In this episode of The Diary Of A CEO, Dr. Pradip Jamnadas explains how metabolic factors contribute to heart disease, with a focus on the effects of high blood insulin levels and visceral fat. He describes how processed foods and refined carbohydrates can lead to insulin resistance and metabolic dysfunction, while also exploring the connection between gut health and cardiovascular function.
The discussion covers several approaches to improving heart health, including different fasting methods that target harmful visceral fat, and exercise recommendations that favor high-intensity interval training over extended cardio workouts. Dr. Jamnadas also addresses cholesterol management, explaining how LDL particle quality affects heart disease risk, and outlines methods for regulating the vagus nerve to reduce inflammation and enhance overall wellbeing.

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Dr. Pradeep Jamnadas discusses the critical role of metabolic factors in heart disease development. He identifies hyperinsulinemia (high blood [restricted term]) as a primary cause of high blood pressure, explaining that elevated [restricted term] levels prevent proper blood vessel dilation. According to Jamnadas, consumption of processed foods, refined carbohydrates, and sugars contributes to [restricted term] resistance and metabolic dysfunction.
Jamnadas emphasizes that visceral fat, particularly around the abdomen, produces inflammatory molecules that contribute to heart disease. He notes that fasting specifically targets this harmful visceral fat, with the body beginning to burn fat stores after approximately 12 hours of fasting.
Jamnadas explains that fasting beyond 12 hours enables the body to access stored fat, particularly visceral fat. He recommends various fasting approaches, from basic 12-12 schedules to more intensive 48-hour fasts, depending on individual needs. During fasting, ketosis occurs, which Jamnadas notes produces cleaner fuel for the body and promotes cellular health through processes like autophagy.
Regarding exercise, Jamnadas argues that high-intensity interval training (HIIT) and resistance exercise are more beneficial for heart health than extended aerobic exercise. He warns that excessive cardio can increase inflammation and plaque buildup, recommending instead a combination of short sprints, HIIT, and resistance training.
Jamnadas describes the crucial relationship between gut health and cardiovascular function. He explains that a disrupted microbiome can lead to leaky gut, allowing inflammatory compounds to enter the bloodstream and damage blood vessels. To improve gut health, he recommends increasing fiber intake, consuming fermented foods, and maintaining adequate omega-3 levels.
When discussing cholesterol, Jamnadas emphasizes that heart disease risk relates more to LDL particle quality than total cholesterol levels. He explains that small, dense, and oxidized LDL particles contribute to inflammation and atherosclerosis. To manage LDL naturally, he advocates for an anti-inflammatory diet rich in fiber and healthy fats while avoiding processed foods and excessive sugar.
Jamnadas discusses the vagus nerve's role in balancing the body's "fight-or-flight" and "rest-and-digest" responses. He suggests various methods to improve vagus nerve function, including breathing techniques, cold exposure, and humming. According to Jamnadas, optimizing vagus nerve function can reduce inflammation, enhance heart rate variability, and promote overall wellbeing.
1-Page Summary
Dr. Pradeep Jamnadas explains the pivotal role of metabolic factors such as [restricted term] resistance and visceral fat in the development of heart disease.
Hyperinsulinemia, or high [restricted term] levels in the blood, is identified as a cause of high blood pressure. This is due to [restricted term]'s preventing the proper vasodilation of blood vessels and capillaries. When [restricted term] levels are decreased through fasting programs and dietary changes, one of the biggest improvements in diabetic patients is the reduction in blood pressure. Jamnadas argues against the notion of "essential hypertension," suggesting that high blood pressure always has a cause, such as hyperinsulinemia.
Jamnadas explains that consuming carbs, sugar, and processed foods, particularly those made from refined wheat, fast foods, and items with artificial additives, can keep [restricted term] levels constantly elevated, promoting [restricted term] resistance. The absence of fiber in processed foods contributes to quicker glucose absorption and increased [restricted term] production. Moreover, sugary and diet drinks can cause [restricted term] spikes, leading to increased hunger and potential [restricted term] resistance.
Particularly noteworthy is the way in which traditional preparation methods of some starches effect [restricted term] resistance. Jamnadas mentions that treating rice to increase its resistant starch content prevents typical [restricted term] spikes. Resistant starch resists absorption until reaching the colon, feeding beneficial bacteria rather than affecting [restricted term] levels. Furthermore, fructose—the sugar found in fruit—can cause a fatty liver, contributing to heart disease and diabetes. Overconsumption of fruit, therefore, can be detrimental.
Patients with heart attacks often show glucose intolerance with spikes not quite to diabetic levels but exhibit exceedingly high [restricted term] levels after testing with a glucose drink. Ultimately, high background [restricted term] levels, even with controlled blood sugar, can damage metabolism and lead to health issues.
Abdominal visceral fat is particularly dangerous and a driving factor in heart disease. The 28-year-old pre-diabetic patient discussed was overweight with a concentration of weig ...
Metabolic Factors and Their Role in Heart Disease
Steven Bartlett and Dr. Pradip Jamnadas explore the connection between fasting, ketosis, and heart health, shedding light on how these factors can significantly affect the body’s physiology and overall well-being.
Fasting is a physiological state that humans have adapted to but lost due to modern living. Jamnadas notes that fasting for over 12 hours starts to pull fat from the body, specifically from visceral fat stores. Fasting effectively lowers [restricted term] levels, which allows the body to burn stored fat and can lead to weight loss and improved body composition. Distinctions are made between fasting and mere calorie restriction, one of which is that fasting leads to skin retraction rather than leaving excess skin that might require surgical removal. Jamnadas recommends different fasting methods, such as 12-12 and 18-6. For those needing significant weight loss, he proposes more intensive fasting like a 48-hour fast once a week or a three-day water fast every nine days. He also discusses the "one meal a day" (OMAD) approach and suggests skipping breakfast for an 18-hour fasting window to optimize energy levels.
Ketosis, achieved through low-carb and low-sugar diets, is touted by Bartlett as beneficial to focus, endurance, and mood. Jamnadas echoes these sentiments, noting ketosis generates a cleaner fuel for the body, ketones, resulting in fewer reactive oxygen species and lessening damage to the body. Autophagy, which transpires during fasting and ketosis, involves cell organelles being recycled, leading to more efficient mitochondrial functioning, reduced reactive oxygen species, and heightened ATP production. Jamnadas explains the advantages of autophagy and mitophagy in improving cell and mitochondrial health.
Although it’s not necessary to be in ketosis all the time, Jamnadas suggests a 36-hour fast at least once a month for normal, healthy people. He explains that fasting yields low [restricted term] levels, enabling the body to burn fats and dissolve into free fatty acids. He also highlights how being in ketosis activates various benefits such as increased brain-derived neurotropic factor and a surge in stem cells, which enhance immunity.
Jamnadas argues that high-intensity interval t ...
Fasting, Ketosis, and Interventions For Heart Health
Pradip Jamnadas discusses the intricate relationship between gut health and cardiovascular function, emphasizing the role of the gut microbiome and inflammation in various medical conditions.
Jamnadas asserts that a disrupted microbiome can cause a breach in the gut lining, allowing bacterial byproducts to enter the bloodstream, leading to systemic inflammation that may contribute to cardiovascular disease.
He describes an example of a patient with plaque in his arteries, which was found to be due to a bad microbiome and chronic constipation since childhood, causing systemic inflammation and coronary artery disease. The gut, which is the biggest interface with the environment, hosts numerous bacteria and viruses that produce micronutrients and maintain the integrity of the gut lining. When this symbiotic relationship is disrupted, it can lead to what's called a leaky gut syndrome, where harmful substances like lipopolysaccharides enter the bloodstream and cause inflammation.
Jamnadas considers a dysfunctional gut microbiome to be a significant contributor to fatty liver and coronary artery disease. He emphasizes the importance of treating fatty liver through dietary changes, increasing fiber intake, and supplementing to restore nutrition, which can halt the progression of coronary calcium.
Jamnadas underscores the necessity of addressing the causes of inflammation to manage coronary artery disease and other inflammation-driven conditions. The microbiome can be improved by eating real food, introducing more fiber to support gut bacteria, and using supplements to restore nutrient levels. He also highlights the connection between mental health issues such as depression and systemic inflammation and suggests that inflammation stemming from the gut microbiome might explain why depression and mental fog occur.
To address leaky gut and related inflammation, which can contribute to arterial hardening, Jamnadas suggests the elimination of inflammatory foods and sensitivities from the diet. For example, after identifying and removing wheat from the diet, a patient with undiagnosed celiac disease and coronary artery disease improved.
For overall gut health, Jamnadas recommends a diet rich in non-processed foods with plenty of soluble fiber, like in resistant starch, suggesting the value of a varied and whole-foods diet. Coffee and cacao are beneficial to the gut microbiome due to their soluble fiber and polyphenols content, leading to less leaky gut and inflammation. Furthermore, fermented foods like kefir introduce beneficial strains of bacteria ...
The Gut-heart Connection, Including the Microbiome and Inflammation
Pradip Jamnadas delves into the specifics of LDL particles and their impact on heart disease, emphasizing the role of dietary and lifestyle choices in managing cholesterol levels without the need for pharmaceutical interventions.
Jamnadas explains that heart disease is not simply about the amount of LDL, often referred to as "bad cholesterol," but rather the quality of these LDL particles. Small, dense and damaged LDL particles can lead to inflammation and atherosclerosis. He elaborates that the condition of the particles, particularly when they are oxidized, contributes to the formation and instability of plaque in the arteries. This plaque formation is closely linked to heart attacks, which happen when the plaque ruptures and causes blood clots.
The blood tests that Jamnadas references measure not only HDL, LDL, and total cholesterol but also the particle sizes, specifically looking for small, dense particles and levels of LDL oxidation. He discusses the inflammatory response caused by damaged LDL, as macrophages try to engulf these particles, causing damage to the glycocalyx, activating the endothelium, and promoting atherosclerosis.
Jamnadas emphasizes lifestyle factors, particularly diet, as pivotal for managing LDL particle size and density. He underscores the need for an anti-inflammatory diet to combat the inflammation that contributes to heart health issues. He notes the negative impact of advanced glycation end products created by overcooking food, which, similar to oxidized LDL, increase inflammation and contribute to plaque in the arteries. Thus, dietary choices that minimize inflammation could improve LDL profiles.
He warns against high-sugar and processed foods, which typically lack fiber and could negatively impact LDL levels. He stresses that a diet richer in fiber from whole foods is beneficial for cholesterol management. Additionally, he criticizes the use of veget ...
Cholesterol, LDL, and Lipid Management Without Drugs
Understanding the balancing act between the body's "fight-or-flight" and "rest-and-digest" responses involves a focus on the vagus nerve, a critical component of the autonomic nervous system. Various interventions can improve vagus nerve function, contributing to a reduction in inflammation and an enhancement in heart rate variability, ultimately promoting wellbeing.
Steven discusses an episode of heart palpitations following intense exercise on his Peloton, questioning if the vagus nerve might be involved. Pradip Jamnadas suggests that the palpitations could be a sign of an imbalance in the autonomic nervous system between the sympathetic and parasympathetic nervous states. He mentions that such an imbalance often results from a poorly functioning vagus nerve, which could lead to heart rate issues such as postural orthostatic tachycardia.
Jamnadas explains that over-exercise could cause relative ischemia to the gut, affecting the enteric nervous system and the vagus nerve. Additionally, lack of sleep can impact the vagus nerve and the gut microbiome. Overconsumption of caffeine could also result in heightened sympathetic activity, indicating an imbalance that could affect the vagus nerve. When the vagus nerve is compromised, it could precipitate conditions such as tachycardia, arrhythmias, and palpitations due to an excess of sympathetic activity.
Jamnadas emphasizes the role of the vagus nerve in transitioning the body from "fight-or-flight" to "rest-and-digest" states and talks about the imbalance caused by continuous stress factors. He states the body should be in a state of sympathetic arousal followed by parasympathetic relaxation and repair, which is mediated by the vagus nerve.
Improving vagus nerve function can encompass a variety of interventions, including breathing techniques, cold exposure, and humming. Putting an ice pack on the front of the neck can stimulate the vagus nerve due to its proximity to the carotid sheath, Jamnadas notes. He further states that activities like humming, laughing, and the diaphragmatic movements caused by laughing effectively stimulate the vagus nerve.
Vagus Nerve and Autonomic Nervous System Regulation
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