About two years ago we began to implement a comprehensive diagnostic health panel from Boston Heart Diagnostics. What started as a test I ordered for patients with high cholesterol or at high risk for cardiovascular disease, has now become a test I want every patient to experience. It starts with a basic lipid panel but then goes on to add a multitude of additional factors that contribute to overall health. Evaluation of lipoprotein size is an important factor as one may have “normal cholesterol” but if the particle sizes are too small they are more likely to get stuck. That teamed up with increased levels of inflammation, can lead to plaque formation in an otherwise normal looking cholesterol profile. This comprehensive test will look at particle size, inflammatory markers such as CRP and LpPLAC2 and an HDL map. Additionally, we include a more in-depth look at diabetes markers. We can see changes in these factors long before fasting blood sugar is elevated and start to make changes to prevent further health decline. Genetic testing for cardiovascular disease as well as markers for increased risk for blood clotting disorders is also available.
This type of testing was not available to us 30 years ago. But now these in-depth measurements are changing the way we think about our lifestyle and especially what was previously considered a healthy diet. We had no measurements of LDL (bad) cholesterol, small-dense LDL (superbad) cholesterol, HDL (good) cholesterol, large HDL (super-good), indicators of inflammation such as C-reactive protein, or the other sophisticated cardiovascular risk factors we can use today to unmask hidden risk and gain insights on how unhealthy diets cause cardiovascular disease. Now we can see the full picture these blood markers provide and make changes to improve them.
So why base our diets on old science? Keeping foods as close to their natural state as possible, reducing heavily processed foods and foods that our bodies were not designed to process efficiently, are changes that are best described with the Paleo or Primal-type diets.
We began testing not only total cholesterol but testing to see if your cholesterol is elevated due to overproduction from your liver or from your diet. We can take the results from these tests to help determine your risk factors for heart attack, stroke or developing diabetes even before they would typically show up in routine blood tests. Then we can discuss supplements and lifestyle/dietary changes specific to you that can put you on the right path to overall better health.
We recently had the wonderful opportunity to meet with Dr. Ernst Schaefer, a co-founder of Boston Heart Diagnostics, in our office as he traveled south from Boston. Dr. Schaefer is a distinguished University Professor at Tufts University School of Medicine and Director of the Lipid Metabolism Laboratory and the Cardiovascular research Clinic in Boston, MA. It is encouraging to have someone as well-renowned as Dr. Schaefer coming to our office to support what we do and give us encouragement that medical research is changing and we can change with it to support the patient as a whole, to make even small changes in lifestyle, supplements and medication as needed to improve heart health.
Our entire staff has had a Boston panel done and we are all using this test to make ourselves even healthier. It has been a great addition to what we do here at Carolina Integrative Medicine. My hope this month is to reach out to every one of my patients and encourage you to have these labs drawn (if you haven’t already). Once the labs are drawn you are able to complete a personalized lifestyle program based on your result. Boston Heart provides integrative nutritionists for two complimentary appointments to review your life plan. The first is a consultation in which you set your goals based on your needs individually and the second is a follow up two weeks later to check in and see if you have any questions. We recommend repeating the panel after these changes are implemented. Depending on the severity of the tests we may recommend repeat testing as early as 3-4 months or as a routine test on an annual basis.
One certainty in life, and in science, is change. The simple blood tests of the past will not suffice to help you know all about your health. So why base our diets on old science?
Although in my daily life I tend towards a primal eating pattern (naturally raised fruits, vegetables, and meats, with much variety and reduction in simple carbohydrates), I do understand we are not all the same and there is no single best diet or eating strategy for heart disease prevention. Heart disease is complex, and the optimal eating strategy for any individual depends on their unique mix of clinical characteristics. The connection between food, inflammation, high cholesterol, atherosclerosis, and heart disease cannot be interpreted by looking only at blood levels of total cholesterol. We need to look at the full picture. We beat heart disease by achieving normal healthy levels of ALL the indicators of heart disease risk, not just total cholesterol. Multiple studies indicate the more effectively we normalize an individual’s combination of heart disease risk factors, the more effectively we beat heart disease—one patient at a time. If you can’t evaluate and effectively treat all the factors we cannot take a true path to correction.
As an integrative medicine office it is often times hard to find labs that test what we want to see. Boston Heart has helped us to achieve a higher standard by providing this personalized look at heart health for our patients.