Lights flashing and sirens blaring, the ambulance races toward the hospital. Inside the ambulance, Mary, a middle-aged woman, lies on a gurney, struggling with chest tightness, sweating, and dizziness.

Within an hour of her arrival at the hospital, Mary undergoes an angioplasty procedure: A wire is inserted into her occluded coronary artery, and then the artery is opened by inflating a small balloon inside. Finally, a “stent,” which resembles the small spring inside a ballpoint pen, is inserted in the proximal, left anterior descending (LAD) artery (one of the heart’s main arteries, a.k.a. the “widow-maker”), to prop it open permanently. Blood flow is restored to her heart. Several days later, she walks out of the hospital. The marvels of modern medicine have saved her life.

Though many catastrophic emergencies can now be treated with modern medical techniques, millions of people every year are still diagnosed with chronic diseases, such as diabetes, high blood pressure, heart disease, cancer, and stroke. And these diseases seem to be striking people at a younger and younger age. What is the cause of this epidemic? Do we simply need to have more ambulances and high-tech life-saving procedures? Or is there a deeper reason for this widespread problem? Why is it that the United States spends more money than any other nation on health care, yet it has the fattest, sickest population of any country in the world? Are we ignoring the root causes of chronic disease and simply trying to fix the problem by throwing money at it?

As I have pondered these questions, I have realized that many of my own relatives are in the same predicament as Mary. Even though most of them appear lean, with skinny faces, arms, and legs, they have visible belly fat — prominent bulges in their midsections — fitting the proverbial definition of “thin outside, fat inside” or TOFI, as it is commonly known.

At the same time, in my practice, I have observed that with just a little weight loss — as little as 7 percent of one’s starting weight, or only ten, twenty, or thirty pounds for many people — my patients’ need for blood pressure or diabetes medication can be drastically reduced. Even their heart-related symptoms can improve. As this occurs, they have a lot more fun and freedom. They can say yes to life’s wonderful adventures more often and participate and engage in activities with their children and grandchildren.

I have often thought: Instead of treating a dangerous condition resulting from chronic disease, what if we implemented proven lifestyle changes before the disease reached the critical stage?

When I first started to scour the research, I found mentors in Dr. Joel Fuhrman and Dr. Neal Barnard, who were already working with thousands of people and helping them reverse chronic diseases and regain their vitality. Other really smart colleagues like Dr. Michael Roizen and Dr. Mladen Golubic were getting amazing results, while pushing for change at a policy level. I am immensely grateful to all of them for guiding the way and influencing my thinking about the reversibility of most chronic disease.

Thus, I started to experiment in using lifestyle optimization as the primary treatment for chronic disease. The results have been astounding. When we shift the focus to correcting the lifestyle factors that lead to disease, we are essentially treating the root cause. At that point, we can start thinking about prescription medications and procedures as a supplement to the first priority, which is treating the causes.

What are the five essential lifestyle ingredients that can reverse disease and add years and years to your life?

1. Impeccable nutrition: Eat enough highly nutritious foods that are not calorie dense. This maximizes nutritional content while minimizing empty calories. The food that we need provides fuel as well as information and intelligence from the environment, and it needs to be as nutritionally complete as possible. It needs to be satisfying and delicious because it is our most primal need. We need to be mindful of the toxins from the environment and to choose foods that minimize these toxins.

2. Optimal hormone balance: Eat the right foods and avoid hormonally dangerous ones ( like dairy and alcohol). At the same time, make good lifestyle choices in terms of physical activity, stress management, meditation, and sleep habits to maintain optimal hormone balance.

3. Regular exercise: Move your body with joy and abandon as it is meant to be moved. Find enjoyable physical activities. Exercise also has benefits in terms of brain health — memory and mood — as well as heart health, metabolic, bone, and muscle health. Do you want to know the secret to Turbo Metabolism in three words? Activate big muscles.

4. Stress management and quality sleep: This combination is the foundation of a healthy lifestyle and the most critical emotional-resilience component of this book’s strategy. Toxic load can also be caused by unmanaged repeated and prolonged psychosocial stress and lack of sleep. We need to be mindful of the importance of avoiding toxicity in our physical, psychological, and social environment as well.

5. Social connections: Loving, supportive relationships; meaning and purpose in life; and involvement in family and community can make a huge difference in health and longevity. Meaningful social connections help build emotional resilience, which is a foundation for healthy eating and active living.

When you start to master these five factors — of which nutritional excellence is the most important, lean muscle mass is the key, and emotional resilience is the foundation — you can improve your quality of life, reverse disease, and enhance your health.

Excerpted from the book Turbo Metabolism. Copyright ©2018 by Pankaj Vij, MD. Printed with permission from New World Library —