You are the Salt of the Earth – Common Myths About Hypertension

Hypertension, commonly known as high blood pressure, is a catalyst for heart disease and stroke, two of the leading causes of death in the United States. Nearly half of the adults in the US have high blood pressure (characterized by a blood pressure of 130/80mmHg or higher) and only one quarter of those are properly managing their condition. Hypertension is known as the “silent killer”. Because there are no warning signs for high blood pressure, many people are unaware that they are living with this condition, and thus do little to maintain control over it.

Have you ever heard the saying: “Be careful what you believe, even salt and sugar look alike”?

Allow me to apply it in de-bunking a common myth about hypertension. While salt and sugar have similar characteristics in terms of size, shape, and coloring, their effects on your body couldn’t be farther from the same. Many people believe excess salt intake to be the primary cause of high blood pressure. Physicians are unestablished on where this consensus arose from, as studies dating back 100 years have been unable to indicate a positive correlation between salt intake and blood pressure. In fact, a 1998 review study comparing dietary sodium intake and mortality rates actually found little correlation between the two, indicating that decreasing your salt intake can lower your blood pressure, but that was only found to be a short-term fix. To that end, a study published by the American Journal of Medicine in 2006 examined a similar relationship and actually found that too little salt (<2400mg/day, as advised by the AHA) can significantly increase your risk of heart disease by 50%.

So, if it’s not just salt, what is the culprit behind hypertension? You might’ve guessed…it’s the not-so-sweet “look-alike”, Sugar.

Obesity, insulin resistance, and increased levels of Triglycerides have been dubbed the Triad of Hypertension. The commonality among them? Sugar. Let’s break them down one-by-one:

Obesity. There are a lot of factors at play when correlating obesity and hypertension. Obesity can alter your sympathetic nervous system (your body’s fight-or-flight response) and induce hormone signaling pathways. One important effect of obesity is the over-compression of your kidneys, which is caused by the increase of visceral fat tissue in your midsection. Your kidneys work to excrete water and regulate the salt levels in your body to maintain the body’s blood pressure. But the increased stress caused by the excess visceral fat tissue can inhibit proper kidney function, which in turn, causes high blood pressure.

  • Insulin Resistance. Insulin resistance occurs when the cells in your body are unable to use insulin effectively. Due to this, your body attempts to produce more insulin, leading to increased levels of glucose in the blood, increased water and sodium retention, and, as a result, increased blood pressure.
  • High Levels of Triglycerides. Triglycerides are a form of fat created by your body after eating, which your body will store for energy use between meals. High levels of triglycerides can occur from over-eating, under-exercising, and high consumption of alcohol. When your body encounters a chronic build-up of triglycerides in the blood, your arterial walls begin to harden and thicken, causing them to narrow. The excess strain on your arteries will, in turn, increase your blood pressure and cause hypertension.

Now that we’ve uncovered the medical causes behind hypertension, here’s how you can manage your blood pressure to prevent hypertension.

  1. Eat well. Your body requires sufficient nutrients to survive. Eating a well-balanced meal is incredibly important in allowing your body to reach its peak performance.
  2. Exercise. It is crucial to allow your body some movement daily. Yoga, walking, or an at-home workout video are great ways to manage your weight and ensure you are keeping your blood pressure under control.
  3. Limit your sugar, salt, and carb intake. Processed foods are chock full of excessive amounts of salt and sugar, both of which are negatively impacting your blood pressure.
  4. Avoid excessive alcohol consumption. Many alcoholic beverages contain high amounts of sugar and carbs, which are directly affecting your blood pressure. Excessive consumption of alcohol is also a common cause of obesity.
  5. Eat anti-inflammatory foods. Healthy fats, such as fish, eggs, turkey, avocadoes, and nuts are great sources of antioxidants, and help to limit inflammation of your blood vessels and reduce your blood pressure.
  6. Avoid inflammatory foods. While anti-inflammatory foods can lower your blood pressure, inflammatory foods can significantly increase your blood pressure. Grain products, fried foods, processed foods, soda, fast foods, and commercial salad dressings are all known to cause inflammation in your blood vessels. It’s best to avoid these to reduce your risk of hypertension.

Excess salt intake is blamed for hypertension, and while it can have negative effects on your blood pressure, excess carb and sugar intake are stronger forces causing hypertension. People with high blood pressure should take care in limiting their salt intake but be conscious in avoiding excess amounts of carbs and sugars, as well. Remember, you’re sweet enough already!

Read more on the 1998 review study here:

Read more on the 2006 second NHANES study here:

You may also be interested in this book where evidence points to other factors beyond salt as the enemy of good health: The Salt Fix – How Experts Got it Wrong

Don’t Go Breaking Your Heart – Myth-busting and Top Tips for a Healthier Heart

I recently listened to a healthy heart masterclass sponsored by the Food Revolution Network where Dr. Mimi Guarneri, a holistic cardiologist, shares tips on how to prevent or reverse heart disease without relying solely on drugs, surgeries or stents. So, in this blog, I’ll highlight the top myths along with health tips to keep your blood pumping machine in optimal condition.

Myth #1:

  • Your genes are not your destiny. Did you know that 90% of heart disease is related to lifestyle? And because these lifestyle and environmental factors are passed down from previous generations, you see family histories of heart disease. 
  • And according to Dr. Dean Ornish who is a proponent of a plant-based diet, four out of five cases of coronary atherosclerosis can be reversed using diet, exercise, meditation and group support. I’m personally a fan of the pegan or flexitarian diet (mostly vegetables and fruits but occasional meat and fish consumption) which is considered mostly plant-based.
  • Age and genetics do not seal your fate. You’re never too old to adopt new habits in spite of what all the old, ‘not-so-wise’ sayings indicate. Based on this Johns Hopkins study, conducted on 6,000 atherosclerosis patients aged from 44-84 years old, healthy lifestyle changes decreased risk of death by 80% no matter what age group they were in. 

Myth #2:

  • There is more evidence pointing to the lack of evidence on dietary cholesterol as the main risk factor in heart disease. In fact, up to 75% of people who experience heart attacks have what’s considered normal cholesterol levels.
  • Read my earlier blog on the role that cholesterol has in heart disease:
  • In order to avoid or reverse heart disease, you need to consider all pillars of health (nutrition, exercise, mind and sleep) and stop focusing on just a number that is not even a good predictor of heart disease.

Myth #3:

  • According to Dr. Guarneri, if medicine took care of heart disease, it wouldn’t be killing eight million people every year. She states that 92% of first heart attacks are totally preventable.
  • Medications can decrease heart disease risk but they are almost never as effective as sustainable and lasting lifestyle changes.
  • Addressing root causes of heart disease is what’s important, not reducing symptoms with medications.

Heart Health Tips #1:

  • Eat more of the right omega oils (omega 3) like oily fish and fish oil to get the right balance.
  • You need omega-6 oils but we consume way too much with oils like corn, safflower, soy, sunflower and canola and these processed vegetable oils create a pro-inflammatory response in our bodies.
  • The best vegetarian sources of omega-3 oils are flax seeds and chia seeds which should be ground up prior to consumption so they are digested properly.
  • Of the three types of Omega 3s (ALA, EPA, DHA), ALA is found in flax and chia seeds but EPA and DHA are mainly found in fish and algae. And your body needs all three, so if you don’t like the idea of consuming oily fish, you can opt for algae. Here’s my favorite that’s been tested to be free of heavy-metals:

Heart Health Tip #2

  • White flour, sugar and other processed foods cause inflammation and increase your risk of heart disease and diabetes.
  • When consuming grains, opt for whole grain to ensure you’re also getting the soluble fiber and the phytonutrients.
  • Pseudo-grains like quinoa, millet, buckwheat and amaranth are good options.
  • I’m personally not a fan of a lot of whole grain consumption – eating a bowl of whole grain pasta will make my glucose monitor sing but when eaten sparingly, it’s fine.

Heart Health Tip #3

  • Dr. Guarneri suggests to NOT eat red or processed meat. Although I agree with avoiding processed meat which is high in salt, nitrates and other additives, I think eating clean, grass-fed meat in small portions should be ok if you are generally healthy and want to avoid heart disease.

Heart Health Tip #4

  • If you don’t visit the dentist regularly for oral check-ups and cleaning, you should know that periodontal (gum) disease is related to heart disease. Evidence has shown that bacteria in the mouth that causes gum disease travels to the heart and triggers inflammation in the blood vessels and increases your cardiovascular disease risk.
  • So keep up the daily flossing, Waterpik (which I love) and the bi-annual visits to the dentist.

Heart Health Tip #5

  • Did you know that evidence shows that emotional intelligence plays a significant role in the occurrence of coronary heart disease? When you experience feelings like anger and hostility, you can increase your risk of heart attack by more than 200%!
  • It’s important to be in loving relationships with family and friends as it will have a physical impact on your heart health.
  • Make sure to take actions to support your emotional well-being with mind care (yoga, meditation, etc.) and positive social interactions.

Heart Health Tip #6

Heart Health Tip #7

  • Dr. Guarneri suggests dancing as an excellent form of exercise as it’s not only great physical movement but the music and the rhythms elicit positive emotional responses which are great for the heart.
  • If you prefer regular exercise over dance, keep it up 3-5x per week and make sure to include aerobics, strength training and stretching into the regimen.
  • Remember – variety, frequency and FUN are key to a sustainable program of movement.

Heart Health Tip #8

  • Did you know that more than 70% of all visits to the doctor are related to stress? And research shows that chronic stress can raise your blood pressure, cause inflammation and increase your risk of a heart attack.
  • Engaging in activities like yoga, meditation and deep breathing exercises can calm your heart and your brain.
  • I like Dr. Weil’s 4-7-8 breathing exercise to shift the energy balance to a peaceful state:

Heart Health Tips #9

  • The journey is as important as the destination so focus on progress with small, tangible steps that you CAN do that will become a habit over the long term.

To learn more about this masterclass visit:

Heart Disease Fighting Foods

As mentioned in my previous blog, cholesterol is just one factor in a comprehensive approach to managing risks for heart disease. Lifestyle factors such as diet, exercise, alcohol, smoking, and toxins/pollution have a significant impact on our vascular health. So in this blog, I will highlight some superfoods that you can incorporate into your diet to keep your arteries in tip-top shape. 

Avocados and avocado oil

Avocados are nutrient dense and packed with healthy, monounsaturated fat. In this study, participants who ate an avocado daily had significantly lower levels of oxidized LDL (the kind that clogs up your arteries).

Avocado oil is mild so it doesn’t impart flavor to the food and comes with a high smoke point (over 500F) so it’s a great option for cooking and stir-frying all types of food. I no longer use olive oil for frying as the high cooking temperature can damage the oil. In general, the safest way is to stir-fry the food in water or some broth and then add in oil towards the end to minimize high temperatures.

Here is an avocado oil to try:


Berries are low in sugar and loaded with disease-fighting phytonutrients like flavonoids and antioxidants. In this study of over 1,200 subjects, regular consumption of berries significantly lowered LDL cholesterol, systolic blood pressure, fasting glucose levels and Hemoglobin A1c.  What’s not to like about blueberries, raspberries and blackberries? I buy fresh berries in season but most of the time, I opt for frozen – they store well with many varieties available anytime.

Broccoli sprouts

Compared to standard broccoli, broccoli sprouts have 30-50X more glucoraphanin – a known antioxidant and anti-carcinogenic compound. In this study, consumption of high glucoraphanins resulted in significantly reduced LDL. You can find broccoli sprouts in the produce section – they come in a small container by the alfalfa sprouts section. You can add some broccoli sprouts to top off salads or add them to your morning shake. 

Dark chocolate

Dark chocolate is a rich source of flavonoids (powerful antioxidants) due to the high cocoa content and has been proven to lower the risk of cardiovascular disease. In this study, an analysis of interventional studies done with dark chocolate/cocoa products showed it reduced low-density LDL and total cholesterol levels. If you love chocolate but don’t want the sugar, try these sugar-free options. I ate these while wearing a continuous glucose monitor and noticed how my blood sugar was smooth and steady even after eating a whole bar!

55% Cacao:

My personal favorite:

70% Cacao:

Fibers from legumes and beans

  • Chickpeas, which are a type of legume, are full of fiber and have been shown to reduce total cholesterol levels and fasting insulin.
  • Lentils are another great plant fiber food. In this study, the substitution of red meat with legumes improved glucose control and cholesterol profiles among diabetic patients. 
  • Other heart-healthy beans to try include kidney beans, pinto beans, black beans and cannellini beans.

Green tea

Green tea is rich in catechins, which are antioxidants (a major active compound is epigallocatechin gallate – EGCG) and have been widely used and studied for reducing inflammation, aiding in weight loss and preventing heart and brain disease. In this clinical trial, subjects treated with green tea extract showed significant reduction in LDL cholesterol and an increase in leptin (the satiety hormone). In this study, daily supplementation with green tea extract improved blood pressure, insulin resistance, inflammation and oxidative stress along with lipid profile.

It’s a superfood with many benefits. In lieu of extracts, I prefer to drink green tea daily. Here are the ones I would try:

Green tea has also been highlighted for fighting diabetes – check out my blog on this topic.  

Konjac root fiber

Konjac plant, or the root, is a Japanese root vegetable that is full of fiber. It has been used by people in East Asia for thousands of years and is mainly grown in Asian countries. Similar looking to an odd-shaped potato (as they come from the same family as potatoes), it contains a fiber called glucomannan – a viscous soluble fiber that is being studied as a dietary intervention for reducing cardiovascular risk. In this study, the use of konjac root significantly lowered LDL cholesterol and non-HDL cholesterol. Did you know that konjac root is used to make noodles and rice? They are called shirataki noodles and are available as a low carb, low calorie substitute for pasta and rice dishes. I use the shirataki noodles to put in soups and the shirataki rice to blend with regular white or brown rice. Here are my favorites:



Oat Bran

Oat bran contains high levels of beta-glucan, a viscous, soluble fiber that is associated with a reduced risk of cardiovascular disease. This systematic review showed that oat beta-glucans have a lowering effect on LDL cholesterol and very low density lipoproteins (which are artery clogging) and hence recommended as part of a vascular health dietary regimen. 

Here’s one to try:

Olive Oil

The vascular protective properties of the Mediterranean Diet have been well documented, with the importance of olive oil highlighted in lowering the risk of heart attacks and strokes. In this study, consuming at least half a tablespoon of olive oil per day was associated with a 21% lower risk of heart disease. Olive oil, particularly, the extra virgin kind, contains the highest concentrations of polyphenols – the powerful antioxidants which have been shown to reduce oxidized LDL cholesterol, improve HDL cholesterol and reduce blood pressure. 

To insure I’m not ingesting any oxidized olive oil (resulting from high temperature and long storage), I buy olive oil in small quantities and use it as a finishing oil (when stir-frying to minimize heat contact) and for room-temperature dressings and toppings. Unfortunately, the olive oil industry is rife with fakes and oil blends. In a future blog, I’ll share what to look for when buying olive oils. These two have been tested by an independent lab to be pure olive oil and are noted for their high polyphenol content: 

Red Grapefruit

Red grapefruit contains higher quantities of bioactive compounds and higher antioxidant potential than the blond variety. In this study, a diet supplemented with red grapefruit improved lipid levels, triglycerides and serum antioxidant activity.


Salmon is fabulous not only for its flavor but also for the high concentrations of heart-protective omega 3 fatty acids. This study has shown that intake of fatty salmon reduced triglycerides and increased HDL cholesterol levels when compared to lean fish (cod). Opt for wild salmon whenever possible as it is higher in minerals and contains less contaminants than farmed salmon (pesticides, PCBs). For convenience, I opt for frozen salmon.


Are you nuts for nuts? How about some walnuts for heart health as they are rich in healthy fats, vitamin E and folate? In this study, inclusion of walnuts in the diet for six months improved endothelial function and LDL cholesterol levels.

More Natural Ways to Lower Your Blood Pressure

According to the latest statistics from the CDC (Centers for Disease Control), if you have high blood pressure, you are among almost half of all American adults. Hypertension (high blood pressure) is a major risk factor for cardiovascular disease, kidney damage, stroke and vision impairment and increases mortality by over 200% compared to those who don’t have high blood pressure. 

So, as a follow-up to my previous blog on the subject, I’m going to share some more evidence-based tips on natural ways to keep your blood vessels healthy and strong. 

Beetroot Juice

Beets get their beautiful red color from the plant pigment known as betanin which has antioxidant and anti-inflammatory properties. Beets are not only delicious but rich in nitrates which get converted to nitric oxide (NO). NO helps maintain healthy blood pressure, is important to vascular dilation and also plays a role in strengthening the immune system by protecting the lungs and lowering the risk of respiratory infections. Beetroot juice is widely used by athletes to enhance their performance.

In this study published in the Hypertension Journal, a cup of beet juice for four weeks lowered systolic blood pressure. 

I love beets in almost every form but am also a fan of adding beetroot juice powder to my daily drink to enhance energy and keep by blood pressure in check. Here is one I love because it’s fermented:


Raspberries, blackberries, blueberries, strawberries – these richly colored berries are high in disease-fighting antioxidants called anthocyanins. Anthocyanins work by suppressing the production of blood pressure-raising angiotensin-converting enzymes while increasing levels of energy producing nitric oxide.

In this study, two servings of berries (~275mg of anthocyanins) consumed daily led to an average systolic blood pressure reduction of 7.3 mm Hg, while helping to raise HDL cholesterol (the good cholesterol, which absorbs cholesterol and carries it back to the liver which then flushes it from the body. High levels of HDL cholesterol can lower your risk for heart disease and stroke.)

When in season, it’s great to enjoy fresh berries. However, I generally prefer frozen options as they are great year-round and I never have to worry about eating them before they expire. I stock my freezer with wild or organic frozen berries and use them for my shake or snack. Here’s a recipe I use for a healthy post-meal dessert:

  • 1 cup of frozen berries
  • A few drops of Stevia or sprinkle of monk fruit sweetener to taste
  • 2 tablespoons of coconut cream or coconut milk
  • Microwave for 20 seconds to soften the berries just a bit. Top with some nuts (walnuts, almonds, cashews) and coconut flakes and enjoy!


Cinnamon is a common herbal remedy used for digestive issues, blood sugar problems and even respiratory infections. One of the active ingredients called cinnamaldehyde is a powerful antioxidant that is also being studied for its ability to decrease blood pressure. In this study, cinnamon had a hypotensive effect on diabetic patients leading to reductions in systolic readings by over 5mm Hg. And this effect can be seen with only 1-2 teaspoons a day.

It’s easy to get in your daily dose by sprinkling cinnamon into coffee, tea, yogurt, smoothie or oatmeal. Here is one to try:


German chamomile (Matricaria chamomilla) has a long history of use as a medicinal herb and is still used today to reduce stress and ease muscle tension. Chamomile tea is also a popular remedy for blood pressure:

  • Chamomile has anti-inflammatory properties and helps blood vessel walls to relax and dilate
  • Chamomile has a natural hypotensive effect by acting as a diuretic to flush fluids out of the body
  • Chamomile has a relaxing and sedative effect that lowers anxiety and stress and promotes calm and sleep

You should wind down with a cup of good chamomile tea to help you relax and get ready for slumber. Here’s one to try.

You can also use chamomile essential oil and add several drops to your diffuser. If you prefer to apply directly to your skin, make sure it’s diluted with a carrier oil like Jojoba.

Here’s one to try that’s already been diluted:


Garlic’s key active ingredient, allicin, has antiviral, antibacterial, antioxidant and anti-inflammatory properties. It also stimulates the production of nitric oxide which helps dilate the blood vessels and reduce blood pressure. Garlic has been studied for its immune boosting properties and improving LDL cholesterol but it’s also great for reducing hypertension. 

In this study, garlic extracts lowered systolic and diastolic blood pressure in hypertensive participants by up to 8.7mm Hg. Meanwhile, in this double-blind, placebo-controlled study, participants with uncontrolled blood pressure taking 960mg of garlic extract daily for three months saw blood pressure drop by 10 points which is comparable to existing blood pressure medications.

Dosages recommended are 4g (one to two cloves) of raw garlic per day. Unless you are chasing away vampires, the easier way to get this in is through a supplement. Here’s an odorless one to try:


Lavender (Lavandula augustifolia) is in the mint family and has long been used to manage mood and anxiety – but did you know it’s also good for blood pressure? In this study, researchers found that inhaling lavender essential oil after heart surgery caused reductions in both blood pressure and heart rate. Add 4-5 drops into your diffuser or you can dilute 3 drops to 9 drops of carrier oil like avocado or jojoba oil and massage it into the back of the neck. Remember, more is not better and make sure you do not ingest lavender oil as it’s not meant to be taken internally. 

Here’s one to try:


Melatonin, a hormone produced by your brain, is an antioxidant that boosts the immune system, protects us from disease and also reduces blood pressure spikes that occur at night and during sleep. This study found that 2.5mg of a melatonin supplement at bedtime reduced diastolic and systolic blood pressure up to 6mm Hg.

It’s best to let your body do the work to produce sufficient levels of melatonin, and nighttime exposure to “blue” light from electronic devices can disrupt the body’s production of this important hormone. So make sure to turn off the TVs, laptops and other light-emitting devices in preparation for shut-eye so your body knows that it’s time to rest and repair. Here’s more on the impact of blue light on melatonin production:

If you feel like you need a melatonin boost at times, you can try low dosages to begin with and go from there. Here’s one to try:

Olive Leaf Extract

The leaves of the olive tree (olea europaea) have been used for centuries to treat viral infections and speed wound healing, and also exhibit the highest content of bioactive compounds. One of the active ingredients known as oleuropein is garnering attention for its ability to modulate blood sugar, reduce cancer risk, boost the immune system and fight inflammation. It is also being studied for its blood pressure lowering effect by improving endothelial function and relaxing artery walls.

In this study, olive leaf extract was similarly effective as a blood pressure medication in lowering systolic and diastolic blood pressures in subjects with stage-1 hypertension.

Olive leaf extracts are readily available in liquids, capsules and tablets – check with your doctor if you are interested in supplementing. Here’s one that I use:

Pycnogenol (French maritime pine bark)

Pycnogenol or maritime pine bark comes from an evergreen tree (pinus pinaster) grown in France and is rich in compounds (procyanidins, flavonoids and polyphenols) that suppress the production of blood pressure-raising angiotensin-converting enzymes while increasing levels of energy-producing nitric oxide. 

This study showed that diabetic, hypertensive individuals taking 125mg of pcynogenol supplements daily for 12 weeks were able to reduce their blood pressure medication by 50%.

When supplementing with pycnogenol, look for a formulation that is standardized to at least 65% procyanidins and check in with your clinician or naturopath to make sure this will put you on the right track. Here’s one to try:


Not only is watermelon a tasty snack, research suggests that the amino acid called citrulline from watermelon significantly reduces blood pressure and oxygen demand in overweight adults.  

Citrulline is converted to arginine which produces nitric oxide that is necessary to maintain healthy vascular tone and regulate blood pressure.

Watermelon is truly a functional medicine food as its hypotensive and vasodilatory effects are pronounced. A cup of watermelon has 250 mg of citrulline which makes it the highest known natural source of this amino acid. Watermelon is also rich in the antioxidant carotenoid called lycopene – the disease-fighting plant pigment also found in red tomatoes.

When shopping for watermelon, look for firmness with a yellow “ground spot” showing where the fruit has rested on the ground. Watermelon should taste sweet but with a firm texture and a sufficient red color (showing off its lycopene content). If buying watermelon off season, check the frozen fruit section.

For more tips on how to eat your way to better health, sign up for my monthly newsletter.

Heart Disease and the Role of Cholesterol

Cholesterol has certainly gotten a bad rap over the years – remember the low fat craze where butter and eggs were considered ‘bad’ for vascular health? Fortunately, medical organizations have reversed their position on cholesterol but many of us are still not looking at the whole picture.

In an interesting podcast by Dr. Elizabeth Boham on the Doctor’s Farmacy, she discusses how cholesterol is only one factor in cardiovascular disease and in lieu of looking at cholesterol as a symptom of heart disease, we need a more comprehensive and balanced approach in considering all the risk factors. So in this two-part blog, I’ll highlight: 1) factors that contribute to heart disease and cholesterol’s role in it, and 2) natural ways to manage heart disease risk factors.

  • Cholesterol is critical for our body to function – it not only makes essential hormones to keep us alive but one quarter of the body’s cholesterol is in our brain so it’s what keeps us mentally sharp. In fact, several studies have demonstrated higher rates of dementia in people with low cholesterol.

  • Cholesterol is composed mainly of two types: high-density lipoprotein (HDL) and low-density lipo-protein (LDL). Lipoproteins are made of fats and proteins and they are the transport mechanism for cholesterol through your body.
    • HDL transports excess fats and oxidized fats back to the liver for recycling and disposal. 
    • LDL carries cholesterol through the bloodstream along with fat-soluble vitamins (A, D, K) and essential fatty acids (DHA, EPA), so it is vital for our body to function. But too much of it can collect in arterial walls and lead to plaque buildup known as atherosclerosis.

  • It’s important to look at triglycerides as they are carried around in your blood by lipoproteins that make up cholesterol. Triglycerides are a type of fat in your blood. Oils and butters and fat are triglycerides but your body also turns excess calories and simple carbohydrates like breads, pasta, sugar and alcohol into triglycerides and stores them in fat cells. Triglycerides are essential to the body but in excess, can lead to obesity, diabetes and heart disease.

  • There is an association of cholesterol with vascular disease but we need to know what the numbers actually mean as the risk factors vary depending on the individual.

  • 75% of patients with heart attacks have normal ranges of cholesterol. However, what’s interesting is that two thirds of patients with heart attacks have either pre-diabetes or diabetes which are un-diagnosed and un-tested.

  • The problem with standard cholesterol testing is that it only gives you the number with no idea how large the particles are. The cholesterol test you should ask your doctor about is particle size testing. It is called the NMR panel (LabCorp) or Cardio IQ (Quest) – it should be covered by insurance. I had mine done about five years ago and it was covered.

  • Size matters! The analogy used to describe cholesterol and particle size was dirt and dump trucks. Cholesterol is the dirt and dump trucks are the particles carrying the cholesterol. What’s desired are big dump trucks (big particle size) to move the cholesterol. Having too many small dump trucks (small particle size) is concerning as this can cause plaque build-up and lead to heart disease.

  • In one patient with a cholesterol of 300, LDL 150 and HDL 110, particle size testing showed that the patient had large fluffy particles (big dump trucks) so the doctor was not so concerned about the heart disease risk in spite of the cholesterol numbers.

  • There is a genetic component – obviously, if you have a strong family history of heart disease, you need to be more careful. But for most of us, it is lifestyle, lifestyle, lifestyle.  Insulin resistance is the key driver in heart disease – 88% of Americans have metabolic inflexibility and 50% have pre-diabetes/diabetes, many combined with excess weight. People with metabolic syndrome and insulin resistance typically have higher triglycerides, lower HDL and more small particle LDL.

  • One easy way to determine if you have insulin resistance is your triglyceride/HDL ratio.  Ideally, your ratio should be below 1. If you are above 1, you should talk to your doctor about getting fasting insulin and other diabetes markers tested.

  • Diet is the key lifestyle component – the Standard American Diet is loaded with white processed carbs and sugar leading to insulin resistance, high triglycerides and high small particle LDL.

  • A whole foods-based, low sugar diet with lots of fiber, good fats, B vitamins, folate, fish oil combined with a vigorous exercise program should be a priority for those wanting to improve their heart disease markers.

  • Inflammation and oxidative stress cause heart disease. Belly fat and/or visceral fat secretes inflammatory markers and leads to oxidative stress. The LDL particles get oxidized due to the excessive free radicals and not enough antioxidants to neutralize them.  The oxidized LDL particles cause plaque build-up. So to understand heart disease risk, it’s not just about the LDL number but the level of inflammation in the body that causes oxidation of these particles.

  • Statins are a powerful anti-inflammatory drug so it can help, but as it comes with side effects there are more natural ways to reduce inflammation in the body.

  • There are also special tests to measure oxidative stress – most likely you will need to see an integrative or functional medicine doctor to get these ordered.

  • There are other factors besides inflammation and cholesterol that affect vascular health and they include: diet, smoking status, calcium and homocysteine levels, vitamin and nutrient status, toxins and pollution, oral health (like gingivitis) and your gut microbiome.

  • And last but not least, heart disease is not a statin deficiency…

To learn more, check out the Doctor’s Farmacy podcast here:

11 Natural Ways to Lower Your Blood Pressure

The American Heart Association estimates that over 100 million American adults have high blood pressure or hypertension. If left untreated, this can lead to serious health conditions. There is evidence that suggests that the risk of cardiovascular disease doubles for each additional 20 mg Hg systolic and 10mg Hg diastolic reading above 115/75 mm Hg. So getting blood pressure under control may be one of the best ways to protect your health.

Blood pressure is measured as the force that is exerted by the blood on the artery walls. The systolic reading (top number) indicates the force of each heartbeat and the diastolic (bottom number) indicates the force in between the heartbeats. The clinical guidelines for “elevated” blood pressure is above 120mm Hg systolic over 80 mm Hg diastolic.

In this two part blog, I’m going to share some evidence-based tips on natural ways to manage blood pressure. 

Bay Leaves

Bay leaves are popular herbs to include in recipes such as soups and stews but did you know that they are also good for supporting the vascular system? This recent study on the Indonesian bay leaf showed it to be effective in reducing blood pressure in hypertensive pregnant women.   

You can easily brew bay leaf tea at home. Put several leaves in 16 oz. of hot water and let steep. Add lemon and stevia or honey to taste. Here’s one to try:

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Cranberries are not only for the holidays – they are a superfruit high in antioxidants, nutrient dense polyphenols and prebiotic fiber, which are all beneficial for your heart. This study suggests that cranberry supplementation is effective in managing systolic blood pressure, body mass index and HDL cholesterol.  Cranberries are readily available during holiday season but the rest of the year, look for unsweetened cranberry concentrate. You can add several tablespoons in sparkling water with some lemon for a delicious drink.

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Also, be careful when buying dried cranberries – most are loaded with sugar which is used in the drying and flavoring process. Here’s a brand without any added sugar:

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Fennel Seeds

These tiny seeds have been used over centuries as a trusted herbal remedy for a variety of ailments. Fennel seeds are rich in minerals needed to regulate blood pressure and they also contain antioxidants and anti-inflammatory compounds. In a study conducted at UC Irvine, researchers found that fennel along with other herbs activate a blood pressure-lowering potassium channel in the blood vessels.

Here’s a fennel seed tea to try: 

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Green Tea

Green tea is packed with polyphenolic compounds called catechins – the main catechin found in green tea is called epigallocatechin gallate (EGCG). Green tea has been touted for a variety of health benefits with cardiovascular disease, cancer, diabetes and weight loss among them. Green tea and its active components have also been studied for lowering blood pressure. In this study, subjects who drank four cups of green tea daily (equivalent to 500mg of catechins) showed lower systolic, diastolic and pulse pressures. 

Here are several brands to try – look for organic if possible and check if it’s been tested for pesticides and contamination:

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Intermittent Fasting

Time-restricted eating or intermittent fasting (IF) has been shown to improve insulin sensitivity and blood pressure. IF is typically done where you eat within a 10 hour window. So if you have breakfast at 8am, plan to have dinner by 6pm – and try to limit snacking because every time you eat, your glucose and insulin levels will rise. Check out my blog on intermittent fasting.


Magnesium is a mineral that is involved in more than 600 biochemical reactions in our body like energy creation, nervous system regulation and muscle movements. Magnesium is critical for our cells to function but deficiencies are common. The National Institutes of Health warns that many older adults don’t get enough of this essential mineral.

Studies have shown that magnesium supplementation is effective in lowering blood pressure in hypertensive adults. You can increase your dietary intake of magnesium with leafy green, nuts (almonds, cashews), black beans, pumpkin seeds, dark chocolate, bananas, avocados, brown rice, yogurt and legumes. Another way to get magnesium is with Epsom salt baths – it is soothing and good for muscles. 

If you are looking for supplements, here is a brand that provides all 7 forms of magnesium our body needs:

I also use this powdered magnesium in the evening to help relax and wind down…

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Omega 3 Fatty Acids

Healthy fats containing Omega-3 fatty acids support heart function and lower blood pressure.  This study found that in adults with hypertension, daily doses of omega-3 fatty acids showed clinically meaningful blood pressure reductions. 

Here is the brand I recommend:

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Potassium is an electrolyte that counteracts the effects of sodium and maintains consistent blood pressure. When diuretics are often prescribed for high blood pressure, it unfortunately accelerates the excretion of potassium by the body which creates the vicious cycle of water retention which was what the diuretic was designed to remove in the first place. The easiest way to replenish potassium is through our diet. Fruits, legumes, vegetables and dark leafy greens are good options.

Here are some foods that are high in potassium:

  • Dried apricots – half a cup of dried apricots contains over 1000mg of potassium
  • Potatoes – a medium baked potato with skin contains almost a 1000mg of potassium
  • Leafy greens – a cup of Swiss chard has almost 1000mg of potassium, a cup of cooked spinach has up to 800mg
  • Lentils – these small legumes have over 700mg of potassium per cup
  • Prunes – half a cup of dried prunes contains 700mg of potassium
  • Carrot juice – a cup of this tasty juice has almost 700mg of potassium

Probiotics have been investigated for their antihypertensive effects; this study shows that supplementation with probiotics resulted in a moderate to significant reduction for either systolic or diastolic blood pressure. Make sure to get plenty of probiotics from fermented foods like kimchi, sauerkraut, miso and yogurt. If choosing supplement form, look for ones with multiple strains and make sure to consume at least 100 billion colony-forming units of probiotics per day for at least two months.

Here are several to try:

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If you like seaweed salad or sushi rolls with nori (seaweed sheets), you are in for a treat.  Seaweed is rich in polyphenols and has a range of health benefits including anti-inflammatory and anti-viral properties which are also useful for high blood pressure. In this study done on children, seaweed consumption lowered diastolic blood pressure in boys and systolic blood pressure in girls.

I enjoy roasted seaweed for a snack – here’s one to try:

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Vitamin D

Experts indicate that over 40 percent of American adults may be deficient in vitamin D and this could have an impact on the epidemic of high blood pressure in the US. Studies have shown that people deficient in vitamin D are more likely to have high blood pressure. Vitamin D metabolism is involved in blood pressure regulation and works by suppressing the production of renin, an enzyme that promotes the activity of a blood pressure-raising protein. It is easy to get this measured through regular testing – talk to your doctor about obtaining your current level. I struggle with low vitamin D levels especially during winter months so supplement with appropriate dosages based on my test results. 

Here are ones to try:

1000 IU

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2000 IU

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5000 IU

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Preventing Heart Disease the Functional Medicine Way

I listened to a fascinating series of podcasts called the Longevity Roadmap offered by Dr. Mark Hyman and his Ultrawellness Center. In one episode, a group of specialists provided a short summary on the causes of cardiovascular disease, how to identify the root cause, adequate testing and ways to protect and support the heart using functional medicine approaches. Here are the highlights:

  • The endothelial system lines the inside of every blood vessel in the body and the one cell thick layer called the endothelium is found in the inner walls of our arteries. The proper function of the endothelial system is intimately tied to our health – it delivers oxygen and removes waste. It needs to be able to relax to allow blood to get to all the different tissues in the body. If it doesn’t relax, blood pressure will go up and inflammation of the system leads to cardiovascular disease (CVD). Oxidative stress can damage the endothelial layer and abdominal visceral fat is an inflammatory trigger for damage. For example, in men, this can cause higher erectile dysfunction. To improve endothelial function, foods rich in anthocyanins like blueberries should be consumed. It has been shown that two cups of blueberries over four weeks helped drop systolic blood pressure as much as regular meditation practice.

  • The misconception is that CVD is about cholesterol – it’s actually about inflammation and they explain why cholesterol has gotten a bad rap.
    • Cholesterol is not water soluble so it needs to be carried around by lipoproteins which include low-density lipoproteins (LDL which carries cholesterol from the liver to parts of the body) and high-density lipoproteins (HDL which carries cholesterol from peripheral parts of the body back to the liver for disposal). 
    • Cholesterol has an affinity for inflammation so if the endothelial lining of the blood vessel wall is inflamed, that creates an opening in the protective lining. The LDL cholesterol then attaches to the inflamed blood vessel and gets underneath the lining and begins to accumulate, eventually turning into plaque. This plaque will restrict blood flow, eventually leading to ischemic heart disease. And when the plaque cracks, it causes the blood clot to fill up the remaining space in the blood vessel leading to a heart attack.

  • What causes inflammation?
    • Processed refined foods with sugar, salt and fake fat and vegetable oils all become inflammatory when consumed. 
    • Leaky gut and leaky mouth can cause inflammation in the brain and cause heart disease so the oral and gut microbiome should be examined. There are tests now available to examine the status of both microbiomes.

  • CVD is not a statin deficiency disease. It’s inflammation, oxidative stress, insulin resistance, hormonal imbalance, toxins, bad diet, lack of exercise and nutritional deficiency that lead to high cholesterol and CVD. Up to 90% of all CVD can be prevented with lifestyle measures like proper diet, exercise, no smoking, reduced stress and sleep optimization.

  • Statins have a role in CVD but for primary prevention, it’s not optimal. They can have side effects including destruction of mitochondria which is critical for energy function. If you require a statin, it’s important to take CoQ10 (an antioxidant nutrient) as statins block CoQ10 which is vital for antioxidant and mitochondrial functions.

  • CVD is the leading cause of death in the US and two-thirds of it is related to our diet and lifestyle. According to Dr. Hyman, the central feature of all age-related disease is insulin resistance. And since we consume around 150 pounds of sugar and 133 pounds of flour per person every year in the US, it makes up 60% of our calories which causes insulin resistance. Only 12% of the US population are metabolically healthy versus the 88% who are unhealthy including 75% of those that are overweight. Even 20-40% of those that are normal weight are also metabolically unhealthy – and these ‘skinny’ fat people are at equal risk for heart disease.

  • The biggest risk factors for those getting very ill or dying from COVID-19 are being overweight with high blood pressure, glucose, insulin resistance and high cholesterol.

  • By decreasing insulin resistance, you can make the small dense LDL particles bigger and fluffier which makes it less athrogenic and plaque inducing. If your LCL cholesterol number is high, you can ask your physician to run an NMR lipid profile test to look at particle size and quantity. The NMR lipid profile determines the actual molecular structure of lipoproteins in your bloodstream and is a more important marker of heart disease than just HDL, LDL or total cholesterol. For LDL, you want a low particle number and a big fluffy size. For HDL, you want them to be big as they collect cholesterol from the body and take it to the liver to be disposed of. So big HDL is like having big dump trucks. You also want to know if you are one of 250 people who have familial hypercholesterolemia, a genetic variation that prevents the body from getting rid of LDL easily, as this condition significantly increases your risk of heart disease. 

  • Some dietary ways to improve cholesterol include:
    • Plant-based foods and proteins like legumes, nuts and seeds. For example, an ounce of nuts 5X a week can improve cholesterol and lower inflammation. Look for organic raw nuts and keep them in the freezer to prevent the good nut oils from oxidizing.
    • B3 (niacin) vitamin can have a positive impact on cholesterol and has been shown to lower triglycerides, lower LDL and raise HDL. Make sure to work with a provider as this vitamin causes uncomfortable hot flushes.
    • Fish oil has been shown to lower triglycerides, LDL and raise HDL. In a study, eating 1 gram of fish oil per day decreased heart risk if you ate less than 1.5 servings of oily fish per week. If you eat more servings of fish, you may not need to supplement. Wild caught salmon, sardines, anchovies and mackerel are good choices.
    • Flaxseeds are also recommended for their omega 3 and fiber content. You can add two tablespoons to your morning shake.  

  • Insulin resistance is the number one cause of CVD and happens when our body has to produce a lot more insulin to get the food into our cells. Even though insulin levels are high, the body becomes resistant and the food and nutrients don’t get into the cells. This results in weight gain around the belly which is the inflammatory visceral fat leading to CVD, stroke, dementia and even cancer. It’s critical to keep insulin levels normal – even though the standard Quest Diagnostics measure considers insulin NORMAL if less than 19.6, it’s worth bearing in mind that this average is based on the entire US population, most of whom are overweight.

  • Here are functional medicine parameters to indicate inflammation and metabolic syndrome which are markers for heart disease:
    • Optimal fasting insulin is less than 5. If you have insulin in the 7-12 range, you are pre-diabetic or have metabolic syndrome.
    • Greater than 0.8 waist to hip ratio for women or 0.9 for men is also a sign of insulin resistance and metabolic syndrome. 
    • High blood pressure is also a clue.
    • If HDL is too low – less than 50 for women, 40 for men and if triglycerides are too high (>150), it’s a signal.
    • Glucose of >100 is a sign of pre-diabetes and if higher than 125, signaling type 2 diabetes.
    • High C-reactive protein (higher than 1mg/l) and homocysteine numbers (higher than 7 micromol/L) are also markers of inflammation.

  • If you have a poor diet, sleep habits and your stress and nutrient levels are off, you should focus on these – there are those with a genetic profile that won’t respond to these parameters but for most of us, it will prevent CVD.

  • It’s important to remember that it’s not a “one size fits all” approach and functional medicine science is personalized to your health. Working on getting the right data with proper testing along with food and diet, exercise, stress management techniques and proper sleep with appropriate supplementations should be of priority.   

There was a very large European study done that showed that following a protocol of no smoking, exercising 3.5 hours a week, healthy eating and maintaining a healthy weight prevented 93% of diabetes, 81% of heart disease, 50% of strokes and 36% of all cancers.  No medicine in the world can do this today! Lifestyle changes and addressing root causes is important and can reverse CVD with miraculous results.

Dr Hyman’s Longevity Roadmap 8-part series is offered here.

Dr. Joel Kahn Podcast Review: Heart Health, Mitochondria & The Gut

I recently listened to one of the earlier podcasts by Dave Asprey (the Bulletproof Executive) on heart health where he interviewed Dr. Joel Kahn, a cardiologist and author of the best-selling book, The Whole Heart Solution. Dr. Kahn is a well-recognized clinician in the field of invasive, interventional and preventative cardiology and was awarded the title of “America’s Holistic Heart Doc” by Reader’s Digest. He is a Clinical Professor of Medicine at Wayne State University School of Medicine in Detroit, MI and the Director of Cardiac Wellness.

It was interesting to hear that Dr. Kahn is a low-fat vegan (which is something Dave Asprey is not a fan of for various reasons) and in this interview, he mentioned that when dealing with patients with cardiac artery disease (CAD), a mostly vegetable and low fat diet (oil free, not fat free) has been proven to help. Note that he didn’t advocate this necessarily for prevention but for treating severe CAD patients.

Here are some key highlights:

  • A healthy mitochondria is the key to a healthy heart. Mitochondria is where ATP is produced and is the powerhouse for cells (ATP or Adenosine Triphosphate is a complex organic chemical that provides energy to drive many processes in living cells). When you have heart disease, your body is producing less ATP and conversely, when you produce less ATP, you are prone to heart disease, fibromyalgia, chronic fatigue syndrome, etc.
  • Your mitochondria is very prone to toxicity – published data has shown that mycotoxins and air pollution can actually trigger heart attacks. In a study conducted around the Beijing Olympics, the incidence of heart attacks went down when all the factories were turned off for the Olympics but then went back up when the factories starting running again. It’s critical to live in a clean air environment. Dr. Kahn advocates a HEPA filter, if necessary, for the home.
  • Heavy metals like mercury amalgams (in your teeth) can also be mitochondrial toxins.
  • Our body makes less CoQ10 (a powerful antioxidant) as we age so we need to bring our levels up after age 40 with supplements. He also recommends PQQ supplement as a booster (Pyrroloquinoline quinone or PQQ is a recently discovered vitamin-like compound that is commonly found in plant foods and can stimulate mitochondrial function).
  • CoQ10 combats oxidative stress and is needed to make ATP – also, drugs like statins deplete CoQ10 so it’s important to take CoQ10 when on statin therapy. A peer-reviewed study conducted in Australia showed the benefit of CoQ10 before and after open-heart surgery: those that took CoQ10 had fewer complications and got discharged earlier.
  • Dr. Kahn is very selective about the use of statins and for non-high-risk patients, prefers to manage patients with lifestyle, diet and detoxification methods.
  • Dr. Kahn also believes that cholesterol shouldn’t be lower than 150 nor does he want to see levels in the high 200+. If patients he sees do not have heart disease, he uses vitamin supplementation to keep mitochondria healthy (Selenium, Glutathione, Vitamin D, CoQ10, Vitamin E, Trans-resveratrol to name a few).
  • Here’s a nice flight tip: Dr. Kahn noted that airline pilots have increased risk of melanoma due to the ionizing radiation in the sky and recommends taking chlorella and glutathione before a flight for protection.
  • He also advocates N-Acetyl Cysteine during flu season.
  • Dr. Kahn has seen transformative results with heart patients on CoQ10, Magnesium, L-Carnitine and D-Ribose supplementation but this is not supported by clinical trials/ research. There are other cardiologists that are using nutraceuticals to support their patients’ heart health.
  • A randomized study of sick heart patients that took the probiotic Saccharomyces Boulardii showed that heart ejection fractions went up with improved symptoms and ability to walk longer distances. Dr. Kahn believes that strengthening the defenses of the gut as a heart-related therapy is important. Having a sick gut from a poor diet that includes gluten, alcohol, sugar, etc. releases endotoxins and this has shown to affect cardiac function.
  • Dr. Kahn recommends taking charcoal to bind endotoxins and resistant starch prebiotics to mediate heart attack risk.
  • Dr. Kahn also recommends eating fermented foods but they must come from the refrigerator section; otherwise, they have been pasteurized so it’s not ‘living’.
  • Dr. Kahn recommends as a preventative measure the Carotid Intima-media thickness (CIMT) test with ultrasound to check the thickness of the inner layers of your carotid artery. 60% of Americans are at risk of heart attack but are asymptomatic so it’s a good idea to get the tests done. He prefers this over CAT scan as it minimizes radiation.
  • An interesting study has shown that repeated ultra exercise may actually accelerate heart calcification (I’m glad I don’t like ultra exercise!)
  • Here is another interesting study since I am a fan of Pellegrino. People that drank a lot of San Pellegrino mineral water took Vitamin D and Vitamin K2 to counteract the large amount of calcium present in the water – and it worked. So, I can continue to drink on!
  • A quote from another well-known researcher, Dr. Thomas Seyfried: “ A man is as old as his arteries.”
  • In summary, here are Dr. Kahn’s three recommendations to perform well:
    • Forks – food is power and can reverse plaque and heart disease
    • Feet – MOVE and avoid SITosis
    • Fingers – don’t smoke

His book Whole Heart Solution can be found on Amazon: