Introduction
“If only I had known.”
Those are the saddest words a doctor can hear from someone who has just been diagnosed with a severe health problem—one that could have been prevented. But you are about to learn how to prevent the most common health problems that damage your body. I know this is a bold promise, but once you have read this book, you will never need to say, “If only . . .”
You are going to know. This book will tell you—clearly. What you do about it, however, will be your decision.
I have been a thoracic and vascular surgeon for over thirty years. I’ve operated on blockages of arteries throughout the body—arteries to the heart, to the brain, to the kidneys and the legs. With my own hands, I have opened arteries that were blocked with so much plaque that vital blood flow was completely choked off. I have bypassed a blockage of plaque by taking veins out of a patient’s leg, sewing one end of the vein into an artery in front of a blockage, and sewing the other end into the artery past the blockage. I have opened the main artery leading to the brain and used a miniature spoon to dissect out plaque that was blocking 95 percent of the blood flow to that half of the brain.
More than half of all Americans, as well as people in many other countries with similar lifestyles to ours, will die because of the war going on inside their arteries. I have been fighting this war all my surgical life, cleaning out those blockages. I have come to the realization that doctors who operate on the arteries in the heart, those who place stents and sew in bypasses, do nothing to cure heart disease. Without a change in lifestyle on the part of the patient, the same damage to the arteries continues after the treatment is done.
So instead of operating on the symptoms of aging, I have decided to try to save lives by teaching people how to prevent what causes the demise of more than half of Americans. In this book, I want to help you prevent the underlying disease process by teaching how to put a halt to the cause. In fact, I’m going to tell you some secrets for which you might thank me for years to come.
Because of a lifetime of research, I have also learned that a huge part of the process we call aging is strategically preventable. So this book will also open your eyes to the most important facts about the aging process. And I am going to help you, one step at a time, begin to turn back the clock of aging. I will keep it simple and straightforward. And as crazy as this probably sounds, five years from now you will be seven to twelve years younger, physiologically, than your chronological age. You will be more active than the majority of your friends, even if they are many years younger than you.
You will learn a three-part, strategic lifestyle plan that will change you. I will teach you what to eat and how to work on your weight until you reach your ideal number of pounds. If you are already at that weight, I will give you some easy pointers for how to maintain it every day. I will take you down the road, step-by-step. And exercise will become a routine part of your life.
Whatever your life expectancy is today, you are going to extend that number by seven to twelve years. But what is even more important is that the years you have left will be quality years.
I know the aging process is inevitable, but because of what I have learned in a lifetime of experience, I also know that the rate of that process can be controlled and, many times, reversed. And best of all, those extra years you are adding to your life expectancy are going to be active, vivacious, vibrant years that you will enjoy. When you commit to the Prescription for Life plan, you will take control of your physiological aging process rather than simply sit by and watch it happen.
It is my desire to show you how to reach your full potential in your physical and mental performance—for the rest of your life!
My First Week in Medical School
I remember my first day of medical school like it was yesterday. “The heart is the single most important organ in your body,” our professor told us in anatomy lab. He went on to compare the heart to the brain, explaining that someone can be comatose—brain dead—but be alive because the heart is still pumping blood throughout the body. That anatomy class was exciting, because I actually got to hold a human heart in my hand. I was able to look closely at the muscle makeup. I could see each artery lying on the surface of the muscle. When the professor spoke of the anterior descending coronary artery, I could see it, touch it.
He then had us gather around the dissecting table to give us a lecture. He had several cadaver hearts laid out on the slab, some with the muscle cut through and some with the arteries spliced open longitudinally to show blockage within the vessels.
He wore a white lab coat, all three buttons neatly through each button hole. His head was freshly shaved, but you could tell he was mostly bald to begin with. And his shoes were shined. His appearance was enough to make you pay attention to what he was about to say, but my eyes were fixed on what he held out toward us in his hands. In each, he had a human heart, both split open, showing directly into the main chamber.
I have never forgotten what he said next: “The heart in my right hand belonged to a gentleman who was what I call a couch potato. He was grossly overweight. Never exercised a day in his life, and from his medical records, we know he was on numerous medications.” He laid the heart in his left hand on the dissecting table and pointed to the wall of the couch potato’s heart.
“As you can see, the wall of his left ventricle is only millimeters thick. His heart was a poor excuse for a pump he depended on every minute he was alive. Remember the thickness. Autopsy results reveal that he died from a massive heart attack—at the age of fifty-two.”
He placed it on the table and picked up the other heart. I looked closely and thought I saw some blood dripping from the opened chamber but quickly realized there was no blood in the organ since the autopsy had been done. (Those were formaldehyde drops.)
“This man’s heart is different. You see the thickness is a good three centimeters. It was strong right up to its last beat. His report said he was someone who was trim, who took good care of his body, didn’t smoke, and was a frequent tennis player. This heart belonged to a sixty-one-year-old gentleman who died in an automobile accident. He was physiologically younger than the fifty-two-year-old couch potato. If you want to live younger, the only advice I can draw from these hearts is to be as active as you can.”
Next he showed us a heart in which he had opened an artery longitudinally. He passed it around. The inside of the artery was as clean as a whistle. Then he passed around several hearts that had partial or complete blockages within the inside of the arteries. He pointed out that most of the cadaver hearts he received from people who had died a non-accidental death had such blockages. He didn’t know the actual cause of the blockages, but he knew they were the cause of the heart muscle not getting the oxygen it needed, resulting in the demise of that particular patient.
Then he made another statement I’ve never forgotten: “The ones with the least amount of blockage are the ones who lived longer.”
My first week of medical school amazed me. I could hardly wait to tell my future wife about holding a human heart in my hands. That weekend, I packed my books into the car and took off to see her. I was so excited that I even wanted to take a heart with me to show Harriet all the exciting things I had learned. So I slipped one out of the building as I left, rationalizing that I wanted to study its valves and arteries over the weekend.
Of course, I knew the real reason was to show Harriet what a human heart looked like inside and out. I could hardly wait to get to her house with my surprise floating inside a jar of formalin.
After two and a half hours of traveling and the usual ritual of giving Harriet a hug and kiss, I reached into the car to retrieve my brown paper sack. I removed the jar containing the heart, ready to demonstrate my newly learned knowledge.
Harriet shifted away from me and quickly took three steps backward as I began my lecture. She showed slight interest, but it was evident that I would not be taking the heart out of the jar to show her any of the details. I couldn’t believe she didn’t have the interest I thought she ought to. If Harriet was to be a doctor’s wife, she ought to want to hold a real heart—at least that was the way I looked at it. However, I accepted reality and placed the jar on the driver’s seat of my car.
Harriet and I had decided to talk with her parents that evening about moving up our wedding plans. We had intended to wait until I completed my first two years of medical school so I could devote all my time to studying and she could finish college. However, I learned that the medical school would hire med students’ wives to work as office assistants, giving us income, and I thought there was no reason to wait so long to marry. After dinner, we sat in the living room with her parents, and I explained that Harriet and I would like their blessing to move ahead with our plans.
Harriet’s dad was tall and thin, with curly hair and glasses. He just looked over the top rim of his glasses toward me, not at me but at a spot somewhere between my eyes and the floor. “I’ve always wanted my daughter to graduate from college,” he said. Then he got up from his La-Z-Boy recliner and walked back toward their bedroom.
Harriet’s mother smiled and said, “I had better go back with him.” At least she smiled.
This was not the response I’d hoped for. All I could do was turn to Harriet and tell her, “When you get back to school Monday, find out what day your class will graduate two years from now, and we will plan to get married the following Saturday.”
As I got into my car to drive back to school the next day, still with two years in front of me before our wedding, I picked up the jar holding the heart and placed it on the passenger seat. I looked at it for a moment and thought, My anatomy professor is correct. Whether it’s a cadaver’s dead heart in a jar or a live “broken” heart in the human thorax of a disappointed fiancé, the heart is the single most important organ in your body.
It is still hard for me to understand why Harriet didn’t share my excitement over learning about that heart. And today I know even more about hearts than I did then; I know about a lifestyle that can make you younger physiologically, and I want to share that knowledge with others.
Yet, so many seem about as interested in changing their lifestyle as Harriet did in holding a human heart. If you want to live life to the fullest, you need to commit to taking your heart “into your own hands.” It will be the most important decision you will ever make about how you live the rest of your life. If you want to better your life, I invite you to read this book to the very end. The story is not over until you learn all three lifestyle strategies and how they are interrelated for your best life.
As I look back on what my anatomy professor taught me years ago and review today’s medical literature, it is easy to explain what the professor concluded. While it wasn’t known back then, the medical journals today show exactly how much exercise you need to strengthen your heart muscle to be actively younger. The literature reveals the significance of being at an ideal weight. And the same literature tells you exactly what foods cause those blockages in your arteries.
Exercise. Weight. Diet. All three strategies intertwine to prevent those obstructions and allow you to live longer.
Hopefully, there comes a time when you realize there are things you can do to improve yourself. Galatians 6:7 in the King James Bible says, “Whatsoever a man soweth, that shall he also reap.” Some people realize this truth too late in life in terms of their health. They look back on their years and grasp the terrible truth that they should have sown differently. I am glad I realized this reality earlier in my journey.
I remember the moment well. I was forty-two years old and trying on a new pair of pants during an annual sale. As I tried to button the pants at the waist, I realized they were just too tight. Twice before, I had to buy pants with a bigger waist size, and now I was faced with the same situation. In that moment, I made a decision. I folded the trousers and neatly hung them back on their hanger.
“I will come back later. These just don’t seem to fit properly,” I said to the salesman as I handed him the pants. What I said to myself was that I would get my weight back to what I remembered as an ideal weight. That happened to be what I weighed when I finished high school. I had stayed at that weight throughout college but only for a few months once I started medical school. I remembered ideally weighing 140 pounds. Even though I stayed in fairly decent shape, I’d slowly added twenty-one pounds, mostly around my waist.
Ideal Weight
After that moment of decision, it took about three months to lose my excess weight. My new rule was to eat nothing between meals or after dinner. No snacks. I also would have no desserts and eat smaller portions. When I got to what I had deemed my ideal weight, I went back to the men’s shop and bought new pants. I had to pay the regular price, but I knew I would be able to wear those pants until they wore out. I was committed to remain at my ideal weight for the rest of my life. I didn’t realize it then, but I had just accomplished one-third of the lifestyle I needed for the rest of my life. The medical literature would teach me the rest of what I needed to learn to keep my body as young, physically and mentally, as possible.
I did not realize that moment of decision would change my future as much as it did. I knew I felt better at my ideal weight and that medically it was the right thing to do. But I didn’t realize it was only my first step toward the quality of life I wanted.
Exercise
It wasn’t too much later when I read in a medical journal about the significant effect exercise has on the muscles of the heart. The article pointed out that the heart is the most important organ in the body and that we have significant control over its effectiveness. The article further stressed the significance of developing a strong heart muscle. Its strength could be determined by counting how many times it beat while at rest. The stronger the muscle, the slower the resting heart rate. The stronger the muscle, the less often it has to contract to force the needed amount of blood to flow throughout the body. The article stated that the magic number for a heart to be at peak performance is a resting heart rate of forty beats a minute.
The article had so much more information than what my anatomy professor had. But they were both right. The heart makes it all happen.
The more I read additional medical literature, the more I committed to developing the strongest heart possible. I had planned to do lots of things before I grew too old to do them, and I wanted to find out what I could do to remain as active as possible for as long as possible. The more I read, the more I realized I wanted to die young, but at an old age. (In fact, I would like to peak at ninety.) The key to that “strongest heart as possible” was a lifestyle of exercise.
Eating Right
The more I read, the more I realized that even with my two new lifestyle changes of exercise and ideal weight, I was still missing one more essential strategy for fighting the aging progression. I hadn’t examined the food I was eating. I was keeping my weight where I wanted it, but I was eating certain foods that would definitely cause blockage of my arteries. Unless I made a change, this would happen no matter what I weighed or how much I exercised.
I read about the significantly harmful effects of saturated fat and dietary cholesterol and began realizing that I needed to add one more strategy to my lifestyle if I wanted to stay as young physiologically as possible. I needed to cut out the foods that were causing plaque buildup in my arteries.
I read an article that pulled it all together for me. The statistics in that report were a real eye-opener, even for a vascular surgeon who had operated on the very problem I was reading about.
The article pointed out that more than half of Americans die as a result of problems of the arteries in their heart or brain. That figure stunned me. That’s more than die from cancer. Then the report pointed out that almost all of these deaths are preventable. I wanted to know the details. I began to pull up more and more articles that explained that damage to your arteries caused by certain foods is the most common factor that causes you to age.
That is the moment I got serious about developing a complete, three-strategy lifestyle to keep me as young as possible, because I realized there were men in their seventies who looked and acted as if they were fifty-five and men who were fifty-five who looked and acted as if they were seventy.
That day, I committed to find out which foods I needed to avoid and which ones to eat.
Further reading showed that a particular cholesterol compound called Low Density Lipoprotein Cholesterol, or LDL, was the particle that gets into the walls of your arteries and sets up an inflammatory battleground, which either causes a clot in the artery or heals as a partial blockage of the artery.
I didn’t want to believe it, but I discovered that Americans eat more saturated fat in cheese than in any other food. And the number one food that raises our LDL cholesterol is cheese. At that moment I decided to quit eating the food that Americans eat more of than anything else. Why? Because cheese causes the highest amount of what injures your arteries.
I will never forget that Christmas. All my patients knew that cheese was my favorite food. Every year, they brought me all kinds of cheeses, cheese balls, and cheese sticks. That Christmas, I didn’t eat a bite of cheese. I love pizza, but I found I could order a cheese-less pizza. I admit, I do get some strange looks from the order taker, but I still enjoy a thin crust with small pieces of spiced grilled chicken and mushrooms and pineapple, with tomato sauce.
I wanted to read what the established medical journals said about a lifestyle of eating that avoids damage to arteries. I didn’t want to rely on what I saw on television or what new fad diet or product some company or celebrity was selling. I wanted to read things that were proven by the double-blind studies the medical profession requires to acknowledge a finding as being factual. I wanted proof, not hype.
I read about red meat and dairy products like ice cream containing a large amount of saturated fat. You guessed it. I ate no more red meat, unless I was at a banquet where only steak was served. Then I would eat maybe half of it. I didn’t want to become a fanatic, but I wanted my eating choices to be based on medical fact. Ice cream was probably the most difficult to give up, but fat-free yogurt made it a little easier.
Putting It All Together
Then a triple bonus: I read that not only the particular foods but also the combination of exercise and ideal weight worked together to keep my LDL Cholesterol down and protect my arteries. I’d uncovered the three lifestyle choices that would keep my body as young as possible. It did not matter what my birth certificate said; that indicated only my chronological age. I realized that after the age of forty, it isn’t your chronological age that is important but your physiological age. And after all my reading, I realized that physiological age is determined by personal choice. I chose to commit to live as young of a physiological age as possible for the rest of my life.
I knew I was doing all the right things from a medical standpoint, but I didn’t actually know medically if the changes I had made were paying off. It was only when I went to the Cooper Clinic in Dallas with one of my best friends that I found out.
My friend was in good shape. He exercised, but only somewhat, and his favorite food was barbecue pork. We both went through the clinic’s complete physical examination program with blood work, treadmill and EKG testing, a colon examination, X-rays—the whole works.
When they hooked me up to cardiac monitors in preparation for a treadmill test, they had me lie down and then they left the room. Ten minutes later, they came back and said, “Are you alive?” My resting heart rate was 38. That was the first official medical indication that my cardiac training had paid off, but the real impact came at the end of the day when they discussed all they had found concerning my workup.
I will never forget how my doctor told me my cardiac status. Smiling, he said I was in the “above” 99th percentile group. He stressed it again by repeating, “Not in the 99th but above the 99th percentile.” My cardiac status was better than over 99 percent of all people they had examined over the years in my age group. Then he told me something that made me realize all my work had paid off. “I just want you to know that, physiologically, you are a year younger than your friend. And he is eleven years younger than you—chronologically.” That was when I realized that the Prescription for Life plan works, that it is medically based, and that I had passed the test.
Even though I’m a doctor, until I started my own quest to be as healthy as I could be, I’d never thought of aging “physiologically” or “chronologically.” It was only at that moment that I realized that as you get older, you might as well throw away thinking about your chronological age. Your physiological age is what really counts. Your physiological age determines how well you live. I know pride is not something you should show, but I remember telling my friend, “I am a year younger, physiologically, than you, even though you are eleven years younger, chronologically, than me.” I know I shouldn’t, but I still remind him of that medical fact.
I began this journey when I was forty-two. I should have started sooner. I recently decided to share what I have learned about living younger longer. That is when I elected to do a current review of the medical literature and write it out in lay terms. That is what the Prescription for Life plan is all about. It’s not about living longer, although you will add chronological years to your life span. It’s not about death rate. It’s much more important than adding x number of years to your life. It’s about the quality of your life. I want quality. I want you to have that same quality. I want those over seventy to know the secret, the same as I want to share it with all the baby boomers. I want to tell young people in their twenties and thirties to realize that the sooner you begin the journey, the smoother the sailing. I want to share how to prevent damage to the arteries that ages you. I have come to the realization that I can save more lives with the Prescription for Life plan than I ever did in my entire surgical career. I shared with you several moments in my life when I made significant decisions that resulted in a younger age physiologically. I ask you to take just a moment right now and decide to fold those pants, place them back on the rack, and get started living younger.