Find a Solution for Erectile Dysfunction

While most men want to jump to an immediate treatment plan for erectile dysfunction (ED), true long term success requires that you first identify the cause, and once identified, then proceed to a correct treatment.

Sadly, many physicians will write for a prescription like Viagra or Levitra in the interest of time without giving this critical issue much thought. WARNING! THE MOST COMMON CAUSE OF ERECTILE DYSFUNCTION IS CARDIOVASCULAR DISEASE FROM CLOGGED ARTERIES, which if not diagnosed can result in a heart attack, stroke, or death, plus permanent erectile dysfunction.

After we discuss the causes and you have clarified which might apply to you, then consider solutions, including the supplement recommendations below.

What are the Causes of Erectile Dysfunction?

  1. Cardiovascular disease (CVD). CVD results in arterial blockage of blood flow to the genitals. Often, the first sign of cardiovascular disease is ED. Viagra, Levitra, and similar drugs might temporarily reverse symptoms as they cause arteries to dilate overcoming the early blockage, but over time you would be at risk for a heart attack, stroke, or death by missing this critical diagnosis. As the blockage worsens, at some point these medications stop working. At the Masley Optimal Health Center, we utilize carotid IMT ultrasound testing (no needles, no radiation, no pain) to clarify your arterial thickness and arterial age. For info on revitalizing your heart and reversing plaque growth in your arteries see “Are you at risk for a heart attack or stroke?”
  2. Low testosterone levels. Nearly 20% of men between 50-60 have low testosterone function.  This is less frequent before age 50 and more frequent after age 60. Low testosterone function does not only cause ED but typically also causes low energy, low drive, low libido, night sweats, poor quality sleep, low exercise interest and difficulty controlling weight. There are two forms of low testosterone function that can cause ED. First is from low total production with low total testosterone levels, and the second is from normal production, but the testosterone is stuck to blood proteins and is not available to stimulate tissues. Because the treatments for the two causes of low testosterone are totally different, it is critical to measure both total and free testosterone levels when evaluating patients with the above symptoms.  Initially Viagra, Levitra, and similar drugs work, but eventually if not treated properly, a man will not have enough libido for success, even if the drugs work with erectile function.
  3. Low Fitness. Some men just are not fit enough to perform. Take my fitness test in the Free Health Evaluation. If you score below the 40th percentile for your age, then you need to get more fit before you should expect normal erectile function. Keep in mind that average fitness for an American (when two thirds of Americans are either obese or overweight) is not such a good thing. In truth, if you want great romantic performance you should aim for aerobic fitness that is in the top 20th percentile for your age group.
  4. Tobacco use. Every time you smoke a cigarette, it decreases the blood flow to your genitals for at least 4-6 hours, limiting your ability to have an erection.  Tobacco use also accelerates arterial plaque growth in your arteries so most smokers will eventually suffer from ED. If you smoke, I strongly encourage you to quit and talk to your medical provider about quitting options that are appropriate for you.
  5. Excessive Alcohol Intake. Drinking more than one serving of alcohol decreases sports and romantic performance. If you suffer from early signs of low fitness, testosterone deficiency, or cardiovascular disease, extra alcohol just compounds your problems. While the average 20 year old has zero erectile dysfunction and might gain a little confidence after 1-2 drinks, most men after 35 will experience a drop in sexual function.
  6. Excessive Stress. Too much stress can lead to insomnia and ED. If stress is impacting your romantic performance, please consider these four key steps to stress management: (1) Get enough sleep (2) Execise daily for at least 30-45 minutes to burn away the tension (3)Don’t overuse caffeine or alcohol (4) Add some form of relaxation time such as weekly massages, meditation, prayer, etc. For details, refer to Ten Years Younger Chapter 7. If nothing is working, then seek the help of a professional mental health counselor.

Are There Natural Supplements for ED?

YES.  There are natural compounds that increase nitric oxide levels (like Viagra and similar medications) in your blood stream and cause your arteries to dilate, including those to the genitals.

Nitric oxide is made from the amino acid (building block of natural protein) called arginine. Studies have shown that taking 5 grams of arginine daily improves erectile dysfunction. Don’t be surprised then to see many over the counter agents put arginine in their treatments. Very rarely, some men might notice dizziness with this dosage and should contact their physicians.

Clinical studies using zinc, gingko, and ashwaganda (called male ginseng in Asia) often seem to help, but once compared to a placebo, do not seem more effective than the placebo themselves.

What About Yohimbine?

The bark of the west African yohimbe tree is a source of yohimbine, a compound that has been found to stimulate blood flow to the penis, increase libido, and decrease the period between ejaculations.

Yohimbine is not recommended, however, because it is potentially dangerous, even in small doses. Side effects may include dizziness, anxiety, nausea, a severe drop in blood pressure, abdominal pain, fatigue, hallucinations, and paralysis.

Erectile Dysfunction (ED) Summary

If you have ED, first clarify you don’t have any of the reversible causes listed above. Once that is done,  talk to your medical provider about treatment options, but do not forget to ask about trying Arginine as well.


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Skin Rejuvenation

Yes, your skin can be younger, softer, lighter, less wrinkled, and less likely to tear or bruise. The following six easy steps to Ten Years Younger skin can make your skin healthier, more radiant, and decrease your future risk for skin cancer (for details, refer to my Ten Years Younger book, Chapter 9).

Step 1: Don’t allow sunlight to age your skin

The first step to skin rejuvenation is to stop damaging your skin with excessive sunlight exposure. Tanning is a sign of skin damage and is not healthy.  80% of facial skin aging is attributable to sun exposure. Sun tanning produces vitamin D, but you can easily get your vitamin D through a supplement without aging your skin. You can safely enjoy 15-20 minutes of sun before 10 am and after 3 pm, but if you plan to stay out longer, or go out during the 10 am to 3 pm time, wear some form of sunscreen.

Sunlight contains two types of ultraviolet rays that damage your skin. UVB are the burning rays that cause sunburn and skin cancer. UVA rays don’t burn, but instead age your skin, in particular by damaging collagen which is the protein that gives your skin elasticity, support, and structure. Many sunscreens provide adequate UVB protection (preventing burning) but not enough UVA protection (leaving your skin wide open to accelerated aging).

The Ten Years Younger Program has elected to use skin care produced produced by Skin Medica. The sunscreens produced by Skin Medica block UVA and UVB rays and are made with high quality ingredients that don’t harm your skin and are not greasy.

Step 2: Increase your antioxidants

Surprisingly, your food choices can rejuvenate your skin. Lycopene, the orange-red pigment in tomatoes and watermelon protects your skin as do many other plant pigments. Enjoy at least five cups of colorful fruits and vegetables daily to protect your skin. For example, during a typical day have a bowl of blueberries, a big green leafy salad with sliced red tomatoes, an apple, and a double portion of sauteed broccoli, yellow peppers, and red onions.

Avoid oxidants, such as tobacco which greatly accelerate skin aging. Have you ever noticed that smokers have twice the wrinkles they should? Each puff approximately doubles their rate of skin aging.

You can also add antioxidants to skin lotions, with agents like CoQ 10, green tea extract, vitamin C, and vitamin E. Keep in mind that many less expensive brands are not designed to actually penetrate into the skin.

Step 3: Hydrate Your Skin

Moisturizing your skin won’t make it physiologically younger, but it will clearly make it look and feel better. Top end products do more than moisturize as they often include anti-aging hydrating agents with antioxidants to repair skin damage noted below, plus SPF sunscreen to protect your skin from the sun.

Moisturizers help your skin by trapping the moisture within your skin.

  • The cheaper and most common lotions help the outer skin layer retain fluid, they don’t really provide much skin hydration. Good examples are lanolin and paraffin.

Hydrating agents include alpha hydroxy acids, propylene glycol, tocopheryl acetate and urea. These agents penetrate into the skin and diminish the appearance of wrinkles making your skin feel younger and softer.

In contrast, avoid soaps and detergents that dry and chap your skin. The more you bathe and expose your skin to soap, the worse your skin becomes. Much wiser would be to use a cleanser, made especially for your face. A high quality cleanser should remove dirt and environmental pollutants without harshly drying your skin. The best cleansers contain hydrating agents.

Step 4: Add Vitamin A to Your Skin

Vitamin A (also known as retinol or retinoid) skin creams have been used for decades to improve skin appearance and to treat early signs of skin cancer. If you add Vitamin A to your skin on a regular basis, it will be shinier, smoother, less wrinkled, stronger (with more collagen), will show less irregular discoloration plus, will reduce your risk for skin cancer.

Retinol is used in high prescription medications to treat acne and the early forms of skin cancer, but these pharmaceutical products are often greasy and cause redness, peeling, and irritation.

Milder forms of retinol creams can be used daily long term, usually providing the vitamin A benefit without the side effects of Vitamin A prescriptions. The challenge is finding an over the counter product that contains enough retinol within to actually work. The best product I have found for this purpose is Tri-Retinol Complex, which is gentle on your skin. If you need a little more powerful agent, which for gentle skin may cause modest peeling, I like Tri-Retinol Complex-ES.

Step 5: Use Natural Hydroxy Acids on Your Skin

Hydroxy acids are natural compounds found in fruit juice, wine, milk and willow bark. They speed the skin cell cycle encouraging your skin to shed the rough surface cells. Cleopatra applied sour goat’s milk to her skin, while Marie Antoinette used wine; they knew their skin would be more radiant with regular use.

High potency concentrations are used by spas and doctors to induce chemical peels. But regular lower dosage lotions are safer and over the long term provide the same type of benefit.

One caveat to remember. Using hydroxy acids will make your skin younger looking, but it will sun burn more easily as well. If you do not use sun protection from hats or sun block, then do not use hydroxy acids on your skin.

Step 6: For Skin Damage, Apply Skin Cell Growth Factors

Burn research has made tremendous progress over the years with burn centers growing skin from human stem cells that can be used to treat severe burns. Stem cells used for burn patients release skin cell growth factors that promote skin healing, collagen formation, and when applied to the skin in a gel or lotion will truly reverse skin aging and fine wrinkles.

A worthy question should be, “Where do they get the stem cells?” The good news is that they do not come from embryos or infertility clinic cell lines, rather they come from  foreskins that are discarded after a circumcision.

This technology does not come cheap but if used twice daily for six months, can reverse past skin damage especially if combined with retinol and hydroxy acids. One of my reasons for choosing the Skin Medica skin care product line is that they have a patent on TNS, which contains these stem cell growth factors.

Baseline photo

3 months after TNS Recovery complex

SKIN CARE SUMMARY

To have success at rejuvenating your skin, you need to choose a plan that is simple and realistic. Two suggested plans are listed below, the first is the minimum I would recommend for skin rejuvenation,  and the second is more comprehensive.

If you want to aim for the minimum plan to save on expense:

  1. In the morning wash your face gently with a nondrying cleanser. Then apply a moisturizer with a mild SPF sunscreen . If you venture out into intense sun, add a 30 SPF sunscreen every 2-3 hours as needed.
  2. In the evening before going to bed, wash your face gently with a nondrying cleanser. Apply a retinol cream Tri-Retinol Complex or Tri-Retinol Complex ES. Then add a hydroxy acid cream at this time.

More comprehensive and beneficial long term:

  1. In the morning wash your face gently with a nondrying cleanser.
  2. Apply TNS Recovery Complex or TNS Essentail Serum to your facial skin.
  3. Then apply a moisturizer with a mild SPF sunscreen (10-20). If you venture out into intense sun, add a 30 SPF sunscreen every 2-3 hours as needed.
  4. In the evening before going to bed, wash your face gently with a nondrying cleanser.
  5. Next, apply TNS Recovery Complex or TNS Essentail Serum to your face, perhaps the backs of your hands as well.
  6. Over the TNS Recovery Complex, apply Tri-Retinol complex, or, the Tri-Retinol Complex ES (extra strength)
  7. Lastly, cover with a moisturizing lotion with hydrating ingredients, such as Ultra Sheer Moisturizer or Dermal Repair.


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Build Muscle Mass

Muscle definition makes you look fantastic, and muscle mass is also essential for long term health. Muscle is made of protein and proteins are made from specific combinations of amino acids, just like words are made from specific combinations of letters. Muscles store amino acids like we store money in the bank. The body uses these amino acids to fight infections, heal and repair tissues, and burn calories, even when resting.  Thus, muscle plays a key role in making you trim and fit. It should not surprise you that your muscle mass is one of the best health predictors of living independently into your 80s and 90s in good health.

Keep in mind that 10% of your muscle mass breaks down and rebuilds every day. To build muscle mass, you need more building than breaking down. After age 30-40, most people lose 1% of their muscle and replace it with 1% more fat every year; in essence they are shifting from free range lean to prime cut fat.

Eating protein also makes you feel full and satisfied, so one strategy to eating less without being hungry means eating more lean protein.

Unlike fat, muscles burn calories even when at rest. Increase your muscle mass by one pound and maintain it for one year, and you burn an extra 40 kcalories every day. At this rate, you burn an extra 14,600 kcalories yearly and if everything else stays the same, you would lose 4.2 pounds of fat—roughly the size of a football.

How to Build Muscles:

  1. Get the right amount and the right type of amino acids.
  2. Stress your muscles to grow, otherwise you convert protein intake into fat.
  3. Limit inflammation, as inflammation breaks down muscle tissue.
  4. Balance your hormones to ensure muscle growth.

Plus there are some finer take home points that I’ll share to optimize your success. Tips that clarify what type of amino acids work best, when to ingest amino acids in relation to exercise, and what type of exercise to do.

How Much Protein Do You Need?

Scientists have studied how much protein muscles can absorb with different forms of activity. Keep in mind 2.2 pounds (lb) = 1 kilogram (kg)

  • The average person who is active for 30 minutes 3-4 days per week, needs 0.8 grams of protein / kg of body weight / day (~0.37 grams of protein per lb of body wt /day)
  • If you exercise 5-10 hrs/wk you need 1.0 gm/kg of body weight/day (0.45 gm protein /lb of body weight /day)
  • Athlete (10-20 hrs/wk intense activity)

– Endurance training athlete (e.g., long distance runner) = 1.2 gm/kg/day

– Strength training athlete (e.g., serious weight lifter) = 1.8 gm/kg/day

– Athlete with 2-3 intense workouts/day (e.g., collegiate football training) = 2.0 gm/kg/day

Here are a couple of examples:

John exercises 8 hours per week and weighs 154 pounds (70 kg). John’s muscles need about 1 gram/kg/day of protein, which is 70 grams.

Jill is a cross country runner, exercising 12 hours per week and she weighs 122 pounds. At 55.5 kg x 1.2 gm of protein/kg/day, she needs 66.5 grams of protein daily.

What Type of Amino Acids Do You Need to Build Muscle?

Muscle needs branched chain amino acids plus glutamine for optimal growth. Both whey and soy protein are rich in branched chain amino acids, making them popular for building muscle mass. Glutamine is more expensive to add, so many supplements don’t provide it.

When to Add Protein with Exercise?

Before a workout, you need a healthy mix of proteins and carbs, plus a little fat. The carbs give you energy for the workout, plus carbs cause insulin levels to rise and an appropriate insulin surge helps to build muscle as well.

The key take home point is that on strength training days (preferably 2-3 days per week) when you stress your muscles to exhaustion, drinking 15-30 grams of protein within 30 minutes of finishing your work out decreases muscle breakdown and accelerates muscle building.

If you have more than 30 grams of protein after a workout (for most people 20 is the maximum they can use), you convert the extra protein into fat. I have searched all over for an excellent quality protein powder. My favorite to date is from Xymogen and is called fitfood LITE whey protein. It tastes great, has 190 calories, comes with 7 grams of healthy fiber, 21 grams of premium New Zealand whey protein, and this includes nearly 4 grams of glutamine and 4 grams of branched chain amino acids.

Strength Training: The Secret to Shaping Up

We all want to feel good in our clothes and look great. Strength training can slim you down and bring back the muscle tone of younger years. But if you eat protein and don’t stress your muscles, you just turn the protein calories into fat.

For details on my Age Busting Fitness Program, refer to Chapter Six in Ten Years Younger. In brief, you need to lift a weight no more than 12-15 times before your muscles are exhausted to add enough stress for them to build (lifting a weight 50 times helps to tone muscles, but doesn’t stress them to the point they are programmed to grow). If you can’t lift a weight at least 8-10 times, then the chance for injury is too high. Somewhere between 8-15 lifts seems ideal with 2-3 sets of those motions. You can use weights, weight machines, elastic bands, or even your furniture. The key is to push your muscles with full, smooth and steady motions.

If you have never done strength training, then likely you would benefit greatly from working with a trainer, even if it is for only 2-4 sessions to get started. Or, for help getting started, set up a coaching session with my Ten Years Younger Coaching Team.

Limit inflammation

When you are inflamed, you tend to lose muscle and grow fat. A simple blood test to measure inflammation levels is a blood test called high sensitivity C Reactive Protein (hs-CRP or cardio-CRP). A good hs-CRP level is <0.5, normal is <1, elevated is 1-3, and > 3 is  considered high risk for a cardiovascular event.

What are steps to lower hs-CRP levels and inflammation?

  • Avoid refined carbs (sugar, sweets, products made from flour, corn syrup), especially important if you have elevated blood sugar levels.
  • Avoid bad fats (saturated fats from fatty meats and all dairy fat, plus trans or hydrogenated fats).
  • Work out 5-6 days per week for 30-60 minutes.
  • Enjoy 1-2 grams of fish oil daily from cold water small mouth fish or a supplement.
  • Eat more fruits and green leafy vegetables.
  • Keep your body fat below 22% (~ BMI under 22) since fat cells release compounds that increase inflammation.

Balance your hormones to ensure muscle growth

Cortisol is a hormone that breaks down muscle, releasing amino acids into your blood stream for repair and fuel. Testosterone is a hormone that helps you build muscle during strength training exercise.

Several factors cause cortisol levels to be high:

Several factors cause testosterone levels to be low:

  • Surgery that removes the ovaries in women (commonly causes a significant abnormal drop in testosterone)
  • Andropause in men
  • Occasionally, menopause in women
  • Obesity (fat cells actually convert testosterone into estrogen, which is one of the reasons men tend to grow breast tissue when they are overweight)

If you suspect either high cortisol or low testosterone levels, then talk to your medical provider about testing.

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Succeed with Weight Loss

Tips to Ensure Your Weight Loss Success. Obesity is an epidemic with expanding waistlines resulting in medical complications that threaten to bankrupt our national budget.

I’ve helped hundreds of patients lose weight, typically 20-30 lbs, but up to 100 lbs of weight loss—no medications or surgeries required!

Here is my outline to successful weight loss:

PLAN A: Most of my patients are able to lose 20-30 pounds following these simple steps

  1. Enjoy real food
  • Choose foods with low calorie density
  • Select foods that provide satiety (they quench your hunger)
  • Stop eating processed food

2.  Burn calories with aerobic exercise

3.  Build muscle mass

4.  Get enough sleep

5.  Meet your nutrient needs

6.  Take supplements that enhance weight loss

If you need help with the details, the I’d strongly encourage you to read Ten Years Younger and/or call for exercise and nutritional support with our coaching program.

PLAN B: Despite the best plan, some people are resistant to weight loss. Either the pounds don’t melt away, or they re-gain the wright they’ve worked so hard to lose. Typically they have one of the following issues holding them back:

  1. Genetically unique dietary needs. The good news is that we now have NutriGenomic (Nutrition-Genetic) testing to help clarify whether people do best with low fat or low carb diets. This same test provides insight into hunger, snacking, satiety, and the tendency to grab food in front of you. Identifying your unique features and designing a plan specifically for you has been shown to markedly improve weight loss success in clinical studies. Contact the Masley Optimal Health Center if you would like to consider NutriGenomic testing (~$400), see www.pathway.com for details.
  2. Low metabolism Some people burn very few calories at rest (they have a low basal metabolic rate, BMR). They have to diet just to maintain their weight. The first step is to test their BMR.  If in fact they do have a low BMR, the trick is diagnosing its cause and fixing it. The first step in answering this question is to measure your body composition with bioelectrical impedance (very accurate & least expensive) or with a DEXA scan.
  3. High levels of unmanaged stress Many people with high levels of unmanaged stress find they can’t lose weight. Ten Years Younger provides detailed information on soothing your stress, so don’t miss Chapter 6 if this applies to you.
  4. Chemical toxins Some people have high levels of toxins. Every time they lose weight, their fat cells release stored toxins into their blood stream slowing metabolism, causing inflammation, and increasing fatigue. The first step should include measuring for heavy metal toxins, and the second would include following a detox program to help remove toxic loads. See Ten Years Younger Detox chapter for details.

PLAN MD:

  1. If you have sincerely tried plans A and B without success and you also have medical problems (not just cosmetic issues) that are worsened by excess body weight, then it is time to talk to a physician about additional weight loss therapies, which might include medications or surgery to ensure you lose weight and keep it off.
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ARE YOU OR A LOVED ONE AT RISK FOR A HEART ATTACK or STROKE?

The truth is most people can prevent and reverse cardiovascular disease, thus markedly decreasing their risk for a future heart attack or stroke.

It is worth noting that there are many names for cardiovascular disease, but they are really the same thing: cardiovascular disease, heart disease, coronary artery disease, myocardial infarction, stroke, cerebral vascular disease, peripheral vascular disease, and so on. The bottom line is that they are all caused by plaque growing in your arteries, and some day this plaque growth, called plaque rupture, has the potential to pop like a pimple, causing a heart attack, stroke, or death.

Yes, you can stop heart disease. Yet, our current medical paradigm is designed to slow progression of this scourge, not to reverse it, and too often people are subjected to unnecessary procedures, too. Screening and treating risk factors for cardiovascular disease may “postpone” having a heart attack and stroke, and might even give some people enough time to die from something else, but testing for risk factors and prescribing drugs will not make your arteries healthy.

The good news is that with the Ten Years Younger Program, you can reverse arterial plaque growth and make your arteries younger!

The Ten Years Younger Program is designed to revitalize your heart and to shrink the plaque in your arteries.

At this point, you should ask, “Why should I trust and/or follow Dr. Masley’s recommendations?” The answer is that I bring a unique perspective to this discussion, and most of my patients use lifestyle choices show a clinically significant improvement in fitness, weight, cardiovascular risk factors, plus they demonstrate a reduction in arterial plaque growth over time.

My past experience varies from:

  • Cardiovascular research within a 500,000 member HMO using lifestyle to reduce cardiac risk.
  • Research funded by the American Heart Association on cardiovascular risk factors for 8,000 elderly subjects followed for 27 years in Florida.
  • Work experience and research results as the Medical Director at the Pritikin Longevity Center.
  • Research at the Masley Optimal Health Center including my upcoming publications on factors that result in arterial plaque reduction.

WHAT DO YOU NEED TO DO TO PREVENT OR REVERSE HEART ATTACKS AND STROKES?

The Ten Years Younger Program is designed to revitalize your heart and provides all the tools you need to be fitter, trimmer, mentally sharper, and physiologically younger. Below are six steps to achieve these goals and revitalize your heart at the same time.

  1. Enjoy eating from my list of Sixteen Vitality Foods.
  2. Strengthen Your Heart with an Age-Busting Fitness Plan
  3. Calm Your Heart with the Ten Years Younger Stress Management Plan.
  4. Succeed with weight loss.
  5. Set and reach heart healthy targets to ensure you stop growing arterial plaque and prevent dangerous blood clots too.
  6. Support Your Heart with Revitalizing Nutrients and Supplements.

Step 1:

Enjoy vitality foods. These are specific foods you should add to your diets to revitalize your heart and circulation. “Adding” is my theme. Not only is adding more vitality foods more beneficial than cutting out foods, it is easier and more fun for you to do.

I’ve worked with programs that tell you what you can’t eat (e.g., Pritikin and Ornish) In fact I was the medical director with the Pritikin Program in Miami, Florida and the bottom line is that theses dramatic restrictions don’t work for most Americans. Both programs offer healthy food ideas and good exercise tips. The problem is that more than 90% of people will NOT be able to follow these austere recommendations long term. Although a few people will be willing to start them, most will give up within a couple weeks and return to where they started.

In contrast, I have published data proving that at least 70% of people can follow my eating plan recommendations long term. We will start our food discussion by introducing my Sweet Sixteen Vitality foods—foods that are readily accessible and should eat daily for health and vitality. Then we’ll expand that list to 100 heart healthy foods with more than 100 wonderful and easy to prepare recipes that should be consumed regularly, which are within my book Ten Years Younger. These will include choices such as:

  • Berries and nonfat yogurt, a fruit and protein smoothie, or a veggie omelet for breakfast
  • Sliced turkey breast, grilled shrimp, or beans with a salad or veggies for lunch
  • Nuts (such as almonds, walnuts, pecans, or pistachios) with a piece of fruit, or hummus dip with sliced vegetables for an afternoon snack
  • A big portion of lean protein (such as wild salmon, scallops, shrimp, lobster, turkey and chicken breast) for dinner with one glass of hearty red wine (or bottled water) plus a generous serving of grilled or sautéed vegetables. If you need more food, consider a side of black beans or lentil soup.
  • And for dessert, some form of luscious dark chocolate, yogurt, and/or fresh fruit

If on occasion readers crave something heartier, like a steak, I suggest they choose healthier cuts, such as sirloin or pork tenderloin instead of fattier heart clogging cuts. One of the better restaurant choices for that occasional treat would be to order “Surf and Turf”—a small lean sirloin steak with seafood, grilled with fresh garlic and herbs and served along with double servings of vegetables—“without the butter”, skipping the white rice/pasta/potato choice on the side. I’ll also ask that they offset meat’s artery clotting potential with an ample serving of garlic, herbs, and/or curry spices, plus a glass of red wine. Not only do these condiments make food taste better, but for people with advanced cardiovascular disease they can be life saving, too.

Step 2:

Strengthen Your Heart with an Age-Busting Fitness Plan

Of all the options for preventing and treating cardiovascular disease, the single most effective one is exercise. People who exercise regularly have 40 percent fewer heart attacks, strokes, and cases of sudden death. As 78 percent of adults engage in less physical activity than currently recommended, simply walking a couple miles on a regular basis would be of enormous cardiac benefit and would cut the risk of all cardiovascular events by at least 33 percent.

Exercise improves blood pressure, blood sugar levels, cholesterol levels, weight control, mental speed and performance, inflammation, and clotting factors. It also improves the function of the critical cells that line the arteries, ensuring that they dilate even when stressed. Regular exercise can help to turn a sick, stiff, plaque-forming artery into a healthy one. Arteries in reality are muscles in tubular form that must be exercised to function optimally.

The Ten Years Younger Program will show you how to use treadmill testing to assess and fine tune an aerobic exercise program at home or in the gym. In particular, I focus on measures you can conduct on your own. In particular, you will focus on three key markers of cardiovascular fitness, namely:

  1. Aerobic capacity, measuring endurance during a standardized treadmill program
  2. Blood pressure response you exercise (measures artery flexibility and ability to dilate under stress)
  3. Heart rate recovery after exercise (measures cardiac fitness)

If you need help with your exercise program, then by all means contact our coaches for ongoing support, Click here for Coaching.

Step 3:

Calm Your Heart with Stress Management

Modern living can be packed with stressors and unhealthy behaviors. A restless soul leads to poor eating, inactivity, and angst. Often, a downward spiral occurs: the worse you feel, the less you exercise, the more poorly you eat, the worse you feel, and on it goes.

Excessive unmanaged stress increases cortisol and adrenaline hormone production. Over the long haul, these hormonal changes lead to weight gain, fatigue, high blood pressure, impaired mental function, bone and muscle loss, and even an increased rate of heart attacks and Alzheimer’s disease. Moreover, people who are too stressed often fail to follow nutrition and exercise regimens.

The goal here is to reverse the spiral. You eat better, you exercise more, and you feel better. As your stress management improves, it becomes easier to maintain a healthy diet and work out regularly. The key steps to stress management are:

  • Add 15-30 minutes of peace and calm every day
  • Ensure adequate sleep—most people need at least 7-8 hours nightly
  • Avoid using caffeine or alcohol in excess.
  • If you are highly stressed, start a meditation (deep prayer) program for 20-30 minutes daily.
  • Ensure you share love, intimacy, friendship, and kindness frequently, at least several times per day.

Step 4:

Succeed with Weight Control

For weight control tips, please see succeed with weight loss.

Step 5:

Set and reach heart healthy targets to ensure you stop growing arterial plaque and prevent dangerous blood clots too.

Sadly, having an average cholesterol, blood pressure, or weight for American is no longer something we should strive towards. Minimal goals reflects drug treatment targets for insurance based health care. If you want to truly reverse and prevent cardiovascular disease, then you should aim to achieve optimal targets without medications, using primarily diet, exercise, and weight control .

For people at high risk for a cardiovascular event, statin medications can be appropriate, which would be prescribed by your physician. For reasons outlined below, I normal recommend you add Co-Q-10 if you take a statin medication. But up to 10% of people don’t tolerate statin medications due to liver inflammation, muscle aches (myalgias), or profound fatigue. If this is your case, then you should discuss the option with your medical provider for using a couple products, in particular red yeast rice extract and a Nutraceutical food product that have been shown to lower cholesterol levels in randomized clinical trials.

Red rice yeast extract isn’t as powerful as most statin medications so it doesn’t lower your cholesterol as much a medication, but in clinical studies where people could not tolerate a statin medication and thus took red rice yeast extract, they often could tolerate the supplement form much better and also had a reduction in their cholesterol levels. The greater tolerability may relate to the idea that red rice yeast extract contains many forms of statin medications, and multiple low dose forms seem to work and be better tolerated in some patients than one high dose form from a med. So if you have high cholesterol, talk to your medical provider to see if red rice yeast extract might be appropriate for you. The challenge is getting a high quality form as many brands may be contaminated with toxins or lack adequate effective ingredients. I would highly recommend a high quality product called Choleast-900 with 1,800 mg of red rice yeast extract per two capsules.

Another product that has been shown to lower cholesterol and blood pressure levels in a randomized clinical trial and has published results behind it is UltraMeal 360. It is a nutraceutical medical food product designed to support conditions associated with the metabolic syndrome and cardiovascular disease. I have used it in my medical clinic, especially for patients with high cholesterol levels who don’t tolerate statin medications.

Step 6:

Support Your Heart with Revitalizing Nutrients and Supplements.

Supplements can only enhance a healthy lifestyle. They can’t replace it. Indeed, they will never make up for eating junk food, or being stressed or inactive. But supplements can benefit health substantially if one eats well, exercises regularly, and manages stress.

I believe everyone should be taking a personalized supplement program. While supplements can’t make up for eating poorly, they can provide some nutrients otherwise lost. At least eighty percent of Americans are nutrient deficient. Yes, we get plenty of calories, but we don’t get enough vitamins and minerals. The top two clinically important nutrient deficiencies impacting the heart are fiber and omega-3 fats. The most common vitamin deficiencies are folic acid, B6, B12, C, D, and food sources of vitamin E. Frequent mineral deficiencies include zinc, calcium, magnesium, and chromium. Moreover, nutrient content continues to drop in the food supply. Despite the fact that iron deficiency is common, from a cardiac perspective too much iron is much worse, as excessive iron acts as a toxin to heart arteries.

Marine sources of omega-3 fats, impact clotting, sudden death risk, artery plaque formation, inflammation, brain function, and are involved in hundreds of anti-aging reactions in the human body. Most Americans are omega-3 deficient, and sadly most fish oil supplements that are sold today are of very poor quality.

For hints on selecting high quality fish oils, visit Fish oil (omega-3 oils) for details…

Please take the Ten Years Younger quiz to customize your supplement needs, and if you feel you need additional information, then please schedule time to address your unique nutrient needs by scheduling time to speak with one of my Ten Years Younger coaches.

If you are taking a cholesterol lowering medication, keep in mind that most statin medications lower an essential compound in energy production called Co-Q-10 by at least 20%, and you should take a Co-Q-10 supplement with your customized supplement regimen.

Co-Q-10 is a chemical compound that has a dual function in energy production. First in nearly every cell in the body, Co-Q-10 carries fuel across the mitochondria membrane to generate energy. Second it neutralizes free radicals produced during energy production, preventing oxidative stress. Co-Q-10 has been claimed to boost energy levels, reverse heart failure, slow aging, and other claims, but in clinical outcome trials has only been proven to slow the progression of Parkinson’s disease.

Although its anti-aging potential seems fascinating from laboratory studies, we are still waiting for clinical evidence as to how it works. On the positive side, it has been studied in multiple clinical trials and appears very safe with normal dosing. Warning! Although Co-Q-10 has had an excellent safety profile in clinical studies to date, for cardiac patients who are taking Coumadin (warfarin), Co-Q-10 can modify their INR levels, potentially increasing bleeding risk, so only consider combining these agents under the strict supervision of your physician and medical providers.

Some patients use Co-Q-10 to boost energy, and although individuals might feel better, there is no proof that it works in this regard.

The most common use is when taking Co-Q-10 with statin medications that lower cholesterol, as lowering cholesterol production typically lowers Co-Q-10 levels by 20% too. No proven harm has been documented from dropping Co-Q-10 levels in this way, but there is growing evidence that restoring Co-Q-10 to normal levels with makes good preventative sense.

Absorption is an important consideration with Co-Q-10 supplementation, as regular inexpensive crystalline Co-Q-10 only has a 1% absorption when taking in tablet form. Co-Q-10 dissolved in oil has a 4% absorption, and nano-lipid spheres have an 8% absorption. So although cheap Co-Q-10 may be 1/3 the cost of more expensive  forms, the very poor absorption makes it in reality more expensive. So buyer beware when choosing Co-Q-10 products.

Having searched extensively for a Co-Q-10 (Ubiquinone) product that is well absorbed and reasonably priced, I recommend Q Best by Thorne Research. Some scientists make a big issue out of choosing Ubiquinol (the reduced form) rather than the typical form, Ubiquinol (which is oxidized). Although ubiquinol is the most active form, these forms convert back and forth thousands of times per second, and my opinion is that the added expense for Ubiquinol isn’t worth it.

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