Let’s stop waiting to measure heart health until there’s already damage.

Heart disease is slow-moving, largely preventable, and in many cases, reversible. Yet it’s still the #1 killer of women—and nearly half of American adults have some form of cardiovascular disease (Circulation, 2019). We should be ahead of this by now. Somehow, we’re not.

Everyday inputs—stress, diet, movement—shape heart health in profound ways. But most of us aren’t testing the right markers, or we’re testing too late. The traditional medical system tends to intervene only after disease has taken hold.

The smarter approach? Personalized, proactive medicine: test the right markers, track them over time, take action early.

This is especially crucial for women. Even those who lift weights, eat protein, and get their fiber dialed in often still struggle with rising cholesterol.

Important reminder: We need cholesterol—it’s the raw material for our sex hormones. But the goal is to get ApoB under 80, the threshold that protects against future heart disease.

This week, we’re breaking down what to measure, why it matters, and how to protect your heart for the long haul.

🤓 What to know: Start measuring heart health at 25. Yes, 25. 

Heart health is measurable. When you catch changes early, it’s easier to prevent disease.

Doctors often use the ASCVD risk score (age, cholesterol, diabetes, smoking) to decide if you need a statin. It’s a solid starting point but in practice, I find it can be overly reassuring.

Here’s what I test instead:

🧪 Bloodwork: Start at 25 (or 35 if cost is a barrier)

• ApoB → Directly measures artery-clogging particles; the #1 predictor of heart disease risk. 

⭐Goal: < 80

• Lipoprotein(a) → A genetic cholesterol variant that doubles your risk if elevated (Cardiovascular Diabetology, 2024).

⭐Goal: < 30 

• Triglycerides → Linked to atherosclerosis.

⭐Goal: < 90

• Metabolic markers → Metabolic syndrome doubles the risk of heart disease.

⭐Optimal HbA1C: < 5.2; Optimal fasting glucose: 70-85 ; Optimal fasting insulin: 2-5

• hs-CRP → A measure of vascular inflammation. 

⭐Goal: <1.0.

• Advanced Lipids (NMR) → Shows several measures including LDL particle size.

⭐Small = damaging, large = less harmful.

⌚ Wearables & functional biometrics

• Resting heart rate → Persistent elevation can flag thyroid or cardiac issues. 

⭐Optimal: 50–70 bpm.

• VO₂ max → A top predictor of long-term heart health; a 3.5-point increase cuts mortality risk by 11–17% (British Journal of Sports Medicine, 2024). 

⭐Optimal: Top 25% for your age & gender.

• Blood pressure → Silent but deadly. Track it at least every 6 months—or more often if you’ve had high readings. 

⭐Goal: 110/70 mmHg

• Arrhythmias → Today’s wearables can catch issues like afib that random ECGs miss.

🔍 Imaging & scans: Catch issues before symptoms

Calcium Score

• Non-contrast CT that reveals calcified plaque.

• Better predictor of heart attack than cholesterol.

• Start at 50—or earlier with family history/high Lp(a).

• Affordable ($100–$250) but misses dangerous soft plaques.

Cleerly scan (CCTA with AI)

• Visualizes soft plaques, which are more unstable and risky.

• Best for those with family history, symptoms, or unexplained high cholesterol.

• Not covered by insurance; $2,000–$3,500.

Cardiac MRI

• Shows heart structure and function.

• Detects scarring, inflammation, or damage.

• For patients with lingering symptoms or post-heart attack recovery.

💪What to do: Test early and support metabolic health.

Testing is just step one. Here’s how to act on it:

✅ Bloodwork every year starting at 25 (or 35 if needed)

✅ Wearables to track trends and catch changes in real time

✅ Imaging by 50, or earlier if you have family history, high cholesterol, or risk factors

All the testing in the world won’t matter if you don’t do anything to protect cardiovascular health. My top recommendations: 

🍎 Eat for metabolic health

• Sugar: under 25g/day

• Fiber: 30–50g/day from veggies, legumes, nuts, seeds, and whole grains

• Protein: At least 0.7g per lb of body weight daily to balance blood sugar

⚖️ Keep visceral fat low

• Belly fat raises risk across the board

• Waist-to-height ratio <0.5

• Get a full-body DEXA scan to assess

🏃‍♀️ Mix cardio, HIIT, and strength

• Zone 2 cardio: 180 min/week to boost fat metabolism and VO₂ max
  

• HIIT: 7% VO₂ max boost in just 8 weeks (Medicine and Science in Sports and Exercise, 2007)
  

• Strength training: Builds muscle, improves insulin sensitivity, reduces fat

💊 Use meds strategically

• Statins: Lower LDL + ApoB. Lifesaving for many with persistent high cholesterol.
  

• GLP-1s: For those with excess weight or insulin resistance. Help lower fat and improve metabolic markers.

🍷 <1 drink/day

• Alcohol raises BP and triglycerides.

• Even alcohol intake is associated with an immediately higher risk of cardiovascular events (within hours) (Circulation, 2016)

🧘 Yoga 3x/week

• Reduces blood pressure, inflammation, arrhythmias, and improves lipids (International Journal of Yoga, 2024)

⚡️ Quick Hits

🧠 HRT timing & Alzheimer’s risk

One of the biggest takeaways from reanalyzing the controversial Women’s Health Initiative HRT data is understanding how protective our hormones are. New data shows starting hormone therapy within 5 years of menopause was linked to a 32% lower risk of Alzheimer’s, while starting at 65+ raised risk by 38% (esp. with progestin). Another reason to be proactive. 

Questions about HRT? Book a free call at Parsley. 

Vitamin D + Exercise = Metabolic Boost

As if we needed another reason to love Vitamin D! A meta-analysis of 18 randomized control trials found that pairing vitamin D supplementation with exercise lowered fasting insulin, improved insulin resistance, reduced triglycerides, and raised HDL more than either approach alone. 

My go-to D3. 

🌫️ Toxic mold: real or hype?

More Americans are attributing fatigue, weight gain, brain fog, and even mood swings to “toxic mold.” Online communities of self-described “moldies” are booming. So how do you know if it’s legit?

Here’s Parsley’s guide to mold toxicity symptoms. 

💛 The Momgevity Files

This week, I’ve been thinking a lot about Dr. Jane Goodall—the anthropologist, chimpanzee expert, and renowned advocate for animals and the natural world—who passed away last week. To me, she defines longevity: both of body (she died at 91 and worked until the end) and of purpose.

I didn’t realize how much she meant to me until she died. She’s someone I’ve been aware of since I was a small child. I remember learning about her in first grade at my girls’ school, and I think I understood, even then, that she stood for the kinds of qualities I could aspire to: passion, intelligence, resilience, fearlessness, grace, and dedication.

While my work doesn’t directly intersect with animal research or conservation, and I hadn’t kept up with her latest activities in recent years, just knowing she was still out there fighting for her cause meant something. Her persistence, through what must have been countless setbacks as well as victories, quietly inspired me more than I knew.

Her passing has made me reflect on my own path. I’ve spent the past decade building Parsley Health, fueled by a 20+ year obsession with transforming human health. Passion, it turns out, requires stamina and sacrifice. I took just two weeks of maternity leave with each of my three children—something I don’t exactly regret, but also can’t quite believe.

Now, as my kids grow older and Parsley approaches its 10-year anniversary, I find myself reckoning with the duality of it all: the joy of purpose, and the cost of relentless pursuit.

Dr. Goodall reminds us that longevity is about more than clear arteries, optimal metabolism, and balanced hormones. Longevity also means sustaining the fire of passion and purpose, those things that make life meaningful. Whether that passion is for raising your children, pursuing work outside the home, or championing a cause close to your heart.

To have real longevity, you have to want to keep going, no matter what. Jane knew she would never truly finish the work, that the cause would outlast her, just as mine will outlast me. But she kept going anyway.

At the end of the day, we can have the healthiest bodies possible, but what really keeps us going is meaning. For me, that continues to be transforming human health. It’s also my children and my family. And it’s being the woman I imagined I could become back in first grade—the one Jane inspired me to be so early on.

My goal is to be her, right up until the end.

Stay strong, stay curious, and breathe, 

Robin

As always, this newsletter is for informational and educational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any health decisions or changes to your treatment plan.