RNC – Health Page

To regulate itself, the body often relies upon sensors that detect something amiss and then emit a signal that is amplified by the body so that a process can be set in motion to fix the issue that set the sensor off. One of the key signals the body relies upon are hormones, as small amounts of these molecules being released are often sufficient to change the internal state of the body drastically. The hypothalamic-pituitary-adrenal (HPA) axis is the body’s central stress response system. It has three main components: the hypothalamus and pituitary gland in the brain, and the adrenal glands on top of the kidneys. When you experience stress, the hypothalamus releases corticotropin-releasing hormone (CRH), which signals the pituitary gland to secrete adrenocorticotropic hormone (ACTH). ACTH then travels through the bloodstream to the adrenal glands, prompting them to release the corticosteroid cortisol (the body’s primary stress hormone). Finally, once cortisol levels are high enough, they signal the brain to reduce CRH and ACTH production, creating a negative feedback loop that prevents over-activation of the stress response. Cortisol, in turn, has a few key functions in the body: • Immune modulation — Cortisol first enhances the immune system’s immediate response to threats (protecting the body during stress), then limits excessive immune activity to prevent autoimmunity. It does this partly by inhibiting proinflammatory cytokines (e.g., IL-1, IL-6) and reducing T-cell activity. Over time, this shifts to immune suppression, making synthetic corticosteroids, a popular treatment for inflammation and autoimmunity. Note: At lower doses, this transition from immune stimulation to immune suppression takes much longer, whereas at high doses it’s faster (hence why high steroid doses are given for dangerous autoimmune flares). • Blood sugar — When blood sugar is low, cortisol raises it by stimulating gluconeogenesis in the liver, mobilizing amino acids (from muscle) and fatty acids (from fat) for glucose production, and reducing insulin sensitivity in tissues like muscle and fat. Excessive cortisol can lead to diabetes, abdominal fat accumulation (obesity), weight gain, insulin resistance, and cardiovascular issues. • Connective tissues — Cortisol promotes protein catabolism (breakdown) in muscles, providing substrates for glucose synthesis and inhibiting collagen synthesis. Excessive cortisol causes muscle wasting, bone loss (e.g., osteoporosis or osteonecrosis), poor wound healing (which is also a result of immune suppression), skin thinning, easy bruising, and purple striae. • Circulation — Cortisol raises blood pressure by increasing sodium and water retention, sensitizing blood vessels to epinephrine and norepinephrine. This causes vasoconstriction and an increased heart rate while also damaging the blood vessel lining. This elevates the risk for cardiovascular disease1,2,3 (e.g., a one-standard deviation increase in morning plasma cortisol is linked to an 18% higher risk of future cardiovascular events4). • Cognition — Cortisol modulates arousal, attention, and memory consolidation. Chronic excess corticosteroids (from either endogenous cortisol or synthetic steroids) impair hippocampal function, causing memory deficits, increased pain sensitivity, attention issues, cravings for high-calorie foods, substance abuse, and, rarely, psychosis. • HPA axis dysfunction — Since the HPA axis is regulated by cortisol levels, once natural or synthetic corticosteroids are chronically elevated, the HPA axis becomes desensitized, leading to excessive cortisol secretion or loss of the ability to secrete cortisol when needed. This in turn creates many issues such as those associated with chronically excessive cortisol or varying degrees of fatigue (e.g., due to the adrenal glands not secreting cortisol when needed). Note: Excessive cortisol can also cause other effects such as blood electrolyte imbalances, alkalosis, cataracts, and glaucoma. Because of this, many argue excessive cortisol secretion and HPA axis dysfunction (e.g., due to chronic stress, poor diet, poor sleep, alcoholism, too many stimulants like caffeine, social isolation, a lack of exercise, or irregular daily rhythms) is a root cause of disease (e.g., the metabolic syndrome afflicting our country). As such, they advocate for lifestyle practices that counteract these HPA axis-disrupting factors, and in many cases significant health benefits follow the adoption of those practices. Corticosteroids The hormone cortisol belongs to a class of steroids known as corticosteroids due to its release by the cortex of the adrenal glands. While many related corticosteroids (henceforth referred to as “steroids”) exist within the body, the body’s primary ones are cortisol (a glucocorticoid) and aldosterone, a mineralocorticoid that regulates blood pressure, volume, and electrolyte balance. In 1946, the first synthetic steroid (cortisone) was synthesized.5 Two years later, enough had been produced to test it on a human, where it was discovered to improve rheumatoid arthritis symptoms (which won the 1950 Nobel Prize6) and was immediately hailed as a ‘wonder drug.’7 Before long, it was discovered that other inflammatory syndromes also responded to cortisone, and a rush of other steroids hit the market: Following its success in rheumatoid arthritis, steroids (e.g., prednisone, hydrocortisone) were rapidly adopted for a wide range of inflammatory and autoimmune disorders, including systemic lupus erythematosus, inflammatory bowel disease, and multiple sclerosis, due to their ability to suppress immune-mediated tissue damage. In the early 1950s, steroids were hailed as a revolutionary treatment for those conditions (and hence widely prescribed), with new steroids (e.g., prednisone) being rapidly introduced to the market, but in the late 1950s, serious side effects began to accumulate from long-term steroid use. By the early 1960s, steroid treatment was “shunned altogether by the rheumatology community”8 (to the point shortly after that NSAIDs like ibuprofen were named nonsteroidal anti-inflammatory drugs to distinguish them from the disastrous steroids9) after which point steroids were prescribed with more caution and at lower doses until it was reborn in the 1980s under a low dose regimen. Currently, steroids remain widely used, and their use has gradually increased. For example, in 2009, 6.4% of American adults had used oral steroids at least once in the last year,10 whereas in 2018, 7.7% did, while a 2017 study found 21.4% of adults (age 18 to 64) had used at least one oral steroid prescription in the last three years.11 Note: After harms were discovered with steroids, a pivot was made that they are safe if “low doses” are given. However, over the decades, what constituted a safe “low dose” has greatly declined (i.e., doses now considered toxic previously were routinely prescribed), and that drop will likely continue to (e.g., in 2016, Europe’s Rheumatology group concluded it was unsafe to give more than 5 mg a day of long-term steroids12 — a figure significantly lower than the current amounts used in America13). Steroid Side Effects As you would expect, the side effects from taking steroids mirror those seen with excessive cortisol, although in many cases are much more severe. Furthermore, they are quite common (e.g., one study found 90% of users report adverse effects, and 55% report at least one that is very bothersome14). Consider this summary of what users across the internet have reported: Likewise, much of that has been established within the scientific literature: • Bone loss — Corticosteroids double one’s risk of a fracture (and even more so for a vertebra15), with 12% of users reporting fractures.16 At typical doses, steroids cause a 5% to 15% loss of bone each year,17 and in long-term users, 37% experience vertebral fractures18 (additionally, high dose steroid use increases the risk of vertebral fractures fivefold19). Steroid bone loss, in fact, is such a common problem that treating it is one of the few official indications the FDA provides for bisphosphonates20 (which while widely prescribed for bone loss have many severe side effects — including making your bones more likely to break). Lastly, higher doses increase the likelihood of avascular necrosis (with 6.7% of users taking higher steroid doses developing it21). • Weight gain — Approximately 70% of individuals taking oral corticosteroids long-term (over 60 days) report weight gain.22 One study found a 5.73 to 12.79 lbs. increase per year,23 and another found a 4% to 8% increase in body weight after two years of steroid use. Additionally, this fat typically stores in areas like the face, neck, and belly.24 • Adrenal insufficiency — Corticosteroids reduce the adrenal gland’s ability to produce cortisol (which can sometimes be life-threatening). This is a huge problem that increases with the duration of therapy and systemic routes of administration (e.g., affecting 48.7% of oral users25). • Diabetes — A systematic review found individuals taking systemic corticosteroids were 2.6 times more likely to develop hyperglycemia26 (with 1.8% of those receiving steroids in a hospital then developing diabetes).27 Likewise, patients who’d taken systemic corticosteroids at least once were 1.85 times more likely to develop diabetes.28 Finally, a meta-analysis found that, in patients without pre-existing diabetes, a month or more of steroids caused hyperglycemia in 32% and diabetes mellitus in 19% of them.29 • Cardiovascular — High doses of steroids have been observed to increase heart attacks by 226%, heart failure by 272%, and strokes by 73%.30 • Eyes — Steroids have been found to increase the risk of cataracts by 245% to 311%31 (with 15% of users reporting this side effect)32 and the risk of ocular hypertension or open angle glaucoma by 41%.33 • Gastrointestinal — Steroids are linked to many gastrointestinal events (e.g., nausea and vomiting)34 and have been found to increase the risk of gastrointestinal bleeding or perforation by 40%.35 • Psychiatric — Between 1.3% to 18.4% of steroid users develop psychiatric reactions (with the rates increasing with the dose),36 and around 5.7% experience severe reactions. Additionally, 61% of steroid users reported sleep disturbances,37 and steroids can also sometimes cause psychosis.38,39 • Infections — Steroids also increase the risk of infections. For example, users of inhaled steroids were found to be 20% more likely to develop tuberculosis,40 and this increased at higher doses in patients with asthma or COPD. Similarly, patients on steroids were 20% more likely to develop sepsis41 (possibly due to the initial symptoms of the infection being masked by the steroids). • Skin — Prolonged topical use of steroids also frequently causes skin issues42 (e.g., up to 5% experience skin atrophy after a year of use). Lastly, certain steroids are much more potent than others, and the more potent ones that persist in the body (e.g., dexamethasone) are more likely to create systemic effects like HPA axis dysfunction. Uses of Steroids The toxicity of steroids greatly increases with prolonged doses and routes of administration that have systemic absorption (e.g., oral). Because of this, many now believe they should be reserved for life-threatening emergencies (with the side effects that frequently follow being an acceptable trade off) and for a prolonged period, only be used in a manner with minimal systemic absorption (e.g., topically). Note: I recently interviewed a variety of specialists for their perspectives on using steroids in their fields of medicine. Collectively, they felt that while steroids can be helpful, they are frequently prescribed in an inappropriate manner that causes more harm than good (discussed here). • Inhaled steroids — Inhaled steroids are routinely used to treat asthma and COPD. Since the systemic absorption of inhaled steroids is much less than from oral steroids, systemic side effects are rarer (but can still occur with prolonged use at higher doses). While inhaled steroids (along with the other medications commonly prescribed for these respiratory conditions) can help and are often the only option available to patients, I believe in most cases natural therapies that directly treat the conditions are preferable. For example, COPD is seen as a progressive and incurable illness which can only be delayed or partially mitigated with the existing therapies. In contrast, when nebulized glutathione is used to replenish the protective lining of the lungs, it halts the progression of the disease, and unlike steroids does so without side effects. Likewise, many natural therapies exist for asthma. • Topical steroids — Topical steroids are routinely used for skin issues and sometimes in other areas as well, such as for certain eye conditions, like preventing graft rejection after a necessary corneal transplant. In these instances, systemic side effects are rare, and most local issues result from prolonged use (e.g., skin changes or skin thinning — particularly on the face). Note: I have long suspected topical steroids in part work by reducing fluid circulation to the skin (via the insterstitium43), thereby preventing inflammatory toxins from arriving there and creating skin reactions (whereas agents like DMSO treat skin conditions by augmenting the skin’s microcirculation so stagnant toxins cannot irritate a set area). As such, due to the potential issues with suppressing skin symptoms, I typically treat skin issues with natural therapies like DMSO or by eliminating the underlying cause of the skin issue. • Injectable steroids — Frequently, when patients have significant pain in a joint, steroids will be injected into the joint to improve the pain. There are three major issues with this approach. ◦ First, a certain degree of systemic absorption occurs, so many of the previously mentioned side effects can follow steroid injections (e.g., high blood sugar for over a week44). ◦ Second, if the injected steroid is not water soluble (most aren’t), it will often remain in the joint (e.g., you can often see previously injected steroids within a joint when it is arthroscopically) examined. ◦ Third, steroids weaken and degrade connective tissue (e.g., the ligaments holding a joint together). Since arthritis often results from weakened ligaments no longer holding the joint in the correct position (causing it to grind against itself when it moves), this creates a situation where a temporary relief is gained from the steroid that is followed by a worsening of the underlying issues, which then typically results in the patient eventually needing surgery — which is very common story with knee replacements and is particularly disastrous in cases where a spinal fusion is performed.45 Note: For this reason, we treat joint pain either by strengthening the joint’s ligaments (which for instance often cures spinal pain) or using a natural therapy which reduces inflammation and pain without damaging the ligaments (such as DMSO). Lastly, it is important to note that many (and arguably the majority) of joint issues have an inflammatory component (e.g., many patients have undiagnosed seronegative spondyloarthropathies46 that often do not show up on standard diagnostic tests47). On the one hand, this illustrates why both conventional and natural approaches for reducing inflammation can help with so many different joint issues. Conversely, it also helps explain why arthritis increase with age, as inflammation and metabolic health worsen with age.48 • Intravenous steroids — Certain more severe illnesses respond to steroids, and as a result intravenous steroids are routinely given to certain hospitalized patients. In those instances (especially given the options available for hospitalized patients),49 this is often necessary and lifesaving. At the same time however, it must be remembered that this approach can lead to significant side effects. • Oral steroids — Oral steroids have the widest range of diseases they are used to treat, which is unfortunate since they also tend to cause the most side effects. Some of their common uses include: ◦ Severe cases of chronic lung conditions (e.g., asthma or COPD). ◦ Allergic reactions of varying severity. ◦ Various rheumatologic disorders, along with many other autoimmune conditions such as inflammatory bowel diseases and certain blood disorders. ◦ Preventing the rejection of transplanted organs. ◦ Replacing hormones that the adrenal glands have lost the ability to produce. ◦ Certain skin disorders. ◦ For disc herniations, along with other acute musculoskeletal issues like gout, bursitis, or tendonitis that are not responding to NSAIDs, or to reduce swelling and pain from a recent severe injury. While some of these are justified, a strong case can be made that many other uses cause more harm than any benefit they provide. Alternatives to Steroids A central issue with steroids is that while they do suppress the immune system (which is sometimes needed), they are too broad in their effects, and as a result, in most conditions, they cause a significant number of unwanted consequences. Because of this, a variety of attempts have been made over the years to find alternative ways to suppress the immune system. For example, Anthony Fauci is a hero to the rheumatology field because shortly after he joined the NIH in 1968, he had the insight that chemotherapy drugs (which destroyed the white blood cells at standard doses), when given at low doses could instead be used to suppress dangerous autoimmune responses.50 This worked, and cyclophosphamide allowed certain once terminal diseases to become quite manageable.51 Many of those drugs were not at all safe (e.g., cyclophosphamide often gives you cancer), but compared to the previously existing options were revolutionary, and as such, immune suppressing drugs which created various consequences of immune suppression (e.g., frequent and unusual infections) were seen as justified and were widely adopted. Note: The drug Fauci pioneered for life-threatening vasculitides, cyclophosphamide, is still used in that manner but never received an FDA approval52 (which is noteworthy given how aggressively Fauci targeted “unapproved” therapies during the AIDS crisis and COVID-19). Since then, a variety of less toxic but still effective rheumatologic drugs have been developed that have greatly improved the prognosis of autoimmune disorders (listed here). Unfortunately, due to the medical field’s tendency to greatly delay the adoption of new therapeutic approaches, many of these newer drugs are rarely utilized and instead far more toxic immune suppressing medications like steroids remain the standard of care. In tandem, a variety of natural approaches have been discovered over the years that often effectively treat a wide range of autoimmune disorders (or at least improve them enough for lower doses and less toxic doses of immunosuppressive medications to be needed). Likewise, much safer natural alternatives have been found for many of the other conditions steroids “treat” (e.g., DMSO for musculoskeletal pain and injury). Note: Many things we have direct control over (e.g., exercise, sunlight exposure, diet, and stress), can greatly improve autoimmune disorders and reduce the need for costly therapies. Conclusion Having an autoimmune disorder often forces a patient to accept utilizing a therapy they know entails significant side effects. However, while drugs like steroids are sometimes necessary, in most cases, a far less toxic alternative exists that allows a patient to live a long and fulfilling life. Worse still, because the increasing toxicity of our environment and the refusal to look at what causes autoimmunity, we are now seeing an annual increase of 3% to 12% in the rates of these life-changing diseases.53,54 For far too long, we’ve had to accept these abysmal trade-offs as the medical system incentivizes lucrative pharmaceuticals irrespective of their toxicity while actively shunning natural therapies. However, now that the MAHA movement is ushering in a historic change in healthcare, we at last have an opportunity to shift this dysfunctional dynamic and begin looking at real solutions to chronic illness rather than outdated ones that no longer serve their purpose. Author’s Note: This is an abridged version of a longer article which goes into more detail on the dangers of steroids, the ways to safely utilize or withdraw from them, and the safest natural or conventional methods for treating autoimmune disorders and musculoskeletal issues. That article can be read here. A Note from Dr. Mercola About the Author A Midwestern Doctor (AMD) is a board-certified physician from the Midwest and a longtime reader of Mercola.com. I appreciate AMD’s exceptional insight on a wide range of topics and am grateful to share it. I also respect AMD’s desire to remain anonymous since AMD is still on the front lines treating patients. To find more of AMD’s work, be sure to check out The Forgotten Side of Medicine on Substack. Test Your Knowledge with Today’s Quiz! Take today’s quiz to see how much you’ve learned from yesterday’s Mercola.com article. Which lifestyle change in your 50s can add the most years to your life? Starting a daily yoga routine Lowering high blood pressure The study highlights that addressing high blood pressure in your 50s provides one of the greatest benefits for extending your lifespan. Managing blood pressure reduces strain on your heart, significantly lowering the risk of cardiovascular issues. Learn more. Eating more red meat Drinking coffee daily

Despite constant messaging about eating better, most people still fall short of daily recommendations. For years, public health campaigns have urged people to eat five servings a day of fruits and vegetables. But that advice often feels overwhelming, especially if your current intake is low. It’s not for lack of information. The problem is motivation, follow-through and how the goal is presented. What if a simpler, more personal approach could make a bigger impact? That’s exactly what a team of researchers from Bournemouth University in the U.K. wanted to find out. Their study looked at how people respond to different types of health advice, and whether changing the way we frame a goal — even slightly — could affect real behavior.1 They weren’t just interested in what people were told. They focused on what people felt they could actually do. And as it turns out, believing a goal is achievable matters more than the goal itself. Their findings offer a powerful reframe: If you want lasting change, don’t start by aiming high. Start by making it feel easy. Let’s take a closer look at what they discovered. Small, Easy Goals Trigger Greater Follow-Through A study published in Appetite explored a key question in public health messaging: Does it matter how hard a nutrition goal sounds when you’re trying to change your eating habits?2 The research focused on fruit and vegetable consumption and tested whether people were more likely to follow through when the goal felt achievable — like eating “just one more” portion per day — versus the standard “five-a-day” recommendation. • Participants were university students, a group known for poor diet habits — The researchers recruited 127 students and divided them into three groups: one received a magnet reminding them to eat five portions of fruits and vegetables daily, another was told to eat just one more portion than they currently consumed, and a third group received no goal at all. Each participant tracked their intake using food diaries before and after receiving their assigned message. • Both goals led to better results than no goal at all — The study found that simply having a goal — whether it was “eat one more” or “eat five a day” — led to significantly greater fruit and vegetable consumption compared to those who were given no dietary message. That means giving someone any target to aim for improved behavior. • What mattered most was how easy the goal felt — The type of goal (one more versus five a day) didn’t significantly affect outcomes on its own. But participants who felt that the goal was easier to follow ate more fruits and vegetables — regardless of which goal they were given. The perception of difficulty played a bigger role than the goal itself. • Ease of the goal strongly predicted success — When participants rated their assigned goal as easy, their final fruit and vegetable intake increased. Statistically, every one-point increase in “ease” was linked to a 0.3 serving bump in daily produce consumption. That finding highlights the value of making the target feel doable, especially for people who struggle with motivation. • Effort and starting habits also influenced behavior — People who said they tried harder to follow their goal also showed better outcomes, a reminder that motivation and self-initiation matter. Additionally, those who were already eating more fruits and vegetables before the study were more likely to succeed with either goal. Believability Beats Pressure in Driving Real Change Interestingly, people’s future intentions to eat more produce weren’t significantly affected by whether they got a goal or not. However, those who reported being more aware of their fruit and vegetable intake did show stronger intentions to keep improving. Awareness, not instruction, influenced long-term planning. • The takeaway: ease beats pressure — The five-a-day group didn’t perform worse, but they didn’t perform better either. What the researchers found instead is that when people feel the goal is manageable, they’re more likely to take action — regardless of what the goal technically says. Framing the message to sound easier helps bypass mental resistance. • Why this matters for real-world behavior change — Most nutrition advice focuses on what people should do. This study shifts the focus to what people feel able to do. That subtle psychological difference — between being told a hard rule and being invited into a small win — proved to be the real lever of change. • Design matters in public health messaging — This wasn’t about strict diets, punishments or food tracking. It was about priming your brain to say “yes” to something that feels possible. Whether you’re trying to eat better, move more or sleep longer, starting with a goal that feels achievable makes it more likely you’ll follow through. Start with What’s Easy, Not What’s Perfect If you’ve been struggling to eat better, stop thinking in terms of perfection. The five-a-day rule sounds good on paper, but if you’re not there yet, it’s just noise. The key to building healthier habits — especially when it comes to fruit and vegetable intake — is starting with one small, manageable change. That change has to feel doable right now, not someday. If you rarely eat produce, jumping from zero to five servings a day will feel like a mountain. And that’s exactly why most people don’t try. But there’s a smarter way — one that actually works for real people with real lives. It’s about building momentum by starting where you are, not where someone says you should be. Here’s how to get moving in the right direction, with results you’ll actually notice: 1. Pick one meal and improve that meal only — Instead of trying to overhaul your whole diet, start with breakfast, lunch or dinner. Choose whichever is easiest for you to change. If you usually skip fruit in the morning, try adding half a banana to your breakfast. If dinner’s your weak spot, steam some broccoli with grass fed butter. Keep it simple and don’t worry about being perfect. 2. Make it a game by tracking “one more” each day — Use a sticky note or a whiteboard to track just one thing: Did you eat one more fruit or veggie than yesterday? That’s it. Turning this into a daily challenge builds momentum — and that little success will start to feel good. You’ll build confidence, which makes bigger changes easier down the road. 3. Use convenience to your advantage — If prepping produce is where you get stuck, plan ahead. Cut large fruits like watermelon in advance so you’re ready with a quick snack for the week. Keep fruit like apples, clementines or grapes on hand so you don’t have to think about it. The easier it is to say yes, the more likely you’ll keep going. 4. Stop aiming for five — aim for “better than yesterday” — If your brain shuts down when you hear nutrition rules, ignore them for now. Your new goal is simple: just do better than the day before. If yesterday you ate no vegetables, one carrot counts as progress. Over time, small gains add up — and you’ll look back and realize you’ve changed your whole routine. 5. Celebrate the tiny wins like they’re huge — Your brain loves rewards. So, when you hit your “one more” for the day, mark it. Literally check it off a list or say it out loud. Each win signals your brain that you’re someone who follows through — someone who’s building a healthier life, one step at a time. That identity shift is where real change begins. When something feels doable, it becomes doable. And when it becomes doable, it sticks. So, stop chasing perfect and start chasing progress — one bite at a time. FAQs About Dietary Goals to Increase Fruit and Vegetable Intake Q: What’s the most effective way to increase my fruit and vegetable intake? A: Start small. Instead of aiming for five servings a day right away, focus on adding just one more fruit or vegetable than you ate the day before. This makes the goal feel doable and helps you build momentum over time. Q: Why is “just one more” more effective than the “five-a-day” rule? A: According to research published in Appetite, people are more likely to follow through when the goal feels easy.3 A smaller, more achievable goal increases motivation and makes it more likely you’ll stick with the habit long term. Q: How does tracking “one more” help me stick to the habit? A: Tracking gives you a clear visual of your progress, turning your healthy choice into a win. This activates a sense of accomplishment and self-efficacy, which boosts your confidence and encourages you to keep going. Q: What if I don’t have time to prep fruits and vegetables? A: Plan ahead and pre-cut large fruits like melon or pineapple in advance, so it’s ready to grab when you need it. This removes the friction that often stops people from adding more produce to their meals. Q: Is it OK to celebrate small successes, even if I only added half a banana? A: Absolutely. Celebrating small victories reinforces your identity as someone who’s making healthier choices. This mindset shift is essential for lasting change and helps you feel successful even when the steps are small.

Every time you get up from a chair, turn to reach for something, or walk across a room, you rely on balance, an ability so automatic that it’s easy to overlook. But these ordinary movements depend on constant input and coordination from your brain, muscles, joints, inner ear, and cardiovascular system. When that connection starts to weaken, balance is often the first thing to falter. Balance is not just important for avoiding falls and staying independent. Several studies have shown that it’s a powerful indicator of overall health, closely tied to both heart and brain function.1,2 These findings highlight why it’s essential to protect your balance before it begins to decline. Poor Balance Signals Higher Risk of Cardiovascular Disease A September 2024 study published in the Journal of the American Heart Association, conducted by researchers from Umeå, Sweden, set out to determine whether impaired balance predicts future cardiovascular disease (CVD) in older adults. Researchers followed 4,927 individuals, all age 70 and without any history of heart attack, angina, or stroke at baseline.3 • How balance was measured — The participants underwent balance testing under two conditions — standing quietly with eyes open and with eyes closed. Their sway was recorded in millimeters, both side-to-side (lateral) and forward-backward (anterior-posterior). These measurements were analyzed alongside other clinical data, including blood pressure, body weight, and medication use. • Lateral sway was a consistent predictor of CVD — Participants who swayed more from side to side during balance tests were more likely to be hospitalized for heart attack, stroke, or angina in the years that followed. For every 1 millimeter of added lateral sway during the test with eyes open, the risk of developing cardiovascular disease increased by about 1.4%. The risk rose by about 1.5% per millimeter when the test was done with eyes closed. • The more you sway, the higher your risk — The results showed that participants in the top quarter for lateral sway had a significantly higher rate of cardiovascular events compared to those in the lowest quarter. This means that even small increases in sway added up to a meaningful difference in future health outcomes. • Unsteady forward-backward movement mattered too — Among those tested with eyes closed, people who had faster and more erratic movement in the forward-backward direction were also more likely to develop CVD. These patterns reflected instability that wasn’t visible during regular medical visits. • Balance testing outperformed some traditional risk markers — Side-to-side sway, especially during eyes-closed tests, ranked among the four strongest predictors of cardiovascular disease, along with being male and taking medications for high blood pressure or clot prevention. These four factors together explained 61% of the risk across the population. Balance alone accounted for about 10% of that risk. • The results were consistent and reliable — Even after removing participants with very short follow-up periods, the findings didn’t change. Just 1 millimeter more sway still raised the risk of cardiovascular disease by up to 1.8%, depending on test conditions. Impaired Balance in Older Adults Is Strongly Linked to Cognitive Decline Beyond heart health, balance reflects how well the brain integrates sensory and motor signals. In older adults, impaired balance is an early indicator of cognitive dysfunction, even before memory loss or disorientation appears. A January 2024 analysis published in The Journal of Prevention of Alzheimer’s Disease evaluated 143,788 community-dwelling Korean adults and found strong evidence linking balance impairment to the future onset of dementia.4 • Balance testing predicted future dementia — Those who showed balance impairment at age 66 had significantly higher rates of new-onset dementia compared to those with normal balance. The dementia rate was more than twice as high in those who could stand on one leg for less than 10 seconds versus those who could hold the position for 20 seconds or longer. • Higher risk of both Alzheimer’s and vascular dementia — Participants with poor balance faced an 83% higher risk of all-cause dementia compared to those with normal balance. Their risk of Alzheimer’s disease was 80% higher, and the risk of vascular dementia was almost three times higher. • Shorter balance time meant higher dementia risk — Even small reductions in balance performance showed a continuous, stepwise relationship with dementia risk. People in the “cautious” category (10 to 19 seconds of one-leg standing) still had a 28% higher dementia risk compared to those who could balance for 20 seconds or longer. • White matter damage and cortical atrophy may explain the link — Poor balance was associated with structural brain changes often seen in early cognitive decline, including white matter lesions and gray matter atrophy in regions tied to motor and memory functions. These changes weaken both physical and cognitive processing, reducing adaptability in daily life. • Microvascular disease contributes to cognitive and motor decline — Vascular-related damage in the frontal-subcortical circuits (which regulate movement and decision-making) explains why balance issues often accompany executive dysfunction, slowed thinking, and increased dementia risk. These shared neural pathways suggest that the same biological disruptions that undermine stability also degrade cognition. • A non-cognitive early marker for dementia — Because balance testing is simple, noninvasive, and predictive, the authors propose it as a valuable screening tool for identifying dementia risk in older adults, especially in those who have not yet shown signs of cognitive impairment. Gait and Leg Strength Also Predict Dementia Risk Supporting the findings from the January 2024 analysis, an August 2024 study published in the Journal of Gerontology5 confirms that poor balance, reduced walking speed, and lower body weakness are strong predictors of future dementia. Drawing from over 9,000 older adults tracked for up to 15 years, the study found that simple physical tests already used in routine geriatric assessments offer insight into cognitive vulnerability before symptoms appear. • Impaired balance predicted up to a threefold increase in dementia risk — Older adults who struggled to maintain a semi-tandem stance (standing with one foot slightly ahead of the other, heel beside toe) had a two to three times higher risk of developing dementia compared to those with stable balance. • Slower walking speed signaled significantly elevated risk — Participants with slower gait at baseline had a 52% to 73% greater likelihood of dementia onset. The walking test, long known for predicting frailty and mortality, also proved to be a powerful early marker of cognitive decline. • Lower limb strength mattered too — Poor performance on the chair stand test, an indicator of leg strength and neuromuscular coordination, was linked to a 56% higher risk of dementia. This adds to growing evidence that physical frailty and cognitive deterioration share overlapping biological pathways. • Risk consistent across sex, age, and genetic risk — The associations were consistent regardless of participant sex, age, or presence of the APOE ε4 gene, a major genetic risk factor for Alzheimer’s. These findings support the role of motor testing as a universal tool for early dementia screening. To learn more about why balance matters as you age, read “Balance Function Serves as a Key Marker for Healthy Aging.” Assess Your Balance with These Simple Tests Adults, especially those over 50, should ideally test and train their balance before trouble begins. As reported by the Associated Press, the basic at-home tests below offer powerful insights into your ability to balance and overall health:6 • Standing on one leg — Dr. Greg W. Hartley, a physical therapy professor at the University of Miami, recommends a simple balance test that involves standing on one leg for 10 seconds. If you’re able to hold it without wobbling, you’re likely within a safe range. Struggling with the test, however, is a signal to seek medical evaluation. For more insight into what one-leg balance tells you about your health, check out “Balancing on One Leg Reveals Important Clues About Your Neuromuscular Health.” • Timed walking tests gauge — The “timed up and go” test (TUG) offers a quick check of your functional balance. You rise from a chair, walk 10 feet (3 meters), turn around, walk back, and sit down. You should ideally complete this in under 12 seconds. Taking more than 15 seconds marks impaired balance. Five Daily Exercises to Enhance Your Balance Don’t wait until you lose your footing — start improving your balance now to support your heart, brain, and overall health. I recommend starting with the five strategies below, which you can fit seamlessly into your daily routine. If you’re just starting out, begin with exercises 1 through 3 and gradually add the others as your confidence grows. 1. Walk heel-to-toe like you’re on a tightrope — Take 20 slow, deliberate steps in a straight line, placing the heel of one foot directly in front of the toes of the other. Keep your arms relaxed and your eyes fixed on a point ahead. This improves your brain’s spatial processing and enhances coordination. 2. Do chair-supported squats — Stand with your feet hip-width apart. While you’re holding the back of a chair, lower yourself as if sitting down. Begin with five reps and increase gradually. 3. Use a stability ball — Sit or kneel on a stability ball for 30 seconds, adding time as your balance improves. This activates deep core muscles and builds full-body stability. 4. Perform gentle Tai Chi or yoga — You don’t need to join a class. Just a few minutes of slow, controlled breathing and movement done at home is enough. These practices blend breathing, movement, and balance to improve coordination and body awareness. 5. Build ankle strength — Weak ankles cause instability. Sit in a chair and try writing the alphabet in the air with your foot. Strengthen your ankles by tracing the alphabet with your foot while seated or doing toe raises while standing. Frequently Asked Questions (FAQs) About Balance Q: What does balance reveal about overall health? A: Balance reflects the integrity of your nervous, muscular, and cardiovascular systems. Research shows that poor balance is linked to a higher risk of heart disease, stroke, and cognitive decline. Q: What does it mean if I sway while trying to stand still? A: Swaying side to side, especially when your eyes are closed, could be a sign that your brain and body aren’t working together as smoothly as they should. Even small increases in sway have been linked to a higher risk of heart problems and memory decline. Q: Can poor balance really predict dementia? A: Yes. Several large-scale studies have found that impaired balance in midlife is associated with a significantly higher risk of developing Alzheimer’s or vascular dementia years later, even before memory issues begin. Q: How can I test my balance at home? A: Try standing on one leg for 10 seconds or completing the “timed up and go” test. Struggling with either is a sign to focus on balance training and seek further evaluation. Q: What’s the best way to improve my balance daily? A: Incorporate simple movements into your routine, like heel-to-toe walking, chair squats, stability ball exercises, and ankle drills. These small, consistent practices make a big difference over time.

If you’re drinking soft drinks daily, you’re silently weakening your bones from the inside out. Soda alters your mineral balance, drains your calcium reserves and interferes with bone metabolism in ways that take years to undo — if they’re reversible at all. This damage doesn’t show up overnight. It’s slow, steady and often invisible, until something snaps. Whether it’s a broken wrist from a minor fall or a stress fracture from daily movement, the root cause often traces back to mineral imbalance and bone loss years in the making. Soft drinks don’t just crowd out healthier choices; they actively create conditions that make your bones more fragile. Even diet sodas — often marketed as smarter alternatives — do more harm than good. Let’s look at what the research shows about soft drinks and fracture risk, starting with a large-scale study published in Nutrients.1 Daily Soda Drinkers Face the Highest Risk of Fractures The study examined how soft drink consumption affected fracture risk in a population of 17,383 Chinese adults between the ages of 20 and 75. Conducted through the China Health and Nutrition Survey (CHNS), the research followed participants for an average of five years to determine whether those who drank soft drinks more frequently were more likely to experience fractures over time. • Dose-response pattern found in shorter-term analysis — In a cross-sectional snapshot, researchers found that fracture risk increased in step with soft drink intake. Those who drank soft drinks daily were 2.72 times more likely to report a fracture compared with non-drinkers, while even those who drank just once or twice a week saw a measurable rise in risk. • Daily soft drink intake linked to nearly fivefold increase in fracture risk over time — In a five-year follow-up, adults who reported drinking soft drinks every day had a 4.69 times higher risk of suffering a fracture compared with those who drank none, even after adjusting for age, physical activity, income and dietary patterns. Researchers said this suggests a strong, time-dependent link between soft drink use and bone damage. Soft Drinks Undermine Bone Nutrition Through Multiple Mechanisms Researchers noted that soft drink intake tends to displace healthier beverages like milk, which provide calcium and magnesium — two minerals required for strong bones. But there’s more to the damage than just what’s missing. Soft drinks, particularly those high in phosphoric acid, interfere with your ability to absorb calcium even when it’s present in your diet. That means you’re not just skipping out on nutrients, you’re actively flushing them away. • Soft drinks contain phosphoric acid, which disrupts the calcium-phosphorus balance in the body — High intake of phosphoric acid throws off your body’s calcium-to-phosphorus ratio, which plays a key role in bone health. When phosphorus levels are too high relative to calcium, your body releases calcium from your bones to restore balance — weakening your skeleton in the process. Over time, this leads to reduced bone density and a greater chance of fractures, especially if dietary calcium is already low. • Even among those who reported high calcium or nutrient intake, soft drink consumption still correlated with fractures — Researchers adjusted for calcium, fat and protein intake and still found that soft drink consumption remained a major predictor of bone fractures. This highlights that the problem isn’t simply poor nutrition. The drinks themselves, particularly when consumed frequently, appear to interfere with mineral regulation and bone turnover — even in otherwise balanced diets. • Obesity, another side effect of soft drink consumption, also plays an indirect role in fracture risk — Soft drinks are strongly linked to weight gain, and obesity changes the way your body handles falls and injuries. People with obesity are more prone to fractures in specific areas such as the upper arms and shoulders, partly due to altered bone metabolism and changes in balance and muscle function. Diet Soft Drinks Do the Most Damage to Your Bones Related research published in the International Journal of Clinical Biochemistry and Research looked at 200 medical and dental students to assess how different types of soft drinks impact bone health.2 Participants were divided into three groups based on their intake: low consumers (less than 200 ml, or 6.8 ounces, per week), regular soft drink users, and diet soft drink users. Blood tests and bone scans were used to evaluate mineral levels, vitamin D status and bone density. The group consuming diet soft drinks daily showed the lowest levels of calcium, phosphorus and vitamin D, along with the highest activity of a marker of bone breakdown. Bone density was also significantly lower in this group compared to both the control and the regular soda groups. The researchers warned that these changes could set the stage for serious bone issues later in life, even if symptoms aren’t obvious yet. This means if you think you’re making a safer choice by switching to diet soda, you’re likely doing more damage to your bones than if you stuck with regular soda, though both are harmful. Diet Sodas Interfere with Nutrients Your Bones Rely On The mix of phosphoric acid and artificial sweeteners in diet sodas creates a very acidic environment in your body. That acidity interferes with a key enzyme in your kidneys — one your body needs to turn vitamin D into its active form.3 Without that active vitamin D, your body struggles to absorb calcium, even if you’re eating enough. When calcium levels drop, your body pulls calcium from your bones to make up the difference, which weakens them over time. • Bone breakdown speeds up in diet soda drinkers — In the International Journal of Clinical Biochemistry and Research study, people who drank diet sodas had the highest levels of a marker that shows how fast your bones are being broken down and rebuilt. When breakdown happens faster than rebuilding, it creates an unhealthy cycle. That imbalance wears down bone strength and increases your chances of fractures, even if you’re young or appear healthy. • The problem wasn’t due to diet alone — diet quality was controlled across groups — What makes these findings even more serious is that the students all ate similar diets. They lived in the same hostel, received the same meals and had equivalent access to calcium-rich foods like milk, cheese and yogurt. This ruled out poor nutrition as the cause of low bone mineral levels, pointing instead to the chemical content of the diet sodas as the driver of bone loss. Reduce Soda Intake to Protect Your Bones and Restore Mineral Balance If you’re drinking soft drinks regularly — whether it’s cola, fruit-flavored soda or diet versions — you’re doing more than just indulging a sweet craving. You’re actively creating conditions that make your bones weaker, your nutrient levels drop and your long-term fracture risk skyrocket. Fortunately, there are clear, simple steps to reverse course and start strengthening your skeletal health from the inside out. Once you remove the daily insult to your mineral balance, your body gets the chance to begin to rebuild. Here’s how to get started. 1. Cut all soft drinks — even the diet ones — If you’re drinking any kind of soda, whether it’s full of sugar or labeled “zero-calorie,” it’s disrupting your bone metabolism. The phosphoric acid and artificial sweeteners create a biochemical environment that leaches calcium, blocks vitamin D activation and speeds up bone breakdown. I recommend removing them completely, not just cutting back. If you need help breaking the habit, start with tracking how many you’re drinking per day and then swap each one out for healthier options like fresh coconut water or sparkling water with real citrus juice. 2. Rebuild your mineral base with bioavailable sources — Once you’ve stopped the soft drinks, your body needs the raw materials to repair the damage. Focus on foods that are naturally high in absorbable calcium and magnesium. This includes high-quality grass fed dairy like cheeses made with animal rennet and eggshells. Make sure you’re also getting adequate vitamin K2 — found in fermented foods like natto, aged cheeses and egg yolks — to guide calcium into your bones — not your arteries. 3. Correct low vitamin D levels with sunlight exposure — If you’ve been drinking soft drinks, especially diet ones, your body’s ability to activate vitamin D is likely compromised. I recommend getting daily sun exposure to stimulate your own production. However, it’s best to avoid direct sunlight during peak hours (10 a.m. to 4 p.m.) until you’ve cut back on vegetable oils for at least six months. Vegetable oils, rampant in processed and fast food, are loaded with linoleic acid (LA). When LA accumulated in your skin interacts with the sun’s UV rays, it triggers inflammation and DNA damage. The elimination period gives your body time to clear some of the accumulated LA. 4. Swap soda habits for bone-friendly routines — Don’t just take something away — replace it with a better routine. Make it enjoyable. Sip warm bone broth instead of soda in the afternoon and add collagen-rich gelatin to tea or smoothies. If you’re having a hard time kicking the soda habit, replace that ritual with magnesium-rich mocktails using sparkling mineral water, fresh fruit juice with pulp and a pinch of sea salt. Engage in strength training and daily walks. You’ll start to feel the difference in your joints, your sleep and your energy levels within weeks. FAQs About Soda and Your Bones Q: How do soft drinks affect my bones? A: Soft drinks — especially when consumed daily — disrupt your body’s mineral balance, reduce calcium absorption and increase bone breakdown. Ingredients like phosphoric acid and artificial sweeteners create an acidic environment that strips calcium from your bones, weakening their structure over time. Q: Are diet soft drinks safer for bone health than regular ones? A: No. Research shows that diet soft drinks are actually more damaging. They’re linked to significantly lower bone density, reduced vitamin D levels and accelerated bone loss. Q: How quickly does soft drink damage lead to fractures? A: A study found that adults who drank soft drinks daily were 4.69 times more likely to suffer fractures compared to those who didn’t drink soft drinks. This risk was independent of age, physical activity and overall diet quality. Q: What can I do to reverse the damage caused by soft drinks? A: Start by eliminating all soft drinks, including diet versions. Replace them with mineral-rich beverages and foods that support bone rebuilding, like hard cheeses, bone broth and sun exposure for natural vitamin D production. Add magnesium, vitamin K2 and calcium-rich foods to help restore balance. Q: How do I know if soft drinks are already affecting my bone health? A: Common signs include joint stiffness, recurring soreness, low energy and frequent muscle cramps. If you drink soda regularly and notice these symptoms, your mineral balance may already be off. Tracking changes after removing soda can help you see measurable improvements in how your body feels.

Every year, 805,000 Americans suffer from a heart attack,1 a condition tied to clogged arteries, high cholesterol, and high blood pressure, as most people are already aware of. But while these factors matter, a recent study shows that there’s another crucial predictor that many people often overlook — your gut microbiome. Composed of trillions of bacteria living in your intestines, your gut microbiome affects more than your digestive function; it’s essential to your overall health. Now there’s proof showing that having an imbalanced gut microbiome could increase your risk for a heart attack. Gut Bacteria Scoring System Predicts Future Heart Attacks A recent study published in the European Medical Journal determined whether gut microbial patterns could be used to predict the risk of major adverse cardiovascular events (MACE) in people with coronary heart disease (CHD).2 The research is part of the CORDIOPREV study, an ongoing randomized controlled trial involving over 1,000 CHD patients from Europe.3 • Researchers focused on high-risk CHD patients — They analyzed data from 679 participants, particularly adults who had already experienced a coronary event at least six months prior to joining the study. The researchers wanted to find out which of these individuals were silently trending toward another serious event, despite receiving conventional care. • They looked at 10 bacteria strains linked to cardiac risk or protection — These bacterial species were closely tied to either a higher risk of future cardiovascular problems or protective effects. The researchers combined the presence or absence of these bacteria into a single algorithm, developing what they called an intestinal microbiota-based risk score. This score predicted which patients were most likely to suffer new MACE, even before those events occurred. • The gut-based risk model predicted worse health metrics — CHD patients who scored high on the microbiota-based risk model had a greater incidence of diabetes, larger waistlines, higher blood pressure, and worse blood sugar control (including elevated glucose and glycated hemoglobin levels) compared to those who hadn’t experienced a recent event. The study findings suggest that the gut microbiome not only reflects cardiovascular risk — it could be driving it as well. According to the researchers, “These results reinforce the relationship between intestinal microbiota and CVD and suggest that a microbiota profile is associated with MACE in CHD patients, in addition to higher endotoxaemia.”4 CHD Patients Have a Different Gut Microbial Makeup The gut bacteria themselves weren’t the only clue. According to the featured study, CHD patients have more distinct gut microbiome diversity patterns compared to healthy individuals without cardiovascular disease.5,6 Specifically, the patients with heart disease had altered alpha-diversity (meaning fewer unique bacterial species) and beta-diversity (a greater shift in microbial community makeup). These are both signs of dysbiosis, or what’s known as gut imbalance. • High levels of Lactobacillus were found in patients with recent events — One key culprit was the genus Lactobacillus. In CHD patients who had recently experienced another major event, levels of Lactobacillus were significantly higher. That might surprise you, since Lactobacillus is known as a beneficial probiotic. However, not all species within the Lactobacillus genus are friendly. Some have been detected in the bloodstream of patients with heart attacks and linked to dangerous immune activation. In this case, their presence seemed to indicate a higher risk, not protection. • Escherichia coprostanoligenes was linked to trimethylamine N-oxide (TMAO) production — The researchers found that E. coprostanoligenes levels were elevated in patients who had suffered new events. This particular strain is known to produce trimethylamine (TMA), the compound that your liver converts into trimethylamine N-oxide (TMAO). TMAO accelerates atherosclerosis, promotes plaque instability, and increases the risk of clot formation. Hence, having E. coprostanoligenes strongly suggests that microbial metabolism of certain foods could be directly influencing heart health outcomes. • Leaky gut and high lipopolysaccharide (LPS) levels were linked to heart risk — Perhaps the most telling detail was the association between LPS levels and cardiovascular events. LPS is an endotoxin released by certain gut bacteria when they die. When your gut barrier is compromised — a condition often called “leaky gut” — LPS seeps into the bloodstream, where it causes inflammation, damages tissues, and triggers immune overdrive. According to the study findings, CHD patients with higher circulating LPS were more likely to experience major cardiac events. Unlike blood pressure or cholesterol, which are routinely monitored, microbial patterns are still ignored in most cardiology clinics and diagnostic processes. But research like this makes it clear that they shouldn’t be, as they provide significant insights into your overall health. Global Studies Show How the State of Your Gut Bacteria Shapes Your Heart Disease Risk A 2022 analysis published in the journal Frontiers in Cardiovascular Medicine examined two decades’ worth of scientific studies connecting CHD to your gut microbiome. This large-scale analysis pulled data from 457 publications between 2002 and 2022.7 The goal was simple but powerful — map out what scientists around the world have found when it comes to how your gut bacteria are linked to heart disease, and figure out where the science is heading. • Most studies focused on high-risk or diagnosed CHD patients — The study looked at research involving adults — most of them already diagnosed with coronary artery disease or at high risk for developing it. These papers covered the most commonly studied bacterial substances as well as a wide range of issues — including dietary patterns, inflammation, and microbial metabolites — and how all of these connect back to cardiovascular damage. • Natural therapies are gaining traction in gut-heart research — A standout pattern was the shift in research toward finding ways to improve gut health using natural therapies. Chinese researchers are now leading the field in exploring herbal remedies, seaweed compounds, and plant-based interventions like berberine, ginseng, and mulberry leaf extract. Many of these target the gut first and the heart second. • Natural remedies like berberine rewire your microbiome — One of the most promising examples was berberine. According to the researchers, it was helpful in “improving hypercholesterolemia and systemic inflammation,” and “inhibiting the production of TMA/TMAO and choline-to-TMA conversion.” Berberine also increased levels of Akkermansia,8 a protective gut species linked to reduced inflammation, improved insulin sensitivity, and better cholesterol profiles. Read more about this compound in “The Neuroprotective Benefits of Berberine.” • Fecal transplants show your gut alone drives disease — The researchers also explored fecal microbiota transplantation (FMT), a technique where stool from a healthy donor is implanted into someone else’s gut to reset microbial balance. In one experiment, researchers transferred gut bacteria from humans with high TMAO into mice. The mice rapidly developed plaque in their arteries, even though their diets hadn’t changed. This showed that the gut profile alone was enough to trigger cardiovascular disease. • Bile acids calm artery inflammation — Once thought of as just a digestive aid, bile acid was found to play a key role in regulating blood fats and immune function. Gut bacteria modify your bile acids into signaling molecules that help control inflammation and cholesterol. One type, lithocholic acid, was even suggested as a biomarker for coronary plaque. The receptor it activates, known as TGR5, was shown to suppress inflammatory responses in artery walls. • Short-chain fatty acids help lower inflammation and regulate blood pressure — Another powerful pathway involves short-chain fatty acids (SCFAs), which are produced when certain gut bacteria ferment dietary fiber. These fatty acids — particularly one called butyrate — regulate blood pressure, improve blood vessel function, and even influence hunger hormones. In animal studies, SCFAs lowered inflammation in heart tissue and supported post-heart-attack healing. Human studies are now trying to confirm if these same effects hold true across different populations. Researchers are now building a complete roadmap of how gut bacteria either protect or destroy your cardiovascular system. And unlike genetic risk, making changes to your microbiome is possible. That means your daily choices — what you eat, how you manage stress, whether you use probiotics or natural therapies — aren’t more than just lifestyle preferences — they’re levers that shift your heart disease risk at the root level. Simple Strategies to Maintain a Healthy Gut Microbiome If you’re dealing with CHD or have reason to worry about future heart issues, optimizing your gut health must be a primary strategy to reduce your risk of cardiovascular events. Here are basic tips to help you nurture your gut: • Skip vegetable oils and processed foods — The modern diet is full of processed foods rich in vegetable oils that make it harder for your cells to produce energy, disrupting your gut bacteria. These oils — like the ones in fried foods, sauces and salad dressings — contain something called linoleic acid (LA), which acts like a poison to your mitochondria. Switching to healthy fats like grass fed butter or ghee keeps things running smoothly. • Choose your carbs wisely — Carbs are key for giving your cells energy, especially since glucose is what your mitochondria (the powerhouses in your cells) love to use. To keep your gut happy, aim for about 200 to 250 grams of carbs a day if you’re an average adult — more if you’re super active. This step boosts your energy and supports your gut health, which makes a difference with MS symptoms. Start slow with gentler options like white rice or whole fruits to let your gut adjust without causing trouble. If your gut health is compromised, too much fiber will only feed bad bacteria, making your symptoms worse. As your gut improves, add more veggies, whole grains or starches. • Once your gut feels better, eat more fiber — Fiber is the primary fuel for your beneficial gut microbes, allowing them to produce SCFAs like butyrate that strengthen your gut barrier. Also eat more resistant starches like cooked-then-cooled potatoes or green bananas — they fuel butyrate production. Remember — Your gut is always sending messages to your heart. You get to decide what kind of messages it sends. Start with these simple steps, and you’ll be rebuilding your foundation, from the inside out. Frequently Asked Questions (FAQs) About Your Gut Microbiome and Heart Attack Risk Q: How does my gut microbiome affect my heart health? A: Your gut microbiome — made up of trillions of bacteria in your intestines — has a direct impact on your cardiovascular system. Recent research shows that certain gut bacteria produce compounds like TMAO and LPS, which contribute to inflammation, plaque buildup, and blood clotting. These factors increase your risk of heart attacks and other major cardiovascular events. If your gut bacteria are out of balance, the risk to your heart rises dramatically. Q: What is the intestinal microbiota-based risk score, and why does it matter? A: This scoring system was developed in the European CORDIOPREV study to predict which patients with CHD are at greater risk of having another major cardiac event. It’s based on the presence or absence of 10 specific bacterial strains linked to either risk or protection. Patients with a high-risk score had higher rates of diabetes, obesity, high blood pressure, and poor blood sugar control — even before symptoms of another heart problem showed up. Q: What are the harmful bacteria and compounds linked to heart attacks? A: The study highlighted specific bacteria like Escherichia coprostanoligenes, which produces TMA — a precursor to TMAO, a compound known to accelerate plaque formation and increase clot risk. Elevated levels of Lactobacillus were also found in CHD patients with recent events, suggesting that some strains contribute to immune overactivation. Additionally, high LPS levels — often caused by a leaky gut — were tied to inflammation and higher heart risk. Q: What do global studies say about gut-heart connections? A: A 2022 global analysis of 457 studies confirmed that gut bacteria play a key role in heart disease. It identified specific microbial metabolites like TMAO, bile acids, and SCFAs as critical players. These compounds act like messengers that influence inflammation, blood vessel function, and cholesterol regulation. The research also pointed to natural therapies like berberine, ginseng, and fecal transplants as promising tools to shift your gut ecology in a heart-friendly direction. Q: What steps must I take to improve my gut and protect my heart? A: Supporting your gut microbiome through diet and lifestyle will help reduce your heart disease risk. Start by cutting out seed oils and processed foods, as they feed harmful bacteria and increase inflammation. Eat the right types of carbs — like whole fruits and white rice — and gradually reintroduce fiber and resistant starches as your gut improves. Natural compounds like berberine also promote beneficial bacteria and reduce harmful ones. Every choice you make helps shape your gut — and your heart health along with it.