Tag: Starts

  • How to Beat Heart Disease Before It Starts

    How to Beat Heart Disease Before It Starts

    Why might healthy lifestyle choices wipe out 90% of our risk for having a heart attack, while drugs may only reduce risk by 20% to 30%?

    On the standard American diet, atherosclerosis—hardening of the arteries, the number one killer of men and women—has been found to start in our teens. Investigators collected about 3,000 sets of coronary arteries and aortas (the aorta is the main artery in the body) from victims of accidents, homicides, and suicides who were 15 to 34 years old and found that the fatty streaks in arteries can begin forming in our teens, which turn into atherosclerotic plaques in our 20s that get worse in our 30s and can then become deadly. In the heart, atherosclerosis can cause a heart attack. In the brain, it can cause a stroke. See the progression below and at 0:35 in my video Can Cholesterol Get Too Low?.

    How common is this? All of the teens they looked at—100% of them—already had fatty streaks building up inside their arteries. By their early 30s, most already had those streaks blossoming into atherosclerotic plaques that bulged into their arteries. From ages 15 through 19, their aortas had fatty streaks building up throughout them, but no plaques yet, on average, as seen below and at 1:15 in my video.

    The plaques started appearing in their abdominal aorta in their early 20s and worsened by their late 20s, by which time fatty streaks had infiltrated throughout. By their early 30s, their arteries were in bad shape, as seen below and at 1:25 in my video.

    But that’s just the abdominal aorta, the main artery running through the torso that splits off into our legs. What about the coronary arteries that feed the heart?

    Researchers found the same pattern: fatty streaks in teens, early signs of plaque in early 20s that progress with age, and by the early 30s, most people already had plaques in their coronary arteries, as seen below and at 1:47 in my video.

    Atherosclerosis starts as early as adolescence.

    That’s why we shouldn’t wait until heart disease becomes symptomatic to treat it. If it starts in our youth, we should start treating it when we’re youths. If you knew you had a cancerous tumor, you wouldn’t want to wait until it grew to a certain size to treat it. If you had diabetes, you wouldn’t want to wait until you started going blind before you did something about it. So, how do you treat atherosclerosis? You lower LDL cholesterol through a diet low in saturated fat and cholesterol—a diet that’s low in eggs, meat, dairy, and junk.

    If we want to stop this epidemic, we have to “alter our lifestyle accordingly, beginning in infancy or early childhood. Is such a radical proposal totally impractical?” (Eating more healthfully? Radical?!) It would take serious dedication to change our behavior, but atherosclerosis is our number one cause of death. In the case of cigarettes, we did pretty well, slashing smoking rates and dropping lung cancer rates. And, yes, healthy eating is safe. According to the Academy of Nutrition and Dietetics, the largest and oldest association of nutrition professionals in the world, even strictly plant-based diets are appropriate for all stages of life, starting from pregnancy. (NutritionFacts.org is among the websites recommended by the Academy for more information.)

    The title of an important study published in the Journal of the American College of Cardiology declares: “Curing Atherosclerosis Should Be the Next Major Cardiovascular Prevention Goal.” What evidence do we have that a lifelong suppression of LDL will do it? There is a genetic mutation of a gene called PCSK9 that about 1 in 50 African Americans are lucky to be born with because it gives them about a 40% lower LDL cholesterol level their whole lives. Indeed, they were found to have dramatically lower rates of coronary heart disease—an 88% drop in risk compared to those without the genetic mutation, despite otherwise terrible cardiovascular risk factors on average. Most had high blood pressure and were overweight, almost a third smoked, and nearly 20% had diabetes, but that highlights how a lifelong history of low LDL cholesterol levels can substantially reduce the risk of coronary heart disease, even when there are multiple risk factors.

    This near-90% drop in events like heart attacks or sudden death occurred at an average LDL level of 100 mg/dL, compared to 138 mg/dL in those without the genetic mutation. This means LDL can drop below even 100 mg/dL. Why does a drop in LDL cholesterol by about 40 mg/dL from a lucky genetic mutation lower the risk of coronary heart disease by nearly 90%, while the same reduction with statin drugs lowers it by only about 20%? The most probable explanation? Duration. When it comes to lowering LDL cholesterol, it’s not only about how low it is, but how long it’s been low.

    That’s why healthy lifestyle choices may wipe out about 90% of our risk for having a heart attack, while drugs may reduce it by only 20% to 30%. If you’re getting treated with drugs later in life, you may have to get your LDL under 70 mg/dL to halt the progression of coronary atherosclerosis. But if we start making healthier choices earlier, it may be enough to lower LDL cholesterol just to 100 mg/dL, which should be achievable for most of us. That’s consistent with country-by-country data that suggested death from heart disease would bottom out at a population average of about 100 mg/dL, as seen below and at 5:21 in my video.

    But that’s only if you can keep your LDL cholesterol down your whole life.

    If you’re relying on medication later in life to halt disease progression, you may need to get your LDL below 70 mg/dL, and if you’re trying to use drugs to reverse a lifetime of bad food choices, you may not get to zero coronary heart disease events until your LDL drops to about 55 mg/dL. If your heart disease is so bad that you’ve already had a heart attack but you’re trying not to die from another one, ideally, you might want to push your LDL down to about 30 mg/dL. Once you get that low, not only would you likely prevent any new atherosclerotic plaques, but you’d also help stabilize the plaques you already have so they’re less likely to burst open and kill you.

    Is it even safe to have cholesterol levels that low, though? In other words, can LDL cholesterol ever be too low? We’ll find out next.

    Doctor’s Note

    Didn’t know atherosclerosis could start at such a young age? See Heart Disease Starts in Childhood.

    For more on drugs versus lifestyle, check out my video The Actual Benefit of Diet vs. Drugs.

    Want to learn more about so-called primordial prevention? See When Low Risk Means High Risk.

    Does Cholesterol Size Matter? Watch the video to find out.



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  • Collective Healing Starts with Deeper Understanding

    Collective Healing Starts with Deeper Understanding

    In today’s interconnected yet paradoxically divided world, the path to understanding each other requires more than just good intentions or calls for unity. While practices like loving-kindness meditation can help soften our hearts, true bridge-building demands something more: the cultivation of a deeper understanding.

    What Is Deeper Understanding?

    Mindfulness practices, including compassion meditations, settle the mind and prepare us to see the bigger picture beyond our immediate judgments. Yet a common mistake we all make is that once we feel calmer, we rush back into our worlds and don’t make time to gain a deeper understanding of the dissatisfactory situations we find ourselves in. If we don’t know the root causes for these situations, we can’t find the right solutions to resolve them.

    Meditation is an important first step. It’s like shining a light on the surface of a lake—it illuminates our immediate thoughts, reactions, and judgments without our getting caught in them. This initial glimpse brings us closer to our present moment experience and is a starting point for discovering what is underlying our reactions.

    Deep understanding is like diving below the illuminated surface to deeper waters, where light gradually dims. Through patient listening to ourselves and others, we begin to uncover hidden layers of meaning:

    • The root causes of our behaviors
    • The subtle biases that shape our views
    • Our needs and intentions
    • The complex web of interconnections between our experiences

    As we venture deeper, each level reveals new insights previously concealed from view, from our personal patterns to our shared human experiences.

    When we take time to listen with genuine openness, we can trace surface reactions back to their sources, examining the assumptions and beliefs that lie in deeper waters. This patient exploration helps us understand not just the immediate situation, but the broader context that created it: the historical patterns that shaped it, the various perspectives that surround it, and the potential consequences of our responses to it.

    This process of illumination and deep listening creates space for transformation. By understanding both what floats on the surface and what lies in the depths, we can begin to shift our habitual patterns and make choices that arise from genuine wisdom rather than reactive impulses.

    The Power of Understanding

    We are all shaped by our experiences, fears, and hopes. Our inherent biases may cloud our ability to see our interconnectedness, but they don’t negate it. The path forward isn’t about eliminating differences—it’s about building bridges of understanding across them.

    The path forward isn’t about eliminating differences—it’s about building bridges of understanding across them.

    What might change if we could:

    • Stop rushing to judgment and truly listen?
    • See our own fears reflected in others?
    • Recognize that everyone is acting from their best understanding?
    • Look beyond political labels to our shared humanity?
    • Address the root causes of our divisiveness?

    Pausing to step back for a deeper understanding is particularly important in the modern world to step out of our echo chambers.

    The Echo Chamber Effect

    Our modern information landscape often amplifies our differences while obscuring our common humanity. Social media algorithms, targeted advertising, and news feeds tend to create echo chambers where we mainly encounter views that confirm our existing beliefs (known as confirmation bias). This is not to say that there aren’t real and significant disagreements around some social and political issues. Yet in many cases, this digital architecture of division can transform different lifestyle choices or policy preferences into seemingly unbridgeable moral chasms.

    Breaking free from these echo chambers requires both personal boundaries and intentional engagement. While working with a group of researchers, I studied the lived experiences of young Black women to understand how to navigate these digital spaces more effectively. Together, we created educational materials including a freely downloadable handbook—“The Intentional User”—for empowered social media use.

    While the handbook was designed for young Black women, it contains useful strategies and skills for everyone to benefit from the opportunities social networks offer for skill building, connecting, and getting our message out while creating boundaries to protect our time and psychological well-being. The handbook also shares crucial skills—curiosity and compassion—for engaging across differences, helping users step outside their algorithmic bubbles while maintaining healthy digital boundaries.

    This dual approach—setting personal limits while reaching across divides—offers a path toward using social media in service of both individual growth and broader understanding. However, shifting the ways we engage with social media is only the beginning.

    Deeper Understanding to Intentional Action: A Three-Step Framework for Collective Healing

    In polarized times, meaningful change starts with how we show up in our communities. We don’t have to wait for the elections or the next big incident to start taking action, individually and collectively.

    If the above statement feels impossible for you right now, know that it’s OK to feel this way. When emotions run high and uncertainty prevails, we first need a framework for processing our experience and beginning to heal within. And, as we know, true healing also calls us to move beyond self-care to engage in dialogue and intentional action based on deeper understanding.

    Below, I share a mindful framework to return, listen, and begin taking practical steps to move from division to connection. The three steps are cyclical and work together.

    Step 1: Return to Non-Judging Awareness

    The first step, before responding on the spot or making decisions, is to return to our non-judging awareness of our present moment experience. Depending upon the situation and available time, choose from mindfulness-based practices such as the ones below:

    i. Pause and Center

    This is an invitation to simply pause and return to centered awareness before responding:

    • Take a few conscious breaths. 
    • Feel the breath moving and creating spaciousness in your body
    • Ground yourself physically—for example, feel your feet on the ground
    • Practice mindful walking, stretching, or being in nature

    ii. Inner Awareness 

    Turn your attention towards your inner experience with non-judgment and curiosity: 

    • Notice physical sensations (tension, racing heart, clenched jaw)
    • Observe thoughts without getting caught in them 
    • Name emotions as they arise, without trying to avoid, justify, or fix them (“There’s anger,” “There’s fear”)
    • Watch for automatic reactions and habitual patterns

    iii. External Awareness

    Once you feel centered in your own experience, direct your attention outward, with non-judgment and curiosity:

    • Observe others’ facial expressions and body language
    • Notice tone of voice and choice of words
    • Pay attention to the broader environment and context
    • Watch for collective emotions in groups
    • Notice what’s being said and what’s left unsaid

    Step 2: Listen for Deeper Understanding

    Once we feel connected with our inner and outer awareness, we can start to listen for a deeper understanding beyond surface reactions. When we hear someone express views that differ from ours, our first instinct might be to argue or dismiss. Instead, try these approaches:

        i. Practice Active Listening

    We use the filters, or default biases, shaped by our past conditioning to listen and react. It is helpful to rehearse strategies for disrupting your default biases and listen with an open mind:

    • Count to five before responding
    • Use phrases like “Help me understand…”
    •  Use phrases like “What I hear you saying is…” to check understanding
    •  Notice when you’re planning a rebuttal instead of truly hearing
    • Ask follow-up questions that deepen understanding rather than pose a challenge

         ii. Acknowledge Valid Concerns and Shared Values

    In my capacity as a town councilor, I worked in a community that was highly polarized on many critical issues. Yet, we shared legitimate fears of change and uncertainty, along with care for our loved ones and the community. In that, we were more similar than different. Experiment with the following suggestions:

    • Instead of “They don’t understand,” ask “What experiences shaped their view?”
    • Shift from “They’re wrong,” to “They’re responding based on their lived experiences”
    • Focus on common desires: safe communities, good schools, economic security
    • Identify mutual concerns: healthcare costs, environmental changes, children’s future

    Instead of “They don’t understand,” ask “What experiences shaped their view?”

       iii. Move Beyond Stereotypes

    No matter how good our intentions are to view situations in a balanced way, each of us brings a conditioned lens which automatically focuses on certain aspects of the situation while leaving out others. Here are a few practical ways to disrupt our stereotypes:

    • Question your assumptions about “those people”
    • Look for individual stories behind group labels
    • Remember times your own views have evolved
    • Seek out diverse perspectives intentionally
    • Notice binary thinking and expand possibilities

       iv. Explore Creative Solutions  

    When we let go of our attachments to our beliefs and assumptions, we make room for new possibilities. Trust that you will know what you need to know. Here are a few suggestions to engage fully and intentionally:

    • Engage with both/and instead of either/or thinking to explore new possibilities
    • Consider multiple truths existing together
    • Focus on shared aspirations
    • Build on others’ ideas

    Step 3: Begin Taking Action

    While our good intentions and deepening understanding are essential, the challenges we face call for engaged action aligned with our intentions and insights for collective healing. In our fast-paced, polarized culture, it’s natural to feel overwhelmed and step back from difficult situations. We might find ourselves avoiding uncomfortable conversations or disengaging from collective challenges that feel too complex or contentious.

    The challenges we face call for engaged action aligned with our intentions and insights for collective healing.

    Yet each of us has the capacity to contribute to positive change, even in small ways. By bringing mindful awareness and a deeper understanding to our various roles—as consumers, leaders, and community members—we can take meaningful steps toward building more connected communities. Here are some practical ways to begin:

    As Conscious Consumers

    Often, we may not see how our daily choices as consumers connect to our deeper values and impact our communities. Yet each purchase we make is an opportunity to support the kind of world we want to create. Our spending decisions ripple out to affect local cultures, environments, and the well-being of our neighbors. 

    Even in times of national division, we can strengthen our local communities through mindful choices about where and how we spend our resources. Here are some ways to align our consumer choices with our values:

    • Support local businesses across community divides
    • Join community-supported agriculture programs
    • Use local financial services that reinvest in your area
    • Participate in resource-sharing networks
    • Consider the values and consequences of the business on suppliers, employees, consumers, and the environment before giving your purchase dollars and attention to that business

    As Leaders

    Leaders have unique opportunities to create environments that foster understanding and bridge divides. Whether leading teams, organizations, or community initiatives, we can use our influence to build structures that support both individual growth and collective healing. Drawing from a deeper understanding of different perspectives and needs, here are ways to lead with intention for collective healing and growth:

    • Model respectful disagreement
    • Build diverse, inclusive teams that bring multiple viewpoints together
    • Create forums for open discussion
    • Implement fair policies that respect different viewpoints
    • Make time and space for developing skills for deeper understanding through workshops, training, and practice sessions
    • Allocate resources for ongoing learning and healing practices within the organization

    As Community Members

    We can seek out opportunities to build bridges across divides by aligning our thoughts, speech, and actions with our insights and intentions based on a deeper understanding of our shared humanity and unique journeys:

    • Join cross-cultural community projects
    • Participate in local government meetings
    • Start neighborhood initiatives that require cooperation
    • Create and join spaces for regular dialogue

    Moving Forward

    True resilience grows through consistent, intentional action emerging from a calm mind and deeper understanding. Each time we return to our non-judging awareness, listen deeply for a deeper understanding, and begin taking action, we create ripples of positive change throughout our communities. The goal isn’t to eliminate differences but to create spaces where differences contribute to our collective strength.

    Remember: Small actions, emerging from deeper understanding and repeated consistently, create lasting change. Start where you are, with what you have, and build from there. Each step toward understanding, no matter how small, contributes to our collective healing.



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