Excerpts

1 Lifestyle and Heart Disease You know Bill. At 58 years old, a strapping six feet two inches tall and 220 pounds with a full head of silver hair, he was outwardly the picture of power and health. He received great medical care. He jogged and golfed frequently. But just like most Americans, Bill loved food -- especially fatty, spicy, salty food. His typical American extra pounds pushed his blood pressure, sugar, and LDL (bad) cholesterol too high and dropped his HDL (good) cholesterol too low. He lived with chronic stress, big time. None of his numbers were awful, but every warning sign was there. One day Bill had chest pain. The next week, his quadruple coronary bypass was all over the news, because Bill is President Bill Clinton. Yes, even American presidents can get heart disease. Since his wake-up call, Mr. Clinton has changed his lifestyle quite a bit. He is now off the ribs and fries and is working hard to do his part to prevent heart disease in this country. Improving your lifestyle after a heart attack or bypass surgery is certainly a step in the right direction, but wouldn't it be so much better to do so before you end up in the coronary care unit or surgical suite? Or worse, the morgue? Our guests at the Pritikin Longevity Center sometimes complain that they don't have enough time to exercise. We remind them that they will have plenty of time to exercise, but not much inclination after they are dead. Heart disease is a great barometer of a lousy lifestyle. Wherever heart disease is epidemic, so are obesity, high blood pressure, high cholesterol, stroke, and diabetes. Obviously, few people are heeding the early warning signs, because I don't know any fellow cardiologists looking for more work. We live in fear of cancer, but heart disease is still the number-one killer in America. I wish I could tell you how to avoid most cancers. Sadly, I can't. But I can tell you how to prevent most heart disease simply by changing your lifestyle. Some cancers may even be avoided by these same lifestyle changes. What you eat, how often you exercise, how you manage your stress...it all matters, and it's all easier to improve than you might think. THE 10 ESSENTIAL INGREDIENTS OF THE PRITIKIN PROGRAM In this book, you will learn the 10 essential ingredients of the Pritikin Program. These 10 Pritikin essentials deal with diet, exercise, and emotional wellness. By adopting these lifestyle practices, as thousands of our patients and participants have, you will get back the seven years of life you might otherwise lose to heart disease. (By the way, if seven years doesn't seem important to you right now, imagine how much more important they will seem to you when you're 75.) You will learn how to lose weight permanently without feeling hungry, to cook really tasty, heart-healthy food, the best ways to be physically active, and how to sidestep stress. You will learn the real science of lifestyle and heart health, so that you are able to make choices every single day that will contribute to your wellness and enable you to live a long, delicious life. You'll learn much more in Part Two about the specifics of the 10 essential ingredients of the Pritikin Program, but here is a quick glance: 1. Healthy, satisfying eating starts with super salads, soups, whole grains, and fruit. 2. Eliminate high-calorie beverages. 3. Trim portions of calorie-dense foods. 4. Snack smarter. 5. Forget fast food; dine unrefined. 6. Watch less, walk more. 7. Go lean on meat, but catch a fish. 8. Shake your salt habit. 9. Don't smoke your life away. 10. Step around stress. Adopting one or two of these essential lifestyle practices is okay, but optimal health requires that you follow the whole program . Why? Because obesity, inactivity, heart disease, and emotions are intricately connected. Couch potatoes tend to be depressed; depressed people eat more; people who eat more gain weight; those who gain weight tend to sack out on the couch rather than exercise; lack of exercise contributes to heart disease; heart disease can trigger depression...you get the picture. You may already be following several lifestyle essentials, but now is your chance to complete the program and get all seven years back, not to mention being able to more fully enjoy your life right here and now. THE PRITIKIN PHILOSOPHY The Pritikin Program is simple, thorough, and most of all, smart. No gimmicks, fads, pseudo-science, or rhetoric here. The philosophy is based on five main points: * prevented through lifestyle changes. * Emotional wellness and heart healthiness are intricately connected. * Wellness is much more than the absence of illness. * Complex health problems do not have simple solutions. * Illness and wellness are global issues: they affect families, communities, and nations. Lifestyle Changes versus Medication I love sushi. Almost every day while we had a sushi bar in our hospital, I would eat ahi along with a green salad. One day, without notice, the sushi bar disappeared; it seems it wasn't making the hospital money. After all, why lose money selling tasty food that just might prevent heart disease when you can get paid a great deal to treat it? Sayonara, sushi bar. Did I complain? You bet! Now it's back. This story illustrates the paradox of our unhealthy culture and medical care. When we become ill, we immediately turn to drugs to fix the consequences of a poor lifestyle. We focus on fixing a problem after we've created it, rather than trying to prevent it altogether. Pop a pill, or hop on the treadmill -- which is easier? Taking a pill, of course. Which is better? Hands down, preventing the illness that mandates the pill in the first place through healthy living. When we change our lifestyle, we not only negate the need for costly medications, we lessen our risk of developing a myriad of diseases, including diabetes, cancer, arthritis, and depression, not to mention heart disease, because these common afflictions share many of the same root causes. I readily admit I will use medications in my practice to lower cholesterol in patients who will not change their lifestyle or for whom this change is not enough. But time and again, I've seen that my patients who do lower their cholesterol through diet and exercise rather than medication look and feel better. Yes, they have to put in a little more time and effort than it takes to pry the top off a pill bottle, but the quality of their lives is far superior. They are more physically fit, emotionally engaged, and energized by their ability to improve their well-being. Prescriptions or Power Walks? Consider This: * Most lifestyle changes are free, or very inexpensive. Salads are still cheaper than any prescription drug. * You don't need preapproval from an HMO to go for a long walk. * Lifestyle changes have few negative side effects. You don't have to worry about mixing good habits, and I have never had a patient allergic to walking. * The most valuable lifestyle changes have no drug substitutes. As yet, we have not been able to capture all the benefits of friendship and love in a pill. Emotions and Heart Disease Our metaphorical "heart," from which we feel love and affection, and our physical heart are actually one and the same. How you feel can absolutely affect your cardiovascular health. As we like to say at Pritikin, a happy life equals a happy heart. Depressed people tend to eat poorly, smoke more frequently, and exercise rarely -- all major contributors to heart disease. There is a lot of research that shows depression and anger increase the chronic factors that contribute to heart disease, most specifically inflammation and a decrease in protective chemicals like nitric oxide (more on this in Chapter 2). And, not surprisingly, the relationship works both ways: depression and anger frequently follow heart attacks and bypass surgery. Can you die of a broken heart? Absolutely. Faced with sudden emotional stress, your heart can actually stop pumping effectively. Learning about the death or illness of a loved one can do it; this is literally called "broken heart syndrome." In response to extreme stress or grief, an outpour of adrenaline and related hormones can stun the heart, mimicking a heart attack. Fortunately, though, the same holds true in reverse. Upbeat emotions and heart healthiness are also intricately connected. It has been proven that watching 30 minutes of a humorous video relaxes your blood vessels. Socially and spiritually connected people, such as churchgoers and others who are socially active, tend to live healthier lifestyles and thus experience less heart disease. In one of the best-known studies of cardiac health, the Normative Aging Study done in VA hospitals, it was shown that optimistic men actually have few heart attacks. There's another component to the link between emotions and heart health: think about how your self-image improves with weight loss and the joy of shopping for slimmer clothes. I know of few compliments more welcome in our society than being told that you look like you lost weight. (By the way, I've come to learn that the only correct answer to your wife's question of whether a dress makes her look fat is, "How could it, dear?") Wellness versus Absence of Illness Just like illness, health and wellness come in degrees. You may not be ill, but can you run a 6-minute mile -- or even a 12-minute mile? You may not be depressed, but are you truly happy? You may not have had a heart attack or stroke yet, but do you really think that all those double cheeseburgers and French fries have not done you any damage? We call heart disease the silent killer. You usually feel fine the day before a heart attack or stroke, but you are really a coronary time bomb. Did you know that 85 percent of 50-year-old people have blockage in the arteries of their hearts without any symptoms? It is a tragedy that high blood pressure and cholesterol aren't painful until it is too late. True wellness is not just the absence of known disease, but also the promise that you will remain well for some time to come. By following the 10 essential ingredients in the Pritikin Program, you are laying the foundation for a lifetime of health. No Simple Solutions I have a real bee in my bonnet about quick-fix promises to health or weight loss. Most of them, to be perfectly frank, are hogwash. There are no simple solutions to complex issues of health and lifestyle. Healthy eating cannot be summarized in single sound bites, like "avoid carbs" or "drink red wine." If it were that simple, we'd all be fit and healthy at the snap of our fingers. Maybe you're thinking of trying a low-carb/high-protein (and thus usually high-fat) diet to lose weight. The truth is that some fats in excess cause heart disease. A skinny waistline is great, but not at the risk of a heart attack or stroke. Drinking a little alcohol regularly does reduce some heart problems, that's true. But too much alcohol weakens the heart and causes high blood pressure and irregular heartbeats. We don't offer quick-fix solutions at Pritikin, because we know better. We know that fads (low-carb), half-truths ("olive oil is good for you"), and popular impressions (anything "natural" must be healthy) are all tempting in their simplicity, but ultimately misleading. Heart Disease Is a Community Concern We share our physical and emotional health with everyone around us. Think about it: if you cook unhealthy food or take your family to fast-food restaurants, you are propagating obesity, diabetes, and heart disease. If you smoke, you are turning the people around you into secondhand smokers, and your children are more likely to follow you down that deadly road and become smokers themselves. If you drive five blocks to a store instead of walking, you are adding to our already clogged roads and overflowing parking lots and polluting our already smog-filled air. Your lost days of work due to illness put a strain on your coworkers and company (not to mention your wallet). As great as this country is, we have too much obesity and physical inactivity, too many workaholics, and too few people living joyously. If our typical fast food were really delicious and nutritious, I could better tolerate the obesity. If we had great longevity, I could better tolerate the inactivity. If we were broadly happy, I could better tolerate our obsession with work. In short, we Americans deserve to live better, and we need to for the sake of our health, our happiness, and all those around us. KNOW YOUR LIFESTYLE STATS If you came to the Pritikin Center, one of the first things you would be asked to do is outline (or, in some cases, admit) your current lifestyle and health status. Shortly after your arrival, we would do a complete physical exam and lab analysis. This is where we start, because those are the true indexes of health. As the old saying goes, you don't know where you need to go until you know where you are to begin with. We have a team of some of the finest doctors, exercise physiologists, nutritionists, and psychologists in the world that would assess your health from every angle. Since you're likely reading this book from the comfort of your living room rather than the Pritikin campus, we'll have to quiz you on your lifestyle stats on paper instead. You're on the honor system, now -- no cheating! Ask yourself these questions: 1. Do you weigh more than 155 pounds at five feet six inches tall, more than 169 pounds at five foot nine, or more than 184 pounds at six feet? If so, you are overweight. Sorry, but it's true. Obesity is a fast track to heart disease, diabetes, and depression. 2. Is your weight concentrated around your middle? Pick up a tape measure. A waist greater than 40 inches in a man or 35 inches in a woman is the unhealthiest form of obesity. 3. Are Big Macs, fries, and shakes a staple of your diet? Do they know you by name at the local KFC? Just walking into a fast-food joint at least twice a week doubles your chance of getting diabetes. 4. On the subject of slow suicide, do you smoke? For every minute that you smoke, you shorten your life by one minute. (And while we're at it, if your answer to this question was yes, where have you been the last 40 years?!?) 5. Is your cholesterol greater than 150? That may sound like a low number, but anything over 150 can cause heart disease. 6. Is your blood pressure 120/80 or higher? If so, you officially have high blood pressure, which leads to stroke, kidney disease, and heart disease. 7. Are you physically inactive? (Hint: if there's an indentation on your couch from your backside, chances are you're not getting enough exercise!) 8. Are you and those around you pessimistic, stressed, or angry much of the time? Emotional problems very often become physical problems, including heart disease. If you cannot say a hearty no to all these questions, a lifestyle overhaul is in order. You're not alone, though; fewer than 10 percent of Americans score perfectly on this test. The good news is that there's plenty of room for improvement! Case Study: Margaret's First Visit Throughout this book, you are going to meet real patients who have changed their lives for the better. Except for well-known individuals, I have left off their surnames to protect their privacy. Here you'll meet Margaret, whom you'll get to know pretty well. I'll tell you about her first visit now, and about her three subsequent visits later. Her story illustrates how one motivated individual translated the Pritikin philosophy and practices into a better lifestyle. Margaret came to see me concerned about her weight and the possibility of heart disease. With curly brown hair and an open, friendly smile, Margaret looked a lot like many people all of us know and love. As the married mother of two with a full-time job as a paralegal, Margaret's life was busy, and she often ate on the run (sound familiar?). Though she was not chubby as a child and weighed 132 pounds when she got married, Margaret gained 10 pounds with each of her children, and the rest accumulated slowly over the next 20 years. She had already tried several popular diets, but failed to keep off any of the weight she lost. Her mother had died of a heart attack at 58, an age that Margaret was rapidly approaching. Her grandfather had died suddenly even younger. Fortunately, Margaret did not have any symptoms pointing to heart disease. I didn't find anything overly worrisome when I examined her, except that she stood 5 feet 4 inches tall and weighed 172 pounds -- an all too typical American combination. Margaret carried most of her extra 40 pounds around her waist, which measured a not-so-svelte 37 inches. Her blood pressure was 138 over 86, which she had been told was normal (it isn't; it's too high). I ordered a cholesterol panel and a fasting blood sugar, but I already knew that Margaret needed to lose weight and lower her blood pressure if she wanted to get on a heart-healthy track. On her first visit, I went through my Pritikin checklist of reasons why people are overweight: 1. I asked Margaret how often she drank high-calorie beverages, such as regular soda, fruit juice, coffee with sugar and cream, and alcohol. Happily, this wasn't an issue. She drank only water or diet soda and used low-calorie sweetener in her coffee. At most, she drank two glasses of wine on Fridays and Saturdays when she dined out with her husband. I marked "OK" next to beverages. 2. I asked some specifics about her diet, most specifically about two of the cornerstones of the Pritikin diet: salads and soups. Margaret told me that she had a salad two or three times a week for lunch and always a small salad and vegetables with dinner. But, like many people, she was drowning her salad in high-fat dressing (two packets equals a whopping 400 calories) and sprinkled cheese (another 100 calories). In reality, her salads were the dietary equivalent of cheeseburgers camouflaged by a few greens. As for soups, Margaret liked the canned variety, such as chicken and minestrone. In the cattle world, these would be considered salt licks. I wrote "needs a little help with salad dressing and salt." 3. Next, we talked about calorie-dense foods -- that is, foods packed with calories. Margaret asked what that meant. The exact definition of calorie-dense is having more than 500 calories per pound of food. It's a safe bet that any foods preferred by teenagers or sold in fast-food franchises are calorie-dense. Meats, cheese, chips, junk food, and desserts are calorie-dense. By contrast, fruits, vegetables, and soups are generally calorie-light. I tried to get a sense of her portions of calorie-dense foods. Did she eat half a bagel scraped with margarine for breakfast, or a whole bagel laden with cream cheese? (Answer: the whole bagel.) Did she regularly eat at fast-food restaurants? (Answer: at least twice a week.) Did she polish off her steak, French fries, and death-by-chocolate dessert when she ate out, or would she routinely leave food on her plate and/or take home a doggy bag? Like many of us, Margaret's mother must have taught her to clean her plate, because she never left anything, even in restaurants notorious for humongous entrée and dessert portions. (Rule of thumb: if a plate is bigger than your torso, it's too much food.) I noted "needs help with calorie density." 4. What about snacking? Did Margaret keep junk food around the house and office? Did she snack while driving or watching TV? Was a movie not quite the same experience for her without Milk Duds and a tub of buttered popcorn? I often don't get an honest answer to that question, but Margaret maintained that she didn't have a sweet tooth and that she rarely snacked at work or home. She got an "OK" on snacks. 5. Lastly, we discussed exercise. Margaret had played high school tennis and did aerobics when she was first married, but like so many busy people, stopped all exercise after she had her first child. She drove to and from work and sat long hours at her desk. Instead of walking her dog like she used to, she simply let her out into the backyard in the morning. Evenings were spent in front of the TV, or curled up with a good mystery novel. I wrote and underlined "couch potato" next to exercise. Like many of the people we see at Pritikin, Margaret thought that she ate reasonable amounts of pretty good food. She didn't understand why she continued to gain weight, especially because she liked salads, drank only diet beverages, and never snacked. Still, Margaret was not following three key weight-loss essentials that we teach: limiting calorie-dense foods, avoiding fast food, and getting daily exercise. She also needed to eat more and better salads and soups and cut down on her salt intake. Although she was practicing some of the Pritikin essentials (she didn't smoke, and seemed to manage her stress level well), I explained that she needed to start practicing all of them if she wanted to get her health on track. We went to work. I told Margaret that, assuming she was typical of our Pritikin guests, she could expect to shed about ten pounds in the first three weeks if she followed my recommendations. After that, I didn't want her to lose any more than three to four pounds each month until she reached her goal of 40 pounds. It would probably take her about a year to do this, which was fine with me; the goal here was not just to lose the weight, but to keep it off for good . We started by tackling the calorie-density issue. I outlined a diet of calorie-light salads, soups, whole grains, vegetables, and fruit, and instructed her to cut back on calorie-dense, refined carbs and fatty foods. I assured her she would not be hungry. "How many calories a day should I eat?" Margaret wanted to know. My answer surprised her. I told her I didn't want her to count calories. "Then how will I know if I'm eating too much?" she protested. "Simple," I said. "You won't be losing weight." My instructions for Margaret included filling up with bigger salads for lunch and dinner. Emphasis on BIGGER! (I joked that the salad bowls at the Pritikin Center come with diving boards at one end.) She could add beans and other vegetables to the salad, but needed to leave off the cheese and fat-laden dressing, or better yet, convert to low-calorie dressings, lemon juice, or tasty balsamic vinegar. If she started with a big salad, she would naturally eat less calorie-dense food later in the meal, and thus lose weight. The science is simple: 100 fewer calories per day means 10 pounds lighter in a year. I told her to forget fast food of any kind. If she was in a hurry, she should go to the deli section of a supermarket, where she could better control her food portions and ingredients. My friend Dr. Bill Castelli quips that when you go through the "golden arches," the "pearly gates" aren't far behind. That resonated with Margaret, especially in view of her mother's history. As for salt, I told Margaret to season her food with anything but. Other spices, lemon juice, and vinegar were fine. Lastly, I told her to invest $20 in a pedometer and measure how much she walked each day for a week. Then she needed to increase her total walking by 3,500 steps, or about two miles a day. Again, simple math: one more mile walked per day means 10 pounds lighter in a year. The whole visit took less than an hour. Margaret took her instructions and headed out the door, filled with determination. I told her to come back and see me in a month to see how she was doing. Stay tuned. Your Lifestyle IQ As you can see from Margaret's story, often we think we know more about what's healthy than we really do. Let's test your lifestyle knowledge. 1. Which is healthier for you, olive oil or canola oil? 2. What is the best dietary advice for your heart: eat less fat, eat more fiber, or eat more fish? 3. How much more would you weigh in five years if you ate one more 100-calorie cookie every day? 4. Which contains more sodium, a portion of cornflakes or a portion of potato chips? 5. Who describes his or her life as less enjoyable, an obese child or a child with cancer? 6. Who benefits more from exercise, a middle-aged person or an elderly person? 7. Is happiness life-saving? Question 1: Which is healthier for you, olive oil or canola oil? Everyone knows that olive oil is good for your heart. Right? Surprisingly, it's actually the omega-3 loaded oils, such as canola, walnut, flaxseed, and fish oils, that have been proven in scientific studies to save lives. Olive oil is better than butter, for sure, but canola oil is even better. Question 2: What is the best dietary advice for your heart: eat less fat, eat more fiber, or eat more fish? In a large British trial, eating less fat, more fiber, and more fish were compared. Eating less fat and more fiber had no effect on mortality, but eating more fish reduced deaths by about 30 percent, mostly because it reduced heart disease. Eating more fish and other omega-3 rich foods is the best dietary advice for your heart. Question 3: How much more would you weigh in five years if you ate one more 100-calorie cookie every day? What's a measly little 100 calories, right? Well, consider this: one additional 100-calorie cookie per day is almost one added pound per month. In five years, you would add 50 pounds just by eating an extra cookie every day. Ultimately, that is terrific news, because it tells you how easy it is to lose weight, even if slowly. Take just one cookie out of your diet and you will lose 50 pounds in five years. We recognize, of course, that you neither want to get thin nor rich slowly. You want to be rich and thin by next Thursday. The truth is that you have almost as much chance of winning a lottery as permanently losing weight by crash dieting. Question 4: Which contains more sodium, a portion of cornflakes or a portion of potato chips? One ounce of cornflakes contains more than 200 milligrams of sodium, even before you add milk. Potato chips vary by manufacturer, but generally contain between 120 and 180 milligrams of sodium per ounce. Most of the high blood pressure generating sodium in our diet is hidden in processed foods we never think of as salty. Canned food and soups are especially loaded with sodium. Question 5: Who describes his or her life as less enjoyable, an obese child or a child with cancer? Obesity in America has exploded in the last 20 to 30 years. Teenagers today are 31 pounds heavier than they were 30 years ago. This is a huge medical problem because, as we already know, obesity is the fastest path to heart disease, high blood pressure, stroke, and diabetes. Jolly fat people exist only in fairy tales. In a recent study, obese children ranked their quality of life on par with children undergoing treatment for cancer. Obesity is anything but enjoyable. Question 6: Who benefits more from exercise, a middle-aged person or an elderly person? The FDA would approve the drug equivalent of exercise in about two minutes flat. Physical activity not only reduces obesity, it slows aging and picks up our spirits. We live an hour longer for every hour we spend physically active. Unfortunately, we have become the ultimate sedentary society. We endlessly circle parking lots looking for the closest parking spot. We panic when we lose the remote control and -- heaven forbid! -- actually have to stand up to change the channel. Our children play video games rather than outdoor games. Yes, our children need to be more physically active, but the original question was about us old farts out there, who are the ones who benefit the most from exercise. In the Honolulu Heart study, middle-aged men had 17 percent less heart disease if they walked 30 minutes daily, but elderly men had 50 percent less heart disease. The older we get, the more we need to exercise. Question 7: Is happiness life-saving? You already know that stress is unhealthy. Sudden deaths triple in the year after a spouse's demise; Mondays and earthquakes both double the incidence of heart attacks. Just as stress, anger, and social isolation accelerate heart disease, joy and mirth can impede its attack. The bottom line here is that the head is connected to the heart in more ways than one. Enjoying life is a great way to keep your ticker strong and healthy. Happy Life, Healthy Heart * In one 10-year study, 1,300 men were evaluated on their optimism. The most optimistic men turned out to have half as many heart problems as the pessimistic men. * In a recent Dutch study of elderly individuals, the happiest participants were half as likely to die over a nine-year period. In other words, the pessimists were twice as likely to kick the bucket. * In a four-year study, 189 heart-failure patients who were happily married died half as frequently as those in unhappy marriages. How did you do on these questions? If you answered all seven correctly, congratulations! If you got some of them wrong, it's perfectly understandable; most of us don't have the facts in hand that can improve and lengthen our lives. The good news is that they are all here in these pages. START TODAY, IMPROVE TOMORROW Some of my patients look at me when I talk about lifestyle as if to ask, "How much time do I have before I really need to start listening to you?" I remind them that a weekend of salads does not immediately undo years of cheese-steak hoagies. Meaningful, long-term changes make big differences, however. If you quit smoking at age 30, the probability is that you will live three to five years longer. When I tell that to my 30- year-old smokers, they tell me that they are not interested in living to 80. Who would want to live to 80? For starters, my 79-year-old patients certainly do. The most compelling reason for starting heart-healthy lifestyle practices at a younger age is that you probably have not yet had a heart attack or stroke. Two-thirds of the time, the first symptom of heart disease is a heart attack -- or worse. Even if you survive your first bout with heart disease, you will be six times more likely to have a rematch. If you already have heart disease, fortunately, the better lifestyle choices you make as of this moment will significantly lower your risk of having another life-threatening event. Just as with obesity, preventing heart disease is much easier than treating it. Trust me, I'm not telling you all this from some doctoral ivory tower. I've lived with the loss of loved ones who didn't take care of themselves. My father-in-law never experienced chest pains; sudden cardiac death was the first sign that he really should quit smoking and bring down his blood pressure. He was 59 years old. So far he has missed the whole of his retirement, three grandchildren, and three great-grandchildren. And those great-grandkids are really cute. If you don't believe me, I'll gladly send pictures. Case Study: Danny, 89 Years Old/Young Danny was a young track athlete at Michigan State in the 1940s. He has raced with the best of the best, even having had the honor of losing to Jesse Owens. By the early 1980s, as a top insurance agent, Danny was doing a different kind of running, working 10- to 14-hour days, eating on the run or not at all, and giving up his jogging schedule to make it all fit in. In 1982, the 64-year-old dynamo suffered a heart attack. Bypass surgery was suggested. Danny refused the surgery, but life was lousy. He was depressed, scared, and bored. Concerned, his rabbi handed him an article about the Pritikin Longevity Center. In April 1983, Danny arrived at Pritikin. The first few days, he couldn't walk more than a block. But at the end of his 26-day program, he was logging 12 to 14 miles daily. His stress tests improved, his cholesterol plummeted from 285 to 147, and his weight dropped from 176 pounds to 159, just three pounds over his college weight. It's now 25 years since that first visit to Pritikin. Danny returns regularly to the center. He takes no medications and has never had another heart problem. Four days a week, he runs three miles. Twice weekly, he lifts weights with a personal trainer. And three days a week, he still takes care of clients, supervising one office in Florida and another in Connecticut. "In those three days, I accomplish more than I used to accomplish in seven," laughs the spry 89-year-old. "I'm still a young man!" KEY POINTS TO REMEMBER* Heart disease is best prevented through lifestyle changes. * For optimal results, you need to adopt all of the 10 Pritikin lifestyle essentials. * Lifestyle changes are far preferable to medications. * You need to know your lifestyle stats to enable you to understand and appreciate fully why you are making these essential lifestyle changes. * Get started today. The sooner you start living better, the more significantly you reduce your risk of having a life-threatening coronary event -- and the greater your chances are of living that long, delicious life that made you pick up this book in the first place!Copyright (c) 2008 by Dr. Robert Vogel and The Pritikin Organization, LLC Excerpted from The Pritikin Edge: 10 Essential Ingredients for a Long and Delicious Life by Robert A. Vogel, Paul Lehr All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.