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Cholesterol itself is not the problem, but when there is endothelial dysfunction and inflammation in the arteries, lipoproteins can get stuck and contribute to plaque build-up. It is important to address lifestyle habits, such as sleep apnea, smoking, lack of exercise, and poor diet, to prevent heart attacks. Tests like the calcium scan can help detect early signs of heart disease. Dr. Michael Twyman, a cardiologist, emphasizes the importance of protecting the endothelial lining to become heart attack-proof.
EKGs and stress tests are not sufficient indicators of cardiovascular risk. They mainly determine the absence of end-stage heart conditions and do not provide a comprehensive assessment of plaque formation in the arteries. LDL cholesterol is also a controversial marker for heart disease. Instead, the focus should be on quantifying the number and size of LDL particles and other risk factors like inflammation and insulin resistance. Inflammatory markers and advanced testing are crucial for detecting early signs of cardiovascular disease and evaluating individual risk.
The endothelial glyco-calix, a sugar coating that lines the arteries, plays a critical role in maintaining arterial health. Damage to the glyco-calix caused by factors like high blood sugar levels, insulin resistance, high shear stress, heavy metals, and spike proteins can result in inflammation and plaque formation. Protecting the endothelial lining is vital to prevent atherosclerosis and other cardiovascular issues. Photobiomodulation, which utilizes light therapy, can also stimulate proper endothelial function and improve cardiovascular health.
Light exposure plays a significant role in cardiovascular health. Morning sunlight helps set circadian rhythms, boosts hormone production, and enhances dopamine and serotonin levels, contributing to overall well-being. Managing light exposure throughout the day and reducing blue light exposure at night improves sleep quality and helps regulate melatonin production. Photobiomodulation therapy, using red and infrared light, can optimize mitochondrial function, support energy production, lower inflammation, and positively impact heart health.
Proper light signals, adequate sleep, and a balanced diet are essential for optimal health. Light signals help regulate our biological functions, while sleep allows our bodies to repair and regenerate. In terms of nutrition, focusing on whole, unprocessed foods and paying attention to meal timing can have a positive impact on health. It is important to prioritize these factors for overall well-being.
Stress management is often overlooked but plays a crucial role in our overall health. Chronic stress and being in a constant fight-or-flight state can lead to negative health outcomes. Monitoring heart rate variability (HRV), which reflects the body's ability to modulate stress responses, can provide insights into stress levels. Implementing stress reduction techniques such as exercise, meditation, and managing mental workload can help improve HRV and overall well-being.
Lipoproteins, specifically apoB particles, and endothelial health are important factors to consider in cardiovascular risk assessment. While nutrition can influence lipoprotein levels, focusing on endothelial health is equally crucial. A healthy endothelial lining acts as a protective barrier against lipoprotein adherence, preventing the formation of plaque. Enhancing endothelial health through lifestyle factors such as light exposure, quality sleep, stress management, and targeted supplementation can significantly reduce cardiovascular risk.
One of the main insights discussed in the podcast is the importance of optimizing glucose and insulin levels for overall health. It is highlighted that while a hemoglobin A1c level of 5.4 may be considered normal, an optimal level is 5.1. The duration that red blood cells last in circulation can vary, and factors like thalassemia trait can result in longer-lasting red blood cells, leading to increased glycation and elevated A1c levels. However, it is noted that an elevated A1c level does not necessarily indicate insulin resistance or diabetes, and other metrics such as fasting insulin levels and C-peptide are important to consider to determine insulin sensitivity.
The podcast also emphasizes the significance of maintaining a healthy fatty acid balance. The test mentioned in the episode, known as the Fatty Acid Balance Test, assesses how well the body absorbs different fats. The importance of avoiding trans fats, which are associated with stiffness in cells and inflammation, is highlighted. It is advised to be cautious of processed foods, fried foods, and salad dressings as potential sources of trans fats. On the other hand, omega-3 fatty acids found in cold-water fish are known for their anti-inflammatory properties and the promotion of cell flexibility. The discussion also touches on the quality of oils, with an emphasis on ensuring authenticity when it comes to avocado and olive oil, as there can be instances of adulteration with vegetable oils.
This episode is brought to you by InsideTracker, WHOOP, and Levels.
Today on The Dhru Purohit Podcast, Dhru sits down with his cardiologist, Dr. Michael Twyman, to discuss the many nuances around cardiovascular health, the top underrated risk factors contributing to heart disease, and how to protect your endothelial lining using diet, exercise, sunlight, sleep, and stress management.
Dr. Michael Twyman is a board-certified cardiologist focusing on the prevention and early detection of heart disease. Dr. Twyman completed his cardiovascular training at St. Louis University after he completed a four-year active-duty tour as an internist at Naval Hospital Beaufort. He has been in private practice since 2012 and uses the best of conventional, quantum, and Functional Medicine and biohacking to get to the root cause of his patients’ cardiovascular issues.
In this episode, Dhru and Dr. Michael Twyman dive into:
-Top myths in cardiology (3:44)
-The limitations of cardiometabolic markers for assessing heart-disease risk (7:22)
-Endothelial dysfunction as a risk factor for heart disease (16:49)
-LDL cholesterol: is it good or bad? (25:10)
-The top drivers damaging endothelial cells (28:30)
-Light exposure: an underappreciated area of health (32:58)
-How light impacts mitochondrial and heart health (37:45)
-The importance of sleep quality for heart health (53:00)
-The importance of stress management for health (57:28)
-The nuances of cholesterol, lipoproteins, and protecting the endothelial lining (1:04:28)
-Dhru’s cardiovascular lab test results (1:07:05)
-Looking at lipids from a plant-based vs. personalized perspective (1:39:51)
-Thoughts on personalized medicine, drugs, and treatment (1:43:20)
-Dr. Twyman’s thoughts about seed oils and inflammation (1:50:58)
Also mentioned in this episode:
-Sleep Master Class with Dr. Sunjya Schweig (Episode 378)
For more on Dr. Michael Twyman, follow him on Instagram @drtwyman, or through his website, drtwyman.com.
InsideTracker provides detailed nutrition and lifestyle guidance based on your individual needs. Right now, they’re offering my podcast community 20% off. Just go to insidetracker.com/DHRU to get your discount and try it out for yourself.
WHOOP is a personalized digital fitness tracker and health coaching platform that monitors your physiology 24/7 and provides personalized recommendations based on what your body needs. To get yours, go to join.whoop.com and to 15% off your membership with code DHRU15.
By leveraging biosensors like continuous glucose monitors (CGM), Levels provides real-time feedback on how diet and lifestyle choices impact your metabolic health. Right now, they are offering my listeners two free months of their Levels Membership. Head on over to levels.link/DHRU to learn more.
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