How to Prevent and Reverse Heart Disease in Women with Dr. Mark Menolascino

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Love Whoa, whoa, whoa. This show is about you, not about me. I want to help you find practical, real world ways to dial in your health and mindset so you can finally lose that weight and feel strong and energized. Stop settling for less than your personal best. It's time to find out how to look and feel better than ever. And I'll be right here with you the whole way. Hey, welcome to the podcast. So this week we are talking about such an important topic that just does not get enough play and that is heart disease. Turns out, you know, we talk about so many different issues for women, especially issues around hormones and breast cancer. But you can put all the cancers together and heart disease has them beat as the number one killer for women. So today we changed that. Today we are going to be Talking to Dark Dr. Mark Menalacino, my buddy from gosh years now. And he has written a book, the Women's Heart Solution, a Proven program to Prevent and Reverse Heart Disease for women. He's really been obsessed about that. I'm going to let him share why he got into this. It's going to warm your heart. But I, you know, I kind of got on. I'm like, that's a really bold topic like to say prevent and reverse. But that is what he's been doing in his clinic. He has over 35 years of healthcare experience. He's one of the very few physicians that's board certified both as an internal medicine specialist and in integrative and holistic medicine and a certified medicine practitioner as well as board certified advanced hormone management and anti aging medicine. He has this super cool clinic out in Wyoming that I've sent a bunch of people to. And in fact, one of the people now who's on our team goes to him and just raves about him. And when they go, he gets this in depth, personalized and whole systems consultation. What that means is that he has been really working with patients now for a long period of time and that allowed him to develop a program that now is in this book that you will be able to put into fast use. And this is super important because again, it's always bothered me that heart disease is this number one killer of women. But yet, you know, we spend so much focus on so many different things. And what he talks about today is how one of the most important things that you can do is to do the right tests. So I'll make sure to also include in the show notes@jjvirgin.com heartsolution it's like the first day with my new mouth. Today I'm going to make sure also to include our resource for LabIQ so that if you have any challenges ordering these tests from your medical facility, you can just order them from there. And I know that our buddy Dr. Alan Hopkins over there is very, very keen on LP. In fact, he did a whole talk on it at Mindshare last year. So you'll hear Dr. Mark talk about this as well. All right, Dr. Mark Menolacino, welcome to the show. So glad you're here.

Thank you, jj.

Well, this is actually not a topic we cover much, which blows my mind because it seems like we're so focus on, say, breast cancer and some of the other issues for women. Yet, you know, heart disease is our number one killer. And I love that you are tackling this subject with your book that I've been waiting for forever. The Women's Heart Solution, A Proven Program to prevent Reverse Heart Disease. Thank you for doing that. What made you decide? Because, you know, I've known you for years. You've so many things that you do at your clinic. What made you decide to focus on this?

Well, my whole career I've wondered why we didn't do it right for women. I saw so many women that came in complaining of nausea or stomach ache or side ache or back pain or neck pain and actually have heart attacks and get dismissed. So we've just done a bad job, jj, of treating women the right way for heart health, and I wanted to change it. And I think that there's so many women that have heart health issues and we focus on all the important things other than heart health for women. And I thought it was time to shine the light on the most important topic, why heart disease is such a big deal for women.

Well, why? I mean, why is that Because I'm consistently blown away that we focus on everything else and not heart disease. Why? Like, why aren't we really talking about this? And I mean, to have women come into your clinic who literally have had all the signs of a heart attack and not been diagnosed is crazy.

It is so surprising that it doesn't get the attention it deserves. And thankfully, all the other conditions are getting attention. But the, the real story is that more women die of heart disease than all cancers combined. And so it is time that we, we raise the veil. And, and honestly, I think the reason is it's a male driven medicine society. We make everything about the men. We do all the studies on men, all the diagnoses, the treatments, all the therapies are based on what works for men. We haven't looked at what works for women. How do we find it? How do we assess and address heart health for women? And now it's changed.

Yeah, I know. Like just looking at studies and stuff, it's like, okay, where are the women? Where are they? Yikes.

Probably the best study on women done of all is the Women's Health Initiative that looked at hormone health in women. Unfortunately, they didn't look at bioidenticals, but when they looked at that data, they looked at how do the cholesterol drugs benefit women. And for stroke prevention, they benefit them not at all. The risk of getting diabetes from taking the cholesterol medicine was over 50% for postmenopausal women. So, boy, we just got it wrong. We're not assessing it right and we're not addressing it. Right.

I also feel like that study just created a ton of fear around hormone replacement and didn't explain that there's a massive difference between bioidentical and synthetics. So I'm not sure that that study did anything really valuable.

Well, studies are great and we want to practice evidence based medicine. We want to look at all the research to help guide us to make the right decision. The problem is we're doing bell shaped curve medicine. We're treating population averages. We're not focusing on the unique individual woman. And I think that's what's changed in integrative and in functional medicine. It's a personalized approach, and that's what women want and that's what they deserve.

Yeah. So let's talk about your approach. What, you know, someone comes into your office and what do you do and how is. And now you've translated this into your, into this book. What's your approach? How is it different?

Well, the first Thing I do is listen. I ask them to tell me their story. What's so unique about them? What is their history? And everybody has such a different story. And again, instead of looking at everybody as the same, let's look at what's unique about the individual in front of us. The average doctor interrupts their patient in 11 seconds. We let them talk for 30 minutes. We hear the whole story. And being a good listener, I think, is paramount to being a good doctor.

So hearing all of these things, how has that helped you put together this plan? Because your promise with this book is to prevent and reverse heart disease. That's pretty bold, my friend.

Well, I appreciate that, and I'm up to the challenge because we do it every day, and I call it the trifecta. And what the trifecta is, there's three things we need to do, and we need to do them right. The first is the right blood test and the standard cholesterol. Good HDL, bad LDL is so 1975. It has not changed since I was in high school. And what we really need to do is look at the sub particles. They call it a fractionated cholesterol. At the small, sticky ones, lipoprotein A, which is the biggest risk factor for women in all of the cholesterol tests. But then we know that heart disease and really, heart attacks have much more to do with inflammation in the heart than they do with cholesterol in the heart. So the first part of the trifecta is do the right blood tests. They're available. Most doctors have access, but most doctors don't even know about them. So find a doctor that knows about these advanced cholesterol panels with the inflammation markers. The second thing is a stress test. You can be a fit woman, and jj, you could pass a stress test, a treadmill stress test, have a 99% blockage. But if you add an ultrasound with the stress test, you can't beat that. So just remember, for everyone listening, don't just do a treadmill stress test. Do it with some imaging, preferably an echocardiogram. It's called a stress echo. Anyone that's gonna have a stress test should have the right kind of stress test. For women, it's a stress echo. For men, it's the stress thallium, because we don't like radiation to women's chest. The third part of it, and a lot of times, this is what's done first. It's called a carotid intima media thickness, or cimt. CIMT for short. What it is It's a non radiation ultrasound of the neck arteries, but it looks at the millimeter level of the lining of the blood vessel, not just how big the pipe is. We thought heart disease was a plumbing problem. It's not. It's an inflammation problem. So it looks at the inflammation of the small lining of that blood vessel and that's probably the best way to see do we have to worry about this woman or not.

Now, we talked a little bit, you know, as we talked about that study about hormones, we kind of floated out there. So let's dive into that and let's go expand it to not just looking at estrogen and progesterone, but also testosterone. Thyroid, adrenal, how, how does all that.

Come into play here?

Well, I think of women as this beautiful symphony. And to feel good as a woman, you have to be in harmony. Your symphony has to be in harmony. The pituitary is the conductor. She's a little gland at the base of your brain that controls everybody. She talks to your thyroid, to your adrenal, to your female hormones. They interact with your gut chemistry and it all works together to have this beautiful harmony of the women's hormone symphony. So it's not just about putting back estrogen or giving progesterone. It's about optimizing thyroid, supporting the adrenal, balancing the female hormones and optimizing gut function. You have to do all of those for a woman to feel good and to have the prevention necessary to prevent things like heart disease or cancer.

So someone reading your book, what's like step one?

Well, I think the first step is to get the right blood test because if you don't know what your risk is, then you really can't make good decisions. I also think the key is to find a doctor that knows how to look at you individually. If you're getting the 45 to 60 minute wait for your doctor, you're getting seven minutes with them. They interrupt you in 11 seconds, go find another doctor. You can go to the Institute for Functional Medicine and find one that's trained like I am. There's more and more out there, but there's very few of us. But there's an army coming and they're an army of nurse practitioners, of health coaches and a functional, integrative minded doctors that want to do a better job and make it more personalized. So they're out there, they're in your community.

You know that blood, the blood test you're talking about, you can now do direct to consumer ordering on them. I love that you're saying this because it makes me think that part of the problem here is that people aren't getting the right labs. They're not even realizing they're at risk. And, you know, I know a lot of times your first sign of heart disease is a heart attack, which is the last way you want to find out.

And here's how scary it is, jj. Two of your three friends will die of heart disease. The first warning sign in half of them, the first warning for half of them is sudden death. You don't get a second chance. Your first symptom could be you're dead. And I don't say that to scare people. But that's what this. That's what the facts are. That's how scary it is. That's how dangerous is. And it's so preventable. If you find the canaries in the coal mine, these people who are at early plaque rupture risk, you can find them with the right blood test. You can sort out their individual risk by this ultrasound of the artery of the neck. And then you can definitely come up with natural ways to support the body to not have to rely on the medications. I'm an internal medicine specialist. I do use medications, but I am very judicious in who I give the medications to. And I try to balance the risk of side effects with food as medicine and sometimes natural supplementation.

Let's talk food. Since you just flew it out there. What would be a good eating plan for someone who is looking to prevent or reverse heart disease? And what are some things that they should absolutely stay away from?

Well, one of the many things I love about you, jj, is you're a food is medicine person, and you've taught more women about good food and good eating and personalized nutrition. You don't use the word diet. The first three letters of diet are the best.

We're so working, like, we are actually working on a whole plan to get people to think about diet so differently. Because I see a diet as a very short term intervention only, you know, that then gives you information that you work into your daily eating plan. I just like this whole idea. In fact, I just read this thing. It made me crazy, Mark. It was this the best diets for 2019. And they rated them based on short term, short term effects, long term effects, you know, And I was like, but wait a minute. Those are two totally different things. Those are completely like, this isn't about getting on an eating plan that you can follow forever. It's very different than a short term Diet, you know, that you're doing for a specific reason. We got to look at these things differently. And I'm a nutritionist. I only have food as my hammer, you know, and some lifestyle changes. So, you know, you've got all the other things. But I know that you really focus on food, so that's exciting. What would you. So what would you say? What are the big things?

Well, I think, you know, obviously, what everybody should do is a keto Paleo with intermittent fasting following the Atkins plan. So there's. There's so many things out there that everybody says is the best, and I don't think there is any one plan that's best. I do think eating real food, whole food, mainly plants, is probably an easy answer. But everybody's unique in how they process it. What foods are inflammatory to. There's controversy around food sensitivity testing. I like it as a good first start, but a lot of times it may depend on what your situation is, what your economic is, where do you live. If you live in a small town in Wyoming, your access to organic vegetables is essentially zero in January. So, you know, we have to. We have to meet them where they are and not come out with this esoteric nutrition diet plan that they can't follow based on their resources, their community, or their social courses. So it's really trying to find a way to personalize it. And if there's a way to access some testing that tells you, hey, these foods are inflammatory for you, that just makes sense. And that's the beauty of a nutritionist. And a natural path is that's where they start, is, okay, what's causing inflammation? How do we get rid of it? How do we develop what you can eat, that you have access to, that you like, that you can learn how to prepare? I mean, most people. What did Michael Poland taught us that most people spend more time watching cooking on TV than actually cooking. I mean, that's a shocking comment. I was watching the cooking last night, and I thought of that. Oh, my gosh. You know, that's me. I'm one of them, too.

Yeah, I'm watching the cookie show. So my son Bryce, when he was 15, 16, one of my friends was, you really should see what he's doing on his computer, because he's probably watching porn. And I'm like, my angel baby is not watching porn. Not my. Not my son. And so I go. But I go on there, like, I'm gonna check. I was like, I'll make sure you know what I discovered. He was watching what cooking Videos. Cooking videos. So funny. But he is obsessed with cooking. It's really quite cool. He does a lot of our recipes for our website. But it's like hilarious because, yeah, I, I, he was cooking, watching cooking videos a lot more than cooking back then. So thankfully I think he's reversed that trend. But it is sad to think that, you know, we really are raising kind of food, illiterate people that don't know what to do in the kitchen.

I remember in high school, the class I liked the least is the one that made me wear an apron. I had to go to home economics and learn how to cook. And it was probably the best thing that I ever did. Way better than my physics or chemistry classes because it let me, number one, appreciate food, but also appreciate the people who prepare it for us, who prepare it with love, who eat in a social way. You know, we were talking about diets and possibly the Mediterranean diet is the one that makes the most sense for the most people. But what is the Mediterranean diet? Is it the same one in Greece, Italy and France? Well, they're different, but it might be because you're eating with people you care about in a loving way and you make it a passion may not have as much to do with the nutritional quality of the food as the setting in which you eat it. So if you do it with a family and people you love versus alone at your desk or in your car.

I love that you brought that up because I think one of the most important things we can do for our health is be with people we love. You know, have a great community. I think like that one. And it's crazy that we have to bring this up, but it is the era now of this silly social media and all the social isolation that we have problems we never could have conceived of 50 years ago. And so sitting down and having meals with people is a hugely important thing.

Better than anything I can provide medically, is to have a good friend that you care about each other and have a dog that's probably keep more people healthy than doctors do.

Yes, yes. Dogs and vegetables. There you go.

Dogs, vegetables and friends.

What do you see as the future coming up? Now, I know you're going to have a big, a big hand in this. Thank you for that. But what do you, what do you see here? Because, you know, it feels like there's starting to be a shift here where women are showing up in studies and we're starting to pay attention. But what's coming up?

Well, what's great is there's more women in medicine. And they're demanding that we do more studies on women, that we look at them as different than men. And we really start personalizing our diagnostic strategies and our treatment therapies for women. And it's going to be a game changer for this. I really think this testing, as you mentioned, is becoming so available. And thank goodness for the work you're doing. The book I have, we're now educating consumers so they don't have to rely on a doctor to distill information. They can get it themselves and they have good sources like your podcast to find it. And people are becoming empowered and they want better care from themselves. They're seeking it and women are driving it. It's not the husbands, it's not the sons. There are unique ones like your son Bryce, but there are. That's the women that are driving this healthcare movement and saying, we can do better, we want to do better. Let's share information. One of the most dangerous people, in a good way is an empowered mother. These are women who are changing the world. They're changing themselves, their kids and their spouses. And it's just great to see this empowerment happening and it's changing medicine all over the place.

Yeah. Well, at home I say that the woman really is the healthcare CEO of the family. But in the functional medicine space, is it. I think like 70% of the docs in functional medicine are women.

Yes. And then a lot of them are nutrition, most of them are nutrition hearted, but a lot of them have advanced nutrition training, they have coaching training. They're not just straight four year MDs, they've done other things too to have access to it. And what's interesting, jj is I grew up with irritable bowel syndrome. I saw there was a different way to take care of the gut than what I was told by my doctor. Most of us that are in functional and integrative medicine, it was ourselves, someone we loved, a family member, we saw that traditional medicine, you know when you have pneumonia, you need an antibiotic. But for most chronic illnesses, the acute care model doesn't work very well. And for most women, they've had a feeling. So many women have digestive disorders, they have menstrual issues, menopause can be a nightmare for them. And there's ways to make that healthier, easier and more enjoyable for them to get through these lives. And women are being empowered to share this information. It's super exciting for me to see.

So I know you're giving everybody listening and this is awesome. You have a webinar that basically walks them through. It's a how to on the book. You're going to want to grab the book, too. And we'll put this in the show notes. You also have the webinar that goes along with us and you'll be able to get that@jjvirgin.com heartsolution tell us a little bit about what they'll get there.

The problem with many books is that it's a lot of information, but it doesn't tell you what to do. So we want to lead you step by step and guide you on the path to really help you find the way to do this trifecta. Figure out how to do the right testing, what other analysis you do. Let's never let you have a heart attack and then share it with the people you care about, with your girlfriends, with your mothers, with your sisters. Let's change this fact of why women's heart health is not done right and let's do it right.

All right. So again, jjvirgin.com heartsolution and Dr. Mark's book is the Women's Heart Solution, a proven program to prevent and reverse heart disease for women. We'll have that in the show notes with the link. And thank you so much for taking time with me today.

Always a pleasure. Thank you for what you're doing, jj.

It's my pleasure. I love it. All right, now after the break, we'll be answering a listener's questions, so stay with me.

Hey, it's J.J. here. Now, let's be honest.

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Welcome back. This is the time where I answer a listener's question. But before that I gotta do a shout out. I gotta do a shout out and I actually thought this was really kind of funny too. So if you could see me right now, I'm in my, my cave back here in the house and it's my podcast and live studio where I have my lights and my mic and all my stuff and kind of stuck in a little chair. I have a stand up desk too, so sometimes I stand up but I'm standing in front of a mic. So I'm right here and then I have two computers and papers and all sorts of stuff. So usually the dog hanging out with me. So here's this one and I want to do a shout out to fit California and she says love the tangible knowledge but dot dot dot. So of course I'm intrigued right away, right? Five stars and says so happy. I discovered this podcast to show realistic medically founded nutrition and wellness tips and direction. My only complaint is there is often distracting background noise. I've heard JJ filing her nails and on the Truth About Ketogenic Diet it sounded like JJ was cracking nuts or cutting some type of vegetable. Makes me feel like she's multi asking and not being an authentic listener for guests. Okay, so here's the deal. I just, I was looking at that going I wish I could be doing that but I'm stuck behind this microphone over here. Probably better because yes, I'm like love to multitask but I can never do that when I'm doing lives and podcasts. However, I have been known and I get in trouble for this for rattling things like I'll get the papers, make notes. So what you're probably hearing me do if you're hearing notes in the background and I read that went okay, I got to be better so thank you for holding me to a higher standard is as I'm interviewing the guest, I have questions that I'm like want to ask. But those half the time go out the window because I'm listening to them, I'm like, oh, I gotta ask this, I gotta do this. So I'm making notes. So that's probably what you're hearing. It's not me cutting vegetables. That would be quite, quite a funny scene back here. I'm not sure how. I guess I could bring a cutting board and some, I don't know, some Brussels sprouts out here. But anyway, there it is. There's the behind the scenes peek. So thank you Fit California. Super appreciate that information because I will try to be better at my rattling and note taking etc. I always think I won't remember the next question. I also always take time here besides doing that shout out. And by the way, I so appreciate when you do those. And if you have not done one yet, please, pretty please, pretty please this, that was me began. And when you're there, make sure you subscribe because we are popping out all sorts of cool episodes. We're starting to do some series. I'm doing more like single ones based on questions you asked about and some crazy ridiculous stuff that I find in the news. Like the latest silly thing that CNN pushed out about gluten. Shame on you cnn. But the other thing we do now is we answer a listener's question and I always try to tie them into the subject at hand. And again, I was so happy to interview my buddy Dr. Mark on heart disease with in women because it's just a subject that does not get addressed enough, which makes me nuts because it's like super important. The other question I get asked all the time is about cholesterol and came up again. And by the way, these, I usually pull them off of my Facebook and Instagram lives. I'm now doing lives on Facebook, Instagram. I'm certain I'm on Amazon as well. And of course we also put them over, we put some of the videos over on my YouTube channel too. So like wherever you your platform of choice you like to hang out on, come join me there. But recently Marcia said, I been told that if I don't get my LDL cholesterol down, I'm going to need to go on a statin drug. What do I do? All right, so this is such a key important one. And Mark started to talk about this some today. You know, it used to be that we looked at total cholesterol and we were like, oh, my gosh, that's too high. You know, and then you had to do something. Then we realized, wow, there's really LDL and hdl. And, you know, kind of for simplicity's sake, said, oh, LDL is good and HDL is bad. That is absolutely not the case. You've got to go to the next level, which is to look at the size of the particle and the number of them. And here's the big challenge that we're finding is the big fluffy particles, both HDL and ldl. These are good. They don't cause the pitting and problems in the endothelial lining that causes that plaque buildup and scarring that can cause the heart attack. It's the small, dense ones that cause the problem. And the LDLs are not just the only ones. If you have small, dense HDLs, these are problematic too. So one of the challenges that you start to see with some of these different medications is that while they're lowering ldl, they're not lowering the, the small dents, they're lowering the big fluffy, which weren't a problem in the first place. That is why that lipoprotein little A is such an important marker. It's the most atherogenic, the worst of the worst of those particles. So that's why you want to look at that one too. With highly sensitive C react protein, a marker of overall inflammation, along with homocysteine. So you've got fibrinogen. You've got to get this whole picture of this. And so again, we will in the show notes@jjvirgin.com heart solution, we will include a link over to our lab testing resource where you can get that stuff if you can't get your doctor to order it.

If you can't get your doctor order it.

Listen to what Dr. Marks said. Find a doctor. And we'll link to this too, at ifm, who will listen to you and will look at this holistically because there's so much more to this. Again, if you have someone saying, oh my gosh, your LDL is high, we need to put you on a statin. Time to go look elsewhere. Because you want someone that's going to look at the entire profile along with looking at your diet and lifestyle and then look at what nutraceuticals. And then see, I mean, you may need to go farther with other things, but, you know, that's kind of the stepwise fashion. Okay, I'm off my soapbox with that. Just one more little reminder. If you haven't subscribed yet, hit the subscribe button so you don't miss anything and I will see you next time. Bye.

That's all for this episode of the JJ Version Lifestyle show, which marks another step towards a healthier body and mind. Don't forget to rate, review and subscribe to the show and we'll talk to you next week.

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