matter, or worse, that it isn’t even “real.” Nothing could be further from the truth.

High cholesterol is one of the most extensively studied risk factors for cardiovascular disease, with incredibly consistent results: lower LDL levels translate to better outcomes, no matter how you get there — through medications, diet, or favorable genetics.

There are even rare individuals who are genetically unable to make PCSK9, the enzyme that slows LDL receptor activity. Their LDL levels hover around 30 mg/dL for life. And they almost never get cardiovascular disease. That’s not myth — that’s biology.

Myth 3: Dietary cholesterol is the main cause of high cholesterol

For years, foods like eggs and shellfish were villainized for raising cholesterol. But dietary cholesterol has much less impact on blood cholesterol than most people think.

Your liver produces the majority of cholesterol circulating in your body. What influences blood cholesterol more strongly is the type of fat (and types of carbohydrates) you eat.

Saturated and trans fats can raise LDL cholesterol.  These fats are all solid at room temperature and include butter, cheese, the marbling in beef, the fat in chicken, coconut oil and all hydrogenated fats.

Unsaturated fats (found in foods like nuts, seeds, and olive oil) are liquid at room temperature and can help improve cholesterol levels.

The bigger picture: food has the power to harm and the power to heal. Poor nutrition doesn’t just raise LDL — it also drives up blood pressure, blood sugar, weight, and inflammation. Eat right, and you improve all of these risk factors at the same time.

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Myth 4: Cholesterol is the only thing that matters

Cholesterol is important, but it isn’t the only player. Cardiovascular disease is multifactorial. High blood pressure, diabetes, smoking, chronic inflammation, and genetics all layer on top of cholesterol to influence risk. Even with high LDL, some people may avoid disease, while others with normal levels may still experience events.

This is why reductionist thinking — blaming everything on a single risk factor — misses the mark. Cholesterol matters, but so do the other pieces of the puzzle.

Myth 5: Medication is the only solution

Statins and other cholesterol-lowering drugs can be transformative for some people. But they’re also an incomplete solution, because they only target one factor. If you lower cholesterol through medication but ignore blood sugar, blood pressure, weight, or inflammation, your risk remains elevated.

Nutrition, on the other hand, is comprehensive. Eat poorly, and you worsen multiple risk factors at once. Eat well, and you lower LDL, improve blood pressure, stabilize blood sugar, reduce inflammation, and support healthy weight — all in one step.

The bottom line

Cholesterol is not a myth. It’s a proven, powerful risk factor for disease. But it’s also not the only one, and it shouldn’t be viewed in isolation. The good news is that food gives us an opportunity to improve cholesterol while simultaneously improving overall cardiometabolic health.

At Step One Foods, we’ve made it easier to take control of your nutrition with convenient options proven to help support cholesterol management. 

The post What everyone gets wrong about cholesterol appeared first on Easy Health Options®.

But there is no question that our bodies are left different. Weight gain is easier. Wrinkles appear out of nowhere. Bones become brittle. Cholesterol shoots up.

Having said all that, it is a misconception that postmenopausal women have no influence over our outcomes or our overall sense of well-being.

The previous four blogs dealt with our main pharmacologic option, hormone replacement therapy (HRT). And there is plenty of evidence that HRT would likely be a net positive for many more women than are being offered this intervention today.  If you missed those blogs, you can find them here: Part 1, Part 2, Part 3 and Part 4.  

However, there is much more we can do than just demand to be placed on drugs! We can also help ourselves get through this period and set ourselves up for better health long term through the way we live.

Spoiler alert: If you’re a regular reader of our blogs, you will see a striking similarity to advice I have given many times before…

Turns out, eating right and exercising regularly has a positive impact, regardless of what we are trying to impact positively.

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Mediterranean Diet and Menopausal Symptomatology

The Mediterranean diet, characterized by high consumption of fruits, vegetables, whole grains, legumes, nuts, and olive oil, has been associated with reduced severity of menopausal symptoms.

A study involving more than 6,000 postmenopausal women over nine years found that higher adherence to the Mediterranean Diet correlated with a lower incidence of hot flashes and night sweats.

Phytoestrogens: Plant-Derived Estrogenic Compounds

Phytoestrogens, particularly isoflavones found in soy products, have been investigated for their potential to mitigate menopausal symptoms due to their structural similarity to estradiol.

Randomized studies have shown that phytoestrogen-based treatments may reduce the frequency of hot flashes and night sweats. However, efficacy varies among individuals, possibly due to differences in gut microbiome composition affecting isoflavone metabolism. 

By the way, the idea that phytoestrogens increase breast cancer risk has been summarily debunked. Even women who have gone through breast cancer treatment can enjoy soy products.

Omega-3 Fatty Acids and Mood Regulation

The decline in estrogen during menopause is associated with an increased risk of depression. Omega-3 fatty acids, like those found in Step One Foods, are known to have positive effects on mood, and higher dietary intake of omega-3 fatty acids has been inversely associated with depression prevalence in postmenopausal women.

Micronutrients: Calcium and Vitamin D

Postmenopausal women are at increased risk for osteoporosis, and adequate intake of calcium and vitamin D becomes crucial for bone health. For women over 50, the recommended daily allowance includes 1,200 mg of calcium and 600–800 IU of vitamin D. Individual vitamin D requirements may be higher in order to keep vitamin D levels in the normal range. You can have your vitamin D level assessed through a simple blood test. 

Dietary sources of calcium include dairy products, leafy greens, and fortified foods, while sunlight exposure facilitates endogenous vitamin D synthesis. It is typically difficult to get adequate amounts of vitamin D through diet alone, although eating mushrooms can help.

Exercise: Bone Strength and Beyond

If there was any time in a woman’s life when staying physically active was critical, it’s after menopause. We can take all sorts of calcium supplements, but unless we engage in weight-bearing and resistance training, all that calcium will just go toward making kidney stones. And unless we expend more energy, the slowdown in metabolism most women experience during this time will yield progressive weight gain. The good news is that we don’t need to engage in extreme or exceedingly strenuous routines to see meaningful health gains.

For optimal metabolic health, spending the majority of our time in Zone 2 is ideal. This exercise level helps build aerobic capacity, increases mitochondrial efficiency, burns fat for energy, increases insulin sensitivity, and helps lower blood pressure. Interspersing short, high-intensity intervals is also a good idea to help build cardiovascular fitness.

And how do you know if you’re in Zone 2? To estimate your Zone 2 heart rate range, subtract your age from 220 (this estimates your maximum predicted heart rate), and then multiply that number by 0.6 to get the lower range (60%) of Zone 2, and by 0.7 to get the upper range (70%). You can also know that you’re in Zone 2 by using the talk test: your exercise intensity is low enough that you can carry on a conversation, but high enough that you’re somewhat breathless and can’t sing.

And what about resistance training? Do that at least a couple of times a week for 30 minutes at a time. You can get fancy and work with a trainer at a gym — or make a minor investment in resistance bands and follow a do-it-yourself program at home.

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We Have the Power!

Menopause is a time of tremendous change — physically and psychologically. But it’s definitely not a time to suffer in silence or simply accept our fates.

Helping ourselves through nutrition and physical activity (the EXACT SAME interventions as the ones that yield cholesterol improvements) will go a long way to maximizing overall health outcomes, especially after our estrogen is gone. And, for most women, HRT — whether systemic or local — can be considered a safe, effective and in many ways proactive step to ensuring a smoother transition to the second half of our lives. 

The WHI deprived too many women of quality of life for too long. 

It’s time to move on.

The post Menopause and the big lie: You’ve got choices appeared first on Easy Health Options®.

The Women’s Health Initiative (WHI) trial concluded that hormone replacement therapy (HRT) was dangerous for women. But the bad news was not as bad as presented, and the good news was glossed over. That didn’t matter: Physicians were — and continue to be — spooked.

To seal the deal, warnings around breast cancer, blood clot, and heart disease risk got printed all over inserts and boxes containing any and all hormone-containing compounds — even if they were not the same formulations as what was evaluated in the trial and even if they were presented in a different dose/format (like vaginal estrogen cream).

Overnight, prescribing HRT was relegated to “fringe” providers. And medical schools effectively stopped teaching doctors about treating menopause.

Today, we live with that legacy: less than 6% of OB/GYN and primary care providers get even one hour (!) of menopause education in their training. The end result? A dearth of physicians who are comfortable managing the symptoms of women suffering through “the change.”

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What New Research Reveals About HRT

Meanwhile, science has marched on. Not that most women — or their physicians — are even aware.

Since the WHI was published, additional studies have found that timing of HRT initiation matters. Women who commence HRT within 10 years of menopause actually experience fewer cardiovascular events compared to those who are not placed on hormones.

Those who commence HRT more than 10 years after menopause do see a small increase in cardiovascular events in the first year of therapy, but then see an overall decrease in the second year onward.

The Role of Formulation and Delivery Method

And in terms of blood clotting, hormone formulation is key. Unlike the pill form, estrogen creams and patches do not raise clot risk. Nor does micronized progesterone (the natural form of progesterone), whether delivered by pill or pessary.

Remember, the WHI used a combination of synthetic progesterone and estrogen and dispensed the hormones in tablet form. This is a wildly different approach compared to the formulations available today.

For women who still want to — or need to — avoid systemic hormone delivery, vaginal estrogen cream has been shown to effectively relieve vaginal dryness and reduce risk of urinary tract infections without increased risk of any negative health outcomes. Though inexplicably, the black box warnings claiming otherwise are still there.

And we haven’t even touched on the potential benefits of testosterone supplementation in women!

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My Personal Menopause Journey

My personal menopause experience was less about hot flashes and night sweats (which I had my share of). It was all about sleep. For the life of me, I could not get more than 4 to 5 hours per night. Sometimes, I hardly slept at all. I was constantly exhausted, my cognitive function was becoming affected, and I was struggling emotionally.

And nothing I tried — meditation, melatonin, magnesium, even CBD — made any difference. But having been in the room when those WHI results were first announced, I never even once considered HRT as an option.

It was only after listening to a random podcast about new HRT data and looking into more recent studies that I asked my GYN physician to place me on hormone therapy. The improvement in sleep that I have experienced since then has been nothing short of miraculous.

Looking back, I now realize I suffered needlessly for 5 years. And I probably missed out on most of the osteoporosis protection. But I just didn’t know any better, even as a physician.

What Women Need to Know

This was my experience and my journey. I’m not suggesting that everything gets better with HRT, or that every woman should even take it, or that everyone will respond the same way I did.

What I really want you to know is that you have options — certainly many options when it comes to the various delivery forms of HRT. And that risks of HRT are relatively low (though obviously influenced by individual health variables unique to each of us). Women have been brainwashed to believe that we have no options. That we just need to buck up and suffer in silence.

That’s simply not true.

Next up, how to help manage menopause and its symptoms without drugs.

The post Menopause and the big lie: The lasting impact appeared first on Easy Health Options®.

I remember watching the Women’s Health Initiative (WHI) investigators present their data at a major cardiology conference. The room was packed. You could have heard a pin drop when the study’s findings were finally revealed.

I also remember all of us rushing back to our practices and immediately de-prescribing HRT. After all, the relative risk of heart attack was 32% higher in HRT users! Breast cancer up 26%! Blood clots up 200%!!  

In one fell swoop, HRT was pronounced dead. Not just estrogen plus progesterone. All of it. Period. And any physician prescribing it could be risking a malpractice claim — or even being reported to their medical board. 

Meanwhile, the media was having a field day. This was the most provocative medical news to come out in a very long time. The story was everywhere!

What the WHI Data Left Out

But here’s the thing: what we didn’t realize at the time — what the investigators chose to de-emphasize — were the many shortcomings of this data.

First, the vast majority of women were over 60 years of age at time of enrollment — many were in their 70s. Meaning, they started HRT 10 to 20 years after their last period.

Second, the type of hormone cocktail used for the trial was more like what’s in a birth control pill and VERY different from contemporary HRT formulations.

And third, large numbers of participants dropped out over the course of the trial. 

In other words, we studied the wrong women, had them on the wrong treatment, and ended up with only partial data on what happened! 

Understanding Relative Risk vs. Absolute Risk

Then there’s the matter of focusing on relative risk of negative health outcomes — which can be deceiving in terms of real impact. For example, if 10 out of 10,000 people develop a liver function abnormality while taking a placebo but 15 out of 10,000 develop it while taking a drug, the relative risk of liver problems is 50% higher in drug users (5 more compared to 10 baseline). Even though the absolute risk of developing a liver issue in drug users is only 0.05% (5 extra out of 10,000), translating to 1 extra abnormal lab test for every 2000 people treated, actually quite low.

Breast Cancer Risk in Context

In the WHI, the absolute increase in the chance of developing breast cancer was 0.1% in estrogen plus progesterone users, which is one extra breast cancer case for every 1,000 women on HRT. That’s not zero, but it’s also far from a guarantee that HRT users will develop breast cancer during their lifetimes.

The other piece of data that received little attention was that there was no difference in the chance of dying from breast cancer regardless of whether a woman took HRT. 

Subsequent data also revealed NO increased breast cancer risk in women who took estrogen alone (which is appropriate only for those who no longer have a uterus).

Revisiting Cardiovascular and Blood Clot Risks

The WHI investigators also did not clearly point out that once other confounding factors were considered, differences in cardiovascular event rates largely disappeared. So HRT is not dangerous for the heart.

And although the risk of developing a blood clot was higher when taking hormone therapy — no argument there — this finding is irrelevant today because contemporary HRT is not associated with increased clotting risk.

Overlooked Benefits of HRT

And this is probably the greatest disservice created by the WHI:  There was almost no emphasis placed on the positive health outcomes found among participants using any form of HRT. These included very significant reductions in osteoporosis-related bone fractures and significantly lower colon cancer risk. 

Ignoring Quality of Life Metrics

There was also no discussion about what withholding HRT meant for the women in the placebo group, even though there were clear signals of reduced quality of life: 11% of the placebo group started HRT during the course of the study, and 38% dropped out of the trial. 

The post Menopause and the big lie: The facts they left out appeared first on Easy Health Options®.

Given that this is a normal physiologic process and not a disease, menopause is supposed to be something women just endure and move beyond. But if you’ve been through it yourself or are in the midst of “the change,” you’ve probably realized that nothing about this process feels even remotely normal!

That is, unless you think hot flashes, night sweats, mood changes, sleep disturbance, vaginal dryness, urinary urgency and incontinence, weight gain, decreased libido, thinning hair and skin, memory and concentration problems, joint and muscle pain — not to mention heart palpitations and out-of-nowhere high LDL — are all normal!

I don’t typically venture outside of conditions that I manage. I’m a cardiologist. I deal with chest pain and EKGs. But I felt compelled to write this blog series because I continue to see so many female patients suffering with many of the symptoms related to menopause while being denied — or fearful of — a proven life-enhancing intervention. All based on faulty data.

I’m talking about hormone replacement therapy (HRT).

You’ve probably heard the warnings: It causes breast cancer. It’s dangerous. It does more harm than good. These statements have become medical dogma. But they are outdated, oversimplified, and in many cases — flat-out wrong.

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Why HRT Deserves a Second Look

If you’re a woman navigating perimenopause or menopause, what you’ve been told about HRT — or what you think you know about HRT — could be standing between you and a dramatically better life.

This blog series is meant to give you the knowledge you need to not only help yourself through this time (and beyond) but also understand a treatment option that is out there. So that you can have a more informed conversation with your care provider.

To be clear — I am NOT advocating that every woman should go on HRT. But every woman should at least be given the opportunity to determine for themselves if it is right for them.

The Whole-Body Impact of Sex Hormones

First, here’s something really important you need to understand: Sex hormones (estrogen, progesterone, testosterone) don’t just have roles in reproduction and sex drive. Receptors for these hormones exist all over our bodies! Not surprisingly, menopause-related whole-body reductions in sex hormone levels have far-reaching effects.

Hormones and Bladder Health

One organ impacted by those far-reaching effects is the bladder. It happens to be very hormone-sensitive. And not just in terms of maintaining urinary continence. When estrogen levels decline, the microbiome of the bladder and vagina changes, making postmenopausal women far more susceptible to urinary tract infections. Indeed, about 20% of women over age 65 will develop a UTI, with close to 1/3 of these experiencing recurrent infections.

Hormones and Bone Loss

The skeletal system is a major casualty. In the absence of estrogen, women can lose as much as 20% of their bone density in the first 5 years post-menopause, with bone loss slowing down to about 1% per year thereafter. As a result, one in two women over age 50 will experience an osteoporosis-related bone fracture. This is incredibly serious — a hip fracture can be a terminal event. Close to 30% of hip fracture patients will not survive one year. And even if a woman makes it past that, the odds of her getting back to prior levels of activity are low.

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Hormones and Brain Function

Brain? The risk of developing dementia and Alzheimer’s is significantly higher for women. The role of sex hormones is not fully worked out here, but even in the shorter term, sleep disturbance can become a huge issue affecting mental clarity.  Estrogen and progesterone help drive circadian rhythms, and the wild fluctuations in their levels during perimenopause can do a number on the sleep cycle. Plus, it’s hard to sleep when you’re drenched in sweat.

Hormones and Heart Disease

As a cardiologist, I see this in my practice almost daily. Heart rhythm disturbances become more common around menopause, probably due to a combination of factors — especially sleep disturbance. Fortunately, most of these rhythm issues are benign. But that doesn’t mean they feel good! Cholesterol profiles almost universally get worse as LDL receptors become less active. As a result heart disease risk accelerates rapidly in postmenopausal women, reaching par with men of equal age about 10 years post our hormonal upheaval.

Menopause-Related Impact on Life Quality

Add vaginal dryness and loss of libido and you have a marked decline in quality of life — right around the halfway point in women’s lifespans.

These may all be “natural” consequences of changes in hormone levels, but are we just supposed to sit back and accept all that?

Would MEN accept all that??

This is part one of a five-part series. See:

Menopause and the Big Lie , Part 1

Menopuase and the Big Lie, Part 2

Menopause and the big lie: The facts they left out, Part 3

Menopause and the big lie: The lasting impact, Part 4

The post Menopause and the big lie appeared first on Easy Health Options®.

But growing research shows a powerful connection: the same choices that protect your heart may also strengthen your bones — and vice versa.

Shared Risk Factors Across Systems

Osteoporosis and cardiovascular disease may seem like two completely different conditions, but they often share the same root causes. Poor diet, a lack of physical activity, smoking, and chronic inflammation can all increase your risk for both. 

Research has shown that people with low bone mineral density are more likely to experience heart-related events. Likewise, signs of atherosclerosis —hardening and narrowing of the arteries — are more common in individuals with weaker bones.

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Lifestyle and Fracture Risk

One large U.S. study looked at how cardiovascular health scores — based on the American Heart Association’s Life’s Essential 8 — related to fracture risk. These eight key health factors include diet, physical activity, sleep, smoking, body weight, cholesterol, blood sugar and blood pressure.

The study found that people with better scores had a significantly lower risk of bone fractures. Compared to individuals with poor cardiovascular health, those with moderate scores had a 22% lower fracture risk, and those with high scores had a 34% lower risk.

This tells us that small steps you take to support your heart — like going for a daily walk or choosing whole foods over processed ones — can also help keep your bones strong.

How Inflammation and Hormones Affect Both Heart and Bone Health

Research has shown that heart disease and osteoporosis often develop together, and inflammation and hormones are two key reasons why.

Chronic inflammation, which plays a major role in heart disease, also contributes to bone loss. When inflammation levels are high, the body produces chemicals that can weaken bone and damage blood vessels at the same time. This means that the same internal stress that leads to clogged arteries can also make bones more fragile.

Hormonal changes, especially in women, add another layer of connection. Estrogen helps protect both the heart and the bones. After menopause, when estrogen levels drop, the risk for both heart disease and osteoporosis accelerates. That’s why, later in life, women often experience both conditions.

The overlap goes deeper. According to research, calcium deposits found in arteries and bone loss seen in osteoporosis may actually be driven by some of the same biological processes. In other words, the breakdown of bone and the buildup of plaque in blood vessels may be two sides of the same coin.

It all serves as a reminder that the body works as an interconnected system. Supporting hormone health and reducing inflammation through healthy habits (and hormone replacement therapy when appropriate) can go a long way in protecting both your heart and your bones.

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Statins and Bone Health

Statins are best known for lowering cholesterol, but they could offer benefits for bones too. Although confounding variables may be at play, several studies suggest that statins can stimulate the growth of bone-forming cells and reduce bone breakdown.

Statins appear to increase levels of a key protein that helps bones grow, while also lowering inflammation and possibly enhancing estrogen activity. These effects have been linked to improved bone mineral density and a reduced risk of fractures, especially in older adults and postmenopausal women.

Having said that, it is possible that these findings are associations rather than causations. People who take statins may be under more regular medical care, might be more attentive to their health in general, and might be more likely to pursue an active lifestyle. The jury is still out on how helpful statins are to bone health. But while more research is needed to fully understand the best use of statins for bone support, these findings suggest that statins certainly do not promote bone loss!   

A Whole-Body Approach to Better Health

When it comes to protecting your health, there’s no need to compartmentalize. Your bones and your heart benefit from the same healthy habits:

• Eat a whole-food, anti-inflammatory diet, rich in fruits, vegetables, whole grains, and healthy fats.
• Get regular physical activity, including weight-bearing and resistance training, which supports both cardiovascular fitness and bone density.
• Don’t smoke, and take steps to manage blood pressure, blood sugar, and cholesterol.
• Talk to your doctor about your risk factors and whether bone density testing is right for you. By the way, this last piece of advice applies to everyone. Although less likely, men with risk factors can get osteopenia and osteoporosis too.

The post The hidden link between heart health and bone strength appeared first on Easy Health Options®.

But we’re seeing a parallel — younger people developing diseases that used to only strike older individuals.

As it turns out, the same thing that causes cardiometabolic disease earlier in life may also be setting us up for earlier and more aggressive colon tumors.

The Worrisome Trend

Colorectal cancer, also known as colon cancer, has long been seen as a disease that primarily affects older adults. But in the past two decades, something concerning has happened…

The rate of colon cancer in people under the age of 55 has more than doubled. And the sharpest rise is among those under 40. These aren’t isolated cases. It’s a growing trend that has doctors and researchers searching for answers.

So far, no single cause has been pinpointed. But new research is starting to reveal potential contributors, and one of them may be lurking in our gut.

A New Clue: Colibactin and Gut Bacteria

A recent study published in Nature has identified a strong link between early-onset colorectal cancer and a toxin called colibactin, produced by certain strains of gut bacteria like E. coli. Colibactin is a “genotoxin,” which is a compound capable of damaging DNA.

Researchers analyzed tissue samples from nearly 1,000 colorectal cancer patients across four continents and found that most had mutations in their tumors that matched a signature left by this bacterial toxin.

What’s especially noteworthy is that patients under the age of 40 were three to five times more likely to carry these mutations than older patients. Even more surprising? These mutations appear to originate in early childhood — possibly even before age 10.

While this doesn’t prove colibactin causes colon cancer, it’s a compelling clue. And it reinforces something we’re learning again and again: the health of our gut microbiome — the trillions of bacteria living in our digestive tract — can have long-term, far-reaching consequences.

We Still Don’t Know the Full Story

Colibactin isn’t the whole story. Not everyone with colon cancer has these mutations. And not everyone with colibactin-producing bacteria gets cancer. So what’s going on?

Researchers believe it’s likely a combination of factors. Our environment, diet, medications, level of physical activity and other lifestyle choices all shape our microbiome, starting even in childhood. Over time, these factors may work together to encourage harmful bacteria to flourish or behave in damaging ways.

For example, early antibiotic use has been linked to an increased risk of colorectal cancer later in life, possibly because antibiotics can wipe out beneficial bacteria and allow harmful strains to take over. Other possible contributors include how we were born (vaginal delivery vs. C-section), whether we were breastfed, and whether our diets as children included ultra-processed foods.

The Fiber Connection

If there’s one thing nearly all Americans have in common, it’s this: we don’t eat enough fiber. In fact, approximately 95% of us fall short of the recommended daily intake.

That’s a big problem, especially for gut health. Fiber is essential fuel for our beneficial gut bacteria. When we eat a fiber-rich diet full of fruits, vegetables, legumes, whole grains, and nuts, we help the good bacteria thrive and crowd out the bad.

Fiber also reduces inflammation, improves digestion, regulates bowel movements, and may even bind to and help eliminate toxins in the colon.

Fiber also has wide-ranging effects on cardiometabolic health. It helps reduce cholesterol absorption, keeping LDL levels down, modulates glucose absorption for steadier/lower insulin release, and supports natural GLP-1 production. 

On the flipside, a low-fiber diet (especially one high in ultra-processed foods) can leave our gut microbiome undernourished, unbalanced, and more vulnerable to disruption. That low-fiber diet also leaves our cholesterol elevated, our blood sugars high and our appetites unsatisfied.

But here’s the important point — we can modify this! 

Animal studies have shown that changing fiber intake can impact tumor growth and the activity of toxins like colibactin. Meanwhile, adding 10 grams of fiber per day (the equivalent of what’s in 2 servings of Step One Foods) raises natural GLP-1 production by 56%! In a matter of days!

Colon Cancer Screening: When to Start

Because early-onset colon cancer is on the rise, guidelines have shifted. The U.S. Preventive Services Task Force now recommends that all adults at average risk start screening at age 45. This can be done through colonoscopy, at-home stool tests, or other approved methods. People with a family history of colon cancer or other risk factors may need to start even earlier.  

So, if you’re over 45 and haven’t yet had your colonoscopy, what are you waiting for? Get screened for this condition. Early detection saves lives. In fact, when colon cancer is found early, it’s one of the most treatable forms of cancer.

And if you’ve not been screened for high cholesterol, high blood pressure or high blood sugar, I’d ask the same thing! 80% of heart disease need not exist. But you can’t possibly know if you’re at risk if you have no data.

The post Young-onset colon cancer and heart disease: A concerning parallel appeared first on Easy Health Options®.

Liquid I.V. is obviously doing a good job of marketing, as the company has quadrupled sales over the last 4 years. Estimates are that we are spending $1 billion on this hydration brand alone. So, if you’re not already using it, clearly a lot of people around you are.

Besides selling to the general public, Liquid I.V. donates its products to hydration programs around the globe, which is highly laudable. But does all that mean you should be reaching for it, too? 

Probably not.

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When Electrolytes Matter

For most of us, the reason to hydrate with something other than plain water is if our dehydration has arisen from prolonged or intense physical activity. This means we have not only lost water through sweat, we have also lost a significant amount of electrolytes, including sodium, potassium, and chloride. In that scenario, we are more prone to muscle cramping and to longer muscle recovery.   

In parts of the world where diarrheal illnesses are common, rehydration with sodium, potassium, and chloride-supplemented water can be lifesaving. This is the whole idea behind Pedialyte — the hydration formula many of us have used when our children experience digestive distress.

Now, I don’t know about you, but I’m a reasonably active person. And except for a few hot days, I rarely sweat enough to worry about electrolyte imbalance. Obviously, if you are extremely active or just sweat a lot with activity, replacing electrolytes may make sense.

However, I just can’t imagine that there are enough uber athletes or excessively sweaty people out there to justify a quadrupling of Liquid I.V. sales. This means people who don’t need the solution have been made to feel like they do — especially with formulas boasting immune support, energy enhancement and better sleep. They even have a formula specifically targeted at children.

What’s Really Inside Liquid I.V.?

The company’s website does not prominently display the nutrition facts panels. At least I could not find them. I had to go to Target’s site to discover that each serving of their sugar-free version includes around 500 mg of sodium, 375 mg of potassium, plenty of B vitamins like folate, B6 and B12, a good amount of vitamin C, allulose and artificial flavors. The cost is about $1.50 per sachet.

500 mg of sodium is a lot — anywhere from a ⅓ to ¼ of the sodium needed for the day. The potassium content is relatively low — about 10%. The zero-calorie sweetener, allulose, can be found in minute quantities in fruits such as figs and dates. However, in larger amounts, it still falls into the non-nutritive sweetener category with all the negative downstream effects. Although this does not make it dangerous, allulose is currently not approved in Europe since their scientific body has determined there is not enough human data to deem it safe.

Other varieties contain cane sugar as well as non-nutritive sweeteners, similar levels of sodium and potassium, and slight variations on other additives. The energy version has added caffeine. The immune version has extra zinc and vitamin C. The sleep version contains melatonin. The kid’s version is mostly a half dose of the regular adult version.

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Do You Actually Need More Sodium?

But here’s the thing — in the absence of dehydration with significant electrolyte loss, about the last thing we need is to add sodium to our diets!

Even if we are tired, sleepy, low on immunity, or still growing. Because we are already swimming in added sodium from the foods we eat.

What we are generally low in is potassium, because we don’t eat enough fruits and vegetables. The ratio of potassium to sodium in Liquid I.V. might be fine if you’re managing diarrhea. But if your goal is to supplement the minerals you are truly lacking, this is not the best solution.

The Real Cost of Electrolyte Powders

Finally, I have to say something about the price tag. 500 mg of sodium can be found in less than a ¼ teaspoon of salt, at basically zero cost. Vitamins and additives are pennies at best.

And you can get more potassium from one banana (with natural sugars, vitamin C and whole food fiber to boot) for about $0.25. At $1.50 per packet of powder, I just don’t see the value. 

But in case you thought I was avoiding a big topic — rehydration drinks can work wonders for a hangover. And if you overdid it, I’m not going to judge. $1.50 might feel like a total bargain at that point! But if consumption of these powders has gone up fourfold due to Americans’ need for hangover management, we have FAR BIGGER problems.

Final Thought: Are Electrolyte Drinks a Fad? 

OK… in this blog, I focused on Liquid I.V., but I would urge you to consider the same points when you reach for any liquid or powder touting its rehydration powers. With few exceptions, plain water is enough.

My overall conclusion? Fad.

The post Electrolyte drinks: Good, bad or Fad? appeared first on Easy Health Options®.

While many individuals are preoccupied with protein intake, a significant number are neglecting a vital nutrient — fiber.

Despite its essential role in maintaining overall health, fiber doesn’t receive nearly the attention it deserves.

The Truth About Fiber Intake

According to a comprehensive study on fiber intake, less than 5% of Americans meet the recommended daily intake for dietary fiber. That’s a 95% deficiency rate for a nutrient proven time and time again to reduce the risk of chronic disease.

As a point of contrast, the statistics are almost exactly flipped for protein:  more than 92% of women consume enough protein to meet their estimated average requirements, resulting in an 8% deficiency rate. Many of us consume more than double the protein we need!

The minimum recommended daily intake for fiber is 25 grams for women and 38 grams for men, but the average adult only gets about 15 to 16 grams per day. 

This shortfall, often referred to as the “fiber gap,” has significant health implications.

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Fiber Matters More Than You Think

Fiber is not just about keeping you regular. It’s a key regulator of metabolism, inflammation, appetite, and immune function, that facilitates superior  cardiometabolic outcomes, including:

• Lower all-cause mortality
• Reduced risk of cardiovascular disease
• Improved lipid profiles (lower total and LDL cholesterol)
• Better  blood pressure regulation
• Reduced incidence of type 2 diabetes
• Lower weight 

All from getting more fiber. Oh, and if that’s not enough, you also get decreased risk of colorectal and breast cancer!

The GLP-1 Connection: Fiber and Appetite Regulation

One of the most fascinating insights from current research is fiber’s impact on GLP-1 (glucagon-like peptide-1), a hormone that helps regulate insulin secretion, blood sugar, and satiety.

When we eat fiber, particularly soluble and fermentable types found in foods like oats, flaxseeds, legumes, and berries, it feeds our gut bacteria. In return, these microbes produce short-chain fatty acids (SCFAs) that trigger the release of GLP-1. This hormonal cascade slows digestion, curbs appetite, and helps prevent overeating.

This is why so many Step One customers report feeling fuller longer and experiencing fewer cravings. It’s all that whole-food fiber at work, activating a powerful metabolic feedback loop.

By the way, if “GLP-1” seems familiar, it’s because this is the hormone that is delivered by drugs like Ozempic, Wegovy, Mounjaro and Zepbound.  And in case you’re wondering why we are injecting artificial GLP-1 into people in the setting of near universal fiber deficiency — instead of first making sure that fiber gap is closed so that GLP-1 levels can go up naturally — welcome to my indignation.

The Fiber Gap and Chronic Disease

Low fiber intake is a public health crisis. It’s directly linked to:

• Obesity and weight gain
• Elevated cholesterol levels
• Hypertension
• Insulin resistance
• Inflammation and oxidative stress

Is it any wonder our society is awash in heart disease, pre-diabetes and diabetes, obesity, and chronic pain? And why are we seeing more colorectal cancer in younger and younger people? While medications can address some of these issues, fiber works upstream, ultimately helping prevent these problems from occurring in the first place.

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Bridging the Gap with Step One Foods

This is exactly why I created Step One Foods. 

Two daily servings of our products deliver at least 10 grams of fiber, using only whole food ingredients like chia seeds, oats, and walnuts. These foods naturally provide the types of fiber (soluble, insoluble, and fermentable) that your body and microbiome need to function optimally.

If the average person is missing about 10 grams of fiber per day, two servings of Step One get you there, closing the fiber gap. All without supplements or drastic diet changes.

Our foods are also backed by clinical data. In a Mayo Clinic-led randomized controlled trial, participants who consumed Step One Foods twice daily saw rapid, significant reductions in LDL cholesterol, providing yet another proof point regarding the health-building properties of our foods.  

It’s Time to Focus on Fiber

We’ve spent decades worrying about fat, carbs, and most recently, protein. But if I could get every patient to focus on one nutrient starting today, it would be fiber.

The science is clear. The benefits are vast. And the solution is simple: eat more real, whole, plant-based foods.

And let Step One help. We’ve done the heavy lifting by creating delicious, clinically supported options that make meeting your fiber goals easy and enjoyable.

Your body will thank you. So will your heart.

The post Focus on protein? The fiber gap matters most appeared first on Easy Health Options®.

From nutrition to skin care, this “ancestral fat” is definitely having its moment.

So, should you just jump on the bandwagon?

What Is Beef Tallow and How Is It Made?

Beef tallow is created by taking the fat that surrounds the internal organs of a cow, cooking that fat down, and straining out the impurities. It’s a way for beef processors to use every part of the animal in order to make useable products — and turn a bigger profit. 

Beef tallow is stable both at room temperature and high heat and, until relatively recently, was the go-to fat for frying and baking. It’s also been used to make candles and soap.

When concerns around the health effects of saturated fats emerged in the 20th century, vegetable oils and margarines largely replaced beef tallow in industrial food production. Around the same time, rates of chronic disease and obesity rose, providing ammunition for beef tallow evangelists — especially within the keto, paleo and carnivore communities.

But as we learned from the seed oils blog series and my post on lectins, one data point does NOT an open and shut case make.

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Beef Tallow Nutrition Facts: Saturated Fat, Calories, and Vitamins

Beef tallow is made up of about 55% saturated fatty acids (SFAs), 40% monounsaturated fatty acids (MUFAs) and 5% polyunsaturated fatty acids (PUFAs). 

By comparison, canola oil is made up of about 5% SFAs, 65% MUFAs and 30% PUFAs.  Tallow also contains fat-soluble vitamins (A, D, E, and K2), though in relatively small amounts.  

With such a high percentage of SFAs, beef tallow is classified as a saturated fat and falls in the same nutritional category as butter, cheese, cream, lard and coconut oil.

Does Beef Tallow Raise Cholesterol and Heart Disease Risk?

Saturated fat can be a strong down-regulator of LDL receptors. If you’ve read some of my previous blogs, you already know that LDL receptor function is important for clearance of LDL from the bloodstream. In other words, if LDL receptor function is diminished, LDL levels go up. Sometimes way up. I have seen patients that go on a keto diet and end up with LDLs in ranges typically reserved for those with Familial Hypercholesterolemia!

But please don’t be fooled by claims that the high LDL you get by eating saturated fat is OK because LDL is now all “big” particles! A high LDL reading means that there are still lots of LDL particles circulating in your bloodstream, and particle size does not rescue you in that setting. Most importantly, if your LDL receptors are downregulated such that you’re not using the LDL for other functions, the only place that cholesterol can go is into artery walls. 

And make sure you also ignore the rhetoric that some of the saturated fat in beef tallow is stearic acid and that makes it better. Stearic acid is a saturated fat found in high amounts in cocoa beans and chocolate and does NOT raise LDL cholesterol. However, beef tallow contains much less stearic acid compared to chocolate — and the rest of the saturated fatty acids in beef tallow DO raise LDL.  

Beef Tallow, Fatty Liver, and Insulin Resistance: What’s the Link?

Like all fats, beef tallow is calorie dense, delivering 9 calories per gram. So overdoing it even modestly but consistently can get you into trouble… fast. Turns out saturated fat is especially good at accumulating in the liver — much more so than unsaturated fat.  

Liver fat accumulation sets off a vicious cycle of metabolic changes that leads to insulin resistance, which can lead to prediabetes and, eventually, type 2 diabetes. Liver fat accumulation can also damage the liver itself, causing fatty liver disease, a condition as serious as liver disease caused by chronic excess alcohol consumption.  

Can Beef Tallow Cause Inflammation?

Although seed oils have been maligned for being pro-inflammatory, saturated fats — including beef tallow — also influence inflammatory pathways.

Saturated fats have been found to “short circuit” immune cells, upregulate pro-inflammatory cytokines, and negatively affect the microbiome, all leading to a higher inflammatory load. 

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Beef Tallow and Chronic Disease: Why Context Matters in Nutrition

Advocates of beef tallow and other saturated fats point to the relative absence of chronic disease in traditional societies with high animal fat consumption. However, these societies also:

• Engaged in high levels of physical activity
• Ate minimal processed food
• Had overall balanced calorie intake 
• Ate a greater variety of foods in general, including various plants, leading to a more diverse microbiome 

In other words, as I’ve noted before, we can never look at one nutrient or ingredient in isolation. We are complex organisms living in complex environments while consuming a complex mixture of foods. It’s not the beef tallow or the seed oils that is the problem. It’s the “with what” and “instead of what” that is the bigger concern. 

Should You Eat Beef Tallow? The Bottom Line

Beef tallow is a real food, derived from natural sources. As such, it is not inherently toxic. However, it is NOT a “health food” nor the answer to all our ills. Context matters.

Occasional beef tallow consumption may be benign as part of a nutrient-rich, calorie-controlled, plant-inclusive diet. (Need I say it? Eat food. Not too much. Mostly plants. Honestly, never gets old.)  However, regular use in the setting of a nutrient-poor or calorie-excess diet poses real long-term health risks. 

So much so that individuals favoring high beef tallow (or other saturated fat) consumption, should be regularly monitored with lab tests, including cholesterol, blood sugar, and liver function parameters.

Robert F. Kennedy, Jr, the US Secretary of Health and Human Services, has declared that beef tallow is healthier than seed oils and is encouraging food companies to use it preferentially. Restaurants like Steak ‘n Shake and Sweetgreen have already made the switch.   

And as far as his opinion, it’s just an opinion. Made by an individual who is not a healthcare provider or nutrition expert. Although I applaud his stance on food additives and ultra-processed foods, as someone who takes care of patients and witnesses what happens with various dietary approaches, I can say without hesitation that he doesn’t get everything right.

Oh — and in case you’re wondering whether you should put this stuff on your face, beef tallow acts like an occlusive barrier rather than a moisturizer. So, it won’t eliminate wrinkles outright although it might aid in the absorption of what you put underneath — like vitamin C serum or retinoic acid. But I suspect you won’t much enjoy the scent! And if you are prone to acne, you might truly regret it.

The post Beef tallow: Benefits, risks and truths behind the trend appeared first on Easy Health Options®.

Eating with the seasons isn’t just good for variety — it also ensures access to the freshest, tastiest and most nutrient-packed produce typically at a lower price point. 

So, what should you keep on hand this spring? Here are the foods I turn to now…

The season’s best

1. Leafy Greens: The Ultimate Spring Superfood

Spinach, kale, arugula, and Swiss chard are loaded with heart-protective nutrients like vitamin K, folate, and nitrates, which help improve circulation and lower blood pressure. I like to use them in salads, toss them into smoothies, or sauté them with olive oil and garlic for an easy side dish.

2. Asparagus: A Springtime Must-Have

Asparagus is packed with fiber, folate, and antioxidants that help lower homocysteine levels — a marker linked to heart disease. It’s also a natural diuretic, helping to reduce bloating and excess sodium in the body. Roast it, steam it, or grill it for a delicious spring side. I love asparagus with fish or as part of a roasted mixed vegetable main course.

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3. Avocados: Healthy Fats for a Healthy Heart

While avocados are available year-round, they’re especially delicious in spring. They’re rich in monounsaturated fats, which help lower bad cholesterol (LDL) while raising good cholesterol (HDL). Mash them onto whole-grain toast, mix them into salads, or blend them into a creamy dressing. My typical approach is to cube the avocado and add it to a salad. I could easily eat an avocado a day.  

4. New Potatoes: Nutritious and Filling

Potatoes in spring are simply the best. Small and flavorful, they’re packed with vitamin B6, vitamin C and potassium, all important for blood vessel function and blood pressure control. In fact, one serving of potatoes can deliver a quarter of your day’s requirement of these nutrients. They’re also versatile and filling. Because the potato peel is the repository of much of this vegetable’s benefit, just wash and cook whole — and eat with the peel. No problem with new potatoes and their delicate and mild-tasting skins. I especially love spring potatoes dusted (OK, doused) with chopped dill.

5. Citrus Fruits: Vitamin C for Vascular Health

Grapefruits and kumquats are at their best in early spring. And they’re high in vitamin C and flavonoids, which help reduce inflammation and improve blood vessel function. You can eat kumquats whole — rind and all — just pop them in your mouth like grapes. Adding grapefruit slices to salads or just peeling and eating like you would an orange can add a quick nutrient boost to your day. My favorite is the Ruby Red.

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6. Rhubarb: Fiber Goodness

Besides being a good source of vitamin C and other antioxidants, rhubarb is brimming with fiber. Chop and cook with a bit of water and sugar to taste and get a beautiful topping for yogurt or even pancakes. I love the sourness of rhubarb, but I also don’t shy away from adding enough sugar to make it palatable. After all, it’s hard for me to realize the health benefits of any good-for-you food if I can’t stand to eat it!

7. Kiwis: Carotenoids and Beyond

Kiwi fruit are available year-round, but they’re at their best in spring – and might be one of your best food-based weapons against colds and flu. Just one kiwi delivers almost an entire day’s worth of vitamin C.  Kiwis are also packed with carotenoids like lutein and beta carotene, that are important for heart — and general — health. I have to admit that peeling a kiwi is not always my favorite task, but experiencing the beautiful color and flavor of the fruit is definitely worth it.

8. Berries: A Heart-Boosting Powerhouse

Strawberries, blueberries, and raspberries finally arrive late spring. They’re rich in antioxidants, fiber, and polyphenols that help lower inflammation and improve blood vessel function. These delicious fruits are naturally sweet and perfect for topping oatmeal, blending into smoothies, or enjoying as a snack. As you may already know, my go-to breakfast consists of a bowl of berries topped with yogurt, Anytime Sprinkle and a spoonful of orange marmalade. Yum!

Step Into Better Health This Spring 

Spring is the season of renewal and the perfect time to renew our commitment to health. And if your resolve slipped a little during winter, prioritizing fresh, whole foods — especially spring’s bounty of vibrant fruits and vegetables — will get you back on the right path in no time, one delicious bite at a time!

The post Spring into heart health: A cardiologist’s list of the season’s best appeared first on Easy Health Options®.

Lowering cholesterol isn’t just about cutting back on high-cholesterol foods or unhealthy fats; it’s about strategically incorporating nutrients that actively work to improve your lipid profile. Fiber, plant sterols, and omega-3s each play unique roles, and when combined, their effects are amplified.

This week, let’s explore the powerful synergy of fiber, plant sterols, and omega-3 fatty acids — a true trifecta for lowering cholesterol and supporting heart health.

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Fiber: The Cholesterol Blocker

Fiber, especially soluble fiber, acts like a sponge in your digestive system, trapping cholesterol and removing it from your body before it has a chance to enter your bloodstream. Research consistently shows that high-fiber diets are linked to lower LDL cholesterol levels and a reduced risk of heart disease.

Foods rich in soluble fiber include:

• Oats and oat bran
• Beans and lentils
• Fruits like apples, pears, and berries
• Vegetables like Brussels sprouts and carrots
• Seeds such as chia and flaxseeds

Eating more fiber doesn’t just help with cholesterol — it also supports gut health, stabilizes blood sugar, and keeps you feeling fuller longer. In fact, fiber is key to supporting your microbiome’s ability to make adequate amounts of GLP-1 (the hormone that drives satiety and blood sugar control — and is mimicked by drugs like Ozempic®).  

Plant Sterols: Nature’s Cholesterol Fighters

Plant sterols (also called phytosterols) are natural compounds found in plants that closely resemble cholesterol at a molecular level. Because of this similarity, they compete with cholesterol for absorption in the digestive tract — meaning less cholesterol makes it into your bloodstream. Studies show that consuming just 2 grams of plant sterols per day can reduce LDL cholesterol by as much as 10%.

Foods that contain plant sterols include:

• Nuts and seeds
• Whole grains
• Fruits and vegetables
• Fortified foods like certain margarines and orange juice

At Step One Foods, plant sterols are a key ingredient in our scientifically formulated products, ensuring you get a clinically meaningful dose with every serving.

Omega-3s: The Heart-Healthy Fat

Omega-3 fatty acids are essential fats that help lower triglycerides, reduce inflammation, and support overall heart function. Unlike fiber and plant sterols, which directly lower cholesterol absorption, omega-3s improve cholesterol balance by increasing HDL (good) cholesterol and reducing harmful blood fats that contribute to heart disease. Omega-3s also possess anti-inflammatory and mild blood thinning properties — which help reduce the risk of acute cardiovascular events (like heart attacks and strokes). 

Sources of omega-3s include:

• Fatty fish like salmon, mackerel, and sardines
• Walnuts
• Flaxseeds and chia seeds
• Algal oil (a plant-based source of omega-3s)

Bringing It All Together

The best way to lower cholesterol naturally is to incorporate all three of these nutrients into your diet consistently. When you do that, the effects can truly be synergistic. For example, we’ve demonstrated that this nutrient combination can yield nearly 40% LDL reductions (far more than what’s possible with plant sterols alone and essentially equivalent to the expected effects of a drug!).  

Step One Foods is here to make it easy to get started on getting enough of these nutrients into your diet. But you can amp up the Step One Foods effect even further. Here’s what a Perfect Trio day might look like:

• Breakfast: Oatmeal topped with flaxseeds and berries (or Step One’s Blueberry Cinnamon version).
• Lunch: A salad with walnuts, chickpeas, and avocado
• Snack: A Step One Foods bar packed with fiber, omegas and plant sterols
• Dinner: Grilled salmon with roasted Brussels sprouts and quinoa

Whether or not you require medications for cholesterol, by making fiber, plant sterols, and omega-3s a priority, you’re giving your heart the best possible support for positive outcomes. And with Step One Foods, getting these nutrients in the right amounts has never been easier.

The post The cholesterol-lowering trifecta that supports your heart appeared first on Easy Health Options®.

In fact, sleep is now officially recognized by the American Heart Association (AHA) as part of the Essential 8 — a set of lifestyle measures proven to enhance cardiovascular health. 

So how does sleep protect your heart? What happens to your body during sleep? And how can you make rest a priority in your daily life?

Sleep: A Cornerstone of the Essential 8

The AHA added sleep to its list of Essential 8 because research has confirmed that good-quality rest is critical to overall health, including the health of your heart.  During sleep is when your body performs vital functions: repairing tissues, regulating hormones, and giving your heart and blood vessels a much-needed break. Without enough rest, these critical processes are interrupted, increasing your risk for high blood pressure, diabetes, and even heart attacks.

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What Happens During Sleep

Sleep is more than just downtime for your body. When you sleep, especially during deeper stages, your heart rate and blood pressure drop, reducing the workload on your cardiovascular system. This nightly “reset” allows your heart to recover and prepare for the day ahead. Additionally, your body regulates essential hormones during sleep, such as:

• Stress hormones: Levels of cortisol, which can raise blood pressure, naturally decrease during sleep.
• Hunger hormones: Sleep balances ghrelin and leptin, the hormones that control hunger and fullness. 

What Happens When You Don’t Get Enough Sleep

Skipping sleep, or even regularly getting less than seven hours a night, puts your heart at risk. Here’s how:

• Higher Blood Pressure: Without the nighttime drop in blood pressure that occurs during sleep, your heart and blood vessels remain under constant stress.  Sleep apnea, specifically, can be the sole reason someone has hypertension.  So if you snore and have high blood pressure, discuss sleep apnea screening with your physician.
• Increased Inflammation: Poor sleep is linked to higher levels of C-reactive protein, an inflammatory marker tied to heart disease.
• Elevated Stress Hormones: A lack of sleep can raise cortisol levels, contributing to higher heart rate, blood pressure, and blood sugar.
• Weight Gain: Sleep deprivation alters hunger-regulating hormones, making overeating more likely. 

Over time, these factors can lead to conditions like hypertension, obesity, and diabetes — all of which strain your heart and increase your risk of heart disease and stroke.

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How to Prioritize Sleep

The good news? Sleep is something you can control. Here are steps to help you get the quality rest your heart needs:

1. Stick to a Sleep Schedule: Go to bed and wake up at the same time every day, even on weekends. A consistent schedule reinforces your body’s circadian rhythm, helping you fall asleep and wake up more easily.
2. Create a Relaxing Bedtime Routine: Ease into sleep with calming activities like reading, meditating, or taking a warm bath. This signals your body that it’s time to wind down.
3. Limit Stimulants: Avoid caffeine, nicotine, and heavy meals in the hours leading up to bedtime. These can disrupt your ability to fall or stay asleep.
4. Turn Off Screens: Blue light from phones, tablets, and TVs can interfere with your body’s melatonin production, making it harder to fall asleep — power down at least an hour before bed.

If You’re Still Struggling

Poor and non-restorative sleep has wide-ranging health effects. This blog has focused on cardiometabolic health, but not getting enough nightly rest can contribute to cognitive decline and even cancer risk. 

So if you’ve tried everything and are still struggling, talk to your doctor.  For perimenopausal women, hormone replacement may be the answer.  For others, sleep apnea evaluation may be appropriate.

In some circumstances, a formal referral to a Sleep Medicine specialist is required. The one thing NOT to do? Ignore your sleepless nights. 

The post What happens to your body and heart during sleep appeared first on Easy Health Options®.

But recently, this sour, fermented apple liquid has found itself in the spotlight — and not just for its cleaning power. ACV is now being touted as a health elixir, with claims that it can aid in weight loss, control diabetes, improve cardiovascular health, and more. 

But how much of this is hype, and how much is backed by science?

Let’s dive into what the research says about apple cider vinegar’s health benefits…

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What the Science Shows

Lowering Blood Glucose Levels

One of the best-supported claims about ACV is its potential to help manage blood sugar.

Several studies have found that consuming apple cider vinegar daily may slightly reduce fasting blood glucose and A1C levels in people with Type 2 diabetes. 

A 2021 meta-analysis of 9 studies showed a reduction in fasting blood glucose by about 8 mg/dL for those with Type 2 diabetes. In a more recent intervention trial, people who consumed 2 tablespoons of ACV daily for eight weeks saw a reduction in their A1C, provided they also followed a healthy diet.

While these results are promising, it’s important to note that all of these studies were relatively small and more research is needed before we can call ACV a game-changer for diabetes management — especially since the blood sugar reductions were relatively minor.

Still, the possibility that incorporating ACV could be helpful as part of a comprehensive approach for managing blood sugar elevations cannot be excluded.

Lowering Cholesterol Levels

Another area where ACV has been touted as a solution is in cholesterol management. The same 2021 meta-analysis also suggested that ACV consumption could help reduce total cholesterol, particularly in people with Type 2 diabetes.

The intervention trial found that diabetic individuals who drank ACV while also adhering to a healthy diet saw improvements in both LDL (“bad”) cholesterol and total cholesterol.

However, we should view all these findings cautiously given that they were seen in the setting of Type 2 diabetes and in combination with dietary modification.  Whether the cholesterol improvement was related to better blood sugar control, a direct effect on cholesterol metabolism, or the dietary changes themselves is unknown.

My best advice would be that if you’re going to try apple cider vinegar as a cholesterol-lowering intervention, don’t just accept it on faith that it’s going to work.

Objectively test your response with a repeat lipid profile evaluation after at least 30 days of consistent use — ideally without changing anything else about your diet or exercise routine.  

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Weight Loss and Appetite Control

There are also claims that ACV can promote weight loss by reducing appetite, slowing gastric emptying, and curbing cravings. However, the studies behind these claims have been small and short-term.

Real, sustained weight loss comes from consistent healthy habits — like eating a nutrient-dense diet, incorporating physical activity, and lowering overall calorie intake. It won’t come from consuming ACV alone.

Supporting Gut Health

Because apple cider vinegar is a fermented product, so long as it is not pasteurized it will contain natural probiotics that can help support a healthy gut microbiome.

Probiotics boost the amount of beneficial bacteria in your gut, which in turn can promote better immunity, digestive health, and even mental well-being.

Including ACV in your diet, whether as part of a salad dressing or marinade, can be one way to add a probiotic boost. 

Downsides of Apple Cider Vinegar

If the above discussion has you thinking – “What do I have to lose?” — just remember that ACV is VINEGAR. That means it can irritate your stomach, worsen gastric reflux, and even strip tooth enamel. “Miracle” cures are often not entirely miraculous. At the very least, in the case of ACV, please never drink it undiluted.  

At Step One Foods, we believe in a holistic approach to health with an emphasis on sustainable, balanced choices—like consuming real, wholesome foods every day. With Step One Foods, you get scientifically formulated products designed and proven to support heart health without any downsides. No miracles required.

The post A cardiologist answers: What can apple cider vinegar really do? appeared first on Easy Health Options®.

Even though it’s far from it! 80% of heart disease need not exist. That’s not a wish. It’s a fact.

And unless you’re diligent, you might be missing an opportunity to avoid it. 

Here are some key facts you need to know:

1. High cholesterol and high blood pressure have no symptoms

Two of the leading preventable causes of heart disease can be present inside your body without you realizing it. Even though both conditions affect nearly half of all US adults, neither high cholesterol nor high blood pressure are associated with obvious physical signs or symptoms. So unless you have them checked, you can’t know if you’re in the clear.

How often should you have these evaluated?  My rule of thumb is that cholesterol levels should be checked once in your teens, twice in your twenties, three times in your 30s, four times in your 40s, five times in your 50s, and yearly there after. More frequent checks are required if abnormal readings are noted at any point along the way. Blood pressure should be checked at EVERY healthcare encounter and AT LEAST as frequently as cholesterol.

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2. Hidden risks are common

Even when you get your cholesterol checked, you may have incomplete information about your true risk. Apo B and Lipoprotein A are tests worth having — although few physicians are aware of these tests and actually order them.

Lipoprotein A is a genetically determined risk factor that can only be uncovered with a blood test. It affects about 1 in 5 Americans. And if you don’t test for it, you won’t know if you’re at increased risk of developing plaque buildup prematurely. You need this tested only once in your lifetime.

Apo B helps determine how confident we are that your LDL reading is a true representation of risk. Apo B can change with lifestyle adjustment.  Timing and appropriateness of Apo B testing is something that your doctor should weigh in on. Apo B and Lipoprotein A (Lp(a)) are both assessed with blood tests that are not expensive and are typically covered by insurance (but always good to check with your specific plan).

3. Heart disease is not just a concern for older adults

Traditionally, heart disease has been viewed as an illness affecting primarily older adults.

However, as outlined in a recent blog, heart disease begins in childhood.  And when we exercise less because we’re glued to screens, and when we’re surrounded by foods that fuel high cholesterol, high blood sugar and high blood pressure, it might not be surprising that heart attacks among adults under 40 have become increasingly common.

Regardless of age, the time to start preventing heart disease is today.

4. Heart disease is the #1 killer of women — and many don’t know it

Many people still think of heart disease as primarily a “men’s issue,” but it’s actually the leading cause of death for women as well. In fact, heart disease kills more women each year than all cancers combined (including breast cancer).

Women are also less likely to experience the classic signs of a heart attack, such as chest pain, which can delay diagnosis and treatment. Symptoms in women can be subtler and may include fatigue, nausea, or shortness of breath. Although many women experience fatigue (Hello! We’re juggling multiple roles!) and both nausea and shortness of breath have many causes, if you have risk factors for heart disease (see #1 and #2), you should take your symptoms seriously — especially if they are new or unexpected. 

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5. Food drives most of it

Globally, heart disease remains the top cause of death. In the United States alone, someone dies from a heart-related condition every 33 seconds. This is roughly the equivalent of a September 11th-like tragedy repeating itself every 24 hours, 365 days a year.  

This statistic underscores just how pervasive and serious heart disease is. But it’s not just about mortality rates — it’s also about the quality of life for millions of people who live with heart conditions. And, to reiterate the point I made at the beginning of this blog, 80% of this represents unnecessary suffering. 

Five of the 7 modifiable risk factors for heart disease (high cholesterol, high blood pressure, high blood sugar/diabetes, excess weight, poor diet) are all due in part or in whole to dietary choices (quitting smoking and moving more are the other two modifiable risk factors).  This means changing what you eat is the most impactful thing you can do yourself to avoid this disease.   

Take charge of your heart health today

Step One Foods exists to help you make the dietary changes needed to impact your heart health destiny, with products that are not only easy to use but also unapologetically delicious.  Our focus is on real food, backed by real science, for real results—because heart disease is not destiny. You have more control than you think and we’re here to help.

The post 5 scary heart health facts that could haunt you appeared first on Easy Health Options®.

Medications can help, but most of my patients are interested in minimizing their need for those and deploying every lifestyle avenue available to achieve their BP goal. Losing weight, quitting smoking, exercising regularly, sleeping well, managing stress, and avoiding sodium and stimulants (like caffeine and alcohol) can all make a big difference.

But new research opens yet another avenue to lower blood pressure readings — spirituality and gratitude.

A groundbreaking study presented at the American College of Cardiology’s Annual Scientific Session found that people with high blood pressure who engaged in daily spiritual practices saw their systolic blood pressure drop by an average of 7 mmHg. This is a medication-level reduction!

In addition, participants also experienced improvements in the health of their blood vessels, as measured by flow-mediated dilation (FMD), a key marker of cardiovascular health.

The Power of Spirituality and Gratitude

The study, conducted in Brazil, followed 100 patients with hypertension over 12 weeks. Half of the participants received daily messages via their smartphones, designed to encourage spiritual reflection and practices such as gratitude, optimism, and forgiveness. These messages were simple yet impactful, inviting participants to take a few moments out of their day to focus on life’s purpose or complete small tasks like sending a message of thanks to someone.

The results were striking. Alongside the 7 mmHg drop in blood pressure, participants in the spirituality group saw their FMD increase by 4.5 percent, indicating healthier blood vessels and better cardiovascular function overall. In contrast, those who didn’t receive the intervention actually experienced a decline in FMD by 3 percent.

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Spirituality Without Boundaries

One of the most compelling aspects of this study is that the intervention wasn’t tied to any specific religious tradition. Instead, it focused on universal concepts such as gratitude and forgiveness, making it accessible to anyone regardless of faith background. 

While previous studies have hinted at the connection between spirituality and heart health, most have been observational, making it difficult to prove a direct link. This new study adds to the growing body of evidence that suggests focusing on positive emotions can lead to measurable health improvements.

Our Complex Self

In medical school, we are taught to look at the body in bits and pieces. Organ systems, targeted pharmaceuticals, treatment sub-specialization.  But when doctors finally go into practice, if they are observant and curious enough, they quickly see that nothing about the human body or human health is separate or isolatable.  

This is why relying only on targeted pharmaceuticals represents a narrow view of health and healing.  Each of us has the ability to help ourselves heal from within.  That doesn’t mean drugs are bad — but why not leverage our complexity to our advantage?  Including our emotions.  

Remember, a key pillar of healthy longevity is a sense of purpose and joy – a sense that is supported by feelings of gratitude, optimism and forgiveness.  What this new research confirms is that those emotions don’t just make us feel good —  they also measurably improve health. 

The post Study links spirituality to healthier blood pressure appeared first on Easy Health Options®.

But what if these two seemingly separate conditions were more connected than we ever thought?

A new study suggests that the health of our hearts and brains might be more closely linked than we imagined and that this connection could hold the key to slowing down the onset — and progression — of Alzheimer’s disease.

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The Role of the Blood-Brain Barrier

When I was in medical school, I spent a lot of time learning about the endothelium — the thin layer of specialized cells that lines the inside of blood vessels. This layer governs what enters artery walls (like cholesterol) and determines how well blood vessels dilate (like in response to exercise). 

I also learned that inside the brain the endothelium is a bit different. There, endothelial cells are so tightly packed that there’s almost no space for anything to slip through without help. This fairly impervious “blood-brain barrier” is designed specifically to protect the brain from being infiltrated by unwanted visitors and compounds, keeping bacteria, viruses and many potential toxins out.

As we age, this barrier can develop tiny imperfections that make it less effective. And new research is showing that it’s the changes in the blood-brain barrier that might be a key factor leading to the development of Alzheimer’s disease, preceding noticeable symptoms like memory loss.

White Matter: The Brain’s Information Superhighway

So, what happens when the blood-brain barrier starts to break down? The answer lies in white matter, the part of the brain responsible for transmitting nerve impulses quickly and efficiently.

Unlike gray matter, which is made up of neural cell bodies, white matter consists of myelinated axon fibers that transmit instructions essential for tasks like memory, problem-solving, and coordination.

Researchers have discovered that when the blood-brain barrier becomes damaged, oxidative stress and inflammation can be seen within brain tissue. This, in turn, can negatively affect the efficiency of signal transmission within white matter, resulting in cognitive issues and memory deficits — the hallmark symptoms of Alzheimer’s disease.

New Insights from Recent Research

A study, in which researchers examined the brains of 28 individuals over the age of 65, revealed that brain blood vessels from those with Alzheimer’s disease didn’t dilate properly — a clear sign of endothelial dysfunction.  

In addition, they saw increased numbers of astrocytes in Alzheimer’s brains.  Astrocytes are specialized brain cells that normally help regulate the exchange of nutrients and waste between the brain and blood.  

In the Alzheimer’s patients, these cells appeared more reactive and inflammatory, another indication of a weakened blood-brain barrier — and a mechanism through which white matter signal transmission could be affected.

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Why This Matters

The good news is that unlike neurodegeneration, which is often irreversible, the inflammation and damage to the blood-brain barrier might be something we can address through lifestyle changes.

After all, eating an anti-inflammatory diet, exercising regularly, quitting smoking, and improving blood pressure, blood sugar and cholesterol levels have all been shown to improve endothelial function in heart arteries.  

They may be more tightly packed, but brain endothelial cells there are just like the ones found in the heart and should respond positively to the same positive lifestyle changes. 

In other words, by preventing endothelial dysfunction in general (or stopping its progression) we might be able to extend the period of normal cognitive function in people with Alzheimer’s disease.  

The Bottom Line

Taking care of your heart isn’t just about preventing heart disease — it’s also a smart way to keep your brain healthy as you age. 

With every serving of Step One Foods, you’re getting the precise nutrients proven to not only lower cholesterol (as we’ve shown in a peer-reviewed published clinical trial) but to also boost endothelial function and improve heart health, as hundreds of studies supporting the ingredient composition of our products will attest.  I can’t claim that Step One Foods prevents Alzheimer’s disease — we’ve never done that trial — but given the central role of blood vessel function in this condition, I believe we can help.

The post Can You Slow Down Alzheimer’s by Taking Care of Your Heart? appeared first on Easy Health Options®.

These low-calorie or no-calorie substitutes are often recommended in dietary guidelines, especially for individuals with cardiometabolic diseases such as obesity and diabetes.

However, the long-term effects of these sweeteners on heart health have not been thoroughly evaluated.  A recent study has shed light on the potential risks associated with one such sweetener: xylitol.

What is xylitol?

Xylitol is a type of sugar alcohol commonly used as a low-calorie sweetener and sugar substitute. It occurs naturally in very small amounts in various fruits and vegetables and is also produced in our bodies as part of normal metabolism.

For use in food production, xylitol can be made by exposing corn fiber to certain fungal strains or it can be chemically extracted from certain wood species and agricultural waste. 

Xylitol is widely used in sugar-free gum, mints, and other products due to its sweetness and ability to prevent tooth decay through the unique effects of xylitol on oral bacteria, saliva production, and acid levels in the mouth.

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Why is xylitol used?

Xylitol is popular among those looking to reduce calorie intake and manage blood sugar levels. It provides the sweetness of sugar without the associated calories or glycemic load, making it a suitable alternative for people with poor blood sugar control.

As another bonus, xylitol delivers some dental benefits, as outlined above.  What could possibly go wrong?

New safety concerns

A recent study conducted by the Cleveland Clinic has raised concerns about the potential cardiovascular risks associated with xylitol. This research follows an earlier study that linked another sugar alcohol, erythritol, to an increased risk of heart disease.

For xylitol, researchers examined data from over 2,000 individuals and found that those with the highest levels of this sugar alcohol in their blood were about 50% more likely to experience a cardiovascular event, such as heart attack or stroke, over the next three years as compared to those with the lowest levels.

The study also explored how xylitol affects blood components called platelets, which play a crucial role in blood clotting. When human platelets were exposed to xylitol, they became more sensitive to clotting signals, similar to the effects observed with erythritol. This increased sensitivity to clotting signals can lead to faster blood clot formation and artery blockage, as demonstrated in experiments with mice.

Further tests involving 10 healthy individuals drinking a xylitol-sweetened beverage, showed that blood xylitol levels spiked 1,000-fold within 30 minutes of consumption and returned to baseline after 4 to 6 hours.

During this period, platelets were more sensitive to blood clotting signals, suggesting that xylitol consumption could have immediate negative effects on cardiovascular health.

The findings from this study indicate that xylitol, like erythritol, may pose cardiovascular health risk by promoting blood clot formation.

This potential risk underscores the need for further safety studies on sugar alcohols used as artificial sweeteners. While xylitol is widely regarded as a healthier alternative to sugar, there’s no question that its potential impact on heart health warrants careful consideration and more comprehensive research.  

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As a general rule, I try to avoid consuming artificial sweeteners.  While I don’t think the occasional breath mint or piece of sugar-free gum is a problem, I always look for artificial sweeteners and sugar alcohols in the ingredient list of every food and beverage product I’m considering at the grocery store – and put the item back on the shelf if I find any lurking in there. 

An important note – sugar alcohols like xylitol and erythritol do not need to be listed as sugars or added sugars on a nutrition facts panel.  That means:

1. The food label might be screaming “low sugar” or “no added sugar” but still be full of ingredients that are counterproductive to health, and…
2. The only way to know if there’s artificial sweeteners in the food is to painstakingly scour the ingredient list.

Natural ways to satisfy your sweet tooth

Craving something sweet without the sugar rush? Opt for naturally sweet foods that also pack a nutritional punch and plenty of fiber. Fresh fruits like grapes, pineapples, mangoes, bananas, melons, cherries, apples, pears, plums, peaches, figs, and even cherry tomatoes can be satisfyingly sweet.

Dried fruits such as raisins, dates, and apricots often taste even sweeter than candy.  

And here’s the best part – just because they are naturally sweet and naturally high in sugar does not mean fruits will spike your blood sugar levels!  Nature designed fruit to be sweet so we would want to eat it — and get the fiber, vitamins and phytonutrients we need to keep us healthy.  Nature did not design fruit to make us sick.

At Step One Foods, our products get their sweetness from whole ingredients like dates, raisins, bananas, and even carrots.  We never add fake sugars or sugar alcohols.  Because we believe you shouldn’t have to scour ingredient lists to protect your health.

The post The not-so-sweet stroke danger of two popular sweeteners appeared first on Easy Health Options®.

They are primarily known for their role in promoting a healthy gut microbiome, which is essential for overall well-being. The gut microbiome consists of trillions of microorganisms that play a crucial role in digestion, immune function, and even mental health.

Probiotics should not be confused with prebiotics which are typically complex carbohydrates that microorganisms in the gastrointestinal tract use as metabolic fuel.  Prebiotics support probiotics and keep them functioning at their best. 

Probiotics help maintain a balanced gut microbiota by inhibiting the growth of harmful bacteria, enhancing the gut barrier function, and modulating the immune response.

This balance is vital for preventing gastrointestinal issues like diarrhea, irritable bowel syndrome (IBS), and inflammatory bowel diseases (IBD). Beyond gut health, probiotics have been linked to various other health benefits, including improved heart health, enhanced immune function and reduced inflammation.

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Probiotics and Cholesterol: The Research

Recent scientific studies have shown that certain probiotic strains can help lower LDL (bad) cholesterol levels. 

One notable study demonstrated that a specific probiotic formulation could reduce cholesterol esters, particularly those associated with saturated fatty acids, which are known to contribute to cardiovascular disease. While LDL declined in this study, HDL (good) cholesterol and triglyceride levels remained unchanged.

Limitations: Addressing Other Risk Factors

While the reduction in bad cholesterol is promising, it’s essential to recognize that probiotics alone do not address all cardiovascular risk factors. High blood pressure, for example, requires its own management strategies, such as lifestyle changes, medication, and dietary adjustments.  Smoking might affect the microbiome but is not caused by it.  

Meanwhile, although diabetes and obesity may be aided by dysregulation of gut microbe function, overcoming that dysfunction alone (with medications like Ozempic for example) without addressing the reason WHY the microbiome is not working properly in the first place (diet) will cure little.  Diabetes and obesity are probably more prebiotic than probiotic-related diseases.   

So, probiotics, though beneficial for cholesterol management, should be seen as part of a broader strategy for heart health that includes addressing these other risk factors — and their drivers — as well.

Probiotics: Pill Form vs. Food Form

When it comes to incorporating probiotics into your diet, there are two primary options: probiotic supplements in pill form and probiotic-rich foods. Each has its advantages and potential drawbacks.

Pill Form:

Convenience: Probiotic supplements are easy to incorporate into daily routines and ensure a consistent intake of specific probiotic strains.

Concentration: Supplements can provide higher concentrations of probiotics compared to some foods.

Targeted Strains: They allow for the selection of specific strains known for particular health benefits.

Lack of Context:  Consuming any dietary component or supplement outside of its natural food context may diminish the full biologic impact.  Plus, if you don’t also change what you eat you will not be addressing the root cause of why your microbiome is messed up in the first place.

These findings suggest that probiotics can effectively target and reduce specific components of cholesterol that are harmful to heart health without adversely affecting other lipid levels in the blood.

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Food Form:

Natural Integration: Probiotic-rich foods, such as yogurt, kefir, sauerkraut, kimchi, and kombucha, naturally integrate into meals and snacks. 

Additional Nutrients: These foods often come with additional nutrients like vitamins, minerals, and fiber, which can further enhance health.

Palatability: Many people find the taste and texture of probiotic foods enjoyable, making them an easy dietary addition.

Having said all that, research indicates that both forms of probiotics can be effective. Some people may find it easier to take a daily supplement, while others might prefer to consume their probiotics through delicious, nutrient-rich foods. I’m sure you can guess which side I come down on!

Where Step One Foods Fits In: Step One products are not probiotics, but they are full of prebiotics that are natural accompaniments to probiotic-containing foods.  For example, putting Anytime Sprinkle on yogurt supplies you not only with probiotics that may help lower cholesterol additionally, but also the specific nutrients those probiotics need to function at their best.  Kefir with Smoothie Mix is another winning combination.

We often hear from customers who are blown away by how much better their digestive system functions when using our foods. I’m never surprised.  After all, our products not only lower cholesterol in their own right, they also add fiber and provide our microbiome with the nutrients needed to keep everything moving happily along.

The post The effects of probiotics on cholesterol levels appeared first on Easy Health Options®.

Additionally, half of all men between the ages of 51 and 60 will experience benign prostatic hyperplasia (BPH) or enlarged prostate. This number increases to 70 percent for men aged 60 to 69 and reaches 90 percent for men over 85.

And while many men stay silent about their prostate problems, ignoring this widespread health issue won’t make it disappear.

Benign Prostatic Hyperplasia (BPH, Enlarged prostate)

The prostate, a walnut-sized gland, helps produce semen, the fluid that carries sperm. It surrounds the urethra, the tube that carries urine out from the bladder. As the prostate grows, it can squeeze the urethra.

As men get older, the prostate often enlarges such that the gland can double or even triple in size — imagine a walnut growing to the size of a lime. The resultant squeezing of the urethra can make urination difficult and prevent the bladder from emptying fully. Those affected may need to urinate more often, especially at night, experience extreme urgency to urinate or may even experience involuntary urination.

What causes an enlarged prostate?

There isn’t enough confirmed scientific evidence about the precise blend of genetic, environmental, dietary, and other influences that lead to prostate issues as men grow older. This uncertainty means there’s no simple way to avoid these problems.

Growing older appears to be the biggest factor in developing an enlarged prostate.

However, research has also shown that men who are overweight, or who have risk factors for cardiovascular disease and diabetes, may be more likely to have an enlarged prostate. So improving cardiometabolic health could potentially have a significant – and seemingly unrelated – side benefit in men.

In the extreme, an enlarged prostate can have serious consequences such as recurrent urinary tract infections or kidney malfunction, but for most men, symptoms are more about quality of life, and treatments aim to ease urinary difficulties. Cutting down on fluids in the evenings and limiting diuretics like caffeine and alcohol can help. For more significant relief, medications can relax or shrink the prostate, and surgical options can reduce its size.

Prostate cancer and at-risk groups

Men who live long enough are likely to develop prostate cancer; 70 percent of those over 70 have some cancerous cells in their prostate. Indeed, prostate cancer is the most common cancer in men. In the U.S. and U.K., prostate cancer is the second leading cause of cancer deaths among men, following lung cancer. The average age at diagnosis is 67, with cases rare in men under 40.

Genetic mutations play a role, with family history increasing risk significantly. Men with two or more close male relatives with prostate cancer are 5-10 times more likely to be diagnosed. Additionally, Black men face a 70 percent higher risk of getting and dying from prostate cancer for reasons not yet fully understood.

When it comes to prostate cancer, the best offense is a good defense. Meaning – getting screened and catching it early. According to the American Cancer Society, starting screening is appropriate at:

• Age 50 for men who are at average risk of prostate cancer
• Age 45 for men at higher risk of developing prostate cancer. This includes African American men and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65).
• Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age)

Prostate gland enlargement does not mean you have prostate cancer or that you will develop it. Prostate cancer and BPH are different conditions.

Treatment for enlarged prostate

Beta-sitosterol, a specific plant sterol, has been shown to improve urinary symptoms and even reduce the risk of prostate cancer. While the data on plant sterols and prostate health isn’t as strong as that for heart health, the benefits are promising.

The actual way plant sterols do this is unclear, but multiple potential mechanisms have been documented. For example, beta-sitosterol has been shown to induce apoptosis (programmed cell death) in the cells involved in the genesis/growth of prostate cancer. In terms of BPH, multiple studies have also shown that beta-sitosterol can significantly improve urinary tract symptoms, but as effectively as pharmaceuticals (though without side effects).

Most plant sterol supplements used for BPH symptoms deliver between 300 and 400 mg of beta-sitosterol. That means if you’re a man and you’re eating even one serving of Step One Foods per day, you’re getting plenty of beta-sitosterol for supporting prostate health as well! One serving of Step One Foods delivers 750 milligrams of beta-sitosterol. Each product contains at least 1000 mg of plant sterols, with around 75 percent being beta-sitosterol.

Beyond prostate support, Step One products offer extra health benefits, including improved heart health — the leading cause of death for men and women. Prostate cancer is clearly a scary prospect. But so is a heart attack or stroke.

The post Prostate problems: Too common to ignore appeared first on Easy Health Options®.

But what if your doctor tells you that your cholesterol is “borderline high”?  Can you just simply “watch” your readings?

First a bit of background: The CDC defines high cholesterol as a total cholesterol of 240 mg/dL or higher.  Normal total cholesterol is defined as a number under 200 mg/dL. “Borderline” readings fall between 200 and 239 milligrams per deciliter. 

If you’ve been told your total cholesterol is “borderline high,” you’re not alone. Turns out, borderline high cholesterol is a common scenario, with about 85 million Americans clocking in between 200 and 239 mg/dL.

If you don’t know what your cholesterol levels are, you can ask for a blood test at your next primary care appointment. If you haven’t had one for a while, rechecking it is a good idea… 

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All about cholesterol readings

As a reasonable rule of thumb, you should have your cholesterol checked once in childhood, twice in your twenties, three times in your thirties, four times in your forties, at least five times in your 50s and yearly thereafter, assuming your cholesterol numbers are acceptable. If at any point they’re elevated or “borderline,” more frequent checks may be necessary.

Coming back to borderline readings: If your total cholesterol level falls between 200 and 239 mg/dL, here’s one important fact you need to know: The number that defines whether a cholesterol reading qualifies as “borderline elevated” or “high” is somewhat arbitrary. There’s nothing magical about the number 239 mg/dL that makes it radically different from 240 mg/dL. Cholesterol numbers fall on a continuum.

So it’s not a matter of absolutely needing to go on medications at 240 mg/dL and being in the clear at 239 mg/dL. It’s far more nuanced than that…

And this is where considering the fuller picture becomes important. For example:

• Do you have other risk factors for heart disease, such as high blood pressure, elevated blood sugar levels or smoking?
• Is there a strong family history of heart disease? 

The more non-cholesterol risk factors you have, the more significant ANY number over 200 mg/dL becomes. 

Simply “watching” your cholesterol numbers is therefore an unwise strategy as elevated cholesterol readings, whether watched or not, only add to your already elevated risk profile.

Next, look at your cholesterol test results a little more closely. The total cholesterol number is just that — a TOTAL.  This means it is made up of components, specifically good (HDL) cholesterol, bad (LDL) cholesterol and triglycerides (TG, mostly fatty particles).  This means you can have various combinations of the three components and end up with the same total cholesterol reading. 

The formula for how these values relate to each other is as follows: Total cholesterol = LDL + HDL + TG/5

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Look at the big picture and relax

So if your total cholesterol is elevated, is it the HDL or LDL cholesterol that’s driving it?

If HDL is high while LDL is low (LDL falling at or below 100 mg/dL would be ideal) — and you don’t have other heart disease risk factors (or very high TGs) — relax:  Even though your total cholesterol is elevated, it does not represent a significant risk factor for developing heart disease.

Now, if it’s the LDL that’s high (regardless of HDL results), the scenario is different, and you need to really pay attention and try to get this number lower. The good news is that most people can see meaningful LDL reductions with a few simple lifestyle changes, thus avoiding the need for medications.

This list won’t come as any surprise to regular readers: If you smoke, quit. Get regular exercise. And eat a whole food, plant-based diet. Step One Foods makes it easier to eat this way.  In fact, our products are clinically proven to lower LDL cholesterol. They’re a great place to start if your cholesterol levels are abnormal but you’re not already following a full-on plant-based Mediterranean diet or if you find the idea of comprehensive dietary change a bit overwhelming.

If your cholesterol is in that murky middle range, your doctor may also advise you to get a coronary artery calcium scan, which is an imaging test of your heart that can determine how much plaque may have built up in your arteries. (If you’re unsure about getting this scan, here’s everything you need to know.) 

In my own practice, I use this test quite frequently because it’s a great way to segment out people at very low risk of heart events that can safely defer going on medications.

Sometimes people have abnormal/borderline cholesterol readings that will not budge despite their best lifestyle efforts. If that’s you, please don’t despair! There’s so much more to heart disease risk — and to health maintenance in general — that goes far beyond a cholesterol result! 

Please know that if you’re living in a way that should help lower cholesterol (even if it doesn’t), you’re also living in a way that helps lower blood pressure, improve blood sugar control, prevent cancer and reduce your chances of developing dementia.

Regardless of whether your cholesterol levels are high, borderline or perfect, doing your best around lifestyle is NEVER a wasted effort.

The post What is borderline cholesterol, and what should I do about it? appeared first on Easy Health Options®.

The first thing to understand is that blood pressure is not static. It varies throughout the day — minute by minute. 

What it’s really doing is oscillating, sometimes quite profoundly, around a mean — and what we’re really interested in is what that mean is. So one reading in a doctor’s office does not a hypertension diagnosis make…

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Taking things into your own hands

What we really need are multiple readings that give us more information.  This is why I always ask my patients to get their own blood pressure cuffs and start taking their own readings at home. Home BP monitors are widely available and relatively inexpensive, and can be invaluable tools for facilitating BP evaluation and management.

The second thing to know is that there are multiple factors that can contribute to high blood pressure that are reversible: excess weight, inactivity, smoking, stimulants (like caffeine and alcohol), non-restorative sleep/sleep apnea, and high sodium intake/poor diet. 

These are not necessarily factors that are chip shots to solve or change, but it’s all doable. Most importantly, making inroads here – even if they’re only partial — can help reduce your readings enough that you can avoid medications or, at the very least, lower the drug doses needed to control them.

How anxiety and depression impact blood pressure

Finally, know that there is a significant connection between mental health and hypertension. Not just anxiety. Depression too can be linked. One recent study found a connection between depressive symptoms and high blood pressure years before hypertension was diagnosed.

The relationship between mental health and blood pressure is complex. On one hand, anxiety and depression may cause people to avoid taking medications or even skip medical appointments altogether. On the other hand, some antihypertensive medications, such as beta-blockers, can have depression and fatigue as side effects. 

High blood pressure causes low-grade inflammation. And inflammation can interfere with mood-regulating chemicals. Left untreated, hypertension can also increase stress-related hormones. And stress, of course, is not good for your mental health.

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We tend to think of mental and physical health separately, but they are so intertwined that it can be hard to tell what is the cause and what is the effect. Is stress making your blood pressure rise, or is hypertension causing your stress? While the answer isn’t always clear, the good news is that treating one should improve the other as well.

The best part is, the treatment doesn’t need to be just drugs, drugs, and more drugs! What we eat has a TREMENDOUS impact on both physical and mental health — including mood and blood pressure readings.  Consuming more whole food fiber, antioxidant-rich fruits and vegetables, and healthy fats is the key.  Sound familiar?

We’ve had lots of customers tell us their blood pressure has improved as a consequence of eating Step One Foods. But I’ll never forget the day that a customer marched into our offices and demanded to know if we put anti-depressants into the foods — because he had never felt better! Not everyone will have such dramatic improvements, but shouldn’t we all feed our bodies in a way that supports health on every level?

The post The significant link between blood pressure, anxiety and depression appeared first on Easy Health Options®.

But before you ditch your Lipitor and reach for a sleeve of black and white disks, read on…

The experiment involved one  27-year-old man managing ulcerative colitis who tried two different approaches to lower his LDL cholesterol levels.

First, he ate 12 OREO cookies every day for 16 days, then after a 3-month cookie break he took 20 mg of rosuvastatin (Crestor) daily for 6 weeks instead. Surprisingly, the OREOs dropped his LDL by 71 percent, while the statin only lowered it by 32.5 percent.

So far, so amazing. But here’s more detail… 

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The catch

The man was following a strict keto diet.  His starting LDL cholesterol was in the 380 to 420 mg/dL range (!).  If you recall, one of the mechanisms that can cause high LDL is saturated fat intake impacting LDL receptor function. 

Keto diets are high in saturated fats and can turn off LDL receptors keeping LDL levels high.  Lesson number 1:  Some people who follow a ketogenic diet can see their LDLs rise to stratospheric levels.

The fact that adding OREOs lowered his LDL is not the point.  The point is that adding CARBS lowered his LDL.  Lesson number 2: The way our bodies respond to nutrients is complex and, for overall health, a mix of nutrients is usually preferred over favoring only one nutrient class.  Maybe, just maybe, a super high-fat diet is not such a good idea.

The fact that he did not have as big a response to Crestor is also not the point.  Another mechanism that can cause high LDL is excess LDL production in the liver related to HMGCo-A reductase activity. 

Statins inhibit this enzyme, but if it’s not a major driver in causing high LDL levels in a specific individual, even high doses of statins are not going to have much of an effect. 

It’s one of the reasons we order follow-up lab tests on people placed on statins.  We don’t know ahead of time if their LDL elevations are HMGCo-A reductase driven.  Lesson number 3:  Not everyone will see dramatic LDL reductions with statins.

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Why whole-food, plant-based wins

Finally, there’s more to health than an LDL effect — whether attained through medications or through food. 

The fact that LDL is lower with OREO cookies added to a restrictive keto diet doesn’t make the OREOs or the keto diet the best choice for health. 

We have boatloads of data showing that a whole-food plant-based diet not only supports better cholesterol levels but is also the dietary pattern most consistently associated with healthy longevity. 

This is why Step One Foods is grounded in the whole-food plant-based approach and why it works to lower cholesterol in most people, not just those following a keto diet. 

In the same vein, we have boatloads of data showing that consumption of highly processed carbohydrates (I’m talking to you, OREOs) contributes to insulin dysregulation as well as chronic inflammation and a higher burden of chronic disease. 

Meanwhile, there are no examples of human populations following a ketogenic diet as experiencing longer life or longer healthspans.

Lesson number 4:  You always knew this was too good to be true.

The post Why you shouldn’t lower cholesterol with OREOS appeared first on Easy Health Options®.

Turns out, on average we don’t only carry around more clothing…

We also tend to carry more circulating cholesterol around.

At least that’s what researchers at Johns Hopkins Ciccarone Center for the Prevention of Heart Disease have shown.

Behavioral Influences

Their study highlighted that this seasonal shift in cholesterol is closely tied to our behaviors.

In the summer, when the weather is warmer, people are more inclined to be active and engage in healthier habits. Conversely, the colder months usher in a tendency to indulge in comfort foods rich in easily digested carbohydrates and fats, coupled with a decline in physical activity.

This all results in a lipid signature associated with higher heart disease risk.

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Study Insights

The study, based on data from 2.8 million U.S. adults, discovered that both LDL cholesterol and non-HDL cholesterol, commonly known as the “bad” cholesterol, were 3.5 percent higher in men and 1.7 percent higher in women during the winter. Additionally, triglyceride levels, linked to obesity and inactivity, saw a 2.5 percent increase in men during the colder season.

Given that there is a linear correlation between percentage shifts in LDL cholesterol and heart disease risk, these changes are not inconsequential. We know that there is some seasonal variation in heart attack rates.  Seasonal LDL variation could absolutely be a contributor. 

Seasonal Affective Disorder and Cardiovascular Health

Beyond dietary and activity changes, the researchers also considered the impact of seasonal affective disorder (SAD) on cardiovascular health.

SAD, often associated with mood changes during winter, can lead to a desire for comfort foods and lethargy.  SAD is also associated with increased risk for heart disease.

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Winter and Cardiovascular Risks

All of this data aligns with prior research indicating that prolonged exposure to cold temperatures can increase the risk of heart attacks.

During winter, blood vessels tend to constrict, increasing the workload on the heart. Piling on less physical activity, less healthful eating habits, worse cholesterol profiles and SAD does not help. 

Key Insights for Heart-Healthy Living

It’s important to put all this in perspective. Especially as we’ve just gone through a polar vortex! Just because it’s winter, obsessive monitoring of cholesterol levels during winter is not necessary. Just try to do your best to maintain your healthy habits throughout the year. Acknowledging the seasonal impact on health behaviors should simply remind us to make better choices and prioritize cardiovascular wellness — perhaps even more intentionally during colder weather.

After all, heart health is always in season.

The post Why winter raises cholesterol levels appeared first on Easy Health Options®.

About that abundant food… My plan is to keep it in perspective.

After all, there is some good news: A study performed by the National Institutes of Health followed nearly 200 individuals over the holiday season and found that, on average, people gained only one pound over the months of November and December.  

So my advice is to enjoy the holidays. Enjoy the celebrations, spend time with the ones you love, and participate fully in your family traditions — guilt-free.

Having said that, I would ask you keep my advice in perspective as well. It’s not about abandoning every good habit you’ve built along the way! It’s about leveraging what you know so you can help yourself move through this time with maximum enjoyment and minimum collateral damage.

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A little indulging won’t erase healthy habits 

How I approach this time of year is to stick with my exercise routine and modulate my eating. If I over-eat at a party, the next day I will go right back to my default healthy dietary pattern, often cutting back on some of the more calorie-dense components (like cheese and nuts). 

And no matter how bloated or tired I am the morning after the night before, I will start my day with my usual 5K run/walk. No excuses. End result?  I typically come out of the holiday season pretty much unscathed. 

This is what works for me. But I fully acknowledge that food traditions and eating occasions during the holidays (and the emotions that surround them) can be complicated and stressful — and dealing with food the way I do might not work for everyone. If my approach is easier said than done for you, consider reframing the way you think about food. 

Instead of thinking of foods as “good” or “bad,” for example, think about whether they are “nutritious” and “satisfying”. Labeling foods as good or bad often leads to guilt and shame and can eventually lead to disordered eating. So thinking about your diet more holistically can promote a healthier perspective.

Here are some other mindful practices that may help too:

Slow down. Surround yourself with some of your favorite people, sit down to eat, chew your food slowly and enjoy it. Eating more slowly has been shown to increase food enjoyment while helping us naturally eat less.

Consider your food choices. Make extra room on your plate for nutritious and satisfying options such as colorful fruits, vegetables, and food that’s spiced with seasonal flavors such as cloves, ginger, rosemary, and sage. For options that are less health-promoting, save room only for those that you find truly pleasurable. In other words, maximize the nutritional impact of the calories you’re consuming and don’t waste them on less healthy foods you don’t truly enjoy.

Make less go farther.  Consuming colder weather favorites such as cheese, chocolate, red wine, and even red meat is possible on a heart-healthy diet so long as portions are reasonable.

Skip the scale. Focus on health, not weight. After all, you’re in this to live a longer and healthier life. If you do that, the weight will take care of itself.

Clear your head.  Make sure to take time for yourself, every day.  It bears repeating that this time of the year can be stressful, and stress can make us less mindful about how we take care of ourselves and what we load up our plates with. Physical activity is a great way to de-stress, so if you can’t get your regular exercise routine in, squeeze in a quick walk as your release valve. Or add a meditation session. Even closing your eyes and taking a few deep breaths can make all the difference in the world.

Finally, don’t beat yourself up when you overindulge. (Notice I said “when,” not “if!”  It’s going to happen to all of us.) Food effects are cumulative; you won’t erase weeks of healthy eating with one excessive holiday party. 

The post The cardiologist says: Eat without guilt over the holidays appeared first on Easy Health Options®.

The hype surrounding these medications has been so intense that Novo Nordisk, the Danish pharmaceutical company that manufactures them, can’t keep up with demand. Novo Nordisk profits are up 32% compared to this time last year and there seems no end in sight to the rivers of money flowing in.  As a drug company, it’s certainly good to be in the weight loss business.

Because there truly is no end to the demand. Today, over 40% of Americans fall into the obese category (BMI >30) and over 30% are overweight (BMI 25-30). A large percentage of these individuals are also diabetic or pre-diabetic, and/or have other health conditions related to excess weight, making them eligible to receive a prescription for one of these medications. 

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Blurred lines, blurred treatments

Ozempic and Wegovy are actually the exact same drug, semaglutide. They are just presented in different doses and with different indications. Ozempic, the first FDA approved lower dose version of semaglutide, is supposed to be for improved blood sugar control in diabetics (and for improved outcomes in people with heart failure and/or chronic kidney disease), while Wegovy, the recently FDA-approved higher dose version, is reserved for people with obesity or excess weight associated with weight-related health conditions.

Both patients and clinicians have figured out that if you want to get the weight loss effect of Wegovy, just take more Ozempic. So, the lines have really blurred between these two versions in terms of which patient is getting what drug. Unfortunately, that means diabetics needing Ozempic for blood sugar control are often getting the short end of the stick, finding the drug they need repeatedly out of stock.

Weight loss achieved with semaglutide IS impressive, with an average 15% weight reduction over the course of a year. So if you start at 200 pounds, in just one year’s time you should expect to be closer to 170.  And if you yourself have ever tried to lose weight, you know that’s a pretty great result. Given that weight loss of even 5% is associated with health benefits, it’s not only great, it’s amazing.

You may have guessed I’m not enthralled with these drugs. I believe they have a role, but in select cases only. 

And here’s why:

• Mechanism of action. Semaglutide is basically the synthetic version of GLP-1, a naturally occurring hormone that acts on the brain to suppress appetite, affects the stomach to slow gastric emptying so you feel fuller longer, and increases insulin production by the pancreas to help keep blood sugar levels steady after a meal. All highly beneficial effects. But what else does all this? FIBER. A high-fiber diet encourages our gut microbiome to grow bacteria that make GLP-1. Given that around 95% of Americans don’t consume even the minimum recommended amounts of fiber (14 g per 1000 calories), we are falling into the usual medical trap — treating the symptom (low GLP-1) not the cause (low fiber) of the health issue. And you already know the truth:  if you never address the root cause, you will never attain a cure. So, if you want to keep weight off, unless you also make marked dietary changes, expect to stay on semaglutide for life. Note that Step One Foods delivers at least 10 grams of whole-food fiber per day in just two servings. That’s enough to close the fiber deficit for most people — which is why they’re formulated to supply this amount. If you want even more GLP-1-producing bacteria, simply add even more fiber-rich foods to your Step One regimen. No Ozempic or Wegovy required.
• Side effects. Slowing gastric emptying is not without hazard.  Slow the process down too much with artificially high GLP-1 levels and you can end up with undigested food sitting in your stomach for days. Nausea, pain and vomiting are the natural results. Just this month, class action lawsuits have been filed accusing drug manufacturers of inadequately warning about this potential problem. Just like it took many years to understand all the various side effects of statins, we might just be looking at the tip of the iceberg here. Especially since most of the studies looking at semaglutide were carried out in limited numbers of diabetics. We have relatively little data on what exposing millions of non-diabetic people to these drugs could unleash.
• Cost. So how much will that amazing weight loss set you back? List price of these drugs is the range of $1350 per month, or around $16,000 per year. $16,000 per year buys a lot of fiber-rich, wonderful food.  Put 3 or 4 semaglutide patients together, and they can splurge for a personal chef. If you step back and look at what we are doing objectively — using an expensive drug to make up for the lack of relatively inexpensive food — you have to conclude this is crazy.

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A fundamental issue: Foods or drugs

The fundamental problem, as for nearly all cardiometabolic conditions (high cholesterol, high blood pressure, high blood sugar, excess weight), is not a lack of the right drugs! It’s a lack of the right foods. And unless we change the food, we will remain sick.

Medications do have a role. I may have started a food company to help people reduce their need for cholesterol-lowering drugs, but that doesn’t mean I don’t prescribe statins. I also believe semaglutide can be useful in specific circumstances. 

And what are those in my estimation? In diabetic patients struggling with blood sugar control despite their best dietary efforts; in people with congestive heart failure or chronic kidney disease who are repeatedly teetering on the edge of being hospitalized for their condition; and in obese patients who are stuck. What do I mean by “stuck”? These are the patients whose weight is limiting their ability to move such that they have no realistic way to affect calorie balance. To the point that even making their diets perfect might not be enough.  In other words, as a clear alternative to gastric bypass surgery.

If you know me or have seen me as a patient, you know that I have great empathy for people struggling with weight. I have family members who battle the scale.  Most people I see in clinic are overweight.  Losing weight and keeping it off is HARD.

 But the longer I’m in practice, the clearer it all becomes — obesity is not the result of some genetically driven GLP-1 deficiency. Obesity (and much of what ails us in general) is the product of a dysfunctional food environment that surrounds us with hyperpalatable, calorie-dense, low-fiber, nutrient-poor foods formulated to be addictive, cheap and convenient. What could go wrong?

But the solution is not an expensive drug that craftily impacts all the drivers of our appetites.  The solution is fueling our bodies with better foods that do this naturally.  Foods that are not only made from high fiber, nutrient-rich ingredients but that are also formulated to build health, not disease.  What could go right?

The post The case against Ozempic and Wegovy appeared first on Easy Health Options®.

Bempedoic acid is a relatively new drug that lowers cholesterol.  It’s taken once daily in pill form and works through the same enzymatic pathways in the liver as statins do. 

But because it affects a different part of the pathway as compared to statins, it does not share the same side effect profile. It has been touted as a great alternative for patients who need to lower cholesterol but can’t tolerate statin drugs.

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But is it?

Bempedoic acid was all over the news recently because a new study showed that in 4,200 patients with high cholesterol that had not yet been diagnosed with heart disease, bempedoic acid reduced rates of heart attack and death from heart disease by 39 percent and all causes of death by 27 percent. 

Those are BIG effects. Blockbuster level.

The superlatives from the trial investigators came pouring out. “Frankly startling” and “a wakeup call” regarding the need to put many more people on cholesterol-lowering medications — especially bempedoic acid.

Not much was spoken about the fact that bempedoic acid can cause gout, gallstone attacks and tendon ruptures — admittedly rare but highly unpleasant side effects that are not all necessarily reversible (a ruptured tendon is a ruptured tendon).

The other thing that was left out of the story was that these 4,200 people were plucked out for analysis out of another, already published trial designed to look at something else.

And this is where everything gets messy

And a little complicated — but stick with me…

The original, larger trial was designed to see if patients with high cholesterol who can’t tolerate statins would see an overall outcome benefit by going on bempedoic acid instead. 

And the answer was yes – looking at everyone enrolled, 14,000 people in all, bempedoic acid reduced the combined chance of someone experiencing a heart attack or stroke or needing bypass surgery/stent or dying of heart disease by about 13 percent. 

Not blockbuster level for a drug, but meaningful for sure. And that’s where the analysis should have ended. But it didn’t.

Let the mess begin…

The original trial included mostly people who had already developed heart disease. Mixed in there were also the 4,200 who hadn’t yet.

And if you know anything about statistics and event risks, right about now your skepticism about that “frankly startling” result in the subset of 4,200 patients should be rising. 

As a proven fact, people with established heart disease are at MUCH higher risk of experiencing a heart event during follow-up than those that only have high cholesterol. This means that ANY intervention that reduces event rates would be expected to have an outsize effect in people starting at a higher risk of experiencing those events to begin with. 

So why would a lower-risk population of 4,200 people have better results with bempedoic acid than the overall group they came from that included many more people at higher average risk?

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Seems odd, right?

Part of that answer lies in the fact that the investigators chose different outcomes to study in this smaller group. The big trial was designed to look at a composite of four endpoints. When the investigators looked at the smaller subset they decided to look at only two of the original four — heart attacks and death due to heart disease alone — while ignoring stroke and bypass surgery/stent.

Would the result be as dramatic if the other two components had also been included? We will never know.

Another part of the answer lies in the act of cutting up the study population into subsets after the fact.  Weird things can happen when you do that — including chance events. 

One famous published example of the perils of post-hoc subset analysis involved aspirin.  In the main trial of nearly 18,000 people the benefit of using aspirin after a heart attack was huge and clear. But when you broke down the studied population into astrological signs, everyone benefited except Geminis and Libras. 

As a Libra myself, I know that’s a chance finding. So was the outsize prevention effect of bempedoic acid in the 4,200 subset a chance finding? That is absolutely possible.   

Finally, we can’t forget motivation. Every drug company wants to create a blockbuster.  And every investigator wants to be famous for their work.  Finding ways to slice and dice data such that you come up with an eye-popping result (even if it could be a chance finding) is one way to get there. 

For my part, I’m not blown away by the results of this trial — because I can see the flaws. Frankly, I’m mostly dispirited by the whole thing. This is potentially more spin than truth and that’s not how we should be conducting ourselves if we are scientists in the business of truly helping people.

Plus, as mentioned above, bempedoic acid is not side-effect free.  And it’s certainly not cheap. 

At around $400/month it comes in at a price tag that can only be justified in very select patients. 

Lest we forget, $400/month buys a lot of beautiful, delicious, health-promoting food (Step One is just one humble example). Food that can help prevent gout attacks, support strong bones and tendons and lower cholesterol too. All the while reducing the risk of heart disease, stroke, and dying from any cause.

The post Nexletol for cholesterol: Blockbuster or just bust appeared first on Easy Health Options®.

Although a heart attack may be “sudden” and “out of the blue,” the substrate that enabled the heart attack to happen has been building for decades. In addition, as you get older, your blood pressure, cholesterol and other heart-related numbers tend to rise, accelerating the formation of plaque, making it more vulnerable and setting you up for disaster.

Sounds pretty bad. But that also means you have a huge opportunity: The more risk factors you can keep under control now, the less likely you are to have a heart attack in the future. And it truly is never too late to start…

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Changing the trajectory

For example, within 24 hours of smoking your last cigarette, your risk of a heart attack goes down substantially. Within 30 days of using Step One Foods regularly (or making other targeted dietary changes), your risk of heart events goes down proportionally to the LDL reduction you see. 

Not only that, research shows that people with fewer risk factors for heart disease are generally healthier. And this makes sense too. After all, smoking doesn’t just affect heart disease risk — it also affects cancer risk and your chances of developing emphysema.

Eating right for cholesterol management improves blood sugar control and helps you attain a healthy weight.

We can’t undo all the damage we’ve caused from a lifetime of smoking or a daily donut habit, but changes in health trajectory are ABSOULTELY achievable even if you start later in life. Especially if you ditch your old habits for better ones.

My book, Slay the Giant: The Power of Prevention in Defeating Heart Disease, has tips for all heart disease risk factors, helping you navigate heart disease prevention as much as possible without medications.

Statins at 60

But you should be aware that most men in their 60s (and beyond) will be advised to go on statins to lower their chances of experiencing a heart event.

This advice is based on a heart disease risk calculator that incorporates gender, age, cholesterol readings, blood pressure results and whether or not someone has a history of cigarette use or diabetes.

But the risk calculator is heavily weighted for age — so a man in his 60s with normal blood pressure and normal cholesterol results without a history of diabetes or smoking will come out with a calculated risk of heart disease that makes him a statin candidate. (By the way, women age 70 and above are in the same boat).

Some men should be on statins, without a doubt. But age is just one factor that makes up a person’s overall risk. So if your birthdate is the major reason you are being prescribed statins, think about having a coronary calcium study done first. The worst thing that can happen is that the scan will confirm that you would benefit from being on the medications.

On the other hand, if your coronary calcium score is 0 (or below 10 depending on age), you’re otherwise healthy with no familial risk of heart disease, you can talk to your doctor about simply keeping a close eye on your cholesterol readings – while you work on lifestyle measures to improve these.

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A sudden cardiovascular event

Finally, in the unfortunate case that you do experience a sudden cardiovascular event, remember that time is of the essence. The sooner you get treatment, the lower the likelihood of permanent damage.

So get familiar with the warning signs of heart attacks and strokes. And, most importantly, do not hesitate to call 911 if you think you may be experiencing any! This is not the time to be tough or blow off warning signs that your body is sending you.

The following symptoms are associated with heart attacks:

• Chest discomfort. Pain or uncomfortable pressure, squeezing or fullness can last more than a few minutes, or go away and return.
• Discomfort in other areas of the upper body, including one or both arms, the back, neck, jaw or stomach.
• Shortness of breath.
• Breaking out in a cold sweat, nausea or lightheadedness.

The following symptoms are associated with strokes:

• Uneven face drooping
• Weakness or numbness in one arm
• Slurred speech
• Sudden confusion or understanding
• Trouble speaking
• Trouble seeing in one or both eyes
• Trouble walking
• Sudden dizziness, loss of balance and coordination
• Sudden severe headache

The post Men’s heart health: In your 60s and beyond appeared first on Easy Health Options®.

Younger adults — especially men — are getting diagnosed with heart disease not only earlier but at rates that we’ve never seen before. Both genders are developing heart disease earlier, but because men typically develop heart disease about 10 years before women do, the ages at which some men are experiencing heart events can be shocking. 

When I was in medical school, a heart attack in a 40-year-old man was quite rare.  It sure isn’t rare anymore. 

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What’s behind all this?

People ages 35-64 are experiencing all-time high rates of obesity and Type 2 diabetes, which appear to be driving this change. Although smoking and cholesterol levels among Americans have dipped (partly because we’re vaping now and lots of people have been placed on statin drugs), obesity has steadily increased.

People with obesity are more likely to develop high blood pressure, a leading cause of heart disease and stroke, as well as a multitude of subtle and not-so-subtle metabolic abnormalities that drive inflammation, cause cholesterol abnormalities that statins can’t fix, and result in reduced blood vessel flexibility.

So if you’re a man in this age range who is starting to see the scale tip upwards or if you’re already heavier than you’d like, understand that your heart disease risk is accelerating and now is the time to double down on prevention efforts. Make sure you’re taking advantage of all the ways that nutrition and lifestyle can help keep ALL your risk factors in check. If you developed healthy habits in your younger years, now’s the time to continue. But if you didn’t, take heart knowing that it’s never too late!

If you have some conditions that put you at risk, learn more about those conditions (as a place to start, you’ll find lots of helpful information in our Blog section) and consult your doctor about managing them. For example, let’s look at high blood pressure and high cholesterol…

High blood pressure

Millions of Americans in their 40s and 50s have high blood pressure. But what puts you most at risk is uncontrolled high blood pressure readings. And how do you know if your blood pressure is uncontrolled? You have to measure it! 

An inexpensive investment in your health is an automated home blood pressure cuff that you can find in any drug store (or pharmacy section of a grocery store or large retailer). They’re easy to use, typically quite accurate and can help you spot a problem well before your next formal checkup. Blood pressure readings vary during the day so one elevated reading does not mean you have high blood pressure.  But if you’re seeing top numbers consistently over 130 and bottom numbers consistently over 85, schedule an appointment with your doctor to come up with a more formal monitoring and management plan.

And don’t forget that lifestyle factors can have a huge impact on BP control so the earlier you start optimizing those the less likely it is you end up on blood pressure-lowering drugs.  

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High cholesterol

If you have diabetes and/or obesity, if you smoke, if you eat unhealthy foods, or if you are sedentary, you are at risk of having poor cholesterol levels. Fortunately, you can control most of those risk factors and even undo the damage they have caused — if you act now.

It’s not as easy to check cholesterol at home so work with your provider to make sure you’re getting regular bloodwork at a frequency that makes sense based upon age and other risk factors. And if you get a high number, don’t panic.  Unless you already have established heart disease, you don’t need to go on medications right away. Cholesterol is almost never an emergency.

And as we’ve proven at Step One, a change in diet can yield dramatic cholesterol improvements in 30 days, so it’s reasonable to try a dietary approach (even if you don’t choose to do Step One) before you commit to a lifetime of medications. Just make sure to test your cholesterol response to whatever dietary/lifestyle intervention you’ve decided to pursue. We’d never assume a drug is working without testing its effects. The same should be true for any food or lifestyle intervention.

Erectile dysfunction

As a middle-aged man, you should also be aware of a male-specific early potential warning sign of heart and vascular disease — erectile dysfunction (ED). 

Not all ED means you have vascular disease, but if you’re starting to experience this, make an appointment with your physician and let them know. They might want to dig in deeper regarding heart disease risk and be more aggressive when controlling your risk factors. This is not about embarrassment — it’s about helping yourself experience your fullest, healthiest, longest life.  

I’ll be back with advice for heart health in your 60s, 70s and beyond soon. 

The post Men: Keeping your heart health in midlife appeared first on Easy Health Options®.

My answer?  It’s a bit complicated.

A large study including over 100,000 patients with chronic kidney disease showed that statin use was associated with lower risk of death even after adjusting for age, gender, and presence of other health issues, regardless of severity of kidney dysfunction. So people with existing kidney disease need not fear statins.  Phew. 

Having said that, other studies have shown that statin use can be associated with deterioration in kidney function. Yikes.  

However, this finding is uncommon and seen primarily in people on high doses of the drugs. Small sigh of relief.

These are three observations that are not all necessarily pointing in the same direction so what’s the best way to put them together? 

Statins, kidneys and answers

Overall, statins are not worrisome when it comes to kidney function but as with any medication, it makes sense to use the lowest possible dose to attain your LDL goal — and to use lifestyle and especially diet to help you need less medication to get there. 

AND to take care of your kidneys in general! 

That means keeping your blood pressure readings under control, avoiding substances that are toxic to kidneys (like nonsteroidal anti-inflammatory medications and CT dye), keeping well hydrated to avoid developing kidney stones, and not going crazy with protein intake.

When it comes to a health issue like kidney disease, the condition is not due to just one big thing. It’s usually the combination of many little things that finally overwhelm the system and affects how well an organ system functions.

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A special note about diabetics… 

We know that diabetes can lead to kidney dysfunction, in large part by damaging renal blood vessels. However, the vascular effect of diabetes is not selective and causes damage in arteries everywhere — including heart and brain arteries. 

This makes diabetics highly susceptible to experiencing heart attacks and strokes — with a risk level similar to that of someone with already established heart disease. So very aggressive prevention strategies make sense, especially since heart disease and stroke (and not kidney disease) are the main reasons diabetics die.

No wonder the American Heart Association, the American College of Cardiology, and the American Diabetes Association all recommend that people with type 2 diabetes between the ages of 40 and 75 take a statin — regardless of kidney function. 

Remember — there are three main groups that have been shown consistently to experience an outcome benefit from using statins: those with established heart or vascular disease, those with diabetes and those with familial hypercholesterolemia (very high LDL levels that are genetically driven). 

That means everyone else should try diet first. And even the three high-risk groups should incorporate dietary efforts to minimize the amounts of statins required to get them to their goal. Not only is that better for overall health, it sure is better for those kidneys!

The post Do statins hurt kidneys? appeared first on Easy Health Options®.

I knew these were all signs of impending menopause, but I also knew there wasn’t much to be done to treat the symptoms. After all, hormone therapy was dangerous. 

At least that’s what I had been told based upon the findings of a seminal scientific study.

Turns out, that study was flawed…

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Jumping to conclusions

The Women’s Health Initiative (WHI) was meant to evaluate the long-term health outcomes of postmenopausal women placed on hormone replacement therapy (HRT). It commenced in 1998. 

Based on signals from smaller studies, there were high hopes that placing women on HRT was going to help them live longer better and that this large study would finally prove it. 

Instead, the study was stopped abruptly in the early 2000s when investigators found that HRT put women at increased risk of heart disease, blood clots and breast cancer. 

Panic ensued and women taking HRT were taken off the drugs immediately while women entering menopause were advised against ever using hormones.

However, if you look at the trial design in retrospect, there were many shortcomings that clearly influenced the results…  

The study used estrogen pills not patches — and we now know that estrogen delivered through the skin is processed completely differently inside our bodies and has much different effects on blood clotting. In addition, many of the women included in the trial were years, if not decades, out from menopause, complicating results interpretation.

A second look

When researchers subsequently reanalyzed the data they came to a different conclusion…

Women who used hormone replacement therapy near the onset of menopause were at no greater risk of negative health events.

In fact, using hormone replacement therapy at the correct time in the correct patient at the correct dose and in the correct combinations helps prevent osteoporosis, has little effect on cancer risk and could even lessen the risk of heart disease.

A couple of caveats: women with a history of breast or reproductive system cancers — or a strong family history of these — should probably still avoid HRT, and HRT should not be used to prevent heart disease as the sole indication (modification of other risk factors is a far more powerful intervention).

Unfortunately, the corrected message came too late to undo the dire headlines published in the early wake of study results or the original treatment guidelines that followed.

Today many women — and even doctors — still aren’t up to date on the current research. That’s a problem for many reasons, the most important being the unnecessary withholding of therapy that could markedly improve quality of life. 

Not to mention that, according to a new Mayo Clinic study, managing menopause symptoms comes at an estimated societal cost of $1.8 billion in lost work time per year and $26.6 billion annually when medical expenses are added.

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HRT is not for everyone

Women need to determine if this is an appropriate treatment for them given symptom severity, their individual risk of cancer, and other health issues that may be present. 

My best advice is to talk to your doctor about hormone replacement therapy and other, nonhormonal options that could be available to you, especially if you are experiencing perimenopausal symptoms and are under age 60. 

Your OBGYN is probably your best resource, and I would start there. If you don’t have an OBGYN or your doctor is not trained in menopause — not all are — here is a list of providers who have this expertise, courtesy of the North American Menopause Society.

Beyond dealing with perimenopause and the symptoms that go along with hormone changes, it bears emphasizing that heart disease risk accelerates during this time. 

Loss of estrogen, specifically, causes LDL (bad) cholesterol to rise. So make sure you’re taking advantage of all the ways that nutrition and lifestyle can help keep your cholesterol profile in a healthy range.

If you’re thinking about making dietary changes, remember that Step One Foods can kickstart that process with easy, twice-a-day food swaps.

Next week, I’ll be back with tips for keeping your heart in tip-top shape after menopause.

The post Women and heart disease: The menopause years appeared first on Easy Health Options®.

After all, heart disease is the number one killer of women in the United States, taking the lives of more women each year than all types of cancers combined. 

In fact, the likelihood that a woman will die of breast cancer is about 1 in 30. The chance that she will die from heart disease is 1 in 3.

Given that heart disease is a woman’s disease and that it is predominantly preventable, I’d like to share some heart-healthy tips for women at every phase of life.

Let’s start with those of you in your 20s and 30s…

Heart disease doesn’t just happen when you get older

Although heart disease disproportionately affects older women, it’s critically important to lower your heart disease risk at as young an age as possible. 

Heart disease — the build-up of plaque in arteries — is a result of the cumulative impact of various risk factors. So the earlier you start addressing those, the better. 

One of the best things you can do for your heart in your 20s and 30s is to not start smoking — or vaping. And quitting if you already smoke or vape. 

About 14% of women between ages 25 and 44 smoke cigarettes.  1 in 5 Americans between the ages of 18 and 29 vapes.  Most people think vaping is much less injurious compared to smoking, but when it comes to heart health, that’s just not true.

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For decades, we’ve known that the toxic chemicals in cigarette smoke damage the cells that line blood vessel walls. 

That not only reduces blood vessel reactivity so that they can’t dilate properly in response to stress — but also makes them more susceptible to accumulating plaque leading to coronary artery blockages, stroke, peripheral vascular disease and abdominal aortic aneurysms.

What we are beginning to see is that vaping nicotine is probably equally dangerous to blood vessel health, and those negative impacts show up even among younger users with less exposure to nicotine than older smokers… 

Recent studies have shown that people who vape or smoke have worse blood pressure, higher heart rates and more blood vessel constriction, and can’t exercise as well as people who don’t use nicotine at all.

Plus, we really don’t know what the health effects may be of regularly exposing your respiratory system to the vaporized scents, flavors and nicotine carriers that are part and parcel of e-juice. 

Many of these compounds are “generally regarded as safe” by the FDA based on data around ingestion, but their effects on the respiratory system might not necessarily be benign. For example, workers at a microwave popcorn processing plant became sick with severe lung disorder, later dubbed “popcorn lung” after airborne exposure to butter flavoring chemicals. What could recurrent exposure to a bubble gum flavor in vape juice do to the lungs of teenage girls? We have no idea.

Make exercise and healthy weight a priority

Besides avoiding all nicotine-containing products, another important health step during your 20s and 30s is to attain and maintain a healthy weight. Our bodies respond to food and exercise adjustments most readily when we are young. I’m not suggesting you have to run marathons or be a stick.  Get your body to a place you are happy with and keep it there — and get back to that place after each pregnancy (I know, easier said than done). 

Making exercise a daily habit now will really help keep you fit down the road. I started regular exercise at the tender age of 54. I wish I had started MUCH earlier because regular physical activity has given me so much energy and has helped me feel so much better! 

Setting aside time to exercise might feel selfish if you have a young family. But no one can do this for you. Plus, don’t you want to be that fun, active mom that can keep up with her kids even when they’re teens?

I’ve never had a weight issue, but I see many female patients who hit 50 out of shape and markedly overweight. And what I can tell you is that losing weight and getting fit is WAY harder after menopause. Being proactive about attaining and maintaining a healthy weight when you’re young is priceless insurance for the future.

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Checkups and testing

Your 20s and 30s are also a great time to start talking to your doctor about risk factors that can only be discovered through testing.

At your annual physical, make sure you have baseline tests for cholesterol and blood pressure. After that, your provider should check your cholesterol blood levels at least every four to six years and your blood pressure every two years, more often if you have a family history of either hyperlipidemia or hypertension.

If you have blood relatives who have experienced early heart or vascular events, let your doctor know that. Under those circumstances, getting your lipoprotein A level checked would be a good idea at this age.

It’s also important to note that gestational diabetes and eclampsia/pre-eclampsia are risk factors unique to women that translate into a higher likelihood of developing heart disease down the road. If you experience any of these during pregnancy, know that controlling all other, modifiable risk factors will be even more important as you age.

And lastly — but certainly not least! — don’t forget to eat like those people in the Blue Zones! As we’ve demonstrated many times, eating a colorful diet rooted in whole foods can go a long way to not only improving heart health but to ensuring healthy longevity. The earlier you include healthier foods in your routine, the better. 

And yes, it’s perfectly appropriate for young adults to consume Step One Foods. You may not need to eat them twice per day for cholesterol control, but you’ll never go wrong incorporating nutritionally dense foods formulated specifically to enhance health into your diet, even if it’s only from time to time.

I’ll be back with tips for women heading into the perimenopausal years.

The post Women and heart disease: Don’t wait to take it seriously appeared first on Easy Health Options®.

But what I really want to do today is tell you about the biochemical pathways inside our bodies that influence LDL levels, as this is something that is not often explained to patients.

There are multiple mechanisms that can drive LDL up, but the major ones are:

1. LDL production in the liver. This process is regulated by an enzyme, HMG-CoA reductase, and its activity, though markedly influenced by lifestyle, is also driven by genetics. This means, at some point no matter how pristine your lifestyle is you will reach a genetically driven threshold of LDL production that additional lifestyle change cannot overcome. Statins, which are all HMG-CoA reductase inhibitors, work to suppress the activity of this enzyme — causing LDL levels to fall. The good news is that if the LDL number we see on a lab test is due to genes (because you’ve done your part to eliminate all lifestyle contributors), even small doses of statins can yield dramatic LDL cholesterol reductions. 
2. Cholesterol absorption and reabsorption in the digestive system. Every single time we eat, the liver and gallbladder (if you have one) squish a bunch of bile into the digestive system. Bile is essential for breaking down food. It’s also very cholesterol-rich and is made from circulating LDL. Because we always need to be ready to digest food, we always need to have plentiful bile reserves. We can keep those reserves full by bringing more LDL back to the liver to make more bile for the next meal. We can also reabsorb any bile that didn’t get used up in the digestive process. When we interfere with bile reabsorption, more LDL will need to be pulled from the bloodstream to make bile for the next meal — and LDL levels will drop. This is where fiber and plant sterols come into play. Fiber traps bile, increasing elimination through the digestive system and plant sterols compete with intestinal absorption of bile, also leading to higher bile loss. Some people are very efficient bile reabsorbers and even a small disruption here can yield marked falls in LDL levels.
3. LDL receptor activity. LDL is removed from the bloodstream by attaching to receptors on cells. The more LDL receptors there are, the more efficient the LDL removal process, and the less LDL is left floating around in your bloodstream. LDL receptor levels are heavily influenced by an enzyme called PCSK9. When PCSK9 levels are high, LDL receptor levels are low, leading to high circulating levels of LDL cholesterol. The opposite is also true: People with a genetic deficiency of PCSK9 have very low circulating LDL levels over their entire lifetimes and typically don’t develop cardiovascular disease. Newer injectable drugs like Repatha, Praluent and Leqvio all lower PCSK9 levels leading to higher LDL receptor numbers, often yielding dramatic LDL reductions.
4. Insulin levels. Insulin is a storage hormone released in response to elevated blood sugar levels and is critical to getting that sugar inside cells. But as a storage hormone, it puts our body generally into storage mode. What’s the storage form of cholesterol? LDL. LDL levels go up when insulin levels are high. This is why type 2 diabetics (who have generally high circulating insulin levels) tend to have higher LDL levels as well.  People who eat simple/highly processed carbohydrates will also experience high insulin levels, and as a result, high LDL. That does NOT mean you should eat a low-carbohydrate diet!  Complex carbs from whole foods (the foods known to support heart health and healthy longevity) take longer to digest, leading to lower blood sugar levels and lower insulin levels, minimizing the insulin-LDL effect. 
5. Sex hormone levels. Estrogen is a protective hormone in women and helps lower LDL and raise HDL (good) cholesterol. When women go through menopause and lose estrogen, most will see a deterioration in their cholesterol profile. Some might even see drastic changes. As an aside, testosterone seems to have less effect on LDL but it can lower HDL cholesterol. Men on testosterone replacement can see significant reductions in HDL levels, which could increase heart disease risk.

In summary, there are MULTIPLE biochemical processes that influence cholesterol levels. Some of these we can impact and some we can’t. This means in some individuals, combinations of therapeutic approaches may be necessary to achieve LDL goals. 

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What you can control

What we CAN control are cholesterol absorption/reabsorption in the digestive system and circulating insulin levels. And this is where Step One Foods shine! By providing concentrated levels of fiber, plant sterols and complex carbohydrates we help you leverage your natural biochemistry!

But not everyone responds to a food-based approach because other mechanisms may be at play — and these are largely genetically driven or age related. 

That doesn’t mean a partial response is not meaningful!  If you’ve helped reduce your LDL through diet, you make it much easier for drugs to get you to goal — at a lower dose! This is HUGE — because medication side effects are more likely with higher drug doses. Plus, a better diet has effects far beyond a cholesterol profile. I suspect most of us don’t want to just lower cholesterol, we also want to avoid getting cancer and developing dementia. No matter what the LDL result, eating better is helping you achieve those goals too.

Finally, not everyone with high LDL needs to be on a drug (or even attain perfect LDL levels). After all, LDL is just ONE risk factor for a multifactorial disease. So if your cholesterol is not perfect — and you don’t already have heart disease (or diabetes which places people at very high risk of cardiovascular events) checking a coronary calcium scan can help determine if, after maximizing dietary approaches, you could experience a clear health benefit from also being on medication for the rest of your life.

The post What causes high LDL cholesterol? appeared first on Easy Health Options®.

And I’m not just talking about fun-sized Skittles: A Starbucks Pumpkin Spice Latte contains 50 grams of sugar — that’s about as much as what’s in two full-sized Snickers bars!

So here are my tips for staying the course and avoiding a two-month slide into bad dietary habits:

1. Switch your mindset. There are plenty of seasonal treats to look forward to that also happen to be health-promoting. Here are a few of my favorites:

• Fall-flavored soups (butternut squash, potato leek, mushroom barley).
• Instant Pot applesauce (toss apples, water and cinnamon in your pressure cooker and your house will smell like an orchard within minutes).
• Roasted pumpkin seeds (get creative with spices).
• Warm breakfasts (this is the time of year I switch from Sprinkles with yogurt and blueberries to Blueberry Oatmeal).

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2. Plan healthy ways to indulge.  Eating real food, not too much, mostly plants is always the right answer, but consuming colder weather favorites such as cheese, chocolate, red wine and even meat is possible on a heart-healthy diet so long as portions are reasonable and are part of a predominantly whole food plant-based dietary approach. 
3. Remember that eating healthy isn’t one big choice.  It’s a series of small, smart choices. Look at what happens when you replace that Pumpkin Spice Latte or Snickers bar with Step One Foods. Keep in mind, these benefits accrue over an entire year. That’s why it’s so important to simply move on after you overindulge.
4. Keep my 5-point strategy for feast days in mind. It IS possible to enjoy everything you love to eat on Thanksgiving Day so long as you’re intentional about how you go about it. 
5. Most importantly, don’t beat yourself up if you do overindulge.  It is NOT the beginning of a slide; it’s simply one bad day. Treat it as such and start fresh the next day.

As a final thought, we’ve probably all experienced personal challenges this year.  So maybe the greatest gift we can give ourselves is to emerge more resilient on January 1. 

That means not giving up on physical activity, social connections, joy and purpose — and eating in a way that supports heart health — between now and the end of the year. 

It doesn’t have to be a slide. Instead, it can be a metamorphosis.

The post 5 cardiologist-approved tips for heart-healthy holidays appeared first on Easy Health Options®.

But an egg also delivers 6 grams of complete protein, loads of B vitamins, zinc and choline. At around 75 calories, eggs even provide omega 3 fatty acids, calcium and antioxidants. All important for general health.

Still, with so much conflicting information out there on eggs, it’s easy to see why many people may be nervous about them.

Especially when yet another report comes out, like the new study published in JAMA this month, that examines the associations of dietary cholesterol or egg consumption with cardiovascular disease (CVD).

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Are eggs good or bad for you?

Let’s start with cholesterol. A large egg delivers around 180 mg of it.

In the past, dietary guidelines advised limiting cholesterol intake to 300 mg per day, 200 mg if you already had heart disease. That recommendation is now gone, with no specific limits placed on cholesterol intake.

But will the JAMA report put that recommended dietary guideline back in place? After all, the conclusion of the researchers was that higher consumption of dietary cholesterol or eggs was significantly associated with a higher risk of cardiovascular disease.

Not so fast…

According to Dr. Frank Hu, Chair of the Department of Nutrition at the Harvard Chan School of Public Health, it may have rekindled the debate, but, “For those who are generally healthy, low to moderate intake of eggs can be included as part of a healthy eating pattern, but they are not essential.”

In fact, an additional statement at the school’s site suggested that the findings of the study should be interpreted in the context of several previous studies, which have shown that low to moderate egg intake is not associated with a higher risk of CVD in generally healthy people.

What really matters about cholesterol?

Turns out the relationship between food and blood cholesterol is much more complex and more dependent on the intake of saturated and trans fats as well as simple/processed carbohydrates — rather than cholesterol per se.

That doesn’t mean eating high cholesterol foods, like eggs, with wild abandon is now OK. It just means that when it comes to blood cholesterol, it’s the overall quality (and quantity) of the food that matters, rather than the level of one single nutrient.

How about saturated fat? A diet low in saturated fat and zero trans fats has been shown to yield significant cardiovascular health benefits.

In fact, strict vegan diets that eliminate saturated and trans fats altogether have been documented to even REVERSE heart disease. So, minimizing saturated fats is a good idea. The American Heart Association advises keeping saturated fat to under 6 percent of calories. For a 2000 calorie diet, that’s under 120 calories or less than 13 grams of saturated fat per day. A single egg contains around 1.5 grams of saturated fat.

Put that all together, and eggs certainly seem to fit with a heart-healthy diet. And extensive research looking at egg consumption and heart disease, much of it coming from Harvard, seems to back that up. Which is why the doctors at Harvard Medical School, based on what we know today, haven’t really changed their thoughts on eggs.

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While you were focused on cholesterol, you missed this…

But there’s more to health than heart disease. And this is where it gets tricky: The choline in egg yolks just might be a double-edged sword.

Choline is a water-soluble nutrient that is related to B vitamins. It supports brain function and helps keep metabolism active. It’s recognized as an essential nutrient but recommended daily intakes have not been agreed upon. Eggs are an especially rich choline source — with one egg supplying as much choline as 6 ounces of chicken.

Choline is also a driver of TMAO production. And if you read our TMAO blog, you know TMAO is a bad actor, enigmatic of the complex relationship between our gut bacteria, food, and health. TMAO has not only been found to promote blood clot formation, but it’s also been linked to a heightened risk of cancer development and more aggressive cancer progression.

In omnivores, TMAO levels have been shown to spike after eating eggs. However, other research has documented blunted TMAO responses in vegans fed animal foods (because the makeup of their gut bacteria is different).

Complex? You bet.

So how do I put all of this together?

Eggs might be fine from a heart disease perspective, but intake should still be limited for overall health — especially in people who also eat other animal-based foods.

One thing that’s important to note is that rather than coming from the food we eat, most of the cholesterol floating inside our bloodstream is actually manufactured by the liver.

So, what do I, a cardiologist, do? I try to follow a whole food plant-based diet. I’m not perfect at it, but I’m getting better. I eat Step One Foods every day. And I limit my egg consumption to, at most, two eggs per week.

Sources:

1. Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality — JAMA: The Journal of the American Medical Association
2. Eggs and cholesterol back in the spotlight in new JAMA study — Harvard: The Nutrition Source
3. Are Eggs Risky for Heart Health — Harvard Health
4. Choline — Oregon State University
5. Eggs Choline and Cancer — Nutrition Facts

The post A cardiologist’s take on eggs, cholesterol warnings and the new study appeared first on Easy Health Options®.

At one extreme are pure cholesterol producers.  This tends to include people with familial hypercholesterolemia. 

Their livers, specifically the HMG-CoA reductase pathways in their livers, are primed to produce cholesterol.  No matter what the inputs are, no matter how pristine the diet, how much people exercise or how thin they are, their LDL levels are stubbornly unmovable — and usually high. 

The good news is that these individuals are typically quite sensitive to statin drugs (which are specifically designed to inhibit HMG-CoA reductase activity).  Meaning that even low doses of statins can yield marked LDL cholesterol reductions in cholesterol producers.

On the other extreme are pure cholesterol absorbers.  Their cholesterol levels are driven primarily by very active bile cholesterol reabsorption related to a cholesterol circulation each of us has in our bodies. 

Cholesterol and the digestive process

Every time we eat, the liver and gallbladder (although you don’t need a gallbladder for this) squeeze a bunch of bile into the digestive system. 

Bile is needed to help digest food. Bile is also very cholesterol-rich. It’s one of the things we use circulating LDL to make.  In fact, if you look at gallstones under a microscope, you will find that cholesterol represents a major gallstone constituent. 

Now, we all need to have some bile at the ready at all times so we can digest food at a moment’s notice.  Keeping that bile “reserve” intact can occur a couple of different ways… 

We can divert LDL from the bloodstream and bring it back to the liver to make more bile for the next meal.  Or we can reabsorb and reuse any bile that’s not used up in the digestive process, thus “sparing” circulating LDL. 

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In other words, if we are really efficient bile recyclers, we might not need to bring much LDL back to the liver to make bile for the next meal and our LDL levels will stay high. 

Efficient bile recyclers/cholesterol absorbers will not respond to statins very well because their high LDLs are not due to excess production.  Their LDLs are high due to reduced LDL consumption. Cholesterol absorbers will typically require higher doses of statins to keep their LDLs down.

But this also means that cholesterol absorbers respond really well to diets high in fiber and plant sterols because both of those dietary components prevent bile reabsorption — so that the circulating LDL that was being spared now has to be used up to make bile.

How to tell which you are

My patients often ask me if there are genetic markers to distinguish cholesterol absorbers from producers.

ApoE genotypes can provide a clue (ApoE 4/4 carriers being more likely to be absorbers) but in all honesty, we don’t have a great way to predict who will respond better to statins and who will have a miraculous cholesterol reduction with food. 

Making it even more complicated, most people fall somewhere in between the two cholesterol pathway extremes.

But that’s why it’s always worth trying diet to see if modifying your cholesterol absorption could impact your LDL levels (or impact them further if you’re already on a statin). 

It’s safe to do, the effects on cholesterol can be seen quickly, and the dietary changes required have the potential of rewarding you with many benefits beyond cholesterol lowering. 

Step One Foods was created to address the cholesterol absorption portion of your cholesterol metabolism — making it really easy to test if that mechanism is significant in you (in as little as 30 days). 

So if you haven’t started cholesterol medications yet, or are on medications but your LDL is still too high, Step One can help you figure out if cholesterol absorption is a significant pathway in you.

The post Cholesterol absorber or cholesterol producer: Which are you? appeared first on Easy Health Options®.

And since it has the word “diet” in the name, you might expect me to write it off. 

But this is one of the rare eating approaches I can get behind — with caveats…  

What is the Nordic diet

As you might guess, the diet is based on the way people in Scandinavia have been eating for years. So while the Nordic diet highlights more lingonberries and fewer olives, the premise is the same: Similar to the Mediterranean diet (my other endorsed method of eating), the Nordic diet is all about eating local, seasonal, mostly plant-based whole foods.

In fact, the biggest difference between the two diets may be the go-to oil, the Nordic diet relies on canola oil, whereas the Mediterranean focuses on olive oil. Both are high in healthier unsaturated fat.

But here’s my big caveat –- conventional canola oil is extracted using a process that can reduce the overall health properties of the oil while leaving unhealthy chemical residues behind. Always look for versions that are “cold pressed”, which means the oil is extracted from seeds using pressure only.

Both the Mediterranean and Nordic approaches de-emphasize meat, but the Nordic diet allows for some game meat (venison, rabbit, bison).

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How should you adapt to this diet if you live in the U.S.?

You could transfer the principles to your local area. For me, in Minnesota, that means more Nordic and less Mediterranean (yes, I can occasionally find lingonberries at my grocery store!) If you’re in California, you can take advantage of year-round produce. If you’re in Maine, load up on those beautiful blueberries and have some lobster from time to time.

Wherever you live, if you eat lots of local produce and cut down on meat, you’ll likely naturally follow the tenets of the Nordic diet. Expect to eat lots of:

• Whole grains, including rye, barley and oats
• Whole fruits (not just the juice)
• Vegetables, including root veggies
• Fatty fish
• Low-fat dairy, such as yogurt
• Legumes

And while they may be prevalent in Nordic countries, you should still consume eggs and game meat in moderation — and alcohol and other red meats only rarely.  And always avoid added sugar, processed meat, foods high in sodium, and fast food (yes, they do have McDonald’s in Sweden, and no, it does not count as local or Nordic.)

According to the Cleveland Clinic, eating the Nordic way should add up to way less sugar than you’d get on a typical American diet, and about twice the fiber and seafood. You’ll reap lots of heart-healthy benefits, too, including reduced inflammation, lower cholesterol, lower blood pressure and maintenance of a healthy weight

Best of all, this isn’t a diet that you need to make a resolution to follow. In fact, the Nordic diet and the Mediterranean diet aren’t really diets at all. They’re lifestyles, which is why you probably won’t fail when you adopt them.

The post The Nordic diet: Fad or lifestyle? appeared first on Easy Health Options®.

Notice I didn’t ask which is higher in cholesterol. Because the answer to that question is the egg with 187 milligrams or about 60 percent of the recommended daily allowance. But although hot dogs have less overall cholesterol (about 40 mg), they’re still way worse for your heart.

Protein-rich eggs are full of B vitamins and iron while relatively low in calories and saturated fat, making them an OK choice to include in moderation in a primarily plant-based diet.

So, since the amount of cholesterol in a food doesn’t always correlate with raising your cholesterol, which high cholesterol foods are the worst culprits for elevating bad cholesterol levels?

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The list is not surprising

You want to steer clear of foods high in cholesterol AND saturated and/or trans fat. It’s the fat type that’s the bigger issue.  

So, if you want to eat better for your heart and lower your bad cholesterol, eliminate (or drastically limit) these foods:

• Red meat. Yep, that includes burgers, ribs, steak, pork chops. If you don’t want to cut out red meat altogether, focus on small amounts of lean meat (and by small, I’m talking portion size — 3 ounces) and eat red meat once per week at most. BETTER CHOICE: Think fish and shellfish. Shrimp may be high in cholesterol but so long as you don’t douse it with butter it’ll supply you with plenty of protein while leaving your blood cholesterol alone. Although meat alternatives exist, I’m generally skeptical of engineered foods. To me, plants were never meant to bleed. By the way, poultry also contains saturated fat — so avoiding red meat does not necessarily mean you should just load up on chicken. 
• Anything fried. Frying ups the calorie count of foods, and what gets soaked up by the foods in the process is often saturated or trans fat and cholesterol. BETTER CHOICE: Bake potatoes, kale, broccoli to a crisp when you’re craving crunch — or invest in an air fryer, which uses much less fat. 
• Processed meat: The World Health Organization has classified bacon, hot dogs and salami as carcinogens. And processed meat is loaded in sodium and saturated fat. BETTER CHOICE: Fake bacon is unlikely to satisfy your cravings for a BLT. My advice? Cut way back on these products and make them special occasion treats.
• Baked goods: Unfortunately, cookies, cakes and pastries usually contain butter or shortening, so they’re also high in saturated fat and cholesterol. (Not to mention sugar, which is also a big culprit of high cholesterol). Mass-produced baked goods can be especially calorie dense and nutrient poor and contain outsize amounts of fat, especially trans fat, and sugar.  BETTER CHOICE: Bake at home, and control the amount and type of fat and sugar you use. You can even cook and bake with your favorite Step One Foods products!

Keep in mind that avoiding these foods will come naturally if you just follow my favorite dietary advice: Eat food. Not too much. Mostly plants.

The post The only 4 cholesterol foods you should avoid appeared first on Easy Health Options®.

So how does insulin resistance develop?   

Through consuming excess calories and, especially, excess fat.

Our bodies are incredibly efficient energy storage machines. We are evolutionarily pre-designed to always be prepping for surviving lean times.

This may have been exceedingly useful when we lived on the savannah and faced periods of starvation. It’s far less helpful when we’re surrounded by food everywhere we go. In fact, it can be downright counterproductive.

Here’s what happens…

How it begins

When we consume fats, they get broken down into triglycerides in the digestive system and are then absorbed. Triglycerides are also formed inside our bodies when we consume excess calories. 

Triglycerides are sources of concentrated energy. And regardless of whether they’re absorbed or formed internally, they end up circulating through our bloodstreams and then get stored in three main places — in adipose tissue (fat cells), in muscles and in the liver. 

Fat cells are designed for fat storage and can accept as many triglycerides as we throw at them. Liver and muscle? They also accept triglycerides readily, but at some point, they start to rebel. After all, liver and muscle cells have much more to get done in a day than just store energy!

Turns out, it’s hard to stop triglycerides from getting into liver and muscle cells for excess energy storage. So the body pursues an alternative strategy and starts to blunt cellular entry of other forms of energy. What’s another form of energy? Glucose.   

Normal cells listen to insulin when it comes knocking to ask for a glucose molecule to enter. Triglyceride-laden cells become progressively hard of hearing and need insulin to knock louder and louder to respond. In other words, they become resistant to the requests that insulin makes. The body’s response? Make more insulin so it knocks harder! The cellular response? Become progressively even more hard of hearing. 

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The hidden dysfunction

And this manifests in a predictable blood sugar profile decline. Initially, the dysfunctional metabolism is hidden by more and more insulin being pumped out by the pancreas. Your blood sugar level might be normal, but you need way more insulin to get it into a normal range. At this point, you are insulin resistant.

Eventually, the pancreas can’t make enough insulin to knock as loud as it needs to, and blood sugar levels start to rise. At this point you are pre-diabetic. 

Finally, the pancreas gets tired, can’t keep up and gives up — eventually pumping out less and less insulin — and voila!  You’re a type 2 diabetic.

A few things that should become obvious to you:

1. Pre-diabetes is a giant misnomer because it’s not a pre-disease! It’s a sign that your metabolism is a LONG way from normal.
2. Waiting for diabetes to develop before you take your blood sugar levels seriously is a highly flawed strategy. The sooner you start an all-out effort to get your metabolism right, the better. Don’t wait until your pancreas is exhausted!
3. A high-fat diet, especially the ketogenic approaches that are in vogue for diabetic patients these days, might not be such a good idea. After all, a high-fat diet directly contributes to triglyceride stores. The reason ketogenic diets “work” is because they limit carbs, meaning it doesn’t matter if your cells remain deaf to insulin! There’s nothing to knock about: blood sugar levels may improve — but this belies the underlying dysfunctional metabolism which stays unchanged. 

The post Insulin resistance: What you need to know appeared first on Easy Health Options®.