Compass Fat Loss



Heart to Heart – Cardiovascular Function & Risk

by | Nov 24, 2022

Happy Sunday To All!

As I release this Sunday’s post, I am most likely sunning on a beautiful beach in Aruba…ah, vacation at last…as unplugged as my nature allows be to be, but still thinking of all of you back home. Just because I’m vacation doesn’t mean you get a vacation from my ramblings (and hopefully a bit of education)! As previous posts over the past couple of weeks have been focused on program changes, etc. I wanted to get back to discussing some pertinent clinical issues which I always hope might give you all a better understanding of why we do what we do.

First, I’d like to concentrate on cardiovascular risk factors and health, digging into those factors which predispose us to a greater risk of coronary disease, stroke, ischemia (compromised blood flow), decreased cognitive function, and yes, for guys, even ED. While there may be some genetic and familial tendencies to have lesser or greater risk here, by far the largest percentage of risk arises from poor lifestyle choices…diet, exercise, stress level, sleep quality and duration, insulin balance, and yes – nitric oxide levels, that little known gas I allude to so often. So, if you have not yet gotten to the point where you have been prescribed medications for lipid control, high blood pressure, or improved cardiac function…or if you are already taking one or more of these meds, read on, as this information can help keep you from needing them, or even help get you off some or all of them. You all know I speak from experience, as I see this occur daily in my practice.

Assuming the heart is functioning properly as a mechanical pump, there are two primary factors which then affect cardiovascular function and health…1. The caliber of blood vessels, and 2. The condition of blood vessels. By the caliber, I refer to the diameter of the internal lumen…is blood coursing through a swizzle straw or a garden hose (extreme example). Obviously the larger the caliber, the more blood can flow, again assuming adequate heart function…so under most circumstances, we want to maintain maximum ability to increase or decrease vessel caliber upon demand, the demand arising from the oxygen and nutrient needs of the specific tissue being supplied. Now, three major factors affect the diameter of blood vessels…1. The nerves which supply the vessel in question, causing them to either constrict or dilate…2. The presence of hormones (ex. Adrenalin)…and 3. Levels of nitric oxide in the bloodstream. The first 2 can be affected by stress from multiple sources, or states or conditions which affect autonomic nerve function; high chronic stress levels or increased sympathetic nerve tone will over time cause a state of chronic vessel constriction, often resulting in hypertension and decreased perfusion (blood flow) to tissues and organs. The 3rd, levels of nitric oxide in the blood can be affected primarily by diet and healthy mouth and gut flora. When good practices are not followed, nitric oxide levels plummet, causing both constriction of blood vessels as well as reduced health and resilience of the vascular endothelium, the most inner lining of your blood vessels, predisposing them to inflammatory processes leading to plaque buildup and ultimate thrombosis (a clot breaking free). Over time the condition of the blood vessels will deteriorate, the endothelium will form plaques, inflammation of these lesions will continue, and the outcome is never good. Current condition can be assessed by specific lab tests, including cholesterol fractionation, LDL pattern, myeloperoxidase, TMAO, and other specific markers, but whatever the findings, or if the testing is not performed at all, things can be done to dramatically reduce risk and even reverse any damage already done. Proper diet (much of the reason you are here in the first place) including foods high in nitric oxide or compounds which promote nitric oxide production, specific nutritional supplementation, proper exercise, proper oral hygiene, and practices to reduce stress and improve sleep will all contribute to improving the risk and outcome dramatically. I’ve taught all of this at one point or anther if you’ve been here long enough to follow it all, but am happy to go into more detail if any patients have specific questions.

This segues us briefly into the final topic, the new practice model…which is designed to allow me more time to spend with patients discussing their personal questions or issues, including more detailed discussions on topics like the above and how to get the most out of the latest research and my knowledge base. Many have already made the switch…some have asked if they choose not to transition to the new model, will they simply cease being monitored and communicated with on a regular basis. In order to accomplish my goal of giving more attention to fewer patients, the tough answer is YES…however, and as I have been telling those who ask, any current Extended Support Plans or Restarts shall continue through to their expiration, at which time each patient may decide whether continuing to work closely with me personally is a good fit for their needs and their budget. I wish to continue to work closely with every patient who finds benefit from the interaction, the process, and remains fully motivated…and I respect any decisions each patient makes at the appropriate time.

Please enjoy the balance of your Sunday; I hope you all had a wonderful Thanksgiving holiday! Be ready for a new clinical discussion next Sunday!


  1. Sharon M

    I am struggling to keep my motivation on this journey. I lost 50# last year but recently regained some … life struggles, illness and death of loved ones, changes at work, stress and decreased time to shop, plan and prep meals has been a struggle. I appreciate the education. I definitely need more work with a counselor. HELP!!

  2. Laura

    When you return from your trip to the beach we need to talk about nitric oxide

  3. Melissa Garuti

    Can we touch base about restart options?


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