Is Your Heart filled with Gold or Is It Clogged?
This could save your life, or your parents or a loved one.
Is Heart Disease Stalking You?
Your heart needs to be open, for from it comes the source of life, your blood.
Just a few weeks ago, I completed my weekly 75 km ride with a hard 23-minute effort in a three-hour ride. I felt strong and fit. 200-watt average, and I thought that at my age of soon-to-be-55 years, I was in the best cardio fitness of my life.
My goal is to increase my VO2Max because it's one of the best predictors of longevity. Then, keep it up until my 80s with 30-minute high-intensity interval bike rides three times a week.
My dearly departed friend Rob Thompson died of a sudden heart attack at age 58 on Feb 10, 2025. His wife, Anita, a physician, implored their 1000s of friends at his celebration of life to get a calcium heart scan. So I got one a couple of weeks ago. My friend Jesse said he was 100% sure I would get a great result. I wasn't so sure, as I ate junk food and fried foods for decades until my mid-30s.
A score of 0 is excellent. My wife delightfully got that 0 score. Me? I was expecting a score of around 200-300--moderate atherosclerosis. I was somewhat shocked to see a score of 500, which signals possible severe atherosclerosis. This score places me in the top 90% percentile for my age group, requiring further investigation to see how much my coronary arteries are clogged.
Your Arteries Start Developing Plaque in Your 20s
The flow of life is impeded by processed foods, stress and lack of sleep.
Dr. Kevin Ham
A Korean War study examined the coronary arteries of 300 American soldiers who had died in their 20s and found that 77% had visible signs of coronary atherosclerosis (plaque buildup in arteries) and 45% had moderate to severe narrowing (≥50% luminal stenosis) in at least one major coronary artery. The soldiers were, young (early 20s), lean, physically fit and had no known symptoms of heart disease. I had a hunch from this study that the sins of my dietary past would be hard to erase. Last year, my neck arteries and carotids showed mild atherosclerosis, so I expected the same in my heart.
When I saw my score of 500, I thought the worst-case scenario was my arteries being clogged by 80%+. But logically, this made little sense to me as I had no chest pain or shortness of breath, even when riding with the fastest bike riders in the city or with pro riders. Could my arteries be that blocked? Did my atherosclerotic plaques calcify because they were older?
Here’s what I learned.
Hard calcified plaques don't cause heart attacks, even though they may narrow arteries.
Soft uncalcified plaques, which aren't detected on calcium heart scans, can cause heart attacks as they rupture into the blood stream, blocking blood flow.
A rate of calcification and soft plaque formation greater than 15% signals a high risk of a cardiac event in the next five years.
A calcium heart scan has the radiation equivalent of a year's worth of background radiation.
Women have less atherosclerosis and lag behind men by 7 to 10 years due to the protective effects of estrogen and menstruation.
Women need to be careful after 50 or when they are post-menopause because estrogen declines significantly, and they lose the protective effects.
Due to my eye condition (wet macular degeneration), which is also likely caused by the same atherosclerotic process, I've cut out almost all processed foods, heated oils, fried foods and most refined sugars. But my diet is high fat, up to 40% fat, as I drink kefir, lattes, butter, liver, fish eggs, meats, eggs, etc. My LDL is slightly elevated ("bad") but my HDL is high ("good"). My blood results are good in all other areas except that I have slightly elevated iron, which I can lower simply by donating blood.
How Much Am I Clogged? And You?
We’re all clogged somewhere because of our past. Why don’t we fix that?
Source: Kauvery Hospital
While my calcium score is pretty high, logically, with my VO2Max being high, I'd be very surprised if my coronary arteries were clogged more than 30%. However, this follows the theory of constraint—where is the most constricted area? If only one area is clogged heavily, I need to modify my lifestyle even more drastically.
I keep thinking of Rob. If only he had a calcium heart scan earlier, he would have found out his LAD was 90% clogged and his RCA 80%, giving him a risk of >70% sudden death. His gift to me may reveal issues with my coronary arteries..
I was riding my bike with my daughter, and for the first time in years, I put on my heart rate monitor. As we rode up the hill, I asked how high her heart rate was. 130. Mine was 100. At 12% grade and a harder effort, hers was 180 and mine 130. I then did my own hard max effort for a minute to see how high my heart rate would go. 220 minus your age is a standard max heart rate. My heart rate climbed slowly and steadily to 171. I pushed it harder, and it hovered there. I relaxed and then, after 30 seconds, went hard again to see … 170.
I think my arteries are under 50% clogged, but I will take it easy until I get a CT angiogram, which will disclose the degree of blockage.
Just like Rob's wife, I ask that you get a baseline calcium heart scan if you are older than 40. You can get one for as little as $100-$200 in the US. I had to pay $700 CAD for mine. I plan to buy a CT scanner one day and offer it for $100 CAD, and I hope to save or prolong many lives in Canada on behalf of Rob's legacy.
How to Prevent and Reverse Heart Disease
Not too many doctors will advise you about diet. Doctors aren’t taught food and nutrition, only diagnosis and medical treatments.
Preventing and Reversing Heart Disease. Figure 1. Coronary angiograms of the distal left anterior descending artery before (left image) and after (right image) 32 months of a plant-based diet without cholesterol-lowering medication showed profound improvement.
In 2012, I was praying to God to reveal to me how to cure heart disease. I often liked to hang out at Regent Bible College bookstore, and as I was browsing the Specials Table, I saw a cover call to me, "Preventing and Reversing Heart Disease." What was a health book doing at a Bible bookstore, I wondered.
As I flipped through it, I looked at before and after CT angiograms of a clogged coronary artery having complete reversal in an unstentable area of the LAD. I was shocked. I never heard of clogged arteries being reversed.
The author was Dr. Caldwelll Esselstyn, who was head of the Cleveland Clinic, one of the top medical clinics in America. He was a cardiac surgeon who studied a group of 24 patients with advanced coronary artery disease. These patients could barely walk to his office without stopping for a rest.
He devised a strict low-fat (only 10%), whole food and plant-based diet based on medical studies that would keep LDL cholesterol lower than 70 (1.4 in CAD measurements). He believed that at these low levels, atherosclerosis could not take place. He followed these patients for over 12 years. At the end of the study, none of the 18 patients who followed the diet had further cardiac events (no heart attacks, strokes or deaths). The six patients who did not adhere to the diet had a combined total of 13 cardiac events among them.
When I saw my score of 500, I knew this was the perfect opportunity to measure my own progress over the next year based on diet. I decided I would follow this essentially vegan diet, minus meat, fish, dairy, eggs, nuts, avocados, and all oils for a 10% fat diet. It will be tough for me, but I only have one body and have always wanted to test this because I had assumed I had blockage myself. I will do annual calcium scans and CT Angiograms.
The other diet I want to test is Dr. William Davis's diet, which is a gluten-free, whole food diet that removes processed foods. You can eat meat, eggs, fish, vegetables, and fruits. A low-carb diet. He is a cardiologist but was getting metabolic syndrome (prediabetes, high blood pressure, 'wheat' belly). His thesis is that modern wheat and refined wheat (white bread) causes the formation of many small-sized LDLs, which readily oxidize and form foam cells when the inner lining of the blood vessels are injured by heated oils and refined sugars (processed foods and fried foods).
You can read his book Wheat Belly. He suggest that ancient grains and sourdough fermented breads are likely fine. He's prevented the progression of heart disease in 80% of his patients. He claims to have solved the 20% who were refractory by helping restore their gut microbiome and getting rid of SIBO (small intestine bacterial overgrowth), ensuring the thyroid is normal and no problems with gums or teeth. Ensure good levels of your Vitamin D, Vitamin K2, Iodine, Magnesium, and omega 3s (EPA/DHA). Take a high-quality multivitamin.
Caveat Emptor
We ask patients who have chest pain what their last meal was. If it was KFC or fast food, the odds of it being a heart attack were quite high. My friend had a 'silent' heart attack with some mild symptoms. She had to have four stents in four of her coronary vessels. Early 50s. I asked her what she had before her heart attack. Five Guys.
China has 11,600 KFCs, increasing by 1350 per year, while the US has 4200. I predict the incidence of heart disease and cancer will rise rapidly in urban China and surpass the US.
If you are addicted to smoking or the Western Diet or have metabolic disease, the solution is simple, but doing it is hard because your dietary and exercise lifestyle have become a habit.
For this, I recommend two books, Atomic Habits and The Compound Effect. A third, if you really like habit-transforming books, is The Slight Edge. Start with Atomic Habits by creating a system and the tiniest version of the habit you would like to do.
Make hard decisions and lifestyle changes now so your life is healthier and easier later. Or, adopt an easy lifestyle now, and it will be hard physically and mentally later.
I pray and hope that this is helpful to you or someone in your circle. Share it with your family and friends and perhaps you too can save a life.
May you live long and prosper.
Life Question:
How long do you want to live and what can you do to make that possible?
I asked a crowd ‘Who wants to live to 100 years?’ and hardly anyone raised their hands. I then asked, how about a healthy 100 years and almost everyone raised their hands.
Dr. Kevin Ham
I do wish to live to 108. Robert Marchand, who set all the world records on the bike for 90 years and older, passed away recently at 109. He's my 'physical' role model.
When I saw my score of 500, I thought maybe I should be content with living an average age of 78. But now I'm determined to help many others because of my own health scare, and I pray that God blesses me with a long life so that I can do more good in the world.
Each day is a bonus day for me since I never expected to live past 40 years when I was younger.
Thank you, Lord. Thank you, family. Thank you, everyone, for making life interesting and worthwhile.
Next week:
Another health newsletter or a Wealth Series?
Health on the heart or preventing cancer risk
Investing for the long term or
How I think the world will change because of AI and how it might disrupt you and how you might leverage it in your life and at work.
Please let me know.
I really enjoy receiving feedback. I will do my best to reply.
See you next Thursday!
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