EP#354 | GUEST | Heart Disease with Michelle Rothenstein: From ApoB Testing to Daily Blood Pressure.
📄 Episode Overview
In Episode #354 of the Deep Shallow Dive podcast, Ray Doustdar welcomes Michelle Rothenstein, a preventative cardiology dietitian specializing in heart disease prevention and management. They explore advanced lab work—like ApoB testing and HSCRP inflammation markers—that go beyond the standard cholesterol test, and why these numbers can be life-saving. Michelle also shares how daily blood pressure monitoring, tracking waist circumference, and adopting a nutrient-adequate diet can dramatically lower your risk of cardiovascular disease.
🎯 Key Takeaways
• 80–90% of heart disease is preventable with the right lifestyle changes.
• ApoB and inflammatory markers are more accurate predictors of cardiovascular risk than LDL alone.
• Blood pressure tracking and waist measurement can detect problems before symptoms appear.
🧠 Summary
This episode is a heart health masterclass, breaking down complex medical markers into clear, actionable strategies. Michelle explains why many doctors overlook ApoB testing, the dangers of soft plaque vs. calcified plaque, and the direct impact of diet, hydration, and sleep on your arteries and blood vessels.
Ray and Michelle also debunk diet myths—highlighting why nutrient adequacy matters more than being “low-carb” or “plant-based”—and provide practical steps for lowering triglycerides, blood pressure, and inflammation naturally.
🔎 Practical Tips
• Measure your waist circumference at the belly button; target under 35" for women, under 40" for men (less if South Asian or post-heart event).
• Take your blood pressure daily—ideal reading is 110/70 mmHg for optimal heart protection.
• Ask your doctor for ApoB, HSCRP, and triglyceride testing in addition to the lipid panel.
📚 Research Spotlight
A 2022 JAMA Cardiology study confirmed that ApoB is a stronger predictor of heart attack and stroke risk than LDL cholesterol, making it a critical but underutilized marker for cardiovascular disease prevention.
❓FAQ
Q: Can lifestyle changes reverse artery plaque?
A: Soft plaque can regress through diet and exercise, but hardened plaque cannot be removed—it can only be stabilized to prevent rupture.
⏱️ Chapters & Timestamps
• 00:00 – Welcome & Introduction
• 01:41 – Michelle’s path to preventative cardiology
• 02:33 – First steps in assessing heart health
• 04:17 – Lipid panel basics and limitations
• 07:25 – ApoB, inflammation, and hidden heart risks
• 15:17 – Waist circumference as a predictive marker
• 20:36 – Understanding triglycerides
• 22:59 – Reversing soft plaque vs. stabilizing hardened plaque
• 26:53 – The truth about diets & nutrient adequacy
• 35:07 – Why daily blood pressure checks matter
• 41:34 – Salt, sugar, and gut health
• 47:38 – Hydration and sleep for heart protection
• 51:09 – Michelle’s go-to foods & sustainable eating
• 1:01:31 – Becoming your own health advocate
• 1:04:07 – How to connect with Michelle Rothenstein
🧭 Final Thought
Heart disease prevention is about being proactive—not reactive. The earlier you track and optimize your numbers, the more control you have over your health span.
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