The Life Plan (5 page)

There are plenty of established, proactive medical protocols that are inexpensive and shown to prevent cardiovascular disease. And yet, are they promoted by cardiologists, the AMA, or health centers? Not sufficiently. As a result, many of us will undergo costly procedures, be prescribed expensive heart medication, and live less-than-desired quality lives. And quite possibly, many of us will go to emergency rooms with chest pain or die suddenly before we get to the hospital.

My proactive approach makes much more sense, since it keeps you disease free for as long as possible. It begins with positive measures, running diagnostics that uncover disease biomarkers so you can take action. And that clearly puts you in a better position to make lifestyle changes, which promote better health and diminish disease risks. Every aspect—nutrition/supplements, exercise, endocrine balance, and mind-body—must work in concert.

Since heart disease is the leading cause of death for men—and is intricately linked to erectile dysfunction—every strategy in this book is designed to help you prevent or reverse cardiovascular disorders and maintain a great sex life. I believe it’s my duty as a physician to present a heart-healthy approach that proactively protects your endothelium. The endothelium forms a dynamic interface between your blood and your body. Endothelial cells secrete substances—like the important messenger molecule, nitric oxide, needed for a number of critical physiological processes—to regulate vital chemical reactions, keep blood moving smoothly, control blood pressure, ensure vascular tone, control inflammatory processes, and prevent oxidation and coagulation.

When not properly cared for, your endothelial cells become dysfunctional and fall prey to numerous disease processes, which cause atherosclerosis, hypertension, inflammatory syndromes, heart attacks, stroke, and dementia. A 2003 Mayo Clinic paper defined endothelial dysfunction as the “ultimate risk” among all the cardiovascular risk factors. If you have any of the conditions/histories listed below, you must start working very hard at improving the health of your endothelium:

Family history of heart disease and/or confirmed heart disease, based on carotid ultrasound diagnostics, abnormal stress test, or an elevated calcium score

History of elevated LDL levels or low HDL levels

Elevated total cholesterol levels

Have been diagnosed with Metabolic Syndrome (see

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)

Elevated triglyceride levels

Elevated cardio CRP (C Reactive Protein) levels

Vascular disease

Take my experience, for example. Thanks to a truly forward-thinking physician, I began undergoing periodic, proactive evaluations and, later, a carotid ultrasound, years before I should have had a heart attack. The normal protocol would have been to wait until I barely survived an emergency room visit. Instead, because of an abnormal carotid ultrasound, I was encouraged to have a 64-slice CT scan and subsequent cardiac catheterization. I learned I had chronic, yet stable heart disease involving my coronary arteries, which probably began back in my 20s. According to my cardiologist, what saved me from advanced disease and an early death was the age management medicine program I had been following for the past seven years: low-glycemic nutrition, supplements, a vital exercise regimen, and correcting my hormone deficiencies.

Further research made me realize that although the low-glycemic nutrition I had been following for years may have been good, it wasn’t enough to fight or reverse heart disease. I immediately changed my whole nutritional approach to a near-vegan-style diet—blending low-glycemic foods with a strong focus on low fat. This more extreme diet approach is probably not necessary if you don’t have heart disease. But if you do, then give serious thought to starting—and staying—on the Heart Health Diet outlined in Chapter 3.

The current thinking in the medical literature is that people lose muscle mass and strength as they age—a disease called sarcopenia—and this is unavoidable. That’s right, the experts believe there is nothing you or I can do to avoid losing muscle tissue and strength as we get older. I say this way of thinking is nonsense. Hasn’t anyone out there ever exercised before?

The Life Plan is based on avoiding the loss of muscle tissue and strength as we age. Sarcopenia is a deadly consequence of getting old. It inflicts enormous declines in quality of life and disability on our aging population.

Sarcopenia begins in your 30s. The muscle atrophy and loss—not to mention the devastating aftermath—affect every facet of your life. If you don’t exercise properly, eat right, and correct hormonal deficiencies, loss of muscle will progress at the rate of 3 percent to 5 percent with each decade starting in your 30s and 40s, then increase to 10 percent to 20 percent every decade after that. The average American male can expect to gain approximately one pound of body fat every year between ages 30 to 60 and lose about a half pound of muscle mass each year over the same time frame. At age 60 and onward it gets even worse as the rise in body fat replaces muscle mass. The largest loss of muscle mass occurs between ages 50 and 75, averaging 25 percent to 30 percent.

Aging, degenerating, and dying mitochondria are now thought to play the key role in causing sarcopenia. Mitochondria are microscopic organelles that are found inside our cells, especially muscle cells. They are the principal sites where all of our energy, in the form of ATP (adenosine triphosphate), is generated. You can thank your mom for your mitochondria, because you get them all from her. As your mitochondria age they lose their ability to produce ATP and muscle cells shrivel and die. If dying and degenerating mitochondria could be replaced with new young vibrant mitochondria, muscle and strength loss could be avoided as people age. This is exactly what the Life Plan is all about, especially my focus on exercise and resistance training.

My Life Plan focuses on the perfect combination of nutrition, the right kind of exercise, and healthy hormone levels to help you replace your old dying mitochondria with new
wild-type mitochondria
—the term scientists use (very appropriate, I might add) for young, healthy mitochondria, no matter what your age is today. This is the “fountain of youth, “in my opinion, and you’ll learn more about it later in this book.

Unfortunately, most doctors devote little, if any, time to teaching patients about preventing disease. That’s because most doctors do not know how to incorporate preventive medicine into their own lifestyle, let alone into their medical practice. Despite all the research pointing to the impact lifestyle has on disease prevention, medical schools continue to churn out doctors who know little if anything about how to prevent disease and preserve vitality through appropriate exercise, proper nutrition, and balanced metabolic/endocrine functions.

This is particularly evident when it comes to men’s health. An October 2008 paper on low testosterone and its association with type 2 diabetes reported that androgen deficiency is a clinically underdiagnosed endocrine disorder affecting a “significant number of men in the United States and can affect up to 50 percent of men diagnosed with type 2 diabetes.” Investigators in a 2004 study estimated that low testosterone deficiency affects 13.8 million men. Yet fewer than 10 percent of these men were receiving treatment.