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Empower Your Heart Health Series: Cholesterol, Insulin Resistance, Inflammation, and more
Episode 718th October 2024 • Open Heart Surgery with Boots • Boots Knighton
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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 

Join the Patreon Community! The Joyful Beat zoom group starts in November 2024.

**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.**

How to connect with Boots

Email: Boots@theheartchamberpodcast.com

Instagram: @openheartsurgerywithboots or @boots.knighton

LinkedIn: linkedin.com/in/boots-knighton

Boots Knighton

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Open Heart Surgery with Boots

Transcripts

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I think that there's a lot of misinformation out there because a

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lot of people are trying to cherry pick the data, right. They're looking at,

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okay, Ldl cholesterol doesn't matter. Only insulin

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resistance matters. You'll hear people saying, no, insulin resistant matters.

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LDl doesn't matter. You can hear everything and anything. I want to break the

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news to you. They all matter. Why are we picking which one matters? They

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may show up in different ways, in different bodies. There

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are many times where insulin resistance will actually turn

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on genetic mutations that increase your risk of heart disease.

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They are both important. And for anyone to tell you that

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only one of these things is important is honestly not looking at the whole

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picture. Welcome to a special October

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edition of open heart Surgery with boots.

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All month long, we're diving into heart healthy

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eating with none other than my cardiac

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dietitian, Michelle Rothenstein. Each

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Tuesday, we are serving up bite sized ten to

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15 minutes episodes to give you practical tips

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to keep your heart in tip top shape. Whether

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you're recovering from surgery or just looking to show your heart a

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little extra love, Michelle's got you covered. Don't

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forget to check out our Patreon at the

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www.patreon.com

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openheartsurgerywithboots. There we are building

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a community of fellow heart buddies where we are going

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to start meeting up on Zoom and being of support to each

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other. And I'll be curating special

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playlists to help you get started on your heart

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journey if you're just starting out. So thank you so

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much for being here. Thank you for supporting this podcast.

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I am so excited to bring Michelle to you

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every Tuesday for the month of October. So let's get right to

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it. Hey, thank you for coming back. It's another

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Tuesday with Michelle, our heart health

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cardiac dietitian, who has been so

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helpful to me, and I'm so excited that she

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is joining us for the month of October. Last week we

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were talking about LdL. Well, first of all, we talked about what is the

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purpose of working with a cardiac dietitian. Michelle, you did a

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great job of explaining that and the importance of your

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work. And then we took a little side trip and started

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talking about supplements and things to like,

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be cautious about when taking supplements, which then led

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us to this really great explanation about

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LDL in particular. And so

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that was such a fruitful conversation. And if you missed last week's, be sure to

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go back because Michelle does such a great job

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explaining about the impact of supplementation

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and what it can do to your kidneys and your liver and

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how that. And this is me explaining from how I

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understood it, Michelle, but, like, the downstream effects of that.

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So it was eye opening for me. So this

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week, we in taking that topic and

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now moving into blood tests in general. I mean, you are

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so great in looking at not just

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one value, say, like LDL, but you are

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a big believer in looking at the whole

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picture. Can you educate us on that

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today? Yeah, happy to. I think that there's a lot of

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misinformation out there, because a lot of people are trying to

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cherry pick the data, right. They're looking at, okay, LDl

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cholesterol doesn't matter. Only insulin resistance matters. You'll hear people

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saying, no, insulin resistant matters. LDL doesn't matter, and you can hear everything

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and anything. I want to break the news to you. They all matter. Why are

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we picking which one matters? They may show up in different ways

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in different bodies. There are many times where insulin

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resistance will actually turn on genetic mutations

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that increase your risk of heart disease. They are the both

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important. And for anyone to tell you that only one of these things is

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important is honestly not looking at the whole picture. Any

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diet that you go on should lower. Atherogenic LDl cholesterol

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should lower inflammation, should lower blood sugar levels to optimal

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levels, should optimize blood vessel health, and blood pressure values

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should lower. Uric acid levels should help with weight

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reduction around the waist circumference, if that is pertaining to

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you. Everything that you are eating should not cause

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another metric to go in the wrong direction. It's all

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cardiometabolic health, and they all matter. And so I really

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want your listeners to understand that it may show up

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differently in different bodies depending on your genetics. Depending

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on the types of genetics you have, it also will show up depending

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on what you're eating, it will show up based off of your athletic

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ability. Heart disease does not discriminate based on body

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shape or size. I have many athletes who have had heart

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attacks. I have many individuals who are obese or morbidly

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obese, who have quadruple bypass surgery. We need to be

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looking at the individual, but really looking at all your cardiometabolic

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metrics and making sure all of them are

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optimized to your standards of risk

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assessment. So what I mean by that is, when you look

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at your blood test, there's a big range of numbers. And a

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lot of times it'd be like, oh, my cholesterol levels are in range. My blood

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sugar is in range. But if you look at your risk

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profile or your genetic susceptibility. So if you have, for

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instance, a high lipoprotein a LP,

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your ranges are much tighter

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and much lower than the general population. Those

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ranges are actually designed for more

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targeted treatment with medications. They are not

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necessarily designed to prevent disease. And so

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we need to be looking at these all and stricter standards

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and ensuring that we're optimizing all of the metrics together.

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A lot of times, we don't really look at inflammation. And

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I want to bring that specifically because there's been a really good study

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in the New England Journal of Medicine that looks at

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individuals who've had a heart attack who have normal ldl because

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they're on medication. But if they have a high

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HsCRP, which is an inflammatory marker, their risk of

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a subsequent heart attack is through the roof. And

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so that's kind of the idea. The information to understand

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if there is havoc in the blood vessel, it's going to

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lead to more complications with heart disease, and havoc

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can happen in many different forms. Havoc can happen from high

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LDL atherogenic cholesterol that's inflammatory,

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it can happen from inflammation. It can happen from

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high blood pressure, it can happen from high blood sugar

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levels. It can happen from a multitude of reasons.

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It can happen also from your hierarch acid levels

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or chronic kidney disease. There are many components

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here that we must look at in order to really reduce your risk

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of heart disease and realize that they all are important

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when we're trying to reduce risk of future complications.

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I'm just thinking about, you know, I rarely watch tv now, and

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if I do, it's like YouTube catching my comedians from

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the night before. So that to say I'm not

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as exposed to commercials as I used to be, but

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when I'm traveling or whatever, and I. And there's a tv

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on, I'm still stunned by the amount of

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pharmaceutical commercials. And it's

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always like, they're always addressing one thing.

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The person's always walking in the park hand in hand with someone, feeding a

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duck, and, like, you know, and.

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And this one pill is gonna lower this one value or

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raise that value or whatever. And I just think

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about how everything you just said is just not

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common knowledge. And again, I was not educated

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on any of this in the hospital, and I don't

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know any heart patients who were. I just struggle

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with how this is so siloed. Yeah, it's an issue.

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You know, a lot of this is awareness and digging it into your own hands

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of understanding what it is. The other truth is that's hard

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is many of my clients will go, okay, I went to my doctor and

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I asked for these additional tests and they told me I can take

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them, and you should go here and you should go there, you have the

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ability to be your own advocate and say,

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I want these tests because of x, y, z,

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and make that a component to the care, to your

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care team. Because without knowing these, you don't really

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feel these symptoms. You don't feel plaque brewing in

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your arteries. You don't feel even borderline high blood pressure

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values. You don't feel these things, so they silently brew.

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And that's why heart disease is so prevalent, because

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we don't have the opportunity to address them timely.

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And so I'm always very big about advocating for these

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components and really making sure it is part of standard

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care. So being your own advocate is so important in this picture

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and understanding why, right. If you just bring in a

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whole slew of labs and say, I want these tested, but you don't give a

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reason for it, it's more likely not to be taken

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seriously versus being like, you're not asking for too much. You're

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literally asking for an assessment of your cardiometabolic health,

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and that should not be denied to you. You deserve to kind of

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know, what are these values? And if they're elevated, we can do something about it.

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So why wouldn't we test it, right? So if they're high, we can then

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implement change and you can retest it and make sure that it's going down and

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it's an optimal direction every three to six months, depending on the

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values that are showing up on your blood tests. You know what's coming to me

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right now is we take better care of our cars

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than our health as a society, at least an american

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society. And when the check engine light comes on, we're running to

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the mechanic, right? And then they, they just, they

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don't ask questions. They just have, like, this little dia diagnostic

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tool that they can plug the car into and tell

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us exactly what's up with the car, right? So I see

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these blood tests as being no different. We should just

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assume that the check engine light comes on every

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year because we're, you know, fallible human beings.

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We're mortal beings. And as we age, things start to,

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you know, go a little awry and just

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us plugging into the. To the diagnostic tool

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and seeing what's up, and we are worthy

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of that. We are worthy of taking care

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of our bodies, and we deserve to have

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excellent health care. We deserve to be listened to by our

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doctors, and we are in the driver's seat of our

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own. We are the CEO of our

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health, and we have also got to change the culture

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of just listen to the doctor. Like, sure, listen to the doctor.

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Be respectful up to the doctor. And while

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you're being respectful, stand up for your health. You deserve to know what

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your numbers. Are so important, that piece of the

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puzzle of standing up for yourself, because, listen, when

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you go to a doctor's office, they have experience in medical management of treatment. They're

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brilliant. I've worked with brilliant cardiologists and intransiges, and I love

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their brains and all the things that they can do to save people's

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lives. But you live in your

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body the most, and so you have a

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gut instinct of things in terms of, you

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should get your questions answered. But if you're feeling

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fatigued, if you're feeling different than usual,

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please, I beg of you not to just think, oh,

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it's because I'm getting older. You know, there's so many times my

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clients will say, oh, I thought I was just getting older. So I was feeling

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low energy, and I couldn't go up the hill, and I couldn't do the things

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that I used to do when I was younger, because, you know, now I'm in

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my fifties and my sixties and my seventies, and then when they nourish their

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body, they're like, no, Michelle, I can actually, I'm faster

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than my kids, I'm faster than my grandkids. Going up that

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hill without huffing and puffing. It was an energy deficit. It

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was the fact that I wasn't getting in these nutrients. So I say this

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because a lot of times we get complacent in our care. We

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say, like, okay, the doctor told me to do this. That's what he said.

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But we don't ask questions. A lot of times, my clients are on medications.

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They don't even know why. They don't know what they're for. And I'm here

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explaining the interactions with food in those medications. I'm

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explaining how these medications work. I'm explaining the side effects, so

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that if they are intolerant to the medication, they're not just

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ignoring it. Your body is telling you

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things, and if you listen to it, you will help with

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increasing your quality of life, increasing your ability for your heart

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to function properly. And you're going to seal,

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you don't need as many medications because your body is resilient

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to recovery. Wow, excellent. Thank you for that, like,

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overall picture. And it's just such

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invaluable information. Let's leave it there for today.

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Again, we're doing bite sized nuggets this month, so,

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Michelle, thank you. And come back next week for

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some more truth bombs. Thanks so much.

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