Several years ago I bought a new four-wheel drive Audi, which gets me through the snow in the wintertime. Six months later, I was driving along the Blue Ridge Parkway when a red light came on. It said “check engine.” I immediately pulled over and got the owner’s manual out of the glove compartment. Page 47 stated that I should not drive the car for a prolonged period of time but should have it checked at the dealership as soon as possible.
I immediately took it in, and they drained the “new engine oil” and replaced it with the standard kind. I thought I had been doing everything I was supposed to do, but I had not realized at what mileage I was supposed to have the initial oil changed.
Your cholesterol numbers are like warning lights for your body. You need to learn what it means when they are on and flashing.
Cholesterol is a fatty substance that exists in the outer layer of every cell in your body, maintaining each cell’s membrane. It is involved in the production of sex hormones, as well as hormones released by your adrenal glands. It insulates nerve fibers. It is significant in the metabolism of certain vitamins, including A, D, and E. It is essential to your body. Cholesterol is carried through the bloodstream combined with a protein. The structure of the cholesterol with the protein is a molecule called a lipoprotein. There are two main types of lipoproteins, both of which you will recognize on your lab report as Low Density Lipoprotein and High Density Lipoprotein, or LDL and HDL.
You may think you are doing everything possible to keep your engine running like the owner’s manual instructs. You may be eating free-range meat and everything organic. You may take vitamins or all kinds of supplements. You may take an aspirin a day because you heard it can keep you from having a heart attack. You may be doing all you know to do, but you don’t know from a medical standpoint that some of the things you routinely eat every day may be harming you a thousand times more than all of the “supplemental medicines” you are taking. As a medical fact, some of your favorite foods may be the ones causing the most damage.
The probability is that your check engine light—in the form of your cholesterol levels—is on and flashing, and like most Americans you haven’t noticed, or if you have, you haven’t done much about it. So many take great care of their car but not of their body.
Stepping aside from specifics about cholesterol for a moment, I want to say that this plan teaches you not to wait for the red light to go on. The Prescription for Life plan is not about treatment; it is about prevention.
Let me tell you a little secret—why you don’t want to wait on symptoms before beginning to do something about protecting your arteries. I say it’s a secret, because hardly anyone talks about it though it comes out of the medical literature. Eighty-five percent of everyone over the age of fifty has some significant blockage in the arteries of their heart, without experiencing any symptoms.
That is a scary statement. They haven’t had the first pain in their chest. They haven’t had any undue shortness of breath. They haven’t experienced any pain shooting down their left arm. That report is saying that most individuals over fifty have significant blockages in their coronary arteries yet don’t even know it because there are no symptomatic red lights warning them.
Two-thirds of the time, the first symptom of artery blockage is a heart attack. There are no bells or whistles before it happens. People are going along routinely, and then they have a heart attack.
And that first attack can be fatal. Now, that’s bad enough, but what if you do wait until you have that first symptom, that first attack? What are your chances then? Even if you survive your first heart attack, you are six times more likely to have another one than someone who has never had such an attack.
Don’t wait until you have symptoms from the blockage of your arteries. Begin working right now on preventing the cause of the aging of your arteries. And even if you have a first attack, a second attack is preventable and you can learn how to avoid it.
Aging of the arteries starts at a much younger age than most people think. By the age of twelve, 70 percent of children have microscopic fatty deposits in their arteries. Studies of twenty-five-year-old individuals who were killed in battle or died in traffic accidents show that up to 60 percent of them already had some visual evidence that this process was taking place in their arteries.
Abnormal cholesterol numbers are great warning lights, better than attacks. Get your physician to order your blood lipids and learn what each means. Get your owner’s manual out and see how your numbers line up to keep your motor running for hundreds of thousands more miles.
Understanding Your Blood Lipid Report
When your physician gives you your lipid profile results, you will see your Total Cholesterol, LDL Cholesterol, HDL Cholesterol, HDL/Total Cholesterol ratio, and triglyceride results. Your doctor will probably tell you that your Total Cholesterol should be below 200, that your LDL Cholesterol should be below 100, and that your HDL Cholesterol should be above 40 if you are male and above 50 if you are female. Your HDL/Total Cholesterol ratio should be below 3.5, and your doctor will probably tell you your triglycerides should be below 150.
Triglyceride molecules start out combined with proteins and break away from them, resulting in your triglyceride number on that report. Triglycerides represent the fat in your body. They are either made in the body or eaten as fat in your food. Calories that are eaten but not used are converted into triglycerides and stored in fat cells. When your body needs energy and there is no food source, triglycerides are released from those fat cells and used for energy. We will not concentrate so much on the triglycerides, because if you do what the Prescription for Life plan says to do, your triglycerides will come down to normal as your cholesterol numbers are corrected.
Total Cholesterol
Both good (HDL) and bad (LDL) cholesterol particles are floating around in your blood. You get cholesterol primarily from two places: your liver produces it and you eat it in certain foods. The liver produces all the cholesterol you need for your body to function. The excess comes from the wrong foods you eat.
When people talk about their “cholesterol” number, they’re usually referring to what’s called Total Cholesterol. When you think of Total Cholesterol, think of adding the LDL and HDL together. You will realize the two don’t quite add up to the total number, but that is because additional particles are not listed.
Let’s see what the medical literature has to say about the significance of your Total Cholesterol number. A report in the Journal of the American Medical Association studied the life expectancy of younger men who had a favorable Total Cholesterol level compared to men of the same age who had a significantly unfavorable Total Cholesterol level. The study concluded that the men who had the favorable, lower level of Total Cholesterol had a life expectancy of 3.8 to 8.7 years longer than the ones with the unfavorable, higher level of Total Cholesterol. There was a continuous, proportional relationship between the amount of Total Cholesterol and the life expectancy difference.
Those figures alone give you a huge insight into the importance of controlling what you are doing to your body. High Total Cholesterol spells danger for you. Remember 3.8 to 8.7 years the next time you think about your cholesterol report.
The next step in understanding your numbers is to realize that the Total Cholesterol is the sum of a whole lot of “bad” cholesterol as well as a small amount of “good” cholesterol. When your Total Cholesterol number is high, the biggest number is the “bad” kind of cholesterol. There are not as many of the “good” HDL particles, but they are much more powerful than the “bad” LDL particles. A little increase of the “good” is as important as a larger decrease of the “bad.”
Understanding the significance of your Total Cholesterol, LDL Cholesterol, and HDL Cholesterol numbers enables you to understand what each cholesterol particle is doing to your body physiologically. Then you’ll want to begin learning which foods cause the aging process and which ones protect against it. And once you understand what foods elevate your “lethal” LDL Cholesterol and what foods lower your “hero” HDL Cholesterol, getting the cholesterol numbers you need becomes almost too easy because you realize why you shouldn’t be eating certain foods. It is almost like cheating.
The numbers you will shoot for with the Prescription for Life plan will be a Total Cholesterol of 200, LDL Cholesterol of 100, and an HDL/Total Cholesterol ratio of less than 3.5. However, you’re not just shooting for a number; you’re shooting for the kind of lifestyle that gets you to that number. Merely taking a pill is not the answer. It is not the same as getting your Total Cholesterol to 200 by eating properly, developing an ideal weight, and exercising routinely. There are no shortcuts in beating the aging process. A pill should be a supplement, not a treatment.
LDL Cholesterol
LDL stands for Low Density Lipoprotein Cholesterol. Think of the L as standing for “lethal,” because it is. LDL is the bad cholesterol. If LDL levels get too high, bad cholesterol gets into the walls of your arteries, and the aging process accelerates. The resulting danger is the inflammation and narrowing of arteries throughout your body.
Years of medical research show a causative link between high cholesterol and heart disease. The term “high cholesterol” actually refers to high LDL Cholesterol, because those are the cholesterol particles that make up most of your total cholesterol number. Back in 1985, the National Heart, Lung, and Blood Institute made the direct correlation between high blood cholesterol and heart attacks. They published the National Cholesterol Education Program to point out the danger of LDL Cholesterol and to show that reducing your LDL Cholesterol reduces your risk for blockage of your arteries, with a corresponding reduction of heart attacks. That was a good basis in 1985 for progressing to what we know today.
THE SPLINTER SYNDROME
Getting a splinter in your finger is the best illustration to show what happens when LDL Cholesterol gets into the walls of your arteries. I call the reactive process that takes place the Splinter Syndrome. The skin where the splinter is embedded begins to swell and turn red. The surrounding tissue considers that splinter a “foreign body,” and if the splinter does not come out, your body’s natural response is to develop a wall of scarring tissue around it.
The initial swelling around the splinter is the result of the body pouring fluid into the area. The fluid is filled with soldier-type cells, called macrophages, that attack the splinter. Many times there is even bleeding into this swollen battlefield. The finger turns red and more swollen. Finally, one of two things happens. The resulting inflammation can be so fierce that it swells and the fluid breaks through the skin and drains out. An example of this is a boil that ruptures and drains from the battleground tissue to the outside. Or, after the battle against the foreign body splinter reaches its height, healing begins to take place. The body sends cells called fibroblasts that begin to lay down fibers that join together to form a healing scar throughout the battlefield.
This scar tissue is not the normal kind of tissue that was once there. Scar tissue is firmer and harder and is not pliable. You can palpate the thickened, hardened area of scar tissue forming just under the skin’s surface. And that scar remains—fixed, thickened, firm, hard, and swollen. And if another splinter enters the skin at that same area, another battle takes place, and the resulting scar area gets larger and larger. After repeated battles, calcium can become a part of the healing, and the plaque buildup is even firmer and harder.
LDL CHOLESTEROL IS THE SPLINTER
A similar process is happening in the walls of your arteries. LDL Cholesterol is the splinter that gets through the lining of the artery and into the media, the middle portion of the arterial wall. However, there is a difference between getting a splinter stuck in your finger and getting an LDL Cholesterol splinter stuck in the wall of your artery.
If you stick your hand into the middle of a thornbush and get stuck, you won’t stick it in again because you felt the pain of the prick. The problem with the LDL Cholesterol Splinter Syndrome is that you don’t feel the splinters going into your arteries. These splinters get through the lining wall of your arteries and cause the battle to begin. The battleground you visualize within the tissue of your finger is very similar to the battleground within the middle part of the wall of your artery. And similar to the reaction to the splinter in your finger is the reaction that begins within the wall of your artery. The area can become so inflamed that there is bleeding with the inflammatory reaction, and it can rupture through the lining into the lumen of the artery. A clot forms and plugs the entire artery at that point.
Or the arterial wall can stay intact and the splinter battleground ends in a healing process. But the scars of battle remain. The enlarged scar formation protrudes into the lumen of the artery, and the result is a partial blockage of the flow of blood through that area (like crimping a straw). This is what is commonly referred to as plaque buildup. The next time an LDL Cholesterol splinter gets stuck in the same area, the process repeats itself. The secondary battleground either pops open and causes a clot to form inside the artery, or it can heal again and bulge even more into the inside of the artery. The result is more plaque buildup. This secondary plaque protrudes even farther into the lumen of the artery, causing the flow of blood to be even less to the heart muscle downstream.
Your only real protection is to keep the LDL Cholesterol splinters from getting into your bloodstream, and the best defense is avoiding three types of food. The first and major cause of LDL Cholesterol elevation is saturated fat. The foods we eat in America are full of saturated fat. It is found in red meat and cheese and other dairy products, as well as in pies, pastries, cakes—and in many more foods as well. The second cause of raised LDL Cholesterol is called trans fat, which is found mainly in pastries and cakes and wrapped foods that need a long shelf life. Trans fat is so bad that the government has recently outlawed it. The third is dietary cholesterol, which you find in foods such as egg yolks and butter.
It is imperative to keep your LDL Cholesterol low. But how you get there is more important than just getting the numbers down. You can be fooled if you’re only looking at the numbers. Taking medication alone, without lifestyle changes, isn’t a guarantee that you are doing all you can to protect your arteries. You should work on your LDL score as you would your golf score—the lower the better.
With the Prescription for Life plan, you learn which foods you commonly eat that contain saturated fat, trans fat, and dietary cholesterol. You are going to implant a picture of these “foods to avoid” deep within your mind. As a matter of fact, you will be able to recite them from memory before long.
HDL Cholesterol
The other side of the coin from the lethal LDL Cholesterol is the HDL Cholesterol. It is called the High Density Lipoprotein Cholesterol. Think of the H as standing for “hero” or “healthy.” This is the good cholesterol you will be attempting to get as high as possible. It actually fights the lethal LDL Cholesterol. The tricky part is that, proportionally, you always have a lot more LDL Cholesterol particles than HDL Cholesterol particles. Think of football or baseball scores when thinking HDL. The higher the better.
It doesn’t seem quite fair to men, but women tend to have more HDL than men. If a man’s HDL is below 40 and a woman’s is below 50, it’s a definite red flag that must be addressed. Having such low HDL numbers is medically similar to being obese, to smoking, or to having diabetes or high blood pressure.
Exercise and weight loss are the two most important factors that affect your HDL Cholesterol. While you concentrate on the idea that certain foods raise your LDL Cholesterol, begin thinking of exercising and weight loss for getting your HDL higher.
HDL Cholesterol protects you by battling the LDL Cholesterol. Here is an easy way to visualize how it works. Think of an HDL Cholesterol particle as a police car that floats through the bloodstream, looking for LDL Cholesterol criminals. Imagine the HDL Cholesterol police car pulling up to an area where LDL Cholesterol “splinters” are getting into the wall of an artery. The HDL police car picks up several splinters and carries them to the liver and deposits them there to be disposed of. The liver takes the LDL Cholesterol particles and passes them out of the body in the bile. While the liver is working to place this excess LDL Cholesterol into the process of forming bile, the High Density Lipoprotein “police car” particle is on its way back to the arteries, where it picks up some more LDL Cholesterol to transport back to the liver.
You want as many HDL Cholesterol “police cars” as you can have. You will learn later how exercise and weight loss get as many HDL Cholesterol particles into your bloodstream as possible.
HDL/Total Cholesterol Ratio
Imagine a gang of hoodlums rioting, turning over cars, breaking store windows, stealing, fighting, and harming innocent citizens. How many police officers would you want to send in to pick up as many of the hoodlums as possible? Obviously, the more police officers you have per hoodlum the better. At the very least, you would want a certain minimum ratio of police officers per hoodlum to be safe.
That same logic applies to your HDL/Total Cholesterol ratio. Even more important than knowing your Total Cholesterol number or your single LDL Cholesterol number is looking at how much “hero” HDL Cholesterol you have in comparison to your Total Cholesterol. The higher your number of HDL particles within your Total Cholesterol number, the more police cars in proportion to fewer splinters.
This ratio is significant because it combines the interworking of both LDL and HDL Cholesterol. The lower your LDL and the higher your HDL, the better that ratio number will be. You figure your HDL/Total Cholesterol ratio by dividing your Total Cholesterol number by your HDL Cholesterol number. The Prescription for Life plan uses 3.5 as the cut-off number. You want your ratio to be below 3.5. The importance of a low ratio number is backed up by multiple studies in medical literature. They show that eating foods high in saturated fat, trans fat, and dietary cholesterol has a negative effect on that ratio, while exercise and weight loss have a positive effect.
The significance of knowing your HDL/Total Cholesterol ratio is that you have two avenues to improve it.
The Three Good Fats
The bad fats are saturated fat, trans fat, and dietary cholesterol. Three good fats improve your HDL/Total Cholesterol ratio. These are monounsaturated fat, polyunsaturated fat, and omega-3 fat.
The best examples of foods that contain these good fats are olives, nuts, and fish. Even though such foods contain some saturated fat, the “good threes” outweigh the danger and actually protect your arteries.
You will notice this if you look at the Nutrition Facts box on a regular peanut butter jar. You will see 2.5 grams of saturated fat. That is way over the zero target and 0.5 absolute limit you will learn about later. However, you will see Total Fat at 16 grams, and the vast majority of that is from the “good threes” fat category. These help raise your HDL and overall protection.
John
He was friendly as can be, and everybody liked to be around him. He had no history of heart disease in his family, and he was on no medication. But John was forty pounds overweight with a high Total Cholesterol count, and he was a true couch potato.
It was a blustery January evening, one so cold you wouldn’t want to take a single step outside if you didn’t have to. On the coffee table by the sofa where he was lounging were several empty wrappers from cheese crackers, two chocolate candy bars, and half a bowl of multicolored candies, which he was eating only two at a time.
John felt a little pain in his chest and mentioned it to his wife. She didn’t think much about it, and they both kept watching television. About thirty minutes later, it hit him again. He abruptly got up from the sofa and quite sternly informed her he was going to the ER. She ran to get her coat out of the bedroom closet, but by the time she got back to the front hall he was driving out the driveway through the snow without her. The pain had suddenly become so severe that he was afraid he was going to die on the spot. He didn’t even take time to get his coat. All he could think of was getting to the hospital before he passed out.
As John was briskly walking up to the admitting clerk at the ER, he suddenly fell, unconscious. They immediately put him on a stretcher, shocked his heart, and pumped medication into his veins. Within hours, a stent was placed in his blocked left coronary artery. If he had left home two minutes later, he would have died in his car on the way to the hospital. But John was a survivor.
At least for the time being.
His doctor informed him his cholesterol was elevated and handed him a booklet about what his diet should be. She told him to lose some weight and that it would be good if he started exercising. John listened to the advice, but all he could think about was his pilot’s license. He flew a small bush plane for Alaskan hunters for his livelihood, and his biggest concern was how to keep his business going. The question in his mind was whether he was going to lose his license because of his heart attack.
It never occurred to John that the disease that caused his near-death event was a continuing process. It never occurred to him that the food he had been putting into his stomach was the cause of his heart attack. He didn’t realize that even though he had one heart artery blocked off, he had multiple additional heart arteries that could also be blocked purely because of his lifestyle of poor eating, no exercising, and being overweight.
Most of all, he didn’t realize that, beginning right then, he could do something to prevent another heart attack—one that could prove fatal.
John’s doctor never stressed the three factors that could stop the deadly process going on in his body—getting thin, getting his LDL Cholesterol below 100, and exercising.
He was given a pamphlet.
Informed—so to speak.
The rest was up to him.
No one told John what a report of the American College of Cardiology/American Heart Association Task Force of Practice Guidelines stated. If he read one of the key statements in the article, he would change his thinking—because it spoke specifically about first heart attacks like his. It said that after having a first heart attack at age forty or older, 23 percent of women and 18 percent of men die within one year and that those death rates jump up—43 percent of women and 33 percent of men will expire within five years because of that initial heart attack.
John just didn’t know. It wasn’t real to him that what blocked one artery would continue to block others in his body unless he did something to halt the process in its tracks.
I saw John several months after his event. “What do you think I ought to be doing?” he asked me, “because I sure don’t want to go through that again. You know how a lot of people who have gone through a near-death experience tell how they saw a light? You know, a light of heaven? Well, I didn’t see a light.” He said it scared him nearly to death going into that emergency room and blacking out. I spent over an hour informing him what he should be doing to prevent further disease to the other arteries in his heart.
As I talked to him, he was attentive, asked a lot of questions, made some notes, and thanked me for my concern about him, not only as a doctor but also as a friend. But within an hour, he was eating some of the exact foods I had just explained would plug his heart arteries again. Will he make it after a second attack? I don’t know, but it doesn’t seem to concern him all that much. At least, it doesn’t concern him enough to change his lifestyle right now.
Eric
Eric was thirty-eight years old and a college football coach. He had been a star quarterback himself and was as dedicated a young man as you can find. He had an extremely nice wife and two little children. His team had recently won a national championship, which was great to have accomplished, but that made a workaholic out of all the coaches in preparation for next season.
Eric’s father had died of a heart attack at age fifty-eight, but no one else in his family had any history of heart disease. Eric was trim, in shape, and ran five miles almost every day. Even during football season, he and three of the other coaches used their lunchtime for a run. If you looked at him and knew how active he was, you thought he was in the best physical condition possible.
Eric’s blood pressure was normal, he ate the usual foods, and he had zero concern, health-wise. Zero concern, that is, until he happened to get a blood test at the college infirmary. And the only reason he did that was because one of the coaches he ran with decided all four of them should stop there to get blood work done free of charge.
That was when Eric came to me with his results: Total Cholesterol—262, LDL Cholesterol—178, and HDL Cholesterol—71.
The school doctor informed him it was essential to get his cholesterol down, and if he could not do it with a change in lifestyle, he would have to start on medication. His doctor explained that because of his family history, he was a prime candidate for a heart attack.
Eric was obviously shaken. He was thinking mostly about his young daughters, his wife, and his dad dying so young. He couldn’t believe it. He was in great shape, a jogger, and not an ounce overweight. He had never thought about having a health problem.
John and Eric are typical of so many Americans. But let’s look at how each of them handled his situation, and you will see the secret to changing your own life for the better. It’s a great secret to learn.
“I will do anything to keep from having a heart attack like my father had,” Eric, the football coach, said. “I want to be around for my wife and children.” He looked at me as earnestly as I have ever seen any patient look. “I will set any goal, do whatever it takes to keep from dying early in life.”
Eric saw his problem and committed to do something about it. I explained that he definitely had to get his LDL Cholesterol down. That would lower his Total Cholesterol also. With the history of his father dying from a heart attack and his cholesterol so extremely elevated, he needed to look at his situation as urgent. He would have to go extreme on his new eating strategy or begin medication now.
He decided to begin the Prescription for Life plan for an eight-week trial and then decide about his medication. We went over what foods he should eat and which ones to avoid. We added some specifics to his exercise with plans to get his heart rate elevated and sustained for thirty minutes at a time, and we planned to wait two months to repeat his lipid studies.
Eric became near fanatical about his eating habits. The other coaches told me they couldn’t get him to eat a single French fry, and fries had been one of his favorite foods. He wouldn’t get near cheese and avoided red meat like it was a poison. He ate a lot of fruit, loads of vegetables, and salads.
At the end of two months, the school doctor called me with Eric’s lipid profile. His LDL was 98 and all of his cholesterol numbers and ratio were completely normal.
I believed Eric when he said he was committed to his new lifestyle—for the rest of his life. He never had to start on the medication, which, again, he would have had to take for the rest of his life. He will never have to be concerned with the possible side effects of that medicine as the years pass. He is in control. With such a good report in hand, I called the football field house and asked to speak with Eric. He couldn’t come to the phone right then; he was exercising.
One year later, John is still forty pounds overweight, with a high Total Cholesterol count. His LDL is high and his HDL is low. He remains as friendly as can be. Everybody likes to be around him. He still keeps a bowl of candy on the table beside his sofa. He still eats only two pieces at a time. I wish he realized he could be around a lot longer—if he weren’t still a true couch potato.
I kept asking myself why there are Erics and why there are Johns. And was there anything more I could do to instruct people like Eric and help people like John. Looking back on my surgical career, I saw the countless individual lives I had the privilege to make better, prolong, or save. And it is comforting to realize the number of people I helped. But I also realized I could help a hundred- or thousandfold more by simply figuring out a plan that would reach both the Erics and the Johns. I came to understand that a big part of why my friends and patients did not take proper care of their bodies is simply because they did not fully comprehend what was going on inside their bodies. They didn’t have the knowledge to see what their future health was going to be.
People have a difficult time correlating what they are eating with how that one specific bite of food is affecting the arteries in different parts of their bodies. They don’t grasp the significance of being twenty pounds overweight or two hundred pounds overweight. They don’t know the importance of exercise in their overall lifestyle. They seem to accept their aging process but do not understand that they have a huge opportunity to control that aging.
John and Eric each put a different “face” on the need. They both need to know the proper plan. And, again, that is why the Prescription for Life plan was conceived. I want to save lives. I want to be able to help you remain healthy and live younger than you are today.
Do you recall the numbers given by the American Heart Association? Within five years after having their first heart attack, 43 percent of women and 33 percent of men will expire. That is unless they do something about their lifestyle. These are people who, for years, had no idea there was a significant blockage problem going on in their arteries. They never acknowledged they needed to change their lifestyle to protect their health. They were scared when they had their first attack. But it’s even scarier when you realize that almost one out of five men who have that first attack will be dead within a year. What is sad is that their attacks could have been prevented—not only the first attack but the second as well.
The statistics are clear: the odds that you have blockages going on in the arteries throughout your body are overwhelming.
Here are some statistics you want to know:
Don’t be a gambler. Don’t even play against the odds. The old saying is, if you’re going to be stupid, you’ve got to be tough. I encourage you to not try to be tough when dealing with the aging process. Don’t wait on symptoms before deciding to do something smart. And even more important, if you do develop symptoms of an impending heart attack or stroke, and they subside, by all means realize that those symptoms are a flashing red warning light signaling what’s going on in your body.
Your goal should be never to have that warning light come on. Your goal should be the prevention of any further plaque buildup in your arteries, from this day forth. Halt the process in its tracks now. Prevent your arteries from becoming any older than they are today, and keep them there.
Some things happen to your body that cannot be changed. However, the great majority of what causes the aging process is preventable. Focus on what you can change that will allow you to live longer and younger.