What I tell my patients at their first cardiology visit

When I see a patient for the very first time, I like to spend an hour getting to know them. Not just to learn about the health problems they’re experiencing, or about what they eat or how much they exercise, but also about what their goal for their health is.

The answer to that last question is almost always the same — “I want to not only live long but also live well.”

And you should know that ultimately, everything we do in medicine has that very goal in mind. Our mission as physicians is to help our patients achieve healthy longevity. We don’t do tests or procedures or prescribe medications simply because we can, we do this because we hope that through testing, fixing or medicating a condition we can help our patients live longer better.

I always point this out to my patients. That my role is not to make a cholesterol or blood pressure number perfect. Those are simply means to an end. My role is to help them achieve their greater health goal.

But when it comes to achieving healthy longevity, the truth is that what I can do pales in comparison to what you can do yourself

The secret to healthy longevity

The secret to healthy longevity lies not in how many procedures you’ve had or whether you’re on the best combination of the latest drugs.  People who live long well do so because they LIVE WELL.

This is always my biggest message at the first visit.  And a discussion about the four pillars of healthy longevity (detailed below) is nearly always part and parcel of my initial consultation with every patient I see. 

That’s because our perception of what is considered mainstay therapies (pills and procedures) versus complementary therapies (diet, exercise, stress reduction, etc.) is completely backward.

The 4 pillars of health longevity include: 

  1. Daily moderate exercise. You have to move your body every day. You don’t have to be a marathon runner or triathlete. In fact, there is a diminishing ROI (return on investment) for more and more exercise when it comes to longevity itself. But you still have to get out there and do SOMETHING. It could be gardening, or yoga or a physically demanding job. Ideally, you should move your body somewhat vigorously for at least an hour every single day.
  2. Social interconnectedness. You have to be part of a group and be an active member of that group. It could be your neighborhood, your faith community, your extended family, your group of friends. It’s important to engage with other people and connect regularly. 
  3. Inner sense of purpose and joy. You have to find and nurture a pursuit that gives you personal satisfaction and contentment. And no one else gets to judge what that is. It could be reading, it could be doing crossword puzzles, it could be your work, it could be meditation or a hobby or learning something new. It’s whatever it is that when you first wake up and look around, you can say — “Great! I get to do that again.”
  4. Eating for health. Evidence is overwhelming that a whole food plant-based diet is the key. There is something special about plants. Per calorie, they can’t be beat for nutrient content, especially when it comes to vitamins and minerals and micronutrients and antioxidants and healthy fats. It’s the fuel our bodies need. The more plant-based your diet the better. But remember, it’s not just plants in any form. A potato chip is a plant-based food. It’s about plants in their most whole and unadulterated forms. 

Core to healthy longevity is what we eat, how much we move, and how we experience joy and love. This is the mainstay therapy. Complementing that is what modern medicine offers — antibiotics, stents, chemotherapy, surgery… 

And here’s the biggest thing you need to know: without the mainstays of diet, exercise, joy and love, any medical intervention I can offer will not only be woefully incomplete but may not even work as well as expected

So as we start the new year, think about what you can do to eat a little better, move a little more or experience more joy.  You don’t have to change everything or be perfect.  But any attempt to shore up even one of your pillars will reward you many times over. 

Especially if your health goal is to not only live long but also to live well.

Dr. Elizabeth Klodas MD, FACC

By Dr. Elizabeth Klodas MD, FACC

"Diet is a major driver of high cholesterol, but instead of changing the food, we prescribe medications. This never seemed logical to me.” Dr. Klodas has dedicated her career to preventive cardiology. Trained at Mayo Clinic and Johns Hopkins, she is the founder and Chief Medical Officer for Step One Foods. Dr. Klodas is a nationally sought out speaker and has an active role at the American College of Cardiology. Her clinical interests include prevention of heart disease and non-invasive cardiac imaging and she has published dozens of scientific articles throughout her career. Dr. Klodas has been featured on CNN Health for her mission to change how heart disease is treated. An independent study performed at leading medical institutions affirmed the ability of Step One Foods to deliver measurable and meaningful cholesterol-reduction benefits in the real world. The results of the trial were presented at the 2018 American Heart Association’s Scientific Sessions. Dr. Klodas has also authored a book for patients, "Slay the Giant: The Power of Prevention in Defeating Heart Disease," and served as founding Editor-in-Chief of the patient education effort of the American College of Cardiology. In addition to her practice and her duties at Step One Foods, she also serves as medical editor for webMD.