Diabetes Archives

Nov

2022

Lack of Sleep Harms the Immune System and Causes Inflammation

By Ray Schilling | Cardiovascular disease, depression, Diabetes, Heart Disease, Inflammation, Insomnia, sleep, Sleep apnea

A research group from Boston, MA and New York, NY found that a lack of sleep harms the immune system and causes inflammation. This was summarized in this CNN article.

Specifically, they first conducted experiments with a mouse model. They studied the effects of sleep disruption and sleep deprivation and could later confirm identical changes in man. The observation was that a lack of sleep caused the hematopoietic cells in the bone marrow to proliferate, but the cell diversity was less than in people with normal sleep patterns. The same pattern of bone marrow proliferation was present in mice. This research was published Sept. 21, 2022 in the Journal of Experimental Medicine.

Chronic sleep deficit

A chronic sleep deficit caused chronic inflammation and eventually autoimmune diseases. Again, this was a pattern present in both the mouse model and in humans. Next the researchers observed what happened with sleep recovery. In the past it was assumed that with sleep recovery all of the physical changes from sleep deprivation would disappear. However, the opposite was true: both in mice and in humans the bone marrow stimulation and the lack of cell diversity persisted.

In the mouse model the researchers could show that there were permanent epigenetic changes, which were caused by sleep deprivation. The same is true with humans, but this is more difficult to show than in the mouse model. The researchers came to the conclusion that sleep deprivation stimulates bone marrow maturation, but restricts the clonal differentiation. In doing so the body initiates inflammation, which becomes chronic even with sleep restoration.

Human sleep studies

There were 14 volunteers that were the test subjects. One group was the normal sleep control. The other group underwent chronic sleep deprivation. Each group did this for 6 weeks. There was a 4-to-6-week washout period. Following this the previous normal sleep group started a 6-week sleep deprivation program. On the other hand, the prior sleep-deprived group switched to 6 weeks of normal sleep. All of the participants had daily late afternoon blood tests.

There are many sleep disruptions, which cause a sleep deficit

In modern life sleep gets disrupted in many ways. There can be sleep fragmentation, sleep restriction, jet lag, obstructive sleep apnea (OSA), and insomnia.

People with these conditions often oscillate between these various types. They may have a few days of normal sleep, but then have sleep deprivation again for a few days. Every time they have sleep deprivation the bone marrow enhances hematopoietic activity. Normally there is a high leukocyte number in the blood at the end of the day and in the morning a lower leukocyte count. But with sleep deprivation there is a high monocyte count in the blood that stays high even when subjects switch back to a normal sleep pattern.

Epigenetic effect of sleep deprivation on bone marrow cells

The authors found that sleep deprivation affects the genetic control of hematopoietic cells in the bone marrow. They called this the epigenetic effect of sleep deprivation. This is responsible for the evening leukocyte response, the monocytosis and the tendency for autoimmune diseases. They summed this up by saying: “Our findings support the hypothesis that periods of poor sleep, even if followed by sleep recovery, have sustained consequences on immunological health.”

Lack of sleep harms the immune system and causes inflammation says the literature

There is ample evidence that a lack of sleep causes cardiovascular disease, diabetes, depression and more frequent infections. Healthy sleep is important when you want to age well without complications. But enough sleep is also necessary to prevent obesity, diabetes and cardiovascular disease. Experts consider getting enough high-quality sleep as essential as a balanced diet and regular exercise.

Lack of Sleep Harms Immune System and Causes Inflammation

Conclusion

So far, most researchers believed that when you miss some sleep for a few nights that a afternoon nap or a few nights of longer sleep would compensate for the sleep deficit with no sequelae. Think again, because new research from a group in Boston, MA and New York, NY found that lack of sleep harms the immune system and causes inflammation permanently. Sleep deprivation stimulates the bone marrow cells to multiply and causing proliferation of monocytes, called monocytosis as well. Despite afternoon naps and recovery sleep this condition remains and can lead to autoimmune diseases. All this was unknown up to now. Our bone marrow cells need regular sleep hours to stay diversified and to optimally fight infections in the body. This prevents autoimmune diseases and keeps our defenses against viral diseases strong.

Nov

2021

How to Fall Asleep Quicker

By Ray Schilling | alcohol, Circadian rhythm, Diabetes, Insomnia, melatonin, Pain, sleep, Sleep apnea

Early October 2021 CNN had an article about how to fall asleep quicker. Most people take 15 to 20 minutes to fall asleep.

Sleep environment

It is important to arrange a sleep environment where you can sleep well. This includes bedroom darkening and keeping the room temperature of 60 to 67 degrees Fahrenheit (15 to 20 degrees Celsius). Make sure your bed is comfortable and use your bedroom only for sleeping and sex. Do not read in the bedroom, keep your cell phone in another room and do not have a TV or computer in the bedroom. These produce blue light, which stimulates your brain. This is exactly what you do not want to have in your bedroom.

Normal sleep duration for different ages

There are always exceptions to rules. In this case there is a rare gene that allows the carrier to sleep only 5 hours at night and still have normal energy during the day. It is called short sleep gene.

Here are the hours of sleep that everybody else needs every night in different age groups:

Adults: 7-8 hours
School-age children: 12 hours
Teenagers: 8-10 hours

If you get the proper hours of sleep, but you are still tired during the day, you may have a lack of quality of sleep. Older people often have to go to the bathroom several times during the night. As it takes some time to reach the deepest level of sleep at night (REM sleep) older people often miss significant amounts of REM sleep during which they dream. The end result is a lack of energy during the day.

Conditions that interrupt your sleep

There are some medical conditions that can interfere with a good night’s sleep. Obstructive sleep apnea is one such condition that 25 million Americans have. A person with this kind of condition snores, gasps, chokes or stops breathing periodically during the course of the night. Restless leg syndrome is another condition, which interferes with a restful, deep sleep. Other conditions are chronic pain, heart disease, diabetes, asthma and gastroesophageal reflux. Medication can affect sleep depth as well.

Falling asleep naturally

Despite many studies it is not clear why some people have no problem falling asleep while others find it difficult. Taking 10 to 20 minutes of falling asleep is normal. If you cannot fall asleep after 20 minutes of trying, go to a dim room and do something calming until you feel drowsy again. Then return to your bed. Follow the same procedure, if you wake up in the middle of the night and you have difficulties falling asleep again. Deep breathing, yoga and meditation are proven remedies to pipe down and help you to fall asleep.

Monitoring sleep at a sleep clinic

A sleep study can be very helpful in diagnosing sleep disturbances. The sleep expert measures several body functions simultaneously. These are heart rate, air flow, blood oxygen level, breathing rate, brain wave activity, muscle movements and eye movements. During a night sleep study, a polysomnogram records all these body functions automatically. The finding helps the sleep expert to diagnose and treat the sleep disturbance.

Self-help supplements for insomnia

My regular sleep supplement every night is 3 mg of melatonin.

Sometimes this is not enough, because I watched an exciting movie or I wrote too much for Quora online. When I can’t fall asleep within 30 minutes, I take a capsule of 500 mg of valerian root. I would say that this helps in 95% of the nights to fall asleep.

If for some reason I still can’t fall asleep, I use 25 drops of Passion Flower Extract: I find that this is very reliable and puts me to sleep within 15 to 20 minutes of taking it. This way I am avoiding prescription narcotics and I am not getting addicted to benzodiazepines. The last step (Passion Flower Extract) I require only once or twice a month. The chemical in the Passion Flower Extract is very similar to benzodiazepines, which means you don’t want to take this every night or your system could get addicted to it.

How to Fall Asleep Quicker

Conclusion

Falling asleep is something we all can learn. It starts with a quiet and relaxing bedroom ambience. We need to allow for enough sleep duration. Adults need 7 to 8 hours of sleep, children and youth more. Deep breathing, yoga and meditation are proven remedies to prepare you to fall asleep easier. When all fails there are a number of self-help supplements you can take to help you ease into sleep. If you still have problems falling asleep a sleep study can be very helpful in diagnosing sleep disturbances. In a sleep clinic your heart rate, air flow, blood oxygen level, breathing rate, brain wave activity, muscle movements and eye movements are recorded with a polysomnogram. The doctor from the sleep clinic can formulate the diagnosis of the sleep disorder and help you overcome any identified problems.

The subchapter “Self-help supplements for insomnia” was published by me earlier here.

Aug

2021

When Stress Becomes Abnormal

By Ray Schilling | alcohol, Alzheimer’s disease, Cardiovascular disease, Diabetes, heart attack, Hormones, Smoking, Stroke, thyroid disease

Recently CNN published an article that dealt about when stress becomes abnormal.

We all have experienced stress. It makes our heart beat faster and our breathing speeds up as well. But when the stressful situation is over, stress usually subsides also. Some people though have so much stress in their lives that they never completely recover from any stressful situation. They develop chronic stress, which can lead to physical illnesses or mental disease. I have previously written about “stress drives our lives”. In the following I am reprinting the next 5 paragraphs.

Heart attacks and strokes when stress becomes abnormal

In a 2015 Lancet study 603,838 men and women who worked long hours were followed for an average time of about 8 years with respect to heart disease or strokes. All of the subjects were free of heart attacks and strokes when they entered into the study. There was a total of 13% more heart attacks in those who worked extra hours in comparison to those who worked 40 hours per week or less. With respect to strokes there were 33% more strokes in those who worked long hours. Researchers noted a dose-response curve for strokes in groups with various workloads. Compared to standard working hours there were 10% additional strokes for 41-48 working hours, 27% for 49-54 working hours and 33% for 55 or more working hours per week.

Stress drives some of us to substance abuse

In order to cope with stress many of us “treat” daily stress with alcohol. It makes you feel good subjectively, but it can raise your blood pressure causing heart attacks and strokes down the road. A low dose of alcohol may be healthy, but medium and high doses are detrimental to your health.

Next, many people still smoke, although scientists have proven long time ago that it is bad for your health. It can cause heart attacks, various cancers and circulatory problems leading to leg amputations.

Overeating is another common problem. Comfort food relieves stress, but it causes us to put on extra pounds. As you know it is easier to put weight on than to take it off. Being overweight or being obese has its own problems: arthritis in the hips and knees makes walking more difficult. The metabolic syndrome sets in, which is a characteristic metabolic change causing diabetes, high blood pressure, heart attacks, strokes and certain cancers. The more weight you carry, the less likely you are to exercise. This can lead to further deterioration of your health.

Diabetes can occur when stress becomes abnormal

Stress causes too much cortisol secretion from the adrenal glands. This raises blood sugar, and when chronic can cause diabetes. In addition, unhealthy eating habits in an attempt to cope with stress can cause weight gain. Insulin resistance causes high blood sugars and diabetes.

Korean immigrant study

In a 2012 California study 148 adult Korean immigrants were examined. They all had elevated blood sugars confirming the diagnosis of type 2 diabetes. They had an elevated waist/hip ratio.

A high percentage of the study subjects had risk factors for type 2 diabetes. This included being overweight or obese and having high blood glucose readings. 66% of them said that they were feeling stressed, 51% reported feeling anxious, 38% said they were feeling restless, 30% felt nervous and 3% said they were feeling hopeless. It is easy to see the connection between stress and disease!

Australian study showed that anxiety can cause diabetes

An Australian long-term follow-up study computed risk factors for developing type 2 diabetes. Stress was a major contributor to diabetes.

A 30-day episode of any anxiety disorder had a 1.53-fold risk to cause diabetes. A depressive disorder had a 1.37-fold risk to cause diabetes and posttraumatic stress disorder had a risk of 1.42-fold to cause diabetes.

Infertility may develop when stress becomes abnormal

Stress changes hormones in women causing ovulation problems and infertility. 1 in 8 couples in America have problems getting pregnant. Physicians identified stress as at least one of the contributing factors. But in men stress can also reduce sperm count and semen quality as this study describes.

Alzheimer’s disease and stress

A 2010 study from Gothenburg University, Sweden examined 1462 woman aged 38-60 and followed them for 35 years.

Psychologists assessed the stress score in 1968,1974 and 1980. 161 females developed dementia (105 Alzheimer’s disease, 40 vascular dementia and 16 other dementias). The risk of dementia was higher in those women who had frequent/constant stress in the past. Women who had stress on one, two or three examinations suffered from higher dementia rates later in life. Researchers compared this to a group of women who did not have any significant stress. Specifically, dementia rates were 10% higher after one stressful episode, 73% higher after two stressful episodes and 151% higher after three stressful episodes.

Hormone system affected by stress

I have written an article before about how stress affects our hormone system.

I am reprinting excerpts from this here (the next 4 paragraphs).

Dr. Andrew Heyman gave a talk about how stress affects our hormone system. He presented his talk at the 24^th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. It was entitled “Understanding the Stress, Thyroid, Hormone Connections & Prioritizing Systems”.

Dr. Heyman emphasized in particular that there is a triad of hormonal connections that is important to remember: the thyroid hormones, the stress hormones (adrenal glands) and the pancreas (insulin production). It seems like we need a balance of these hormones for optimal energy production and circulation. Under stress our sugar metabolism can markedly derail, we develop obesity and fatigue. But when balanced, we experience vitality and wellbeing.

Metabolic activation pathways

Dr. Heyman projected a slide that showed the metabolic activation pathways. Likewise, he stated that a number of different factors could influence the hormone system:

Diet: trans fats, sugar, too many carbs, food allergies.
Drugs: drug-induced nutrient depletion (over-the-counter drugs, prescription drugs).
Physical exercise: frequency and type matters.
Environmental exposure: chemicals, pesticides, herbicides, heavy metals, plastics, molds, and pollens.
Stress: physical stress, psychogenic stress.
Genetics: methylene-tetra-hydro-folate reductase enzyme deficiency (MTHFR mutation), APOE genes, lack of vitamin D
Disease: past or present conditions, active disease or syndromes.

Target areas within your system

The target areas in your system are the

Pancreas, where blood sugar can rise because of insulin resistance. In particular, too much insulin production causes inflammation, hormone disbalances, kidney damage, and hardening of the arteries through plaque formation.
Thyroid gland, which depends on TSH (thyroid stimulating hormone) for activation. Autoantibodies can also affect it negatively.
Brain: decrease in serotonin resulting in anxiety, depression and food cravings; decreased melatonin causing sleep disturbances; increased ghrelin and decreased leptin secretion leading to overeating and obesity.

Other target areas of stress

Liver/kidneys: both of these organs are important for detoxification; the liver produces thyroid binding globulin, which when increased can lower the free thyroid hormones.
Immune system (gut, lymph glands): the Peyer’s patches in the gut mucosa produce a large portion of the immune cells; lymph glands, the bone marrow and the spleen supply the rest. A leaky gut syndrome can affect the whole body, in addition causing inflammation and autoimmune reactions.
Hypothalamus/pituitary/adrenal glands: this is the main axis of the stress reaction. A brain under stress activates the hypothalamus. It sends a cascade of activating hormones via the pituitary gland and likewise activates the adrenal glands. Finally, this leads to cortisol overproduction, and release of epinephrine and norepinephrine from the center of the adrenal glands. High blood pressure, anxiety, heart palpitations, arrhythmias and more can finally develop from this.

Treatment suggestions to cope with stress

There are thyroid supplements that can support the function of the thyroid gland. Similarly, there are several supplements to support the adrenal glands.
Chromium, vitamin D, magnesium, alpha-lipoic acid, fish oil and others are useful to support the pancreas. Relaxation methods like self-hypnosis, meditation, yoga, Tai-Chi and others are very useful to counter stress. If you can change your job to evade stress, take the opportunity and find another job with less stress. See a health professional and discuss what you can do to become more stress-resistant. If you are overweight or obese, see a dietitian to help you lose weight. Aerobic exercises like running for 30 minutes on a treadmill can help reduce stress. Various relaxation methods mentioned earlier also can counter stress. They help you to block out worrying about the past and the future, but instead focus on what is positive in the present.

When Stress Becomes Abnormal

Conclusion

I have described what stress can do to your body. It can give you heart attacks and strokes. Stress in some people can lead to substance abuse. It can cause diabetes, infertility and even Alzheimer’s disease. I described how thyroid hormones, insulin and brain hormones are interconnected and suffer with stress. Other factors can make the effects of stress worse or better as I discussed in detail. Treatment of stress-induced conditions requires a combination of preventative steps and medical therapies. Ignoring stress is not an option as this could lead to premature death. Managing stress, as mentioned before, and keeping it to a minimum is the answer.

Jan

2021

Melatonin Is More Than a Sleeping Aid

By Ray Schilling | Alzheimer’s disease, Anti-aging medicine, Autism, autoimmune disease, Cancer, Cardiovascular disease, Circadian rhythm, Dementia, Diabetes, Health, heart attack, Heart Disease, Hormones, immune system, Inflammation, Insomnia, melatonin, Menopause, mitochondria, Multiple sclerosis, neurological disease, Osteoporosis, Parkinson’s disease, sleep, Stroke

Notably, the January 2021 issue of the Life Extension magazine informs you that melatonin is more than a sleeping aid. It contains an interview between Dr. Roman Rozencwaig and a Life Extension (LE) magazine reporter. It must be remembered that Dr. Rozencwaig dedicated much of his career to the healing effects of melatonin. Another keypoint is that in 1987 Dr. Rozencwaig published a paper together with two other researchers. Specifically, it showed that melatonin production by the pineal gland declines in older age. Markedly, they stated that this is the reason why people age and why diseases of aging develop. Another key point is that Dr. Rozencwaig also stated that taking oral melatonin can promote a healthier life.

Melatonin deficiency causing aging and various illnesses

With the aging process the pineal gland calcifies and melatonin production is steadily declining. Surely, along with this is a deterioration of the circadian hormone rhythm. Meanwhile, the neuroendocrine system in the brain gets disorganized. Accordingly, this causes various diseases to occur. To emphasize, Dr. Rozencwaig says that a proper balance between melatonin and neurotransmitters is what we need to maintain health and longevity. As a result, a daily intake of melatonin supports healthy aging and longevity.

The many clinical effects of melatonin

Oral melatonin tablets help you to fall asleep easier, particularly the population that is older than 60 years.

But besides that, melatonin has many other clinical effects.

Melatonin improves immunity, which improves resistance against infections. It helps also in cancer prevention
Melatonin maintains the circadian hormone rhythm by synchronizing pituitary and hypothalamic hormone production
It protects the brain and may prevent Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, autism, and others
Melatonin modulates anti-inflammatory cytokinins in different diseases

Dr. Rozencwaig mentioned that melatonin slows down the aging process. There are multiple intertwining reasons for this.

Melatonin’s actions against the aging process

Melatonin regulates gene expression. This means that some signs and symptoms of aging can be reversed through genetic switches
Because melatonin regulates the immune response, the body is more protected against viral, bacterial and parasitic infections
Melatonin helps to overcome chronic inflammation that produces cytokines
Melatonin is also liver-protective through stimulation of an enzyme (AMPK). This enzyme regulates cellular metabolism.
There are other processes that melatonin is involved in: energy metabolism by protection and restoration of mitochondria.
Melatonin protects against osteoporosis by balancing and regulating bone formation versus bone loss.

More actions of melatonin

An important function of melatonin is the stimulation of antioxidant enzymes like glutathione peroxidase and superoxide dismutase (SOD)
Melatonin regulates sirtuins, which are proteins that maintain cellular health. They protect you from obesity, type 2 diabetes, cancer, heart attacks and strokes, dementia and more
As already mentioned, melatonin is a neuroprotective agent and may prevent Alzheimer’s and dementia
Melatonin stimulates apoptosis of cancer cells.
Oral health and melatonin are related. Melatonin suppresses herpes infections and periodontal disease. Melatonin prevents oral cancers to a certain degree. In addition, dental implants survive better when melatonin is present in saliva.

Prevention of cognitive decline

Dr. Rozencwaig mentioned that melatonin stops much of the cognitive decline of aging. To achieve this the following processes take place.

Melatonin improves the sleeping pattern and increases the amount of REM sleep.
During sleep melatonin removes toxic amyloid and tau proteins. We know that with Alzheimer’s disease these are the proteins that accumulate in the brain.
Melatonin improves myelination of white matter in the brain. This prevents brain atrophy of old age.
The brain is metabolically very active and produces toxic free radicals. But melatonin is a strong antioxidant dealing with free radicals. Melatonin can cross the blood brain barrier and stimulates enzyme production to eliminate toxic reactive oxygen species.
Chronic inflammation also increases with age, but melatonin deals with this condition in the brain.
Here are 3 subtypes of melatonin receptors. The body integrates the multitude of actions of melatonin with the help of these receptors.

Melatonin Is More Than a Sleeping Aid

Conclusion

Melatonin is a powerful antioxidant that has many other useful protective qualities as explained. The body integrates various functions like anti-aging, anti-free radical activity, neuroprotection in the brain and more. Melatonin even synchronizes pituitary and hypothalamic hormone production. This helps to integrate the effect of melatonin, which benefits the body in many ways. Melatonin prevents Parkinson’s and Alzheimer’s disease, multiple sclerosis, autism, obesity, type 2 diabetes, cancer, heart attacks, strokes and dementia. Melatonin production deteriorates from the age of about 60 onwards. It is important to supplement with melatonin at nighttime from that age on. Usually, you only need small amounts of melatonin, between 1mg and 3 mg at bedtime. This prevents most of the serious diseases of old age, stimulates your immune system and lets you age gracefully.

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Dec

2020

Mother’s Lifestyle Predicts Heart Attack Risk for Offsprings

By Ray Schilling | Cardiovascular disease, cholesterol, Diabetes, exercise, food, heart attack, High Blood Pressure, lifestyle, Nutrition, Smoking, Stroke

A European Society of Cardiology study found that mother’s lifestyle predicts heart attack risk for offsprings. This study was published in the Journal of Preventive Cardiology, a journal of the European Society of Cardiology. It was also summarized in Science Daily. The study author Dr. James Muchira of Vanderbilt University, Nashville said: “This maternal influence persists into the adulthood of their offspring.” What he meant is that the study found that lifestyles of mothers influence the choices of lifestyles of the offsprings, and with poor choices even determine when the next generation gets their heart attack or stroke.

In previous research the team established that both genetic factors as well as environmental and lifestyle factors are responsible for cardiovascular disease. Now the researchers wanted to determine the influence of each parent on the risk of cardiovascular disease of the offspring.

Set-up of the study

The study was done with offspring and the parents of the Framingham Heart Study. 1989 children from 1989 mothers and 1989 fathers were enrolled 1971 and followed for 46 years. The average age of the offspring at enrolment was 32 years. The study ended 2017. Dr. Muchira said: ”Crucially, the study followed children into most of their adult life when heart attacks and strokes actually occur.”

Risk factors for cardiovascular disease

The researchers rated the risks of fathers and mothers in the study according to 7 factors.

Smoking status (non-smoker preferred)
Diet (healthy or not)
Physical activity
Body mass index (normal or not)
If blood pressure is too high
Level of blood cholesterol
Blood sugar values

The researchers established three categories of cardiovascular health: poor (fulfilment of 0 to 2 factors); intermediate (fulfilment of 3 to 4 factors) and ideal (fulfilment of 5 to 7 factors). The researchers wanted to know how long the offspring were able to live without symptoms of cardiovascular disease.

Findings of the study

Here are the findings of the study.

Children of mothers with ideal cardiovascular health lived free of cardiovascular symptoms for 27 years; they were on average 32+27= 59 years when symptoms started.
Children of mothers with poor cardiovascular health lived free of cardiovascular symptoms for 18 years; they were 32+18= 50 years old when symptoms started; this is 9 years earlier than children from mothers with ideal cardiovascular health.
Father’s cardiovascular health did not influence the children’s onset of cardiovascular symptoms.

Cardiovascular risks of the children are due to a combination of things

A combination of the health status during the pregnancy and the environment in early life influenced the children.

Dr. Muchira said: “If mothers have diabetes or hypertension during pregnancy, those risk factors get imprinted in their children at a very early age. In addition, women are often the primary caregivers and the main role model for behaviors.” Sons were much more affected by their mother’s cardiovascular health status. Dr. Muchira explained: “This was because sons had more unfavourable lifestyle habits than daughters, making the situation even worse. It shows that individuals can take charge of their own health. People who inherit a high risk from their mother can reduce that risk by exercising and eating well. If they don’t, the risk will be multiplied.”

Discussion

We remember that the Framingham Heart Study long time ago established the above-mentioned risk factors for heart disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159698/ It is also important for the offspring to quit smoking as this is a high-risk factor for heart disease. Next eat a balanced diet, like the Mediterranean diet. With this you eat more vegetables, less meat, more fish and add olive oil. Engage in regular exercise, which will raise the protective HDL cholesterol. Keep your body mass index low (in the 21.0 to 22.0 range, but definitely below 25.0). Keep your blood pressure in the normal range (120/80 or less). Make sure that your blood cholesterol and blood sugar values are normal. This will give you the lowest risk to develop a heart attack or a stroke.

Mother’s Lifestyle Predicts Heart Attack Risk for Offsprings

Conclusion

We are normally concerned about our own cardiovascular health. But in a new study researchers examined children of participants in the Framingham Heart Study and their parents. This showed that the cardiovascular health status of the mother had a significant influence on the children’s cardiovascular health. The offspring had an average age of 32 years when the researchers started to follow them for 46 years. When the mother was in poor cardiovascular health, the offspring developed cardiovascular symptoms at age 50. But when the mother’s cardiovascular health was ideal, the children got symptoms of cardiovascular disease only at age 59. This delay of 9 years of disease onset was purely due to the mother’s cardiovascular health status.

Risk management of cardiovascular risks

The authors of the study say that the children can do a lot to minimize the cardiovascular risk. They need to work to reduce the known risk factors and also start a regular exercise program. The authors of the study mentioned that even people who inherited a risk for cardiovascular disease benefit significantly from cutting out risk factors for cardiovascular disease.

Aug

2020

Health Benefits from Vitamin C Supplements

By Ray Schilling | Cancer, Cardiovascular disease, Diabetes, diet, heart attack, High Blood Pressure, immune system, Mortality, Stroke

Notably, there are health benefits from vitamin C supplements as I will explain below. A recent publication in the Journal of Intensive Care stated that vitamin C may lower ventilator time for sick patients in the ICU. In this case, researchers performed a meta-regression analysis. It is important to realize that higher doses of vitamin C changed the need for ventilation. Vitamin C given intravenously or by mouth significantly reduced the need for ventilation in sick patients. To explain, the researchers pooled eight clinical trials and compared them to a control group who did not receive vitamin C treatment. In detail, the researchers noted that there was a 14% reduction with regard to ventilator use in the treatment group. To clarify, they had received vitamin C infusions while patients who did not receive vitamin C infusions served as controls.

Five of the clinical trials involved patients who received 10 hours or more ventilation treatment. Certainly, these patients were sicker than the average ICU patients. They experienced a 25% reduction of ventilator time after receiving between 1 and 6 grams of vitamin C. The physicians gave this intravenous or orally.

History of Mega doses of vitamin C

Indeed, in the 1940’s mega doses of vitamin C were given intravenously in an attempt to treat polio. Eventually, in the late 1960’s Linus Pauling called high doses of vitamin C the “healing factors for diseases”. But subsequent clinical investigations showed that vitamin C had limitations. The Oregon State University website reports that some of the claims about vitamin C in the past went overboard. Here are some points about vitamin C that we need to remember.

Vitamin C is an important cofactor in many enzymatic reactions, such as the biosynthesis of collagen, carnitine and neuropeptides. In addition, the regulation of gene expression requires vitamin C and vitamin C is an important antioxidant.
A prospective cohort study showed that higher vitamin C blood levels lowered the risk of high blood pressure, coronary heart disease and strokes.

More effects of vitamin C

Patients in need of a surgical procedure benefitted from vitamin C. Researchers showed that vitamin C was a valuable adjunct to conventional medicine in cardiovascular disease Vitamin C reduced arrhythmia and myocardial injury following cardiac procedures.
There is insufficient evidence that regular vitamin C intake prevents cancer. Randomized controlled clinical trials reported no effect of vitamin C on cancer.
10 grams per day of vitamin C has no association with toxic or adverse effects in most people. However, some adults are more sensitive to vitamin C and develop gastrointestinal disturbances and diarrhea with megadoses of vitamin C. For these people physicians recommend taking up to 2 grams per day of vitamin C.

Vitamin C and disease prevention

Several clinical trials involving vitamin C supplements showed significant positive effects on patients. Below I am briefly reviewing these clinical trials.

Endothelial function

Endothelial function was improved with doses of above 500 mg of vitamin C. This likely is the reason that there is a reduction of cardiovascular disease in people who consume 1000 mg of vitamin C daily.

High blood pressure

Vitamin C at 500 mg daily lowers high blood pressure. A clinical trial found that 500 mg of vitamin C daily lowers the systolic blood pressure by 3.84 mm mercury and the diastolic blood pressure by 1.48 mm mercury. Over several years’ time this can prevent premature heart attacks and strokes.

Vitamin C and the immune system

Vitamin C is a powerful antioxidant. It can neutralize reactive oxygen species, which are produced when the immune cells fight viruses and bacteria. Neutrophils, lymphocytes and phagocytes are all supported by vitamin C. Vitamin C and E co-operate in their antioxidant functions. Vitamin C is essential for a strong antibody response with bacterial or viral infections. I take 1000 mg of vitamin C once daily.

Heart failure, strokes and heart attacks

Many studies showed some effects on reduction of heart attacks, strokes and congestive heart failure. With respect to strokes there was a 42% risk reduction over 9.5 years when the highest vitamin C plasma level was compared to the lowest level. But results regarding heart attack prevention and prevention of CHF were only marginal.

Cancer and vitamin C

Stomach cancer: there was a 45% reduction of stomach cancer when high vitamin C plasma level cases were compared to low plasma level cases.

Colon cancer: A pooled study based on 13 prospective cohort studies showed that vitamin C supplementation reduced colon cancer risk by 19%.

Large B cell lymphoma: After 11 years of follow-up the Women’s Health Initiative found that vitamin C supplementation reduced diffuse large B cell lymphoma by 31%.

Researchers could not show significant effects of vitamin C on other cancers.

Type 2 Diabetes (=adult onset diabetes)

A large European study going on for 12 years showed a strong inverse relationship between blood levels of vitamin C and the onset of diabetes. Patients with the highest vitamin C blood levels had a 62% lower risk of developing diabetes. Physicians compared this to low level vitamin C controls.

Mortality reduction with vitamin C supplementation

In the EPIC-Norfolk prospective study a clear inverse relationship was found with higher vitamin C blood levels and a reduction in risk of all-cause mortality.

Recommended dietary allowance for vitamin C

The official dietary recommendation for vitamin C in adults is 90 mg daily for males and 75 mg daily for females. However, in view of the above mentioned clinical trials I would recommend the following. Supplement with 500 mg to 1000 mg of vitamin C daily to have enough vitamin C reserves. The reason I say this is that the official dietary recommendation was based on preventing scurvy, the historic insufficiency disease of vitamin C. In addition, as mentioned before, vitamin C is safe to take up to 10 grams per day. Many physicians recommend taking a smaller amount of vitamin C found to prevent strokes, high blood pressure, type 2 diabetes, improve endothelial function and strengthen the immune system.

Health Benefits from Vitamin C Supplements

Conclusion

In my review I discussed health benefits from vitamin C supplements. Briefly, doctors noted that severely sick patients on respirators in the ICU setting were able to reduce the ventilator use. This was significant after they received between 1 and 6 grams of intravenous or oral vitamin C. However, patients with the highest vitamin C supplementation had a 62% lower risk of developing diabetes than low level vitamin C controls. Vitamin C lowered high blood pressure moderately and prevented strokes by 42%. Vitamin C stimulates the immune system together with vitamin D, A, E and some trace minerals. There are many more health benefits from vitamin C supplements. The official dietary recommendation for vitamin C in adults is 90 mg daily for males and 75 mg daily for females. However, I take 1000 mg of vitamin C daily as the evidence shows that this is healthier.

Jul

2020

Key Factors for Centenarians

By Ray Schilling | alcohol, Alzheimer’s disease, Cancer, Cardiovascular disease, Diabetes, diet, exercise, fasting mimicking diet, fish oil, food, heart attack, Mortality, olive oil, omega-3 fatty acids, Prevention, Processed food, stress, Stress management, Stroke

A study from Washington State University (WSU) showed some of the key factors for centenarians to survive. The publication of the study goes back to June 17, 2020. In general, it was common knowledge that genetics plays a role in 25% to 35% of centenarians for their survival. That is to say, the remainder is the result of lifestyle factors. It is important to realize that the environmental factors play a significant role in the survival of centenarians, said Rajan Bhardwaj, a second-year WSU medical student. He and his research team determined what allowed centenarians to reach an age of 100 or above. Briefly, they identified the following factors that were necessary.

Three factors identified by the Washington State University study

walkability of the neighbourhood, which encourages regular exercising
belonging to the higher socioeconomic class
a high percentage of working population in the neighborhood (a mixed population) was also important

In the discussion the authors of the WSU study said that “blue zones” of centenarians had been mentioned before in the literature. To clarify, these are areas in the world where more than the average of centenarians live. Dan Buettner used the term “blue zones” in a National Geographic article about where centenarians were located.

The blue zones

He wrote a book about the location of the 5 blue zones. Notably, they are located in Sardinia (Italy), the islands of Okinawa and a group of Seven Day Adventists in Loma Linda. California. In addition, the Nicoya Peninsula of Costa Rica, and the island of Icaria, Greece complete the 5 blue zones. Specifically, Dan Buettner described the following characteristics of the lifestyle of centenarians.

They engage in regular physical activity
Mostly eating a plant-based diet including legumes
Calorie intake is moderate
Moderate intake of alcohol, mostly wine
Having a purpose in life
Engaged in family life
Having an active spiritual life
Reducing stress
Engaged in social life

Other attributes of centenarians

Dr. Thierry Hertoghe gave a presentation in Las Vegas on Dec. 14, 2019 where he stated that centenarians are positive thinkers. This was at the 27^th Annual World Congress on Anti-Aging Medicine. In particular, the topic of his talk was “Positive Psychological Attitudes of Centenarians “. Dr. Hertoghe is an endocrinologist in Belgium. He took an interest in people above the age of 100. These people, he felt, are special people with a very optimistic outlook on life. Dr. Hertoghe went on to say that centenarians have a will to live. Indeed, they adapt to changes; they have a sense of purpose, and they stay active.

More positive attributes of centenarians

Other psychological features, by the same token, show that they have a positive mood and they avoid stress and anxiety. Another key point is that they have self-determination. It must be remembered also that they are very sociable, have close family ties, love their relationships and often have a strong religious faith. In addition, there is a connection between their basic values, beliefs and spirituality. Truly, centenarians insist on their freedom and they have a feeling of youth. For one thing, centenarians have their own centenarian spirit where they can feel young or old.

In the following I am reviewing some of the details that Dr. Hertoghe gave.

The will to live

For one thing, it takes courage to grow old, and all centenarians have this. They say “Life is worth living”. Essentially, they have a certain resiliency in a world that has an obsession about youth. Despite negative experiences they had to overcome they do not give up and they enjoy life as much as they can. A Finnish study examined 400 individuals aged 75-90 and followed them for 10 years. Group 1 who wished to live less than 5 years had a mortality rate of 68%. Group 2 wished to live for 5-10 years. They had a mortality of 45.6%. The last group, group 3 wanted to live more than 10 years. Surprisingly, their mortality was only 33.3%. Be careful what you wish for!

Adaptability

In other words, this describes the capacity to overcome adversity and your ability to adjust. In a study of 7400 Chinese centenarians’ resilience to changes was measured with psychometric psychological tests. The majority of subjects did not qualify for being resilient. However, 9% of male centenarians and 6% of female centenarians had the resiliency where they qualified for high adaptability. This high resilience group had a 2%-4% lower mortality risk. They had a 36%-55% higher probability of not developing cognitive impairment. That is to say, they rated themselves to be in good health and having a “good life” satisfaction. These resilient centenarians had a 7%-12% higher probability of not developing a physical disability. In essence, these high resilient centenarians had no short-term health decline.

Remaining active

If a centenarian remains active and moves about several hours per day, the body functions are preserved. Anna Mary Robertson Moses who was known by her nickname “Grandma Moses” took up painting at age 78. She died at age 101 in 1961.

Positive emotions

One study of 54 Ashkenazi Jewish older adults (aged 98-107) compared those with positive emotions to those with negative emotions. The researchers noted that a positive attitude about life allowed centenarians to live longer.

A study involving 2282 Mexican Americans aged 65 to 99 showed that positive affect scores were a predictor for the following. Subjects with a high positive affect had a 52% lower probability of becoming physically disabled. They were 36% less likely than the negative controls to lose their walking speed. In addition, they were 47% less likely to die during the two-year observation period than their negative controls.

Nurses’ Health Study and Veterans Affairs Normative Aging Study

Two studies, the Nurses’ Health Study (NHS) and men from the Veterans Affairs Normative Aging Study measured optimism. The researchers found that those with the highest optimism scores had a 1.5-fold higher probability in women and 1.7-fold in men to survive to age 85. This was compared to a control with the lowest optimism scores. Dr. Hertoghe provided 19 more studies that showed the effects of positive emotions regarding long term survival. For brevity reasons I will not dwell on them here.

What is the centenarian spirit?

When people are older than 100 years, they often have a mix of humor and eccentricity; they express emotions openly and they are happy people. They accept the death of spouses, siblings and significant others.

By the way, humor has a strong predictive survivor value. In a study that researchers conducted over 15 years, there was a clear positive effect of humor regarding mortality. A sense of humor reduced the all-cause mortality by 48% in males. In women humor lowered mortality regarding cardiovascular disease by 73%. Humor reduced death due to infections in women by 83%. Men had a non-significant reduction of all‐cause mortality by 12% and a significant lower mortality due to infections by 74%. Dr. Hertoghe cited three more publications that showed the power of humor in reducing disease and disability.

The fasting mimicking diet helps you to reach a longer life

A clinical trial with 100 subjects was undertaken by Dr. Longo and his research team. He measured markers after 3 cycles of a fasting mimicking diet for 5 days every month. They found that the FMD reduced aging markers, improved diabetes and reduced susceptibility for cancer and cardiovascular disease. In another publication Dr. Longo and co-authors describe how autoimmune diseases can be improved by the use the fasting mimicking diet for 5 days every month.

Another publication by Dr. Longo describes that “age-related disorders including diabetes, cardiovascular disease, cancers and neurological disorders such as Alzheimer’s disease, Parkinson’s disease and stroke” can be prevented by fasting mimicking diet for 5 days every month.

Even cancer prevention and cancer treatment can be helped by the fasting mimicking diet. The FMD makes chemotherapy more tolerable.

Key Factors for Centenarians

Conclusion

As we reviewed the factors that lead to longevity, we learnt that engaging in regular moderate exercise is one of the key factors. But belonging to the higher socioeconomic class and living in a mixed neighborhood with people from all walks of life is also important. We also reviewed the blue zones according to Dan Buettner. Mostly eating a plant-based diet including legumes with moderate calorie restriction prolongs your life. Add to this moderate intake of alcohol, mostly wine, and having a purpose in life. Augment this further with being engaged in family life, having an active spiritual life and reducing your stress level.

Living longer is a matter of fulfilling these longevity factors

With all of this you are on your way to become a centenarian. A review by Dr. Hertoghe in a lecture given at an Anti-Aging Conference in Las Vegas in 2019 added more criteria centenarians have. He provided references regarding the will to live, being adaptable, remaining active and harboring positive emotions. The more of these factors you can adopt, the longer you will live. At the same time, you will avoid getting diseases like heart attacks, strokes or cancer, which leads to a longer and healthier life.

The above text contains parts of this blog. The part about the fasting mimicking diet was published here before.

Jul

2020

Fat Deposits Mean Higher Covid-19 Risk

By Ray Schilling | Diabetes, diet, food, heart attack, Infectious Disease, Inflammation, lifestyle, Mortality, Nutrition, Obesity, Stroke, sugar, Weight loss

A new study showed that fat deposits mean higher Covid-19 risk. This study was reviewed here.

The article is based on the June 10, 2020 publication of the British Medical Journal.

They did large population studies showing that obesity is an independent risk factor for severe disease and death from Covid-19. One study with 428,225 participants had 340 admitted to hospital with confirmed Covid-19 coronavirus. 44% of them were overweight and 34% were obese. Another study, the OpenSAFELY study used linked electronic health records. 17,425, 445 participants were included and 5,683 Covid-19 deaths occurred. In this study there were 29% overweight and 33% obese persons. The researchers noted a dose-response relationship between excess weight and severity of Covid-19. The researchers removed confounding factors like age, sex, ethnicity, and social deprivation.

Critical illness and death rates in overweight and obese people

They realized that critical illness caused by Covid-19 was increased compared to normal-weight people as follows.

Covid-19 risk 44% higher in overweight people
Covid-19 risk 97% higher in people with obesity

This means that the risk for serious illness from Covid-19 was 1.44-fold for overweight persons and 1.97-fold for obese persons compared to normal-weight controls. The OpenSAFELY study also looked at the death rates from Covid-19 for people with obesity. Two obesity categories were investigated: obesity with a BMI of 30-34.9 and BMI of greater than 40 compared to normal-weight controls. Here are the death rates.

BMI of 30-34.9: 1.27-fold increased risk
BMI of greater than 40: 2.27-fold risk

Possible mechanisms explaining fat deposits mean higher Covid-19 risk

The researchers mentioned three possible mechanisms why overweight and obese people may have higher Covid-19 disease and death rates than normal-weight controls.

First, angiotensin converting enzyme-2 is found with higher frequency in fat cells of overweight and obese persons. Researchers are aware of the fact that the Covid-19 coronavirus uses this enzyme to enter body cells. It may also be the reason that fat cells become reservoirs that can shed virus for much longer than in normal-weight people with less fat cells. They pointed out that others have seen this also and found it with other viruses. In the case of influenza A, obesity prolonged viral shedding by 42% compared to normal-weight controls. And with H1N1 influenza obesity was an independent risk factor for hospitalization and death.

Weaker immune system, more lung resistance

Secondly, any virus can weaken the host’s defence of the immune system. Researchers showed this previously with the influenza virus. But now with Covid-19 coronavirus the cytokine storm due to a weak immune system is a major factor in making the viral infection worse. A lack of vitamin D is another factor in promoting the cytokine storm.

Third, obesity decreases lung function and it is difficult to improve this. There is greater lung resistance in the airways and it is difficult to expand the lungs in obese patients. When the doctor transfers patients with obesity to the intensive care unit, it is more difficult to increase their oxygen saturation with artificial ventilation.

Unhealthy environment, so fat deposits mean higher Covid-19 risk

The researchers point out that we live in a very unhealthy environment. In 2016 there were 1.9 billion people worldwide who were overweight or obese. These figures are rapidly rising. Presently about 65% to 70% are overweight or obese in the UK or the US. Obesity causes high blood pressure, heart disease, strokes, type 2 diabetes and cancer. We are all surrounded by processed food with extra salt, sugar, wheat and other unhealthy ingredients. The high mortality and deaths rates of Covid-19 in overweight and obese people point to the problem that society has.

Reduce salt, sugar and saturated fats in food

The culprits are salt, sugar and saturated fats. Merchants and food producers must reduce them in processed food. In the UK new government regulations have already resulted in lower salt content in foods. As a result, there is less high blood pressure and cardiovascular disease is in decline. All nations need to reduce salt, sugar, and saturated fat. When the weight comes down, we all are less prone to catching dangerous viruses.

Fat Deposits Mean Higher Covid-19 Risk

Conclusion

The pandemic has taught us a new lesson, namely that overweight and obese people are at higher risk of contracting Covid-19 coronavirus. In a research paper of the British Medical Journal concrete figures showed that the Covid-19 risk is 44% higher in overweight people and that it is 97% higher in people with obesity. The OpenSAFELY study also showed that obese people with a BMI of 30-34.9 have a 1.27-fold increased risk of catching Covid-19. But morbidly obese people with a BMI of greater than 40 have a 2.27-fold risk of catching Covid-19. There is a clear linear dose-response curve between the amount of fat a person accumulates and the risk for Covid-19.

Cut out junk food and decrease your risk for Covid-19

Covid-19 is directly related to the amount of junk food we eat. As a result we can say that eating junk food increases the Covid-19 risk. The opposite is true also: sensible eating and cutting out junk food makes you lose some pounds, and your risk for Covid-19 decreases.

Jun

2020

Chronic Inflammation Can Cause Many Diseases

By Ray Schilling | Alzheimer’s disease, Asthma, Cardiovascular disease, Diabetes, fish oil, heart attack, Inflammation, kidney disease, Obesity, omega-3 fatty acids, osteoarthritis, Pain, polyunsaturated oil, Vitamins and supplements

We knew since the mid 1990’s that chronic inflammation can cause many diseases. Among these are cancer, hardening of the arteries (atherosclerosis), arthritis, dementia (Alzheimer’s disease), frailty and other degenerative disorders. LifeExtension reviewed this topic in 2019.

Older people often accumulate chronic inflammation, which associates with the aging process. Persistent pain is one of the symptoms that chronic inflammation can cause.

Doctors use tests like the C-reactive protein, hemoglobin A1C, homocysteine and the erythrocyte sedimentation rate to measure chronic inflammation.

When the doctor diagnoses chronic inflammation, it is important to find ways to inhibit it and finally resolve it. Curcumin, ginger and non-steroidal anti-inflammatories are examples of measures that help inhibit inflammation. But it is only lately that scientists have found specialized pro-resolving mediators (SPM) that help to resolve chronic inflammation. They are polyunsaturated fatty acids, which health food stores offer as supplements.

Specialized pro-resolving mediators (SPM)

Researchers isolated several pro-resolving mediators that are metabolites of omega-3 fatty acids. This link discusses an experiment where researchers obtained synovial fluid from arthritis patients who took omega-3 fatty acids. They compared this to synovial fluid from volunteers who also took omega-3 fatty acid supplements. Within 4 weeks there was a big difference for the arthritis patients with higher levels of E- and D-series SPMs in synovial fluid and plasma. Dr. Silverman reviewed the action of SPMs here. He points out that they can be taken as supplements and that they are safe, because they do not have any side effects. Conditions such as asthma, irritable bowel syndrome and various musculoskeletal conditions with chronic inflammation respond very well to SPM supplements. Omega-3 fatty acid supplements (EPA) metabolize into the E-series resolvins. On the other hand, Krill oil with Docosahexaenoic acid (DHA) metabolizes into protectins, maresins and the D-series resolvins.

Three vital tasks of pro-resolving mediators

SPMs fulfill three vital tasks, called remove, restore and renew. First, they activate macrophages, which remove dead cells and cellular debris as a result of chronic inflammation. Second, they restore the healthy balance of inflammatory compounds and anti-inflammatory substances. Third, SPMs help renew tissues that were damaged by chronic inflammation.

Some examples where SPM’s were helpful resolving inflammation in health conditions

Alzheimer’s disease patients had reduced SPMs in cerebrospinal fluid of living patients and in the hippocampus of corpses who had Alzheimer’s disease.
A research group showed that defective SPM resolution can be responsible for missing resolution of atheromatous plaques in arteries. This leads to more and more hardening of arteries until a heart attack or stroke occurs.
With obesity or metabolic syndrome insulin resistance develops. Researchers found that certain SPM’s are missing in obesity, which causes chronic inflammation. However, they also found that precursors of SPMs such as 17-hydroxydocosahexaenoic acid (17-HDHA) can serve as a novel treatment agent to treat obesity-related complications.

Newer studies about SPMs

62 patients with knee osteoarthritis had the precursor of resolvins, 17-HDHA tested in the blood. Compared to controls with no arthritis the 17-HDHA level in the arthritis patients was low. When levels of 17-HDHA were high, there was no pain in osteoarthritis patients.
Chronic periodontitis is a chronic inflammatory condition in the mouth. In a rabbit model this condition was cured with resolvin E1 derived from omega-3 fatty acids.
Delayed wound healing is typical for type 2 diabetes. In a mouse model with diabetic mice researchers inflicted skin wounds on mice. Subsequently they showed that with resolvins mice wounds healed much faster than in control mice.
Chronic kidney failure, liver impairment, diabetes, obesity and coronary heart disease showed abnormalities in the SPM system in humans. Potentially they will be healed with the help of resolvins or their precursors, which includes the omega-3 fatty acids EPA and DHA.

Chronic Inflammation Can Cause Many Diseases

Conclusion

New compounds have been detected that derive from the omega-3 fatty acids EPA and DHA. They have the name specialized pro-resolving mediators (SPM). Included are the resolvins D1 and D2, the resolvins E1, E2 and E3 as well as the precursors 18-hydroxyeicosapentaenoic acid (18-HEPE) and 17-hydroxydocosahexaenoic acid (17-HDHA). The function of these compounds is to stimulate macrophages to clean up areas of chronic inflammation and remove cell debris and injured cells that cannot survive. While anti-inflammatories like ginger and curcumin only tone down the inflammation, SPMs help to resolve chronic inflammation. Various chronic clinical conditions were identified as being due to chronic inflammation. Chronic kidney failure, liver impairment, diabetes, obesity and coronary heart disease showed abnormalities in the SPM system. We may soon see alternative approaches treating these conditions with specialized pro-resolving mediators.

Jun

2020

Mediterranean Diet Reduces Heart Attacks and Strokes in Diabetes

By Ray Schilling | Cardiovascular disease, cholesterol, Diabetes, food, heart attack, Heart Disease, High Blood Pressure, Mortality, Nutrition, olive oil, omega-3 fatty acids, Processed food, Stroke

A recent publication came to the conclusion that a Mediterranean diet reduces heart attacks and strokes in diabetes. This Canadian and Spanish study compared prospective cohort studies and randomized trials (RCT). 41 reports (3 RCTs and 38 cohorts) formed the basis for this analysis.

Details of the study

Metaanalysis showed that a Mediterranean diet reduced the cardiovascular disease incidence by 38%. It also reduced myocardial infarctions (heart attacks) by 35%. Next the authors compared the highest to the lowest adherents to the Mediterranean diet (Med diet). The highest Med diet adherents showed the following reductions:

Cardiovascular disease mortality: 21%

Coronary heart disease incidence: 27%

Coronary heart disease mortality: 17%

Stroke incidence: 20%

Stroke mortality: 13%

The conclusion was that the Mediterranean diet is beneficial to prevent heart disease and strokes in people with diabetes.

Other studies

In a study from the United Kingdom dated March 2019 several clinical trials were analyzed regarding non-diabetic populations. Again, the question came up, what the effect of a Mediterranean diet was on cardiovascular disease incidence and mortality. The authors reviewed 30 RCTs (49 papers) with12,461 randomized participants and seven ongoing trials. In one study the observation time was 46 months. A Mediterranean diet reduced the cardiovascular disease mortality by 65%!

Another study from Spain published in 2019 examined 7356 older adults (average 67 years) and followed them for 6.8 years. The investigators kept track of the physical activity and put everybody except the controls on a Mediterranean diet. The group on the lightest leisure-time physical activity consuming a Mediterranean diet had the lowest mortality. The all-cause mortality of this group was 73% lower than the control group.

What is so healthy about the Mediterranean diet?

Despite a wide variation between all the 15 countries bordering the Mediterranean Sea, there are common characteristics: an abundance of vegetables and fruit, along with nuts and legumes. Cereal products are largely whole grain. Olive oil is the principal fat source, and people eat fish, seafoods and poultry in moderation. They consume red meat rarely. Cheese and yogurt can be part of the diet, depending on the region.

The first clinical evidence supporting the health benefits of the Mediterranean diet came from the Lyon Heart Study. The researchers placed patients who had a heart attack either on the diet designed by the American Heart Association or a Mediterranean style diet. After a follow-up of 27 months, the group eating the Mediterranean diet had a reduction of heart attacks by 73% and a decreased mortality by 70% compared to the other group.

More detail on the ingredients of the Mediterranean diet

An analysis of the various foods of the Mediterranean diet shows the reasons for the health benefits clearly. The fats that people on a Mediterranean diet eat are heart-healthy monounsaturated fats like olive oil or fats that contain omega-3 fatty acids. They come from fish (tuna, salmon, trout, sardines) or from plant sources (walnuts, other tree nuts and flax seed).

As there is an emphasis on natural foods, the diet is extremely low in trans fatty acids (hydrogenated fats), which increase the risk for cardiovascular disease. As people consume more than 300g of vegetables per capita daily, the contents of antioxidants and other beneficial plant chemicals is much higher in comparison to Western diets. There are many individual components of the Mediterranean diet that contribute to the reduction of disease. This is particularly true for heart disease. It also is apparent, that it is not one single food or nutrient that is responsible for the health benefits. What matters are the interactive effects of all the nutrients that lead to the health benefits.

No processed food means healthier living

The practical application does not mean deprivation and starvation, but a move away from processed fats (margarine), baked goods (donuts, muffins, pastries), and high saturated fat snacks and trans fats (chips, crackers, cookies, pies). Food choices move towards those of fresh fruits and vegetables, nuts, fish, and olive oil. Portions or servings have to be adequate to maintain a healthy weight.

Mediterranean food is not the heaping plate of pasta with an afterthought of vegetables. It also is not the super-size fast food pizza with pepperoni and cheese. Mediterranean food incorporates fresh food rather than the fast food. It entails a shift from large portions of red meat to smaller portions of fish, a transition from highly processed foods to ample helpings of dark green vegetables with a dose of olive oil. Low amounts of alcohol, especially red wine can make a meal enjoyable, which means one drink per day for women, and two drinks per day for men. And after dinner go for a walk!

Olive oil is one of the reasons why the Mediterranean diet is so healthy

In the past it was thought that the monounsaturated fatty acids in olive oil would be the reason why it is protective of the heart. However, newer studies have shown that it is the polyphenols and among these in particular hydroxytyrosol that lower blood pressure and protect you from hardening of the arteries.

In a 2012 study from Spain it was found that mortality from heart attacks was 44% lower than that of a control group who did not incorporate olive oil in their diet.

How polyphenols in olive oil work for you

Only two tablespoons of extra virgin olive oil per day protect you from heart disease. It does so by reducing the total cholesterol level in the blood as well as the LDL cholesterol level. When there is more polyphenol in olive oil (such as in extra virgin olive oil), the body produces more HDL, which is essential to extract oxidized LDL from arterial plaque. On top of that polyphenol rich olive oil will increase the size of the HDL particles (these larger particles are called HDL2), which are more efficient in extracting oxidized LDL from arterial plaques. A Sept. 2014 study in humans showed that higher polyphenol olive oil as found in extra virgin olive oil caused an increase in the more effective HDL2 particles, which cleans out plaques from arteries more efficiently than the regular, cheaper olive oil.

Endothelial function

The endothelium is the lining of the arteries. Normal endothelial functioning involves widening of the arteries and maintaining its flexibility. The body achieves this through production of a signal molecule, called nitric oxide; the endothelial cells that line our arteries from inside produce it. Exercise increases the production of nitric oxide as well (Ref.1).

In a group of patients with poor endothelial function 2 tablespoons of olive oil (polyphenol rich) per day given over 4 months (the time of the study) showed a significant improvement of endothelial function.

The authors suggested that an enzyme in the endothelial cells, called nitric oxide synthase is being stimulated by components of polyphenol-rich olive oil. This leads to protracted release of nitric oxide, which in turn keeps blood vessels flexible and wide open. Other investigators found that olive oil can influence even a hereditary gene variant of endothelial nitric oxide synthase found in people with a history of premature heart attacks. This high-risk group of people should take extra virgin olive oil regularly to prevent premature heart attacks and strokes.

Endothelial dysfunction occurs when the arteries no longer can deliver adequate amounts of blood to vital organs like the heart or the brain. Endothelial dysfunction is also present in patients with type 2 diabetes, obesity, high blood pressure and metabolic syndrome. Introducing extra virgin olive oil in the diet of these patients will help restore their endothelial function.

Lowering blood pressure

In a study on 23 hypertensive patients it was shown as far back as in 2000 that extra virgin olive oil over 6 months allowed physicians to reduce high blood pressure medications by 48%. When the study was crossed over, the reverse was the case for the control group on sunflower oil. The polyphenols of olive oil released nitric oxide, which is known to lower blood pressure. This is an important finding. High blood pressure is a risk factor for the development of hardening of the coronary arteries. This leads to heart attacks, congestive heart failure, but also stroke. Regular intake of 2 tablespoons of extra virgin olive oil often will reverse high blood pressure and restore normal endothelial function.

Preventing heart attacks and strokes

In April of 2013 The New England Journal of Medicine published a Spanish diet study that showed that a participants on a Mediterranean diet with olive oil or nuts had 30% less heart attacks over 5 years than people on a low fat control diet. Other studies have also shown that olive oil and omega-3 fatty acids play a big role in preventing heart attacks and strokes. We also know that regular exercise reduces the risk further; so does keeping your body mass index below 25.0. Extra virgin olive oil is part of the protection from heart attacks and strokes. The study did not show any protection against cancer.

Mediterranean Diet Reduces Heart Attacks and Strokes in Diabetes

Conclusion

A Mediterranean diet reduced heart attacks and strokes in diabetic patients, but also in patients without diabetes. Here I attempted to show what the ingredients of a Mediterranean diet are that lead to such astounding positive effects. There is an emphasis on vegetables and fresh ingredients of food. In addition, olive oil and a lack of processed food are also important. With these wholesome ingredients the lining of the arteries works best. The body reduces cholesterol and lowers blood pressure. The end result is that there are less heart attacks and strokes, and people live longer.

Note: Part of this was previously published here and also here.