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.

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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.

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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 events.

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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.

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Cardiometabolic risk develops gradually through visceral fat accumulation, insulin resistance and rising blood pressure. A structured escalation model — from supported self-management to specialist review and selective GLP-1 therapy — allows proportionate intervention before overt cardiovascular disease emerges. Early, coordinated action can alter long-term risk trajectories.

For more details see the blog article https://www.scvc.co.uk/metabolic-health-weight/cardiometabolic-risk-in-2026-from-self-management-to-structured-escalation/

To review all podcasts and blogs in series, see https://feeds.transistor.fm/the-naked-heart

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.

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********NOTICE***********

This is the last blog in Naked Heart Series for a year. Weekly blogs are to be released on Metabolic Health instead with a view to book launch in 2026 'The VAT Trap'. 

Sign up to the new Metabolic Health newsletter to stay informed

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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 excess glucose to safe storage — but when that system fails, metabolic chaos follows. In this article, we explore how your mitochondria manage energy, what causes them to overload, and how lifestyle changes can help restore balance and protect long-term health

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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 be made. Lives literally depend on a prompt anatomic test being done in time. Until this has been made available nationally, patients experiencing unexplained chest symptoms who have not had clinical follow up and diagnosis confirmed are advised to 'vote with their feet'- either head back into hospital in event of further symptoms, or even consider arranging to fund their own urgent CT angiogram from an independent medical provider.

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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 cause of cryptogenic stroke. All standard tests including an echocardiogram can be normal- it can be only be diagnosed using a bubble contrast study and once diagnosed, treatment with clam shell closure is high effective.

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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 fat is, how it affects your breathing, and — most importantly — what you can do about it. 

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