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  • Writer's pictureDr. Kogan

Holistic approach to the roots of Heart Disease

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Prevention is the cornerstone of the holistic perspective on any illness. In my office, one of the common risks of heart disease I tackle is obesity. It might seem odd that in a country like the US, with the most gyms and trainers, and fancy dietary aids, our obesity numbers continue to climb. In fact, a chilling report published in The New England Journal of Medicine at the end of 2019 reported that by the year 2030, nearly 1 in 2 adults will have obesity. The prevalence of obesity will be higher than 50% in 29 states and not below 35% in any state, so we are all in this together. Europeans join us in this tough predicament: a 2022 report by the World Health Organization stated that being overweight and obese now impacts 60% of European adults. The numbers are also awful for both American and European children, but since I only treat adults, I will focus on that slice of population in this article.

One of the main mechanisms by which obesity causes heart disease is by first creating a silent disease called Metabolic Syndrome. You will also hear doctors refer to it as Insulin Resistance Syndrome, Syndrome X, and Dysmetabolic Syndrome. So, how will you know if you have it? This potentially lifesaving diagnosis can be made by making some basic measurements in your doctor's office:

  • Have your waist circumference measured. It should be less than 35 inches in women and less than 40 inches in men. Increased circumference heralds central obesity.

  • Have your blood pressure measured. It should be equal to or less than 130 for the first number and equal to or less than 85 for the second number.

  • Have your fasting blood work done:

  • Your fasting sugar (glucose) should be less than 100 mg/dL

  • Your fasting Triglycerides should be less than 150 mg/dL.

  • Your fasting HDL cholesterol (the good guy which protects your heart) should be 50 mg/dL or higher for women and 40 mg/dL or higher for men.

  • If at least three of these five criteria are off—you are likely to have Metabolic Syndrome.

It is important to note that when we discuss waist (central) obesity, we should keep in mind ethnic differences in body types. Europeans, Asians, Africans, and Middle Easterners have stricter cutoffs for healthy waist circumference.

Metabolic Syndrome is an insidious but reversible condition that can lead to sugar dysregulation and ultimately diabetes, hypertension, abnormal lipids, and ultimately heart disease. Additionally, Metabolic Syndrome is a major cause of developing Nonalcoholic Fatty Liver Disease (NAFLD), hormonal dysregulation, and many types of cancers. This is why identifying and treating it early is of paramount importance.

We are all born with different genetic predispositions. Unfortunately, when suboptimal genetic code combines with compromising lifestyles, a disease state is often triggered. This is where the strength of holistic prevention lies. Identifying the issue and working closely with your physician on reversing it takes a partnership and commitment coming from both you and your doc. You become a team that zooms in on the variables in the Metabolic Syndrome equation which can be modified: and all of them pertain to your lifestyle. I highly recommend putting together a customized nutritional program, optimizing quality and quantity of sleep, developing an exercise plan, and working on attenuating stress, depression, and anxiety. All these factors feed into one another and to achieve a new balanced state of healthy metabolism—each factor must be addressed.


Dr. Kogan is a Concierge Holistic Internal Medicine doctor in Naples. For more information, please visit or call 239.676.6883.


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