The True Root Causes of Cardiovascular Disease

Nov. 17, 2017

Dr Jeffry N. Gerber, MD, FAAFP is a board-certified family physician and owner of South Suburban Family Medicine in Littleton, Colorado, where he is known as “Denver’s Diet Doctor”. He has been providing personalized healthcare to the local community since 1993 and continues that tradition with an emphasis on longevity, wellness and prevention.

In this interview, Dr Gerber describes the major root causes of cardiovascular disease, the most important of which is insulin-resistant Type 2 Diabetes.

Worried about your heart disease risk? Get a coronary artery calcium (CAC) score.

Your CAC score (and the rate of progression of your CAC score) is probably the best easily-available predictor of cardiac events. A recent paper from the CARDIA study also showed that an elevated CAC score was highly predictive of long-term heart disease risk in younger adults (18-30 year-olds).

Here’s the outline of this interview with Dr. Jeffry N. Gerber, MD:

[00:01:27] Clinical experience.

[00:02:27] Interest in low-carb diets.

[00:03:21] Presentation: Ivor Cummins: “Roads to Ruin?” The Pathways and Implications of Insulin Resistance.

[00:03:38] Book: Diabetes Epidemic & You by Joseph R. Kraft.

[00:04:23] Professor Grant Schofield and Catherine Crofts, PhD. Podcast: Hyperinsulinaemia and Cognitive Decline with Catherine Crofts, PhD.

[00:05:08] Hyperinsulinemia and CVD.

[00:06:39] The 2 hour insulin test < 30 UI/mL.

[00:07:20] Fiorentino, Teresa Vanessa, et al. "One-hour postload hyperglycemia is a stronger predictor of type 2 diabetes than impaired fasting glucose." The Journal of Clinical Endocrinology & Metabolism 100.10 (2015): 3744-3751.

[00:07:51] < 5 UI/mL fasting insulin.

[00:10:40] What causes CVD?

[00:11:49] Carl von Rokitansky.

[00:12:02] Rudolf Virchow.

[00:12:19] Blog: Dr. Malcolm Kendrick.

[00:13:49] Russell Ross.

[00:15:40] List of things that cause CVD.

[00:16:44] Nitric Oxide.

[00:17:43] Jerry Reaven.

[00:19:19] Vega, Gloria Lena, et al. "Triglyceride–to–high-density-lipoprotein-cholesterol ratio is an index of heart disease mortality and of incidence of type 2 diabetes mellitus in men." Journal of Investigative Medicine 62.2 (2014): 345-349.

[00:20:17] The Framingham study.

[00:21:53] LDL-P and advanced testing.

[00:22:32] CAC score.

[00:23:41] Intimal media thickness.

[00:26:11] Ordering a scan.

[00:26:41] 64-slice EBCT machine.

[00:27:08] Valenti, Valentina, et al. "A 15-year warranty period for asymptomatic individuals without coronary artery calcium: a prospective follow-up of 9,715 individuals." JACC: Cardiovascular Imaging 8.8 (2015): 900-909.

[00:28:15] Soft plaque.

[00:28:57] CT angiogram.

[00:29:44] Don't let perfect be the enemy of very good.

[00:30:34] How to get a zero score.

[00:31:28] Industrial seed oils.

[00:32:02] D3/K2, magnesium, vitamin C.

[00:33:29] Statins.

[00:33:47] Absolute risk reduction data.

[00:34:13] Ridker, Paul M., et al. "Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein." New England Journal of Medicine 359.21 (2008): 2195.

[00:34:40] NICE guidelines for prevention of cardiovascular disease.

[00:36:45] Studies: Puri, Rishi, et al. "Impact of statins on serial coronary calcification during atheroma progression and regression." Journal of the American College of Cardiology 65.13 (2015): 1273-1282, Sattar, Naveed, et al. "Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials." The Lancet 375.9716 (2010): 735-742, and Preiss, David, et al. "Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis." Jama 305.24 (2011): 2556-2564.

[00:37:22] Interview: Calcification and CAC with the Expert: Professor Matthew J. Budoff, MD, FAAC, Part 1 and Professor Matthew J. Budoff Part 2: Primary Care Physicians and CAC.

[00:37:41] Book: Eat Rich, Live Long: Mastering the Low-Carb & Keto Spectrum for Weight Loss and Longevity by Ivor Cummins and Dr. Jeffry Gerber – February 6, 2018.

[00:38:50] Four body types: Skinny, insulin-resistant type, the overweight, typical T2 diabetic type, the overweight, insulin-sensitive type, and the metabolically healthy type.

[00:40:50] Conference: Low-Carb Breckenridge 2018.

[00:41:28] Dr Rod Tayler.

[00:42:25] Dr Andrew Mentee and the PURE study.

[00:42:46] List of speakers at Low-Carb Breckenridge 2018.

[00:43:06] IHMC STEM-Talk Episode 41: Dr David Diamond talks about the role of fat, cholesterol, and statin drugs in heart disease.        

[00:44:15] Dr Jeffry N. Gerber, MD, FAAFP.

[00:45:27] Rebuttal: 9NEWS – Explaining the science behind the keto diet with Dr Jeffrey Gerber.

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