I am a veteran interventional cardiologist. I have seen families torn apart emotionally, financially and professionally because a family member experienced an untimely heart attack. Too many of the patients I treat are in their late 30s and 40s, and I have noted that cardiac patients are younger and younger with each passing year.

I attribute this trend to poor lifestyle choices. These poor choices translate into poor metabolic health (increased waistline, low HDL, high blood pressure, elevated fasting sugar in the blood, high triglycerides). As a compassionate doctor, husband, father and friend, I began to consider how I could convince my patients, friends, and family members to make important lifestyle choices to improve their metabolic, and ultimately, cardiac health.

Lifestyle is a powerful tool in designing any healthy future, whether we are talking about financial, health, or fitness goals. If you dont make adjustments to balance your lifestyle, nature will find the balance for you in the form of emotional and physical burnout, heart attack, stroke, and/or an untimely death.

I developed a program to maximize metabolic health and I call it NEST, which stands for:

Nutrition

Exercise

Sleep

Tackling stress

These four principles can help anyone develop the proper habits to ward off and even reverse high blood pressure, diabetes, high cholesterol and coronary artery disease.

Nutrition is vital to optimizing metabolic health. People can have short-term suc- cess with fad diets, such as the Keto plan, but I recommend the Pesco Mediterranean Diet with intermittent fasting as recently published by Dr. J. OKeefe. I personally adopted this diet program that is rooted in eating fresh vegetables, fruits, nuts, and fish with periodic fasting.

How to build your NEST

Just like you can build a nest egg for your retirement, you can build your metabolic health NEST egg, too.

Small daily wins add up to successes over the week, month and year. Want to lose 30 pounds to achieve your ideal weight? Start with a goal of 10 pounds at a rate of 1 to 2 pounds per week.

Incorporate exercise because it reduces stress, helps us to lose weight and promotes good sleep. Wearable technology can assist us in tracking our metabolic rates, sleep patterns and more.

Sleep is another component that is critical for overall physical and mental health. The average adult should strive for 8 to 9 hours of restorative sleep. Sleep allows your body to repair itself, it reduces stress and cortisol levels and recharges you for the next day. In general, my patients who sleep at least 8 hours a night have more energy, are in better moods and have the motivation to exercise, eat well and live better.

Finally, tackling stress is necessary for success when building your NEST. Stress causes our blood pressure to rise and cortisol to be released into our bloodstream, which can be seen around our waistline as belly fat. Stress triggers mindless eating, and it keeps us awake at night. Develop a plan to combat stress that includes both cardio workouts and mood boosting activities. Yoga relaxes the body and mind.

Dancing gets your heart going and lightens your mood. Free weights build muscle and releases stress.

Build your health wealth

In my practice I coach patients, so they achieve their optimal health. Together we establish goals based on the results of various assessments that offer me a picture of their metabolic and cardiac health.

Cardiac and metabolic changes happen over time and begin in your 20s. The earlier you make changes to protect your NEST, the fuller and longer life you likely will live.

Dr. Frederick Yturralde is an interventional board-certified cardiologist with Coastal Cardiovascular Care as well as a fellow of the Academy of Integrative Health and Medicine. Coastal Cardiovascular Care physicians are available to discuss your heart health care concerns through telemedicine and in-office appointments at 700 Garden View Court, Suite 204, Encinitas, CA 92024. For more information call 760-452-6334 or go to http://www.coastalcardio.com.

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