This protocol is about protecting the cardiovascular system and brain from further damage while actively creating the conditions for repair and resilience. The goal is not just to avoid heart disease/dementia but also to build a strong, efficient, flexible circulatory system that supports energy, cognition, hormonal balance and longevity. What you do each day consistently matters more than any single intervention.
Understanding what we are trying to prevent
Atherosclerosis is the gradual build-up of plaque inside the arteries. This plaque is not just cholesterol. It is a mix of oxidised lipids, inflammatory cells, calcium and connective tissue. Over time it narrows blood vessels and restricts blood flow. The danger is not only blockage but rupture, where a plaque breaks open and forms a clot that can trigger a heart attack or stroke. This process is strongly influenced by inflammation, insulin resistance, oxidative stress and poor lifestyle habits.
Arteriosclerosis is different. It refers to stiffening and loss of elasticity in the artery walls. Think of it as the hose becoming rigid rather than blocked. When arteries stiffen, blood pressure rises and the heart has to work harder. Age contributes, but metabolic dysfunction, mineral imbalance and chronic inflammation accelerate it significantly.
Dementia
Dementia is a broad term for a group of conditions that cause a progressive decline in brain function, affecting memory, thinking, reasoning, language, and the ability to perform everyday activities. It occurs when brain cells are damaged or lost, disrupting communication between different areas of the brain, and symptoms typically worsen over time rather than appearing suddenly. Dementia is not a normal part of ageing, although the risk increases with age, and it can be caused by various diseases and conditions, most commonly Alzheimer’s disease, along with vascular damage, inflammation, and neurodegeneration, all of which can impact a person’s independence, behaviour, and quality of life.
Drivers of poor Cardiovascular health
1. Understanding Cholesterol
Understanding the different types of cholesterol is critical because “cholesterol” is not a single substance acting in isolation. It is a transport system made up of particles carrying fats through the bloodstream. The behaviour, size, number and condition of these particles matters far more than the total amount.
Cholesterol itself is not floating freely in the blood. It is packaged into lipoproteins, which are essentially transport vehicles. These vehicles have different roles, sizes and risk profiles.
LDL cholesterol
LDL stands for Low Density Lipoprotein. It is often labelled “bad cholesterol” but this is an oversimplification. LDL is not inherently bad. It is a delivery system that transports cholesterol from the liver to tissues where it is needed for hormone production, cell membranes and repair.
The issue is not LDL existing. The issue is
Too many LDL particles
Small dense LDL particles
Oxidised LDL particles
LDL in an inflammatory environment
Large buoyant LDL is generally less harmful. Small dense LDL is more likely to penetrate the arterial wall and become oxidised. Oxidised LDL is what triggers immune response and plaque formation. This is why insulin resistance, smoking, processed foods and chronic inflammation are such strong drivers of cardiovascular disease. They damage the LDL, not just increase it.
HDL cholesterol
HDL stands for High Density Lipoprotein and is often called “good cholesterol.” HDL acts like a recycling and clean up system. It transports excess cholesterol away from tissues and arteries back to the liver for processing and elimination. Higher HDL levels are generally associated with lower cardiovascular risk, but function matters more than number.
You can have normal or even high HDL that is dysfunctional if inflammation, oxidative stress or metabolic dysfunction is present. HDL quality is influenced by exercise, omega 3 intake, sleep quality and overall metabolic health.
Triglycerides
Triglycerides are not cholesterol but they are always discussed alongside it because they reflect how the body is handling energy and carbohydrates. High triglycerides usually indicate excess sugar intake, insulin resistance, poor metabolic flexibility or excessive alcohol intake.
High triglycerides often correlate with small dense LDL and low HDL. This combination is one of the most concerning lipid patterns because it reflects metabolic dysfunction rather than just isolated cholesterol elevation.
ApoB
ApoB is one of the most important markers yet is often overlooked. Each atherogenic lipoprotein particle such as LDL and VLDL carries one ApoB molecule. Measuring ApoB tells you the number of potentially artery penetrating particles, not just the amount of cholesterol they are carrying.
You can have normal LDL cholesterol but high ApoB. This means you have many small particles carrying a moderate total amount of cholesterol, which increases risk. ApoB is a far better predictor of cardiovascular risk than total cholesterol alone.
Non HDL cholesterol
Non HDL cholesterol is total cholesterol minus HDL. It represents all potentially atherogenic particles combined. It is a simple but useful marker when ApoB is not available because it gives a broader picture of risk than LDL alone.
VLDL
VLDL stands for Very Low Density Lipoprotein. It primarily transports triglycerides rather than cholesterol. Elevated VLDL often reflects poor carbohydrate metabolism, excess calorie intake and insulin resistance. It contributes to the formation of small dense LDL over time.
Lp(a)
Lipoprotein(a) is largely genetic and acts like an LDL particle with an added protein attached. Elevated Lp(a) increases clotting tendency and plaque formation risk. Lifestyle improvements help overall cardiovascular health but Lp(a) is less responsive to diet and exercise compared to other markers. It is worth testing at least once in life to understand inherited risk.
Particle size and density
Not all LDL particles are equal.
Large buoyant LDL is less likely to enter the artery wall.
Small dense LDL is more likely to penetrate the endothelium, become oxidised and trigger inflammation.
Particle size is heavily influenced by diet and metabolic health. High sugar intake, refined carbohydrates and insulin resistance push LDL toward the small dense pattern. Strength training, reducing processed carbohydrates and improving insulin sensitivity tend to shift LDL toward larger, less harmful particles.
Oxidised LDL
This is the most dangerous form. Oxidation occurs when LDL particles are damaged by free radicals, smoking, pollution, poor diet and chronic inflammation. The immune system recognises oxidised LDL as a threat and initiates plaque formation. This is why antioxidants, nutrient dense foods and anti inflammatory lifestyle habits are so important. The damage to LDL is often more critical than the absolute level.
Putting it into perspective
Cholesterol is not simply good or bad. It is functional or dysfunctional depending on the environment it exists in. A person with moderately elevated LDL but low inflammation, good insulin sensitivity, strong HDL function and low ApoB may have a lower risk than someone with “normal” LDL but high triglycerides, high ApoB, insulin resistance and chronic inflammation.
The goal is not blindly lowering cholesterol numbers. The goal is improving particle quality, reducing particle number where excessive, lowering inflammation, supporting endothelial function and correcting the upstream drivers such as poor diet, sedentary behaviour, sleep deprivation and chronic stress.
When the metabolic environment improves, cholesterol patterns often improve as a downstream effect rather than the primary target.
Step one is measure before you guess
You cannot manage what you do not measure. Establish a baseline so decisions are data driven rather than emotional.
Essential blood testing
Full lipid panel
ApoB
Lp(a) at least once in life
hs CRP for systemic inflammation
Fasting insulin and fasting glucose
HbA1c
Homocysteine
Vitamin D
Liver and kidney function
Omega 3 index if available
Thyroid panel if fatigue or metabolic issues are present
Imaging and functional assessment
CAC scan every three to five years depending on risk
Carotid ultrasound if family history or elevated risk markers
Resting and home blood pressure monitoring
Body composition analysis rather than only body weight
Exercise tolerance or stress testing if symptoms or strong family history
2. Nitric oxide and vascular function
Nitric oxide is a signalling molecule produced by the lining of the blood vessels called the endothelium. It is one of the most important molecules for cardiovascular health. Nitric oxide relaxes and dilates blood vessels, improves circulation, supports healthy blood pressure, enhances oxygen delivery and protects against platelet aggregation.
Low nitric oxide levels are associated with endothelial dysfunction, hypertension, erectile dysfunction and increased cardiovascular risk.
Nitric oxide production declines with age, poor diet, inactivity and oxidative stress. Fortunately, it is highly responsive to lifestyle and nutrition.
Ways to naturally increase nitric oxide
Ultimate cardio and Boost 3 naturally stimulate Nitric Oxide production
- Regular exercise especially interval and resistance training
- Leafy green vegetables such as spinach, rocket and kale
- Beetroot and pomegranate
- Citrus fruits and vitamin C rich foods
- Adequate dietary nitrates from vegetables rather than processed meats
- Nasal breathing and good oral hygiene without excessive antibacterial mouthwash which can disrupt beneficial bacteria
- Sunlight exposure and circadian rhythm alignment
- Reducing chronic stress and sympathetic overload
3. Inflammation
Chronic inflammation is a central driver of cardiovascular disease because it damages the inner lining of blood vessels (the endothelium) and sets the stage for plaque formation. When inflammation is present, immune cells and inflammatory chemicals circulate through the bloodstream and infiltrate artery walls, making them more permeable to cholesterol particles, particularly LDL. These particles become oxidised within the vessel wall, triggering an even stronger immune response and leading to the development of fatty streaks that can evolve into atherosclerotic plaques.
Over time, ongoing inflammation causes these plaques to grow and become unstable. Inflammatory signals weaken the fibrous cap that normally keeps a plaque intact, increasing the risk that it will rupture. When rupture occurs, the body treats it like an injury and rapidly forms a blood clot, which can partially or completely block blood flow. This is the mechanism behind most heart attacks and many strokes, explaining why inflammation is now recognised not just as a contributor, but as a key underlying process in cardiovascular disease progression.
4. Metabolic Syndrome
Metabolic syndrome accelerates this process by creating a constant pro-inflammatory and pro-atherogenic environment in the body. Insulin resistance, excess visceral fat, elevated blood sugar, abnormal cholesterol levels, and high blood pressure all interact to increase oxidative stress and inflammatory signalling. Fat tissue—especially around the abdomen—actively releases inflammatory molecules, while insulin resistance worsens lipid abnormalities and endothelial dysfunction. Together, these changes dramatically increase the speed at which atherosclerosis develops and significantly raise the risk of heart attack, stroke, and other cardiovascular events.
5. Movement and physical conditioning
The heart is a muscle and the vascular system thrives on movement. Exercise improves endothelial function, insulin sensitivity, blood pressure and mitochondrial efficiency. When we don't move enough, our cardiovascular system becomes weak.
Daily walking as a non-negotiable baseline
Resistance training two to four times per week to maintain muscle mass and metabolic health
Aerobic conditioning such as cycling, swimming or jogging
Short bursts of higher intensity intervals if medically appropriate
Mobility and flexibility work to maintain joint and fascial health
Consistency is more important than intensity
6. Sleep and nervous system regulation
Poor sleep and chronic stress are major drivers of inflammation and arterial damage. Hormonal balance and cardiovascular repair occur primarily during deep sleep.
Aim for seven to eight hours of consistent sleep
Keep regular sleep and wake times
Reduce blue light exposure in the evening
Use breathwork, meditation or time in nature to reduce sympathetic nervous system overload
Avoid constant stimulation and overtraining
Putting it all together as a practical protocol
Remove the drivers of damage
Eliminate smoking and vaping
Moderate alcohol intake
Improve Sleep
Minimise exposure to environmental toxins where practical
Address chronic infections or inflammatory conditions with appropriate medical guidance
Exercise Regularly
Eat balanced and unprocessed
Nutrition as daily medicine
The cardiovascular system responds profoundly to dietary patterns. The aim is to reduce inflammation, improve insulin sensitivity and provide the raw materials for cellular repair.
- Base the diet around whole unprocessed foods
- Prioritise colourful vegetables at every meal
- Adequate high-quality protein from fish, eggs, poultry, lean meats or plant sources if preferred
- Healthy fats such as extra virgin olive oil, avocado, nuts and seeds
- Regular intake of omega-3-rich fish such as salmon, sardines or mackerel
- High fibre intake from vegetables, legumes and some whole grains if tolerated
- Minimise refined sugars, sweetened drinks and excessive alcohol
- Reduce ultra-processed foods and industrial seed oils where possible
- Stay hydrated consistently rather than in bursts
Carbohydrate intake should match activity levels and metabolic health. Those with insulin resistance or elevated triglycerides generally benefit from moderating carbohydrate intake and focusing on low glycaemic sources.
Targeted natural support
Nutrients and botanical compounds can provide meaningful support when layered on top of lifestyle foundations. They are adjuncts, not replacements.
Vitamin K2
Supports correct calcium placement into bones rather than arteries. Particularly valuable when combined with vitamin D and magnesium.
CoQ10
Essential for mitochondrial energy production in the heart muscle. Important for anyone over forty and especially for individuals using statin medications. Supports energy and antioxidant protection.
Omega 3 fatty acids
Reduce inflammation, support triglyceride reduction and improve endothelial function.
Magnesium
Assists blood pressure regulation, vascular relaxation and insulin sensitivity.
Garlic, berberine and plant sterols
Can assist lipid balance and metabolic regulation when used appropriately.
Ultimate Cardio
Designed as a comprehensive cardiovascular support formula addressing circulation, endothelial integrity, antioxidant protection and lipid balance. Best used alongside testing and lifestyle optimisation rather than as a standalone strategy.
Boost 3
Boost 3 supports metabolic and cardiovascular health by improving the internal environment that drives cholesterol behaviour, energy production, and vascular function rather than simply targeting cholesterol levels. By supporting mitochondrial function, antioxidant defences, and nitric-oxide pathways, it may help reduce oxidative stress, improve circulation, and support endothelial health.
Used alongside proper nutrition, resistance training, good sleep, and blood sugar control, Boost 3 helps shift the body away from inflammation and insulin resistance toward better metabolic flexibility, where cholesterol particles are less likely to become damaged—working best as part of a structured lifestyle protocol rather than a standalone solution.
Summary
The long-term objective is to reduce systemic inflammation, improving metabolic flexibility, maintain arterial elasticity and ensuring minerals and lipids are managed correctly. Small consistent actions performed daily compound over years into meaningful protection. Cardiovascular health is not built in a month. It is built through disciplined, informed habits sustained over decades.
If you would like personal guidance with your health then the Butterworth Health Optimisation Program could be a good fit for you. To learn more click here
