Cardiometabolic Health, Diet, and Hormones Throughout a Woman’s Life

Part 1

Cardiometabolic Health, Diet, and Hormones Throughout a Woman’s Life

Cardiometabolic health in the United States is getting worse by the year. According to current data, only 6.8% of adults have optimal cardiometabolic health ! That means over 93% of us have poor metabolic health.

Cardiometabolic health in the United States is getting worse by the year. According to current data, only 6.8% of adults have optimal cardiometabolic health! That means over 93% of us have poor metabolic health.

While this statistic is staggering, it’s not surprising given the rates of obesity and insulin resistance, a food system built on ultra-processed products, and socioeconomic factors that make access to lifestyle medicine challenging.

My goal with today’s article is to educate and inform you about this topic that affects all our lives. We will cover:

What is cardiometabolic health? Important lab tests Women’s hormones and cardiometabolic health How to improve cardiometabolic health

Then, please join me in Part 2 of this series, where I’ll dive more into a functional medicine approach, nutrition and cardiometabolic health strategies, and more!

What is Cardiometabolic Health?

Cardiometabolic health refers to factors affecting metabolism and heart health. Poor cardiometabolic health may lead to cardiovascular disease (heart attack and stroke) and other chronic disease like diabetes and cancer.

Risk factors for heart disease and related conditions include:

Insulin resistance High Blood pressure Smoking Trauma Exposure to toxins Poor sleep Hidden inflammation And more!

Many of these risk factors are modifiable with diet and lifestyle changes to lower the risk of heart disease.

Assessing Cardiometabolic Health

Various tests and measurements help assess cardiometabolic health. These include:

Fasting glucose – a blood glucose measurement first thing in the morning. Along with hemoglobin A1C and fasting insulin can help uncover insulin resistance well before it reaches prediabetes or diabetes criteria.

HS-CRP – a protein marker of hidden inflammation. High HS-CRP correlates with metabolic syndrome, insulin resistance, and inflammation associated with heart disease.

Blood pressure – Elevated blood pressure is associated with metabolic syndrome and a heart disease risk factor.

BMI and waist measurement – Excess body fat, especially around the midsection, correlates with metabolic dysfunction.

Lipids – Looking at lipids beyond HDL and LDL provides a comprehensive assessment.

What is the Cardio IQ Advanced Lipid Panel?

Consider the Cardio IQ Advanced Lipid Panel your cardiometabolic health score. This simple blood test available through Quest Diagnostics provides more complete information than a standard lipid panel.

Total Cholesterol

Total cholesterol is the total lipoprotein particles in the bloodstream. Total cholesterol doesn’t tell the whole story, and we often want to dig deeper.

HDL/LDL Cholesterol

LDL cholesterol, or “bad” cholesterol, also doesn’t tell the whole picture. The cardio IQ advanced lipid panel also looks at the density of the LDL particles. Small, dense particles are more problematic than lighter ones.

HDL cholesterol, or “good” cholesterol, is protective. I like to see levels above 50 for women.

Apolipoprotein B

ApoB is associated with LDL cholesterol, and increased levels predict an increased risk for heart disease.

Triglycerides

Triglycerides are how fat is transported in the blood. Elevated triglycerides are typically associated with poor blood sugar control, high carbohydrate intake, and metabolic syndrome.

Lipoprotein (a)

Lipoprotein (a) is associated with an increased rate of plaque development in the arteries, increasing the risk of blood clots, heart attacks, and stroke.

Lipoprotein Fractionation

The Cardio IQ Metabolic Panel looks at the subfractions of lipoproteins. It provides a better assessment of the risk associated with elevated total cholesterol or LDL, especially when looking at the entire clinical picture.

How Women’s Hormones Impact Cardiometabolic Health

Estrogen (particularly estradiol made by the ovaries) plays a significant role in heart health for women. As women lose estrogen through the menopausal transition, cardiometabolic risk factors may increase.

Perimenopause

Perimenopause is the 3-10 years leading up to menopause when women’s hormones fluctuate and eventually decline. Perimenopause is the time when many women experience uncomfortable symptoms, including:

Insomnia Depression Hot flashes Increased weight and visceral fat Vaginal dryness Low libido

Menopause

Menopause is the one-year mark after a woman’s last period. After that day, she is officially in post-menopause.

Post-menopause

Post-menopause is a significant life phase as many women spend three decades or more. With the loss of ovarian hormones, post-menopausal women are at increased risk for bone loss, muscle loss, dementia, and heart disease.

The risk of heart disease escalates after menopause due to a loss of estrogen signaling. In post-menopause, heart disease is the number one cause of death for women.

The risk of heart disease escalates after menopause due to a loss of estrogen signaling. In post-menopause, heart disease is the number one cause of death for women.

How to Improve Cardiometabolic Health

Poor cardiometabolic health doesn’t happen in a day; it happens slowly over time. The good news is that changing daily habits help preserve cardiometabolic health.

Lifestyle Medicine

How we live our lives, day in and day out, creates our health. There isn’t a magic pill or quick fix; it comes back to the basics of eating quality food, moving our bodies, reducing stress, and sleeping well.

Exercise

Moderate exercise helps improve lipid balance, reverse insulin resistance, and address other cardiometabolic risk factors, so get moving! Find exercise that brings you joy and make it a regular part of your lifestyle.

Nutrition

In Part 2 of this series on cardiometabolic health, I’ll dive into the nutrition strategies I recommend to patients to lower their risk of heart disease, including the Med diet and reducing glycemic load. Plus, I’ll give you some of my best functional approaches for living a long and happy life without chronic disease.

References

O'Hearn, M., Lauren, B. N., Wong, J. B., Kim, D. D., & Mozaffarian, D. (2022). Trends and Disparities in Cardiometabolic Health Among U.S. Adults, 1999-2018 . Journal of the American College of Cardiology , 80 (2), 138–151. Clegg, D., Hevener, A. L., Moreau, K. L., Morselli, E., Criollo, A., Van Pelt, R. E., & Vieira-Potter, V. J. (2017). Sex Hormones and Cardiometabolic Health: Role of Estrogen and Estrogen Receptors . Endocrinology , 158 (5), 1095–1105.