The 7 Blood Markers That Predict Heart Disease Better Than Cholesterol | Dr.Cabral x Mind Pump 2952

Dr. Brawl, welcome back to the show. Great to be here. Yeah, it's always fun to have you on. Okay. So today we're going to talk about some health markers that you say are far more important to look at than cholesterol. These are ones we should pay attention to because they can predict a risk of things like heart disease and heart attack. Yes. So let's, let's, let's talk about these. What are they and why are they important? So there's seven markers that we've found to be just far more valuable for predicting the number one cause of death for both men and women, which is sudden cardiac death, heart attack, or heart disease. And these are typically a slow burn, meaning they happen over decades. So men can start having real heart disease in their fifties. If you're predisposed, that's why genetics do matter, but all of genetics are able to be overcome with a lot of health, healthy lifestyle factors that we talked about in the, in the previous podcast. But when we look at what causes the plaque to build up in the arteries or those arteries to become more stiff, these markers are going to be better for that. The first one, and anyone has access to these now. So five years ago, I wouldn't be able to say the same thing, but now anybody can run these markers for blood work. So you can go get tested for these? You can do them at home. You can do them, just blood work at a lab corp, a quest, wherever you want. Cool. So the first one is APOB. So it used to be called, or sometimes referred to as APOB 100. And then I'll give you scores for all of these. So your score should be ideally below 100. The new metrics are 70 to 90 you want your value at, or ideally below that. So the lower the number, the better. Now, what APOB is, is looking at your LDL cholesterol. So LDL, we often refer to as oxidized cholesterol or bad cholesterol, putting that in air quotes, but we need LDL cholesterol. Conventional medicine, they want to get your LDL below a 55, which is really low for your cholesterol. And we need, so, but we do need LDL for cell membrane health. We need it for testosterone production. We need it for vitamin D conversion. So it's not the enemy, but the more of it you have and the more it's in your bloodstream, along with inflammation in your arteries, the more damage that it could cause. Now, it's not the LDL cholesterol's fault. It's the actual damage to the arteries that we'll get into a little bit later in the show. Okay. So APOB is a part of LDL? So it's actually looking at the number of particles. So the potential damage for atherosclerosis, the higher the number, the more particles there are that could cause damage to the arteries. Is this the same thing as looking at particle size of LDL? It's looking at total particle number. Just total. But it also takes into account LDL and then its size, which is VLDL, very low lipoprotein, very low density lipoproteins. Okay. So these are all specific proteins. And then apolipoprotein little a, which I didn't put in my top seven, but I'll tell you why. It's a very important marker that takes into account with this APOB and that's the genetic predisposition to heart disease. So if you have a high apolipoprotein little a, like above a hundred, you're definitely more susceptible to heart disease and plaque buildup in your arteries. Okay. So it doesn't mean you're going to get it. It just means that you need to be more conscious about your diet and your exercise and making sure that you're doing the preventative measures. I was just going to ask if my APOB is higher than a hundred, what are some things I can do to lower it? So it is the typical recommendations that we went over previously, but it is getting enough fiber, 30 to 35 grams per day, getting in three to four days of aerobic based cardio every single week, which are typically 30 to 40 minute sessions, two of the Norwegian protocol that we talked about, which would give you the vigorous exercise. And then we're looking at your daily steps every single day, which is important. And then you're getting in enough sleep, enough antioxidants, things we're going to talk about today to combat that. Olive oil is another great one. And they're finding lycopene from tomatoes, part of the Mediterranean diet, is extremely important for heart disease as well. For people who react poorly to things like saturated fat, because it depends on the individual, but would this be, in this case, lowering saturated fat intake help with APOB? It is going to help for a specific segment of the population with that APOE genotype, 3-4-4-4. They do not process saturated fat well, and it stays in their bloodstream longer. So for them, that fiber will help pull it out a little bit more. Intermittent fasting will help, but they also want to bump up their HDL with all the things that we just spoke about as well. So APOB is the big one to look at. It is the one now all cardiologists look at as the most, it's the most prevalent factor in what will cause heart disease if that number is high. Wow. So of all the measurements, this is the one? This is probably the one. Wow. All right. What's next? The next one that we're going to look at is high-sensitivity CRP. So HSCRP, when we look at that, we're looking at nonspecific inflammation in the arteries. And so when we look at, so high-sensitivity CRP, we used to look at only CRP before. Now the number and the value hasn't changed. We still want to blow a 0.5, but it's saying anywhere in your body you have some type of inflammation. The inflammation could be from autoimmune issues, gut issues, viral issues, food sensitivities. We don't know, but we see an elevation. Why this matters is that if inflammation is elevated in the body, it's elevated in the arteries. If it's elevated in the arteries, now that cholesterol moving by the LDL is going to be able to insert itself, embed itself in that endothelial tissue, which then starts over time. So essentially what happens is then your immune system begins to go over that after those fatty acids. And so it literally converts to these things called foam cells. The foam cells expand. They start to create collagen, fibrin, and calcium, calcification around them. That's what creates the plaque. Okay. So we need to keep inflammation down in the body. And this is, and they're, they're H, they're highly specific. What would you, a highly sensitive? High sensitive. That's the name of the test. Got it. So CRP is just another type of protein. So CRP is the C-reactive protein. High sensitivity is the new test that came about, about a decade ago. It became more prevalent. Got it. Used to just be CRP before that. Now, really specific. So for example, let's say you got a common virus. Your CRP might go up to a 30 or 40. Right. Not ideal. Right. But after two weeks, it'll go back down. But when you run it, you just have to take into account, okay, do I have a virus when I'm running my lab? Okay. It should be below a one. Got it. In our practice, for our clients, we want it below a 0.5. Low inflammation, less chance of plaque building up in the arteries. Got it. Okay. Uh, next. What's another one? Next one's homocysteine. So homocysteine is part, it's amino acid. So it's part of methionine metabolism. Okay. Some people more susceptible to it. You've talked about MTHFR gene mutations before in the show, right? Is this showing methylation issues? Methylation issues, kidney issues, thyroid issues. But people that have the MTHFR gene, heterozygous one copy or homozygous two copies, going to be more susceptible. We'll talk about how to fix it really easily in a moment. Let's say that they have MTR, which is kind of like an MTHFR issue or a COMT issue with detoxification. All of these people have to be a little bit more, again, cautious when they see their homocysteine above a nine or an eight and a half or nine. Now on your blood work though, it'll say you're fine until a 15. It's way too high. So in our practice, we want people between a six and a half and a nine at the highest. And the way that you're able to bring that down is not just through methylfolate. So methylfolate used to be kind of like the catch-all. It's really B6, B9, B12, and B2. So just essentially a B complex. All methylated. All, well, methylated would be for like the B9 and the B12, methylfolate and methylcobalamin. The B6 should be what's called P5P, pyridoxal 5-phosphate, and B2 is riboflavin. Today's episode, we had Dr. Stephen Cabral back on the show. We love him. He's the best functional medicine practitioner we know of. And in today's episode, he talks about an inflammation test. In fact, we all took the test and he talks about our results. In fact, we took the test a while ago. So did we improve our score? By the way, if you go to Stephen is spelled S-T-E-P-H-E-N and then Cabral, C-A-B-R-A-L. So .com forward slash inflammation. And so you can take this test and see what your score looks like. Look, if your inflammation is out of control, well, then you're not going to recover as well from your workouts. It can affect things like hormones. It can make it more difficult to become fit. One more time at StephenCabral.com slash inflammation. Now this episode is brought to you by Z Biotics. So this is a company that made a probiotic that was genetically modified. So they took bacteria and they changed it in a lab to break down something called acetaldehyde. All right. What's acetaldehyde? Well, when you drink alcohol, acetaldehyde gets released and this causes all kinds of problems. Now, normally your liver breaks it down. No problem. But some of this gets released in your gut. And when that happens, you feel like crap. That's what happens. But if you drink Z Biotics before you go out and drink the Z Biotics, the bacteria breaks down the acetaldehyde. So you drink this, then you go drink and hang out with your friends. And here's what happens to me when I do it this way. I feel way better. Go through our link at 15% off. Go to zbiotics.com. That's zbiotics.com slash mindpump26. Use the code mindpump26, get 15% off. We also have a brand new workout program, MAPS Abs and Butt. It's a full body program, but the focus, most of the training is focused on developing incredible abs and a big round butt. Get this program now for 40% off because it's brand new. And I'll throw in to one of these two MAPS programs for free. Muscle Mommy 15 or Muscle Mommy. Go to mapsabsandbutt.com. Use the code launch, get the 40% off. And then we'll also throw in Muscle Mommy 15 or Muscle Mommy. All right, here comes the show. All right, real quick. If you love us like we love you, why not show up by rocking one of our shirts, hats, mugs, or training gear over at mindpumpstore.com. I'm talking right now, hit pause, head on over to mindpumpstore.com. That's it. Enjoy the rest of the show. Does, I've heard that supplementing with creatine helps with methylation issues because it reduces the amount of methylation that needs to happen. Is that, are you familiar with that? I'm not familiar with that. That might be true. Trimethylglycine, we use that in our creatine. So it's, it's called an advanced cell force. It has trimethylglycine at two grams that has been shown to drive down homocysteine. We use taurine, which helps with detoxification as an antioxidant. We use citrulline malate, which increases nitric oxide because part of getting older, you produce less nitric oxide, but nitric oxide, nitric oxide also gives those vessels more elasticity. So it can help improve blood pressure and improve vasodilation. And then we add creatine. So it's possible that there is causal factor there. I haven't seen that. Okay. And, and not to go too side, sidetracked here, but what about the use of low dose PDE5 inhibitors like Cialis for nitric oxide and blood vessel? There are some studies showing that that might be beneficial, even just prophylactically once a week, maybe twice a week. Okay. So it's interesting. I haven't started using that with individuals in my practice. Now, some people are using that for erectile dysfunction and other factors as well, but some people now are using it prophylactically for cardiovascular reasons. And it might be appropriate, maybe micro dosing in the future or just using it once a week or so. But right now, 100 percent. Okay. Yeah. What's, what's the next one? Next one is, sorry, let me look at my list. Yeah, yeah. Go ahead. Pull it up. I had these in order because I wanted to do them in order. But they'll edit it all out. I have the list up there if you want to take a look at it. All right. So the next one is going to be total cholesterol to your HDL levels. So that's a ratio. The ratio. Exactly. So this one right here is a better look than just what your HDL is, because when you go into your doctors, they're going to say, we want your HDL above a 59, which that is great to have, challenging for a lot of men to get their HDL levels above a 59. But when you think about what is HDL, the high density lipoproteins versus the low, is that it's essentially taking your LDL cholesterol and bringing it back to your liver for recycling. So it's helping to pull it out of your blood. So if you have a lot of LDL, but low HDL, then there's more LDL building up in your bloodstream and circulating. Again, LDL is not bad until the tissue is damaged, and then it becomes a real problem. So what conventional medicine says is like, we're not going to worry about the damaged tissue. We're just going to make so low, your LDL so low that there's not enough to be able to go in and patch up, we'll say, the arterial tissue in the first place. That's why even people with low cholesterol still have heart attacks. Right. Because they didn't fix the underlying root cause, which is the damaged arteries, the damaged endothelial tissue. But if we look at your total cholesterol, and let's say it was a 240, which is like the upper limit of normal, right? So usually doctors want to blow 200 or cardiologists, they typically want to blow 180 and they try to drive it down below 120, believe it or not, which I think is too low for cholesterol. But that's what they're looking for because they're essentially saying the lower the cholesterol, the lower incidence of heart disease, not the lower incidence of mortality, but the lower incidence of heart disease, which the research does actually back that up. Doesn't mean they live longer, but they get less heart disease. So there's that. And it does lower your coenzyme Q10, which makes your heart weaker. But again, that's a story for another day. So what we say is, okay, let's say that your cholesterol is 240. Well, if your HDL is 80, it's a three-to-one ratio. And so that's great. So we look for a cholesterol to HDL ratio of a three-to-one. Got it. All right. And the next one? The next one is now going to be another ratio. It's triglycerides to HDL levels. Okay. Triglycerides are fascinating because they are essentially packaged fatty acids. They're packaged energy. And so they raise from excess caloric intake of regardless of basically calories, specifically from alcohol, high sugar, processed carb intake, and not a lot of movement, not a lot of exercise. So that's a recipe for disaster because it's leading to metabolic disease. Right. Metabolic disease would be your high cholesterol, high blood pressure, high blood sugar. And that's the worst of all conditions. But that's likely where two thirds of the United States, at least population moves to by the time they get to their late 50s, early 60s. And that's what decreases life expectancy the greatest. Because, again, if we look at all the reasons for dying at 75, which is average life expectancy for a male, 78 for women, it really comes down to, did you get high cholesterol? Did you get type 2 diabetes? Did you get high blood pressure? The other factors are cancer and Alzheimer's, but it's harder to get cancer and Alzheimer's if you don't have those first three, because obesity typically comes along with them. High blood sugar comes along with it. Hard to get Alzheimer's if you've got good hemoglobin A1C, which we'll talk about in a moment. What's the, what was the ratio for triglycerides ratio? Ideally a one-to-one, that's what we look for in our practice. So in an ideal world, triglycerides are a 70, HDL is a 70. That would be absolutely perfect. Now, because triglycerides are little packets of energy, is one of the go-to ways to lower triglycerides to be in a calorie deficit? Absolutely. Intermittent fasting, great way to do it. Get enough sleep, so your fasting glucose levels are a little bit lower. Exercise, getting in your 10,000 steps a day, especially walking after dinner helps to soak back up and doesn't allow your postprandial blood sugar spike to be as high. It's actually found that not only does your blood sugar not get as high in terms of the peak, the overall time it stays elevated is less. So if you only do one walk a day, post-dinner is probably the best time to do it. Would a diet that is devoid of carbohydrates, because I know triglycerides, packets of energy, right? Stored glucose, possibly. Would a ketogenic diet help lower that even if the calories are high, or is it more about the calories or the total energy? Calories do matter. If you drive up your calories high enough, your fatty acids still could go up. However, a lower carbohydrate diet can fix this in the short term, for sure. Okay, cool. So we are typically using a lower, a lot of people don't think that I use low calorie, low carb diet and people are like, yeah, but you believe in a high carb diet. Well, you know, it's kind of like when you do the math and you look at all your macronutrients for the day, like the best protein is typically somewhere between like 20 and 30% of your macros is your protein. And if you're eating 3000 calories a day for an individual and you take 30% of that's 900 calories from protein, like that's going to be probably plenty for most people, right? It's like, okay, like how much protein do you really need? It's like, you know, even if you're doing one gram per pound of body weight, like you're still going to meet that. And then it's your fat. Well, again, it goes back to basically how your body processes fat, but most people do really well between 15% and 30%, 35%. So all that's left is carbohydrates. And so it's like, not necessarily a high carb individual, but like that's what's left. And so then it can come from mainly vegetables, from fruit, like however you want it. But we try to get in that fiber per day because we show that lowers cancer incidence, cholesterol, et cetera. But there's a time and place that many of our clients do a low carb diet for anywhere between three weeks and 16 weeks where we're trying to improve all of these markers as we then reverse diet and get carbs back into their body once their cell membranes are better. Wow. Okay. So you use a reverse diet as well. So you're taking people's calories down in the short term initially to solve an issue. And then you start to raise their calories or you just increase carbohydrates or is it both? We do both. Okay. Yes. So we absolutely believe in phases for weight loss. So a lot of people just chronically put you in a deficit until you're eating 800 calories a day. That's a miserable existence. You're not going to maintain that and you're going to lose a lot of muscle and bone. So we're always thinking about, okay, you're 40 years old. You want to lose 50, 60 pounds. We'll get you there, but we don't want to do it as a detriment of keeping that weight off or your health for the next 30, 40, 50 years. So we'll have an initial weight loss. Then we need to then actually add calories back a little bit and carbs, put on more muscle to boost the metabolism, improve overall thyroid and hormones. Then we'll start to dip again, but ideally more through exercise output than dipping of calories at that point. And then we'll just keep phasing it until we get them exactly where they want. And the body transmission is amazing. That's literally look better. Yeah, that's awesome. It sounds like you sound like somebody who's worth a lot of people. And that didn't happen overnight, right? Because we did that in the beginning too, when I was 18 years old and working as a personal trainer, it's like, this is what you just cut. You just cut people and make a move more. That's right. Exactly. And so then they, and they do lose weight, but then, you know, plateau, plateau, hard. And then what do you do? You've got nothing left. You run out of days. You're going to do 90 minutes of cardio a day or two hours a day. And some people do. Then the new thing is like walking for like three hours a day. Sure. Is that really the new thing? Yes. You walk in forever and not doing cardio. And they're just doing walking sessions of an hour, twice a day. And, and, and also, you know, being a little bit of caloric deficit, like look at my six pack abs. I get it. But is that maintainable? Can you maintain that? That's a lot. I love to walk and, you know, it's good for your health, but three hours a day is a bit much. All right. What's next on the list? So the next one is hemoglobin A1c. Okay. So this one right here is all about your blood sugar. It's essentially your ratio of average glucose over the past two to three months, basically 90 days. So this is better to look at than just blood sugar, right? Like sometimes this could be high blood sugar, it'd be good, but this is high, right? You know, I find in my practice, and I don't know if you've seen this. I have a lot of people wear a continuous glucose monitor. But I'm doing less of that now. And really just looking at the hemoglobin A1c. And the reason is I work with a lot of athletes. I work with, I've worked with Olympians, I've worked with all sorts of individuals, and their blood sugar is all over the map. And they get their hemoglobin A1c back and it's like a 4.4. I'm like, how is this possible? You're averaging, you know, 65 for your glucose all day? No, because I see their continuous glucose monitor. So what happens is, for lack of a better term, the cells themselves are less sticky. Your arteries are less inflamed. There's less oxidative stress. They're exercising a lot. They're eating pretty well, but their blood sugar is up and down. So what we want to look at is, when your blood sugar is elevated for a chronic level of time, it creates these advanced glycation end products, these ages. That creates oxidative stress, which then damages your arteries, your vessels, your tissues. Then over time, then that allows for that cholesterol and that plaque to build up. So it always comes back to inflammation, but inflammation always has a root cause. In this case, it's blood sugar. Now, they don't worry about pre-diabetes until you get to a 5.7, 5.8. In our practice, we're looking at a 4.8 to a 5.2. That's what we want. A lot of people come into our practice a 5.4 to 5.6, so they're trending in the wrong direction. We just need to make sure every six months they're down another 0.1, and we just get them down into that 4.8 to 5.2, where the likelihood that they're going to start to then build up more inflammation, or, and by the way, the inflammation in your arteries and your heart- Goes to your brain. Is going to your brain. Yeah, because this has got to be correlated to Alzheimer's, dementia, because I've heard researchers refer to those as type 3 diabetes. Exactly correct. Well, not to take you off track here, but you said something I'm so curious about now with the glucose monitors. So with what you've seen, is there a correlation between people that work out and have a lot of muscle mass, and they have these crazy spikes, but then they don't have this negative taste? What are you seeing? That's right. Yeah, tell me what you see. So again, I work with many professional athletes, and they're not even eating always the best. Right. And, but a lot of these, I'm not talking about 20, you can get away with a lot at 22 years old. I'm talking about, I'm working with athletes in their mid thirties to early forties, like people that have been doing this for a while, and all of these things should have caught up. The exercise is very protective for glucose levels, blood sugar levels. And so although their blood sugar levels are spiking, their average overnight is great, no doubt about it, but they're getting to like 180 after a meal. And they're, but their hemoglobin A1C is a 4.4 to 4.8. It's fantastic. So it does not affect, those spikes are not affecting them and they don't need to try to drive their blood sugar levels down, which is then detrimental to their athletic performance. So that's what we're finding there because they're, people are worried about eating carbohydrates, but if they're the right carbs with the right fiber, also getting enough protein per meal to balance those glucose levels, I'm not seeing that, that a direct correlation. Now, continuous glucose monitor for someone trying to figure out the best foods for them and they're 50, 60 pounds overweight. No problem with that. That makes a lot of sense. Makes a lot of sense. Yeah. When you're looking, there's a bit of a, like there's an athletic bias, I would say with athletes, more muscle mass, stronger, sensitive, insulin sensitive muscle because of the exercise and performance. But the biohackers that are wearing CGMs all day long, probably not necessary. Yeah. That's not, that's why I'm asking is you have a lot of fitness people that are utilizing a tool like this and it's just like, you know, trying to manage their, their level at this perfect all day long. It's like, I mean, you got, you know, 50 pounds of muscle, more than the average person. It's like, does, is it really that important? If you run your blood work and it's dialed in for that 4.8 to 5.2, you most likely don't need to worry about it, especially if you're doing a 12 to 16 hour fast overnight, eating the right foods. Unlike, it's likely leading to more stress and more dysfunction around food than it's worth. That's what we found. I mean, we've run every year, we run between 60,000, 100,000 lab tests. And so the amount of, we have 6 million biomarkers of data and I can assure you all of these things are far more necessary if you're overweight. And that's why, again, the number one thing that we try to do is just get people to a healthy weight, not for vanity standpoint, but it's the number one thing you can do for your health and longevity is get to a healthy weight. Okay. And then I think we have one more left, right? One more is the omega-6 to omega-3 ratio, which this is looking at inflammation from another standpoint versus blood sugar, is looking at it from fatty acid profile. So our job is to make sure that the cell membranes, which essentially control what comes in and what goes out are healthy. And the right balance is less than a 5 to 1, but ideally a 3 to 1 ratio. There's one other metric as well. So basically omega-6 to omega-3s. We've done a previous show a couple of years back on this. We're going to do a little check on your labs, which will be fun to look at where you're at. But what matters is that these cell membranes control a lot of the inflammation, you know, and when those cells become damaged, they're not as sensitive to insulin. And this is when you're not able to get the glucose into the cells and you have more inflammation in the arteries. The other part of this is what people are talking about is omega-3 index, because if you're above a 9%, which I just like to refer to as like saturation of omega-3s in your blood. If you're above a 9%, you have a 90% risk reduction rate for cardiovascular death, sudden cardiovascular death. 90? 90%. Yes. Wow. So all because here's why they're looking at it. Think about the stenosis or tightening of the arteries, or you're thinking about the plaque that's building up. A lot of this is happening based on inflammation and stiffness over time. Omega-3s are the antidote to that. They allow for, as an anti-inflammatory, and they allow for elasticity. So no one marker is the end-all be-all. That's why we look for all of these seven markers, but if you're getting your ratio to a 3 to 1, you can get away with a lot more. Oh, cool. I think I asked you this a long time ago, and I can't remember how you answered it, so I'm just going to ask it again to you, because I think I remember seeing an article on this before that the omega-6s out-compete the omega-3s. In other words, if you were eating so much of the omega-6s that you can't take a supplement like an omega-3 and still get all the benefits from it, is there truth to that? You're saying if you're eating too many omega-6s, you can't take a supplement? Well, you can take the supplement, but you're not going to get the same benefits. Yeah, it's not going to make that much of a difference on all the benefits that we talk about from omega-3s, because your cell is basically being out-competed. The ratio is too far off. Yeah, the ratio is too far off. You would have to take more and more. That's why the test is so important. Yes, but you don't want to take more and more. It always is whole food first, and then the supplementation. So we previously spoke about the Due Health study on the top nutritional supplements that improved overall, basically, aging and mortality. And omega-3s was at the top of that list. Vitamin D3 was the second place, essentially. And it showed people taking only one gram a day, but it improved, essentially, rate of aging by about 3.3 to 4 months every three years. That essentially, if you kind of do the correlation, you're getting about one more year of life every decade. And so omega-3s are, it shouldn't be the panacea, but it should be one of the number one supplements in your arsenal. Now, you can overdo omega-3s just like you can overdo anything. In the last show, we talked about natokinase and proteolytic enzymes. OK, 10,000. So back in the day, 15 years ago, we were still using this 2,000 to 4,000 FUs, fibrinolytic units per day, empty stomach. That was great. New studies should be 10,000 for 6 to 12 months to reduce arterial plaque by 36.6%. Great. But if you do 30,000, it doesn't mean that it's better than 10, and it may lead to too much thinning of the blood. Too many omega-3s might lead to too much thinning of the blood. So we look for that three to one ratio. That's really what we're looking for. That's why testing is so important. That's right. And so let's say you were taking 10 grams a day of omega-3s. Not only do I not think it's more beneficial, I actually think it starts to go the other way. It's essentially a U-curve. Not taking omega-3s, not good for you. Taking too many, not good for you either. It's that this is a sweet spot of about one to three grams per day. That's so important. And for you guys, we'll look at your tests, but it might be three grams instead of two because you have more muscle, you eat more meat, and that has to balance. And so maybe that's where the article is coming from, is that if you have it because it basically saying if you have a crappy, poor diet, right, and you're throwing these omegas on there. So then the amount you would have to take to get the positive benefits from omega would be higher than what you would probably recommend. Absolutely. But there's still all the detrimental effects of those omega-6 foods. So when you look at omega-6s, they eventually, we spoke about this before, come down to arachidonic acid. Since we chatted, though, I did a whole about 90 minute teaching on pain. So arachidonic acid, people come to chiropractors all the time and they say, why do I have this pain that just kind of moves around my body? Why do I have neuralgic pain? Why do I have migraines? Why do I have all these issues? And that's because arachidonic acid from omega-6s can actually turn into leukotrienes. It can turn into thromboxanes. It can turn into eicosanoids, prostaglandins. And these things cause inflammation in the body. And it's nonspecific. It goes to wherever your genetic weak spot is. Could be allergies. Could be migraines. Could be, back in the day for me, it converted to leukotrienes. I had the worst seasonal allergies, like debilitating seasonal allergies every April in Boston when things started to bloom. Got that under control, got my omega-3 to omega-6 ratio under control. Gone. And fixing my gut as well. And then it was gone. Wow. So I had to do both of those. I think I told you this last time, but you know, arachidonic acid was sold as a supplement for a while for people to try to build muscle. And because there is truth to that, right? So that's why there's always truth to all of these things. They didn't tell you about all the inflammation it creates. It does help build more testosterone. As a stupid kid, if something, you know, when I was a kid, if something built muscle, I would take it. And I did. Yes. And I took it and I got so stiff. As it did in my teeth. Oh, that's interesting. Yeah. I got stiff and super sore from my eyes. This sucks. I don't care how much muscle it puts on. All right. So let's go over our test. And what's this test looking at again? This is looking at omega-3. Yeah. This is a very simple blood spot test that looks at your omega-6s to omega-3s. And it's not judging your diet. It's not judging anything. It's simply saying, what is your ratio of the omega-6s you get in your diet to omega-3s? That's it. That's all this looks Now, am I, because of my autoimmune at a higher, higher risk here than these, these two knuckleheads? Does that? This is just looking at the fat you have. I'm trying to build up your excuse case. No, this is not measuring. This is not measuring your CRP. It's not measuring anything like that. Yes. And I already know I'm probably going to leave. But the higher the ratio will make you more susceptible to autoimmune issues with those omega-6s because it's creating more inflammation. So this is giving you basically a root cause of inflammation. OK. So omega-6s are going to come from like roasted nuts, oxidized nuts, those types of things which are a little higher than raw nuts. It's going to come from non-grass fed meat, non-pastured chicken, non-wild fish. That's where a lot of these omega-6s are coming from. Vegetable oils, etc. I'll tell you again, you might find something different. I have difficulty even find anyone that will show me the ratios of omega-6s to omega-3s in grass fed meat. So I know there's more supposedly more omega-3s in grass fed than they're in conventional. Without a doubt. So usually conventional is anywhere from an 18 to like a 25 to 1 of omega-6s to omega-3s. That's how detrimental it is. They're fed corn. They're fed soy. They're fed all sorts of different things. Most people, it's for grass fed, it's about a 6 to 8 to 1 most likely. I've tried to see people that have said that it's a 3 to 1, like it is for more like fatty fish. But I haven't been able to see that. It's still better than the. Way better. You're talking about half. Oh no, it's so much better. So and like that'll get you close to the ratio. So anyway, just saying that that's that's what it's from. OK. All right. So let's start. Let's go from highest omega-6 to omega-3 ratio to lowest. And then also this test looks at arachidonic acid to EPA. So arachidonic acid would be the. We need arachidonic acid, so I don't want to say that we don't, but it's the most inflammatory, the most egregious to create prostaglandins. And then EPA, we look at that as the most anti-inflammatory, even though DHA is part of that as well. So that's what we're looking at. All right. OK. All right. So Justin came in and again, we're shooting for five to one or less, ideally three to one. Just don't want to be last. Is it all the cotton candy? So cotton candy will definitely raise it. The vegetable oils. I don't know what I said. Barbecue sauce. So 7.5, which I'll go back to your. Two years ago we did this. So it's been two years. You're an 8.1 down to 7.5. He's going in the right direction. He's switched to grass fed cheese. That's winning you guys. I know cheese was the big one. I compete only with myself. Yes. And then the arachidonic acid, EPA, we still want this below a five to one, ideally three to one. It was a 15.5. So when we look at this, you'll see most people's ratios are higher on the second one. And the reason is, is that their EPA is lower. OK. So remember, omega threes could be from flax or chia. And those are your alpha linoleic acid, your ALA. But not necessarily converting the most anti-inflammatory. So the AA to EPA is really the one that we're looking for. So that's the one we want to do a little bit more work on. Justin was wondering if fish sticks count. I think the outside offsets the inside. It's cod. Cod counts, right? Cod does have omega threes, there's no doubt about it. So I should say the best way to get your omega threes are the small fish, the sardines, the mackerel, the anchovies, the wild salmon, the wild trout. Salmon are a little larger, but they're lower in mercury. So we usually recommend those higher omega threes. So they're great to get. Now, I'm assuming you weren't supplementing with omega threes when you took this test. No. OK. So for you, based on your numbers, probably only need two grams a day. Well, that's not much at all, dude. OK. So that's it. Or a can of sardines. I'll do the two. Yeah. So you could do a can of sardines a day. That is true. Yeah. And as long as you have no purine issues or histamine issues, that'll work great. In our practice, we see people that eat a can of sardines four to five times a week can achieve the three to one levels. Awesome. All right. Next up is Adam. Adam, two years ago, you were 7.3. Now you're a six. So that's pretty good. What you been doing? Almost at the 5.1 ratio, which we like. I feel like I'm there right now. Huh? I feel like I'm there right now. Have you been supplementing with the fish oil? I just did right now. No, no. Have you been? No, I have not. So we have no idea how you dropped this. Yeah. Better diet. Oh, yeah, for sure. I'm better diet right now. So I will say the majority. You were a lot fatter before. The majority of people that are not supplementing but eating a healthy diet come in around six and a half. Yeah, I'm super curious if I just consistently did omegas. Like, I mean. You'll be. Well, your arachidonic acid EPA is at 19.7, though. So this is usually more eggs, more red meat, more pork, higher arachidonic acid foods. So high EPA fish oil will be good. OK. So a lot of those things. Again, two grams a day, maybe three for you, but probably just two. We'll knock that right down. OK, without a doubt. That's all that I will take. And these are important, too, just because you shared before in the show. Obviously, I wouldn't share this, but you said you have psoriasis and other factors with that. That'll help tremendously with that. But you'll start slow and you'll just ease it up. OK, nice. All right. So let's see where you were in 2024. 7.8. Two years ago. Today, 4.9. Oh, well, the 5 to 1 is pretty great. Yeah. And the arachidonic acid to EPA was, I remember it being high before, 13.8. That's not bad, but it's higher. Went down to 11.6. So we're at the 5 to 1, which we like. We still want to drive down the arachidonic acid to EPA. Same thing. Two to three grams maximum per day. I know that you eat a good amount of eggs or at least used to eat a fair amount. I still I still eat. We'll probably eat a couple eggs a day. But are you still eating sardines? It depends. So sardines for me are just, I enjoy them. So I go through like bouts of enjoying them. And then where I don't eat much of them. Maybe before this test, you're eating a little bit more if you weren't supplementing. I was thinking I might have been taking omegas at some omegas. OK, now. And that's the thing with omegas is just like you should eat in an ideal world, eat fish two or three times a week. The only reason I wouldn't say is more is just because of all the microplastics out there. It's just. And if you are, if the small fish, then they're not going to have as many microplastics. But can be great for your health. Good source of protein. But you do just, again, take a good quality high EPA to DHA, ideally a two to one ratio of EPA to DHA to get you there. And that'll be the best way to do it. All right. Doug in twenty twenty four was a three point nine. Winner. And he's a three point seven now. So ideal ratio, arachidonic acid to EPA to three point four. So fantastic. You're already there. I'm assuming you're taking omega threes. How many are you taking today? Yeah. So I'm going to sell your product because I use your brand and I take one in the morning and one in the afternoon. There you go. Every day. Have you been consistent with that for a long time? Oh, yeah. For several years now since we started this. The best way to do is just be regimented. Same with your vitamin D three. Even if you get sun, you can just take your vitamin D three. With low, with something like this, a really good, you know, arachidonic acid, EPA ratio, really good omega three, omega six. When it's really good, are you more resilient to stress? Physical stress? Yes. Emotion, mental, emotional. You're still going to have those cortisol levels because what's happening is your hypothalamus inside your brain is telling you what to do. I was just I was trying to make the case. But it will buffer what it's doing to your arteries for sure. Yes. Can I do the same with my omegas as I do with my vitamin D? I didn't know that I could like if I missed two or three days in a row, I forget to take my vitamin D. I can take the three X, the dose. Can you do that with the omegas? I wouldn't necessarily do that. No. I mean, you could take. I know it's probably not ideal. The reason is, so think about like vitamin D3. If you take a high dose of vitamin D3, like a lot of people say 50,000 I use at one time, it's going to pull more calcium into your bloodstream, which could then, not ideally, stick in the arteries if the environment is right. So I like what we would get from nature. So if you're eating a good six ounces, eight ounces of fish, you're going to get your couple grams of omega threes. That would be totally natural. Vitamin D3 from the sun, maybe 10,000 I use for us in our practice. Typically, it's 5000. I use a vitamin D3 on a daily basis. That's what's going to get you, which we spoke about on the last show. The 38 percent reduction in many types of cancer, prostate, colon being one of those and the 85 percent reduction in breast cancer. If you get your vitamin D3 levels up to that 60 milligrams per deciliter. So that's really it's all based on lab testing. We do the vitamin D3 test independently or with the stress immunometabolism test. This one is a simple at home omega three inflammation. So when we when we back in the days we did vitamin D with you a long time ago and I was taking 5000 I use and still tested low. And so I take 10,000 by using it. But I'm also can be inconsistent. I can miss like three days and then I'll take 30. Is that OK? Or do you think that I should should just chalk it up as I missed it and then get back to taking my 10? I really like to work on the consistency. So, yeah, it's OK. That's good to know because I had I had heard that I could I could take it like that. So you can. But there are then the side effects. Sure. So let's just say you took 10 grams of fish oil to make up for what, five days. Yeah. Right. Then what happens is you get one big dose, but you miss the anti inflammatory effects for those previous four days. Yeah. And now you get a massive blood thinning effect. OK. That you may not. It might be detrimental to your recovery. You also work out and you haven't tested your vitamin D in a while. I mean, I'd be curious to see how especially with all the sun I get to see how it is. Yeah. It'd be interesting because we when we tested way back in the days, I lived in a different place and I get a hell of sun. Yeah. I get a lot of sun now. And it's funny because a lot of people, they think that their vitamin D levels are adequate because they get a lot of sun. And oftentimes they are. But some people are not great at converting that vitamin D3 in the liver, which is the majority of that transformation taking place. And so they don't get the conversion. Now, again, I'm always whole food and sun first if you can do it. Yeah. But it's usually not enough for everybody. And it's not enough year round. So most people get sun on the weekends when they're out and about. Not during the week. That's not gonna be enough. They're not getting a full body tan. They're getting kind of their arms and legs. But the way that we know is you just test. That's it. And then the co-factors for vitamin D3 are your K2, your magnesium, your zinc. There's other factors that allow you to better absorb that that D3. Yeah. Yeah. It'd be interesting now. Yeah. You should test it because you've been taking vitamin D for a while consistently and you get sunlight. Be interested to see if you're at that number now. And test all the blood markers that we spoke about today. You know, these are becoming just much more prevalent that you're able to just look at these and there is no one end all be all marker. But when you look at them in their totality, that's what ultimately leads to a longer, healthier life. And when things start to then go off track, you can correct them right away because you know those underlying. Which one of your tests test vitamin D? Because that's one I think everybody should do. We have a standalone. So all of these are just that. You can just do a vitamin D test. That's right. At home, finger stick. That's what we did way back when. That's one of the first tests we did with you. And then we do it with the stress minimum metabolism test, which looks at all your thyroid markers like your T3 looks at all your cortisol throughout the whole day. Testosterone, estrogen, DHEA. So that's like the big antiagent and hemoglobin A1C. So that's the big test that we always recommend in the show notes. We'll give you a link for that, too. I know we always offer like 50 percent off that for your listeners. We weren't going to do that this time, but we'll make that happen. Oh, cool. And I mean, because that is the test to look at blood sugar, vitamin D3, cortisol, hormones, all the things that lead to aging. And this one's, what is it called? The stress metabolism? Stress, mood, and metabolism test. Mood and metabolism. Now, some of these things, you really have to change your lifestyle to move. But what we're talking about right now, this omega-6, omega-3 ratio, supplements make a big difference, like a big difference. One of those very few things you could change just by supplementing, right? Yes. So when I talk about like, what do we do for our clients? OK, it's called the de-stress protocol. Diet, exercise, stress reduction, toxin removal, rest, emotional balance, scientifically backed supplements, success mindset, like all the things, right? But supplements is 10 seconds of your day, just putting them in your mouth. And you don't need to take 50. But there are a few that really do matter that move the needle. Omega-3s is one of those. It just is. There are 30,000 studies on how much omega-3s improve your overall health. I mean, surely it does attest to the fact that he's been able to maintain his diet, that he's just been consistent with it. What do you, what do this, what do people report? They get their omega-6, omega-3 ratio better. They get their raccadonic acid EPA ratio better. What do they report in terms of how they feel? So, cool. The test says I'm better. What are they noticing? That's a good question. Sleep, inflammation, recovery, mood. Those are the big ones, just like off the top of my bat, what I can think. And they work fairly quickly, about six weeks to 12 weeks. And the reason is that you need enough time for them to start to integrate themselves into the cell membrane, which right now, if there's more omega-6s, it becomes more what's called dysaerobic, so less oxygen is able to enter those cells. The cell membranes get a little bit more gummed up with sterols. Again, we need sterols. We actually need more of them than we need these polyunsaturated fats, which I know, you know, the people say are detrimental. Again, there's no, there's no black and white. There's nuance to this. You want less polys than you want of the sterols, but you still need them for waste coming out of the cells and nutrients coming in. And so the anti-inflammatory effect helps with the pain. The mood is the more omega-3s helps with overall mood like that is just, again, clinically proven. It's been shown to help with ADHD. It's been shown to help with autism. So these are just, our bodies are meant to have these omega-3s in them in a ratio of about three to one, at least less than five to one. Let's talk about your supplement because you guys have a high EPA fish oil. Yes. Is it true that one of the challenges with fish oils is supplements is you're taking one and they're rancid. They went bad because it's like a food product, right? So how do we, like, how do people know what they're taking is good and not gone bad? Like what's, how do we know this? So one of the biggest issues, like, just like you said, is the oxidized cholesterol. So the oxidized fish oil that's in it themselves. So one is you want to use more of a cold process. So the less that you heat up the oil itself, the less rancid it gets. If you think about all the oils we cook with, people always rate the oils, right? So it's like, is olive oil better than tallow, better than whatever it might be. For high temperature or whatever. And that's at a high temperature, right? So the lower temperature, always the better, regardless of the oil and avocado oil or an olive oil are unique. Especially olive oil has the oleic acid, coconut oil, a little higher smoke point. Same with like butter or ghee or whatever it might be. With this more of a cold process, more triglyceride bound so that you can actually absorb it. And then you want to look for low mercury or ideally no mercury. So we third party test all of our products. So there's no mercury. And the reason is, is that if you're getting your fish oil from fish, which you should be, then there's a higher likelihood. The more compressed fish oil there is, the more mercury there's going on. So really important that you're not putting mercury in your body, which creates inflammation and potentially could lead to inflammation in the brain, causing dementia, Alzheimer's. Does it help to refrigerate or freeze your fish oil capsules? Does that make a difference? Not anymore. All of these, even probiotics are shelf stable for the most part now. So you can leave them out. Even the oil I use. So you can use a soft gel or an oil, small bottle, dark bottle. So the light's not off. It's all about oxidizing that oil. The gelatin now that's used on them helps prevent that oxidation should be in a dark bottle. Would it make sense to, when you're taking your vitamin D, to take it with your fish oil since the vitamin D is fat soluble? Does that make a difference? We actually, it's a great question. We actually recommend taking your vitamin D earlier in the day, just like you would get it from the sun. Take it at breakfast or take it at lunch. So to time it like you're, hey, I'm up and the sun is out. That's right. And they've shown that if you take your vitamin D at least at a higher dose at night, it might detrimentally affect melatonin because you're getting the sun more studies need to be done on that. But that was interesting. And it makes sense to me. You get your vitamin D peak time is 10 to 2, right? So take it in the morning, let it absorb. It's in your body from that 10 to 2. That makes sense. We tell all of our clients, simple, take it at breakfast with food. Vitamin D3 is absorbed better with a fatty meal. Or just it doesn't have to be like 50 grams of fat, just fat at that meal. We, vitamin D3, we put ours with a little bit of medium chain triglycerides. So it's already got the fat. Yeah, because you don't need a lot. And then omega-3, take it any time of the day. Totally fine. You're taking it at, you said, breakfast and lunch? Yeah, breakfast and around five o'clock in the afternoon. So that's great. So you're kind of spacing it out. Myself, a lot of clients, I just take two at dinner. You can take one at lunch, one at dinner. I just take it mid-meal for anybody who has trouble digesting it. Always take your supplements mid-meal, little food under it, little food on top. You won't get as much if people are prone to reflux or whatever it might be. OK, OK. Helps eliminate. You mind if I ask you a question a little off topic, but I think you might be the person to ask. So right now, you're hearing all this news about this parasite that's on the lettuce, you know, Cyclosporia. OK. Can the, can parasites be treated naturally or does it always have to be pharmaceutical to get rid of them? Like. Well, here's the interesting thing about this particular parasite. So in your right, it's called Cyclospora. So it's always been around. It's just now we've got a concentrated number of cases. Seems to be around the Ohio based area, but spreading throughout the country. Last time I checked, there's about 4,000 cases, which is much more than normal. The problem is, is that it's not, at least they say, responding to normal antiparasitics like Ivermectin or Mevendazole or whatever it might be. And they're saying it's responding to Bactrim. Yeah. But it's a parasitic. Exactly. It's an antibiotic. So that's fascinating that it's responding to that. And also Bactrim is a sulfa based drug, which a lot of people have massive reactions to. It's extremely strong. It's detrimental to the rest of your body. So I can't recommend taking it. So in our practice, we use a natural protocol first and only go for the pharmaceuticals as needed. So we use what's called the Parasupport Protocol. First thing is the actual people have had parasites since the beginning of time, right? So what have they used? They've used Artemisia or Sweet Wormwood. They've used Mimosa Putica. There's I mean, people can just look it up. We don't have to go through every single one. Black Walnut Hulls. These are all things that have always worked. Pumpkin seed or something like that. Actually, raw pumpkin seeds works great. Garlic, crushed garlic works great for parasites. And then we use a biofilm disruptor to help remove if it's embedded itself in your intestines and then a binder, universal binder that's low histamine. So that's basically our Parasupport. Anybody can take a look at what that looks like. How effective is the natural approach to getting rid of parasites? Or should I say, how often do you have to then go pharmaceutical? Because parasites can be hard sometimes. That's right. I would say effective, if I'm being honest, 70 to 80 percent of the time. That's not bad. No, that's not bad. Because we do stool testing. So that's how we know for sure. So if if someone has an autoimmune issue or real, like they've been sick for a decade, we all we don't it's not part of our big five labs then. But we'll add it on, which is a bacteria and parasite stool test. If they have H. pylori, it's going to make them more prone to cancer. It's going to make them more prone to autoimmune issues. If they have a parasite, again, more prone to inflammation, autoimmune issues. So we test for that. We always do our protocol. We'll do it one to two times as needed. If they're still showing up. OK, we'll use a 21 day course of a of an antiparasitic. Is teeth clenching is one of the symptoms of parasites, right? Yes, anal gene, teeth clenching, night sweats, adult acne on the neck and back. Yeah. Wow. Interesting. All right. I just want to bring that up because it's like top of mind right now because everybody's talking about it. Now I will say. The diarrhea lettuce. Exactly. They did. They have been able to locate what it was from now. And so it's going to be eliminated hopefully very quickly. Oh, so it's not from workers pooping on the lettuce. Well, we don't know. It's from one particular company. I won't out them right now. That supplies lettuce to Taco Bell. So it is from Taco Bell. But now they're producers for other things as well. So you mean you get diarrhea from Taco Bell from the parasite? That's right. I thought it was just saying not to make a statement. This is the best. Now, they have said that it's potential on raspberries and basil and all sorts of different things. But hopefully that did it. They did a mandatory recall of all of their lettuce and produce from this company. So hopefully now that that's going to put an end to it. And it's not person to person transmissible. Which is good. Meaning like from. Wife to husband. Exactly. It is permissible from fecal matter on these food that transmit the parasite. Which is gross. But literally workers don't always wash their hands. It gets onto this. It then begins to multiply. And then we we have parasites now. All right. All right. Well, Dr. Cabral, this was awesome. Appreciate you coming back on. And so I love this. So you're going to. So you're going to offer some one of these one of these tests at a discount. I'd love to be able to get your audience. This is just for your audience at stevencabral.com slash heart. 50 percent off the same omega six to omega three inflammation test. Run your labs. Again, if you think you have the best diet in the world. Great. Like you can literally prove that to be true. And if you do that, then you don't need any supplementation, but it'll tell your exact ratio. And this is the easiest thing to do. Everybody just listening. It's literally it's at home. There's some drops of blood. You put in a card, you mail it in. It's a piece of cake. You don't have to go into a lab. And then you can use one or two grams, three at the very most of a good quality. We use the daily omega three support by equal life. You can do that. But again, why guess? Just do a simple lab test done right from home. The whole family can do it. My daughters have done it and you'll be able to see your levels and then you're good to go. You don't need to worry about. Very cool. Thanks again. Yeah. Thank you. I appreciate you. All right. I know you like that episode. If you did check this one out. Walking. It's one of the best things you do for your health. Bar none. But there's a better way to approach it. Yes, you can just walk. But if you follow the right protocol, it's far more effective. Let's talk about walking. I can't wait to hear walking protocol. Well, there is. Well, there is a protocol. So and I'll start with the first thing, right? Because just first off, let me start with this. One of the reasons why walking is such a great form of just activity is because it's low risk of injury. Now, sometimes.