Live Younger Longer

Death by a thousand cuts
It’s tempting to think that personal health tends to decline all at once. To be
honest, that’s how most of us probably perceive illness. We’re not aware of
the small, silent changes going on inside of our bodies until a heart attack
happens or a tumor becomes noticeable. When the diagnosis hits, it feels
like it’s the diagnosis that has put us over the health precipice and sent us
careening onto a path we didn’t anticipate.

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“I’d be fine If I just wouldn’t have had that single episode of illness.” I hear
this often from my patients. That single episode might be an infection, a
heart attack, a blood clot in the lungs or something else that led to a series
of other medical problems.
Although we often see illness as a single event, it’s no more of a single
event than is wealth. You may see a businesswoman who has a nice car,
house or other signs of wealth. But unless she won the lottery, which is
extremely rare, she probably acquired these things through many years of
steady work.
In the same way, disease often develops over many years. For example, a
heart attack, in most cases, is the culmination of years of chronic
inflammation in the arteries (see “Artery inflammation” on the next page).
The blood vessel lining (endothelium) gradually develops a small area of
damage, which leads to a blood clot. The clot can close off the artery like a
cork in a bottle, cutting off blood supply to the heart and causing a heart
attack. Amazingly, almost half of all heart attacks occur because of a blood
clot lodging in an artery that’s only mildly narrowed.
Likewise, we’re typically not aware of cancer cells growing in our bodies
until a test reveals them or a tumor forms and signs and symptoms appear.
Often, the growth of a tumor takes years to develop. Even Alzheimer’s
disease is now known to develop over many years, even decades, before
symptoms appear.
Most chronic diseases develop over time as the result of a buildup of small
detrimental changes inside the body. One small plaque in a blood vessel
likely won’t kill you. But a long-term buildup of plaques can. The good

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news is that this slow pathway presents an opportunity to stop and even
reverse the progression of disease.
A look inside
What are these small detrimental changes in the body that lead to chronic
illness? Although scientists are still exploring the mechanisms for many
chronic illnesses, a common thread that appears to run through almost all of
them — and a source of intrigue and fascination to many scientists — is a
subtle state of low-grade chronic inflammation.

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The 
endothelium
, a thin layer of cells lining the inside of
your arteries, can be damaged by multiple causes, including
things like smoking, high blood pressure and a poor diet.
The damage activates the body’s immune system, bringing
in immune cells (