Fats for your Heart

In 2002, the American Heart Association released a scientific statement, “Fish Consumption, Fish Oil, Omega-3 Fatty Acids and Cardiovascular Disease,” on the effects of omega-3 fatty acids on heart function (including antiarrhythmic effects), hemodynamics (cardiac mechanics) and arterial endothelial function. The link between omega-3 fatty acids and CVD risk reduction are still being studied, but research has shown that omega-3 fatty acids

• decrease risk of arrhythmias, which can lead to sudden cardiac death
• decrease triglyceride levels
• decrease growth rate of atherosclerotic plaque
• lower blood pressure (slightly)

What do epidemiological and observational studies show?

Epidemiologic and clinical trials have shown that omega-3 fatty acids reduce CVD incidence.  Large-scale epidemiologic studies suggest that people at risk for coronary heart disease benefit from consuming omega-3 fatty acids from plants and marine sources. The ideal amount to take isn’t clear.  Evidence from prospective secondary prevention studies suggests that taking EPA+DHA ranging from 0.5 to 1.8 grams per day (either as fatty fish or supplements) significantly reduces deaths from heart disease and all causes.  For alpha-linolenic acid, a total intake of 1.5–3 grams per day seems beneficial.

Randomized clinical trials have shown that omega-3 fatty acid supplements can reduce cardiovascular events (death, non-fatal heart attacks, non-fatal strokes).  They can also slow the progression of atherosclerosis in coronary patients.  However, more studies are needed to confirm and further define the health benefits of omega-3 fatty acid supplements for preventing a first or subsequent cardiovascular event.  For example, placebo-controlled, double-blind, randomized clinical trials are needed to document the safety and efficacy of omega-3 fatty acid supplements in high-risk patients (those with type 2 diabetes, dyslipidemia, hypertension and smokers) and coronary patients on drug therapy.  Mechanistic studies on their apparent effects on sudden death also are needed.
 

Increasing omega-3 fatty acid intake through foods is preferable.  However, coronary artery disease patients may not be able to get enough omega-3 by diet alone.  These people may want to talk to their doctor about taking a supplement.  Supplements also could help people with high triglycerides, who need even larger doses.  The availability of high-quality omega-3 fatty acid supplements, free of contaminants, is an important prerequisite to their use.

AHA Recommendation
Omega-3 fatty acids benefit the heart of healthy people, and those at high risk of — or who have — cardiovascular disease. 

We recommend eating fish (particularly fatty fish) at least two times a week.  Fish is a good source of protein and doesn’t have the high saturated fat that fatty meat products do.  Fatty fish like mackerel, lake trout, herring, sardines, albacore tuna and salmon are high in two kinds of omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

We also recommend eating tofu and other forms of soybeans, canola, walnut and flaxseed, and their oils. These contain alpha-linolenic acid (LNA),  which can become omega-3 fatty acid in the body. The extent of this modification is modest and controversial, however. More studies are needed to show a cause-and-effect relationship between alpha-linolenic acid and heart disease.

The table below is a good guide to use for consuming omega-3 fatty acids.
 
Summary of Recommendations for Omega-3 Fatty Acid Intake

Population	Recommendation
Patients without documented coronary heart disease (CHD)	Eat a variety of (preferably fatty) fish at least twice a week. Include oils and foods rich in alpha-linolenic acid (flaxseed, canola and soybean oils; flaxseed and walnuts).
Patients with documented CHD	Consume about 1 g of EPA+DHA per day, preferably from fatty fish.  EPA+DHA in capsule form could be considered in consultation with the physician.
Patients who need to lower triglycerides	2 to 4 grams of EPA+DHA per day provided as capsules under a physician’s care.

Patients taking more than 3 grams of omega-3 fatty acids from capsules should do so only under a physician’s care.  High intakes could cause excessive bleeding in some people. 

Source: American Heart Association, www.americanheart.org

Keep Yourself Flu-Protected

Influenza-like illnesses (ILI) and upper respiratory tract infections (URTI) typically peak in prevalence during cold months. The media extol the benefits of good hygiene and immunizations, echoing the advice of healthcare professionals. In addition, home remedies and natural products have long been used to prevent and treat common viral illnesses. Here are the few important things you can do to keep yourself flu-protected this season. 

1) Practice good hygiene. Yep, it's as simple as that. Wash your hands. Often, and thoroughly. Transmission of the flu virus can occur through contact -- shaking hands, door knobs, an so on -- and regular hand washing throughout the day can help keep you from becoming infected with the flu. Keeping your hands away from your face helps too, as the flu virus can enter your system through your mouth, nose and eyes.

2) Maintain good hydration. "Drink plenty of fluids" is well-worn advice that may have a basis in its common sense consequences. Dehydration can dry the respiratory mucosal surfaces; however, there is little evidence that drowning in extra fluids improves resistance to viral infections. On the other hand, the frequent trips to the restroom necessitated by larger than usual intake of fluids may promote additional hand washing, thereby reducing the spread of infections.

3) Avoid sleep deficit. "Get plenty of sleep" is another adage voiced by grandmothers as well as clinicians, with the intent of supporting immune function. Sleep deprivation is associated with disruptions of immune function. (1) In laboratory studies, depriving healthy adults of sleep induces a significant increase in both pro-inflammatory and anti-inflammatory markers. Sleep deprivation can also impair the immune response to influenza vaccine. In a study of adult volunteers, influenza immunizations were administered to one group after 4 nights of partial sleep deprivation (sleep restricted to 4 hours per night) and to a second group after 4 full nights (7.5-8.5 hours per night) of sleep. Ten days after vaccination, mean antibody titers in the sleep-deprived volunteers were less than half of those in the volunteers who had normal sleep durations. (2) Because individuals with poorer responses to vaccines also experience higher rates of illness, these findings support the concept that adequate amounts of sleep are important for optimal immunity during respiratory illness seasons. There are no data to suggest that excessive sleep (more than 10-12 hours per night for adolescents and adults) further improves immune function, but it appears prudent to avoid sleep deficits.

4) Take immune-boosting supplements. A growing number of randomized controlled trials have evaluated the effectiveness of natural health products.  

Vitamin C. Vitamin C (ascorbic acid) is the vitamin most often associated with warding off viral respiratory infections. A subgroup analysis of 642 very healthy adults engaged in highly physically stressful activities (marathon runners, skiers, and soldiers on subarctic exercises) showed a 50% decrease in the risk of developing a cold among those who took vitamin C supplements. (3) In the 30 studies that examined the impact of prophylactic vitamin C supplementation on the duration of URTI symptoms, vitamin C conferred a consistent benefit on reduction of cold duration (8% in adults and 14% in children).

Vitamin D. Despite widespread fortification of food with vitamin D and the use of multivitamins, suboptimal vitamin D levels are increasingly reported in adults and pediatric populations. In addition to its well known effects on bone health, vitamin D is an important immune regulator, stimulating innate immunity and moderating inflammation. A secondary analysis of NHANES data from 1988-1994 showed an inverse relationship between vitamin D levels and incidence of URTI.(4) These results have been supported by other studies that show an increased risk for severe acute lower respiratory illness in people with low vitamin D levels.(5)(6) Historically, the association between rickets and risk for severe respiratory infection is well known,(7) and vitamin D deficiency is associated with an increased risk for influenza.(8)(9) 

Zinc. The essential mineral, zinc, plays an important role in immune function. Zinc is a structural component of many enzymes and serves as an intracellular signal between immune cells.(10) The activity of virtually all immune cells is modulated by zinc, and zinc deficiency leads to dysfunction of both humoral and cell-mediated immunity and increases susceptibility to infection. Zinc deficiency is associated with an increased incidence and severity of pneumonia.(11) A meta-analysis of studies reported that zinc supplementation reduced the incidence of acute lower respiratory tract infections in children by approximately 15%.(12) 

Echinacea. Research generally supports the use of high quality Echinacea purpurea products by adults to prevent or treat URTI. A 2007 meta-analysis of 14 controlled trials in adults concluded that E purpurea(13) A 2006 Cochrane review evaluated studies of echinacea as a therapy for URTIs.  A large controlled trial in pediatric patients found that echinacea may help prevent pediatric colds when taken during cold and flu season.(14)
taken prophylactically decreased the odds of the common cold developing by 58% and decreased the duration of a cold by 1.4 days (both statistically significant). 

Garlic. Garlic (Allium sativum) is a commonly used food and folk remedy for preventing and treating the common cold. One high-quality trial of the effect of garlic supplementation on the common cold found that a daily garlic supplement (180 mg allicin content for 12 weeks) significantly reduced the incidence of the common cold.(15) Garlic is generally safe, but its unpleasant effects on breath, belching, and body odor are well known. You may choose an odorless formulation of a garlic supplement. 

Probiotics. Probiotics encompass a large heterogenous group of bacteria that are normal inhabitants of the human gastrointestinal tract. These live microorganisms have undergone intensive study as treatments for gastrointestinal problems such as diarrhea, constipation, and IBS and as therapy for atopic conditions. Recently, research has focused on the potential role of probiotics in preventing respiratory illnesses in adults and children. More than a dozen studies on the effectiveness of probiotics in preventing URTIs have been conducted, with mixed results. Most studies have shown some decrease in the severity and number of illness days in participants randomly assigned to treatment groups.(16) Recent randomized, placebo-controlled, double-blind studies conducted over 3 winter seasons in healthy adult volunteers in Italy evaluated several synbiotic preparations. These preparations contained 3 to 5 strains of Lactobacillus plantarum, L rhamnosus, and Bifidobacterium lactis; lactoferrin; and prebiotics such as short-chain fructooligosaccharides (FOS) or galactooligosaccharides (GOS). The overall incidence, duration, and severity of URTI and ILI were significantly decreased in participants treated with synbiotics vs those in the placebo group.(17)

It is prudent to ensure good hygiene, immunizations, adequate rest, and adequate fluid intake, while avoiding deficiencies of essential nutrients to protect yourself from flu and other respiratory diseases. 

References:

1) Irwin M. Effects of sleep and sleep loss on immunity and cytokines. Brain Behav Immun. 2002;16:503-512. 

2) Spiegel K, Sheridan JF, Van Cauter E. Effect of sleep deprivation on response to immunization. JAMA. 2002;288:1471-1472.

3) Douglas RM, Hemila H, Chalker E, Treacy B. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2007:CD000980.

4) Ginde AA, Mansbach JM, Camargo CA Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2009;169:384-390.

5) Wayse V, Yousafzai A, Mogale K, Filteau S. Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 y. Eur J Clin Nutr. 2004;58:563-567. 

6) Hughes DA, Norton R. Vitamin D and respiratory health. Clin Exp Immunol. 2009;158:20-25.

7) Walker VP, Modlin RL. The vitamin D connection to pediatric infections and immune function. Pediatr Res. 2009;15:438-449.

8) Laaksi I, Ruohola JP, Tuohimaa P, et al. An association of serum vitamin D concentrations < 40 nmol/L with acute respiratory tract infection in young Finnish men. Am J Clin Nutr. 2007;86:714-717.

9) Cannell JJ, Vieth R, Umhau JC, et al. Epidemic influenza and vitamin D. Epidemiol Infect. 2006;134:1129-1140.

10) Haase H, Rink R. Functional significance of zinc-related signaling pathways in immune cells. Annu Rev Nutr. 2009;29:133-152. 

11) Meydani SN, Hamer DH. Serum zinc and pneumonia in nursing home elderly. Am J Clin Nutr. 2007;86:1167-1173.

12) Brown KH, et. al. Preventive zinc supplementation among infants, preschoolers, and older prepubertal children. Food Nutr Bull. 2009;30:S12-S40.

13) Shah SA, et. al. Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis. Lancet Infect Dis. 2007;7:473-480.

14) Weber W, Feder-Mengus C, Chiarugi A, et al. Echinacea purpurea for prevention of upper respiratory tract infections in children. J Altern Complement Med. 2005;11:1021-1026.

15) Lissiman E, Bhasale AL, Cohen M. Garlic for the common cold. Cochrane Database Syst Rev. 2009:CD006206.

16) Vouloumanou EK, et. al. Probiotics for the prevention of respiratory tract infections: a systematic review. Int J Antimicrob Agents. 2009;34:197e1-e10.

17) Pregliasco F, et. al. A new chance of preventing winter diseases by the administration of synbiotic formulations. J Clin Gastroenterol. 2008;42 Suppl 3 Pt 2:S224-S233.

The Role of CoQ10 in Heart Disease

HEALTH NEWS 


The use of CoQ10 as an adjunct therapy in treating serous illness particularly cardiac conditions now gains gradual support from current clinical research and reviews. 

Pharmacology and Therapeutics, an international review journal that presents critical and authoritative reviews of currently important topics in pharmacology and one of the top 10 most cited journals in its field, recently published a study highlighting the role of co-enzyme Q10 in various cardiovascular conditions including congestive heart failure, hypertension, ischemic heart disease, arrythmias, mitral valve prolapse syndrome, Meniere-like syndrome and its protective role during cardiac surgery and against doxorubicin cardiotoxicity. An abstract of the study is made available below.
___________________________________________________________________
 
Pharmacol Ther. 2009 Jul 25.
Role of coenzyme Q10 (CoQ10) in cardiac disease, hypertension and Meniere-like syndrome.

Kumar A, Kaur H, Devi P, Mohan V.

Cardiology Deptt, Govt. Medical College/GND Hospital, Amritsar, Punjab, Amritsar, Punjab, India.


Coenzyme Q10 (ubiquinone) is a mitochondrial coenzyme which is essential for the production of ATP. Being at the core of cellular energy processes it assumes importance in cells with high energy requirements like the cardiac cells which are extremely sensitive to CoQ10 deficiency produced by cardiac diseases. CoQ10 has thus a potential role for prevention and treatment of heart ailments by improving cellular bioenergetics. In addition it has an antioxidant, a free radical scavenging and a vasodilator effect which may be helpful in these conditions. It inhibits LDL oxidation and thus the progression of atherosclerosis. It decreases proinflammatory cytokines and decreases blood viscosity which is helpful in patients of heart failure and coronary artery disease. It also improves ischemia and reperfusion injury of coronary revascularisation. Significant improvement has been observed in clinical and hemodynamic parameters and in exercise tolerance in patients given adjunctive CoQ10 in doses from 60 to 200 mg daily in the various trials conducted in patients of heart failure, hypertension, ischemic heart disease and other cardiac illnesses. Recently it has been found to be an independent predictor of mortality in congestive heart failure. It has also been found to be helpful in vertigo and Meniere-like syndrome by improving the immune system. Further research is going on to establish firmly its role in the therapy of cardiovascular diseases.

___________________________________________________

 

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What Causes Heart Disease? Part 3

Fats And Fast Oxidizers 

Fast oxidizers often develop problems with cholesterol. There are several reasons for this. One cause of elevated cholesterol or high LDL levels in fast oxidizers is a diet high in sugars and carbohydrates. The problem occurs because carbohydrates further unbalance their fast oxidation rate. This places more stress on the body, which in turn can increase the cholesterol level. 

One might think fast oxidizers would have low cholesterol because they burn their fats and other nutrients faster. In theory, this is true. However, many people with a fast oxidizer pattern on their hair analysis are in fact slow oxidizers under stress. The stress is of a type that causes a temporary speed-up of their oxidation rate. We know this is true because on a retest the oxidation rate often slows. Stress of any kind can elevate the cholesterol level as the body seeks to produce more raw material to make stress hormones. 

Fast oxidizers often require some fats or oils in their diet. These often do not further elevate the cholesterol level. Fast oxidizers may become irritable, hungry and nervous if they go on a very low-fat diet. 

If your hair analysis indicates fast oxidation and you wish to restrict your fats, use high-quality vegetable oils which contain no cholesterol. These include avocado, palm oil, coconut oil, olive oil and health store oils like flaxseed and hempseed. Although palm and coconut oils contain saturated fasts, they contain no cholesterol. It is best to avoid processed vegetable oils, like corn, soy, sunflower, safflower, and peanut oils sold in the supermarket. These have had all their vitamin E removed, and can cause more problems. 

Some health authorities recommend restricting all fats and oils when the cholesterol is elevated. However, fast oxidizers often note a reduction in cholesterol when some fats and oils are added to the diet, substituting for high carbohydrates in the diet. 

Fast oxidizers are often deficient in copper, zinc and magnesium. Any of these deficiencies can contribute to cardiovascular disease. Fast oxidizers may also develop excessive constriction of the coronary arteries due to excessive adrenal activity, and low calcium and magnesium levels. This can precipitate sudden and massive heart attacks. 

Slow Oxidation 

Slow oxidizers have more difficulty converting cholesterol into adrenal and sex hormones. The body may compensate by raising cholesterol to help produce more stress hormones. This is one possible cause of elevated cholesterol levels. The solution is to improve glandular activity. Slow oxidizers do not feel as well on fats. Therefore, they do best restricting fats and oils of all types. Slow oxidizers may be under stress for other reasons, which can elevate their cholesterol level. They may also have zinc deficiency and/or high levels of toxic metals such as cadmium, which can lead to arterial disease. 

Low Sodium/Potassium Ratio 

A hair analysis pattern often associated with cardiovascular disease and elevated cholesterol is a ratio of sodium to potassium less than 2.5:1. This is a chronic stress pattern, associated with excessive tissue breakdown, fatigue, diabetes, and heavy metal toxicity, all of which may contribute to cardiovascular disease. 

Other Hair Analysis Patterns 

Other mineral patterns associated with heart disease include low copper, low magnesium, low zinc, elevated cadmium.  

Margarine And Other Plastic Foods

Many people think they are doing themselves a favor by eating margarine. They are not. All margarine is made by heating vegetable oil and bubbling hydrogen through the mixture to produce an artificially saturated fat. (The advertising about polyunsaturated oil used in margarine is misleading. The oil is saturated by the time they finish with it.) The problems with margarine are:

   

• Nutrients in the oil such as vitamin E are destroyed when the product is heated. (Vitamin E deficiency from overeating on refined vegetable oils increases the risk of heart disease).
•  Hydrogenation produces trans-fatty acids. These are non-naturally occurring fatty acids that contribute to inflammation, one of the causes of heart disease. (Some margarines today claim to have the trans-fatty acids removed).
• Nickel is added as a catalyst in making margarine. Nickel is a highly toxic metal - fine for making coins, but not for eating.
•  Artificial color and flavor must be added to margarine to make it palatable. These chemicals have their own toxic effects.
• A recent study showed that margarine elevated the undesirable LDL cholesterol.

The problems with margarine apply equally to commercial peanut butters, vegetable shortening such as Crisco, fake whip cream products such as Cool-Whip, and many fried foods, salad dressings and crackers made with hydrogenated oils. These artificially saturated fats are worse for the body than naturally-occurring fats. 

Reducing Elevated Cholesterol And Triglycerides 

Reducing cholesterol and increasing the HDL/LDL ratio can usually be accomplished with nutritional methods. Here are some guidelines: 

• While some fat restriction may be helpful, other dietary factors are often much more important. A properly performed and interpreted hair analysis will provide much information about diet as well as mineral deficiencies, heavy metal toxicity and supplement recommendations to correct stress patterns.
• Food products containing refined white flour and white sugar - in all its forms - should be totally eliminated from the diet.
• Extra nutrients may be helpful including vitamin C, niacin, chromium, ginger, lecithin, omega-3 oils and extra fiber.
• Conditions such as dental infections and diabetes need to be addressed. 
• Lifestyle considerations are important, including exercise, weight control, adequate rest and sleep, and smoking cessation.

Such a holistic approach is endorsed by Jonathan Wright, MD, a leading holistic physician and former medical columnist for Prevention Magazine. He writes: 

"Only a few patients of the hundreds I've treated for high cholesterol have had to severely limit dietary intake (of fat). Usually, it is a matter of correcting the metabolism rather than the diet".(13)

Cholesterol-Lowering Drugs 

Several classes of drugs are used to lower cholesterol. Unfortunately, many have significant side effects. For example, in one study, patients placed on gemfibrozil did have reduced cardiac events than a placebo group. However, the overall death rate was almost identical. Those taking the drug had a higher incidence of violence, accidents and intercranial hemorrhages.(14) Note that studies show that a low cholesterol level, below 130, is not beneficial either.

New recommendations suggest the use of medication whenever cholesterol is over 200 mg.(15) This ignores the research that total cholesterol is not nearly as important as LDL and its ratio to the total cholesterol.

Drugs do not address the biochemical causes for high cholesterol in most cases. This means that pathology in the body may continue to progress, despite the use of these drugs. Drugs ought be used as a last resort, only after natural methods have been tried.

Natural approaches to cholesterol and heart disease have no side effects, except perhaps improved general health. Also, they address deeper causes to create a more permanent correction. Before stopping any medication, we recommend consulting a physician.

Conclusion 

In summary, high cholesterol can often be a symptom of stress or imbalanced chemistry, but not necessarily the cause. If you are healthy and your cholesterol level is within normal limits, don't be a fat hater and abandon all eggs, butter and meats. Do skip refined foods such as white flour, sugar, margarine and other hydrogenated oil products. Fats and oils are not all the same, by any means. Eating healthful fats and oils often pose no problem, whereas the refined oils can cause significant heart problems.

Some people need to restrict fats, including slow oxidizers and at times those with elevated cholesterol. A mineral analysis will provide more information in this area. By combining a scientific nutrition program with healthful lifestyle and appropriate diet most people can reduce their cholesterol and their risk of heart disease 

without drugs.

References: 

13. Wright, J., M.D., Dr. Wright’s Book of Nutritional Therapy, Rodale Press, Emmaus, Pa. 1979.

14. Frick, M.H. et al, Helsinki Heart Study. Primary Prevention Trial with Gemfibrozil in Middle-aged Men with Dylipidemia, New England Journal of Medicine, 317 (1987), pp. 1237-45. 

15. Journal American Medicine Assn., May 16, 2001;285:2486-2497.

What Causes Heart Disease? Part 2

What Causes Heart Disease? 

If cholesterol is not the cause of heart disease, what are the causes? Many factors may contribute to cardiovascular disease. A properly performed hair mineral analysis can help identify a number of them. Here are some of the major factors suspected in cardiovascular disease. 

•  Klevay showed that copper deficiency is associated with atherosclerosis. Copper is required for connective tissue synthesis.
• Zinc deficiency reduces the flexibility of the arteries and causes hardening. It may also cause inflammation of the arterial walls.
• Magnesium and taurine deficiencies may contribute to high blood pressure and other heart problems. 
• Cadmium toxicity is associated with hardening of the arteries. 
•  Elevated homocysteine levels are a factor in heart disease. Homocysteine is an amino acid. Its level can be reduced by increasing the intake of vitamin B6 and folic acid. 
• According to Rath and Pauling’’s unified theory of heart disease, the causes are deficiencies of vitamin C and lysine. These are required for collagen synthesis. This theory asserts that high levels of lipoprotein-A, part of LDL cholesterol, is responsible for arterial damage.
• Other vitamins and minerals are involved. Chromium supplements, for instance, have been shown to lower cholesterol levels. Chromium, manganese and B-complex vitamins may reduce stress by enhancing carbohydrate metabolism. 
• Low thyroid activity is associated with heart disease. Hypothyroidism may have numerous causes, including nutritional deficiencies and toxic metal poisoning. 
• Inflammation and infections are now known to be important in cardiovascular disease. These can include seemingly unrelated infections such as dental infections. These can spread toxins that affect every organ. 
• High blood pressure from any cause is a factor. 
• Smoking, diabetes, obesity, coffee-drinking and a sedentary lifestyle are risk factors. 
• Oxidant damage from vegetable oils and other oxidant exposure contributes to vascular disease. This factor may explain why populations that consume more animal fats often have less heart disease. 
• Artificially-hydrogenated fats found in margarine, dressings, fried foods and elsewhere may contribute. 
• Chlorinated and fluoridated drinking water, and residues of ionic detergents may be an important factor. 
• Drinking homogenized milk may be harmful for the arteries.   
• Adelle Davis in Let’s Get Well noted that "animals and human volunteers that are fed sugar instead of unrefined carbohydrates develop high cholesterol levels". 
• Familial and genetic tendencies, and emotions such as hostility appear related to heart disease.  

Why Does Cholesterol Rise? 

Modern nutritional science reveals several important facts about cholesterol:

• High cholesterol can be a symptom of an imbalanced body chemistry. One can observe high cholesterol levels in vegetarians who consume no cholesterol at all.
•  Stress can increase cholesterol. Cholesterol is needed to make stress-fighting hormones such as cortisone and cortisol. A body under excessive stress (from internal or external sources) may produce extra cholesterol to increase the anti-stress hormones.
•  Cholesterol plaques may protect weak arteries to prevent breakage. 
• Cholesterol may in fact protect the body against free radical or oxidant damage. This theory was first advanced by Dr. Elmer Cranton in the book, Bypassing Bypass. This may be why high HDL which is non-oxidized cholesterol is positive, while LDL, which is oxidized cholesterol, is more of a risk for heart disease. In coping with oxidant stress, the HDL is oxidized, or converted to LDL. 
• Some people seem to have a familial tendency for elevated cholesterol.
• Excessive consumption of sugar can contribute to high serum lipid levels. 
• Fingerstick cholesterol tests are among the least accurate medical tests. Always have such tests repeated. 
•  HDL and LDL levels are as important or more important than total cholesterol. A simple cholesterol reading is not too revealing.
  

What About Dietary Fat? 

There are many points to be considered. For example, the egg was indicted as a major cause of elevated cholesterol based on studies in the 1940s and 1950s. However, it turned out that in those studies powdered eggs were used.(10) These processed eggs contain oxidized cholesterol, the type known to cause problems. However, when the studies were repeated with fresh eggs, they did not raise cholesterol significantly.(11) However, many physicians and health authorities still quote the old studies. 

Also on the subject of eggs, it has been found that eggs from chickens that are allowed to run free, so-called cage-free eggs, have less cholesterol. This means the way our food is produced influences its nutritional content. 

There are many different types of fats. Studies have shown that a diet high in fish, which contain anti-inflammatory fats, can reduce heart disease.(12) 

In nutritional research, there are different body types. Some handle fats much better than others. Those whom Dr. Paul C. Eck called fast oxidizers require some fats and oils to help normalize body chemistry. Slow oxidizers, by contrast, do poorly on fats. This fact alone means that studies that look at the effects of fats on large groups are flawed unless they take into account different body chemistries. 

This can help account for divergent results of studies, some of which show no ill effect of fats, while others show that saturated fats, for example, are not healthy. Thus, the idea of metabolic types can be most helpful to assess the effects of fats on any particular person. Let us explore this is more detail.

References:

10. Cook, R.P., Cholesterol: Chemistry, Biochemistry, and Pathology, Academic Press, NY, 1958.
11. Passwater, R., Super Nutrition for Healthy Hearts, Deal Press, NY 1977. See also Flynn, M.A. et al, Effects of Dietary Egg on Human Cholesterol and Triglycerides, American Journal of Clinical Nutrition, 32 (May 1979) pp. 1051-1057.

12. Wright, J., M.D., Dr. Wright’s Book of Nutritional Therapy, Rodale Press, Emmaus, Pa. 1979.

What Causes Heart Disease? Part 1

Over the years, the debate on the role of cholesterol in the development of atherosclerosis and heart disease continues. When it was first proposed that high cholesterol increases heart attack risk, the medical establishment ridiculed the idea. However, decades of disputes changed the stance of the medical establishment, now the concept that high cholesterol causes heart attack has become a scientific consensus.
But many of today’s complementary medicine practitioners, who would have been early proponents of low-saturated fat diets, now question the association between cholesterol and vascular disease. This has become what is known as the "cholesterol controversy." The fact that confusion still exists over this straightforward medical principle helps explain why atherosclerotic disease remains today’s leading preventable killer.

While browsing through available scientific literatures and reviews on the topic, I came across an article by Dr. Larry Wilson, MD detailing important aspects in our understanding of the role of cholesterol in heart disease. The following is an exerpt of the article entitled "The Cholesterol Controversy" which I will present here in a three-part series.
_________________________________________________

Medical authorities continue to recommend drugs and low-fat diets to reduce cholesterol. However, there is much more to the cholesterol story.

What Is Cholesterol?

Cholesterol is an essential body chemical, mostly synthesized in the liver. It is the precursor or raw material used to make the vital pituitary, adrenal and sex hormones. Cholesterol is also required to form vitamin D and bile acids. The liver makes about 2 grams of cholesterol daily, regardless of diet. Under stress, the body makes more cholesterol in order to make more adrenal or stress hormones.

Cholesterol is a mixture of compounds. These include high density lipoproteins or HDL, and low density lipoproteins or LDL. The latter contain lipoprotein-A, thought by some authorities to be important in the genesis of heart disease.

HDL, which is unoxidized cholesterol, is sometimes called ‘‘good cholesterol’’, while LDL, the oxidized form, is often termed ‘‘bad cholesterol’’. Blood laboratories often measure the ratio between the HDL and total cholesterol. 

Does Cholesterol Cause Heart Disease? 

The cholesterol theory of heart disease asserts that: 1) The risk of cardiovascular disease correlates with the serum level of cholesterol; and 2) Eating cholesterol-containing foods raises your cholesterol level. Let us explore this theory and alternative hypotheses in more detail.

About 100 years ago scientists noted that fatty deposits in the arteries often contain cholesterol. Of course, it was not known whether cholesterol deposits were the cause or the result of heart disease. Studies were done, including the large Framingham study, that found a definite correlation between high serum cholesterol levels and the risk of heart disease.

However, the picture is not as clear as it seems. The Framingham study found that LDL or oxidized cholesterol was more predictive of heart disease than total cholesterol. Also, the study could not correlate eating foods containing cholesterol and an increase in the blood cholesterol.

Furthermore, many studies from around the world do not support the simplistic idea that eating more cholesterol or saturated fat increases the risk of heart disease. In an interesting book, The Milk Of Human Kindness Is Not Pasteurized,(1) William C. Douglass, MD cites the following:

• The famous heart surgeon Michael Debakey analyzed 1700 patients with hardening of the arteries and found no correlation between blood cholesterol levels and the degree of atherosclerosis.(2)
• The New England Journal of Medicine reported that a group of Guinea natives whose diet is normally low in cholesterol were fed eggs to see how much the eggs would influence their cholesterol. There was no significant effect on cholesterol levels.(3)
• A study done by the American Cancer Society revealed that non-egg users has a higher death rate from heart attacks and strokes than egg users. This was a large and therefore convincing study involving over 800,000 people.(4)
• Eskimos living on a diet of mostly meat and fat, have low cholesterol levels (about 130mg) provided they stay on their native diet.
• The Masai tribe of Africa drink about 7 quarts of milk per day containing 60% saturated fat. Yet the average adult cholesterol level is 122.(5)
• The American Academy of Pediatrics is warning against the latest call for low cholesterol foods for children, since it is known that cholesterol is vital for children's growth

Many other studies show no significant effect on blood cholesterol from eating eggs or other cholesterol-containing foods. Several are reported in The New Vegetarian, by Gary and Steve Null. A study in France found that although butter consumption is much higher in Western than in Eastern France, the mortality from heart disease in Western France is almost half that of Eastern France.(6)

Before Western eating habits were introduced into the Eskimo population, they lived almost exclusively on animal meat and fat. Yet the incidence of heart disease was very low and cholesterol levels were below 200 mg.(7) Similar results were found in studies in the Soviet Union, India, and elsewhere.(8)(9)

The cholesterol theory of heart disease is very simplistic. It is like saying that duct tape wrapped around a damaged water hose is the cause of the hose damage. More likely, the tape - and the cholesterol - are the result of the damage, not the cause. In fact, two scientists, Brown and Goldstein, won a Nobel Prize in 1985 for their research into this theory. Cholesterol plaques are often there to protect a damaged artery. After all, a clogged artery is far preferable to a ruptured one. Elevated cholesterol is associated with heart disease, but may not be its cause.

References: 

1. Douglass, W.C., The Milk of Human Kindness is not Pasteurized, Copple House Books, Lakemont, Ga., 1985.

2. JAMA 189:655-59 (1964).

3. New England Journal of Medicine, 98:317 (1978).

4. Abrams, Journal Applied Nutrition, Vol. 32, #2, pp. 53-87.

5. Cardiovascular Disease of the Masai, Mann et. al.

6. Maclennan, R. and Meyer, F., Food and Mortality in France, The Lancet, 2 (1977): p. 133.

7. Ho, K.J. et al, Alaska Arctic Eskimo: Responses to a Customary High Fat Diet, American Journal of Clinical Nutrition, 25:1972, pp. 737-745.

8. Malhotra, S., Graphic Aspects of Acute Myocardial Infarction in India with Special Reference to Patterns of Diet and Eating:, British Heart Journal, 29:1967, pp. 337-344.

9. Prior, I.A. et al., Cholesterol, Coconuts, and Diet on Polynesian Atolls: A Natural Experiment, American Journal of Clinical Nutrition, 25:1972, pp. 737-745.

Risk Factors in Heart Disease

Extensive clinical and statistical studies have identified several factors that increase the risk of coronary heart disease and heart attack. Major risk factors are those that research has shown significantly increase the risk of heart and blood vessel (cardiovascular) disease. Other factors are associated with increased risk of cardiovascular disease, but their significance and prevalence haven't yet been precisely determined. They're called contributing risk factors.

The American Heart Association has identified several risk factors. Some of them can be modified, treated or controlled, and some can't. The more risk factors you have, the greater your chance of developing coronary heart disease. Also, the greater the level of each risk factor, the greater the risk. For example, a person with a total cholesterol of 300 mg/dL has a greater risk than someone with a total cholesterol of 245 mg/dL, even though everyone with a total cholesterol greater than 240 is considered high-risk. 

What are the major risk factors that can't be changed?

Increasing age: About 82 percent of people who die of coronary heart disease are 65 or older. At older ages, women who have heart attacks are more likely than men are to die from them within a few weeks. 

Male sex (gender): Men have a greater risk of heart attack than women do, and they have attacks earlier in life. Even after menopause, when women's death rate from heart disease increases, it's not as great as men's. 

Heredity (including Race): Children of parents with heart disease are more likely to develop it themselves. African Americans have more severe high blood pressure than Caucasians and a higher risk of heart disease. Heart disease risk is also higher among Mexican Americans, American Indians, native Hawaiians and some Asian Americans. This is partly due to higher rates of obesity and diabetes. Most people with a strong family history of heart disease have one or more other risk factors. Just as you can't control your age, sex and race, you can't control your family history. Therefore, it's even more important to treat and control any other risk factors you have. 

Major risk factors you can modify, treat or control by changing your lifestyle or taking medicine

Tobacco smoke: Smokers' risk of developing coronary heart disease is 2–4 times that of nonsmokers. Cigarette smoking is a powerful independent risk factor for sudden cardiac death in patients with coronary heart disease; smokers have about twice the risk of nonsmokers. Cigarette smoking also acts with other risk factors to greatly increase the risk for coronary heart disease. People who smoke cigars or pipes seem to have a higher risk of death from coronary heart disease (and possibly stroke) but their risk isn't as great as cigarette smokers'. Exposure to other people's smoke increases the risk of heart disease even for nonsmokers. 

High blood cholesterol: As blood cholesterol rises, so does risk of coronary heart disease. When other risk factors (such as high blood pressure and tobacco smoke) are present, this risk increases even more. A person's cholesterol level is also affected by age, sex, heredity and diet. Here’s the lowdown on where those numbers need to be:

Total Cholesterol: Less than 200 mg/dL
 
LDL (bad) Cholesterol:

• If you're at low risk for heart disease: Less than 160 mg/dL
• If you're at intermediate risk for heart disease: Less than 130 mg/dL
• If you're at high risk for heart disease (including those with existing heart disease or diabetes): Less than 100mg/dL

HDL (good) Cholesterol: 40 mg/dL or higher for men and 50 mg/dL or higher for women
 
Triglycerides: Less than 150 mg/dL 

High blood pressure: High blood pressure increases the heart's workload, causing the heart to thicken and become stiffer. This stiffening of the heart muscle is not normal, and causes the heart not to work properly.  It also increases your risk of stroke, heart attack, kidney failure and congestive heart failure. When high blood pressure exists with obesity, smoking, high blood cholesterol levels or diabetes, the risk of heart attack or stroke increases several times. 

Physical inactivity: An inactive lifestyle is a risk factor for coronary heart disease. Regular, moderate-to-vigorous physical activity helps prevent heart and blood vessel disease. The more vigorous the activity, the greater your benefits. However, even moderate-intensity activities help if done regularly and long term. Physical activity can help control blood cholesterol, diabetes and obesity, as well as help lower blood pressure in some people. 

Obesity and overweight: People who have excess body fat — especially if a lot of it is at the waist — are more likely to develop heart disease and stroke even if they have no other risk factors. Excess weight increases the heart's work. It also raises blood pressure and blood cholesterol and triglyceride levels, and lowers HDL ("good") cholesterol levels. It can also make diabetes more likely to develop. Many obese and overweight people may have difficulty losing weight. But by losing even as few as 10 pounds, you can lower your heart disease risk. 

Diabetes mellitus : Diabetes seriously increases your risk of developing cardiovascular disease. Even when glucose levels are under control, diabetes increases the risk of heart disease and stroke, but the risks are even greater if blood sugar is not well controlled. At least 65% of people with diabetes die of some form of heart or blood vessel disease. If you have diabetes, it's extremely important to work with your healthcare provider to manage it and control any other risk factors you can. Persons who are obese or overweight should lose weight to keep blood sugar in control.    

What other factors contribute to heart disease risk?

Stress: Individual response to stress may be a contributing factor. Some scientists have noted a relationship between coronary heart disease risk and stress in a person's life, their health behaviors and socioeconomic status. These factors may affect established risk factors. For example, people under stress may overeat, start smoking or smoke more than they otherwise would.

Alcohol: Drinking too much alcohol can raise blood pressure, cause heart failure and lead to stroke. It can contribute to high triglycerides, cancer and other diseases, and produce irregular heartbeats. It contributes to obesity, alcoholism, suicide and accidents. The risk of heart disease in people who drink moderate amounts of alcohol (an average of one drink for women or two drinks for men per day) is lower than in nondrinkers. One drink is defined as 1-1/2 fluid ounces (fl oz) of 80-proof spirits (such as bourbon, Scotch, vodka, gin, etc.), 1 fl oz of 100-proof spirits, 4 fl oz of wine or 12 fl oz of beer. It's not recommended that nondrinkers start using alcohol or that drinkers increase the amount they drink. 

Diet and Nutrition:  A healthy diet is one of the best weapons you have to fight cardiovascular disease. The food you eat (and the amount) can affect other controllable risk factors: cholesterol, blood pressure, diabetes and overweight. Choose nutrient-rich foods — which have vitamins, minerals, fiber and other nutrients but are lower in calories — over nutrient-poor foods. A diet rich in vegetables, fruits, whole-grain and high-fiber foods, fish, lean protein and fat-free or low-fat dairy products is the key. And to maintain a healthy weight, coordinate your diet with your physical activity level so you're using up as many calories as you take in.

Source: American Heart Association. www.americanheart.org 

Heart Benefits of CoQ10

Coenzyme Q10 or simply CoQ10 is a naturally-occurring enzyme found in all cells of the body hence its alternate name ubiquinone derived from the word ubiquitous which means “found everywhere”. CoQ10 plays a key role in energy production located in the mitochondria, tiny power plants found in every cell that helps fuel the body's daily activity. It is most concentrated in the heart, liver, muscles and other organs with high energy demands.

As a co-factor in the electron transport chain between cells, CoQ10 is a powerful antioxidant, scavenging free radicals. It prolongs the lifespan of another antioxidant, Vitamin E which it recycles to keep it most active. When this body’s important source of cellular energy is depleted, many medical conditions are aggravated and made worse. Low CoQ10 levels are implicated in a number of cardiovascular diseases.

The benefits of CoQ10 are crucial to maintaining cardiovascular health. CoQ10 is a safe and effective treatment for a broad range of cardiovascular diseases. A number of studies and clinical trials around the word attested to CoQ10’s impact on cardiomyopathy, arrhythmia, coronary artery disease, congestive heart failure , mitral valve prolapse and hypertension.(1) CoQ10 has been used for years to fight heart disease and to treat the early stages of congestive heart failure in Europe and Japan.

A study of 144 patients with acute myocardial infarction (heart attack) that was published in 1998 demonstrated a halving of total cardiac events in those given CoQ10 compared with placebo.(2) In a study involving 126 patients with cardiomyopathy, 87 percent displayed noticeable improvements in heart function without adverse effects.(3) More than a few studies confirm that dosages of 60 – 100mg per day will significantly lower blood pressure readings.(4) Another recent study concluded that CoQ10 supplementation improves endothelial function in patients with Type II diabetes.(5) Diabetes is the most common metabolic cause of heart disease.These studies clearly show that there is no doubt that CoQ10 helps in protecting us against diseases of the heart and blood vessels.

As we get older, our body's supply of CoQ10 slowly diminishes. Though our bodies still manufacture some amounts of CoQ10 and trace amounts can be obtained from food, it will still be inadequate in the presence of free radicals and other heart risk factors. It is, therefore, important for us to keep an optimal amount of CoQ10 with supplements. CoQ10 has no known side effects and can be readily bought over the counter. Thus, many physicians are not even aware of its many benefits.

Safety Caveats

Supplementation of Co Q10 in persons with heart disease should be done with the supervision of their physician.

• Statin cholesterol-lowering drugs or HMG Co-A Reductase Inhibitors have been found to lower the body's CoQ10 levels.
• CoQ10 has a similar chemical structure to vitamin K, a vitamin involved in the ability of blood to clot. CoQ10 may antagonize the effects of anti-clotting medications such as warfarin or heparin.
• Beta-blockers, calcium channel blockers and diuretics are medications that can lower blood pressure. CoQ10 has been found to lower blood pressure, so it may interact and increase the effects of these drugs.

References:
1 Greenburg, S. and W.H. Frishman, Journal of Clinical Pharmacology, 1990; 30: 596 – 608.
2 Cardiovascular Drugs Therapy 1998;12: 347 –53.
3 Langsjoen, P. H., et al., Americal Journal of Cardiology,1990; (65): 521 – 23.
4 Digiesi, V., et al., Current Therapeutic Research, 1992; 1126: 247 –54.
5 Watts G.F., et al., Diabetologia, 2002 March; 45(3):420 – 6).

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