Optimal Health & Wellness

03/31/2026

It's interesting. If I ask Grok if LDL causes cardiovascular disease, it confirms yes. if, however, I ask what are the major contributory factors to cardiovascular and metabolic disease, this is the response.

The major root cause factors for cardiovascular disease (CVD) and metabolic diseases** (such as type 2 diabetes, metabolic syndrome, non-alcoholic fatty liver disease, and related conditions—often grouped as **cardiometabolic diseases**) are primarily lifestyle-driven and interconnected through mechanisms like **insulin resistance**, **chronic low-grade inflammation**, **oxidative stress**, and **adipose tissue dysfunction**.

These are not isolated “symptoms” but upstream drivers that create a vicious cycle leading to endothelial damage, dyslipidemia, hypertension, hyperglycemia, and atherosclerosis. Genetics and aging play roles, but modifiable factors dominate.

Here are the **primary root causes**, based on scientific consensus from NIH/PMC reviews and major journals:

Insulin Resistance (the central hub)**
This is the most frequently cited core mechanism. It impairs glucose uptake in muscle/liver, drives excess free fatty acid release from fat tissue, promotes inflammation, and leads directly to hyperglycemia, dyslipidemia, hypertension, and visceral fat accumulation. It underlies the progression from normal metabolism to full cardiometabolic disease.

Obesity, especially visceral/abdominal fat and adiposopathy (dysfunctional adipose tissue)
Excess fat (particularly around organs) releases inflammatory cytokines, free fatty acids, and adipokines that worsen insulin resistance and promote systemic inflammation. This directly fuels atherosclerosis, fatty liver, and vascular damage.

Unhealthy diet (ultra-processed foods, excess sugar/refined carbs, poor fat quality)
High intake of ultra-processed foods, added sugars (including from sodas and sweet tea), and calorie-dense refined items triggers inflammation, oxidative stress, insulin spikes, and gut microbiome disruption. This rapidly drives obesity, insulin resistance, and lipid abnormalities.

Physical inactivity / sedentary behavior
Lack of movement reduces muscle insulin sensitivity, impairs fat metabolism, promotes visceral fat gain, and amplifies inflammation. It synergizes with poor diet to accelerate the entire cascade.

Chronic stress (and related factors like poor sleep)
Elevated cortisol from ongoing stress promotes insulin resistance, central obesity, inflammation, and hypertension. Disrupted sleep worsens all of the above by impairing glucose regulation and increasing appetite for junk food.

Additional contributing factors** (often secondary but still major):
- Smoking and excessive alcohol → direct vascular damage and inflammation.
- Environmental/genetic predispositions → can amplify the above (but are far less influential than lifestyle).
- Low-grade chronic inflammation & oxidative stress → these are both a cause *and* consequence, creating the feedback loop.

03/31/2026

Here is a fairly good depiction of how cardiovascular and metabolic diseases develop.

It starts in childhood. It progresses in adolescence and early adulthood. It manifests in early to late adulthood. Most concerning is that these conditions are now starting to manifest earlier in life, with even teenagers developing adult onset diabetes, high blood pressure, and fatty liver.

Honestly, we should not be feeding our children ultra processed foods, endless sugar, and sweet drinks simply for the sake of them being children. They may appreciate it now, because, after all ,who doesn't like sweets and treats, but they will pay for it later.

If changes are not effected now, this trend will continue to progress, and the epidemic of these diseases will continue to grow. Many people seemed angered by the new dietary guidelines, but you should ask yourself why. Is it because those palatable grain foods are being minimized? The baked goods, the pasta, the cereals, the bread? Is this really what should be the centerpiece of the human diet? I don't think so. Our disease epidemic certainly confirms this. Our diets are not the only cause, but they are certainly contributory. It is the One singular factor we have the greatest control over, and the one we are happy to relinquish to the food industry.

Yes, people are more sedentary than ever before.

Yes, we now carry more stress on a daily basis than our ancestors ever did.

All of these benefit from being addressed. We need to start where we can, and where we have the greatest control. That is with your food choices. It is hard, particularly in this modern society of hyper-palatable foods, but it is a necessity.

For some of us, it may be too late to stop the progression toward an initial major event, but it is never too late to start focusing on improvements, and possibly preventing the second major event. Disease progression does not stop because you crossed a threshold. You are not limited to one heart attack or stroke in your lifetime. Trust me, you can have multiple. I've seen it. Ideally, that initial major event can be prevented, but that is not possible unless significant changes are made.

03/30/2026

Somehow, we seem surprised!

I recall when I was working in the emergency department I would be admitting someone for chest pain, scheduled for a heart catheterization the following morning, and their family would walk in with a bag of McDonald's or Bojangles. It does not seem to resonate what the real causes are of cardiovascular disease.

Cardiology often blames it on LDL cholesterol or genetics. You get started on medications to reduce that cholesterol, told to eat a low fat diet rich in grains and fruits, with seed oils that also help lower cholesterol. Inevitably, you have another cardiovascular event, and you are told there was nothing you can do about it, and this is an inevitable progression. If this is true, what is the point of all those medications? Is it simply to delay the onset until the next event? We are made to feel helpless by the healthcare system, yet we are not provided true guidance on what can be done for prevention, including secondary prevention.

Does something seem wrong here?

03/30/2026

A delicious meal of tuna, salmon, yellow tail, and wagyu beef sashimi today. Beautifully laid out for us. They always do such a great job.

We've been going to this restaurant for over 17 years, ever since we relocated to North Carolina. One of the best.

03/30/2026

It's great to see us represented at a local gym.

03/29/2026

The health benefits of natural sunlight and sun exposure.

03/29/2026

We get asked about this occasionally. It is something we generally cannot recommend based on the available science. The risks appear to outweigh any benefits. We would urge caution if you plan to do this. It is not the equivalent of natural sunlight.

03/29/2026

What's the difference between Conventional Medicine and an Integrative & Functional Medicine approach?

ALMOST EVERYTHING!

03/29/2026

If you are in need of a Therapeutic Massage, Relaxation and stress relief, or interested in a Lymphatic Massage, consider scheduling with us.

03/29/2026

Our little healing space...
The Optimal Healthcare office.

03/29/2026