In this episode of Medicine 3.0, Dr. Jared Pelo interviews Dr. Manesh Patel, Head of Duke Cardiology, about the latest advancements in cardiovascular health. Dr. Patel's unique journey from Uganda to leading cardiology in the United States provides valuable insights into the evolution of heart care.
The Future of Cardiovascular Risk Assessment
Dr. Patel emphasizes the importance of holistic risk evaluation beyond traditional markers. He envisions a future with universal screening using advanced imaging techniques, blood tests, and even retinal scans to provide a comprehensive picture of cardiovascular health.
Lifestyle Factors for Optimal Heart Health
The discussion highlights the significance of the Mediterranean diet, regular exercise, and stress management in maintaining heart health. Dr. Patel offers practical tips for incorporating these elements into daily life.
Cutting-Edge Treatments and Medications
Dr. Patel explains the benefits of statins, PCSK9 inhibitors, and emerging therapies that could revolutionize heart disease prevention and treatment. He stresses the importance of personalized approaches, tailoring treatments to individual needs and responses.
The Role of Data and AI in Cardiovascular Care
Looking to the future, Dr. Patel shares his excitement about the growing role of data and AI in personalizing heart health strategies. This aligns with Bionic Health's approach to healthcare, leveraging technology for better patient outcomes.
Dr. Patel's insights offer a glimpse into a future where cardiovascular care is more precise, personalized, and proactive. By combining advanced diagnostics, tailored treatments, and data-driven approaches, we're moving towards a world where heart disease could be significantly reduced or even prevented.
Tune in to hear about some of the topics we discussed in this episode!
Fighting Heart Disease Like Cancer: A Conversation with Dr. Mike McConnell
In this episode of the Bionic Health podcast, Dr. Jared Pelo sits down with cardiologist Dr. Mike McConnell to discuss a revolutionary approach to heart disease prevention. Dr. McConnell, who authored the book "Fight Heart Disease Like Cancer," shares his expertise on early detection, risk assessment, and proactive treatment strategies.
Rethinking Heart Disease
Dr. McConnell challenges the traditional view of heart disease as simply a "plumbing problem" where arteries gradually get clogged. Instead, he frames it as an active biological process more similar to cancer, where growths develop in the arteries that supply blood to the heart. These growths can remain asymptomatic until a blood clot forms, potentially causing a sudden and catastrophic event - as happened with Dr. McConnell's own father-in-law.
"We're in this amazing era of tools, both for prevention from a lifestyle perspective and from a medication perspective that we can really stop this," Dr. McConnell explains. "We shouldn't be having people who have blockages and need stents or bypass surgery or having heart attacks."
Early Detection and Screening
The conversation explores various screening methods for heart disease, including:
Risk Assessment Scores - Evaluating factors like age, gender, cholesterol levels, blood pressure, diabetes status, and smoking habits
Coronary Calcium Scans - A rapid CAT scan that detects calcified plaques in arteries
CT Angiograms - More detailed imaging that shows both calcified and soft plaques
Retinal Imaging with AI - An innovative approach using eye scans to detect cardiovascular risk
Dr. McConnell highlights the importance of early screening, especially for those with a family history of heart disease. He also discusses how these imaging tools can help motivate patients to take their risk factors seriously and adhere to treatment plans.
The Essential Eight for Heart Health
The American Heart Association's "Life's Essential Eight" provides a framework for heart disease prevention:
Blood sugar management
Cholesterol control
Blood pressure regulation
Regular physical activity
Healthy diet
Avoiding smoking
Maintaining healthy weight
Getting adequate sleep
Dr. McConnell adds two more important factors to this list: limiting alcohol consumption and managing stress.
Combining Lifestyle and Medication
While lifestyle modifications are important, Dr. McConnell acknowledges their limitations. He advocates for a combined approach:
"The more you can do with lifestyle, the less you need medication. So that's sort of part of the bargaining or discussion that we have," he explains.
Dr. McConnell notes that only about one in three eligible people in the US are taking cholesterol-lowering medication, even though guidelines would recommend it. He sees tremendous opportunity in increasing awareness and proactive treatment.
Looking to the Future
Dr. McConnell shares exciting developments in heart disease prevention, including using AI to analyze retinal images for cardiovascular risk assessment. His company, Toku, is working to bring this technology to market, which could potentially identify at-risk individuals during routine eye exams.
"Not everybody's day to day, unlike me, most people are not thinking about their heart disease risk every day," he says. "Why not when you're making contact with optometry, ophthalmology, getting an eye exam, that there's an opportunity to say, look, your retina looks like you have some increased risk."
For those interested in learning more, Dr. McConnell's book "Fight Heart Disease Like Cancer" and website (FHDLC.info) provide additional resources and guidance.
As Dr. Pelo notes at the conclusion of their conversation, following Dr. McConnell's advice on screening and prevention could save countless lives - perhaps the greatest impact a physician can have.
Timestamps:
00:00 - Introduction and welcome 00:22 - Dr. McConnell's background and career journey 03:09 - How Dr. McConnell decided to become a physician 05:35 - Framework for understanding heart disease 09:18 - Personal stories motivating heart disease prevention 10:30 - Heart disease screening approaches and risk assessment 14:58 - The "Life's Essential Eight" for heart health 19:11 - Retinal imaging for cardiovascular risk assessment 24:03 - Expanding heart health screening through eye exams 27:08 - Using imaging to motivate patients 30:05 - Balancing lifestyle changes and medication 33:39 - Advanced imaging: CT angiograms and soft plaque detection 40:15 - Where to find more information 41:22 - Closing thoughts
Member Spotlight: Alex Ladan on Finding Personalized Health Support After Competitive Athletics
In this Member Spotlight, we talk with Alex Ladan, former gymnast and current clinical researcher in women's health, about her journey with Bionic Health and how personalized health coaching has transformed her approach to nutrition, stress management, and overall wellness.
From Competitive Athlete to Health Researcher
Alex Ladan's relationship with health and fitness began early. As a former gymnast, she was accustomed to being considered "healthy" simply because she was athletic. "Growing up as an athlete, I was always just considered healthy," Alex explains. "I was never given true information about anything. It was like checking the box—you went to your physical, great job, how's gymnastics going? And that was it."
This experience ultimately led Alex to pursue kinesiology in undergrad, followed by a master's degree in sports science at UNC Chapel Hill. Now working in clinical research focused on women's health, Alex brings a unique perspective to her own health journey.
Why Bionic Health?
When Alex moved to North Carolina for her master's program, she faced challenges many young adults encounter: managing her own healthcare appointments for the first time while balancing a rigorous academic schedule.
"It was my first time moving away from home, which came with making my own doctor's appointments and keeping up with my health," Alex shares. "I really liked the flexibility of Bionic, but I also really liked the advisor portion of it."
What particularly appealed to Alex was Bionic's comprehensive approach that went beyond what traditional providers typically addressed: "It brought in the body composition piece, the exercise piece, all of the things that I feel like my traditional provider was never asking me about or never really understood because I was a gymnast and I was active, so that was good enough."
Evolving Goals and Personalized Support
One of the most valuable aspects of Alex's Bionic Health experience has been working with her advisor, Anna. Their relationship has allowed Alex to address changing priorities over time—from managing nerve pain and anxiety to developing sustainable nutrition practices and preparing for her upcoming wedding.
"I feel like my goals change every time I meet with her," Alex laughs. "I think originally I was experiencing some nerve pain, and I wasn't sure if it was related to physical activity or high anxiety levels."
Through regular check-ins with Anna, Alex gained important insights about stress management. "She helped me a lot with recognizing that from an outsider's perspective, like, 'Yeah, actually, this is not a normal level of stress.'"
Making Nutrition Personal
For Alex, nutrition was a complicated area due to her gymnastics background. "I was hyper-fixated on food for my entire upbringing," she explains. After years of not thinking consciously about nutrition during college, Anna helped her develop practical approaches to meal planning.
"She helped me a lot with understanding the importance of planning my meals before work...things that are maybe so small and mundane but ended up being really impactful for me."
Rather than following a one-size-fits-all approach, Alex and Anna crafted strategies that worked for her specific preferences. For instance, with meal prep, Alex notes: "I don't like to feel like I'm eating the same thing over and over again. I can prep fruits, vegetables, and starches, but I have to prepare my protein each day. Otherwise, mentally, I just don't feel like it's fresh."
Meaningful Progress Beyond Numbers
The true value of Alex's Bionic membership has been in the gradual, sustainable changes that have significantly improved her quality of life:
Improved Energy Levels: By tracking her sleep and adjusting her alcohol consumption, Alex noticed dramatic improvements in her energy throughout the week. "I used to feel like I'm dragging my feet on Monday and Tuesday. But now I actually look forward to Sundays because I look forward to prepping my meals, and then I feel more energized going into the week."
Better Work-Life Boundaries: With Anna's guidance, Alex transformed her morning routine. "I would wake up and immediately start mentally clocking into my job. Now I take more time in the morning for restorative activities, listening to a podcast during my commute instead of thinking about work."
Personalized Approach to Protein: Rather than tracking all macronutrients, Alex focused specifically on protein intake. "It's actually funny that you asked specifically about protein because that is really the only thing that I keep track of each day."
Working Through Barriers, Not Around Them
One of the most valuable aspects of Alex's experience has been identifying and addressing barriers to her goals. For example, when discussing resistance training: "I remember myself being like, 'Well, this is the reason why that's not going to work.' And then we talk through it...recognizing what the barriers are is so, so key."
Alex appreciates the collaborative approach: "It's never just Anna being like, 'You need to do this, and if you don't do it by the next time we meet, then you failed.' It's more fluid and a conversation."
Advice for Health Professionals
As someone with a background in health and fitness, Alex offers valuable insight for other professionals who might think they already know enough:
"It is so hard for me to stay consistent with a routine of exercise and nutrition when I get really busy. This helps to have something consistent. Maybe in the periods where I'm falling through the cracks with my own nutrition and exercise, I have somebody there consistently."
Looking Forward
As Alex approaches her one-year anniversary with Bionic Health, she reflects on how her goals and motivations have evolved: "What I would have said at the beginning and what I would say now is so different—why I'm still a member has changed so much across time."
With her wedding approaching later this year, Alex continues to work with Anna on maintaining a healthy perspective amidst wedding culture pressures. "I told her upfront, 'I feel like this is going to become an issue, and it hasn't yet, but I can feel it starting.' And just having her to talk through that and talk through the things that maybe I'm seeing on the internet and to help get ahead of it has been really helpful."
Interested in learning how Bionic Health can support your health journey? Contact us today to learn more about our personalized approach to optimal health.
Interview Timestamps:
0:00 - Introduction
0:56 - Why Alex joined Bionic Health
3:02 - Initial health goals and expectations
5:54 - Meeting frequency with health advisor
8:02 - Stress management and physical symptoms
11:33 - Perspective changes as a Bionic member
15:08 - Insights from lab testing and body composition
The Science of Body Composition: How DXA Scans Help Optimize Your Health Journey
In a recent episode of Medicine 3.0, Bionic Health physician Dr. Catherine Isaac and advisor Kelly Joniak dive deep into the world of body composition analysis, specifically focusing on DXA scans and their importance in health assessment and optimization.
Understanding Body Composition Assessment
The conversation begins with Kelly explaining different methods of body composition assessment. DXA (dual-energy X-ray absorptiometry) scans emerge as the gold standard, providing a three-compartment model that measures:
Bone mineral density
Fat mass
Fat-free mass (including lean soft tissue)
While home bioimpedance scales (BIA) only measure two compartments (fat and fat-free mass), DXA provides a more comprehensive picture with greater precision. Kelly describes BIA scales as "reliably unreliable" - consistent but not always accurate compared to DXA measurements.
Beyond Aesthetics: The Medical Value of Body Composition
Perhaps the most compelling aspect of the discussion is how body composition analysis serves as a powerful preventive healthcare tool. Dr. Isaac shares several examples of how DXA scans help identify health risks that might otherwise go undetected:
Visceral adipose tissue (VAT): This fat surrounding internal organs is invisible from the outside but strongly correlates with chronic disease risk. DXA can precisely measure VAT, helping identify people at risk for diabetes, cardiovascular disease, and even fatty liver disease.
Bone health: DXA provides T-scores and Z-scores that can signal early bone density concerns, particularly valuable for perimenopausal women and men with potential testosterone deficiency.
As Dr. Isaac notes, "We're definitely being proactive in a way that you don't normally have the tools to be."
Common Misconceptions and Mindset Shifts
The podcast challenges several fitness myths:
"I just want to lose weight": The experts emphasize that body composition matters more than the number on the scale. Someone might maintain the same weight while replacing fat with muscle, drastically improving their health.
"Muscle is more metabolically active than fat": Kelly clarifies that both tissues are metabolically active - a surprising correction to a common belief.
"Progress is linear": Both experts stress that health improvements rarely follow a straight line. Consistency matters more than perfection.
The Importance of Community and Consistency
Beyond the technical aspects, the conversation highlights the human elements that contribute to success. Kelly emphasizes that having supportive community makes consistency easier, whether it's workout partners, family involvement, or the workplace culture at Bionic Health.
Dr. Isaac shares her personal journey with weight training, including setbacks and the mental training that came with them: "Mindset is really what's going to help you achieve your goal, whatever area of your life."
Finding Your "Why"
The podcast concludes with both experts sharing their personal motivations for maintaining physical health. For Dr. Isaac, it's keeping up with her active son. For Kelly, it's seeing her 60-70 year old mother and aunt living vibrant, active lives - playing pickleball daily or hiking mountains around the world at 70.
These personal stories remind us that the numbers from a DXA scan aren't the end goal - they're tools to help us live fuller, more active lives for decades to come.
Whether you're looking to optimize athletic performance, prevent chronic disease, or simply understand your body better, this conversation provides valuable insights into how modern body composition analysis can guide your health journey with precision and purpose.
Timestamps:
00:01: Introduction to the Body Composition Module
01:48: Explanation of DXA scan technology
06:13: Drawbacks of different body composition methods
09:37: Information about skinfold testing
13:45: Discussion of visceral adipose tissue (VAT)
15:27: How visceral fat relates to chronic disease risk
18:33: Exercise recommendations for reducing visceral fat
21:05: Bone mineral density assessment
24:25: Importance of protein for muscle and bone health
27:32: Shifting focus from weight to body composition
30:08: Metabolic activity of fat and muscle tissue
