The aging process depends primarily on the condition of your arteries. If you remember nothing else I have said thus far, remember this: your arteries play a monumental role in the physiological aging of your body. The flow of blood through your body carries nutrients, oxygen, electrolytes, and other essentials that keep the body running like a new engine. That blood is pumped through your system by the heart and is carried by sixty thousand miles of arteries, plus veins.
The condition of the arteries determines how well the body is supplied with all it needs to function at 100 percent. As those arteries become damaged by certain cholesterol particles, the walls begin to respond by developing a battlefield to fight those foreign bodies, and either plaque buildup or inflammation results in a clot. Both events can cause the blood flow to either completely stop or become markedly decreased. The downstream area becomes starved for oxygen.
If the heart is involved, a portion of the muscle quits working and the remaining fibers are called on to carry an extra load of pumping your blood. The result is a less effective pump.
If the affected organ is the brain, that portion of brain tissue supplied by that particular artery quits working. If it is sudden, you have a stroke in which the part of the body supplied by that portion of the brain quits working immediately. If it is a slow blockage process, you could end up with what is called dementia, and slowly, over the years, you begin to forget, function slower, lose your reasoning, and finally lose your memory.
How Blockages Begin
The blockage process in an artery begins with certain cholesterol particles floating in the bloodstream. At different locations, usually where the artery divides or branches, there is turbulence in the blood flow. In such areas, these particles are pounded into the wall of the artery. They are forced through the inner lining and end up implanted within the wall. As time goes by, many more of these minute particles continue building up, and your body sends in special cells and a flood of fluid to begin fighting off these foreign bodies, which, of course, are not supposed to be there.
The result of such a battle is a partial or complete blockage. If it goes on long enough, even calcium can be deposited into the plaque formation. This is a silent process. It doesn’t cause you any pain. It doesn’t give you a headache or make your chest hurt. It works quietly while you order extra cheese on your hamburger.
Most people don’t understand this process. You are getting ready to know exactly what is going on. I believe if you were standing in the middle of the railroad tracks and a freight train was coming, you would jump out of its way before it ran you over. I’m sounding the alarm so you can avoid that train with your health. When we finish, you won’t be able to plead ignorance. You can do specific things every day for the rest of your life that will keep those blocking particles out of your bloodstream and those arteries youthful.
Let’s look at the layers of an artery and see what happens when you eat the wrong foods. The thin inner layer is called the intima. Think of it as the protective portion of the arterial wall. It should be capable of keeping anything from getting through the inner lining and into the wall of the artery. Picture it as being made up of individual pieces of a thousand-piece jigsaw puzzle, each piece with a Teflon coating. This makes it smooth and slick, and nothing sticks to it or penetrates it. If you could magnify the intima, you would see that each of these interlocking cells is held together by little proteins, locked arm in arm. Think of these proteins as a line of soldiers that will not let anything penetrate through this lining.
Now let’s go through that very thin inner lining and look at the next layer. This thicker, spongy layer is called the media. This is where the fighting takes place. Think of the media as the battleground of the aging process. This is where all kinds of things happen that determine whether you stay young or get older ahead of your chronological time frame. Even though so much fighting takes place in the media, the big problem is that we don’t feel anything while the battle is going on.
If you were to hit your finger with a hammer, you would make all kinds of fuss. You would make sure that would never happen again. You would see the place the hammer hit immediately begin to swell. You most likely would put ice on it and elevate it to help prevent more swelling. But the problem with the damage that goes on in your arteries is that you are completely unaware it’s happening, and you let it happen again and again.
Finally, we come to the outer layer, which is a thin, smooth covering that is fairly firm but pliable and doesn’t really play a part in any of these problems.
You Are Only as Young as Your Arteries
Think about it a minute. If your arteries begin to age, you age. If you protect your arteries, you will, physiologically speaking, stop the clock. You can even turn your physiological age back quite a few years with some basic lifestyle changes that you can maintain the rest of your life.
Heart attacks, strokes, dementia, and erectile dysfunction are all caused by not protecting your arteries with a proper lifestyle. The same blockage happening in your heart is happening in the arteries to your kidneys, to your intestines, to the muscles in your legs, to every part of your body.
You may have absolutely no symptoms of blockage in your arteries, but I assure you that you have cholesterol deposits building up in your arteries. By the time patients present with EKG changes, or chest pain, or numbness going down their arm, it has already happened. We see the same thing with brains, when patients present with weakness, or numbness around their mouths, or dizziness.
It’s an ongoing process because of your eating habits.
Many of these arteries are already 95 percent blocked. I have operated on many carotid arteries, the two main arteries going to the brain. Some have been 90 to 95 percent blocked without the patient ever having any symptoms. Their doctor just happened to find the blockage in a routine physical examination.
Don’t wait for symptoms caused from the blockage of your arteries before you do something to prevent a stroke or heart attack. And for you men, the same goes for erectile dysfunction. Don’t wait until it happens to decide you are going to protect your arteries.
Don’t Let Your First Symptom Be Death
A few summers ago, I was at a fishing lodge in Alaska. A well-known individual lived nearby, and I had the opportunity to visit his home one afternoon. He appeared to be in excellent health except for being overweight. He said his blood pressure had always been normal. He had an almost constant, natural smile. Everything seemed great.
As I was standing by the lake before leaving, he mentioned he had experienced some occasional dizziness and that his doctor had started him on a blood thinner. I placed my right index and middle fingers on the left side of his neck to feel for his carotid pulse. The two carotid arteries, one on each side of the windpipe, are the major arteries feeding our brains. I wanted to see if I could feel turbulence in the blood flow. If dizziness happens to be the result of a partial blockage of the carotid artery, I can actually feel a vibration (physicians call that vibration a “thrill”) as the blood squeezes through the partially blocked area. If there is partial blockage, that plaque can be removed to get normal flow going to the brain before a stroke occurs. If I felt such a vibration, I was going to tell him to go into town and have his arteries checked out.
I was surprised—not only did I not feel a “thrill” in his left carotid artery, but I didn’t feel any pulse at all.
That was not good, because you can’t operate on the artery after it is completely blocked. There is nothing surgically you can do to restore the blood flow to that side of the brain. My assumption was that he was supplying his entire brain from the remaining carotid. As he kept talking, I felt for the pulse in his right carotid.
Nothing.
He had no blood flow through either of the major arteries to his brain. The brain has only four arteries supplying it, the two main carotids and two very small arteries in the back of the brain. I knew the only blood he was getting to his entire brain was from those two minute vertebral arteries. They normally carry less than 10 percent of total blood flow to the brain, but for him, they were carrying 100 percent.
I felt sick. The vehicles for the main blood supply to his brain were demolished. He had no symptoms except a little dizziness from time to time. Even though I realized nothing of significance could be done, I recommended he see his doctor again, concerning the dizziness. As I got into the boat to leave, I knew he had only a short time left on this earth.
He did see his doctor, but nothing could be suggested for him to do. Three months later, a friend informed me the gentleman had had a massive stroke and died.
The damage to his arteries had taken years and years to completely block the flow of life-giving blood to his brain. I tell you this story to emphasize you can have partial blockage of an artery in your body for years without any symptoms at all. His first symptom of dizziness was a warning that came too late for him to halt the process. Don’t wait for symptoms. Even then, it may be too late.
And sometimes the first symptom is death.
You might think that gentleman in Alaska led a good life right up to the end, that he went quickly and didn’t suffer so how he died might not be all that bad. But because of his lifestyle, his life ended way before it should have. He missed years and years that he could have spent with his family and friends—“if only.”
Your Initial Symptom Could Be More Devastating Than Death
A stroke occurs when the blood supply to a particular part of the brain is suddenly halted. This can occur either by rupture of the artery, resulting in bleeding into the brain tissue, or by the artery becoming blocked, cutting off the oxygen to that area of the brain. Almost 90 percent of strokes are of the latter type, where arterial blockage is taking place due to plaque buildup. The stroke can be small and transient, called a transient ischemic attack (TIA), with temporary changes that disappear, or it can permanently change your mind and body. Strokes are the leading cause of long-term disability in adults and the fourth leading cause of death.
The moment you survive even a TIA you have five times more chance of dying prematurely than someone who has not had a stroke. Plus, within the next five years, 15 to 30 percent will have some form of permanent disability due to a second stroke. Most strokes leave you with years of aftereffects. You may have slurred speech, be paralyzed on one entire side of your body, become bedridden, or develop dementia. You can live for years that way, affecting not only yourself but also loved ones who have to care for you.
Two million brain cells die each minute during a stroke. Six months after such a stroke, 20 percent of survivors who are sixty-five or older have difficulty speaking, while a third can’t walk without assistance, and 25 percent end up in a nursing home.
I am trying to get your attention with all these statistics, but let me point out the most significant statistic concerning the blockage of arteries to your brain. Sixty-one percent of stroke patients die or are back in the hospital within twelve months. The American Heart Association informs us that stroke is the second leading cause of hospitalizations among the elderly. We are talking primarily about those over the age of sixty-five, but at any age when a stroke happens, only one phrase comes to my mind: “It’s too late now.” And one phrase you should never have to say to yourself is, “If only I had known.” You are going to know—so that you can sow differently.
Too many people do not even realize they’re at risk for a stroke. Last week I heard from a doctor who is practicing medicine in Africa for a six-month period. He is a typical American doctor, doing a very good service for humanity by helping out overseas. His numbers look pretty good except for low HDL Cholesterol. But he doesn’t exercise, and he is about fifty pounds overweight. He said that one particular morning, as he was walking up the hill toward the hospital, he began having a little trouble with his balance. As he got near the hospital, rather than going to the usual ward to see his patients, he mysteriously found himself in the hospital laboratory. When he left the lab, he began having difficulty walking and was bumping against hedges, but he finally made it to the patient ward. He tried to tell the nurses something was wrong, but he had trouble coming up with the right words. His speech was slurred. It wasn’t long before he was very dizzy and had double vision. All this happened within about thirty minutes. He was taken to a large city hospital where a CAT scan showed he had a small blockage in one of the arteries in his brain. Over the next forty-eight hours, his symptoms disappeared and he returned to normal. He went back to the hospital where he had been working, and within a few days he was carrying on as usual. Now his message to me was how thankful he was to be “back to normal,” thankful that he had regained all his strength and was now able to do all the things he did before his “light stroke.”
I hope I sounded the alarm by telling him not to be merely thankful that it was a light stroke and that he had fully recovered. I told him what he ought to be the most thankful for was that he’d received a warning signal.
The warning is this: someone who has had even a TIA is going to end up with a debilitating stroke sometime down the road if they don’t do something about their lifestyle. Similar blockage is going on in the arteries of their heart, and if they don’t do something about it right now, their fate and their future are already established.
Such individuals need to get to an ideal weight. They need to get an exercise program going, five to six days a week. Certain foods—as if they contain little sticks of dynamite—are imbedding trouble into the arteries to their brains, and they need to learn what is going on in their bodies and what they must eat and not eat to stop the impending danger. Anyone who has had any type of stroke is definitely a candidate for the Prescription for Life plan.
Aside from being rehospitalized for related causes, the sad reality is that within one year after having a stroke, 5 to 14 percent of patients end up having another stroke. And within five years following a stroke, 24 percent of women and 42 percent of men will have another stroke.
The American Stroke Association put together some stroke prevention plans and associated statistics that should get your attention. First, they recommend a similar diet to the one in the Prescription for Life plan—a diet low in saturated fat and in dairy products, such as cheese and whole milk, and high in fruits and vegetables. They also emphasize a normal body weight and exercise. All this sounds familiar because stroke prevention is the same as heart attack prevention. Both events are caused by the same process in your arteries—resulting in either blockage or hemorrhage. Physiologically, a stroke is just a heart attack in the brain.
Stroke is the fourth most common cause of death among Americans. Of individuals who survive a stroke, 20 percent remain in a hospital or nursing home or recovery institution for three months. Think about how depressing that can get. But this is the statistic that scares me. This is the one I tell anyone I know who has had a stroke. I tell them as a “moment” of thought to encourage them to do something to get rid of the dynamite.
Fifteen to 30 percent of people who survive a stroke become permanently disabled.
You don’t want to wait until you have a stroke to think about how lifestyle change is the major factor in preventing a stroke.
Science tells us that your actions rely on knowledge. You are much more likely to enact change in your lifestyle if you understand what happens in your body. I firmly believe that if you know what happens when you put bites of certain foods into your system, you will be much less likely to put that particular food into your mouth again. You won’t need a medical degree to understand this, but by the time you are finished with this book, I assure you that you will equate the condition of your arteries with the process of aging.
The Arterial Path through Your Body
Because the physiological aging process is the result of damage to the walls of your arteries, I want to take you on a short anatomical trip covering your major arteries so you will understand the impact of how you decide to live.
Let’s start with the heart. It is the most important of the organs because that is how physicians determine that someone is dead: the patient’s heart stops beating. When a doctor looks at an EKG monitor, he or she can see each beat of an active heart. But when there is a straight line across the screen, there is no cardiac activity. At that moment, the patient is pronounced dead. It’s not when the kidneys shut down, or when the intestines quit working, or when the liver backs up bile into the body. Death is determined when the heart quits beating. The amount of blood flowing through the arteries of that heart muscle is the most significant factor to the function of the heart.
The aorta is the main large artery coming out of the heart. The carotid arteries, feeding the brain, branch off just past the heart. The aorta then passes through the chest on down through the abdomen, dividing to enter each leg.
Whenever I hear someone talk about brain damage, I think of that gentleman in Alaska, the one I was hoping had only a partial blockage of his carotid arteries in his neck so it could be surgically corrected. Your carotid is about the size of your index finger. I have operated on them following a stroke or after discovering a partial blockage. In surgery, with the artery open, I have found all degrees of the aging process going on. When I cut it open to clean it out, there may be a soft plaque that feels like butter blocking 80 percent of the artery. It may have no calcium in it at all. Another patient may have a 95 percent blockage, and the process of the obstruction may have been going on so long that calcium has been laid down throughout the plaque. After I take it out and hold it in my fingers, it feels like bone.
You don’t have to be even half smart to realize that you want to do everything possible to prevent having anything like a piece of bone stuck inside the main source of blood supply to your brain.
As we look beyond the large carotid, we see thousands of smaller arteries within the brain. Visualize some of them beginning to block. Many times, the result is dementia. Think about the aging process going on in these smaller arteries the next time you forget where you left your car keys or can’t remember someone’s name.
Soon after the aorta enters the abdomen, the artery that feeds our small intestine comes directly off that main aorta. Just below it are the renal arteries, which supply the kidneys. The partial blockage of these is one of the causes of high blood pressure. Any organ that doesn’t get sufficient blood supply doesn’t function properly.
Moving lower in males, you come to the penile artery. The same process that causes blockage in the arteries of the heart causes blockage in the arteries supplying the penis. And just like that kidney, the penis does not function properly without good blood supply. Partial blockage of the penile artery is the most significant cause of erectile dysfunction. Recent studies in the medical literature show a correlation between erectile dysfunction and disease in the heart arteries. Some of these studies are showing that up to a fourth of the time, erectile dysfunction is a warning sign that there are blockages in the arteries of your heart.
Later in this book, there is an entire section on erectile dysfunction—preventing it, reversing it. But now I want to emphasize the possible connection between blocked arteries and this condition that is affecting so many men. It has to be a common problem if you can’t turn on the television without seeing an advertisement about it.
A research article published in the medical journal Circulation talks about the relationship between erectile dysfunction and heart disease in patients who have a high risk for heart disease. The title of the paper is “Erectile Dysfunction Predicts Cardiovascular Events in High-Risk Patients.” It addresses high-risk patients, but the lesson to be learned is this: if you do have erectile dysfunction, you need to be aware of the possibility that it is caused by a partial blockage of the penile artery. Blood flow tests can be performed to show significant blockage, but the main idea is to prevent it from ever happening by following the Prescription for Life plan. Such blockage can be a significant warning flag that the same blockage process may be going on in the arteries of your heart, which can be fatal.
This will be discussed in more detail later, but the main point you need to carry away from this discussion is the fact that if you have blockage of arteries in one area of your body, you most likely have it in multiple places throughout your body.
Let me give you an example of this “multiple artery problem.” At the age of eighty-seven, my father developed a little chest pain. He had never had any symptoms prior to that day. After he was examined, he had an emergency operation to bypass the blockage that had been forming in that artery in his heart for years. It was a successful procedure, but four years later he began having abdominal pain. A surgeon performed another emergency operation in his abdomen and found that the artery supplying his small intestine was completely blocked and his small bowel had died. All the surgeon could do was sew my father’s abdomen back together. That blockage of the main artery to his small intestine had been forming for years.
The partial blockage of the artery in his heart preceded the complete blockage of the artery to his intestines. The process was taking place throughout his body, not just with his heart. There were no symptoms warning him of what was happening.
Similar to how blockage of the artery to the kidney does not let the kidney function normally, and how blockage of the artery to the heart keeps the heart muscle from performing properly, and how blockage of the artery in the neck keeps the brain from functioning properly, the complete blockage of the artery leading to the small intestine caused my father’s intestines to turn necrotic and quit functioning. Nothing could be done to save the intestine, and my father died post-op. If he had known there were things he could have been doing to prevent blockage of his arteries, he would have done them.
If I had known the Prescription for Life plan back then, he would not have lived in a way that blocked the artery to his small intestine. I would have made sure he knew what to eat. I would have had him begin something I never saw him do—exercise. He wasn’t obese, but he was overweight. I would have encouraged him to get down to his ideal weight.
Yes, I wish I had known then what I know now.
The aging process that took my father is the aging process you are going to avoid by developing a new lifestyle to give you physical quality for the rest of your life.
The Drool Factor
Let’s take a minute to not talk about death. Let’s concentrate on one of the most important reasons for developing the Prescription for Life way of living. The problem usually begins several years before you die. It is a process of intellectual deterioration called dementia, and I want you to fully understand how to prevent what may be the worst problem of aging. I think it is worse than death, because suffering with dementia can last a long, terrible, devastating period of time.
Many underlying causes play a part in developing dementia, but a significant cause is a decrease in blood flow through arteries leading to and throughout the brain. Some people call its results the “drool factor.” Others call it the “sunset club syndrome.” To me, avoiding dementia is one of the major reasons to commit to the Prescription for Life plan. So many times, the aging process nears its end with a person’s body alive but their mind “gone.” I am sure you have elderly friends, or even parents, who have no idea who you are when you visit them. They can carry on a conversation about the past very exactly but have no idea about today. This is the prime example of what you want to avoid by developing a better lifestyle. Now is the moment of realization that you want quality years up to the end of your life, no matter when that may be.
Alzheimer’s is a form of dementia and a growing problem in America. In fact, it is now the sixth leading cause of death. If you categorize it by age group, in people over sixty-five it is the fifth leading cause of death. It causes more deaths than diabetes.
I have had individuals tell me, “I don’t really want to live to be ninety. I’ve seen too many people in nursing homes, sitting in chairs, staring. I don’t want to be one of them.”
No matter how old you live to be, you do not want those last years to end up with you not knowing what day it is, or where you are, or who in the world is talking to you. You don’t want to have any form of dementia, whether Alzheimer’s or arteriosclerotic dementia. You want to be like the seventy-five-year-old Italian jogger I met on the beach, who said, “I want to be active when I die.” We should all want the same—to still be both physically and mentally active when we die.
Alzheimer’s is a common disorder among the elderly. The good news is that it is found in only about 1 percent of individuals sixty to sixty-five years old. The bad news is that the percentage doubles every five years until Alzheimer’s is found in more than 40 percent of individuals over the age of eighty-five. Those are terrible odds. Here is an even worse statistic: Alzheimer’s currently is affecting over 5.6 million people in the United States and is expected to be triple that number before 2050.
When talking about maintaining the quality of your life, dementia is the huge brick wall. When people make plans for their later years, many will have to include stays in a nursing home or other means of care because their minds will not be functioning at their full potential.
However, dementia can be prevented. The Prescription for Life plan path is the one to take. There are two main subtypes of dementia: vascular dementia and Alzheimer’s disease. The vascular risks we have been discussing also apply to vascular dementia and even partially to Alzheimer’s disease. Look at it this way: when you block portions of the arteries in your brain, you are decreasing the blood flow through that vessel. If you’re drinking a glass of water through a straw and you crimp that straw, the flow of water diminishes. When you consider all the nutrients necessary to keeping the brain’s memory functioning properly, your brain tissue is going to falter if you block a significant portion of blood flow.
The bottom line is that arterial aging is a major cause of memory loss.
An article in the Journal of Nutrition, Health and Aging had lots of food for thought. It reviewed several studies, including the Rotterdam Study, in which almost eight thousand individuals fifty-five or older were followed. The overall results found an association between certain foods individuals ate and the incidence of dementia. It was found that total fat, saturated fat, and dietary cholesterol intake increased the risk of dementia, especially of vascular dementia. Another journal article pointed out similar findings, where there is a correlation between the amount of saturated fat consumed and the prevalence of Alzheimer’s disease among individuals over the age of sixty-five.
A third journal article emphasizes the significance of your LDL Cholesterol level. In this book, you will be learning how eating the wrong foods results in an elevation of the LDL and that this elevation is related to developing Alzheimer’s.
The study consisted of two groups of patients. One group had Alzheimer’s and the other group did not. The patients with Alzheimer’s disease had higher levels of LDL Cholesterol than patients who were in the non-Alzheimer’s control group. That result was mainly due to the bad foods eaten by the Alzheimer’s group versus the good foods eaten by the non-Alzheimer’s group.
The Prescription for Life plan will result in your not only living longer but also living with a better quality of life, decreasing your worry about the “drool factor.”
But first, let’s learn more about cholesterol.