• What Causes P.A.D.?

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    By: Dr. Michael Dansinger

    Dr. Michael Dansinger is Wellness Director at Boston Heart Diagnostics and Founding Director of the Diabetes Reversal Program at Tufts Medical Center in Boston . He also serves on the CDC’s Expert Panel for Worksite Wellness Programs and on the Council of Directors for the True Health Initiative, a leading international voice for health and wellness. Dr. Dansinger previously served as the Nutrition and Obesity Editor for Medscape Journal of Medicine and was the principal investigator of the Tufts Popular Diet Trial comparing the Atkins, Zone, Weight Watchers and Ornish eating plans for weight loss and heart disease risk-factor reduction (published in JAMA). Dansinger was the nutrition doctor for NBC's The Biggest Loser for 10 years and designer of the Biggest Loser Diet, which won top awards from U.S. News & World Report (including No. 1 Best Diet for Diabetes).

  • Fire in the Arteries

    Your Arteries Are On Fire!!!!

    The bad news: most people with peripheral arterial disease (PAD) have ongoing daily progressive damage to their arteries—we call this “arteries on fire”. Unfortunately you can’t feel the fire burning, but if you could feel the burn (imagine an internal sunburn) it would definitely grab your attention.


    The good news: you can “put out the fire” by understanding and eliminating all the different causes of ongoing arterial damage and allow your arteries heal.


    Ten Potential Causes of Artery Damage

    1. Tobacco and toxins
    2. Junk food
    3. High blood pressure
    4. Dyslipidemia
    5. High blood sugar
    6. Obesity
    7. Under-activity
    8. Emotional stress
    9. Gut microbes
    10. Genetics

    Tobacco and toxins:

    The worst thing you can do to your arteries is smoke. Cigarettes and tobacco are loaded with toxins that damage the arteries. It is easy to make the connection between smoking and “fire in your arteries”. If you still smoke you have probably tried to quit because you know it damages your arteries. heart, and lungs. Please get help. Second-hand smoke also damages arteries. Did you know that other toxins can damage arteries? Too much alcohol, recreational drugs, and the cumulative effects of chemicals in highly processed foods and beverages can all potentially contribute to fire in the arteries. Even air pollution has a damaging effect on your arteries.

    Junk food:

    We’re talking about food products made in factories that have long lists of ingredients. Highly processed foods that do not exist in nature and did not exist 100 years ago. There are thousands of these food products in grocery stores, and they are designed and manufactured specifically to make you love them, crave them, and keep buying and eating them. Your body thrives on natural food not junk food or unhealthy fast food. It’s not surprising that these unnatural foods damage the arteries and fuel the fire in them. Not only are these foods bad for your body—every time you eat those foods you’re missing out on the opportunity to eat healthy foods that heal your arteries. Don’t let junk food and unhealthy treats replace healthy food.

    High blood pressure:

    A healthy blood pressure is around 120/70 or less. Even 130/80 is okay, but any higher fuels the fire in your arteries. High blood pressure has many causes, but the main ones you can affect are related to food choices, exercise, body weight, and emotional stress. Healthy arteries are relaxed and flexible. Unhealthy arteries are tense and stiff, which forces your heart to work harder to pump blood resulting in high blood pressure. The high pressure in the arteries causes damage to the artery lining.


    When the fats in your blood are out of balance we call this “dyslipidemia”. Having “high cholesterol” or “too much bad cholesterol” or “not enough good cholesterol” or “high triglycerides” are just some of the different forms of dyslipidemia people talk about. There are many different types of fats (lipids) and lipid particles that carry fats in the blood. Certain lipids and lipid particles damage your arteries and fuel the fire inside them. You must work with your healthcare team to AGGRESSIVELY manage your blood lipids and lipid particles. The right eating, exercise, medication, and supplement strategy are crucially important to minimizing the damaging effect of dyslipidemia or unbalanced fats in your blood.

    High blood sugar:

    Everybody has sugar in their blood to provide energy to the organs and tissues. However, if the sugar level gets too high it causes all sorts of havoc with the arteries. Your arteries are on fire if your blood sugar level is too high. This is especially true for people living with diabetes that is not well controlled. High blood sugar directly damages the proteins in the artery lining and slows the healing of artery damage. In a way, high blood sugar is like a toxin to your arteries. Even if you don’t have diabetes, there is a good chance that you have “prediabetes”, which is a milder form of high blood sugar. In either case, eating the wrong meal is like throwing gasoline on a fire.


    Excess body fat, especially in the abdominal cavity, fuels the fire in your arteries. Unhealthy fat accumulates inside the liver and muscles leading to dyslipidemia, high blood pressure, and prediabetes/diabetes. A fatty liver, also known as “Non-alcoholic Fatty Liver Disease” leads to all sorts of chemical imbalances inside the body that collectively damage and inflame the artery lining and heart. Have you ever heard the term “Metabolic Syndrome”? This is a common condition with a combination of the risk factors discussed above, usually linked to obesity. Reducing your daily calorie intake and increasing your physical activity on a permanent basis are the keys to preventing or minimizing the damaging effects of obesity. All body sizes are beautiful, but if you’re struggling to lose excess body fat to improve your health, please seek help. The external accountability, structure, and other benefits of a health coach or formal weight loss program can mean the difference between long-term success or not.


    Your muscles, heart, arteries and the rest of your body are begging for you to exercise daily and be active. Unfortunately you can’t hear or feel them pleading with you to do so. Increasing your exercise, including gradually increasing your walking, would make a favorable difference in your artery health. Exercise stimulates the blood vessels and blood flow in multiple positive ways. A combination of cardiovascular type exercise, resistance type exercise, and flexibility/balance exercise is ideal.


    Emotional stress generates “stress hormones” that stress out your arteries. Arteries have a layer of muscle running along their length, and stress hormones cause that muscle layer to tighten. This temporarily makes the arteries tighter, stiffer, and less flexible, causing blood pressure to temporarily increase. Deadlines, traffic jams, negative people, disappointment, anger, upsetting news, and a whole range of negative stressors have the potential to burn up your arteries by triggering your stress hormones. Minimizing the effect of chronic daily stress is all about avoiding situations that trigger it, and practicing “positive attitude”, which is a skill that benefits from daily intentional practice. You can’t always affect what happens to you, but you can affect the way you react to it. Studies show that negative attitude fuels arterial damage, while positive attitude helps minimize it.

    Gut microbes:

    Your large intestine is loaded with helpful bacteria and other microbes that eat what you feed them. They love vegetables, fruit, and fiber. The wider the range of plant material you eat, the healthier and happier your gut bacteria are. When you feed them junk food, it fuels a bad cycle. The bacteria turn unhealthy food into unhealthy chemicals that get absorbed into your blood and damage the arteries. An overall unhealthy diet also reduces the types of healthy bacteria and increases the types of unhealthy bacteria in your gut. The science is still emerging, but there is no question that part of the favorable and unfavorable health effects of food is related to the gut microbes. Don’t forget they eat what you feed them so be kind to these little fellas.


    We know that some people are at a higher risk of cardiovascular disease than others because of the genes they inherited from their parents. However, studies show that most of the risk for artery problems results from the things you CAN control rather than your genes. Actually, there could be even some genes such as an MTHFR mutation, which messes with how your body processes amino acids, the building blocks of proteins, which you can also learn to control. Also, clotting disorders such as Factor V Leiden (FVL), or factor “5” Leiden, a genetic mutation, that makes the blood more prone to abnormal clotting, can be controlled by medicine. The higher your genetic risk of cardiovascular disease the greater the payoff resulting from aggressive management of the factors you can control. As you can see from the above list of 10 potential causes of fire in your arteries, 9 of them are preventable and/or controllable. In some cases, knowing your specific genes provides helpful information for doctors to help make specific recommendations about food, supplements, and medications to help manage and minimize the risk of cardiovascular disease.

    Cancer Treatment

    While cancer and PAD are two different conditions, they are linked in some ways. For example, both cancer and PAD can be caused by lifestyle factors such as smoking and poor diet. Additionally, some cancer treatments can increase the risk of developing PAD. One study found that cancer survivors who had undergone chemotherapy or radiation treatment had a higher risk of developing PAD than those who had not undergone these treatments. This is likely because these treatments can damage the blood vessels and increase the risk of plaque buildup.


    Most people with PAD have a tremendous opportunity to improve several different issues that continue to harm their arteries on a daily basis. The number of unsolved issues has a lot to do with how hot and fierce the fire is burning. On the other hand, if you can make progress on every issue that needs work, then you can put that fire out and let your arteries gradually heal over time. Work with your healthcare team to discuss and protect yourself from each of these potential sources of internal damage. A great start is discussing advanced bloodwork that can help you and your doctor get to the heart of what's setting your arteries on fire.