Does the thought of heart disease terrify you? Join the club. When I was a small child, my father suffered from an irregular heartbeat and high blood pressure, and the possibility of a heart attack or stroke was always looming. A few years ago he succumbed his disease. So did several of his siblings, who passed away in their late sixties. For many years I thought that I, too, was doomed to this kind of disease.
As it turns out, I was wrong. While we inherit our genes, we don’t inherit how they express themselves. That means that if you come from a family history of poor heart health, you don’t have to be stricken with coronary heart disease. Conversely, if you come from a family history of good heart health, you aren’t automatically granted longevity. It’s all a question of how well you take care of yourself.
Gene expression, says functional medicine physician Dr. Steven Masley, is shaped by environmental influences, especially the way we treat our bodies. His book The 30-Day Heart Tune-Up: A Breakthrough Medical Plan to Prevent and Reverse Heart Disease[i] tells you exactly what you can do to get your heart and arteries into tip-top shape. For a summary of this important work, read on.
How clogged are your arteries?
The book’s goal is to improve your circulation, strengthen your heartbeat, and shrink arterial plaque, the primary culprit of cardiovascular disease.
As a first step you should determine how clogged your arteries are. For that, Masley would like you to enlist help from your doctor, who, in addition to taking your blood pressure and performing a battery of blood tests,[ii] should also administer a 10-minute ultrasound test, called the carotid intimal medial thickness (IMT) scan. It measures the plaque build-up in your carotid arteries – those blood vessels that run through your neck and supply the head with blood. If performed once, the scan can help assess your risk for heart attack or stroke.[iii] If performed regularly, it can trace the advancement of disease or the success of treatment. Out of pocket an IMT scan costs between $150 and $500. Unfortunately most insurance companies in the U.S. do not yet cover it.[iv]
These tests give you a baseline of your wellness. They tell you whether your arteries are clogged and inflamed and how old your heart really is.
Learning that you have significant plaque in your blood vessels is unpleasant. You might therefore be tempted not to get your wellness exam in the first place. But that would be the wrong approach, because not knowing does not make you any healthier. Knowing, on the other hand, enables you to heal yourself, especially since Masley’s regimen, if followed consistently, promises to reduce your arterial plaque and rejuvenate your heart.
Pillar 1: Eat for heart health
The heart tune-up rests on four pillars. The first is proper nutrition. When Masley was still a young idealistic doctor, he prescribed the plant-based diet to his patients:
In the 1990s, I tried to bring the Dean Ornish Program to a 500,000-member cooperative clinic in Olympia, Washington (the Group Health Cooperative). I wanted to offer something more than just drugs and surgery to our patients, and I spent nearly one year fighting to initiate a lifestyle program that had been proven to reverse heart disease. The difficulty following the Ornish Program was that it was ultra-low-fat, vegetarian, and required daily meditation. Fewer than 5% of our high-risk cardiac patients would even consider it.
A few years later, while working at the Pritikin Longevity Center in Florida, Masley saw patients with advanced diabetes or heart disease thrive on a regimen that included a very high-fiber, high-carb regimen with little protein or fat. But once these patients returned to their meat-and-fat-eating families, they lost the ability to stick with the program, fell back into their old habits, and once again became sick.
Out of pragmatism Dr. Masley now recommends a nutritional program that is high in fiber from fruits, vegetables, whole grains and legumes (including organic soy), but also contains meat or fish at two out of three daily meals.
Fatty meats, milk, butter, and cheese are eliminated for their high levels of saturated fats. Since dietary cholesterol is much more weakly connected with serum cholesterol than saturated fat,[v] Masley permits the consumption of eggs, provided they come from free-range, organic, flax-fed hens, because in that case they are high in omega-3.
Dr. Garth Davis, the author of Proteinaholic, would likely bemoan that even with the dairy removed, the nutritional plan is too high in protein and animal products, and I would agree. But I can’t blame Masley for creating a nutrition plan that most Americans can stick with.
Pillar 2: Exercise for heart health
The second pillar of the heart tune-up is aerobic physical exercise. It has an amazing number of benefits:
Exercise improves your blood pressure, blood sugar, cholesterol levels, weight control, mental speed and performance, sleep, clotting factors, and lowers inflammation. It also enhances the function of the critical cells that line your arteries, ensuring that they dilate even when stressed. … Regular exercise can help to turn a sick, stiff, plaque-coated artery into a healthy one.
Do you hold a desk job at work and are a couch potato at home? Then it’s time for you to get up and moving.
The first thing you need to do is determine the heart rate zone at which you become aerobic. To do that, you take the Bruce Protocol Treadmill Stress Test. A well-educated trainer at your gym can help you make the necessary calculations. That test will determine your cardiac fitness level,[vi] and your trainer can also record your maximum heart rate. Using that rate, you can then deduce your aerobic zone. Dr. Masley describes it as the zone
where you are able to speak in short sentences but unable to sing. Regardless of what the gym tables tell you, this is a great range for sustained exercise. It’s the level you should be trying to reach during your daily aerobic workouts.
Then it’s a matter of doing your favorite workout five times weekly for thirty minutes per session, always making sure you get into the aerobic zone.[vii] Add to that a fifteen-minute bout of strength exercise twice a week and a two to five minute stretch at the end of each workout. If you can invest even more time, Masley suggests doing one or two yoga sessions per week.
Yes, all this exercise eats into your day. It’s therefore important that you don’t consider your workouts a frivolous waste of time but an investment in your future, an effort to take care of yourself and prevent disease down the road. Allow yourself to enjoy your gym time!
Pillar 3: Stress reduction for heart health
We all need some stress in our lives, but many of us have too much of it, and it impacts our heart health. To reduce stress, the doctor marshals two counterbalancing blood chemicals: the “cuddling” hormone oxytocin and endorphins. To unleash these hormones and reduce your stress level, he recommends that you cut back on caffeine, alcohol, and television, as they either stimulate or depress your brain; spend time with loved ones or on community projects you believe in; get at least seven hours of sleep; get regular exercise; and schedule 15-30 minutes of daily relaxation time, for example in form of a meditation session.
Pillar 4: Nutrients for heart health
The fourth pillar of the program is to ensure that you are getting specific nutrients important for your heart health either through the food you eat or through high quality supplements. Most importantly, Masley wants you to get the right amounts of the following substances:
- Fiber, which lowers serum cholesterol, reduces your blood sugar, and decreases inflammation.
- Omega 3 fatty acids, which reduce inflammation by counterbalancing the inflammatory effects of omega 6 fatty acids.
- Magnesium, which supports your body’s health in myriad ways.
- Vitamin D, which you naturally get from sun exposure.
- Vitamin K, which prevents the calcification of your arteries.
- Potassium, which dilates arteries and regulates blood pressure.
The book offers you detailed guidance on how to determine your specific nutrient needs and how to purchase high-quality supplements, should you need them.
Chock-full of information
The 30-Day Heart Tune-Up is fully in line with the European Guidelines on Cardiovascular Disease Prevention[viii] and it is chock-full of information. It explains how heart disease works and how to prevent it, provides detailed strength training techniques, explains the impact of cardiovascular health on your sex life, and offers a detailed meal plan that will ensure that those Americans who do not want to go on the vegan Ornish plan can be their healthiest selves. To give you the tools of better nutrition, Masley even completed a chef internship with the Four Seasons Restaurant in Seattle. The result is a list of delicious, easy-to-make recipes in part 3 of the book. I won’t try the recipes containing meat but have already chosen a few that are plant-based to try out.
The 30-Day Heart Tune-Up is an important book, even if you decide not to spring for the IMT test – not everyone can afford it, after all. Ultimately you, not your physician, are responsible for your health, and this book gives you the tools you need to do this right. If you follow its advice, it may save you from heart catheterization or a similarly unpleasant experience. That would make it a excellent investment.
Notes and works cited
[i] Masley, Steven. 2014. The 30-Day Heart Tune-Up: A Breakthrough Medical Plan to Prevent and Reverse Heart Disease. New York, NY: Center Street (Hachette Book Group).
[ii] He would like your doctor to perform several blood tests: a fasting lipid profile that measures your blood cholesterol; an advanced lipid profile if the values of the fasting lipid profile are worrisome or inconsistent with the assessments tests; a fasting blood sugar profile; a high-sensitivity C-reactive protein test, which measures the level of inflammation in your arteries; a test measuring your level of thyroid-stimulating hormone; and a hemoglobin workup to check for anemia.
[iii] Bots, Michiel L., Arno W. Hoes, Peter J. Koudstaal, Albert Hofman, and Diederick E. Grobbee. “Common Carotid Intima-media Thickness and Risk of Stroke and Myocardial Infarction – the Rotterdam Study.” Circulation 96, no. 5 (1997): 1432-1437. Freely available online.
[v] This is confirmed by the European Guidelines on Cardiovascular Disease Prevention, p. 1665. For the complete citation see note viii.
[vi] You can then look up your results in Masley’s “aerobic capacity testing table for women” and “aerobic capacity testing table for men” on page 128 to see how you compare to the rest of the population.
[vii] If you are not yet fit, you may have to start out with a lower initial exercise level.
[viii] Perk, Joep, Guy De Backer, Helmut Gohlke, Ian Graham, Željko Reiner, Monique Verschuren, Christian Albus et al. “European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (version 2012).” European Heart Journal 33, no. 13 (2012): 1635-1701. Freely available online.