NEWS

How to Stay Free of Heart Disease

January/February 2003

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John Cooke tosses almonds and walnuts on his salads. He also runs a lot. And pops the occasional dietary supplement. All of which ensures that his endothelium is pumping out steady doses of nitric oxide to keep his body healthy.

Endo-what?

That would be the thin film that lines the insides of blood vessels. If you flattened a person’s endothelial cells, they would cover six tennis courts; if lumped together, they would constitute the body’s largest organ. “The endothelium is a hot topic right now in cardiology,” says Cooke, an associate professor of medicine and director of Stanford’s vascular medicine program. “People are beginning to realize that it exerts tremendous control over vascular tone and vascular structure.”

Cooke and Judith Zimmer recently published The Cardiovascular Cure: How to Strengthen Your Self-Defense Against Heart Attack and Stroke (Random House, 2002). The premise of the book, which advocates changes in nutrition, exercise and medication, is that restoring endothelial health can prevent hardening of the arteries and virtually eliminate cardiovascular disease.

The book explains how nitric oxide, an air pollutant when it’s outside the body, provides a host of benefits inside. As the body’s self-manufactured heart medicine, it relaxes blood vessels and makes the endothelium behave more like Teflon (good, because nothing clings while passing through the blood vessels) and less like Velcro (bad, because white blood cells and platelets may stick).

“When I was a [postdoctoral] fellow, angioplasty was the answer for coronary disease, and if you saw a narrowing, you’d dilate it,” Cooke recalls. “But now I think we have a much better idea of when angioplasty is useful and when it’s not.” Still, he says, “I think there is not enough emphasis on prevention today.”

In Cooke’s book, ounces of prevention are measured in recipes for tofu and bacon scrambler, zucchini frittata, Moroccan red snapper and bulgur pilaf. “I think you can have really nice, palatable, healthy meals,” he says. “It’s not as difficult as an ultralow-fat diet, and more healthy for you than the [low-carbohydrate, high-protein] Atkins diet.”

Do his four children like the meals? “They’re teenagers. Need I say more?”

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