Science says eating just one meal per day can improve your health. Learn more at https://highintensityhealth.com/OMAD ----- Access the show notes: http://highintensityhealth.com/drhouston 5:01 Advanced Lipid Testing: In the U.S., we tend to think that if we get lipids/fats under control, no one will have heart attacks. Measuring only blood cholesterol ignores other important risk factors. The methodologies that measures lipids are not done with advanced testing. Doctors perform the obsolete total quantity testing for HDL, LDL, cholesterol, and triglycerides; but particle size, particle number and, in some cases, the functionality of HDL, with reverse cholesterol transport. 6:35 Big LDLs and Small LDLs. It makes a difference: Heart disease and heart attack risk is driven by the number of LDL particles and the size of LDL particles. If LDL particles are small and in great number, they slip through the lining of the vascular system and cause inflammation, oxidative stress, and immune dysfunction. It creates a plaque formation with ruptures and causes a heart attack. Think of the lining of the vascular system as the net on a tennis court. A tennis ball won’t go through the net, but a golf ball will. The tennis ball is a large LDL and a golf ball is a small LDL. A lot of golf balls going through the net, begins the inflammatory process. Generally, the tennis ball, larger LDL is not a problem. 8:10 HDL is the Cleanup Crew: If you have a lot of golf balls on the wrong side of the net, you might be able to fill your wheelbarrow with them in one trip. If you only have a bucket, you might have to make multiple trips to pick up the golf balls. If your wheelbarrow has a flat tire or broken handle, you still won’t be able to remove very many golf balls. You want your HDLs to be big and you want them to function well. You want a lot of wheelbarrows and you want them operating optimally. 9:22 What Causes Dysfunctional HDL? It is most often caused by inflammation from any cause, but it could be from things like rheumatoid arthritis or chronic infection. Heavy metals could be the cause. Dysfunctional HDL can also be caused by poor micronutrient intake or poor macronutrient intake. When HDL is damaged, there is no oxidative defense, there is poor reverse cholesterol transport and there are none of the other activities that HDL does to prevent atherosclerosis. Basic lipid testing does not differentiate between adequately functioning HDL and poorly functioning HDL. Advanced lipid testing shows the various conditions and activities of HDL. 10:53 What Happens When Small LDL’s Get into Our Cardiovascular System? Small LDLs are more likely to be modified. Glucose can cause oxidation, inflammation, glycation, or acetylation of HDL. It is common in people who are diabetic or have insulin resistance, obesity, or metabolic syndrome. Small LDLs stick in the subendothelial layer and you cannot get them out. A type of white cell, called macrophages, moves into the layer below the endothelium because they love to eat small LDLs. They have no appetite control. They eat small LDLs until they burst. The mess literally ruptures into the subendothelial layer and even into the lumen, causing the area to clot, eventually creating a myocardial infarction/heart attack. 12:36 How Can We Stop the Golf Balls? There are 38 different mechanisms that you can use to interrupt the process of heart disease. Exercise and nutraceuticals are the keys. There is lycopene, from tomatoes and grapefruit, lipoic acid, N-acetylcysteine, resveratrol, berberine, red yeast rice, niacin, omega 3 fatty acids from cold water fish and many more. The Mediterranean diet with lots of extra virgin olive oil helps too. It is important to stay on a low carbohydrate diet. 15:06 Causes of Endothelial Dysfunction: Dr. Houston can list over 400 causes for ED. The top 5 that are typically talked about are blood pressure, lipid, diabetes, obesity and smoking. They cause insult to the endothelial lining, causing endothelial dysfunction. Dysfunction is related to inflammation, oxidative stress, immune dysfunction within the arteries, clotting and abnormal growth factors that make the arteries stiff and enlarges the heart, causing heart failure as well as heart attacks. 24:02 Poor Gut Health and Heart Disease: Gastrointestinal problems are directly linked to cardiovascular problems. You must clean up the diet and repair the gut to reduce metabolic endotoxemia after eating. This is actually low grade sepsis, producing a huge inflammatory response, oxidative stress, and immune dysfunction in the gut that is transported into the vascular system.