The most effective approach to heart health and reversing arterial plaque involves consistently incorporating a few high-yield, nutrient-dense foods into one's diet, rather than strictly adhering to restrictive, unsustainable fad diets.
Mind Map
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If you ask 10 people what the best
hearthealthy diet is, you're going to
get 10 different answers. Somebody would
say, "You got to cut out carbohydrates
or you got to do keto or carnivore." And
another person may say, "Well, you have
to avoid meat and go vegan." And then
there's Mediterranean and Dash and
Paleo. But after more than 10 years of
practicing medicine and helping my
patients use food as medicine, what I
found was the prescribing a diet often
times is not that helpful because many
people, not everyone, but many cannot
stick to a very restrictive plan. And
none of those diets matter if you can't
stay on them. So the way I see it,
following a nutrition plan that's only
70% good, but one that we can do for the
rest of our lives is much better than
something that's 100%, but we can only
stick to it for 6 months. So the goal
isn't to chase the next perfect diet,
but to pick the most high yield foods
that keep showing up again and again
across all studies and meta analyses
that have been done on heart disease.
And make sure you incorporate them into
your routine, whatever that routine may
be. And as we go through these, I also
want to go over foods that are sold as
heart healthy, but you need to be
careful with. And at the end of the
video, I want to go over the best
exercise and a good supplement that has
really good evidence behind them to help
you reverse plaques even faster. Now,
before we go over the best foods, you
have to understand how we get plaques in
the first place. Because if you
understand that process, you'll be able
to tailor with more precision which high
yield foods you need to lean into.
because everyone's individual
circumstances and risk are different and
what works for one person may not work
for you. So arterial plaque buildup is
not a simple process. It's not just high
cholesterol and it's not high sugars or
high blood pressure or inflammation.
plaque forms with a perfect storm of
endothelial damage which is just injury
to the thin layer of cells that lines
the inner surface of blood vessels and
then LDL particles that contain apo B
slip through the vessel wall and then
inflammation oxidizes those particles
and that's what triggers your immune
system to step in and try to repair the
damage but instead it just causes the
plaque to grow even bigger and the more
oxidative stress in the environment the
more the cycle repeats itself. So the
high yield foods that you need to
incorporate into your regimen need to
target all those mechanisms. Lower Apo B
and reduce inflammation and improve your
nitric oxide which then lowers your
blood pressure and protects the
endothelium. And finally you need to
calm down that overreactive immune
response. So if you look through all the
major studies and meta analyses of diets
that help with atheroscerosis one
pattern that emerges is the foods that
are rich in lycopine. And lycopine is a
carotenoid that's mainly found in red
and pink fruits and vegetables. So you
get it in tomatoes and guava. Watermelon
has a lot of lycopine, pink grapefruit,
papayas. And lycopine helps because it's
an incredibly powerful antioxidant. And
one of the main drivers of plaque
formation is oxidative stress that leads
to cell damage. So lycopene can reverse
that by targeting harmful reactive
oxygen species. And we have studies that
show that high carotenoid levels may
slow early stages of atheroscerosis
progression. And there was an
observational study out of Finland that
suggested that lycopene or processed
tomato intake may reduce kurateed
atheroscerosis. Now another recurring
theme that I see in all of these studies
is phytosteriles which is just a natural
plant compound that's found in nuts and
seeds especially flax seed and sesame
seeds. And you can also find
phytosteriles in legumes and whole
grains and in many fruits and vegetables
like carrots and broccololis and uh you
can find them avocados and in many leafy
green vegetables. So phytosteriles look
almost identical to cholesterol and when
you eat them they compete with
cholesterol for absorption in your
intestines which means less cholesterol
can make it through and get absorbed.
But that's not where the magic happens.
Because when it comes to cholesterol in
our blood, most of it does not come from
cholesterol that we eat. It's the
cholesterol that's produced internally
by our liver. So how this whole process
works is the liver senses a drop in
absorb cholesterol. And because your
liver tries to maintain its own
cholesterol balance and homeostasis, it
starts pulling more LDL particles out of
the bloodstream. So over time, you
basically get less LDLs that carry apo B
moving through your arteries. And that's
important because LDL and more precisely
Apo B has been shown to cause heart
disease. If you look at meta analyses
and if you look at the mandelian
randomization studies, it is one of the
main drivers of aththeroscerosis. It's
not the only factor, but it's key in
developing plaques. And we have several
meta analyses that show that eating more
phytosteriles can significantly reduce
your LDL with an average reduction of
about 14 mg per deciliter. Okay, another
food that is essential for plaque
reversal are flavonoids, which are just
natural compounds that are found in
fruits like berries and apples and
oranges. You can also find them in
onions and leafy greens. And there's a
lot of flavonoids in dark chocolate. So,
this is how they work. When plaque
builds up in your blood vessels, it
starts with LDL particles getting
trapped and damaged in the inner lining
of your blood vessels. And this LDL
particle starts getting oxidized which
makes the whole area very sticky. So
white blood cells called macrofasages
are drawn to that area and they cause
inflammation. And this whole process is
what makes the plaque grow. So this is
where flavonoids come in. They lower
that adhesion molecule expression.
Basically they make arterial walls less
sticky so fewer cells can attach and
that in turn lowers inflammation and it
helps macrofasages work in a calmer way.
so they don't turn LDL into its damaged
and oxidized form. And one subset of
flavonoids that is especially important
is kakans which you can find in green
and black teas. And there was a meta
analysis that looked at nine prospective
studies that showed that drinking three
or more cups of green or black tea is
associated with a 21% reduced risk of
stroke compared to the consumption of
less than one cup per day. Now another
important and very powerful nutrient is
extra virgin olive oil. Now this pops up
across many studies and high intake is
associated with a significant reduction
in major cardiovascular events like
heart attacks. Olive oil is very high in
polyphenols and monossaturated fats
which have antioxidant and
anti-inflammatory properties. So they
help smooth out the damaged endthelium
or arterial inner lining. And on top of
that olive oil may also help with
insulin sensitivity and reduce
inflammation. So mechanistically you
target multiple steps that lead to
atheroscerosis. Now another food that
will help is fatty fish like salmon and
mackerel or sardines. These fish are
rich in omega-3 fatty acids, especially
EPA and DHA that are incredibly
important in keeping your heart and
blood vessels healthy. There's clinical
studies that show that people eating
fatty fish one to three times per week
had a lower risk of heart disease and
strokes. And then we have the multithnic
study of aththeroscerosis which is one
of the largest and longerunning studies
on heart disease that found that higher
DHA levels was associated with a 12%
lower risk of corateed plaque
progression. So this is the plaque that
can lead to strokes. These omega-3 fatty
acids calm down the immune response that
aggravates plaques and they can also
increase your nitric oxide production
which then stabilizes the plaque and
makes it less likely to rupture and
cause clots and problems downstream.
Now, when it comes to atheroscerosis,
it's not enough to eat the right foods,
but it's also just as important to try
to limit certain foods, especially foods
that are very inflammatory. So, no
surprise here, but we especially want to
be careful with processed carbohydrates
like pastries and cereals and any foods
that are full of sugar or fructose. So,
some of the most common offenders that I
see, so we're talking about foods that
are promoted as hardhealthy, but they're
actually harming you, flavored yogurts.
Many of them are packed with added
sugar. So, it's much better to buy plain
full fat yogurts and just add your own
sweetener of choice for taste. Now, at
this point, most people know that most
breakfast cereals are basically dessert
and just processed sugars, but there's
alternatives that masquerade themselves
as healthy, but are not really that much
better. So, I'm talking about many
breakfast bars or granola bars. Make
sure you look at the ingredient labels,
as many of those are still packed with
sugar, but just with healthier
packaging. And another sneaky food that
I always bring up is, well, it's not a
food, but it's a drink and it's juices.
If you drink apple juice or orange
juice, any type of juice, you're
probably getting a lot of added sugars.
But even if the label on the bottle says
there's no added sugars or this product
only has natural sugars, well, these
sugars may be natural, but they're still
absorbed in a highly concentrated form.
And another problem is these juices
don't come with a protective fiber that
we would normally get if we're getting
it from a fresh fruit. So, as I
mentioned before, fresh fruits are
wonderful and they're heart healthy, but
it's very easy to overconume sugars and
fructose in a fruit if you're getting it
in liquid form. Now, as a bonus, here's
some non-food related things that will
also help you expedite reversing your
atheroscerosis. First, no surprise here,
but exercise is extremely important for
your heart health. But there's one type
of exercise where we actually have
evidence in showing that it can reverse
arterial plaques. So there was a
randomized control study published in
the European Journal of Preventive
Cardiology that showed that just 6
months of supervised highintensity
interval training or HIT showed a
significant reduction in plaque volume.
And what was especially amazing, the
plaque volume regression after 6 months
of this exercise was slightly larger
than what they observe with statin
intervention. Now because
aththeroscerosis is a disease that
develops over many years and decades, we
don't know how that translates to actual
clinical outcomes. But the initial
results from the study are pretty
remarkable. Now beyond exercise, there
is one supplement that I want to
highlight that actually has decent
evidence in slowing the progression of
coronary atheroscerosis and that is aged
garlic extract. So there was a double
blind randomized control trial that
showed that aged garlic extract can
stabilize vulnerable plaques. And there
was another randomized control trial
that showed that the group that was
randomized to take an age garlic extract
for one year had a lower progression of
coronary artery calcification and
improve blood pressure. Now, one more
bonus tactic that I recommend to my
patients that may help improve
cardiovascular health and that is sauna
therapy. Now, this is not something
where we have direct evidence that shows
plaque stabilization or regression with
sauna, but there's plenty of indirect
associations. So there's studies that
show a link between sauna bathing and
improvement in endothelial function. And
there's meta analyses like this one that
show that sauna can help with blood
pressure. Now most of the evidence is
based on observational and mechanistic
data, but there is enough indirect data
that supports its health benefits. Not
just when it comes to heart disease, but
there's also linked to significantly
lower risk of all cause mortality. So,
based on the current imperfect evidence,
I still think it's a worthwhile
intervention to try if you have access
to saunas. All right, I hope this was helpful.
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