heart attack Archives

Oct

2023

Sudden Cardiac Death in Athletes

By Ray Schilling | heart attack, Mortality

This article is about sudden cardiac death in athletes. Dr. Robert A. Harrington and Dr. Manesh Patel reported from the European Society of Cardiology 2023 Congress in Amsterdam. Notably, this congress took place from August 25-28, 2023 with 30,000 participants. Another key point is that one of the important topics was sudden cardiac death in athletes. In general, you normally assume that athletes are healthy, and their hearts would support their peak athletic activities. It is important to realize as Drs. Harrington and Patel reported that under certain circumstances athletes can suddenly die.

Bronny James, a high school basketball player was rescued from a cardiac arrest as this article shows. Apparently, he has a congenital heart condition, which makes him more vulnerable to get an irregular heartbeat. It must be remembered that his can cause his heart to stop beating. Fortunately, he was revived at the Mount Sinai Hospital in New York. To clarify, there are a number of non-invasive procedures that interventional cardiologists use to correct abnormalities in a heart. Specifically, following such procedures the person’s heart is more stable.

Ventricular fibrillation

To explain, irregular heartbeats leading to ventricular fibrillation is one cause of death in athletes. Another key point, often there can be other underlying conditions that lead to this. Examples are a long QT interval on an ECG, a big thick heart (medical term: hypertrophic cardiomyopathy), and dilated aortas in tall people.

Success stories of reviving people and athletes with sudden cardiac death

In other words, over the years two methods showed success in rescuing athletes with sudden cardiac deaths. The first is CPR (cardiopulmonary resuscitation). This keeps the blood flowing and delivers oxygen to the lung capillaries. Next the emergency medical team is called in who provide an automated external defibrillator to the chest. This can revive up to 100% cases of athletes with sudden cardiac deaths. The key is to do CPR right away and to have the emergency medical team use the automated external defibrillator (AED) right away.

Screening methods to prevent sudden cardiac death in athletes

With this in mind, the medical profession has started to do preventative tests of athletes. First, Italy is one of the countries that has persistently done standard screening. Physicians order ECG’s and echocardiograms. They can readily diagnose hypertrophic cardiomyopathy with these tests. Second, a new stethoscope can get sounds and some ECG signals at the same time. This helps to diagnose several abnormal cardiac conditions.

Third, another point is that there have to be enough people around a sports event who have experience in performing CPR (cardiopulmonary resuscitation). Certainly, the sooner you start CPR, the more successful is the outcome with respect to a full recovery. Next medical personnel with the AED equipment are necessary to bring the heart rhythm back to a sinus rhythm. When the patient’s heart beats normally again, the patient needs transportation to the nearest hospital for further monitoring and stabilization.

Commotio cordis

When there is a lower chest impact from a hockey puck, baseball or lacrosse ball the heart can suddenly come to a standstill. Physicians call this commotio cordis. These athletes need immediate CPR to keep them alive followed by timely administration of an automated external defibrillator. Often the heart beats normally after this. If immediate medical help is not available, these young athletes die and it becomes an upsetting newspaper story.

Sudden Cardiac Death in Athletes

Conclusion

Dr. Harrington interviewed Dr. Manesh Patel, a cardiologist from Duke University regarding sudden cardiac death in athletes. A thump to the chest from a hockey puck or a baseball can cause the heart to stop beating. In order to save this athlete from dying bystanders have to start CPR right away. This helps to continue blood circulation and brings oxygen into the tissues. Next medical personnel apply electrode pads from an automated external defibrillator (AED) to the chest wall. One or two electric shocks are administered. This often revives the heart or converts irregular heart contractions to the normal sinus beats, and the athlete recovers. The emergency medical team transports the patient to the nearest hospital for observation and further treatments. CPR and AED in combination can save up to 100% of cases that would otherwise turn into sudden cardiac deaths.

Jul

2023

Poor Health is Linked to Loneliness and Social Isolation

By Ray Schilling | Anxiety, Cancer, Cardiovascular disease, depression, heart attack, Heart Disease, Mortality

In June 2023 a new study showed that poor health has a link to loneliness and social isolation. It was also reviewed by CNN. There have been many studies in the past examining whether poor health shows an association to loneliness and social isolation. But this new study is different: it is a meta-analysis of 90 prospective studies with follow-up from 6 months to 25 years. The study included only persons age 18 years and older. There was a total of 2.2 million participants. The study specifically examined the links between loneliness, social isolation and early death.

The Meta-analysis

This new meta-analysis is significant, because with such a high number of participants the statistical strength is much better than with smaller studies. All of the 90 studies examined were prospective studies. The meta-analysis showed the difference between controls and various experimental groups suffering loneliness, social isolation and early death. The researchers identified independent risk factors of subsets among the 2.2 million subjects as discussed further below.

Loneliness

The definition of loneliness in the study was the subjective distress people feel when there is a discrepancy between the social relationships they have and what they want. If their is no fulfillment of the need for connection or intimacy in their relationships, this too can be a source of loneliness. There is increased isolation of Americans due to the increase in TV watching, spending more computer time and increase in cell phone use. This is loneliness by choice. But very few know that this can cause disease.

Social isolation

When people are under social isolation, they are under chronic stress, which translates into disease. In the statistics below it is apparent that cancer and cardiovascular mortality show a significant elevation from social isolation. In women with breast cancer there was a 51% increased mortality due to social isolation.

Findings of the study

Here are the findings form the metaanalysis. All the findings of patients suffering from loneliness and social isolation were in comparison to control groups without social deprivation.

There is a 32% all-cause mortality from loneliness and social isolation
Loneliness is responsible for a 14% increase in mortality compared to those who are not lonely
There is a 24% increased cancer mortality due to social isolation
Social isolation is responsible for a 34% increase of cardiovascular mortality
Socially isolated individuals with cardiovascular disease had a 28% increased all-cause mortality
Socially isolated women with breast cancer had a 51% increased all-cause mortality

Life style factors part of loneliness and social isolation

Turhan Canli, a professor of integrative neuroscience in the department of psychology at New York’s Stony Brook University had no involvement in the study. He said: ”People who feel socially isolated or lonely tend to have unhealthy habits, such as smoking, alcohol use, poor diet or little exercise. Having a small social network or little to no contact with the outside world can also make someone less likely to receive medical care if they don’t have anyone checking on them.”

Broadening social connections

We learnt how devastating loneliness and social isolation are for your health. It follows from this that the solution is to concentrate on broadening social connections as a preventative measure. Canli said: “Think of maintaining a social network like any other health-promoting activity: exercising regularly, eating well, looking after yourself.” Cultivate your social connections with a higher priority than in the past. Engage in new circles of like-minded people. Seek opportunities out like joining an exercise class or a discussion group.

Conclusion

Loneliness and social isolation are a real entity that threatens all of our health. A meta-analysis of 90 prospective studies (6 months to 25 years of follow-up) including more than 2 million people showed the following. There is a 32% all-cause mortality from loneliness and social isolation. Cancer mortality is up 24% due to social isolation. Socially isolated individuals with cardiovascular disease had a 28% increased all-cause mortality. Socially isolated women with breast cancer had a 51% increased all-cause mortality. There were more findings than these. Overall, this stresses the importance to cultivate your social connections, which prevents social isolation and loneliness. You will stay healthier for longer and not die prematurely.

Apr

2023

What you Must Know about Male Hormones

By Ray Schilling | andropause, Anti-aging medicine, Cancer, Diabetes, hair loss, heart attack, Infertility, prostate cancer, prostate hypertrophy, Stroke, testosterone

Dr. Pamela Smith, an anti-aging physician gave a talk about what you must know about male hormones. She spoke on Saturday, Dec. 10, 2022 at the Sands Conference Center of the Palazzo Hotel in Las Vegas. The title was “What you must know about male hormones”. She presented 199 slides, so the following can only be a brief summary of what she said. She started by saying that the term “male menopause” goes back in time to 1944. Other terms are andropause and late onset hypogonadism.

Different testosterone levels at different ages

It is important to realize that at age 20 the blood testosterone level is around 900 ng/dL, but this declines after age 30. It is 550 ng/dL at the age of 40. At the age of 50 the testosterone level is 350 ng/dL. And at the age of 70 the testosterone level has shrunk to 200 ng/dL or less. With this in mind, there are also seasonal variations with higher levels of testosterone occurring in summer and early fall, and low levels happening in winter and early spring. A healthy male produces the following male hormones: Testosterone, 5-6 mgs/day; Androstenedione, 3 mgs/day; DHT, 0.300 mgs/day; DHEAS, 50 mgs/day; and DHEA, 15 mgs/day.

Functions of testosterone

In other words, testosterone is the male hormone responsible for the male body characteristics. Every male body cell has testosterone receptors on it. Truly, this way testosterone is involved in protein manufacture and muscle maintenance. In fact, bone formation depends on testosterone and oxygen uptake as well. It is also controlling blood sugar together with insulin. In addition, normal sperm production depends on testosterone. To clarify, testosterone also regulates cholesterol and the immune system. By all means, it also helps to improve mood, is important for mental concentration and helps protect against Alzheimer’s disease. Finally, there is stimulation of platelets and megakaryocytes by testosterone, which makes blood clotting easier.

Symptoms of andropause

It must be remembered, towards the end of their 60’s many men get symptoms of tiredness, loss of energy and depression. Specifically, they may get a bad temper, present with irritability, anxiety and nervousness. Specifically, they complain of a loss of memory, loss of sex drive and libido. Certainly, their erections are getting weak or they lose them altogether. There is a decreased intensity of orgasm and they are gaining weight. All this should prompt their physician to have a total testosterone blood test done. When the testosterone level is less than 500 ng/dL the person should see their physician for replacement testosterone therapy.

Other signs of testosterone deficiency

There are other signs and symptoms of testosterone deficiency: backaches and joint pains, loss of fitness, being overstressed. In addition, testosterone-deficient males experience a decrease in job performance and a decline in physical fitness. They have bone loss, elevation of their blood cholesterol and an increased risk of heart disease. They often also have increased insulin resistance, diabetes and metabolic syndrome. Mortality in men with low testosterone is much higher than in controls with normal testosterone. Several dozens of literature references were provided to support the above statements.

Testosterone replacement and hormone balance

When a patient is on testosterone replacement, a digital rectal exam should be performed to check for the size of the prostate gland. A PSA should be done every year (in former prostate cancer patients every 3 months). PSA should stay below 4.0 ng/mL. If the PSA rises by 1.5 ng/mL in one year or by 0.75 ng/mL in two consecutive years, a urologist should be consulted to rule out prostate cancer.

Men produce small amounts of estrogens, which are important for memory function of the brain and for strong bones. Androgens and testosterone aromatize into estrogen via the enzyme aromatase in fatty tissue. There are a few reasons why aromatase increases: obesity, excessive alcohol intake, chronic inflammation and high insulin levels.

The following medications lower estrogen levels: phenobarbital, carbamepazine, trazodone, chlordiazepoxide and sulcrafate.

Side effects from elevated estrogen levels

Increased estrogen levels in males cause gynecomastia (colloquially called “beer tits”), decreased sex drive, heart attacks, strokes and benign prostate hypertrophy. Elevated estrogen levels also cause insulin resistance, rheumatoid arthritis and prostate cancer. Dr. Smith referenced all of these statements again with many literature quotations.

Dihydrotestosterone (DHT)

This metabolite of testosterone is 3-times stronger than testosterone. It is formed from testosterone by the enzyme 5-alpha reductase. It is responsible for the male-specific characteristics, the male genitalia and the prostate gland. Low levels of DHT cause reduced sexual function, decreased libido and weakened muscle function. On the other hand, elevated DHT causes male pattern baldness, hirsutism and benign prostate hypertrophy (BPH). There are two 5-alpha reductase inhibitors, namely finasteride and dutasteride, that clinicians use to lower elevated DHT levels. This can reduce the risk of prostate cancer by about 50%. Dr. Smith provided many literature quotations to support these statements.

Testosterone replacement therapy

Based on more than 3 dozen literature quotations Dr. Pamela Smith outlined the following:

Most men tolerated transdermal testosterone application very well.
Erectile dysfunction affects 1 in 5 older men.
Erectile dysfunction in association with low blood testosterone and low libido responds to transdermal application of testosterone very effectively.
It may take 14-25 weeks before transdermal testosterone treats erectile dysfunction successfully, more than 50% of men respond to this.
Testosterone replacement prevents beta amyloid precursor protein production, which increases memory and decreases the risk of Alzheimer’s development.
High stress produces high cortisol levels in the blood, which affect the hippocampus, where memory is located. Testosterone is neuroprotective, and it preserves memory.
Transdermal testosterone decreases coronary heart disease by relaxing coronary arteries. This prevents heart attacks and strokes.
Testosterone decreases inflammation and lowers LDL cholesterol.

More facts about testosterone replacement therapy

Testosterone lowers inflammatory cytokines and stimulates interleukin-10 production. This has anti-inflammatory and anti-atherogenic actions, which prevents heart attacks.
There was a reduction in mortality from heart attacks in the testosterone treated group of between 66% and 92%. In addition, 30 nonfatal strokes and 26 nonfatal myocardial infarctions occurred in the control group, but none in the testosterone group. Testosterone deficient heart failure patients responded very well to testosterone replacement therapy.
Prostate cancer or benign prostate hypertrophy do not increase with transdermal testosterone replacement therapy.

A Meta-analysis showed that older men with the highest risk for prostate cancer have the lowest testosterone blood levels.
Type 2 diabetics with a high insulin resistance respond well to testosterone replacement therapy. They increase insulin sensitivity and lower their blood sugars. This improvement peaks after 3 months and the effect stays for 12 months.

Further facts about testosterone replacement therapy

Testosterone replacement is safe. It provides significant benefits for erectile dysfunction, for muscle mass, prevention of Alzheimer’s disease, prevention of heart attacks and strokes. Testosterone treatment is for males above the age of 50, there is no cut-off for higher ages. There are many controlled clinical trials spanning over 70 years, which support all of what is presented here.
Testosterone can’t be taken orally, because it is rapidly metabolized in the liver. Instead, patients use transdermal testosterone gel or cream. Gels are commercially available and very expensive. Compounding pharmacies can provide testosterone creams for you, which are considerably cheaper and can be dosaged according to the patient’s needs. Testosterone esters in oil are available for subcutaneous or intramuscular injection twice per week. This ensured a steady testosterone level.

Improvements after testosterone replacement therapy

Timing of improvements: cholesterol reduction occurs by 12 months, for triglycerides it takes 22 months. Testosterone levels take 4 to 12 weeks to normalize. Fasting blood sugars and Hemoglobin A1C come own within 3 months with further improvements by 12 months. Sexual desire and energy are back to normal within 3 to 6 weeks.
It is important that you go for blood tests to measure testosterone levels every 3 months initially (blood level). If the levels are stable, the physician may decide to only order tests every 6 months.

What you Must Know about Male Hormones

Conclusion

The goal in the aging male is to maintain optimal male hormone levels. This achieves optimal health and prevents diseases of older age. First, it is important to preserve his erections, but at the same time testosterone replacement therapy prevents Alzheimer’s disease and memory loss. It also prevents heart attacks and strokes. Testosterone helps to preserve muscle mass. Hormone replacement therapy keeps lipids like cholesterol and triglycerides under control. Testosterone replacement reduces blood sugars and prevents type 2 diabetes mellitus. Replacement therapy also reduces elevated insulin levels. The end result is that testosterone replacement therapy maintains the health of the aging male.

Apr

2023

Erythritol is Linked to Heart Attacks and Strokes

By Ray Schilling | blood clots, Cardiovascular disease, heart attack, Mortality, Stroke

A recent publication found that erythritol is linked to heart attacks and strokes. The study from the Cleveland Clinic was published Jan. 19, 2023 in Nature. It showed that people with diabetes had a 2-fold risk of getting a heart attack or stroke. Researchers measured the highest concentration of erythritol in their blood versus a control group with no erythritol in it. The study further showed that erythritol causes platelets to form clots, which could break of and travel to the heart or brain vessels. This triggered a heart attack or stroke. Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute said: “We never expected this. We weren’t even looking for it.”

Erythritol is what causes heart attacks and strokes

What the research team was looking for was “find unknown chemicals or compounds in a person’s blood that might predict their risk for a heart attack, stroke or death in the next three years. “This is how erythritol was identified as a risk factor.

Erythritol is a sugar alcohol

Like sorbitol or xylitol, erythritol is a sugar alcohol, which occurs in many fruits and vegetables. Erythritol has less laxative effect than some of the other sugar alcohols. It tastes like sugar and adds bulk to any stevia-based sweeteners. These are the reasons why it became the preferred zero calorie sweetener of the industry. Also, in a mixture it diluted the pronounced sweet effect of stevia, but added the crystalline texture appearance like sugar to the sweetener. This is what the consumer expected of a sweetener.

The clinical trials showing there is a link between erythritol and heart attacks as well as strokes

One group of patient’s tests were 1,157 blood samples from people at risk for heart disease collected between 2004 and 2011. Another batch of blood samples came from over 2,100 people in the United States and an additional batch from 833 samples gathered by colleagues in Europe through 2018. 75% of the participants in all three populations had coronary disease or high blood pressure, and about 20% had diabetes. Over 50% were male and in their 60’s and 70’s. All of those samples showed the following. Higher levels of erythritol showed a correlation to a greater risk of heart attack, stroke or death within three years.

Blood coagulation

Our blood has a delicate balance between coagulation from clotting factors and platelets on the one hand and fibrinolysis, which counters clotting, on the other hand. This ensures that we are not spontaneously bleeding and also not getting clots from hypercoagulation. The researchers found that it is this balance, which erythritol disturbs. Dr. Hazel said: “But what we’re seeing with erythritol is the platelets become super responsive: A mere 10% stimulant produces 90% to 100% of a clot formation”. This was the reason for the higher heart attack and stroke rates in the higher levels of erythritol in the blood.

Erythritol levels checked in healthy volunteers

The last part of the study involved tracking blood tests of erythritol in 8 healthy volunteers. They drank beverages containing 30 Grams of erythritol, which is the amount many Americans consume. According to the National Health and Nutrition Examination Survey, which examines American nutrition each year 30 Grams is the average daily consumption of Americans. The researchers took blood tests of erythritol for the next 3 days including tests of clotting risks. Dr. Hazen said: “Thirty grams was enough to make blood levels of erythritol go up a thousandfold. It remained elevated above the threshold necessary to trigger and heighten clotting risk for the following two to three days.”

Reaction of the industry

Robert Rankin, the Calorie Control Council’s executive director, an industry association, wrote in an email: “The results of this study are contrary to decades of scientific research showing reduced-calorie sweeteners like erythritol are safe, as evidenced by global regulatory permissions for their use in foods and beverages.” But this seems to be a lame excuse. The platelet clotting effect of erythritol simply was not what the FDA expected or tested for. The same was true for other regulatory bodies when they released it as safe. I have drawn my own conclusion and thrown out all sweeteners I had in my possession that contained erythritol.

Conclusion

Sometimes studies come out of the blue, which change our everyday practice. One of these studies is Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute. He showed that erythritol as an artificial sweetener is not harmless as previously thought of. This included the FDA as a regulatory agency, which labeled erythritol as GRAS (=generally recognized as safe). Now new evidence of clinical studies showed that erythritol is responsible for a twofold risk of heart attacks, strokes or death in the next three years. Dr. Hazen included all kinds of controls and also fed healthy volunteers erythritol. No matter how he looked at it, the risk remained.

Erythritol causes clots, which cause heart attacks and strokes

In animal experiments he could also show that erythritol caused platelets to stick together and cause clot formation. These clots could travel into the heart and brain vessels and cause heart attacks and strokes. For any consumer it is the most sensible approach to NOT use any sweetener that contains erythritol. This involves reading product ingredients before you buy any sweetener. Assuming that products are harmless, when the label reads “Stevia” is a fallacy! In numerous products the ingredient list will show the word “erythritol”. Buyer beware!

Jul

2022

What Electronic Cigarettes Do to You

By Ray Schilling | e-cigarettes, heart attack, Lung Disease, Prevention

A review paper of Canadian researchers showed what electronic cigarettes do to you. They can be an effective smoking cessation aid for motivated smokers who eventually want to quit. But when people continue to inhale electronic cigarettes, their use can cause heart attacks, strokes, high blood pressure and increased heart rates. With regard to the lungs electronic cigarettes can cause vaping-associated lung disease, obstructive pulmonary disease, asthma and chronic cough. A literature review showed that e-cigarettes are less harmful to the heart and the lungs than smoking combustible cigarettes.

Increased use of e-cigarettes in younger people

In Canada the 2017 Canadian Tobacco, Alcohol, and Drugs Survey, which included all ages, found that 15.4% tried e-cigarettes. But among adolescents between 15 to 19 years old 22.8% were using e-cigarettes. For young adults aged 20 to 24 the figure of e-cigarette users was 29.3%. In addition, there was a significant increase of Canadian adolescents aged 16 to 19 from 29.3% in 2017 to 37.0% in 2018. Data from the US shows similar trends. E-cigarette use among US high school students increased from 11.7% in 2017 to 27.5% in 2019.

Some facts about e-cigarettes, cigarette smoking and smoking cessation

First, researchers noted that the smoking of e-cigarettes has a 3.62-fold risk of leading to subsequent cigarette smoking.
Second, a UK study found that when people used e-cigarettes for smoking cessation, 80% of the e-cigarette group were still smoking e-cigarettes after 1 year. In contrast, only 9% of those who used traditional nicotine replacement therapy (Nicorette etc.) to quit smoking were still using nicotine replacement after 1 year.
One study compared heart attack rates in a group of regular cigarette smokers and compared this to e-cigarette smokers. Cigarette smokers had a 2.72-fold higher heart attack rate than non-smokers, while e-cigarette smokers had a 1.79-fold heart attack rate compared to non-smokers.

Effect of e-cigarette use on heart and lung disease

Several studies looked at the relationship between e-cigarette use, heart attacks and strokes. There was a 1.4-fold higher incidence of coronary artery disease in e-cigarette smokers in comparison to non-smokers. The e-smokers had a 1.71-fold higher stroke incidence and 1.59-fold higher heart attack rates. In a large metaanalysis done with e-cigarette smokers, researchers noted the following facts: Electronic cigarette smokers were compared to non-smokers. Researchers noted a 2.27-fold increase of the heart attack rates in e-cigarette smokers. There was a 2-fold elevation of the systolic and diastolic blood pressure in e-cigarette smokers.

Switching from cigarette smoking to e-cigarettes

Patients who switched from tobacco smoking to chronic electronic cigarette use had a 7-fold reduction of their systolic blood pressure and a 3.65-fold reduction of their diastolic blood pressure. The researchers concluded that switching from cigarette smoking to e-cigarettes had some merit in terms of risk reduction for cardiovascular disease. But the final judgment on this is still pending. Certainly, quitting entirely from cigarette smoking is the best choice. I reported previously that e-cigarette smokers find it difficult to quit completely and if they smoke conventional cigarettes to stop that.

Effect of e-cigarettes on lungs

In addition to cardiovascular effects there is a direct effect from e-cigarette smoking on the bronchial tubes and the lungs. The vaped substances from e-cigarettes contain a lot of noxious gases that irritate the lining of the respiratory tract. This syndrome is called EVALI (electronic vaping associated lung illness). In 2019 and 2020 there was a rush of EVALI cases in the US with 2807 hospitalizations and 68 deaths. In Canada there were 19 cases of EVALI, 15 hospital admissions, and no deaths. Patients with EVALI have problems breathing, they cough and they have chest pain. Researchers suspect that vitamin E acetate and tetrahydrocannabinol are the major culprits that cause EVALI. But at this time there is no definite proof for that.

Poor quality of vaping fluid from the black market

These substances are not present in commercial e-cigarettes, but when you buy vaping fluid on the black market, it is often mixed in. Prolonged use of e-cigarettes can cause changes on spirometry, such as chronic obstructive pulmonary disease (COPD). Chronic use of e-cigarettes may cause premature onset of COPD.

What Electronic Cigarettes Do to You

Conclusion

E-cigarette use is increasing at an alarming rate among youths and persons who never smoked. The emerging evidence from researchers showed that there is a risk when you expose yourself to the smoke of e-cigarettes. There is an association of both heart disease and respiratory disease to e-cigarette smoking, but the risk is less than with exposure to regular cigarette smoke. Some researchers think that a switch from cigarette smoking to e-cigarettes could provide a viable harm reduction strategy for some smokers. But unfortunately, many continue to smoke e-cigarettes instead of quitting altogether. And in this case the risks for heart disease and lung disease remain!

Feb

2022

How healthy are Carbohydrates?

By Ray Schilling | diet, fasting mimicking diet, heart attack, Inflammation, lifestyle, Nutrition, Processed food, Stroke

A recent review article asked: how healthy are carbohydrates? The three food components that occur in natural food are carbohydrates, fats and protein. Among the carbohydrates it is important to distinguish between simple carbohydrates (such as sugar) and complex carbohydrates. Simple carbohydrates are readily absorbed into the blood, which causes an insulin peak. After a few hours the peak is gone, and there is a “crash”. You will know the feeling of feeling hungry just a few hours after eating doughnuts! Complex carbs like peas, beans, fruit and vegetables take longer to get digested. The final breakdown product of the digestive process is sugar as well. But this process takes longer meaning that the concentration of sugar in the blood is much lower. There is also no “crash”. The result is that complex carbs cause less insulin secretion into the blood.

Long-term effect of eating too much sugar

Integrated over several decades of life, this means that a person who constantly consumes beverages with sugar and snacks containing sugar is at a higher risk of developing type 2 diabetes. In contrast, a person who eats well balanced meals where the insulin secretion is low, will not develop diabetes and have much less hardening of the arteries. This translates into a lower risk to develop heart attacks and strokes.

The types of carbohydrates

Before I discuss the health effects of various carbohydrates, we need to look at the types of carbohydrates.

Simple carbohydrates

Table sugar is a disaccharide, which consists of one molecule of glucose and one molecule of fructose.

The enzyme amylase very quickly breaks down the chemical bond between fructose and glucose and creates these monosaccharides in the small intestine from which they are rapidly absorbed. Milk sugar is a disaccharide, which consists of a molecule of glucose bound to a molecule of galactose. Milk contains 2 to 8% of milk sugar. We have to watch these simple carbs, because they trigger insulin production and lead to accelerated hardening of the arteries, heart attacks and strokes.

Complex carbohydrates

In contrast, complex carbs are healthy, because they take some time to be digested in the digestive tract. They consist of polysaccharides, long chains of sugar molecules. Both starches and dietary fiber consist of complex carbohydrates. They often are present in vegetables and many fruit. Complex carbs slow down the absorption of their breakdown products and minimize the insulin response. Dietary fiber is the indigestible part of fruit and vegetables. It contributes to good gut health as the beneficial gut bacteria can multiply on the fibre particles.

Healthy carbs

When simple carbohydrates dominate in our food intake, we are in trouble because they are loaded with calories. Overconsumption of them leads to weight gain and obesity, to diabetes, heart attacks, strokes and even cancer. On the other hand, consumption of complex carbohydrates is healthy. We get them from eating apples, bananas, berries, vegetables like spinach, tomatoes and carrots. Other healthy complex carbs are whole grain flour, quinoa and brown rice. Black beans, lentils, peas and garbanzo beans are also healthy complex carbs. Dairy products like low fat milk, yogurt and ricotta cheese are healthy as well.

Mediterranean diet as an example of a healthy, balanced diet

In 2019 a study was published where women with polycystic ovary syndrome (PCOS) were either put on a Mediterranean diet or not. This study showed that a Mediterranean diet was anti-inflammatory, reduced insulin resistance and reduced testosterone levels in PCOS patients. But the same is true in a general population. The Mediterranean diet is one example of a healthy, balanced diet with complex carbohydrates. It prevents insulin resistance, inflammation and hormone disbalance. Other diets have similar effects like the DASH diet, the Zone diet and the Pritikin diet.

Quantity and quality of your food intake matters

A 2018 study from India showed that it matters how many carbohydrates we consume. On average Indians eat a diet with 65-75 percent of calories coming from carbohydrates. Many of these carbs are the unhealthy simple carbohydrates. How healthy are carbohydrates? The authors recommended to reduce complex carbohydrates to 50-55% and to add 20-25% protein, mostly from vegetable sources and add 20-30% from fat. The fat consumption needs to include monounsaturated fats (e.g., olive oil, nuts and seeds). Among the carbs a lot of green leafy vegetables help to balance the diet. This prevents the development of type 2 diabetes, heart attacks and strokes.

The above addresses the issue of quality of food. But it is also important what quantity of food we are eating. This is where counting or estimating calories comes in. If we overeat, we will very quickly gain weight and eventually can develop obesity.

The glycemic index and glycemic load

In order to help you with the choice of right carbohydrates the glycemic index was developed.

Here is another reference about the glycemic index/glycemic load.

In table 1 towards the end of the last link you find a column designated “GI” for glycemic index. All the foods that have a value less than 55 are foods that you can eat freely.

Problematical carbohydrate foods

Baked russet potatoes and boiled potatoes are very high on the GI index list. Puffed rice cakes, doughnuts, jelly beans and corn flakes measure high on the glycemic index list. But water melons, dried dates, white bread and white rice are also items to be avoided.

You best avoid anything with a glycemic index above 55. The column to the right of GI shows you a serving size and the last column on the right the glycemic load. The lower the glycemic load per serving, the better it is for your health. The glycemic index and the glycemic load are useful concepts of helping you to sort out your diet items.

My wife and I used this in 2001 to shed weight. We both lost 50 pounds (=22.72 kilograms) each in a period of 3 months.

Fasting mimicking diet (FMD)

According to Dr. Longo intermittent fasting stimulates the stem cells of the bone marrow. This leads to new clones of lymphocytes (B cells and T cells), which are part of the immune system. Your immune system becomes stronger from this.

Dr. Longo has done detailed mouse experiments, which inspired him to develop a new diet plan. Patients would receive a fasting mimicking diet (FMD) on 5 consecutive days per month. The rest of the month consists of a normal, balanced diet. 5 days of the month the person consumes a low 600-800-calorie diet. This reduced calorie intake is enough to ensure adherence to the diet, but low enough to lead to enormous positive metabolic changes including youth-preserving stem cell stimulation.

I am following the FMD

I have followed a FMD since December 2017. It helps me to keep my weight (BMI) in the 21 to 22 range. I feel more energetic and have managed to stay in good health.

The above chapter on the FMD was previously published here.

How healthy are Carbohydrates?

Conclusion

Healthy eating consists of 50-55% calories from complex carbohydrates; add to this 20-25% protein, mostly from vegetable sources and add 20-30% of total calories from fat. The fat consumption needs to include monounsaturated fats (e.g., olive oil, nuts and seeds). Unfortunately, most “convenience foods” (=processed foods) are incompatible with a healthy lifestyle. They contain too much simple carbs (sugar). Many people live on 65-75 percent of calories coming from simple carbohydrates, which are too many carbs. It should be complex carbs that digest slower and that do not induce insulin resistance. The glycemic index and glycemic load are useful concepts to help you chose the right foods that keep you healthy. The fasting mimicking diet can help you to take the last few pounds off that may be difficult to shed. Weight loss and weight maintenance are possible when you choose the right foods.

Nov

2021

Marijuana and Uncontrolled Vomiting

By Ray Schilling | Abdominal Pain, addiction, chronic pain, heart attack, marijuana, schizophrenia

Marijuana was considered safe in the past, but now marijuana and uncontrolled vomiting suddenly make the news. Recently there also were reports of marijuana causing heart attacks and schizophrenia.

Abdominal pain with cannabis hyperemesis syndrome

Cannabis hyperemesis syndrome or cannabinoid hyperemesis syndrome (CHS) is a relatively new disease entity. It occurs in people who use marijuana daily for several years. But people affected by this condition often do not realize that it is an overdose of marijuana that brings on the nausea and vomiting of CHS. When they started marijuana use, they may have used intermittent doses of marijuana to treat nausea and vomiting. In intermittent doses marijuana may have been helpful, however constant use is a different story! During several years of use of marijuana, patients never had abdominal pains or vomiting, until one day CHS started.

Possible mechanisms regarding marijuana and uncontrolled vomiting

The body has its own endocannabinoid system with cannabinoid receptors that are distributed throughout the body. There are two cannabinoid receptors, CB1 and CB2. In the central nervous system, there are mainly CB1 receptors, in the rest of the body CB2. It appears that stimulation with intermittent small doses of marijuana suppresses nausea and vomiting in the hypothalamus area. However, constant stimulation of CB2 receptors in the gut with higher doses of marijuana are the cause of CHS. When a person develops cannabis hyperemesis syndrome, the only permanent cure is to stop marijuana use completely. This eliminates the CB2 receptor stimulation and allows the body to heal the gut. Researcher believe that Tetrahydrocannabinol, or THC is more powerful than the endocannabinoids. THC overwhelms the CB1 and CB2 receptors. When people who were cured of CHS restarted marijuana, their symptoms of nausea and abdominal pain returned.

In some people hot bath and hot showers help uncontrolled vomiting

Researchers noted that people reported how sometimes having a hot shower or a hot bath stopped the vomiting. The hypothalamus controls both body temperature and vomiting. A hot bath may send a signal to the hypothalamus, which interrupts the vomiting for a period of time. But with continued use of marijuana the vomiting reoccurs.

Increased strength of marihuana preparations

Dr. Wang, an associate professor of pediatrics at the University of Colorado Anschutz Medical Campus in Aurora, Colorado noted: “It’s been well documented that the amount of THC that now comes in cannabis is increasing substantially. In the ’90s the average was like 4% or 5%. Now in Colorado, it’s anywhere from 15% to 20%.” This means that THC causes more and more toxicity in patients.

In Colorado medical marijuana was legal since 2009 and recreational marijuana was legal since 2014. Dr. Wang researched the cannabis hyperemesis syndrome in Colorado. He found over 800,000 cases of vomiting in Colorado between 2013 and 2018. This was an increase of 29% from the time before marijuana became legal.

Symptoms of cannabis hyperemesis syndrome

The 5 most common symptoms of cannabis hyperemesis syndrome are continuous nausea, repeated vomiting, abdominal pain, weight loss because of decreased food intake and dehydration from fluid loss. Many people have several showers a day because it diminishes their nausea.

Three phases of cannabis hyperemesis syndrome

The cannabis hyperemesis syndrome often presents in 3 stages: the prodromal phase, the hyper emetic phase, and the recovery phase.

During the prodromal phase symptoms consist of nausea and abdominal pain early in the morning. The eating pattern is still normal in this phase. Some people increase their marijuana consumption as they hope to treat the nausea this way. This phase can last for months or years.

During the hyper emetic phase all of the 5 symptoms mentioned above can occur. This phase often continues until the patient gives up all marijuana consumption. This is when the recovery phase starts.

In the recovery phase the patient returns to a normal eating pattern. All of the symptoms gradually disappear. This phase lasts between days to months. But if the patient starts marijuana again, the symptoms return very quickly.

Treatment of cannabis hyperemesis syndrome

Patients who have severe vomiting require treatment in a hospital. The doctor starts intravenous fluids to treat dehydration. Some medicine to stop vomiting helps in the beginning. The physician must convince the patient to completely stop marijuana use, which helps to treat nausea and abdominal pain. Antacid medication like proton-pump inhibitors is useful to treat stomach lining inflammation. Frequent hot showers help to tone down nausea and vomiting. Hot showers seem to work via the hypothalamic brain center, which is responsible both for nausea/vomiting and heat perception. The physician may prescribe small amounts of benzodiazepams to treat anxiety.

By avoiding marijuana in any form THC, which is a powerful stimulus for CB1 and CB2 receptors gets washed out of the system. This allows the endocannabinoid system to rebalance itself. As long as the patient stays away from marijuana there is usually a complete recovery.

Marijuana and Uncontrolled Vomiting

Conclusion

Since marijuana is legal in many jurisdictions the cannabis hyperemesis syndrome (CHS) occurs more and more often. Emergency teams at hospitals are kept busy treating these types of patients. It appears that CHS develops in patients who use marijuana regularly and use it in higher concentrations. Nausea and vomiting are the most common symptoms. Some patients can cope for a period of time by taking frequent hot showers. But eventually this home remedy does no longer work. A brief hospital stay may help the patient to recover from this syndrome. The patient needs to stay away from marijuana products to recover from CHS completely, otherwise there will be a relapse.

Oct

2021

Marijuana Causes Schizophrenia and Heart Attacks

By Ray Schilling | addiction, heart attack, marijuana, schizophrenia, Substance abuse

Two new studies showed that marijuana causes schizophrenia and heart stacks. Marijuana use has been increasing significantly in the general population since the 1990’s. Initially many believed that marijuana would be harmless. But increasingly there are medical publications showing the opposite.

In the following I present data how the use of marijuana causes these two documented side effects, heart attacks and schizophrenia.

Schizophrenia increased since the 1990’s

A July 21, 2021 study from Denmark included all people of Denmark who were older than age 16 from January 1, 1972 to Dec. 31, 2016. The number of participants were 3 ,595 ,910 women (50.0%) and 3 ,590 ,924 men (50.0%). The total number of individuals in the study were 7,186 ,834.

Here are the figures of the percentages of cannabis related schizophrenia cases in Denmark according to the study:

1995: 2% of all schizophrenia cases related to cannabis use in Denmark
2000: 4% of schizophrenia cases due to cannabis use
2010: 8% of all schizophrenia cases from cannabis use

The researchers found that the risk of coming down with schizophrenia heightens with increased cannabis use. Heavy users are more likely to develop schizophrenia than light users.

Cannabis use disorder

One subgroup of cannabis users are people with a cannabis use disorder. They use cannabis, but they become tolerant to it. This requires a higher dose of cannabis to achieve satisfaction. But they are unable to reduce cannabis. They spend more and more time to obtain cannabis, use it and recover from the effect. They give up other activities in favor or cannabis and they continue the use despite negative consequences. Researchers found that this group of individuals had the highest risk to develop schizophrenia. The authors of the Danish study found that patients with cannabis use disorder over the past 2 decades have increased their risk for developing schizophrenia by 3- to 4-fold. They feel it is because of the increase in use and the increase in potency of cannabis.

Heart attacks increased with cannabis use

A Canadian study assessed a cross-sectional study of 2017 and 2018.

The study in question was the American Behavioral Risk Factor Surveillance System survey of US adults. The authors zeroed into young adults (aged 18–44 yr.) with recent cannabis use and a history of a heart attack. Among 33,173 young adults there were 4,610 respondents with recent cannabis use (17.5%). 61 respondents among the recent cannabis users reported that they had a heart attack, which is 1.2%. In comparison non-cannabis users had a heart attack rate of only 0.8%. The adjusted odds ratio for cannabis users compared to non-users was 2.07. This means that the probability of getting a heart attack when using cannabis was 2.07-fold higher when compared to non-users. Also, the investigators found that a history of a heart attack had a probability of being due to cannabis use with a probability of 2.31-fold.

Cannabinoid receptors

Researchers found endogenous cannabinoids in the brain that function as messenger molecules. They need to activate their targets, the cannabinoid receptors, called CB1 and CB2. CB1 receptors are found mainly in the central nervous system. CB2 receptors are located mainly in the immune system. Reproductive organs have their own cannabinoid receptors. The lining of the uterus contains only CB1 receptors. Ovaries and testicles both use CB1 and CB2 receptors. Tetrahydrocannabinol (THC) from smoking or ingesting marijuana is the main psychoactive compound in cannabis. It stimulates these cannabinoid receptors also. But compared to the body’s own cannabinoids THC is much stronger. This leads to more pronounced effects that concern many physicians.

The overwhelming response of the cannabinoid receptors to THC leads to a blunting of the signals of the body’s own cannabinoids. This causes a breakdown in communication between neurons and body cells.

Marijuana Causes Schizophrenia and Heart Attacks

Conclusion re. marijuana causes schizophrenia and heart attacks

Legislators in Canada and many of the states in the US legalized the use of marijuana. As a result, the cannabis use in the younger age group of adults (between 18 to 44 years) has increased significantly. This means that more and more people are exposed to THC from cannabis, which overstimulates the body’s own endocannabinoid system. As explained this leads to a breakdown of communication between neurons and body cells. In time diseases like heart attacks and schizophrenia can develop, a fact overlooked by the media and the public. The overuse of marijuana leads to more than a 2-fold risk to get a heart attack and a 3- to 4-fold risk of coming down with schizophrenia. These are the facts right now. But with further increased use of cannabis researchers will likely find many other diseases that THC can trigger.

Sep

2021

Effects of a Plant-centered Diet on Cardiovascular Disease in Midlife

By Ray Schilling | Cancer, Cardiovascular disease, cholesterol, diet, exercise, heart attack, Mortality, Nutrition, olive oil, omega-3 fatty acids, Processed food

A study followed younger patients for 32 years looking for the effects of a plant-centered diet on cardiovascular disease in midlife. The researchers determined the heart attack and stroke rates when the participants were in their 50’s to 60’s. When on a plant-based diet cardiovascular disease rates fell by 52% compared to a control group with a meat containing diet. One subgroup changed the diet from a regular diet to a plant-based diet over 13 years. This reduced the risk ratio by 61% for heart attacks and strokes when assessed later.

Details of this study

There were 4946 adults as participants of this 32-year study. They were recruited in 1985 and 1986, at which time none of them had cardiovascular disease. The study completed in 2018. The results were published on Aug. 4, 2021. The researchers assessed the plant-centered diet quality using a tool with the name “A Priori Diet Quality Score” (APDQS). The higher the score, the higher the quality of the food. This means the person consumed nutritionally rich plant foods, limited amounts of high-fat meat products and less healthy plant foods.

Although a plant-rich diet consisted primarily of nutritionally rich plant foods, small amounts of animal products were also allowed. This involved low-fat dairy products, non fried poultry and steamed or grilled fish. This made the diet tastier and ensured that people would stick to this diet for decades.

Improvements of heart attack rates with plant-centered diet

After 32 years 289 cases of cardiovascular disease developed. The researchers compared participants with the highest food quintile to participants with the lowest food quintile. As mentioned, the risk for participants on a plant-based diet was 52% lower to get a cardiovascular disease. Moreover, a subgroup changed from a higher risk (fatter meals, meat, less vegetables) diet to a lower risk diet (lean fat, lean poultry, vegetables). Physicians followed this subgroup for 13 years and the risk ratio for heart attacks and strokes fell by 61%.

Comparison to other diet studies

There are other studies that looked at the effect of diet changes on the risk of developing heart disease. One such study examined 86 cross-sectional studies and 10 prospective studies in a meta-analysis. Vegetarian diets reduced deaths from heart attacks by 25% and brought down the incidence of total cancer rates by 8%. A vegan diet reduced the risk of total cancer by 15%.

In a study from the United Kingdom dated March 2019 several clinical trials were analyzed regarding non-diabetic populations. 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) with 12,461 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

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 otherwise increases 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 there 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 fruit 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 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 that the limit is one drink per day for women, and two drinks per day for men. 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.

A 2012 study from Spain has 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 increases the size of the HDL particles (these larger particles have the name 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. This cleans out plaques from arteries more effectively than the regular, cheaper olive oil.

Effects of a Plant-centered Diet on Cardiovascular Disease in Midlife

Conclusion

Several large, well-controlled studies showed that there are pronounced effects of a plant-centered diet on cardiovascular disease in midlife. Heart attack rates and mortality rates were reduced by 25% to 73% on a Vegan diet or a Mediterranean diet. When people combine a plant-centered diet with regular physical exercise they also live longer. One of the ingredients of a Mediterranean diet is extra virgin olive oil. It contains polyphenols that lower total and LDL cholesterol. It also increases the larger particles of HDL cholesterol with the name HDL2. HDL2 is more efficient in extracting oxidized LDL cholesterol from arterial plaques.

What you can eat on a plant-centered diet

A plant-centered diet incorporates fresh food rather than 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. Instead of large portions of beef and sausages shift to seafood (tuna, salmon, trout, sardines), walnuts, other tree nuts and flax seed. The statistics clearly showed the effects of a plant-centered diet on cardiovascular disease in midlife with a reduction of heart attacks and mortality.

Some of the text above was published previously 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.