Shownotes
Hey Heart Buddies! Our October series with my cardiac dietitian, Michelle Routhenstein, continues. Today, we tackle the widespread misinformation about heart health. Michelle emphasizes the importance of a holistic approach, stressing that both LDL cholesterol and insulin resistance matter for heart health. They discuss the value of comprehensive blood tests and the need for patients to advocate for themselves. Michelle warns against cherry-picking data and highlights the significance of various health metrics, including inflammation and blood pressure. The episode encourages listeners to take charge of their health, understand their blood test results, and maintain open communication with their healthcare providers.
How to find Michelle
Michelle Routhenstein, MS, RD, CDCES, CDN
Cardiology Dietitian and Preventive Cardiology Nutritionist
Owner of Entirely Nourished, LLC
Sign up for her next Optimize Group at here. This is an affiliate link and by signing up, you support this podcast. Thank you!
About the program: Optimize is a six-week virtual heart optimization group program designed to teach you how to protect your heart through science-based nutrition. In this live program, Michelle Routhenstein, a cardiovascular dietitian, leads Zoom lectures that delve into arterial health and how to enhance your cardiovascular risk profile. She addresses underlying issues like inflammation, oxidative stress, and insulin resistance using evidence-based nutritional strategies. Throughout the six weeks, you'll also have access to a private community for questions, support, and the implementation of science-based heart-healthy changes to safeguard your heart for the long term.
Get in touch...P: (646) 979-0328 E: Michelle@EntirelyNourished.com
http://www.entirelynourished.com
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**I am not a doctor and this is not medical advice. Be sure to check in with your care team about all the next right steps for you and your heart.**
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Transcripts
I think that there's a lot of misinformation out there because a
Speaker:lot of people are trying to cherry pick the data, right. They're looking at,
Speaker:okay, Ldl cholesterol doesn't matter. Only insulin
Speaker:resistance matters. You'll hear people saying, no, insulin resistant matters.
Speaker:LDl doesn't matter. You can hear everything and anything. I want to break the
Speaker:news to you. They all matter. Why are we picking which one matters? They
Speaker:may show up in different ways, in different bodies. There
Speaker:are many times where insulin resistance will actually turn
Speaker:on genetic mutations that increase your risk of heart disease.
Speaker:They are both important. And for anyone to tell you that
Speaker:only one of these things is important is honestly not looking at the whole
Speaker:picture. Welcome to a special October
Speaker:edition of open heart Surgery with boots.
Speaker:All month long, we're diving into heart healthy
Speaker:eating with none other than my cardiac
Speaker:dietitian, Michelle Rothenstein. Each
Speaker:Tuesday, we are serving up bite sized ten to
Speaker:15 minutes episodes to give you practical tips
Speaker:to keep your heart in tip top shape. Whether
Speaker:you're recovering from surgery or just looking to show your heart a
Speaker:little extra love, Michelle's got you covered. Don't
Speaker:forget to check out our Patreon at the
Speaker:www.patreon.com
Speaker:openheartsurgerywithboots. There we are building
Speaker:a community of fellow heart buddies where we are going
Speaker:to start meeting up on Zoom and being of support to each
Speaker:other. And I'll be curating special
Speaker:playlists to help you get started on your heart
Speaker:journey if you're just starting out. So thank you so
Speaker:much for being here. Thank you for supporting this podcast.
Speaker:I am so excited to bring Michelle to you
Speaker:every Tuesday for the month of October. So let's get right to
Speaker:it. Hey, thank you for coming back. It's another
Speaker:Tuesday with Michelle, our heart health
Speaker:cardiac dietitian, who has been so
Speaker:helpful to me, and I'm so excited that she
Speaker:is joining us for the month of October. Last week we
Speaker:were talking about LdL. Well, first of all, we talked about what is the
Speaker:purpose of working with a cardiac dietitian. Michelle, you did a
Speaker:great job of explaining that and the importance of your
Speaker:work. And then we took a little side trip and started
Speaker:talking about supplements and things to like,
Speaker:be cautious about when taking supplements, which then led
Speaker:us to this really great explanation about
Speaker:LDL in particular. And so
Speaker:that was such a fruitful conversation. And if you missed last week's, be sure to
Speaker:go back because Michelle does such a great job
Speaker:explaining about the impact of supplementation
Speaker:and what it can do to your kidneys and your liver and
Speaker:how that. And this is me explaining from how I
Speaker:understood it, Michelle, but, like, the downstream effects of that.
Speaker:So it was eye opening for me. So this
Speaker:week, we in taking that topic and
Speaker:now moving into blood tests in general. I mean, you are
Speaker:so great in looking at not just
Speaker:one value, say, like LDL, but you are
Speaker:a big believer in looking at the whole
Speaker:picture. Can you educate us on that
Speaker:today? Yeah, happy to. I think that there's a lot of
Speaker:misinformation out there, because a lot of people are trying to
Speaker:cherry pick the data, right. They're looking at, okay, LDl
Speaker:cholesterol doesn't matter. Only insulin resistance matters. You'll hear people
Speaker:saying, no, insulin resistant matters. LDL doesn't matter, and you can hear everything
Speaker:and anything. I want to break the news to you. They all matter. Why are
Speaker:we picking which one matters? They may show up in different ways
Speaker:in different bodies. There are many times where insulin
Speaker:resistance will actually turn on genetic mutations
Speaker:that increase your risk of heart disease. They are the both
Speaker:important. And for anyone to tell you that only one of these things is
Speaker:important is honestly not looking at the whole picture. Any
Speaker:diet that you go on should lower. Atherogenic LDl cholesterol
Speaker:should lower inflammation, should lower blood sugar levels to optimal
Speaker:levels, should optimize blood vessel health, and blood pressure values
Speaker:should lower. Uric acid levels should help with weight
Speaker:reduction around the waist circumference, if that is pertaining to
Speaker:you. Everything that you are eating should not cause
Speaker:another metric to go in the wrong direction. It's all
Speaker:cardiometabolic health, and they all matter. And so I really
Speaker:want your listeners to understand that it may show up
Speaker:differently in different bodies depending on your genetics. Depending
Speaker:on the types of genetics you have, it also will show up depending
Speaker:on what you're eating, it will show up based off of your athletic
Speaker:ability. Heart disease does not discriminate based on body
Speaker:shape or size. I have many athletes who have had heart
Speaker:attacks. I have many individuals who are obese or morbidly
Speaker:obese, who have quadruple bypass surgery. We need to be
Speaker:looking at the individual, but really looking at all your cardiometabolic
Speaker:metrics and making sure all of them are
Speaker:optimized to your standards of risk
Speaker:assessment. So what I mean by that is, when you look
Speaker:at your blood test, there's a big range of numbers. And a
Speaker:lot of times it'd be like, oh, my cholesterol levels are in range. My blood
Speaker:sugar is in range. But if you look at your risk
Speaker:profile or your genetic susceptibility. So if you have, for
Speaker:instance, a high lipoprotein a LP,
Speaker:your ranges are much tighter
Speaker:and much lower than the general population. Those
Speaker:ranges are actually designed for more
Speaker:targeted treatment with medications. They are not
Speaker:necessarily designed to prevent disease. And so
Speaker:we need to be looking at these all and stricter standards
Speaker:and ensuring that we're optimizing all of the metrics together.
Speaker:A lot of times, we don't really look at inflammation. And
Speaker:I want to bring that specifically because there's been a really good study
Speaker:in the New England Journal of Medicine that looks at
Speaker:individuals who've had a heart attack who have normal ldl because
Speaker:they're on medication. But if they have a high
Speaker:HsCRP, which is an inflammatory marker, their risk of
Speaker:a subsequent heart attack is through the roof. And
Speaker:so that's kind of the idea. The information to understand
Speaker:if there is havoc in the blood vessel, it's going to
Speaker:lead to more complications with heart disease, and havoc
Speaker:can happen in many different forms. Havoc can happen from high
Speaker:LDL atherogenic cholesterol that's inflammatory,
Speaker:it can happen from inflammation. It can happen from
Speaker:high blood pressure, it can happen from high blood sugar
Speaker:levels. It can happen from a multitude of reasons.
Speaker:It can happen also from your hierarch acid levels
Speaker:or chronic kidney disease. There are many components
Speaker:here that we must look at in order to really reduce your risk
Speaker:of heart disease and realize that they all are important
Speaker:when we're trying to reduce risk of future complications.
Speaker:I'm just thinking about, you know, I rarely watch tv now, and
Speaker:if I do, it's like YouTube catching my comedians from
Speaker:the night before. So that to say I'm not
Speaker:as exposed to commercials as I used to be, but
Speaker:when I'm traveling or whatever, and I. And there's a tv
Speaker:on, I'm still stunned by the amount of
Speaker:pharmaceutical commercials. And it's
Speaker:always like, they're always addressing one thing.
Speaker:The person's always walking in the park hand in hand with someone, feeding a
Speaker:duck, and, like, you know, and.
Speaker:And this one pill is gonna lower this one value or
Speaker:raise that value or whatever. And I just think
Speaker:about how everything you just said is just not
Speaker:common knowledge. And again, I was not educated
Speaker:on any of this in the hospital, and I don't
Speaker:know any heart patients who were. I just struggle
Speaker:with how this is so siloed. Yeah, it's an issue.
Speaker:You know, a lot of this is awareness and digging it into your own hands
Speaker:of understanding what it is. The other truth is that's hard
Speaker:is many of my clients will go, okay, I went to my doctor and
Speaker:I asked for these additional tests and they told me I can take
Speaker:them, and you should go here and you should go there, you have the
Speaker:ability to be your own advocate and say,
Speaker:I want these tests because of x, y, z,
Speaker:and make that a component to the care, to your
Speaker:care team. Because without knowing these, you don't really
Speaker:feel these symptoms. You don't feel plaque brewing in
Speaker:your arteries. You don't feel even borderline high blood pressure
Speaker:values. You don't feel these things, so they silently brew.
Speaker:And that's why heart disease is so prevalent, because
Speaker:we don't have the opportunity to address them timely.
Speaker:And so I'm always very big about advocating for these
Speaker:components and really making sure it is part of standard
Speaker:care. So being your own advocate is so important in this picture
Speaker:and understanding why, right. If you just bring in a
Speaker:whole slew of labs and say, I want these tested, but you don't give a
Speaker:reason for it, it's more likely not to be taken
Speaker:seriously versus being like, you're not asking for too much. You're
Speaker:literally asking for an assessment of your cardiometabolic health,
Speaker:and that should not be denied to you. You deserve to kind of
Speaker:know, what are these values? And if they're elevated, we can do something about it.
Speaker:So why wouldn't we test it, right? So if they're high, we can then
Speaker:implement change and you can retest it and make sure that it's going down and
Speaker:it's an optimal direction every three to six months, depending on the
Speaker:values that are showing up on your blood tests. You know what's coming to me
Speaker:right now is we take better care of our cars
Speaker:than our health as a society, at least an american
Speaker:society. And when the check engine light comes on, we're running to
Speaker:the mechanic, right? And then they, they just, they
Speaker:don't ask questions. They just have, like, this little dia diagnostic
Speaker:tool that they can plug the car into and tell
Speaker:us exactly what's up with the car, right? So I see
Speaker:these blood tests as being no different. We should just
Speaker:assume that the check engine light comes on every
Speaker:year because we're, you know, fallible human beings.
Speaker:We're mortal beings. And as we age, things start to,
Speaker:you know, go a little awry and just
Speaker:us plugging into the. To the diagnostic tool
Speaker:and seeing what's up, and we are worthy
Speaker:of that. We are worthy of taking care
Speaker:of our bodies, and we deserve to have
Speaker:excellent health care. We deserve to be listened to by our
Speaker:doctors, and we are in the driver's seat of our
Speaker:own. We are the CEO of our
Speaker:health, and we have also got to change the culture
Speaker:of just listen to the doctor. Like, sure, listen to the doctor.
Speaker:Be respectful up to the doctor. And while
Speaker:you're being respectful, stand up for your health. You deserve to know what
Speaker:your numbers. Are so important, that piece of the
Speaker:puzzle of standing up for yourself, because, listen, when
Speaker:you go to a doctor's office, they have experience in medical management of treatment. They're
Speaker:brilliant. I've worked with brilliant cardiologists and intransiges, and I love
Speaker:their brains and all the things that they can do to save people's
Speaker:lives. But you live in your
Speaker:body the most, and so you have a
Speaker:gut instinct of things in terms of, you
Speaker:should get your questions answered. But if you're feeling
Speaker:fatigued, if you're feeling different than usual,
Speaker:please, I beg of you not to just think, oh,
Speaker:it's because I'm getting older. You know, there's so many times my
Speaker:clients will say, oh, I thought I was just getting older. So I was feeling
Speaker:low energy, and I couldn't go up the hill, and I couldn't do the things
Speaker:that I used to do when I was younger, because, you know, now I'm in
Speaker:my fifties and my sixties and my seventies, and then when they nourish their
Speaker:body, they're like, no, Michelle, I can actually, I'm faster
Speaker:than my kids, I'm faster than my grandkids. Going up that
Speaker:hill without huffing and puffing. It was an energy deficit. It
Speaker:was the fact that I wasn't getting in these nutrients. So I say this
Speaker:because a lot of times we get complacent in our care. We
Speaker:say, like, okay, the doctor told me to do this. That's what he said.
Speaker:But we don't ask questions. A lot of times, my clients are on medications.
Speaker:They don't even know why. They don't know what they're for. And I'm here
Speaker:explaining the interactions with food in those medications. I'm
Speaker:explaining how these medications work. I'm explaining the side effects, so
Speaker:that if they are intolerant to the medication, they're not just
Speaker:ignoring it. Your body is telling you
Speaker:things, and if you listen to it, you will help with
Speaker:increasing your quality of life, increasing your ability for your heart
Speaker:to function properly. And you're going to seal,
Speaker:you don't need as many medications because your body is resilient
Speaker:to recovery. Wow, excellent. Thank you for that, like,
Speaker:overall picture. And it's just such
Speaker:invaluable information. Let's leave it there for today.
Speaker:Again, we're doing bite sized nuggets this month, so,
Speaker:Michelle, thank you. And come back next week for
Speaker:some more truth bombs. Thanks so much.
