Category Archives for Clinical Excellence

Mature man and woman, smiling, running across a bridge

How to Lower Cholesterol Levels With These Easy Lifestyle Changes

While cholesterol is produced naturally in the body by the liver, having too much of it can put your health at risk. High levels of low-density lipoprotein, also known as LDL or “bad” cholesterol, can accumulate within the artery walls, increasing risk for heart disease, the leading cause of death in the U.S. [1], as well as stroke.

National standards suggest that levels between 130 and to 159 milligrams per deciliter (mg/dL) are considered borderline, and 160 and above qualify as high cholesterol.[2] Cenegenics, however, looks to achieve more optimal ranges to reduce disease risk and in many cases, aims for LDL levels near 100 or 120 mg/dL. 

How to Lower Cholesterol Levels 


Although medications are available to treat especially high cholesterol, there are many effective lifestyle changes you can make to bring your levels into a healthy range. Discover some of the most effective strategies below.

What Does a Cholesterol-Healthy Diet Look Like?

In general, the eating habits that support healthy cholesterol levels are also in line with dietary patterns that support long-term weight management and overall health. Specifically, here are a few items to incorporate into your diet to manage your cholesterol:

Four green olives next to a small glass bowl with olive oil being poured into it
  • Foods high in soluble fiber: Soluble fiber controls the amount of cholesterol your bloodstream absorbs. Fiber also helps you stay full, which can prevent you from snacking on nutritionally poor foods in between meals. While Cenegenics commonly suggests higher amounts, eating as little as 5 to 10 more grams of fiber per day can lower LDL cholesterol by 5 to 11 points on average, or possibly more. [3] Foods rich in soluble fiber include:
    • Whole grains, such as oat meal, barley, and quinoa
    • Lean protein, such as beans
    • Healthy fats, including avocado and chia seeds
    • Vegetables, such as cabbage, carrots, onions, broccoli, and Brussels sprouts
    • Starchy vegetables, including green peas and sweet potatoes
    • Fruits, such as apples, bananas, peaches, and pears
brown basket on rustic wooden table with raw vegetables: red beets, turnips, tomatoes, spinach, yellow pepper
  • Polyunsaturated & monounsaturated fats: These fatty acids help lower LDL. Many plant-based oils are rich in these fats, including olive, avocado, and sunflower oil. In fact, swapping your low-cost butter out for olive oil can reduce your LDL cholesterol by as much as 15%, which is as effective as some low doses of cholesterol-lowering medications. [4] Fatty fish, including tuna, salmon, and mackerel, are also good sources of these key nutrients, as are nuts and seeds.
  • Whey protein: Commonly found in dairy products, whey protein can lower total and LDL cholesterol, as well as blood pressure. [5] Cheese, yogurt, and cow and goat milk contain whey protein.

Which Foods Should Be Avoided?

junk food including soda pop, French fries, hamburger, donut, candy, cookies, chips

While including cholesterol-lowering foods in your diet can help you achieve measurable differences in your levels, it’s important not to undo your progress with foods that can raise LDL cholesterol. In specific, steer clear of trans fats.

Although there has been pressure on the food industry to phase out these dangerous additives, they may still appear in food products and could be described as “partially hydrogenated” in the ingredients list. Specifically, look out for them in:

  • Cakes
  • Pie crusts
  • Stick margarines
  • Frozen pizza
  • Cookies

Staying away from fried foods, baked goods, refined sugars and grains, and other heavily-processed foods is also essential to keeping cholesterol in a healthy range.

Will Exercising Help?

Three men with helmets on, smiling, riding 10-speed bicycles outside on a sunny day

While it’s impossible to compensate for a poor diet with exercise, regular physical activity could improve cholesterol by raising high-density lipoprotein, or the “good” cholesterol. [6] Ideally, you should aim for 30 minutes of moderate exercise on most, if not all, days of the week – with your doctor’s approval, of course.

Incorporating physical activity into your daily routine can also help you achieve long-term weight management, which supports healthy cholesterol levels as well. Here are some types of physical activity to consider:

  • Cycling, indoors or outdoors
  • Taking a brisk walk each day
  • Swimming

Are There Any Other Lifestyle Changes to Consider?


A woman seen from behind in black exercise clothes doing yoga next to a lake on a sunny day

In addition to diet and exercise guidelines above, here are a few more things you can do to lower your cholesterol levels:good HDL cholesterol​HDL cholesterol​​​

  • Minimize stress: Managing stress can be easier said than done, but it’s important to a number of health outcomes, including lowered cholesterol. Research shows chronic stress is associated with high LDL cholesterol and lower HDL cholesterol, so aim to manage your stress with calming techniques such as journaling, yoga, meditation, regular massage, or any other healthy tactics you prefer. [7]
  • Quit smoking: Smoking cessation can improve your HDL levels. Plus, within one year of quitting, your risk of heart disease is slashed in half. [8]
  • Reduce alcohol intake: Moderate alcohol intake has been shown to help boost good HDL cholesterol, but excessive drinking is associated with high blood pressure and stroke, among other serious health issues. If you drink, limit it to one glass a day, and if you don’t, continue to abstain – the benefits aren’t strong enough to support a defense for alcohol for people who don’t drink already.

It’s Easier Than You Think! – In Conclusion


Discovering you have high cholesterol may be alarming, especially when you consider the implications of allowing it to go unaddressed. Luckily, though, there are plenty of ways to control your cholesterol levels, many of which have added health benefits.

Eating a heart-healthy diet and exercising regularly, for instance, can also help you achieve long-term weight management. Reducing stress, reducing your alcohol intake, and quitting smoking are likewise beneficial for your cholesterol levels and overall health.

Although embarking on any new health goal can be daunting, the team from Cenegenics can help. Our trained clinical staff works with each patient to set specific goals based on their individual biomarkers.

Over time, they can help you reach and maintain optimal cholesterol levels, while also working towards any other short- and long-term health objectives you may have.

Next Steps to Lowering Your Cholesterol Levels

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

About the Contributor

Rudy Inaba 
Global Director of Nutrition & Exercise

Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

References

[1] CDC, “High Cholesterol Facts.” 6 Feb. 2019. Retrieved from URL: https://www.cdc.gov/cholesterol/facts.htm 

[2] Cleveland Clinic, “Cholesterol Numbers: What Do They Mean.” 26 July 2017. Retrieved from URL: https://my.clevelandclinic.org/health/articles/11920-cholesterol-numbers-what-do-they-mean

[3] National lipid Association, “Adding Soluble Fiber to Lower Your Cholesterol.” Retrieved from URL: https://www.lipid.org/sites/default/files/adding_soluble_fiber_final_0.pdf

[4] Ratini, Melinda, DO, MS. “Lower Your Cholesterol With These 11 Easy Tips.” WebMD. 12 Nov. 2015. Retrieved from URL: https://www.webmd.com/ahrq/11-tips-to-cut-your-cholesterol-fast#1

[5] Mayo Clinic, “Top 5 lifestyle changes to improve your cholesterol.” 11 Aug. 2018. Retrieved from URL: https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/reduce-cholesterol/art-20045935

[6] Mayo Clinic; see above.

[7] NIH, “How to Lower Cholesterol.” 27 Feb. 2019. Retrieved from URL: https://medlineplus.gov/howtolowercholesterol.html

[8] Mayo Clinic; see above.

“Cholesterol” written on art pad with stethoscope and magnifying glass nearby

HDL Cholesterol | Everything You Need to Know

When it comes to cholesterol, the “bad” kind, or low-density lipoprotein (“LDL”) cholesterol, tends to get most of the attention. And, it makes sense – after all, high LDL cholesterol can lead to a number of serious health issues, including an elevated risk for heart attack and stroke.Yet, the “good” cholesterol, or high-density lipoprotein (“HDL”) is also an important measure of heart health.

Find out what you should know about the causes, optimal levels, and methods for achieving optimal HDL cholesterol below.  

What Is HDL Cholesterol?


Computer keyboard with green HDL Cholesterol button

Cholesterol is a waxy protein found in all of the cells. It has many important functions, including the ability to build the body’s cells, and plays a crucial role in the development of hormones and vitamin D.

LDL or “bad” cholesterol can eventually accumulate within blood vessel walls, and narrow passageways, potentially leading to a clot which can cause heart attack or stroke. HDL cholesterol, on the other hand, eliminates excess cholesterol in the blood by picking it up and transporting it back to the liver. There, the excess cholesterol is broken down and removed from the body.

People with higher levels of HDL cholesterol have a lower risk of heart attack and stroke. [1] Having high HDL can have anti-inflammatory and antioxidant effects. [2] Yet, because elevated LDL levels are known to pose a risk for serious health issues, doctors will often focus on LDL levels first. With that said, there is significant overlap among lifestyle recommendations for lowering LDL cholesterol and raising HDL cholesterol. 

Optimal HDL cholesterol levels vary by age and sex. In general, the recommendations for healthy HDL levels are as follows:

  • Ages 19 or younger: >45 mg/dl
  • Men age 20 or older: >40 mg/dl
  • Women age 20 or older: >50 mg/dl [3]

What Causes Low HDL Cholesterol?


Junk food on one side, chips, candy, burger and fries, and healthy food on the other, tomatoes, lettuce, grapes, apple.

There are a number of factors which can affect HDL levels. Some of these factors are within your control to address, while others are not. Here are some of the most common causes behind low HDL:

  • Uncontrolled diabetes: Too much glucose in the blood, a common characteristic of diabetes, can lower your HDL levels, while also increasing LDL and triglyceride levels. Lifestyle modifications and medications can help people with diabetes control their blood sugar levels.
  • Inactivity: A sedentary lifestyle could contribute to low HDL levels, along with many other health issues.
  • Poor diet: There are many foods which can affect cholesterol levels. Processed foods prepared with shortening, including cakes and cookies, as well as fried foods, often contain trans fats. These harmful substances can reduce your good cholesterol and raise bad cholesterol levels.
  • Being overweight: In addition to diet and physical activity, being overweight in itself can also impact HDL. Low HDL levels could be caused by carrying excess weight, especially if it’s concentrated to the waist area. [4]
  • Smoking: Smoking and secondhand smoke can cause HDL levels to drop. [5]
  • Certain medications: Blood pressure medications such as beta blockers, certain anabolic steroids and progestins, and benzodiazepines (sedatives used to treat anxiety and insomnia) could lower HDL levels in certain individuals. [6]
  • Genetic factors: In some cases, extremely low HDL levels could be passed down by family members. In specific, significantly low HDL levels may be attributed to Tangier’s disease and hypoalphalipoproteinemia.

How Can You Raise Your HDL Cholesterol?


Muscular middle-aged man in blue tank in kitchen cutting up a chicken breast

While there are medications available to help individuals control their cholesterol levels when clinically indicated, there are also many lifestyle habits you can adopt to raise your HDL levels. Here are some of the most impactful changes you can make to boost your HDL:

  • Following a Healthy Diet: While eliminating processed foods containing trans fats is a good place to start, people with low HDL cholesterol can also benefit from eating a rich blend of vegetables, fruits, and lean protein. In addition to controlling cholesterol, this eating style can also help to address high blood pressure and reducing the risk of heart disease. Eliminating foods with added sugars is another dietary habit to adopt for better overall health. [7]
  • Increasing Activity Levels: Regular exercise is an important way to increase HDL levels. In fact, you may witness benefits with just 60 minutes a week of moderate-intensity aerobic exercise. [8] Because each individual’s physical fitness needs can vary, however, it’s a good idea to consult with a professional to develop an exercise plan tailored to your needs and heath goals.
  • Losing Weight: Exercising regularly and eating well will help you control your cholesterol, with the added benefit of allowing you to enjoy a healthy weight over the long term. And, because a higher waist circumference is associated with lower HDL levels, controlling your weight is important to keeping cholesterol levels in check.
  • Quitting Smoking: If you smoke, develop a plan to quit. In addition to reducing good cholesterol, especially in women, smoking can also cause triglycerides and LDL levels to spike. [9]
  • Controlling Alcohol Consumption: Up to one drink a day for women and two drinks a day for men 65 and younger has been linked to higher HDL levels, so if you normally drink more than this, be sure to limit your consumption. Excess alcohol could lead to weight gain, high blood pressure, and elevated triglyceride levels, so don’t start if you don’t drink already. [10]

How To Improve Your Good Cholesterol – In Conclusion


Although low HDL levels are a health concern which should be addressed, there are many practical ways to raise them. From exercising regularly to enhancing your diet to minimize processed foods and prioritize heart-healthy choices, the lifestyle habits you use to achieve healthier cholesterol levels will also lead you to greater overall wellness.

And, with the help of the Cenegenics team who can offer tailored recommendations based on your comprehensive health evaluation, you can have the peace of mind in knowing you’re making the best choices to optimize your cholesterol levels and your health. 

To learn more about both the bad and good types of cholesterol and how they affect your health, read our full-length blog – Causes of High Cholesterol​.

Next Steps in Maintaining Healthy Cholesterol Levels

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

About the Contributor

Rudy Inaba 
Global Director of Nutrition & Exercise

Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

References

[1] Mayo Clinic, “HDL cholesterol: How to boost your ‘good’ cholesterol.” 24 Oct. 2018. Retrieved from URL: https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/hdl-cholesterol/art-20046388

[2] K Mahdy Ali, et al. “Cardiovascular disease risk reduction by raising HDL cholesterol – current therapies and future opportunities.” British Journal of Pharmacology. Nov. 2012. Retrieved from URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3504986/

[3] NIH, “HDL: The ‘Good’ Cholesterol.” 18 Apr. 2019. Retrieved from URL: https://medlineplus.gov/hdlthegoodcholesterol.html

[4] NIH; see above.

[5] NIH; see above.

[6] NIH; see above.

[7] NIH, “DASH Eating Plan.” 25 Apr. 2018. Retrieved from URL: https://medlineplus.gov/dasheatingplan.html

[8] Mayo Clinic; see above.

[9] Mayo Clinic; see above.

[10] Mayo Clinic; see above.

Interior of artery with red blood cells, LDL cholesterol, HDL cholesterol and other miscellaneous cells

What Is LDL Cholesterol & How Can You Control Yours?

Oftentimes, we hear about the importance of lowering our cholesterol levels, without really understanding what cholesterol even is or how it affects our overall health. Yet, for 95 million adults in the U.S. over the age of 20, high cholesterol is a reality which demands attention – and in some cases, medical intervention.[1]

Left unaddressed, having too much LDL cholesterol could lead to serious issues, including heart attack and stroke. Discover what you need to know about this widespread issue and its potential implications on your health below.

What Is LDL Cholesterol?


blue block with “L”, red block with “D”, and yellow block with “L”

Cholesterol is a waxy lipid generated by the liver. Although it plays a crucial role in the development of cell membranes, hormones, and vitamin D, having too much cholesterol can lead to a number of health issues.

You may have heard that there are two types of cholesterol: the “good” kind and the “bad” kind. LDL, or low-density lipoprotein, is associated with the “bad” cholesterol. Because cholesterol can’t dissolve or move through blood on its own, this protein carries particles of cholesterol through the blood. It can also accumulate within the artery walls, causing them to harden and narrow in a condition known as atherosclerosis. 

Having too much LDL cholesterol in your blood increases the risk for heart disease, the number-one cause of death in the U.S.[2] Heart disease is the collective term for a number of conditions that affect the heart, many of which can cause heart attack or stroke. When cholesterol accumulates on the artery walls, it can lead to what’s known as a cholesterol plaque. Over time, this plaque can impede blood flow, preventing the heart or brain from getting the oxygen needed to function. If the blood flow is blocked completely, a stroke or heart attack can ensue.

Ideally, your LDL cholesterol level should fall below 100. Yet, many individuals fall within the following range:

  • 100-129: near optimal
  • 130-159: borderline
  • 160-189: high
  • 190 or higher: very high [3]

What Causes High LDL Cholesterol?


A faceless woman in a white t-shirt holding up broccoli with one hand and a donut with pink icing and sprinkles in the other

As with many conditions, the causes of high cholesterol are vast. While some factors are within your control to change, others, such as age and family history, are not. Here’s a closer look at some of the most common causes for high LDL cholesterol.

  • Diet: Cholesterol comes from two sources: the liver and a regular consumption of poor food choices. Foods with trans fats, including heavily processed meats, cause the liver to produce even more cholesterol, which can lead to high cholesterol levels in some individuals. In addition to heavily processed animal products, many baked goods also contain trans fats and should therefore be avoided. [4]
  • Exercise Habits: Inactivity can contribute to high LDL cholesterol. While any exercise can support optimal health, regular aerobic activity, in specific, can help control LDL levels. [5]
  • Weight: Obesity and excess abdominal fat are associated with high cholesterol. [6]
  • Age & Gender: Cholesterol levels tend to rise naturally with age. Prior to menopause, women’s total cholesterol levels tend to be lower than their male peers. After reaching menopause, however, their LDL cholesterol often rises.
  • Family History: Individuals with a family history of high cholesterol, heart attack, or stroke should begin having their cholesterol tested at a young age, as they could be at a higher risk for elevated LDL levels. While younger adults should have their levels tested every 5 years, men should begin testing annually at the age of 45, and women at the age of 55. [7]

In addition to these factors, cigarette smoking and certain medications could raise LDL levels.

How Can You Lower Your LDL Cholesterol?


A brown-haired woman in neon orange shirt and man in black running clothes running together

Fortunately, there are many ways you can take control over your LDL cholesterol. While individuals with especially high levels may be advised to take cholesterol-lowering medication, there are many lifestyle changes you can pursue to lower your cholesterol as well. Outside of medications, here are a few of the most effective ways to lower your LDL cholesterol:

  • Following a Heart-Healthy Diet: In addition to limiting trans fats, eating a rich blend of vegetables, fruits, and lean protein can help to control cholesterol, while also lowering high blood pressure and reducing the risk of heart disease. Eliminating foods with added sugars is another dietary habit to adopt for better overall health. [8]
  • Exercising Regularly: In general, it’s recommended that individuals get at least 30 minutes of moderate physical activity most, if not all, days of the week. Yet, it’s also possible to break total exercise time down into shorter, more intense bursts of exercise, called high-intensity interval training (HIIT), or to make workouts lengthier but low-impact. Ultimately, the exercise plan you’re most likely to stick with is the best one for you to follow, and a physical fitness expert like those from the Cenegenics team can help create a plan to meet your unique needs and preferences.
  • Maintaining a Healthy Weight: Exercising regularly and eating well will help you control your LDL cholesterol, but you’ll also be able to enjoy a healthy weight over the long term as an added bonus. And, because higher LDL is associated with obesity and a larger waist circumference, controlling your weight is important to keeping cholesterol levels in check.

Take Control of Your LDL Cholesterol – In Conclusion


While finding out you have elevated LDL cholesterol can be worrisome, the good news is that there are plenty of ways for you to turn your levels around. From exercising regularly to refining your diet to include heart-healthy eating patterns, the lifestyle habits you use to achieve healthier cholesterol levels will also lead you to greater overall wellness. And, with the help of the Cenegenics team to offer prescriptive guidance based on the results of your extensive health evaluation, you can rest assured you’re making the best choices to optimize your health and enjoy a richer quality of life.

To learn more about both the bad and good types of cholesterol and how they affect your health, read our full-length blog, The Main Causes of High Cholesterol.

Next Steps to Begin Lowering Your LDL Cholesterol

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

About the Contributor

Rudy Inaba 
Global Director of Nutrition & Exercise

Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

References

[1] CDC, “High Cholesterol Facts.” 6 Feb. 2019. Retrieved from URL: https://www.cdc.gov/cholesterol/facts.htm 

[2] CDC; see above.

[3] Cleveland Clinic, “Cholesterol Numbers: What Do They Mean.” 26 July 2017. Retrieved from URL: https://my.clevelandclinic.org/health/articles/11920-cholesterol-numbers-what-do-they-mean

[4] American Heart Association, “Control Your Cholesterol.” 30 Apr. 2017. Retrieved from URL: https://www.heart.org/en/health-topics/cholesterol/about-cholesterol

[5] Bhatt, Ami, MD, FACC. “Cholesterol: Understanding HDL vs. LDL.” Harvard Health. 12 Apr. 2018. Retrieved from URL: https://www.health.harvard.edu/blog/understanding-cholesterol-hdl-vs-ldl-2018041213608

[6] Bhatt, Ami; see above.

[7] NIH, “LDL: The ‘Bad’ Cholesterol.” 4 Dec. 2017. Retrieved from URL: https://medlineplus.gov/ldlthebadcholesterol.html

[8] NIH, “DASH Eating Plan.” 25 Apr. 2018. Retrieved from URL: https://medlineplus.gov/dasheatingplan.html

3D Rendering of chromosome with emphasis on the telomere tips

Telomere Function in the Aging Process

Genes are like the story, and DNA is the language

 that the story is written in.

Sam Kean

Imagine if we had the power to predict patient lifespan based on a snapshot of current health. Doctors could then use this information to make individualized recommendations to help you optimize your wellness, reduce the risk for serious illness, and lead a more fulfilling life at every age. While modern science hasn’t yet allowed us to precisely predict longevity just yet, we’re getting closer.

Now, forward-thinking physicians are using an important biomarker of aging, telomere length, to monitor patient health and make more informed treatment decisions and lifestyle recommendations. These insights can also help pinpoint risk factors and aid in prevention efforts for serious conditions such as heart disease. Ultimately, looking at telomeres can allow doctors to encourage behaviors that shape a more rewarding future for their patients. If you’re new to the world of telomeres, find out more about these powerful measures of health below.

What Are Telomeres?

Telomere health loss concept with loss of telomere length

Every cell throughout the body carries genes, which are unique to each individual person. These genes dictate what cells should do and when. Comprised of DNA, these genes are connected in strands known as chromosomes. Within each cell, there are 23 pairs of chromosomes. Telomeres are sections of genetic material located at the end of each chromosome.

Telomere Function | What Do They Do?

Telomeres function as a protective cap meant to prevent the fraying of chromosomes when cells replicate. Telomeres have a vast number of DNA sections included within them, but when cells divide, the telomeres become a bit shorter with each time. 

When they become critically short, telomere function becomes compromised, and they no longer possess the capability to protect chromosomes. Cells die as a result, which is a natural component of the aging process – but only when it occurs at a natural pace. Accelerated cell death caused by unusually shortened telomeres is linked to a number of health issues, which we’ll explore below.   

What Is the Link Between Telomeres and Aging?

Mature couple laughing outside near hiking trail

Because telomeres shorten each time a cell replicates, telomere length is an important biomarker of aging. In particular, the rate at which telomeres shorten could hold powerful insights into the pace of aging, and potentially disease. Accelerated telomere shortening, in specific, is associated with certain age-associated diseases, as well as reduced overall lifespan. [1]

Telomerase, or the enzyme which replenishes telomeres, has the ability to add telomeric repeats to the ends of chromosomes. While this enzyme is present in certain renewing cells, such as stem cells, it is either extremely low or absent altogether in most normal cell types.

According to research, introducing telomerase, or a telomere repeat sequence, to the end of telomeres has been shown to extend cells beyond their normal finite lifespan of divisions. This ability to maintain cells in a useful state holds significant potential in terms of research and medical applications, though researchers have yet to tap into the full potential of the enzyme. [2]

Risk Factors of Shortened Telomeres

While telomere length decreases naturally with age, it is also believed to be affected by a number of other factors:

These factors are all likely to contribute to the rate of telomere loss. [3] In particular, smoking, poor eating habits, obesity, chronic stress, and other unhealthy lifestyle factors are linked to shorter telomeres. And, it’s therefore no surprise that shorter telomeres are associated with a lower life expectancy and increased rates of chronic disease. [4]

Indeed, shorter telomeres can unlock insights into specific diseases or disease risk within certain individuals. At least 5,000 to 10,000 Americans have conditions associated with shorter telomeres, but the prevalence could be far higher than that. [5] For example, shorter telomeres are associated with a higher mortality rate due to heart and infectious diseases. [6] Telomeres which appear to be shortening at an accelerated rate are also linked to the early onset of other age-associated conditions, including:

  • Heart failure
  • Diabetes
  • Osteoporosis
  • Increased cancer risk

Ultimately, older adults with shorter telomeres have three times the risk of dying from heart disease, and eight times the risk of dying from an infectious disease. [7]

While this news may seem grim, studying telomeres actually presents a huge area of opportunity to improve patient outcomes. Because telomeres are affected by many lifestyle habits within our control to change, identifying telomere length not only gives us an idea of the conditions for which we might be at risk, but it also gives us control to optimize our overall health and minimize the impact of aging. One powerful way this is done is through telomere testing.

What Is Telomere Testing?

test tube with blood sample for telomere test, biological age prognosis via blood test

Telomere testing is an assessment which gauges the length of telomeres. Currently, there are a few ways to undergo telomere testing, including web-based orders which can direct patients to local labs. Yet, one-time tests only provide one piece of the puzzle: the current length of telomeres. Further testing and monitoring are needed to paint the full picture of telomere function. Experts are performing tests at one, three, five, and ten-year intervals, but this timeline can vary significantly based on many different factors which make up a patient’s individual risk profile. [8]

Some doctors are already using telomere testing as a means of informing treatment decisions for patients with certain conditions. For example, a group of heritable conditions characterized by bone marrow failure and lung scarring are linked to significantly shortened telomeres. Johns Hopkins professors have begun measuring telomere length in populations with these symptoms and known genetic mutations linked to telomeres.

Their findings helped physicians uncover new insights about telomere defects, and in some cases, led them to explore different treatment options. Because patients with short telomeres may be more susceptible to side effects from procedures and medications, for instance, discovering shortened telomeres has prompted doctors to use less aggressive therapies for certain patients. [9]

Of course, it’s important to keep in mind that shortening telomeres don’t guarantee imminent disease, just as longer telomeres don’t mean a person will be able to avoid disease altogether. What these tests can do, however, is provide patients with an accurate insight into telomere status, which could serve as the wake-up call needed to kickstart a healthier lifestyle – no matter your age.

What Are the Best Ways to Safeguard Telomeres?

Mature couple exercising outside on urban sidewalk

A physician with insights into your individual patient profile will have the best advice for promoting healthy telomere function, and therefore helping you optimize your wellness at every age. With that being said, there are a few general guidelines which could help maintain optimal telomere length: 

  • Quit or avoid smoking: Smoking increases oxidative stress, which ultimately accelerates aging and telomere shortening. By some measures, the wearing of telomeres caused by smoking a pack a day for 40 years is equivalent to 7.4 years of life. Smoking cessation and avoidance are important not only for telomere length, but for promoting better overall health. [10]
  • Exercise regularly: Exercise can help to minimize excess body fat and expedite the process of waste elimination, which can reduce oxidative stress and help to preserve DNA, including telomeres. Athletes have been shown to exhibit elevated telomerase activity and reduced telomere shortening, compared to individuals who do not exercise regularly. With increased telomere stabilizing protein, people who exercise regularly may be able to enjoy a slower aging process and a reduced risk of age-associated diseases.  [11]
  • Maintain a healthy weight: Obesity has been linked to increased DNA damage, and BMI actually bears a strong correlation to the biomarkers of DNA damage regardless of a person’s age. In fact, the effects of obesity on telomere length appear to be even worse than smoking, with a telomere loss equivalent to 8.8 years of life in obese individuals. For this reason, maintaining healthy eating habits and exercising regularly are critical components of a healthy life. [12]
  • Follow a nutritious diet: In addition to long-term weight management, diet in itself may also influence telomere length. Researchers believe portion sizes, antioxidant-rich diets, and healthy protein sources are all important to promoting longevity and wellness. Each individual has unique dietary needs, so working with your physician can help you find the eating style that best fulfils your specific nutrient requirements. 
  • Control stress: It’s unrealistic to assume anyone can avoid exterior stressors altogether, especially for busy professionals, individuals with family responsibilities, and other people with demanding lifestyles. Yet, finding healthy ways to cope with stress may be important to avoiding oxidative damage to DNA, which could contribute to early onset of age-related health issue. If you feel as if you’re consistently stressed, talk to your doctor about healthy stress management practices. 

Should You Get Your Telomeres Tested – In Conclusion

The more you know about your health and your individual patient profile, the better informed you are for making the right decisions to promote wellness. The physicians at Cenegenics stand by this belief, which is why each patient undergoes comprehensive clinical testing at the conception of their program. This allows our wellness optimization specialists to uncover key insights into current health status, risk profile, and key biomarkers that help shape effective treatment decisions and lifestyle management recommendations.

If you’re interested in learning more about your DNA to better your health, don’t hesitate to contact your nearest Cenegenics location. Their physicians will help you uncover details about your health you’ve never been able to access before. Armed with this information, you can collaborate with your Cenegenics physician to make the most appropriate and beneficial choices that allow you to feel your best at every age.

Next Steps to Schedule Your Telomere Test

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

About the Contributor

Rudy Inaba 
Global Director of Nutrition & Exercise

Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

References

[1] Shammas, Masood A. “Telomeres, lifestyle, cancer, and aging.” Current Opinion in Clinical Nutrition & Metabolic Care. Jan. 2011.

[2] A.G. Bodnar, et al. “Extension of life-span by introduction of telomerase into normal human cells.” Science. 16 Jan. 1998.

[3] Shammas, Masood A.; see above.

[4] Harvard Health Publishing. “Can this DNA test help predict your longevity?” April 2018. Retrieved from URL: https://www.health.harvard.edu/staying-healthy/can-this-dna-test-help-predict-your-longevity

[5] Johns Hopkins Medicine. “Accurate Telomere Length Test Influences Treatment Decisions for Certain Diseases.” 26 Feb. 2018. Retrieved from URL: https://www.hopkinsmedicine.org/news/newsroom/news-releases/accurate-telomere-length-test-influences-treatment-decisions-for-certain-diseases

[6] R.M. Cawthon, et al. “Association between telomere length in blood and mortality in people aged 69 years or older.” Lancet. 1 Feb. 2003.

[7] Shammas, Masood A.; see above.

[8] Harvard Health Publishing; see above.

[9] Johns Hopkins Medicine; see above.

[10] Shammas, Masood A.; see above.

[11] Shammas, Masood A.; see above.

[12] Shammas, Masood A.; see above.

Conceptual 3D Rendering of cells in bloodstream

What is Methylation and Why Should You Care?

While weight loss is important, what's more important is the quality of food you put in your body - food is information that quickly changes your metabolism and genes.

Mark Hyman

The process of methylation is more important than you may think. It can impact everything from fat metabolism, to energy production, and even contributes to DNA production. So, let’s explore what methylation is, and why you should even care.

What is Methylation?

Simply put, methylation is the chemical process of transferring one carbon and three hydrogen atoms from one substance to another. Although methylation may sound foreign of scientific, you’re much more familiar with the process than you might think. It’s happening at a cellular level in your body, and in fact, occurs in every cell and tissue.

The process of methylation is critically important. It changes the way proteins behave, thereby impacting enzymes, hormones, and genes.

Why is Methylation Important?

The process of methylation contributes to all of the following: 

  • DNA production
  • Neurotransmitter production
  • Detoxification
  • Histamine metabolism
  • Estrogen metabolism
  • Eye health
  • Fat metabolism
  • Cellular energy
  • Liver health

In most healthy individuals, methylation takes place freely. Our bodies have a universal methyl donor called SAMe (S-adenosylmethionine) which readily contributes its methyl group to support the body’s ability to perform the aforementioned functions. Yet, this becomes complicated by the fact that SAMe production is dependent upon 5-MTHF (methyl-folate), a B vitamin. In itself, this isn’t a problem, but the bad news is that up to 50% of the population has a genetic mutation, the MTHFR gene variant, which makes it difficult for the body to create enough 5-MTHF. [1] When we can’t initiate the methylation process, it impedes our ability to create a significant number of molecules, including:

  • Glutathione
  • Coenzyme Q10
  • Melatonin
  • Serotonin
  • Nitric Oxide
  • Norepinephrine
  • Epinephrine
  • L-Carnitine
  • Cysteine
  • Taurine

What Happens When Methylation is Impaired?

Disruptions of Methylation

Disruptions of methylation can contribute to the following conditions:

  • Diabetes
  • Chronic obstructive pulmonary disease (COPD)
  • Cancer
  • Muscular dystrophy
  • Inherited genetic disorders
  • Stroke
  • Dementia
  • Depression
  • Pregnancy or fertility complications
  • Decreased energy production
  • Decreased recovery

Because it contributes to detoxification, impaired methylation can allow toxins to build up in the body. As a result, a host of issues can arise. For example, researchers have established a link between abnormal DNA methylation and autoimmune disorders, such as lupus. [2] Disruptions in methylation have also been associated with diabetes, chronic obstructive pulmonary disease (COPD), [3] cancer, muscular dystrophy, and several inherited genetic diseases. [4] It can also contribute to conditions such as stroke, dementia, depression, and pregnancy or fertility complications.

Beyond contributing to disease, however, methylation impairment can also take its toll on wellness even in disease-free individuals. Methyl groups control energy production, inflammation response, the repair of cells damaged by free radicals, and the production of glutathione, a powerful antioxidant. These factors can make you feel as if your energy is depleted and your body is unable to recover as quickly as it should.

How to Improve Methylation in Your Body

Middle aged businessman eating salad in restraint while talking on his cell phone

Individuals with a healthy diet take in a variety of B vitamins, especially from cruciferous vegetables like broccoli, cabbage, kale, and bok choy. Dark leafy greens, asparagus, almonds, fish, and eggs are also rich in the B vitamins the body needs to support methylation. Yet, even the healthiest diet is likely to have some nutritional gaps, and it may be difficult to get enough B vitamins through food alone every day to support optimal methylation. Moreover, B vitamins found in food may not be in an optimal form for our bodies to use them most efficiently. When coupled with the prevalence of genetic issues, it’s no surprise why B vitamin deficiencies are seen so commonly.

To some degree, methylation can be promoted through many of the lifestyle adjustments you’d make to support overall health, such as reducing stress, alcohol intake, and exposure to toxins. These toxins burden the liver, which plays an essential role in methylation. Yet, in people with MTHFR gene variants or other issues inhibiting methylation, these behaviors alone won’t be enough to provide the body with enough 5-MTHF. Thus, getting tested for a deficiency is a good starting point for most individuals. If you are, you will likely be recommended for supplements.

What Active Forms of Vitamins are Essential for Improved Methylation

There are some vitamins and nutrients which can be supplemented to increase B vitamin levels, and subsequently methylation. It’s important to note, however, that with these vitamins, it is imperative that patients use the active form, which in most cases is already methylated. The non-methylated form, on the other hand, is less effective for raising 5-MTHF levels in the body.

For this reason, Cenegenics offers a special methylation formula which empowers the body by raising vitamin B levels to support methylation. It contains five ingredients which are essential to the methylation process, starting with 5-MTHF, the vitamin responsible for making the primary methyl donor SAMe. It also contains an optimal amount of methylcobalamin (B12), riboflavin (B2), and pyridoxine hydrochloride (B6). Finally, the last ingredient is known as betaine (trimethylglycine), which also acts as a methyl donor. Ultimately, these ingredients combine to return your B vitamins back to their peak for healthy methylation.

The Benefits of Methylation Supplements

Supplement pills in wooden spoon again grain background, herbal supplement in pill and capsule on wood table with green leaves

In addition to helping to keep autoimmune disorders at bay, methylation formula can facilitate overall healthy aging. It supports:

Methylation also protects the body’s telomeres, or the tails on DNA and chromosomes which can accelerate aging if not protected. This impacts the body not just physically, but mentally as well. Thus, methylation slows overall aging, in terms of both bodily function and mental acuity. This, combined with hormone regulation, boosted energy, reduced inflammation, and detoxification can help you feel better not just shortly after taking the supplement, but also far into the future.

Plus, as with all of our nutraceuticals, our methylation formula is manufactured in the U.S.A. and without any harmful additives. Because supplements aren’t nearly as heavily regulated as pharmaceuticals, it’s critically important to make sure yours come from only trusted sources. Our clinical nutraceuticals are pharmaceutically-tested and far surpass the quality of low-cost, generic retail supplements. That’s because we believe that what goes into the body directly influences the quality of health outcomes.

If you feel sluggish, achy, or otherwise under the weather, you could be suffering from the genetic defect that affects methylation. To find out more about what you can do to start feeling like the best version of yourself, contact your nearest Cenegenics location.

Next Steps in Understanding Methylation

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

About the Contributor

Rudy Inaba 
Global Director of Nutrition & Exercise

Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

References

[1] The Permanente Medical Group, 2015. Retrieved from URL: https://mydoctor.kaiserpermanente.org/ncal/Images/GEN_MTHFR_tcm63-938252.pdf

[2] Richardson, B. “DNA methylation and autoimmune disease.” Clinical Immunology. Oct. 2003. Retrieved from URL: https://www.ncbi.nlm.nih.gov/pubmed/14585278

[3] EA Vucic et al. “DNA methylation is globally disrupted and associated with expression changes in chronic obstructive pulmonary disease small airways.” American Journal of Respiratory Cell and Molecular Biology. May 2014. Retrieved from URL: https://www.ncbi.nlm.nih.gov/pubmed/24298892

[4] Robertson, Keith D. “DNA methylation and human disease.” Nature Reviews Genetics. 01 Aug. 2005. Retrieved from URL: https://www.nature.com/articles/nrg1655

3D illustration of thyroid gland in human body

What is Hypothyroidism | Causes, Symptoms and Treatment

Keep your vitality. A life without health is like a river without water.

Maxime Lagacé

The thyroid is a small, butterfly-shaped gland located at the front of the neck. Despite its small size, however, the thyroid plays an important role in many key processes throughout the body. It influences metabolism, helps to regulate body temperature, and aids in growth and development.

Under normal circumstances, the thyroid secretes optimal levels of two hormones, thyroxine or T4, and triiodothyronine, or T3. Outside the thyroid, in organs such as the liver, kidneys, and brain, T3 is also converted from T4. Both T3 and T4 are stored in certain amounts within the thyroid, and when it is needed by the body, the gland secretes the hormones into the bloodstream to meet the cells’ metabolic needs. [1]

In certain cases, the thyroid is unable to produce sufficient critical hormones. Known as hypothyroidism, this condition can spur a chain reaction in which a number of body-wide symptoms arise. Here, we take a closer look at hypothyroidism, including its causes and treatments.    

What Is Hypothyroidism?


Illustration of healthy thyroid gland with anterior and posterior views

At the most basic level, hypothyroidism refers to an underactive thyroid. In individuals with hypothyroidism, the thyroid gland cannot produce enough thyroid hormone to keep the body functioning normally. Doctors can confirm hypothyroidism based on symptoms and blood test results. Blood tests may measure thyroid-stimulating hormone (TSH), which is used as a messenger from the pituitary gland to tell the thyroid how much thyroid hormone to produce. When TSH is low, it signals the thyroid to slow down hormone production. This essentially slows down all of the body’s functions, causing you to experience a number of seemingly unexplainable symptoms. [2]

What Are Symptoms of Hypothyroidism?


Mature male businessman wearing suit holding the bridge of his nose with closed eyes, Tired businessman suffering from cognitive/mental fatigue

The symptoms of hypothyroidism can develop slowly over time. In many cases, patients experience weight gain, despite maintaining a regular diet or even eating less than normal. Because the thyroid regulates body temperature, another common symptom of hypothyroidism includes increased sensitivity to cold. Fatigue, dry skin, hoarseness, constipation, and muscle weakness may also ensue.

Since the hormones produced by the thyroid have body-wide effects, symptoms are rarely isolated. Some of the other widespread symptoms patients tend to notice include:

The thyroid is also a part of the endocrine system, which includes the ovaries in women and the testicles in men. With hypothyroidism, symptoms such as heavy or irregular periods may occur. The condition can also lead to fertility issues, as improper hormone levels could affect ovulation.

The challenge with hypothyroidism lies in the fact that the signs and symptoms may be difficult to notice at first, and can vary based on the condition’s severity. Symptoms such as fatigue and weight gain may creep up slowly, and are often attributed to the natural aging process. Nonetheless, symptoms tend to become more pronounced as the metabolism continues to slow.

In some cases, the root cause of this chain reaction is easy to pinpoint. Thyroid surgery, for example, will likely lead to diminished production of hormones by the thyroid. There are other potential causes behind hypothyroidism, however, which are discussed below.

What Causes Hypothyroidism?


Stethoscope and tablet with blue screen and white letters stating HYPOTHYROIDISM

While there are many potential causes behind hypothyroidism, the most common is autoimmune disease. In particular, an autoimmune disorder known as Hashimoto’s thyroiditis is the most common reason behind an underactive thyroid. In this condition, the immune system attacks the thyroids, resulting in inflammation of the gland and an inability to produce sufficient hormones. While it is unknown why certain individuals produce antibodies that target the thyroid gland, this condition often runs in families. It tends to occur in middle-aged women, but it can affect individuals of any age, including men and children. [3] Another autoimmune disorder that can affect the thyroid includes atrophic thyroiditis.

As mentioned above, thyroid surgery can also result in hypothyroidism. If all or a large portion of the thyroid is removed, it typically results in a lifelong need for thyroid hormones. Radiation therapy to treat cancers of the head and neck may also lead to hypothyroidism.

In addition, there are some cases in which medications can contribute to hypothyroidism. For one, patients being treated for hyperthyroidism, in which the thyroid produces too much thyroid hormone, may over-respond to medications. Radioactive iodine or anti-thyroid medications are implemented to restore normal thyroid function, but in pursuit of correcting hyperthyroidism, it’s possible to lower thyroid production too much, causing hypothyroidism. In addition, lithium, which is commonly used to treat psychiatric disorders such as bipolar disorder and mania, can also cause hypothyroidism.

Causes of Hypothyroidism

Hypothyroidism can be caused by the following:

  • Autoimmune disease
  • Thyroid surgery
  • Radiation treatment
  • Certain medications
  • Failure of the pituitary gland
  • Pregnancy
  • Iodine deficiency

While rare, hypothyroidism can also result from other conditions. For example, congenital hypothyroidism, in which a baby is born with a missing or defective thyroid gland, can occur. Most states require thyroid screening in newborns to assess for this condition. Failure of the pituitary gland, which may be a result of a benign tumor, can also lead to insufficient TSH, and subsequently, hypothyroidism. Some women also experience hypothyroidism during or after pregnancy. Finally, the condition can also be caused by an iodine deficiency. Although rare in many parts of the world, the addition of iodine to table salt has almost altogether eliminated the deficiency in the U.S.

Certain populations face an increased risk for hypothyroidism, including women and individuals over the age of 60, as well as people with a family history of the condition. Other autoimmune diseases, including type 1 diabetes and celiac disease, appear to be associated with a higher risk for hypothyroidism as well. [4] 

How Is Hypothyroidism Treated?


Diagnosing and treating hypothyroidism is important, as leaving it unaddressed can lead to a number of complications. In an attempt to prompt the thyroid to produce more hormones, the pituitary gland will make more TSH. This constant stimulation can lead to an enlargement of the gland, known as a goiter. While not typically uncomfortable, a pronounced goiter may lead to swallowing or breathing difficulties.

In individuals with an underactive thyroid, increased levels of low-density lipoprotein, also known as the “bad” cholesterol, may occur. This can increase the risk for cardiovascular complications, including heart disease and failure. Depression and peripheral nerve damage may also occur. A rare but life-threatening condition caused myxedema can also result from prolonged, untreated hypothyroidism, and is characterized by severe drowsiness, intolerance to cold, and potentially, unconsciousness.

Luckily, treatments are available to combat hypothyroidism. Typically, the synthetic thyroid hormone levothyroxine is used daily to restore hormones to their appropriate levels. This hormone is identical to the hormone the thyroid produces naturally. It can also help alleviate or reverse the signs of hypothyroidism. Finding the right dose may require some trial and error, so medical professionals perform further blood tests a few weeks after introducing hormones. [5]

In addition to using medications, certain lifestyle changes, including adopting a diet for hypothyroidism, may help control symptoms.

The Best Diet for Hypothyroidism


Birdseye view of food including green grapes, grapefruit, blueberries, black cherries, strawberries, who grain crackers, cheese, shish kabobs

Dietary changes alone won’t restore normal functioning in the thyroid, and aside from an iodine deficiency, eating habits are unlikely to cause hypothyroidism by themselves. With that being said, diet can have a significant impact on symptoms in individuals with hypothyroidism. While certain foods can improve symptoms, others may worsen them or interfere with medications.

Widely recognized for their health benefits, cruciferous vegetables such as broccoli, Brussels sprouts, collards, cauliflower, cabbage, and Russian kale with plenty of fiber, vitamins, minerals, and phytochemicals and relatively few calories, have been linked to benefits such as protection against cancer. [6] Yet, they also contain goitrogens which, in some hypothyroid scenarios, are not heavily advised to be consumed in excess.

Nonetheless, having hypothyroidism doesn’t necessarily mean you must avoid cruciferous vegetables altogether. These foods are part of a well-rounded diet and can usually be enjoyed sparingly, since experts believe goitrogens may only impact hormone levels when eaten in excess. Moreover, cooking can deactivate the effects of goitrogens. Individualized lifestyle modifications such as these can be beneficial not only for hypothyroidism, but also any health issues affected by diet. [7]

Soy is also believed to affect the thyroid when consumed in excess. Soy products include soy milk, soy sauce, edamame, tofu, and miso. For this reason, enjoying these foods only in moderation, especially if you have a known thyroid condition, is recommended. Processed foods that can promote weight gain, which is a common struggle in hypothyroidism, should also be avoided.

At the other end of the spectrum, foods with the nutrients iodine, selenium, and zinc can help maintain optimal thyroid function. Iodine-rich foods include eggs, milk, cheese, and saltwater fish. Selenium, which aids in the production of thyroid hormones, is found in Brazil nuts, turkey, chicken, beef, and tuna, along with eggs and oatmeal. Zinc can be found in oysters, crab, beef, pork, legumes, and yogurt.

An Underactive Thyroid – In Conclusion


If you’re experiencing fatigue, slow weight gain, or any of the other symptoms described herein, it’s a good idea to discuss a potential thyroid issue with a medical expert. While there’s no guarantee hypothyroidism could be behind your symptoms, ruling out this or any other root cause is important to optimizing your quality of life, both now and into the future.

In fact, wellness optimization is at the forefront of what we do at Cenegenics. We believe that to feel one’s best and minimize disease risk, we must establish a complete patient profile, compiling data from factors like hormone levels and other key indicators. With this knowledge, we make informed and individualized treatment recommendations to help our patients maintain the greatest possible level of wellness. For many individuals, our strategic, patient-oriented approaches such as dietary modifications and hormone replacement where clinically indicated can make a life-changing difference in restoring energy, regulating weight, and enhancing overall quality of life.

Next Steps to Combating Hypothyroidism

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

About the Contributor

Rudy Inaba 
Global Director of Nutrition & Exercise

Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

References

[1] Garber, Jeffrey R., Ph.D. The Harvard Medical School Guide to Overcoming Thyroid Problems. McGraw-Hill.

[2] Garber; see above.

[3] “Hashimoto’s Thyroiditis.” American Thyroid Association. Retrieved from URL: https://www.thyroid.org/hashimotos-thyroiditis/

[4] Mayo Clinic, “Hypothyroidism.” 4 Dec. 2018. Retrieved from URL: https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284

[5] Mayo Clinic; see above.

[6] Wallig, M., et al. Journal of Nutrition, 2005;135(12S):2972S-7S. Steinmetz, K.A., and Potter, J.D., Journal of the American Dietetic Association, Oct. 1996

[7]

Marengo, Katherine, LDN, RD. “Hypothyroidism: Foods to eat and avoid.” Medical News Today. 28 Mar. 2019.

diagram of skeleton holding knee joint radiating red for pain

A Guide to Osteoporosis & Bone Strength

When you know in your bones that your body is a sacred gift, you move in the world with an effortless grace. Gratitude and humility rise up spontaneously.

Debbie Ford

Osteoporosis is commonly perceived as a condition experienced exclusively by elderly individuals. In reality, our bones begin to change much earlier than most people realize, which is why it’s never too early to start thinking about what we can do to preserve bone strength. In fact, like health in general, caring for our bones should be a priority at every age. Whether you’ve already been diagnosed with or face an increased risk for osteoporosis or you’re taking the steps to safeguard your health against disease in the future, here’s everything you need to know about bone health and osteoporosis. 

What is Osteoporosis?


Osteoporosis stage 4 of the upper femur bone in 3D rendered image

The literal meaning of osteoporosis is “porous bone.” All bone is somewhat porous, and when viewed under a microscope, healthy bone has a honeycomb-like appearance. In individuals with osteoporosis, however, the holes and spaces within this honeycomb structure are much larger.

Like other types of living tissue, bone tissue is constantly broken down and regenerated. This process slows down over time, and when new bone can’t be created as quickly as old bone is lost, it results in osteoporosis. Bone density and mass is reduced, leaving bones weaker and more vulnerable to fractures.

In fact, osteoporosis significantly increases the risk of fracture — so much so that simply mild physical activity (such as bending over) could result in fracture in individuals whose bones have become especially brittle. The most common sites for fractures related to osteoporosis are the hip, wrist, and spine.

Risk Factors of Osteoporosis

The following factors can increase your risk of osteoporosis:

  • Gender
  • Family History
  • Smaller Body Frame
  • Age
  • Ethnic Background
  • Certain Health Conditions
  • Specific Medical Procedures
  • Autoimmune Disorders

Unfortunately, osteoporosis is a common condition. More than 50 million Americans either have the condition or are at an increased risk for it due to low bone mass. [1] It’s most prevalent in individuals over 50, at which age 1 in 3 women and 1 in 5 men experience an osteoporosis-related fracture. [2] Bone density typically peaks during the late 20s, and begins to weaken by the mid-30s. Thus, age is one of the non-modifiable risk factors of osteoporosis.

Another non-modifiable risk factor is sex. Women are more likely to develop osteoporosis than men, especially after menopause. Individuals with a family history of the condition and smaller body frames also tend to face a higher risk. Having a smaller body frame means there could be less bone mass to draw from with age. Being of white and Asian descent can also increase risk.

In addition, certain health conditions and medical procedures can contribute to bone loss. Autoimmune disorders, such as rheumatoid arthritis, lupus, and multiple sclerosis, as well as diabetes, premature menopause, low levels of testosterone and estrogen in men, and certain types of cancer have been linked to osteoporosis, among other medical conditions. In terms of medical procedures, gastrointestinal bypass surgery and gastrectomy have been linked to bone loss. [3]

In addition to these non-modifiable risk factors, there are also risk factors within your control. We’ll discuss these in an upcoming section on osteoporosis prevention. First, let’s look at some of the symptoms of osteoporosis.

Symptoms of Osteoporosis


Mature man gripping backside from pain

During the early stages of bone loss, individuals may not notice any identifiable symptoms. Once bones become weaker, however, issues such as loss of height, back pain, and stooped posture may occur. These can result from a fractured or collapsed vertebra. Of course, another telltale sign of osteoporosis is a bone which breaks far more easily than expected. If you’re over the age of 50 and have broken a bone, you may be a good candidate for a bone density test.

Bone Density Tests

A bone density test is the only assessment that can be used to diagnose osteoporosis before breaking a bone. The DEXA scan is one cutting-edge test that can accurately measure bone density. This noninvasive body composition test sends multiple X-ray beams through the body at different energy levels to measure total body bone density, as well as bone density specifically in the spine. This helps physicians determine a patient’s risk of fracture. The findings from bone density test scans can also be used to form treatment plans, which brings us to our next section.

How to Treat Osteoporosis


Woman in bright orange shirt laying on DEXA machine as doctor operates mechanics via computer

Osteoporosis is now largely treatable. Through a combined approach encompassing lifestyle changes and tailored medical treatment, fractures can often be avoided. The objectives of treatment include:

  • slowing the development of osteoporosis
  • maintaining adequate bone mineral density and bone mass
  • minimizing pain
  • preventing fractures
  • optimizing quality of life for the patient

A patient’s treatment plan is usually based on their projected risk of fracture within the next 10 years. Data such as findings from bone density tests is the common basis for informing treatment recommendations. For patients whose risk is low, treatment might focus on modifying risk factors for falls and bone loss.

Treatments can include:

  • Bisphosphonates
  • Monoclonal antibody medications
  • Additional bone-building medications
  • Hormone replacement therapy
  • Lifestyle modifications

If there’s an increased risk of fracture, bisphosphonates may be prescribed to strengthen the bones and slow or prevent bone loss. These medications inhibit the development of osteoclasts, which break down and reabsorb minerals such as calcium from bone tissue. Monoclonal antibody medications can also be given via injection to specific patients to reduce the risk of fracture and increase bone density. In patients who can’t tolerate more common treatments, other bone-building medications may be explored.

When clinically indicated, hormone-related therapy may also be used to treat osteoporosis. Estrogen, in particular, can help post-menopausal women maintain healthy levels of bone density. Hormone replacement therapy (HRT) can also be used as a primary prevention for osteoporosis and, in conjunction with a calcium-supplemented diet, has been shown to prevent hip, vertebral, and other fractures, even in low-risk patients. [4]

In addition to the above treatments, the following lifestyle modifications used to prevent the condition may also be used in combination to optimize quality of life in patients who have already developed osteoporosis.

How to Prevent Osteoporosis


Your likelihood for developing osteoporosis depends, to some degree, on the amount of bone mass you attained during youth. Peak bone mass is partly inherited and can vary by ethnic group. The higher your peak bone mass, the more bone you have stored, and thus, the less likely you are to develop osteoporosis.

With that being said, there are ways to promote bone health at every stage of life and regardless of your individual risk. We’ll explore some of the most effective ways to strengthen bone tissue below. 

Calcium-Rich Foods for Bone Health

Set of natural calcium rich food on marble background viewed from top

Most adult men and women need 1,000 milligrams of calcium per day. When women reach the age of 50 and men turn 70 that amount increases to 1,200 milligrams. [5] The body constantly removes small amounts of calcium from the bones and replaces it with new calcium, which is why a calcium-rich diet is important for maintaining bone health at every age.

Calcium-rich foods for bone health include:

  • dairy products
  • leafy green vegetables such as:
  • collard greens
  • spinach
  • kale
  • certain varieties of beans and lentils
  • tofu and other soy products

If you find it difficult to take in enough calcium through food alone, you could be a good candidate for calcium supplements. Be sure to discuss any new supplements with the specialist overseeing your wellness and nutrition treatment plan, however, as it’s also important not to exceed a certain amount of calcium on a daily basis.

The Importance of Vitamin D

Vitamin D helps the body absorb calcium, and these nutrients therefore play an important collaborative role in promoting bone health. The body can take in vitamin D when direct skin is exposed to UV rays, or through supplements. Vitamin D is also found in very few foods, but even the food it is found in contains a very small amount of the nutrient. Vitamin D supplementation is therefore widely recommended for patients — especially those at risk of developing osteoporosis. In elderly individuals, the risk of falls is reduced by 20% with vitamin D supplementation, and the risk of hip and vertebral body fractures is also reduced.

Hormones

Fracture risk has been shown to be reduced in women who take HRT, regardless of whether or not they have established osteoporosis. In fact, women who used HRT over a 10- to 20-year timeframe experienced a risk fracture reduction ranging from 40% to 50%. Estrogen is instrumental in bone development, through the constant ebb and flow of formation, remodeling, and resorption. [6] Thus, when clinically indicated, HRT is a practical treatment option for promoting bone health and preventing osteoporosis.

Weight & Exercise

Happy mature woman listening to music with earphones while jogging

Finally, some important lifestyle factors which can support bone health include maintaining a healthy weight and exercising regularly. While being underweight can increase the chance of bone loss, and subsequently, fractures, being overweight can also increase the risk of fractures. Achieving and maintaining an appropriate weight can therefore promote bone health and help to optimize wellness in general.

Regular exercise can also contribute to bone strength. No matter how or when you start, exercise can benefit your bones and your overall health. With that said, the younger you can begin, the better it will be for your bones. A combination of weight-bearing exercises and balance training can help to minimize the risk of falls and build strength in the body.

Controlling Osteoporosis with Cenegenics – In Conclusion


Whether you have a family history of osteoporosis or you’re simply seeking ways to take control of your health for long-term, optimized wellness, bone strength should be a priority at all stages of life. Osteoporosis is common yet largely preventable, and even when it does develop, there are both lifestyle modifications and medical treatments available to minimize the condition’s impact on daily life.

If you’re looking for ways to feel stronger and healthier now while pursuing practical disease prevention strategies, Cenegenics can help. Our physicians specialize in wellness optimization programs tailored to each patient’s unique needs. Through our strategic lifestyle, nutrition, and exercise recommendations, along with supplementation and HRT when clinically indicated, we give individuals the resources they need to enhance their health and feel their best at every age. To learn more about how Cenegenics can help you, contact your nearest location for a consultation. 

Next Steps to Preventing Osteoporosis

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

About the Contributor

Rudy Inaba 
Global Director of Nutrition & Exercise

Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

References

[1] National Osteoporosis Foundation

[2] International Osteoporosis Foundation

[3] National Osteoporosis Foundation

[4] Leake, Jeffrey Park, M.D., CPT, and Greenberg, Todd David, M.D., CSCS. Textbook of Age Management Medicine: Volume 2. Leake-Greenberg Ventures, LLC, 2015. p. 75.

[5] Mayo Clinic

[6] Leake, Jeffrey Park, M.D., CPT, and Greenberg, Todd David, M.D., CSCS; p. 128-129.

Are you at risk for heart attack and stroke? A carotid intima-media thickness (CIMT) test is often used as a preventive measure to check just that!

What is the Carotid Intima-Media Thickness Test?

Information leads to transformation.

Isrealmore Ayivor

Diagnostics have come quite a long way in recent years, and the carotid intima-media thickness (CIMT) test is no exception. Nowadays, this noninvasive assessment can give physicians in-depth insights into heart health, accessing information which has traditionally only been available through more invasive means. Moreover, the data gleaned from this test often goes overlooked, as the conditions for which CIMT tests aim to identify often present no outward symptoms.

Yet, some patients may wonder if the CIMT test is really necessary. After all, most individuals have never even heard of it, let alone received a referral for one. Is the CIMT test right for you? Discover what it entails and how it could be the very test to unlock life-changing results below.

What is a CIMT Test?

Panasonic CardioHealth Station, Carotid Artery Testing Equipment

The CIMT test is often used as a preventive measure to check for serious conditions such as heart disease and stroke. Heart disease often exhibits no symptoms or warning signs, and many people only become aware of their individual risk through biomarkers uncovered by lab work. While in some cases symptoms such as fatigue, irregular heartbeat, and chest pain may be present, in many cases, the first symptom of heart disease is a heart attack. [1] This is because plaque can slowly and silently build up along the walls of the arteries for many years. While the arteries can become thickened, resulting in what’s known as atherosclerosis, there may be little to no outward sign of a medical issue. Blood pressure changes and elevated C-reactive protein (CRP) levels (identified through blood work) are among the few indicators that might alert physicians to this systemic inflammation.

The CIMT test is used to evaluate the carotid arteries by measuring changes in plaque and the thickness of the vessel walls. Even if no atherosclerosis is present, there could still be changes in artery thickness which can alert doctors to an elevated risk for heart attack or stroke. With this early intervention, medical experts can determine and predict risk for cardiovascular disease or stroke and can subsequently make clinical recommendations to support the best possible patient outcomes.

Using ultrasound scanners, sonographers perform CIMT tests, which use sound waves to pinpoint the extent of plaque buildup in the walls of the arteries which supply oxygenated blood to the head. The sound waves are high-frequency and inaudible and are measured by a computer to depict real-time imaging on a monitor.

Why is Carotid Intima-Media Thickness Important?

ultrasound image of carotid artery

The carotid intima-media thickness measures two separate layers of the carotid artery: the intima and the media. There are actually two carotid arteries; one on either side of the neck. Because this artery branch supplies blood to the brain, it’s one of the most important systems within the body. Clinically examining these arteries can uncover important evidence of a number of conditions. For instance, inflammation within this artery could suggest an autoimmune condition or previously undetected infection.

An increase in intima-media thickness (IMT) is often the first structural change that can be detected in atherosclerosis. [2] Moreover, the state of the carotid arteries corresponds with the state of the arteries all throughout the body, including those within the heart. Having thicker arteries can increase the risk of developing coronary heart disease, peripheral artery disease, carotid artery disease, and chronic kidney disease. [3]

While aging contributes to thicker carotid intima-media, there are a number of other factors which play a role in the arteries’ thickness:

These can all lead to increased thickness in the carotid intima-media. [4] Although certain behaviors can certainly contribute to increased risk for heart conditions, researchers have determined that CIMT predicts future vascular events independently of conventional risk factors for heart disease or stroke. [5] Thus, while increased IMT may exhibit no outward symptoms at all, it’s among the most powerful predictor of a cardiovascular event — but continues to go overlooked by most practitioners of traditional medicine.

Consider the fact that four times as many fatalities are caused by heart events compared to cancer, and traditional medicine mischaracterized 50% of patients as low-risk who would later experience a heart event. Physicians who employ the CIMT test aim to take a more accurate approach to assessing heart attack risk, while also preventing heart events in at-risk populations by offering effective, proactive interventions.

Benefits of the CIMT Test

mature man smiling as he stretches before run

Aside from the fact that research shows the CIMT test to be an effective predictor of future vascular events, there are a number of other advantages of the assessment. [6] For one, CIMT is believed to be valuable for collecting a more refined perspective of an individual’s risk for cardiovascular disease. For another, the test is noninvasive, requires no blood draws, and uses ultrasound waves, which are generally considered safer than many other types of waves. The test itself is fairly quick, and no special preparation is needed on the patient’s part. Likewise, there is no required recovery time, and the test is therefore non-disruptive to an individual’s daily lifestyle.

Compare this with other forms of testing used to evaluate heart disease risk. While many of these tests still have their place in certain circumstances, some may present certain challenges. For example, cardiac CT angiograms require the use of contrast dye, to which some individuals have an allergy. Left heart catheterization requires the use of a catheter in the femoral artery in the groin or wrist, which can lead to bleeding or hematoma formation at the site. [7]

Yet, despite the many advantages of CIMT testing, there are some factors to consider before pursuing it. For one, it is only offered in the most modern facilities, as it’s still generally considered cutting-edge technology. Moreover, not all physicians are trained in interpreting the test’s results, which is why it’s critically important to work with a clinical team well-versed in CIMT testing.

What Should You Expect from This Carotid Artery Test?

The ultrasound exam will be painless and non-invasive, but it’s still a good idea to wear loose-fitting, nonrestrictive clothing so you can stay comfortable during the test. An open-necked shirt is ideal, as the technician will need to access your neck area. There is no other preparation required for the carotid artery test.

The technician will apply a thick gel to the skin, which allows soundwaves to move from the machine into the body with the help of a transducer. As the sound waves bounce off the arteries, echoes are communicated to the transducer. The transducer then creates electronic signals which are processed by the computer. A report will then be generated identifying your unique risk profile.

Results of a CIMT are typically classified into four categories:

  • normal CIMT with no plaque
  • abnormal and no plaque
  • normal with plaque
  • abnormal with plaque

Depending on your unique results, your doctor will go over risk factors and generate an individualized treatment plan to help you manage your risk for heart disease or stroke.

Typically, doctors who are familiar with the CIMT will only order the test if a patient is believed to have a moderate risk for heart disease.

Risk Factors for Heart Disease

Risk factors could include:

  • sedentary lifestyle
  • obesity or being overweight
  • history of smoking
  • hypertension
  • family history of heart conditions, among others

Nonetheless, it’s important to bear in mind that patients are often mischaracterized as low-risk. Thus, physicians with a focus on disease prevention are likely to recommend this test as a worthwhile preventive measure for most adults approaching or in their middle ages.

Do You Need a CIMT Test – In Conclusion

At Cenegenics, our focus is always on helping patients defy their age through practices that help to minimize the risk for serious disease. In particular, heart health is one of our most important priorities, as we know that heart disease is the leading killer in the U.S., and far too many patients go undiagnosed with cardiovascular concerns which could otherwise be addressed proactively. For these reasons, we include the CIMT test in all of our patient evaluations.

Our carotid artery ultrasonography exam is an FDA-approved, noninvasive exam which allows for early detection and proactive strategies to help reduce the risk of catastrophic events. When clinically indicated, our team of expert physicians will empower you to take control of your health with prescriptive lifestyle and diet modifications as needed. In doing so, we give you the tools that will help you cultivate a rich and healthy life well into your retirement as you reclaim your glory days™. 

Next Steps to Schedule Your CIMT Test

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

About the Contributor

Rudy Inaba 
Global Director of Nutrition & Exercise

Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

References

[1] Mayo Clinic, “Heart Disease.” 22 March 2018. Retrieved from URL: https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118

[2] Simova, Iana. “Intima-media thickness: Appropriate evaluation and proper measurement, described.” European Society of Cardiology. 05 May 2015. Retrieved from URL: https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-13/Intima-media-thickness-Appropriate-evaluation-and-proper-measurement-described

[3] Rogers, Graham, MD. “What You Should Know About the Carotid Intima-Media Thickness (CIMT) Test.” Healthline. 31 Jan. 2017. Retrieved from URL: https://www.healthline.com/health/heart-disease/cimt-test

[4] Cedars-Sinai. “Carotid Intima-Media Thickness Test (CIMT).” Retrieved from URL: https://www.cedars-sinai.org/programs/heart/clinical/womens-heart/services/cimt-carotid-intima-media-thickness-test.html 

[5] Matthias W. Lorenz, et al. “Carotid Intima-Media Thickening Indicates a Higher Vascular Risk Across a Wide Age Range.” Stroke. 8 Dec. 2005.

[6] Matthias W. Lorenz, et al. “Prediction of Clinical Cardiovascular Events With Intima-Media Thickness.” Circulation. 30 Jan. 2007.

[7] Rogers, Graham, MD. See above.

cholesterol build up in arteries blocking significant blood flow

The Main Causes of High Cholesterol | Road Map to a Heart Attack

Healthy citizens are the greatest asset any country can have.

Winston S. Churchill

High cholesterol is very common in the U.S., but being commonplace doesn’t make it any less serious. While 95 million U.S. adults over the age of 20 are believed to have high cholesterol, it’s possible there are many more undiagnosed cases. [1] Oftentimes, people who have high cholesterol don’t know they have it. This is concerning considering the fact that high cholesterol is associated with serious health issues such as heart attack and stroke.

Despite its widespread nature, there are many things most of us don’t know about cholesterol. From understanding the differences between “good” and “bad” cholesterol to determining what you can do to improve your levels, there’s a lot to learn about this health phenomenon. Luckily, even if you’ve been diagnosed with high cholesterol or have a family history of the condition, there are many risk factors within your power to change. Explore what you need to know about high cholesterol below.

What is High Cholesterol?


Cholesterol is a waxy substance naturally produced by the liver. It’s a type of lipid which is crucial to the development of cell membranes, vitamin D, and key hormones. Yet, while it plays a critical role in these functions, having high cholesterol can be dangerous—particularly when there’s too much “bad” cholesterol. Thus, to understand the ways in which cholesterol can impact our health, it’s important to first explore the different types.

Types of Cholesterol

Because cholesterol can’t dissolve or move through blood on its own, it must be attached to proteins to be transported throughout the body successfully. The combination of cholesterol and proteins is referred to as a lipoprotein. There are two main forms of lipoproteins:

  • Low-density lipoprotein (LDL): Also known as the “bad” type of cholesterol, LDL carries particles of cholesterol through the blood. It can also accumulate within the artery walls, causing them to harden and narrow.
  • High-density lipoprotein (HDL): Commonly referred to as the “good” cholesterol, HDL carries excess cholesterol back to the liver. 

If your body has too much LDL, you could face an increased risk for serious health issues. Alarmingly, however, high cholesterol exhibits no symptoms, and the only way to test for high cholesterol is to have a blood draw.

Causes of High Cholesterol


Mature man eating donut while holding a second donut in his hand

The causes of high cholesterol span far and wide. Some contributing factors are within an individual’s control to change, while others are not. For example, while diet, weight, and exercise levels can influence HDL, factors such as age, gender, and genes can also contribute to LDL or HDL levels. Thus, the best way to maintain healthy cholesterol levels and thus support better cardiovascular health, is to focus on the factors within your control to change. Let’s take a closer look at the causes behind high cholesterol.

  • Diet: Cholesterol comes from two sources. While the liver produces all the cholesterol the body needs, we also take in cholesterol from foods derived from animals. This isn’t to say that eating meat or dairy products is bad for you. Foods with trans fats, however, cause the liver to produce even more cholesterol, which can lead to high cholesterol levels in some individuals. In addition to heavily processed animal products with trans fats, many baked goods can also trigger the liver to produce excess cholesterol. [5] 
  • Exercise Habits: Having a sedentary lifestyle can contribute to high LDL cholesterol. Regular aerobic activity, in particular, can help control LDL and in some cases promote healthy HDL levels. [6]
  • Weight: A large waist circumference and obesity are also associated with high cholesterol. [7]
  • Smoking: Smoking can lower your good HDL cholesterol, but it can compromise cardiovascular health in many other ways. In itself, smoking can increase the buildup of plaque in the blood vessels, damage the cells that line the blood vessels, and cause the vessels to thicken and narrow. [8]
  • Age & Gender: Cholesterol levels tend to rise naturally as we age. Prior to menopause, women’s total cholesterol levels tend to be lower than their male peers. After reaching menopause, however, their LDL cholesterol levels tend to rise, and HDL may also decrease. [9]
  • Hereditary Factors: Genetics play a role in the amount of cholesterol the body produces. High cholesterol can run in families, so individuals with relatives who have high cholesterol should be especially proactive in getting their levels checked.

Dangers of High Cholesterol


mature man gripping chest while sitting on couch in pain, mature man having heart attack on couch at home alone

Having high LDL cholesterol increases the risk for heart disease, the leading cause of death in the U.S. [2] Heart disease refers to a range of conditions which can affect the heart, many of which can lead to heart attack or stroke. Also known as hypercholesterolemia, high LDL increases fatty deposits within the arteries, thereby also increasing the risk of blockages. When cholesterol builds up on the artery walls, it forms what’s known as a cholesterol plaque. This plaque can restrict blood flow, also increasing risk for blood clot. Should a blood clot block the artery in the heart or brain, it can lead to a heart attack or stroke.

The good news is that high cholesterol can be treated with medication and managed through lifestyle modifications. First, however, you must know where you stand. Here is a general scale of LDL cholesterol numbers and what they mean.

  • Less than 100: optimal
  • 100-129: near optimal
  • 130-159: borderline
  • 160-189: high
  • 190 or higher: very high [3]

Keep in mind that in addition to having high LDL, having low HDL (again, the “good” cholesterol) can also put you at risk for heart disease. Thus, this too should be measured, with an ideal score of 60 or more. If HDL is less than 40, it could be considered a risk factor. [4]

The American Heart Association advises every adult over the age of 20 to have their cholesterol tested every four to six years, but these figures will vary based on the factors outlined above and on previous clinical indications.

Should high cholesterol be discovered in your blood test results, there are many ways to begin controlling it.

How to Lower Cholesterol Levels


Mature couple jogging and running outdoors in the city, Mature couple carrying reusable water bottles while jogging through the city

Lifestyle and diet changes are among the most effective ways to prevent and lower LDL. Additionally, if you’re a smoker and haven’t already done so, make a plan to quit. Here, we’ll explore some detailed changes that work well for lowering LDL cholesterol.

Dietary Changes

While there are many wise eating habits you can incorporate into your dietary plan to improve cholesterol levels, the lowest cholesterol levels are found in diets with the highest soluble fibers. [10] Diets high in soluble fiber often align with the typical anti-inflammatory diet, which emphasize foods like kidney beans, Brussels sprouts, and apples. Soluble fiber has the ability to reduce cholesterol absorption in the blood, making it a powerful nutrient for individuals with high LDL cholesterol. [11]

Additionally, eliminating trans fats found in margarine and store-bought, processed snack foods can help to reduce cholesterol. Individuals may also wish to incorporate foods rich in omega-3 fatty acids such as walnuts, flaxseeds, salmon, and mackerel. While these foods won’t affect LDL cholesterol themselves, they do have other cardiovascular benefits, such as the ability to help reduce blood pressure.

Exercise

Regular physical activity can support better cholesterol by increasing HDL. [12] Generally, most individuals can benefit from 30 minutes of exercise five times per week, or 20 minutes of high-intensity exercise three times a week. With that being said, it’s important for each person to work with an experienced physician who can make exercise recommendations based on the individual’s starting physical health.

Losing weight is another helpful way to control cholesterol, which can often be achieved with a strategic approach to dieting and exercising. Reducing alcohol consumption may also help to control cholesterol levels.

In some cases, medications may be needed in conjunction with the lifestyle and dietary changes described above to control especially high cholesterol levels. Even if medications are needed, maintaining a healthy lifestyle can help keep medication doses as low as possible. 

Understanding Your Risk for High Cholesterol – In Conclusion


Because it exhibits no outward symptoms, high cholesterol is a dangerous threat to health, which can have serious implications if left unaddressed. Its impact on heart health cannot be overstated, and while there are some factors which are beyond an individual’s control to change, many behaviors that influence cholesterol can be modified.

At Cenegenics, your individualized treatment plan begins with a comprehensive lab panel to test for underlying health issues, such as high LDL or low LDL cholesterol. Based on the findings, our clinical team devises tailored roadmaps to help you become healthier and enjoy a better overall quality of life. For instance, while our approach to healthy eating and exercise will certainly help to lower high cholesterol with ongoing compliance, it can also support weight loss, improved cardiovascular health, and reduced risk for disease. With the knowledge that the many measures of health are complex and often interconnected, we treat the entire patient, not just a single symptom or isolated condition.

If you’re interested in controlling your cholesterol and optimizing your wellness overall, contact your nearest Cenegenics location for more information.

Next Steps to Controlling Your Cholesterol

FREE Consultation

Our world class physicians create a personalized plan to help you feel 10+ years younger. You'll be more energetic, lose weight, sleep better, have more libido, and think more clearly. Click below to schedule a free consultation with one of our physicians. It's quick + easy. 

About the Contributor

Rudy Inaba 
Global Director of Nutrition & Exercise

Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

References

[1] CDC, “High Cholesterol Facts.” 6 Feb. 2019. Retrieved from URL: https://www.cdc.gov/cholesterol/facts.htm 

[2] CDC; see above.

[3] Cleveland Clinic, “Cholesterol Numbers: What Do They Mean.” 26 July 2017. Retrieved from URL: https://my.clevelandclinic.org/health/articles/11920-cholesterol-numbers-what-do-they-mean

[4] Cleveland Clinic, see above.

[5] American Heart Association, “Control Your Cholesterol.” 30 Apr. 2017. Retrieved from URL: https://www.heart.org/en/health-topics/cholesterol/about-cholesterol

[6] Bhatt, Ami, MD, FACC. “Cholesterol: Understanding HDL vs. LDL.” Harvard Health. 12 Apr. 2018. Retrieved from URL: https://www.health.harvard.edu/blog/understanding-cholesterol-hdl-vs-ldl-2018041213608

[7] Bhatt, Ami; see above.

[8] CDC, “Smoking and Heart Disease and Stroke.” 28 Jan. 2019. Retrieved from URL: https://www.cdc.gov/tobacco/campaign/tips/diseases/heart-disease-stroke.html

[9] Cleveland Clinic; see above.

[10] Leake, Jeffrey Park, M.D., CPT and Greenberg, Todd David, M.D., CSCS. The Textbook of Age Management Medicine: Volume 1. 2015, Leake-Greenberg Ventures. (125)

[11] Mayo Clinic. “Top 5 lifestyle changes to improve your cholesterol.” 11 Aug. 2018. Retrieved from URL: https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/reduce-cholesterol/art-20045935

[12] Mayo Clinic; see above.

= Mature business man in suit standing outdoors with urban background

Benefits of Fish Oil on Mental Health & Overall Wellness

We need, ultimately, to be able to view mental health

with the same clear-headedness we show

when talking about physical health.

Matt Haig

While physical health may command the most attention from the media, flooding inboxes and capturing magazine headlines with information on how to lose weight, brain health is equally deserving of our attention. After all, without our mental acuity, very little is possible. It’s therefore essential that we begin looking for more ways to boost our mental health, giving it equal respect and effort as we do our physical wellbeing.

Supporting mental health doesn’t just mean practicing self-care and doing things that improve your mood. It also means nourishing the brain in the same ways you would your body. We tend to put so much emphasis on how what we eat will affect our physical appearance and fuel our body, that we wind up overlooking how our diets can influence one of the most important organs of all: the brain.

Frustratingly, the modern American diet has many gaps, even for those who follow healthy eating principles, but that doesn’t mean you can’t address these gaps. While mental health is influenced by many complex factors, some of which are not always within our control to change, it is possible to supply your brain with the type of fuel it needs most. Specifically, incorporating a supplement into your daily routine could help to nourish your brain with powerful essential nutrients. Discover the benefits of the leading supplement for brain health, marine fish oil, here.  

What is Fish Oil?


Fish oil pills in wooden spoon on table

Fish oil is a natural substance derived from certain types of marine life. It’s rich in two essential polyunsaturated fatty acids which are necessary for normal growth and development: EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). These nutrients cannot be produced by the body and can therefore be obtained only through diet. Because omega-3 fatty acids are difficult to take in through diet alone, taking a dietary supplement is the most effective way to address gaps.

The Main Benefits of Fish Oil


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The omega-3 fatty acids DHA and EPA are extremely valuable for promoting healthy brain function. They can even support cognitive function in patients with Alzheimer’s disease (AD) and, in fact, research suggests that low intake of the two nutrients could be associated with an increased risk for AD.  This could be because DHA plays an important role in nervous system function, which may influence AD and overall cognitive function. Studies have found that diets high in omega-3 fatty acids are strongly associated with a lower AD risk. [1]

Benefits of Fish Oil

Fish oil supplementation plays a large role in brain health, as well as mental health. Fish oil can: 

  • Support cognitive function in patients with Alzheimer's disease
  • Alleviate symptoms of schizophrenia and bipolar disorder
  • Promote better overall brain health
  • Slow rate of mental decline with age
  • Support mental health

Beyond potentially aiding in AD prevention, however, it’s suspected that fish oil can support brain function in other ways. The brain is nearly 60% fat, much of which is made up of omega-3 fatty acids. Certain research shows that people with some mental disorders, including major depression and schizophrenia, have lower levels of omega-3s in their blood. [2] Studies have shown that taking marine fish oil supplements regularly can improve symptoms of or even prevent certain psychotic disorders in at-risk individuals. [3]

Supplementing with fish oil could also alleviate symptoms of schizophrenia and bipolar disorder. [4] Thus, while there may be a complex interplay of factors contributing to the risk and development of brain and mental health conditions that are beyond our control, we should take full advantage of the steps that are within our control, such as nourishing the brain and adopting healthy lifestyle habits overall.

Support Brain Health

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Fish oil doesn’t just help to lower your risk for AD and mental disorders, however. It can also support better brain health in all individuals. While brain function slows down as we age, certain nutrients have the power to slow the decline in mental function. Individuals who eat more fish, in particular, have been shown to experience a slower rate of mental decline through old age than their peers. Fish oil has also been associated with improved memory in healthy elderly populations. [5]

Clearly, getting enough omega-3 fatty acids is one of the best things you can do to support brain health. Yet, the American diet has evolved over the years and, while the current American diet tends to be high in saturated fats, it’s generally low in omega-3 fatty acids. Fish oil supplements are primary sources of EPA and DHA, which is why they’re so widely recommended as a powerful preventive health tool. [6] Yet, there are even more compelling reasons to take fish oil supplements. Outside of their ability to support mental health, they also have a number of other advantages on wellness overall.   

Why Should We Be Taking Fish Oil Supplements | Additional Benefits


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The benefits of fish oil extend far beyond brain health alone, improving health outcomes in a number of key areas. Here are just a few of the ways taking fish oil supplements can support your physical wellness:

  • Improves cardiovascular health: Heart disease is the number-one cause of death worldwide. Individuals who take in sufficient fatty acids have lower heart disease rates. This is likely because fish oil can regulate cholesterol levels, lower triglycerides, lower blood pressure in individuals with elevated levels, reduce arterial plaque, and reduce fatal arrhythmia events. [7]
  • Supports flexibility of joints and cartilage: The Arthritis Foundation® recommends fish oil as a treatment for reducing inflammation and morning stiffness in joints, especially for individuals with rheumatoid arthritis (RA). In fact, the foundation even suggests that fish oil may inhibit RA development. RA patients who took fish oil s