TL;DR: Heart health isn’t just about pills, it’s about lifestyle. Diets rich in whole, minimally processed foods and daily walking outperform medications in preventing and reversing cardiovascular risk. Track your triglyceride-to-HDL ratio, reduce refined carbs and seed oils, move your body, and protect metabolic health because prevention and reversal are entirely within your control. Click to listen.
Hi everyone,
In medicine, we often reduce cardiovascular risk to numbers. LDL, blood pressure, glucose, and triglycerides.
But when we step back and look at the populations with the lowest rates of heart disease, a different pattern emerges. It is not a pill. It is not a target LDL. It is a way of living.
The Mediterranean regions studied in the mid-20th century were not simply eating differently. They were living differently.
Meals centered around whole foods: vegetables, legumes, olive oil, fish, nuts, modest amounts of dairy, minimal ultra-processed food. Saturated fat was not eliminated, but it was not industrialized. Sugar intake was low. Fiber intake was high.
Yet diet alone does not explain the outcome.
These populations moved daily. Not structured workouts, but habitual movement. Walking to markets. Working outdoors. Gardening. Physical activity embedded into life rather than scheduled as compensation for inactivity.
They also ate slowly. In community. Stress physiology matters. Chronic sympathetic activation drives vascular injury and insulin resistance. Shared meals and social connection blunt that stress response in ways we are only beginning to quantify.
Large trials, including PREDIMED, have shown that a Mediterranean dietary pattern reduces major cardiovascular events by roughly 30% in high-risk individuals. Not by aggressively lowering a single number, but by shifting the entire metabolic environment. Inflammation decreases. Insulin sensitivity improves. Lipoprotein oxidation falls. Endothelial function stabilizes.
This is the deeper lesson.
Heart disease does not begin with cholesterol alone. It begins with injury. And lifestyle determines whether that injury accumulates or resolves.
Medication can be protective when disease is present. But prevention is built on rhythm: whole foods, daily movement, restorative sleep, stress modulation, and social connection.
The Mediterranean model reminds us that health is not engineered in isolation. It is cultivated.
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