Jacqueline Stoken, DO, PC

10/27/2025

Good advice. Keep moving!

There’s a lot of buzz about Dr. Peter Attia’s message that cardiorespiratory fitness (and strength) may predict longevity even better than blood pressure, cholesterol, or glucose levels.

He’s right — aerobic and muscular fitness are enormously protective. Every 1 MET increase in fitness (that’s one “metabolic equivalent,” roughly the energy cost of walking at 3 mph) can lower all-cause mortality risk by about 10–15%. METs are reported on exercise based stress tests. If you’ve had one in the past, go back and look and see what your MET level achieved was.  If you achieved greater than 8. That’s good. Greater than 10, even better. No uncomfortable VO2 max mask required.

But that doesn’t mean fitness replaces the importance of blood pressure, lipids, or insulin sensitivity. The best outcomes come from stacking these wins, not trading one for another.

👉 Blood pressure goal:
If you can keep your systolic pressure below 120 mm Hg naturally (through nutrition, activity, weight control, and sleep), that’s ideal.
If medication is needed, then maintaining below 130 mm Hg is still highly protective — the small difference mainly reflects that medications can sometimes introduce mild side effects that lifestyle doesn’t.

👉 Cholesterol & insulin sensitivity:
Fit people often have better insulin sensitivity and lipid profiles, but high ApoB or non-HDL cholesterol can still drive plaque formation even in athletes. Fitness reduces the risk — it doesn’t erase it.

👉 VO₂ max and METs — keep it simple:
You don’t need a fancy VO₂ max lab test to know your fitness level.
• METs can be easily estimated from a standard treadmill exercise stress test — something most hospitals and clinics can do.

• Or try a Cooper 12-minute run/walk test (distance covered in 12 minutes) to estimate aerobic capacity yourself (for instance, 8 minute mile at my age of 57 would be excellent).

• If you can briskly climb several flights of stairs without breathlessness (meaning the inability to reasonably speak) or sustain a solid 30-minute brisk walk, jog, or bike ride, you’re already in the range where cardiorespiratory fitness powerfully lowers mortality risk.

Formal VO₂ max testing is fascinating for elite athletes and researchers, but it’s not required — nor scalable — for population health. The principles are simple and low cost, even free: Move often. Stay strong. Be consistent.

09/02/2025

09/01/2025

A large international study has found that a Covid-19 infection can accelerate the aging of blood vessels, particularly in women.

The research, published in the European Heart Journal, suggests that even mild cases of Covid may result in what scientists call “early vascular ageing”—a condition in which blood vessels become stiffer and behave as if they belong to someone older, thereby increasing the risk of cardiovascular events such as heart attacks and strokes.

The study followed 2,390 participants across 16 countries. Researchers measured the stiffness of their arteries using pulse wave velocity (PWV), a method that tracks how quickly blood pressure waves move through the body. Higher PWV readings indicate stiffer vessels and a higher “vascular age.”

The results showed that people who had Covid—whether mildly or severely—had stiffer arteries compared to those who had never been infected. In women, even mild infections led to a clinically significant rise in PWV, equivalent to approximately five years of vascular aging. The stiffening was more pronounced in those who experienced long Covid symptoms like fatigue and breathlessness. Women treated in intensive care saw the greatest increases in vascular aging, with their PWV rising by over 1 meter per second.

Vaccination appeared to offer some protection, with vaccinated individuals showing less arterial stiffening than their unvaccinated counterparts. Importantly, the vascular effects seemed to stabilize or slightly improve over time.

Scientists believe the virus may damage blood vessels by targeting ACE2 receptors, which are abundant in the vascular lining. Women’s stronger immune response might paradoxically lead to greater post-infection inflammation, explaining their heightened vulnerability.

Follow Science Sphere for regular scientific updates

📄 RESEARCH PAPER

📌 Rosa Maria Bruno et al, “Accelerated vascular ageing after COVID-19 infection: the CARTESIAN study”, European Heart Journal (2025)

08/31/2025

The American College of Cardiology now recommends that adults with heart disease receive vaccines against influenza, COVID-19, and RSV, citing their higher risk for severe respiratory infections, hospitalization, and death. http://ms.spr.ly/6186swiZp

08/29/2025

Are you a football fan? Got the munchies?

Score big with these crowd-pleasing vegan Super Bowl recipes that will have even meat lovers coming back for seconds!

08/28/2025

Could fiber be any more delicious?

From breakfast to dessert, these tasty meals are all vegan and full of fiber to help you feel full for longer.

08/13/2025

A toast to your health ~

100 easy vegan recipes for beginners! Easy plant-based meals that use simple ingredients found in your pantry.

08/04/2025

Something else to consider

Try these tests – from balance to aerobic fitness, personal trainers share different ways to measure your health, and how to improve it.

08/04/2025

Here’s a quick test for you!

If you can finish with 10 points, you're in great shape

07/15/2025

A new policy adopted by the AMA recommends a plant based diet amongst other lifestyle activities in the prevention of breast cancer.

In June 2025, the American Medical Association (AMA) introduced a new policy focused on reducing breast cancer risk through lifestyle modifications, emphasizing proactive prevention strategies to empower women and address health disparities. This policy, highlighted by Neal Barnard, MD, FACC, in a discussion with Contemporary OB/GYN, encourages clinicians to educate patients on four key strategies: adopting a plant-based diet, engaging in regular physical activity, minimizing or eliminating alcohol consumption, and maintaining a healthy body weight. These recommendations stem from growing evidence that lifestyle factors significantly influence breast cancer risk and outcomes, offering women practical steps to take control of their health.

The AMA’s guidelines underscore the power of nutrition, particularly the benefits of a plant-based diet. Such diets, rich in fruits, vegetables, and whole grains, support weight management, which is critical since excess body weight is a known risk factor for breast cancer. Notably, the guidelines clarify that soy products, once thought to increase risk, can reduce breast cancer risk by up to 30%. Conversely, cow’s milk, which contains estradiol—a hormone linked to higher cancer risk—should be replaced with alternatives like soy milk for a simple yet impactful dietary shift. Regular exercise is another cornerstone, as it helps maintain a healthy weight and reduces cancer risk, while also improving outcomes for those already diagnosed.

A significant focus of the AMA’s policy is reducing alcohol consumption, a well-established risk factor not only for breast cancer but also for other cancers. The guidelines advocate for minimizing or eliminating alcohol to lower risk, addressing a gap in public awareness—only 28% of women in a 2024 survey recognized diet and lifestyle as cancer risk factors, with many prioritizing screening over prevention. To overcome barriers like time constraints and reimbursement issues that limit physicians’ ability to provide in-depth counseling, the AMA suggests referring patients to registered dietitians for tailored guidance.

The policy also tackles racial disparities in breast cancer outcomes. While Black women are 5% less likely to develop breast cancer than white women, they face a 38% higher mortality risk, often due to diagnoses at younger ages and with more aggressive cancers. The AMA’s emphasis on lifestyle interventions aims to complement screening efforts, such as mammograms starting at age 40, to improve early detection and treatment outcomes, particularly for high-risk groups. By aligning with initiatives like the Physicians Committee for Responsible Medicine’s “Let’s Beat Breast Cancer” campaign, the AMA seeks to raise awareness and empower women to adopt these preventive measures, fostering long-term health and reducing the burden of breast cancer across diverse populations.

07/04/2025

Happy Fourth of July 🇺🇸 Beautiful Des Moines