You: On a Diet plus Collins GEM Calorie Counter Set. Michael Roizen F.

coffee doesn’t cause hypertension-but caffeinated sugar and diet drinks do. The reason? It may be the corn syrup or caramel coloring that’s responsible for the change. It’s something to keep in mind when considering caffeine as a potential waist-control drug.

      The closer your waist is to ideal, the healthier your arteries and your immune system will be. The healthier your arterial and immune systems, the longer—and better—you’ll live. And the more energy you’ll have every day.

      Highways to Health

      Before you know what’s inside your arteries, you need to know how they’re structured—so you can see what kind of damage they can sustain and what kind they can’t. Made up of three layers, your arteries are the monorails of your body—they transport blood throughout your body and deliver nutrients to all of your organs (see Figure 5.2).

      Inner layer: The innermost layer of your arteries (the intima) comes in contact with blood; it’s slippery like Teflon so blood can easily flow through. This normally smooth layer helps protect the muscular middle layer (the media) and is the layer most susceptible to attacks from outside sources.

      Middle layer: The middle layer of your arteries supports the entire arterial structure by working a little like a hand squeezing a hose or a boa constrictor squeezing a neck. When you’re depressed or anxious, the layer can constrict, narrowing the amount of space where blood can flow through (the lumen). But it also has an advantage; it can release tension by dilating (the hand releasing the hose) to pull the Teflon layer outward and open up more space in the part of the artery where blood flows—say, when you exercise. When that happens, it allows more red cells, oxygen, and other nutrients through. You feel more energy when that layer functions like it did when you were nine years old.

      Figure 5.2 Moving Through The artery has three layers—the inner to help blood move through the artery (intima), the outer (adventitia) to protect it from the outside, plus a middle, muscular layer (media). Damage to the inner layer hurts the tile-like layer of cells, injuring the delicate media layer.

      Outer layer: The outer layer (the adventitia) shields the artery from the rest of your body like sausage casing; it holds the artery together from the outside.

      Under normal circumstances, the inner layer is lined with delicate cells, and blood runs freely. Think of the structure as a tile wall—it’s a smooth wall made up of individual tiles connected together with little gaps throughout. In the tile wall, you have white gooey grout; in the artery, you have tight junctions holding the cells together.

      Now, in your arteries, that wall will stay tight unless something comes along and starts chipping away at the junctions between those smooth cells. The most damaging tile buster—high blood pressure—is the arterial sledgehammer. But plenty of other pickaxes can chip away at the arterial lining: cholesterol, nicotine, high levels of blood sugar, stress, anger, and about forty other smaller risk factors, primarily stemming from lifestyle choices you make. The effect? They chip away and cause little nicks in the intima of your arteries, and those injuries trigger the anatomical starter’s pistol. As shown in Figure 5.3, the race to destroy—and repair—your arteries is on.

      The Effects of Fat

      For years, you’ve been used to looking down at a scale’s needle to determine your health. Wrong needle, bucko. What you need: a needle in the hands of someone who can draw your blood. With results from a simple blood test, you’ll find out what your current settings are and then be equipped with the data you need to take steps that will reset the settings to the factory originals.

      Blood Pressure: These days, blood pressure machines are everywhere—at the pharmacy, in your gym, in mall kiosks. Even in Wal-Mart and McDonald’s. That’s good. Actually, it’s great. (Get your BP, hold the fries.)

      Figure 5.3 Clog Jam Low-quality (LDL) cholesterol stimulates white blood cells to attack and the combatants are soaked up into the artery walls. The resulting toxic terrain creates rough patches, which are sealed off with platelets and blood clots that ultimately close off the artery completely and cause a blood-flow traffic jam—a heart attack.

      Super HDL: The Future of Cholesterol Drugs

      In a northern Italian village on Lake Garda, the villagers have low levels of HDL Science would tell us that, without high levels of the protective cholesterol-carrying protein, they should all be dying of coronary artery disease. But they aren’t. It turns out that these villagers have supercharged, Drano-like HDL (called apo-1a-Milano) to clear away the gunk from their arteries and allow blood to flow smoothly. This case study points to the next wave of cholesterol drugs: drugs that enhance HDL action to clear the bad LDL away, rather than those that work by lowering the LDL levels in the first place.

      That’s because you need to track your blood pressure—your most crucial vital sign—even more diligently than Geraldo reacts to the news. High blood pressure still reigns as the leading cause of heart attack, stroke, heart failure, kidney failure, and impotence. While most of your other blood numbers reveal levels of substances inside your blood, your BP gauges how your blood travels through your body. Simply, blood pressure refers to the amount of force exerted by your blood on your arterial walls as it passes through. It’s measured through the systolic pressure (the pressure being exerted when the heart contracts; the top number) and the diastolic pressure (the pressure on your arteries when your heart is at rest).

      Now, if the force of that pumping is too high, it’ll gouge holes in that smooth inner lining of your arteries (see Figure 5.4), causing those nicks in the tile wall that trigger a chain reaction of grouting, then destructive inflammation and clotting (which we’ll discuss in detail below). Think of it as the beating of a bongo. If you hit a bongo with your fingers, the drumhead will stay intact. But slug away with two baseball bats, and that bongo head will feel like a roach in an exterminator’s crosshairs. Your goal: Treat your arterial walls with a nice steady rhythm—let your blood tap tap tap them; not pound pound pound them. (Blood pressure fluctuates throughout the day; the goal is to have your total BP picture under control.)

      Certainly, many factors can make your blood pressure soar higher than an Albert Pujols home run (stress, high levels of the mineral sodium, lack of the mineral calcium or potassium from not enough fruits and vegetables, lack of physical activity). But it’s also clear that being overweight leads directly to high blood pressure.

      Figure 5.4 Pressure Situation With hypertension, the arteries squeeze down so tightly that the heart struggles to keep the blood moving forward. To compensate, the heart gets too thick, like a muscle-bound weight lifter. It becomes so stiff that it loses flexibility and can’t relax. If it can’t relax, blood has trouble traveling through the arteries, and the resulting high blood pressure damages the arteries.

      This happens in part when the kidneys, squashed by fat, feign death unless they are fed with a higher blood pressure. (Your kidneys are the organ primarily responsible for regulating blood pressure.)

      Luckily, you can reduce your blood pressure quickly and dramatically by addressing your waist issues. Losing 10 percent of the weight you’ve gained since you were eighteen (that’s only four pounds if you’ve gained forty) can result in a decrease of 7 mmHg (stands for millimeters of mercury to measure the partial pressure of a gas) from your systolic number and 4 mmHG from your diastolic one. The message is clear: Drop your waist and you’ll drop your BP.

      Cholesterol: Hear the word cholesterol and you’re likely to think of eggs, heart attacks, and a mandate from your doctor. But cholesterol is part of your body’s arterial repair kit; it’s designed to help