Heart Health Tune-Up

May 3, 2021

If you are concerned about your cholesterol numbers, a blood vessel blockage wondering why cardiovascular disease is still the #1 killer of Americans, listen in. We have Dr. Steven Masley, author of The 30-Day Heart Tune-Up, joining us and explaining the myth about cholesterol and why Statin medications may not be the best answer for your heart health.

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DARLENE: Well, good morning to everyone and welcome to Dishing Up Nutrition. It's brought to you by Nutritional Weight and Wellness. You know, we have a lot of interesting questions today. And if you're concerned about your cholesterol numbers and as a nutritionist, we see that all the time, don’t we Carolyn?


CAROLYN: Oh my gosh. Pretty much every day, right?


DARLENE: Yes. Yes. You know, or maybe you've had a blood vessel blockage and maybe you've even had a stint. And you're wondering about what caused it and you want to do something about it. Or the other one that's overriding is why is cardiovascular disease the number one killer of people in America? I mean, what's going on? So we have a lot of questions and we have a really popular author with us today, Dr. Steven Masley. And he is the author of The 30 Day Heart Tune-Up. So he's going to look and address the myths about cholesterol and why statin medications may not be the best answer for your heart health. So I'm Darlene Kvist. I'm a Certified Nutrition Specialist. And our cohost is Carolyn Hudson, who is a Registered and Licensed Dietitian. So welcome this morning to you, Carolyn.


CAROLYN: Thank you, Dar. It's so great to see you. We were just saying, oh my gosh, how long has it been since I've seen you?


DARLENE: A year; a year and a half.


CAROLYN: It feels like, well, at least a year and a half, I think. So good morning everyone. And welcome to Dishing Up Nutrition. So you may be wondering who is this Dr. Steven Masley? Well, he is a physician and an author. And Dr. Masley, Steven Masley's also a nutritionist. But I have to actually put this other plug in here. He's not just a nutritionist, but he is a fellow of the American College of Nutrition. So that's pretty high up there, right? He's also a trained chef and the creator of the PBS TV special, 30 Days to a Younger Heart.


DARLENE: And I think a lot of people saw that and listened to it.


CAROLYN: Obviously. It's a very, very popular special. So today we're going to focus on his most recent book, The 30 Day Heart Tune-Up, which not only tells us about how to prevent heart disease, but also how to reverse heart disease. And I think that's really, really important. How do we reverse this? What's going on, and as our number one killer in America? As dietitians and nutritionists, so often we see clients who have very high cholesterol and clients with dangerously high blood pressure.




CAROLYN: And clients who are prediabetic or diabetic, and even some clients who have had stints placed or inserted because of a blockage in a blood vessel.


DARLENE: So, you know, Carolyn, this topic is really dear to me because I don't think people realize this; that my mother died of a sudden heart attack. And then my older brother, he also passed away during open-heart surgery. I have a younger brother who had his first heart event. He doesn't call it an attack; event.




DARLENE: At age 48. And interestingly, his son now who is only 39, is already having problems with high blood pressure. So then there's me. So I've been working really hard for my 82 and three quarters years to not have a heart attack. I'm still working on it.


CAROLYN: You’re still working on it, but you've already surpassed quite a number of members in your family. Right?


DARLENE: Exactly. So tell food makes a difference.


CAROLYN: Oh, food makes a huge difference. And not just any food, right? And we're going to get into that. So, Dr. Masley, it is such a pleasure to have you joining us on Dishing Up Nutrition today. You know, if we look at all of the different factors of heart disease, for most people, they've been told that the risk factor is cholesterol, but you know, that is the classic thing. But in fact, we're told that cholesterol, we actually need cholesterol. We're not told that, but we actually need cholesterol.


DARLENE: It’s confusing.


CAROLYN: And, you know, since there are many forms of cholesterol, some obviously more beneficial than others, it doesn't make any sense to just lump all of that cholesterol together. But you know, you very wisely point out that it's not just about cholesterol, but rather, other things, like, okay, so I want to know, and we had a, we had a listener ask us, Dr. Masley, “Why is there such a large gap and difference in advice between the heart health advice from maybe a medical doctor or some of those conventional clinics or hospitals, and what nutritionists like us talk about?”


DARLENE: Or like what you're talking about, Dr. Masley.


CAROLYN: Yes, exactly. So that, and, and this whole thing about diabetes. Why is that all so important?


DARLENE: So we just loaded up the questions for you Dr. Masley. So welcome to the show, and we'll just turn it over to you and let you talk for the next hour. How's that?


DR. MASLEY: Well, I really, really appreciate being invited to speak with you both today, because this is such an important topic; and how food impacts heart disease.

And there are so many myths out there. I think your first question, if I heard it right, is why are we over focusing on cholesterol and not on a more important risk factor like blood sugar? I think part of it is we've been falling into this trap of what is, what things can we track with lab tests and treat with the drug because it's easy? I think the average physician thinks getting people to change what they eat is harder than writing the prescription. The reality is what you eat is far more beneficial to you than what those prescriptions can provide. So I'm not anti-statin, but my goal is people wouldn't need to take a statin if they ate the right foods most of the time. And blood sugar: when you sugar coat your proteins, they burn up more quickly. It's like putting gas on wood and putting it in the fire. So when our blood sugar levels are even mildly elevated, that has a much bigger impact on our risk for growing plaque and having a heart attack, stroke or death than our cholesterol does. I mean, it's a really important thing. So cholesterol isn't not important, but it's not nearly as important as blood sugar and several other risk factors like blood pressure and probably even the gut microbiome is more, might be more important than our cholesterol.


DARLENE: Dr. Masley, you know, you just said it's just, even if the blood sugar is elevated a little bit, now, I don't know what people that are listening think about that. I know we think about it, but are there, I see so many people that come in now for consultations and they're, they're in that pre-diabetic, they're up on that upper end of pre-diabetic range and they don't seem to be concerned about that. We're concerned.


DR. MASLEY: Well, you're right to be concerned because even a mild, you know, the cutoff for normal is a hundred, but 90 is actually quite a bit better than a hundred. So if you're a hundred you're not safe. If you're 99, you could be far better off by dropping your level. You know? So when I think about it, the number one cause for heart disease is mildly elevated blood sugar. And the number one cause for dementia is mildly elevated blood sugar. And I, you're right. Most people are not aware of that.


DARLENE: So I think, you know, say that one more time because people just don't understand that that is what causes plaque buildup and, and probably, you know, blockages. So, because they don't understand this blood sugar thing at all, and I think hearing it from you, maybe they'll listen. So I'm asking you to say it one more time.


DR. MASLEY: Well, mildly elevated blood sugar is the number one cause for heart disease, for dementia and memory loss. It's one of the major causes for cancer. And clearly it's the number one cause for progresses to diabetes. So of the most important diseases in America today, blood sugar should be our number one focus.


DARLENE: We totally agree with you. And I think that's what we, we nag at clients all the time. No, we don't nag at them, but we really encourage them to lower that carbohydrate load. And I don't know if you look around, what do you think is kind of causing all these higher blood sugars? You know, maybe if listeners could understand what they're eating that's causing that increase in blood sugars.


DR. MASLEY: Well, so it's, it's, it's fourfold; most important is food, but there's four factors, four key factors here; these four pillars that cause heart disease. One is the food we're eating. I'll come back to that. Second is our activity. Aerobic activity and strength training: both are very effective at lowering blood sugar. And we're not active enough. Third is nutrient intake. There are some key nutrients that are deficient in the American diet like magnesium and zinc that are essential for blood sugar control. And fourth is stress. If we have unmanaged excess chronic stress, it raises cortisol, which raises blood sugar. So there are several factors. But as I said, the most important is food. And most people are eating too much sugar and flour. And flour, whether it's whole grain flour or white flour has the same impact on our blood sugar as eating just plain table sugar. And I think most people miss that point and they’re eating way too much sugar and flour. And sugar is hidden in a lot of processed foods. So unless you're cooking vegetables and fruit and beans and protein from scratch, if you're getting it in a packet it's probably loaded with sugar and you don't realize it.


CAROLYN: Yeah. Well I'm sure you know that we just tell all of our clients: no processed foods, like just get them out of your diet; eat real food. And then we have that whole section of the population who thinks gluten-free eating is healthy. But of course we know as nutritionists that gluten-free often can be even worse because those rice flours and things like that, they raise the blood sugar just as much if not more than regular wheat flour.




DR. MASLEY: Well at least equally. Yeah, any flour is sugar. So whether it's corn flour or wheat flour or rice flour, it doesn't matter. It's all sugar. So for the 20% of Americans who are gluten sensitive, I think they should avoid gluten. But I think your point is really important that they've got to stop adding sugar to… and feeling good. Okay. I'm, gluten-free. I'm eating candy basically. I’m eating rice and rice flour and corn flour and corn. And all of those are just basically sugar.


CAROLYN: Well, let's hold that thought. We are ready for our first break. You are listening to Dishing Up Nutrition brought to you by Nutritional Weight and Wellness. Our topic for today is all about heart health. And joining us in the discussion is Dr. Steven Masley. He's the author of 30 Day Heart Tune-Up. If you have questions about cholesterol numbers stay tuned because we will be discussing your cholesterol concerns and the use of statins when we return. And we’ll be right back.




DARLENE: Welcome back to Dishing Up Nutrition. You know, this is the first day of May. We finally made it. And a very important day is coming up very soon because Mother's Day is May 9th. And I think a lot of listeners are her saying, “What am I going to get mother this year?” It's always that question. So if you've got that question, let me have a suggestion for you. What about getting her in the Weight and Wellness cookbook? You know, it's a simple way of cooking. It's real food. It’s heart healthy recipes. We use the right fats. We keep the carb level down. And people can order the Weight and Wellness cookbook online at weightandwellness.com. Or you can give our office a call at (651) 699-3438. And we'll take of all of your information and send it directly to your moms so you don't even have to worry about it.


CAROLYN: You don't have to worry a one bit about it.


DARLENE: And you know you've given her something that's going to be heart-healthy for her.


CAROLYN: Well, you know, in your book, Dr. Masley, The 30-Day Heart Tune-Up, you wrote, “The cause of cardiovascular disease is arterial plaque.” You wrote also that “Getting to the heart of the matter means getting to the plaque.” So I would like you to explain to our listeners what plaque is and how sugar contributes to plaque in our arteries.


DR. MASLEY: Okay. Well, that's a really important question because plaque is, cholesterol isn't the issue. Plaque is the issue. So what factors cause us to grow plaque? And to clarify plaque, think of like, if you were to put whole milk in a glass and empty the glass and you see a film, well, every time we eat food that, especially if it has sugar in it, the sugar inflames these bubbles of fat in our bloodstream. So when we have sugar coating our LDL cholesterol, it becomes an irritation. It gets into the lining of the artery and it's thick and it gradually over time, it thickens it. So if we have an occasional bad meal, our artery constricts by 20%, and we lose 20% of our blood flow for about six to eight hours.


CAROLYN: Wow. That is really interesting.


DR. MASLEY: One bad meal.


DARLENE: One bad meal.


DR. MASLEY: You decrease your performance. You decrease your romantic sexual function. You don't feel as energized.


CAROLYN: Hey, maybe we'll get then men to really listen up. Maybe you should say that again.


DR. MASLEY: Well, sex is good for your heart. And following this program is wonderful for your sex life; for men and for women, because when you increase circulation, that's what does, that's what romantic function requires is good circulation. And when we're eating sugar, bad, you know, bad carbs and bad fat, we grow, we, it inflames the lining and it gradually grows a film, at which becomes plaque. And the most dangerous plaque is the soft, foamy plaque in there, like a pimple on your skin. And those pimples can pop. So actually micro-plaques; it only blocks 50% of the artery, but do not cause any symptoms and do not cause an abnormal stress test, are the most dangerous plaque. So big plaques can be calcified and they cause symptoms, but they don't cause events. Little plaques that are growing because we eat the wrong food are the dangerous ones. And that's what, that's why we can make a huge difference with food choices because the right foods will shrink your plaque and prevent it from growing. So I've helped hundreds of my patients shrink their plaque by more than 10% and make their arteries literally 10 years younger.


DARLENE: That is amazing. You know, one of the things that I've noticed a lot of clients ask me is, “Should I get a calcium score?” I think that's what it's called. And I…


DR.MASLEY: A calcium score is looking at old calcified plaque. And as a one time screening tool, it can be helpful. It's not something you want to do repeatedly because every time you expose yourself to radiation when you do that. But once it would be fine. But I think better than a CT scan to look at your calcium score is to do an ultrasound test. Ultrasound measures the age of your arteries. How old are your arteries? And over time, if you did it yearly, you can see if you're growing plaque or if your plaque is shrinking from following the right lifestyle.


DARLENE: And I think, and I know I'm going over this a million times, but cholesterol statin drugs don't necessarily shrink that plaque. Am I hearing that right?


DR. MASLEY: Well, if you only take a statin, I've seen people grow more than 5% more plaque per year while taking a statin and having a perfect, supposedly perfect cholesterol level, but they did everything else wrong. They ate too much sugar. They ate the wrong fats. They didn't meet their nutrient needs. They didn't exercise. They didn't manage their stress. They kept growing plaque rapidly on a statin. Now statins can help. If you do everything right, a statin can help you shrink your plaque. Although as you know, statins have a lot of side effects, many of which doctors don't even talk about.


DARLENE: Let's talk about some of those for people, because they don't hear, they don't know this. And I think coming from a medical doctor, they'll listen before they will from a nutritionist, to be honest with you.


CAROLYN: And I think one of the really interesting things that most people don't know, and you say very succinctly in your book is that statins do not affect what you eat or what you eat are not affected by the satins.


DR. MASLEY: Right. I mean, people tell me they go out and eat a burger and fries and a milkshake. And I just pop an extra statin med. And I cringe. That statin med doesn't prevent them from forming the… The statin meds block your liver from making cholesterol. And they also decrease some inflammation, but they don't stop you from growing plaque.


CAROLYN: So important; so important.


DR. MASLEY: It’s because of the foods you eat.


CAROLYN: Right; right.


DR. MASLEY: And as you said, they do have side effects. I mean the most common ones, doctors think of liver inflammation and muscle inflammation and muscle breakdown. And those are important, but they impact like one in a thousand people in a major way. But 10% of people get muscle aches from statins. And that's a significant problem to point out. They might need to stop them. But there are many other side effects from statins. They increase blood sugar and diabetes. And the number one cause for heart disease is elevated blood sugar and they increase blood sugar. They decrease memory and concentration and ability to focus. So they also, they lower CoQ10, which is what gives us energy. They block the conversion of vitamin K1 to K2, which is the active form of vitamin K that prevents plaque calcification. And the thing they really don't talk about is they lower testosterone in a significant way for men or women. They decrease our drive, our energy, our enjoyment. So I'm not anti-statin. My goal is that people follow a lifestyle that heals their arteries, supports them from needing them so that they don't have to take them. They can shrink their plaque without them.


CAROLYN: Well, that’s great.


DR.MASLEY: Although I will admit sometimes I still use them on my patients.


CAROLYN: So it's already time for our second break. So you're listening to Dishing Up Nutrition. And after working with clients for over 30 years, I've come to realize it's really challenging for many people to follow a real food, heart healthy plan. So there's always a family get together or lunch with the girls or, you know, whatever to be luring you away from your healthy eating plan. I find clients who schedule and attend monthly appointments do better.




DARLENE: Well, welcome back to Dishing Up Nutrition. You know, my mother was a very healthy cook and she actually followed a pretty heart healthy plan when my dad was alive. She was cooking for two and she cooked very nicely. But when she started cooking for herself, not such a good job. And I bet this sounds familiar to a lot of listeners who are living alone. So what we are doing right now is to kind of keep you motivated to cook heart-healthy meals, we're offering cooking classes, you know, once a month, twice a month. And so this month, Marianne, our nutrition educator culinary expert is bringing you some cooking tips in her, a class called Batch Cooking for Simple Weeknight Dinners. That way you cook ahead and you've got some extra things when you don't feel like cooking. And that happens a lot of times. So you can go to weightandwellness.com or call (651) 699-3438 and sign up. And these classes are only $25 and Marianne is an excellent teacher.


CAROLYN: Yes. And before we went to break, I was saying, you know, people do much better when they are supported on a weekly, monthly whatever basis. So again, you can call that same number: (651) 699-3438 and set up an appointment with any one of our nutritionists. So Dr. Masley, you know, in your book, you address the importance of exercise, but because this show is really more about nutrition, we really want to focus on those eating choices and habits that Americans are causing that plaque buildup. So I'd like you to talk now a little bit about fats and hydrogenated, refined, damaged oils. And of course, if sugar kind of goes in there too, that would be good.


DR.MASLEY: Well, very important are the type of fats we eat. Number one is to cut out the sugar and flour. Number two is to eat smart fat, not toxic fat, not bad fat. So the worst of the fats are the hydrogenated fats. When they hydrogenate and they make them stiff, and they're, they're no longer like a natural fat. They're kind of mostly alien to the human body. And when we eat them, we're basically embalming ourselves. And I don't think most people realize that hydrogenated fats act like embalming fluid in the human body.


CAROLYN: That's a good way to put it.


DR. MASLEY: You don't find them when you're cooking really food from scratch, maybe unless you use margarine. But, or, you know, these older fats that I think most people are now avoiding. But they're in processed food. So if you're eating food out of a package or, you know, or food out of a can, there's a decent chance they've made it with hydrogenated fat. The food industry loves them because it makes the food last much longer. They’re stiff, unnatural fats. You know, word is cockroaches won't even eat them. We humans should be avoiding it.


DARLENE: Wow. So, you know, I think the other thing is we, and we see it now during the pandemic, that there are long lines at the fast food drive-throughs now. I mean, cars are backed up a mile or two to get their burger or whatever they're eating at the fast food. Maybe talk a little bit about what kind of fats are in fast foods.


DR. MASLEY: Well, they’re oftentimes cheap fats that cause us to be inflamed and achy; things like corn oil and soybean oil. And then when they put them in fryers, they become damaged and they become hydrogenated. So even, so in the past, they chose to use hydrogenated fats because they could keep using them over and over again. And I think they got away from that because people are realizing, well, hydrogenated fats are toxic. But they don't mention that when they choose corn oil and soybean oil and they put it in the fryer, they’re turning that oil into hydrogenated fat and we end up eating it anyway.


DARLENE: Okay. There we are.


DR. MASLEY: So you’re right that fast food places typically use the absolute worst fat.


CAROLYN: Exactly. And of course, those are the cheapest. So of course that's what they're going to be using.


DARLENE: So, you know, I have another, and this is off topic a little bit, Dr. Masley, but when you were talking about sugar and flour and how it causes plaque buildup, the one that popped into my brain we should talk about is what about alcohol? You know, you hear, we get a mixed message on alcohol. It's heart-healthy they say. Well, we don't think so.


DR. MASLEY: We have to be clear. So beer and hard liquor have no health benefits.




DR. MASLEY: Red wine: if you could, if you can limit your consumption to one to two servings a day; by serving, I mean like four and a half ounces, there is some modest health benefit to that. At least there's not much harm. Anyone drinking more than three servings a day is clearly harming themselves; plain and simple. And it does convert to sugar.




CAROLYN: There, that's the point I think that that's really important.


DR. MASLEY: Here’s the interesting thing: if you had one glass of red wine with dinner, it actually helps improve insulin sensitivity and helps with blood sugar levels. But when you over consume, you're basically just downing a sugary drink.


DARLENE: So once you go over that four ounces, it's damaging to your body then?


DR. MASLEY: It's, no. So one is probably beneficial. Two's okay. More than three is clearly too much. And remember there's no benefit to beer and hard liquor. We're only talking about red wine. Clearly in moderation, not excess.


DARLENE: Let's switch our conversation to saturated fats because that's the other one that we hear all the time. They can't eat, you know, they shouldn't eat butter. They shouldn't eat coconut oil. They shouldn't eat steak. Talk about, talk about saturated fat. Is that okay, Carolyn?


CAROLYN: Yeah. Well, I was just going to add that's what happens when our clients are going into even the cardiologist or their doctor. They say, “No, saturated fat is bad. Coconut oil is bad.”


DARLENE: Butter is bad.


CAROLYN: Eat, eat, yeah, “Butter's bad. Eat those fake, you know, I Can't Believe It's Not Butter; those types of products.


DR MASLEY: So, well, if they're substituting butter for margarine, that's a terrible choice. They're basically choosing hydrogenated fat, which is, think of it as embalming fluid when you think of hydrogenated fat. And I think you get the idea. But you know, saturated fat: for years we condemned it. But when we look back at the research from the eighties and the nineties, that might've been more political than scientific. The current evidence is that saturated fat, it, there's some controversy. Is it harmful or not? It's, it's a toss up. It's like neutral, maybe slightly harmful, you know, or maybe neutral. The real issue is sugar and flour and bad fats. Do you meet your nutrient needs? Do you eat enough vegetable, fruit, beans, or nuts? Those are the critical ones. So I've steered away from having people focus on saturated fat because it's not having a significant big impact. What does have a big impact is avoiding sugar, flour, hydrogenated fats. And eating healthy fat is really good for us; olive oil and nuts and avocado oil. So if I'm cooking, I'm going to use avocado or almond oil for higher heat. And I'm going to use extra virgin olive oil for low heat cooking and salad dressings. And I use mostly extra-virgin olive oil for most of my fat because it's the healthiest fat out there along with eating nuts and avocados and seafood. And those are all healthy fats we should eat more of. And I think that's far more important to focus on those and less important to focus on saturated fats.


CAROLYN: Exactly. And we tell all of our clients: have a balance of fats. Have all three types of fats all the time, you know, moderate what you're eating. Don't do all saturated. Don't do all mono, you know, do your all three types of fat every day.




DARLENE: And no, and no hydrogenated fats, no damaged fats.


CAROLYN: No hydrogenated fats.


DARLENE: Exactly. I don't know, Carolyn, do have another question? I've got a couple that I want to ask.


CAROLYN: Yeah, go ahead. Go ahead.


DARLENE: You know, one of the other things that I think people don't understand some of these terms, you know, like, you know, sometimes people have had a stroke or a TIA. I think if people understood what that really meant, they might have more motivation to eat better. So maybe, you know, maybe explain to people what, what happens when you have a stroke or what happens when you have a TIA.


CAROLYN: Or angina even. That's a common one.




DR. MASLEY: Let's look at an angina and a heart attack first. So angina is a warning you're about to have a heart attack. You've got some blockage, usually because a minor plaque, a baby plaque, a micro-plaque, is ruptured and causes a clot to form. And that can cause angina. And as you grow more plaque over time, you can decrease your flow and you start getting angina, chest pressure, heaviness, shortness of breath, just trying to walk up a flight of stairs. That's someone who's on the verge of heart attack, stroke or death. At any, you know, by the time you reach that point, it's a very dangerous situation. Similarly is the TIA and a stroke. The TIA is the warning of a stroke. A stroke is permanent. A TIA means you have a transient blockage of blood flow to your brain and you have symptoms like you, you can lose your speech or you can't move your left arm cause of weakness. Or one side of your body goes out. That's, if it lasts less than 24 hours and you have a full recovery, we call it a transient ischemic attack, lack of blood supply to the brain transiently less than 24 hours. If it's more than that, the cells die. They don't come back and it's permanent or relatively permanent. You can gain some function back over months, but typically it's permanent. That's like, you can't speak anymore. You can't walk anymore. You're disabled. I mean, probably to me, worse than a heart attack is a stroke, because it can leave you disabled. And you become a burden to the people you love. So that's what we want to avoid. That's what we want to prevent. The first symptom of heart disease oftentimes is a heart attack, which puts you in heart failure or a stroke and you're disabled. And, that's an awful way to try to keep living and we can prevent more than 90% of that just with lifestyle.


CAROLYN: Well, great. Now it's already time for our third break. You're listening to Dishing Up Nutrition. Two weeks ago, Cassie and Mel talked about our gut health and our microbiome. Most of us know that antibiotics can hurt our gut microbiome, but did you know that artificial sweeteners such as Splenda, NutraSweet and Equal adversely affect our good gut bacteria, which in turn also makes us gain weight? What exactly does that mean? It means that those artificial flavored sodas, pops that are advertised to help us lose weight: they are actually making people gain weight. And we see it clinically all the time, but now it is actually in the research. And we'll be right back.




DARLENE: Well, welcome back to Dishing Up Nutrition. Here's another nutritional tip that Dr. Masley included in his book. And I think most people know this that omega-three fish oil is recommended for heart health. But we know that not all omega-3 supplements are created equal. And here's the trick. He said, “What if your fish oil supplement is rancid?” That's a question. How can you tell? You know, if you get a yucky belch after you take your supplement it probably is rancid. And what you can do is you can break open that softgel that the oil is in and taste it. And if it tastes yucky, it may be rancid. And rancid fish oil is harmful, not heart-healthy. And you know, our Omega-3 1000 is fresh. It's certainly not rancid. So it's heart-healthy so we, you know, I usually suggest to people to take three or four every day, at least, and just to have that omega-3.


CAROLYN: So good quality fish oil is really, really important. So Dr. Masley on a personal note, I read that you spend time in the Mediterranean on your sailboat. I'm so envious.


DR. MASLEY: Well, I spent three summers, I mean, almost three to five months each time looking at recipes and foods. I mean the Mediterranean is where people live the longest on the planet. They have some of the least heart disease, dementia, and diabetes rates on the planet.


CAROLYN: They eat healthy fats.


DR. MASLEY: I really wanted to explore that. And yeah, my wife and I spent more than a year over three summers sailing from Spain to Turkey and from Greece back to Spain, exploring recipes. And, you know, why can you know how the French can eat fat, the Italians eat pasta and all these things about why can they do these things and not have disease? It was really fascinating. It's just mostly because they eat the right food. They eat it from scratch; local, unprocessed food with herbs and spices and olive oil. They eat lots of vegetables, fruit, beans, and nuts. It's the healthiest diet on the planet.


CAROLYN: Exactly. Well, I'm envious that you got to spend three summers. I, I'm an avid sailor and I've spent many, many days on sailboats, mostly in the summer in the Atlantic or Pacific around the Great Lakes. But I just have to share a little tidbit. I get to go on a, a boat adventure down the Mississippi from St. Paul all the way to Galveston, Texas. This is coming up May 29th is our expected leaving date. We don't probably get to eat all the great foods that you got to eat.


DARLENE: But you will have good foods on.


CAROLYN: Oh, I will. Yes, I will. I'm going to be the chief cook and bottle washer. So that's of course, that we will have good foods on board. Exactly. But I'm really looking forward to that venture. But one day I hope to be able to do the Mediterranean as well and explore the foods there. I know that's really where I got my love of food in Spain the very first time, way back in the seventies.


DARLENE: So, yeah. Okay. So I know you had a hard question for Dr. Masley.


CAROLYN: I did. You know, I really wanted to talk to you about, or have you talk to us more or less about triglycerides and why there such a big risk factor for that plaque buildup? So I'm wondering if you could go into a little more detail about triglycerides.


DR. MASLEY: Well, triglycerides are these much smaller, you know, fats compared to like LDL cholesterol or HDL cholesterol, which are big bubbles that contain fat and nutrients and protein. So LDL cholesterol and HDL: those are like the delivery trucks that carry nutrients to our body and inside of them are triglycerides. Our bodies convert energy into triglycerides; small little fat units that can be used by cells. What happens is when we have too much sugar or flour, we make an excess of triglycerides and they're like trash bags out in the street blocking flow. And eventually, so it's, you know, these little trash bags, these triglycerides eventually start contributing to plaque growth. So high triglyceride levels are usually a sign that you're eating too much sugar. You're getting too much refined energy in your diet. And they’re clearly a risk factor.


DARLENE: What do you think is too high of a number for triglycerides? What do you think people should aim for to keep their triglycerides normal?


DR. MASLEY: The cutoff for normal is 150, but anything over a hundred to me is really elevated. It's sign you're eating too much sugar.


CAROLYN: Right on.


DARLENE: Yeah, we, we agree. We, honestly, we have a lot of people coming that have been working with us for a while. Their triglyceride number is 50, 55, maybe 60. And that tells us that they've cut out the processed carbs and they're eating vegetables, you know, basically.


DR. MASLEY: You don't get that from eating fruit and vegetables from whole fruit and real vegetables. That doesn't happen. You get it from fruit juice, which is not a fruit. It’s a processed food.


CAROLYN: So it's so interesting because our clients, when they come to see us, they bring us their lipid panel. And you know, they're, they're told that it's that LDL that is the most disconcerting to them or to their doctor. And of course I always zero in on the triglycerides and say, this is easy. You know, we can get rid of that really fast.




CAROLYN: So what about that LDL?


DR. MASLEY: Well, LDL is the delivery. If you eat healthy food, healthy fats, and you don't eat sugar and flour, you have LDL, that's the delivery truck. It carries nutrients from your gut to your cells. We want that. If you eat junk, your LDL gets inflamed and grows plaque. So if you're following the SAD, standard American diet, your LDL is a problem. If you're following a healthy low-glycemic version of a Mediterranean diet; that's what I advocate in The 30-Day Heart Tune-Up, the LDL for most people doesn't harm you at all. So it really depends how you, and you can tell that by doing more than just looking at LDL, there's something we call a particle size and particle level. How big is it? Big, large, fluffy LDL does not grow plaque. Small, little LDL is very inflammatory. So if your doctor is saying you need to take a statin, I would say, well, “Can you look at my advanced lipid profile? What kind of LDL do I have? The good stuff or the bad stuff?” And from that you can decide. And the number one treatment for little LDL is to eat less sugar and fiber and to eat more healthy fat and more vegetables, fruit, beans, and nuts.


CAROLYN: What maybe you want to go into that fiber component a little bit, because we also obviously tell people, you know, all those vegetables are good, but you know, getting as much fiber as possible is, is really helpful too.


DARLENE: But probably as you know, when people say fiber, they think slices of bread.


CAROLYN: Oh, that's true. Thank you, Dar, for pointing that out.




DR. MASLEY: Yeah, so I would say fiber without flour.


DARLENE: Oh, I like that. That’s simple.


DR. MASLEY: That means vegetable, fruit, beans, and nuts. If you eat more of those, you lower your cholesterol, you lower your blood sugar, you lower your blood pressure, you decrease inflammation and you feed your gut microbiome, which helps you, which does so many important things for us, including reducing our risk for heart disease.


DARLENE: You know, one other food that I'd love for you to address is pizza. Because I, I swear this, this is the one thing that everybody seems to need to have on Friday night is the local pizza person needs to deliver it to their house. So talk a little bit about that habit.


CAROLYN: Probably only have about another minute so if you can wrap that up quickly.


DR.MASLEY: Pizza can be one of the worst things we eat. It's mostly flour. It's got cheese. Oftentimes it's got fatty meats on it that are not, we're not talking grass-fed steak. We're talking pepperoni and sausage that are full of chemicals and toxins.


CAROLYN: Nitrates.


DR. MASLEY: So, you know, you can do a cauliflower crust pizza and put veggies on it and it can be pretty healthy. But the average pizza that people eat is just toxic.


CAROLYN: That is for sure.


DARLENE: You are very wise person. And I think everybody should pick up your book. Honestly, it's a great book. It's got so many wonderful tips. You know, honestly, I didn't know about the artificial sweeteners. And that was a great tip that you put in there. So we really, really appreciate you being on. You're a great educator. Thank you so much today.


CAROLYN: Dr. Steven Masley's books are really easy to read and available for purchase. Dr. Masley, Dar and I want to thank you so much for joining us today on Dishing Up Nutrition and for sharing your knowledge and insights about how to tune up your heart health.


DR. MALSEY: It was a pleasure. Thank you for inviting me.


CAROLYN: So for our listeners, if you want to share how, how are they going to find you? How are they going to find your book?


DR. MASLEY: Well, easiest is The 30-Day Heart Tune-Up is available wherever books are sold. It's now out in paperback version, so they don't have to pay the extra money. They can get it right there: The revised vision of The 30 Day Heart Tune-Up. And the best way to get more information is to go to my website, drmasley.com. I send out free health tips and recipes every month to keep people up to date and healthy and happy and eating delicious food.


CAROLYN: Thank you for listening today. Have a great day.


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