The Naked Heart

The bathroom scale has somehow become the judge of whether we're winning or losing at health. It's the wrong judge — and there's a humble £2 tool in your drawer that does the job far better. Read article

One of my cardiology patients — under my care for poorly controlled blood pressure — loses close to a stone in six weeks on a dose below the licensed minimum, with almost no change to his diet. The honest answer to how is the most interesting thing about him, and the reason this series exists. Read full blog

After 60, muscle becomes deaf to protein signals. You need 3 grams of leucine per meal, not just daily totals, to flip your muscle-building switch. Same protein portions that worked at 40 barely register at 70. Threshold dosing with resistance training breaks this cycle. Read full article

Traditional weight loss approaches fail because they treat metabolism as fixed rather than dynamic. The Choice model combines weekly micro-decisions between lifestyle changes and medication adjustments, offering a flexible system that adapts to continuous metabolic changes and breaks the cycle of initial success followed by plateau and regain. https://www.vat-trap.com/post/metabolic-doom-loop-choi...

The four pillars of coronary prevention map directly onto dementia risk reduction through shared vascular mechanisms. Cardiovascular risk factors in midlife predict cognitive decline decades later, making optimal heart health our strongest defence against age-related cognitive impairment and dementia. Read Blog

Done well, a week of home readings is more informative than almost anything that can be measured in a single clinic visit. Here is the method I have used, refined over twenty years — and a free calculator that does the averaging for you. Read the full blog and link to a free blood pressure tool here

Naked Heart is now hosted by Author Dr Leatham's cardiometabolic health channel launched 1st June 2026 www.vat-trap.com. What better topic than a look at recent ACC/AHA guidelines for cholesterol targets and no note that cardiovascular deaths fell 70–80% in sixty years — one of medicine's greatest triumphs. But progress is now slowing. Visceral fat, not LDL-C, is the upstream driver of the four re...

Grip strength measurement reveals cardiovascular risk more accurately than traditional markers by reflecting muscle function as endocrine organ. Declining strength drives coronary disease through inflammatory pathways. Progressive resistance training provides powerful cardiovascular protection.

When a patient arrives breathless and unable to climb a hill, the instinct is to blame the heart. Sometimes the answer lies in the blood itself. Iron deficiency anaemia reduces oxygen delivery, forces the heart into a hyperdynamic state, and can even produce a murmur over a completely normal valve. Read blog

What if the heart works like a hybrid engine? Continuously switching between fatty acids, glucose, and ketones, it optimises fuel use for efficiency and demand. But in metabolic disease, this flexibility is lost. The result: poorer fuel, narrowed supply lines, and a strained engine — a new way to understand cardiovascular risk. Read the full blog Naked Heart Podcast series

This N-of-1 article explores a simple hypothesis: erectile dysfunction in many men may reflect reversible metabolic disruption driven by visceral fat rather than fixed arterial disease. By tracking waist reduction and symptoms over time, individuals can test whether improving metabolic health restores endothelial function, drug response, and erectile reliability. Read blog https://feeds.transistor...

Groundbreaking research from Oxford University reveals it is possible to detect and quantify ‘coronary inflammation’ – invisible to the human eye on conventional CT images, but detectable using artificial intelligence techniques. Read story

Coronary heart disease often presents without warning, making early prevention essential. This article outlines a personalised approach to identifying individual risk, detecting underlying coronary inflammation and plaque, and implementing structured preventive strategies. Combining risk scoring, advanced imaging and holistic management, we help patients reduce the likelihood of future heart event...

N-of-1 medicine shifts the focus from population averages to personal biology. This blog series explores how individuals with curiosity can run simple, safe self-experiments — using themselves as the control — to test plausible health hypotheses, track meaningful outcomes, and discover what genuinely improves their own health and wellbeing over time. To view the blog To see Naked Heart Podcast ser...

HIIT interrupts this cycle by dramatically improving insulin sensitivity and glucose uptake in skeletal muscle — particularly in the large lower-limb muscles of the thighs and glutes. A single 20-minute session of HIIT can activate GLUT-4 transporters in muscle cells for up to 24–48 hours, drawing glucose out of the bloodstream and away from storage in the liver and visceral fat depots. Read full...

Mitochondria are the power stations inside every cell, converting food into energy. But in modern life, with constant carbohydrate intake and low energy demand, they become overwhelmed. Just like solar panels producing too much electricity for full batteries, mitochondria have nowhere to send surplus fuel. This triggers oxidative stress, inflammation, and early ageing. Insulin is meant to divert e...

Troponin-negative chest pain presentations are often sent home without a timely work up or prompt imaging tests like a CT angiogram.  A delay can be critical. As clinicians, we must identify which patients need further testing urgently. Where clinical suspicion is high, irrespective of troponin rise doctors and health commissioners should prioritise resources, so that an accurate diagnosis can to...

Before birth, the foramen ovale is a vital foetal opening between the right and left atria, allowing oxygen-rich placental blood to bypass the inactive lungs. After the first breath, pressure in the left atrium increases, closing the flap naturally. In around 25% of adults, the flap does not seal fully — this persistent communication is called a Patent Foramen Ovale (PFO) which is an important cau...

If you have ever found yourself feeling breathless climbing stairs or walking uphill — even though your lung and heart tests are “normal” — you are not alone. Many people attribute it to age or fitness. But recent research has uncovered a powerful hidden cause of breathlessness: visceral fat — the fat stored deep inside your abdomen, around your organs. In this blog, we will explore what visceral...

“For every threat that rises against us, humanity answers with a greater invention. Show us the enemy, and we will forge the remedy.” For much of modern cardiology, in its battle against coronary artery disease—one of mankind’s greatest threats—the “enemy” seemed clear. When I trained, the diagnostic armoury was focused on accurately identifying flow-limiting narrowing of one or more coronary arte...

How an ILR Works An ILR is a matchstick-sized device implanted under the skin of the chest, usually under local anaesthetic in a brief outpatient procedure. Once in place, it continuously monitors the heart’s electrical activity, storing recordings of any abnormal events it detects automatically or when triggered by the patient using a handheld activator. Modern ILRs have: Automatic arrhythmia det...

In the evolving world of preventative healthcare, one size no longer fits all. We are learning that each person has a unique biological blueprint – shaped by their DNA, lifestyle, and environment – which determines how they respond to food, exercise, and medications. Today, sophisticated tools allow us to uncover this blueprint and personalise health advice in a way never before possible. The goal...

Dietary fats have been wrongly maligned for much of modern nutritional history. But as the science evolves, it's clear that fat – far from being harmful – is a vital macronutrient that supports energy metabolism, hormonal health, brain and heart function, and even weight control. Rather than fearing fat, we should focus on: Avoiding refined carbohydrates and ultra-processed foods. Prioritising who...

As we age — particularly if we have inherited genes that predispose us to metabolic disarray that accompanies modern diet and lifestyles, we start to gain weight as visceral fat increases, and muscle mass declines. This double effect worsens blood pressure, cholesterol triglycerides, and blood sugar — contributing to what is known as the metabolic syndrome. Fat cells that have reached their capaci...

In the UK, the recommended minimum daily protein intake is 0.75g per kilogram of body weight. However, mounting evidence suggests that this baseline is not enough, especially for older adults, those managing chronic conditions, or anyone engaging in weight loss strategies. In practice, most people are falling short of even this modest target. In this article and podcast, strategies to maintain ske...