Michelle Routhenstein, MS, RD, CDCES, CDN’s Post

WORLD HEART DAY: 29th September  This World Heart Day let's spotlight a critical but often overlooked concern in healthcare — mitochondrial health. Healthy mitochondria are shown to be at the heart of maintaining optimal cardiovascular health. While numerous studies have highlighted the impact of the COVID-19 pandemic on the cardiovascular system, it's vital to recognise the broader health implications, such as brain fog and fatigue.[i] Shockingly, one in six Australians grapple with cardiovascular issues, imposing a staggering $5 billion burden on our healthcare system annually.[ii] World Heart Day serves as a timely reminder for us all to prioritise our heart health. According to the eminent integrative cardiologist, Dr Ross Walker, maintaining high levels of ubiquinol—which naturally declines with age—is crucial for supporting heart function. Supported by over 90 clinical trials and studies, ubiquinol is gaining prominence as a scientifically-based, all-natural treatment option that healthcare practitioners can use to address multiple health conditions. A 2020 study published in the American Journal of Cardiovascular Drugs unveiled promising results from ubiquinol supplementation in treating peripheral endothelial dysfunction—a condition linked to coronary artery disease and the development of acute coronary syndrome.[iii] This World Heart Day, let's make a commitment to not only raise awareness but also take proactive steps towards heart-healthy living. Let’s always remember: A healthy heart translates to a healthier life!    #WorldHeartDay #CardiovascularHealth #HeartDiseaseAwareness #PreventiveCardiology #PatientCare #HealthAdvocacy  #MedicalCommunity #HeartHealthAwareness #HeartHealth #HealthyLifestyle #kaneka #ubiquinol #heart #cardiology #cardiologist #pharmacist #naturopath #clinical #mitochondrialhealth #mitochondria #antioxidant #freeradical  #covid #longCOVID #functionalmedicine #complementarymedicine #integrativemedicine #nutrition #nutrient #supplement #nutraceutical #health #wellbeing #PoweredByUbiquinol #research   Kaneka Nutrients Kenta Ikeda Kazuki Takita Tsuyoshi Takakuwa Gillian Fish Ella Harris Daniela Iacono SHIN YNG LEE Stephanie Berglin Divya Kulkarni Pranjal Setia Dr Ross Walker References:  [i] DePace NL, Colombo J. Long-COVID Syndrome and the Cardiovascular System: A Review of Neurocardiologic Effects on Multiple Systems. Curr Cardiol Rep 2022;24(11):1711-1726.   [ii] The Heart Foundation 2021. Key Statistics: Cardiovascular Disease [online] Available at: <https://lnkd.in/gUezkHNX> [Accessed 15 September 2023].   [iii] Kawashima C, Matsuzawa Y, Konishi M, et al. Ubiquinol Improves Endothelial Function in Patients with Heart Failure with Reduced Ejection Fraction: A Single-Center, Randomized Double-Blind Placebo-Controlled Crossover Pilot Study. Am J Cardiovasc Drugs 2020;20(4):363-372.  

When I have talked about getting the Lipoprotein(a) test before, many of you mentioned how you got pushback from your physician.⁠ ⁠ On April 1st, the national lipid association (NLA) put out a press release with updated guideline which should help you advocate for this test at your next appointment. ⁠ ⁠ Happy to share the link, just send me a message with LIPOPROTEIN(A).⁠ ⁠ What does the update say?⁠ ⁠ 1️⃣ The NLA’s focused update on Lp(a) is backed from research emphasizing the link between cardiovascular risk and elevated values. This stresses the importance of universal Lp(a) level assessment among adults, acknowledging that Lp(a) testing is currently not standard practice and must be incorporated to enhance preventive strategies.⁠ 2️⃣ Risk categories determined by Lp(a) levels are low (<75 nmol/L), intermediate (75-125 nmol/L), and high (≥125 nmol/L), with additional screening recommended for relatives of those at high risk.⁠ 3️⃣ Those who have elevated Lp(a) need early and intensive treatment to lower their heightened risk. This includes lifestyle changes to optimize cardio-metabolic risk factors, lipid-lowering drugs, and, in some cases, treatments like lipoprotein apheresis. ⁠ ⁠ ⭐️ Know your numbers and understand what you need to do to lower your risk of cardiovascular disease and its complications.⁠ ⁠ 👉🏼 Join my next 6 week heart optimization group program on May 10th to understand how to optimize your heart health through science based nutrition and implement effective strategies. ⁠ ⁠ ❤️ Spots are limited and filling up fast! Secure your spot by enrolling on my website at https://lnkd.in/e5eigZgA #lipoproteina #highbloodpressure #highcalciumscore #highcholesterol #lowerbloodpressure #heartdiseaseprevention #cholesteroldiet #hearthealthydiet #cardiacdiet #cholesteroltips #lowerbloodpressurenaturally #heartattackrecovery #cardiacbypasssurgery #cardiacrehab #heartdiseaseawareness #heartattacksurvivor #atherosclerosis #lowcholesterol #foodovermedicine #cardiacbypasss #hearthealth #hearthealthy #antiinflammatory #antiinflammatorydiet #coronaryarterydisesae #heartdiseasesupport #cardiacsurgery #heartsurgerysurvivor #heartattackprevention #heartdisease

#762 A 28-year-old previously healthy gentleman is brought to the emergency department by his wife after she noticed mild confusion, weakness, fatigue, and dyspnea. She also notes that he has had a persistent nocturnal cough for the past 7 days. Approximately 10 days prior, he developed fevers, chills and myalgias; this was accompanied by a nonproductive cough and mild dyspnea. His fevers and myalgias resolved spontaneously, but she has noted a progressive decline in his energy level since. They have a 4-year- old son, and he has had difficulty keeping up with him on the playground. He has no prior medical history, and does not take any medications or dietary supplements. On exam, he is obtunded. VS: Afebrile. BP 78/60 mmHg, HR 118. Pulse oximetry 93% on RA. Height: 69 inches, weight: 165 pounds. Extremities are cool. There is no lower extremity edema. Heart sounds are regular with an audible S1 and S2. There is an S3 gallop noted. There is a faint holosystolic murmur at the LV apex which does not radiate. His neck veins are distended to 15 cm of water. Laboratory studies reveal a normal CBC, normal TSH, BUN 35 mg/dL, Creatinine 1.95 mg/dL, AST 1235 U, ALT 1412 U, Lactic acid 7.6, TnI 0.53 ng/mL (normal <0.03), NT-proBNP 23,055 pg/mL. ECG: Sinus tachycardia. CXR shows a mildly enlarged cardiac silhouette and dilated upper lobe vessels. Initial management of the patient includes all the following EXCEPT: A. Oxygen therapy via nasal cannula B. IV enalaprilat C. IV dobutamine D. Consideration of placement of a PA line E. Loop diuretics Answer: B. The patient has clinical evidence of hemodynamic instability, including, hypotension, sinus tachycardia, change in mental status, lactic acidosis and evidence of end organ dysfunction. Initial management should be aimed at restoration of hemodynamics and relief of symptoms. Initiation of an ACEi during profound shock could lead to worsening hemodynamics, and pre- ferred agents would be those named at improving inotropy.

Kidney and heart health are closely interconnected through various physiological mechanisms, to highlight a few:⁠ ⁠ 1️⃣ Blood Pressure Regulation: The kidneys regulate blood pressure by managing fluid balance and releasing hormones like renin, while the heart pumps blood throughout the body. Dysfunction in either organ can lead to high blood pressure, putting strain on both the heart and kidneys and potentially leading to complications such as heart failure and chronic kidney disease.⁠ ⁠ 2️⃣ Fluid and Micronutrient Balance: The kidneys regulate the body's fluid and electrolyte balance, which is essential for maintaining proper heart function. Imbalances in fluid and electrolytes can lead to conditions such as dehydration, electrolyte abnormalities, and fluid overload, all of which can affect heart function and increase the risk of cardiovascular events.⁠ ⁠ 3️⃣ Inflammatory Processes: Chronic inflammation, often indicated by markers such as hsCRP and exacerbated by factors like increased abdominal weight, plays a pivotal role in the pathogenesis of kidney and heart diseases by promoting endothelial dysfunction, oxidative stress, and fibrosis, ultimately leading to tissue damage and organ dysfunction.⁠ ⁠ 4️⃣ Abnormal cardiometabolic labs: particularly LDL, apoB, and blood sugar can promote atherosclerosis, leading to narrowed arteries and reduced blood flow to both organs.⁠ ⁠ ⭐️ The kidneys and heart are closely interconnected organs that rely on each other for proper function. Dysfunction in one organ can significantly impact the other, highlighting the importance of comprehensive care and management strategies that address both kidney and heart health.⁠ ⁠ 👉🏼 We need to focus on addressing all the controllable risk factors to optimize both heart and kidney health.⁠ ⁠ ❤️ For a deep dive into science based nutrition to address these controllable risk factors to protect your heart and optimize blood flow to all organs of your body, consider joining my next 6 week heart optimization group program that begins on Friday, March 22nd! ⁠ 👉🏼 Limited spots available, enroll today to secure your spot: https://lnkd.in/ecCQWHrQ #bloodpressure #bloodpressurecontrol #bloodpressuremonitor #bloodpressureproblems #bloodpressurecheck #bloodpressurehealth #bloodpressureculf #bloodpressuretest #lowerbloodpressure #lowerbloodpressurefoods #lowerbloodpressurenaturally #hypertensiontreamtent #hypertensiondiet #hypertensionmanagement #hypertensiontips #hypertensionsupport #hypertensionawareness #hypertension #hypertensionprevention #strokeprevention #transieentischemicattack #ministroke #heartattacksurvivor #heartattackprevention #hearthealthyfood #hearthealthyfoods #heartdisease #heartdiseaseawareness #preventandreverseheartdisease #heartdiseaseprevention

In this study of 83239 patients with constipation (including people who were prescribed laxatives) were matched with 832,384 controls without constipation to assess the risk of cardiovascular disease in individuals with constipation.   It showed that constipation was associated with 2x risk of venous thromboembolism, 24% heart attack, 50% ischemic stroke, 34% increased risk of peripheral artery disease, 27% increase risk of Atrial Fibrillation (Afib) or atrial flutter and 52% risk of heart failure.    Why may this be? Some proposed mechanisms:    1️⃣ Constipation, aka decreased gut motility may cause inflammation in the gut impairing gut health, which negatively impacts heart health and function. This may also contribute to stiffening in the arteries.  2️⃣ Chronic constipation may lead to straining at stools, which can also be associated with transient increases in blood pressure, and stiffness in the arteries putting extra pressure on the heart to function properly. 3️⃣ Constipation is associated with a dysbiosis in the gut microbiome. When gut health is impaired, the gut bacteria may not be able to create the positive metabolites from food to contribute to optimal heart health. 4️⃣ We also know if we are not eliminating properly, we aren’t effectively getting rid of LDL cholesterol which can cause more plaque to form in the arteries.   ⚠️ Don’t ignore constipation and if you are relying on laxative use to go, I would seek further assistance from a qualified health professional.   I talk about bowel health with all my clients because of its importance with optimal cardiovascular health. In the first 90 minute comprehensive evaluation session, many of my clients may say “I am regular,” but when they start paying attention to their bowel movements and as we work together to improve elimination, they admit “I wasn’t regular at all, now I know what a perfect bowel movement should be!” Aim for a type 4 on the bristol stool chart, with a little bit more volume.    👉🏼 Sign up to my email list, here (https://lnkd.in/eAEbtf_E) or on my website (entirelynourished.com), for more heart disease prevention tips.   Study reference: https://lnkd.in/e-9DymAM #diverticiulitis #diverticiulosis #diverticulitisdiet #diverticulardisease #diverticulitisrecovery #constipation #constipationrelief #heartdisease #heartattack #myocardialinfarction #heartattacksurvivor #heartdiseaseprevention #heartattackprevention #calciumscan #atherosclerosis #inflammation #inflammationrelief #antiinflammatorydiet #hearthealthydiet #heartdiseaseawareness #highbloodpressure #insulinresistancediet #insulinresistance #hearthealth #highcholesterol #cardiovascularhealth #cardiacrehab #cardiacbypass #cardiachealth #lowerbloodpressure

Your genes, family history and/or a high Lp(a) can increase your risk of heart disease, but epigenetic research shows that through science based heart healthy lifestyle behavior change that modify modifiable cardiovascular risk factors these genes can be down-regulated. What that means is that you must take a more proactive preventative approach to reduce your risk of developing heart disease.  What does a proactive preventative approach entail? 1. Take ownership of your health - don’t wait until the doctor says you need to take this more seriously or should take medication. ⭐️ Ask questions from your care team, request labs that may not be routinely done (ie if you don’t know your Lp(a) or ApoB or HsCRP ask for it!), review your labs, assess your trends, and understand what lab levels you need to achieve based on your medical history and genetic history. ⭐️ If these labs (cholesterol, blood sugar, blood pressure, etc) are elevated or trending in the wrong direction, optimize your nutrition and lifestyle and retest in 3 months to ensure they are normalized. ⚠️Those who have a genetic history or are at increased risk, need to have stricter laboratory standards (ie LDL less than 70mg/dL, ApoB less than 80mg/dL, HgA1c less than 5.4%, blood pressure 110/70mmHg, hsCRP less than 1mg/dL, etc).  2. Understand what is going on - ask questions from healthcare providers who can take the time to explain the WHY behind the recommendations. 3. Seek support from a registered dietitian who specializes in heart disease and can help manage any cardiometabolic conditions, teach you how to improve your cardiovascular risk profile, and understands how to take a preventive stance in your blood vessel health. ⭐️ I teach you how to be proactive in your health in my 6 week heart optimization group program. I take the time to answer all of your questions and explain the WHY behind it so you can implement this for the long haul. ❤️ My next and last 2023 six week heart optimization group program will begin on October 27th and there are limited spots available. Enroll now to secure your spot: https://lnkd.in/efbtVMdC Study reference: https://lnkd.in/eWKp4b72 #highcholesterol #highbloodpressure #highcalciumscore #lowercholesterol #lowerbloodpressure #heartdiseaseprevention #cholesteroldiet #hearthealthydiet #cardiacdiet #cholesteroltips #lowerbloodpressurenaturally #heartattackrecovery #cardiacbypasssurgery #cardiacrehab #heartdiseaseawareness #heartattacksurvivor #atherosclerosis #lowcholesterol #foodovermedicine #cardiacbypasss #hearthealth #hearthealthy #antiinflammatory #antiinflammatorydiet #coronaryarterydisesae #heartdiseasesupport #cardiacsurgery #heartsurgerysurvivor #heartattackprevention #heartdisease

Osteoporosis, often called brittle bone disease, has been linked with an increase in atherosclerosis (artery hardening and narrowing).⁠ ⁠ We know that women have an increased risk of heart disease after menopause. One of the factors causing this may be the increase in osteoporosis after menopause as well.⁠  ⁠ In a study of 12,681 women aged 50 to 80, low bone density in the spine, femoral neck, and hip increased heart attack risk by 16 to 38% over 9 years, even after considering other risk factors like high blood pressure, age, high cholesterol, smoking, and prior bone fractures.⁠  ⁠ Why would this happen?⁠ ⁠ 1️⃣ Chronic inflammation and oxidative stress, common in both age-related bone loss and plaque formation, may occur simultaneously, contributing to both conditions.⁠ ⁠ 2️⃣ Dysregulated calcium and phosphorus metabolism can accelerate both bone loss and arterial plaque formation.⁠ ⁠ 3️⃣ Osteogenic mediators released during bone loss, such as osteocalcin, osteoprotegerin, and sclerostin, directly influence blood vessel biology, promoting arterial plaque formation.⁠ ⁠ To support both bone and heart health:⁠ ⁠ a) Nutrient-Rich Diet: Consume foods rich in calcium, vitamin D, vitamin K, magnesium, lean proteins, and healthy fats to strengthen bones and promote heart health. ⁠ ⚠️ Opt for dietary sources over excessive calcium supplementation to avoid potential plaque progression.⁠ ⁠ b) Weight-Bearing Exercise: Engage in regular weight-bearing activities such as walking, jogging, and strength training to enhance bone density and cardiovascular function.⁠ ⁠ c) Maintain Healthy Habits: Sustain a healthy weight, refrain from smoking, moderate alcohol intake, and prioritize stress management to mitigate the risk of osteoporosis and heart disease while fostering overall well-being.⁠ ⁠ ⭐️ Subscribe to my email list for additional heart disease prevention tips! Visit my website at www.entirelynourished.com or find the link in my bio.⁠ ⁠ ❤️ For personalized support on your heart health journey, visit my website (www.entirelynourished.com) to book a discovery call and learn more about how I can assist you.⁠ ⁠ Study reference: https://lnkd.in/eb2saD2w #osteoporosisprevention #osteoporosisawareness #womensheart #womenshearthealth #womensheartdisease #womenshearthealthawareness #microvasculardisease #womenshealth #menopause #menopauseawareness #menopausesupport #hearthealthmonth #hearthealth #hearthealthydiet #menopausediet #coronaryarterydisease #highcalciumscore #atherosclerosis #heartdiseaseprevention #heartdisease #heartdiseaseawareness #heartattackprevention #cardiacdiet #cardiacnutrition #coronarycalciumscore #highbloodpressure #insulinresistance #hearthealthy #cardiovasculardisease #osteoperosisdiet

When I ask my clients what their goals are by working with me, they often mention how they want to live longer and keep their heart working optimally.⁠ ⁠ As a cardiology dietitian, the way I strive to help my clients achieve these goals is to focus on a nutrient sufficient diet that addresses several things:⁠ ⁠ 1. Stabilizing the plaque already present in your arteries⁠ 2. Preventing further promotion of plaque⁠ 3. Reducing the overtaxing on the heart to allow it to optimally function to prevent heart failure, heart enlargement, and heart pumping complications.⁠ 4. Optimizing all the risk factors you may have, such as lowering LDL and non-HDL cholesterol, hs-CRP inflammation markers, insulin resistance, and waist circumference⁠ 5. Addressing the underlying root causes of heart disease, like inflammation, oxidative stress, insulin resistance, overweight or obesity, and plaque buildup.⁠ ⁠ ❤️ While this may sound like a lot, I teach my clients the how to so that they can protect their heart for the long term and be able to live a confident, anxiety-free, heart healthy long life with the people they love.⁠ ⁠ ⭐️ I teach these principles and how to implement a truly nutrient sufficient, heart healthy diet in my 1 on 1 personalized programs and in my 6 week heart optimization group program. ✨ My next group program is closed for enrollment. If you are interested in future cohorts, be sure to sign up to my email list here: https://lnkd.in/eAEbtf_E ❤️ I would love to support you! #coronaryarterydisease #coronaryheartdisease #coronaryangiography #coronarycalciumscore #heartattack #heartattacksurvivor #heartattackprevention #heartattackrecovery #hearthealth #hearthealthy #hearthealthydiet #hearthealthawareness #hearthealthyliving #highcalciumscore #hearthealthyrecipes #heartdisease #heartdiseaseawareness #heartdiseaseprevention #heartdiseasesurvivor #heartdiseasewarrior #heartdiseasesupport #highcholesterol #cardiacbypasssurgery #cardiacrehab #cardiacsurgery #cardiacdiet #heartfailureawareness #heartfailure #heartfailuresurvivor #heartfailurediet