Good morning. It’s Tuesday, January 13th.

In today’s email:

• Learn: CKM Syndrome

• Try: Cut the Sugar

• Measure: 10 Key Biomarkers

• In the News: Running Unplugged

• Brain Games: Logic Equations

Stat of the Day

The percentage of Americans over 20 that have signs of CKM syndrome. (JAMA, 2024)

Learn

Cardiovascular-kidney-metabolic (CKM) Syndrome

We still talk about disease as if it’s one problem at a time: heart disease, diabetes, kidney issues.

But we aren’t a body made up of isolated parts. We’re one interconnected system.

Weight gain. Brain fog. Fatigue. Heart disease. Diabetes. Kidney problems. These aren’t separate failures. When our cells are under chronic stress, the effects show up everywhere - across the entire system.

A recent study published in JAMA calls out how we should be thinking about this - as a single disease that encompasses all these factors - cardiovascular-kidney-metabolic (CKM) syndrome.

The study calls out CKM syndrome as the number one cause of death in the U.S. - and it hasn’t improved over the last 10 years.

Here are the stages:

• Stage 0: no risk factors.

• Stage 1: excess body fat and higher than normal blood sugar.

• Stage 2: type 2 diabetes, high cholesterol, and high blood pressure.

• Stage 3: issues with heart and blood vessels, but no noticeable symptoms.

• Stage 4: signs of heart disease, including coronary heart disease, heart failure, stroke, or kidney failure.

Only 10% of adults are Stage 0. Even among people under 44, only 18% qualify as truly low risk.

Most people don’t realize they’re in Stage 1 or 2 - because they still feel “fine.” That’s exactly why CKM progresses quietly for years before symptoms show up.

The good news? Stages 1 and 2 are often reversible.

One System - One Disease

The heart, kidneys, and metabolism don’t operate independently - they move together in a feedback loop:

• Poor metabolic health (blood sugar, insulin resistance, inflammation) damages blood vessels

• Damaged vessels strain the heart

• Reduced circulation and chronic inflammation impair kidney function

• Declining kidney function worsens blood pressure and metabolic control

It’s a loop. And once it starts, it tends to accelerate unless something changes.

That’s why the American Heart Association has (finally) shifted away from treating these issues in silos and started framing CKM as a single disease process. The goal isn’t to chase symptoms - it’s to fix the system.

One of the biggest drivers of CKM is what we eat.

The Inverted Pyramid

There’s been a lot already said on the changes the current administration made to our recommended dietary guidelines.

There are plenty of critics and it’s definitely not perfect. But to be honest, it’s a huge step in the right direction.

Here’s what the guidelines get right:

• Eat real food - that’s the best place to start

• That includes multiple servings of fruits and vegetables throughout the day

• Eat more protein and healthy fats

• Basically eliminate refined carbs and added sugars

We can nitpick here - for instance:

The visuals emphasize meat and dairy, which has led some people to assume “fat is back, eat all you want.”

But the actual guidance is more precise: saturated fat should be limited to 10% of total fat consumed.

Another major omission: fiber.

Fiber deserves special attention because it affects everything tied to CKM.

Adequate fiber intake improves blood sugar control, feeds gut bacteria, reduces inflammation, and helps the kidneys eliminate waste. If you’re eating enough vegetables, beans, whole grains, and fruit, fiber follows - but it’s too important not to call out directly.

The Real Takeaway

Don’t think “I have a heart problem” or “my kidneys are struggling.”
Think about your entire body.

Improve metabolic health, and you support your heart.
Support your heart, and you protect your kidneys.

The loop works both ways - and with the right habits, it can become a positive flywheel as you age.

One last thing to remember: symptoms are late. Labs are early.
Your bloodwork often shows trouble years before you’ll feel it.

Try

Cut the Sugar

Find just one daily moment where added sugar or refined carbs show up - breakfast, snacks, or late-night dessert - and remove it.

Not forever. Not perfectly. Just one consistent shift.

Lower sugar intake improves blood sugar, insulin levels, triglycerides, and inflammation - all upstream drivers of CKM.

Small change. Huge impact.

Thrive25 Partner Spotlight

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Measure

The 10 Biomarkers for CKM

Here are the biomarkers to make sure you get included in your annual bloodwork to catch any sign of the earliest indication of CKM syndrome:

Metabolic Markers

1. HbA1c (average blood sugar over 3 months) - ideal range 4.1-5.2%

2. Fasting glucose - ideal range 72-85 mg/dL

3. Fasting insulin (often missed, but critical) - ideal range 2-6 µIU/mL

4. C-reactive protein (CRP) for inflammation - ideal range 0.2-1.0 mg/L

Heart Markers

5. ApoB - ideal range 21-60 mg/dL

6. Triglycerides - ideal range 2-100 mg/dL

7. Lp(a) (just need to measure 1x) - ideal range 2-30 mg/dL

Kidney Markers

8. Calcium - ideal range 9-10 mg/dL

9. BUN - ideal range 10-15 mg/dL & Creatinine - ideal range 0.75-1.15 mg/dL

10. eGFR (filtration health) - ideal range 95-110 mL/min/1.73 m^2

(Ranges may vary slightly by lab - use these as targets, not diagnoses.)

It’s not about being “perfect.” It’s about spotting trends early, understanding your personal risk, and having confident, informed conversations with your doctor - so health supports your life instead of getting in the way.

H&L in the News

Run Unplugged. Feel More: Ditch the headphones and the data. Running without music or a watch sharpens body awareness, improves pacing, and unlocks a deeper runner’s high - helping you reconnect with effort, breath, and why you run. (Outside)

Reversing Alzheimer’s, Reimagined: Scientists reversed advanced Alzheimer’s in mice by restoring the brain’s energy balance, not targeting plaques alone. The findings challenge a century of assumptions - and hint that true recovery may be biologically possible. (StudyFinds.org)

The Focus Gap: Modern life fragments attention into nonstop “urgency.” This research reframes focus as a trainable system - not a personality trait - revealing four science-backed attention muscles that help cut noise, restore clarity, and make progress feel possible again. (Big Think)

Brain Games

Logic Equations

9 variables today - A, B, C, D, E, F, G, H and I - with nine possible values - 1, 2, 3, 4, 5, 6, 7, 8, 9. None of the variables can share the same number. Based on the following equations, what do the variables equal:

1. 4F = A

2. D = 3H

3. 2E = 4H

4. B > C

5. B = 4G

6. I > E

9 variables and only 6 equations, but you got this! Get out the stop watch and see how fast you can solve!

Credit: Brainzilla

** For answer, scroll to the bottom of the email

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Brain Games Answer

Answer: Yellow are the values for the variables. A=4, B=8, etc.

Why?…

• Start with equations (1, 5). Both equations have a variable equal to another multiplied by 4. For these to be true with A and B < 10, A and B are in the set {4,8} and F and G are in {1,2}.

• Now, look at equation (2). D = 3H, in this case H can only be 1, 2 or 3. But since F,G = {1,2}, H = 3 and D = 9.

• We know H, so let’s look at equation (3). 2E = 4 * 3, E = 6.

• Since E = 6, go to equation (6). If I > E and 8 (A or B) and 9 (H) are accounted for, then I = 7.

• Last, look at equation (4). There’s only one value for C not accounted for, so C = 5. If B > C, then B = 8. If that’s true, returning to the first step: A = 4, F = 1, G = 2.

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To health!